Settlement Agreement 34

REVISED TEMPLATE
DISCLAIMER
The provisions of this settlement agreement template are generic. The template
must be customized to each particular situation. Therefore, it is always advisable
to consult with legal counsel prior to finalization of any settlement agreement.
SETTLEMENT AGREEMENT AND RELEASE
This Settlement Agreement and Release is made and entered into by and between
(Grievant) and the _________________ (Respondent). [If the matter is being settled without a grievance,
it would be more appropriate to refer to the parties as “Employer” and “Employee”.]
WHEREAS, the Grievant is [or “was”] employed by Respondent as a _________________, Pay

Grade ___, with a salary of $__________ per month, [if applicable]. [Set forth details of complaint or
adverse personnel action here and, if applicable, that Grievant challenged the action through the
grievance procedure. Include enough information to make the details of the specific events readily
apparent.]
WHEREAS, Grievant and Respondent are desirous of entering into this Settlement Agreement and
Release to resolve all matters relating to this grievance; and
NOW THEREFORE, for good and valuable consideration and the mutual covenants contained herein,
Grievant and Respondent agree as follows:
1. Respondent agrees to _______________________.
2. [If applicable] Considering any applicable personnel transactions (salary advancements,

salary adjustments, leaves of absence, and/or overtime differences) that may have occurred between
__________ and __________, the Grievant will receive $________ back pay, plus $________ interest [if
applicable], for a total gross amount of $________. Grievant agrees that any liability for federal or state
tax payments upon the amount paid to Grievant pursuant to this Settlement Agreement and Release shall
be the sole responsibility of Grievant. It is the intent of all parties that the whole amount of these back
wages be pensionable.
3. Grievant shall dismiss with prejudice this grievance and does hereby waive, release, acquit
and discharge Respondent from any and all liabilities, attorney fees, claims, demands, controversies,
damages, actions and causes of action of every kind and character, arising from the facts and
circumstances of this grievance, which he or she may now have or may have in the future concerning the
subject matter of this grievance, including but not limited to, any rights brought under the West Virginia
Human Rights Act, Americans with Disabilities Act, Workers’ Compensation Act or Title VII of the Civil
Rights Act as well as any complaints filed and/or proceedings pending with the Public Employees
Grievance Board, West Virginia Human Rights Commission, West Virginia Equal Employment
Opportunity Office, West Virginia Division of Labor, United States Equal Employment Opportunity
Commission, and United States Department of Labor.
4. This Settlement Agreement and Release shall be binding on Grievant and Respondent hereto
and their assigns.
Settlement Agreement and Release
[Grievant’s name]
[Agency]
[Date]
Page [#]
5. Grievant acknowledges that he or she has read this Settlement Agreement and Release and
has had a reasonable period of time to consider this Settlement Agreement and Release and to consult an
attorney, if desired. Grievant further acknowledges that he or she understands all the terms of the
Settlement Agreement and Release and has knowingly and voluntarily agreed to those terms, which may
not be changed.
6. Grievant and Respondent expressly acknowledge that the entire agreement is contained in
this Settlement Agreement and Release and no representations, promises, or inducements have been made
by or to Grievant other than as appear in this Settlement Agreement and Release. The parties understand
and agree that this Settlement Agreement and Release may not be changed orally. This Settlement
Agreement and Release supersedes all prior agreements and understandings concerning the subject matter
hereof, including, but not limited to, Grievant’s employment with Respondent.
7. [Use only if confidentiality is desired.] Grievant [and his or her legal counsel or his or her
representative] agree[s] that he or she will keep the settlement negotiations and the terms of this
Settlement Agreement and Release completely confidential. Although the Respondent will not
unilaterally distribute, disseminate or otherwise release this Settlement Agreement and Release, the
Grievant acknowledges and understands that the Respondent is a public agency of State government [or
public college or university] and may be obligated to release this Settlement Agreement and Release
pursuant to West Virginia Supreme Court case precedent, the West Virginia Freedom of Information Act,
West Virginia Code §§ 29B-1-1 et seq., or other applicable law.
THE PARTIES UNDERSTAND AND AGREE that this Settlement Agreement and Release and the
settlement it represents are entered into solely for the purpose of avoiding further expenses of litigation.
This Settlement Agreement and Release and the settlement it represents in no way constitutes an
admission by Respondent of any violation of any federal, state or local law, whether statutory or common,
and Respondent denies that a violation of any such law has occurred with respect to Grievant’s
employment with Respondent or the cessation of that employment with Respondent.
IT IS FURTHER UNDERSTOOD that this Settlement Agreement and Release is a preliminary

document and requires the review and approval of the Division of Personnel. If the Division of Personnel
determines that any of the terms are not compliant with the Division of Personnel’s laws, rules and
policies, then this Settlement Agreement and Release is null and void.
Settlement Agreement and Release
[Grievant’s name]
[Agency]
[Date]
Page [#]
IN WITNESS WHEREOF, Grievant and Respondent execute this Settlement Agreement and Release,
effective the latest of dates set forth below.
__________________ ____________[signature]___________
Date [Type name]
Grievant
__________________ ____________[signature]___________
Date [Type name]
Grievant’s Representative/attorney [if any]
__________________ ____________[signature]___________
Date [Type name]
[Type Agency Name]
Respondent
__________________ ____________[signature]___________
Date [Type name]
[Type Title of Respondent’s Legal Counsel]
Approved as to compliance with the

Division of Personnel’s law, rules and policies:
__________________ ____________[signature]___________
Date Sara P. Walker, Director
WV Division of Personnel

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REVISED TEMPLATE

WHEREAS, the Grievant is [or “was”] employed by Respondent as a _________________, Pay

1. Respondent agrees to _______________________.

2. [If applicable] Considering any applicable personnel transactions (salary advancements,

IT IS FURTHER UNDERSTOOD that this Settlement Agreement and Release is a preliminary

Approved as to compliance with the

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