Agreement To Pay For Reimbursement Tolentino PEPSI Pampanga

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AGREEMENT

KNOWN ALL MEN BY THESE PRESENTS:

STOCK CARE CARGO AND WAREHOUSING, INC,. a corporation


organized under Philippine laws, with principal office address, at
Lot 2-A Quirino Highway, Barangay Sto Cristo, San Jose Del
Monte, Bulacan, represented by its Counsel, John Lerrie Torre,
and hereinafter referred to as First Party

-and-

Arsenio, Caoli Tolentino, Filipino, of legal age, with address at


________________________________________________________

__________________________ and hereinafter referred “SECOND


PARTY”

-WITNESSETH-

WHEREAS, due to the negligence of the FIRST PARTY’s employee,


specifically, Renato Tayag Lising, the SECOND PARTY suffered
injuries in his leg.

WHEREAS, the SECOND PARTY needed immediate Medical


Attention.

WHEREAS, the FIRST PARTY shouldered all the Medical Expenses


incurred by the SECOND PARTY amounting to
__________________________________________________. (PHP
_______________.00).

Whereas, due to the goodwill of the FIRST PARTY, the SECOND


PARTY agrees to absolve and/or opt to no longer seek or file any
legal action of whatever nature against the FIRST PARTY.

Whereas, the SECOND PARTY agrees that he will file the applicable
Legal Action against the RENATO TAYAG LISING only and
exclusively, and shall no longer involve the FIRST PARTY.

WHEREAS, the SECOND PARTY shall institute the action in order


to recover the medical expenses incurred for the SECOND PARTY’s
Recovery.

WHEREAS, the SECOND PARTY shall reimburse any monetary


amount that he will recover from RENATO TAYAG LISING to the
FIRST PARTY.
WITNESSES:

______________________ _____________________

ACKNOWLEDGMENT

Before me, a Notary public for _______________________________ and


the Province of __________________, personally appeared the following:

Name Proof of Identity

both known to me and to me known to be the same persons who


executed the foregoing AGREEMENT, and they acknowledged to me that
the same was executed by them freely and voluntarily.

This instrument consists of ______ pages including this page on


acknowledgment.

WITNESS MY HAND AND SEAL on the day and place above


written.

Doc. No. _______


Page No. ________
Book No. _______
Series of 2018:
Jing2

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