Waiver, Release, and Quitclaim Deed

I,__________________ hereby waive, release, and quitclaim any and all claims,
demands, actions, or causes of action that I may have against 21 st RNR Construction Inc.
arising out of Reimbursement of non-remittance of PhilHealth contribution due to transition of
new system and pandemic. This waiver covers the agreement between the employee and the
employer.

This day of __________________ I received the total reimbursement of

____________________ from the company Amounting __________________. Upon
receiving my reimbursement, 21st RNR Construction Inc. will be no longer have liabilities from
me regarding the mentioned above.

I acknowledge that this waiver is voluntary and that I have had the opportunity to seek
legal counsel if desired. By signing below, I confirm that I understand the consequences of this
waiver, release, and quitclaim.