FULL RELEASE OF ALL CLAIMS AND INDEMNITY AGREEMENT

(Medical Bills Incurred/Open Medical Agreement)

Claim number:22-2244834

IT IS UNDERSTOOD AND AGREED THAT I, Timothy Hairston, for and in consideration of the payment of one thousand dol-
lars($1,000.00), the receipt and sufficiency of which is hereby acknowledged, and in further consideration of the promise to pay addi-
tional reasonable, necessary, and causally-related medical and/or dental expenses up to a maximum of N\A dollars ($N\A), incurred
by me for my treatment prior to the date of this release, and in further consideration of the promise to pay additional reasonable, nec-
essary, and causally-related medical and/or dental expenses up to a maximum of one thousand five hundred dollars ($1,500.00),
incurred by me for my treatment within 30 days after the date of this release, do hereby for myself, my heirs, executors, administra-
tors, successors, and assigns, and all other persons, firms, employers, corporations, associations, and partnerships release Katia
Stephens from all obligations, suits, claims, demands of any kind or nature whatsoever, damages, loss of income, expenses, hospital
and medical expenses which the undersigned may now have or which may accrue on account of or in any way arising out of all known
and unknown personal injuries which have resulted from or may in the future develop from an accident that occurred on or about 06-
04-22, at or near Danville, VA.

The undersigned warrants that all medical and hospital bills have been paid, or will be paid immediately upon receipt of the settlement
proceeds, and that no other person or entity has asserted or is able to assert any lien, claim, or entitlement to any portion of the consid-
eration being paid for this release. The undersigned agrees to indemnify and hold harmless the released parties and their insurers or
representatives from any such liens or claims which may be asserted at any time by any such person or entity.

In consideration of the above payment, the undersigned agrees to indemnify the released parties and their insurers or representatives
and save them harmless from all further liability arising because of any injuries and damages sustained by the undersigned, and, if
necessary, in order to save them so harmless, to satisfy on their behalf any judgment against them arising in any way out of the acci-
dent.

It is understood and agreed that this settlement is in full compromise of a doubtful and disputed claim as to both questions of liability
and the nature and extent of the injuries and damages, and that neither this release nor the payment made shall be construed as an ad-
mission of liability.

The undersigned declares that no representation made by the party or parties released, or their representatives, regarding their legal
liability or financial responsibility, or about the nature and extent of the injuries, disabilities, or damages has induced the undersigned
to make this agreement; that in determining the amount of the payment indicated above, the undersigned has considered not only the
known injuries, disabilities, and damages, but also the possibility that there may be unknown injuries, disabilities, and damages, and
that injuries sustained may be permanent and progressive and recovery uncertain and indefinite, so that unforeseen consequences may
occur.

The undersigned further declares and represents that no promise, inducement, or agreement not herein expressed has been made to the
undersigned; this release contains the entire agreement between the parties hereto; and the terms of this release are contractual and not
a mere recital.

I have read this release and understand it.

Pursuant to Virginia law, if you execute this release within thirty (30) days of the incident giving rise to your claim or action
for personal injuries, you have a right of rescission until midnight of the third business day after the day on which you execute
this release, provided: (1) you are not represented by counsel when you execute this release; (2) you make the rescission in
writing to the person or persons being released, their representative, or insurance carrier; and (3) you return to the person or
persons being released, their representative, or insurance carrier all drafts or settlement proceeds you received prior to the
rescission.

It is a crime to knowingly provide false, incomplete or misleading information to an insurance company for the purpose of
defrauding the company. Penalties include imprisonment, fines and denial of insurance benefits.

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Signature Date Witness Signature Date

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Signature Date Witness Signature Date

R VA 100C 06/2011