Appendix B
RELEASE OF ALL CLAIMS FORM
Marco Polo Restaurant
Department of Justice Complaint No. 202-48-196
For and in consideration of the payment of $750.00 and pursuant to the provisions of the Settlement Agreement entered into by, and between, the United States and the Marco Polo Restaurant, I, Philip McCarthy, hereby release and forever discharge the Marco Polo Restaurant, and its current, past, and future officials, employees, and agents, of and from any legal and equitable claims arising out of Department of Justice Complaint No. 202-48-196.
This Release constitutes the entire agreement between myself and the Marco Polo Restaurant without exception or exclusion. This Release will be considered null and void in the event that the Marco Polo Restaurant fails to deliver a check for $750.00, made out to me, to the Department of Justice within thirty (30) days of receipt of this executed Release.
I have read this Release and understand the contents thereof and I execute this Release of my own free act and deed. I also acknowledge that a copy of the Settlement Agreement has been made available to me.
Signed this _________________ day of _______________, 2008.
_______________________
Philip McCarthy
Sworn and subscribed to before me this _____________ day of ______________, 2008
_______________________
Notary Public
My commission expires: _______________