24-104.00JohnsonAndJohnsonOpioid Settlement Participation Form EXHIBIT B
Settlement Participation Form
Governmental Entity: Cib nF SI� tOb State: '',,/A
Authorized Official: f„X L .-h) pef,,,5 (,1J,
Address 1: IDito , SprUn,,,{ i4 .
Address 2:
City, State,Zip: Kt.Ka nt va,11 t ) 144 Q9job
Phone: S Oq 7 Z 0 ,S l jk)
Email: e l4,11 a crot, tt4ti„,,,, y�v
The governmental entity identified above("Governmental Entity"), in order to obtain and in
consideration for the benefits provided to the Governmental Entity pursuant to the Janssen
Washington State-Wide Opioid Settlement Agreement dated January 22,2024 ("Janssen
Settlement"), and acting through the undersigned authorized official,hereby elects to participate in
the Janssen Settlement,release all Released Claims against all Released Entities, and agrees as
follows.
1. The Governmental Entity is aware of and has reviewed the Janssen Settlement,understands
that all terms in this Election and Release have the meanings defined therein, and agrees that
by this Election, the Governmental Entity elects to participate in the Janssen Settlement and
become a Participating Subdivision as provided therein.
2. The Governmental Entity shall,within 30 days of the filing of the Consent Judgment, secure
the dismissal with prejudice of any Released Claims that it has filed.
3. The Governmental Entity agrees to the terms of the Janssen Settlement pertaining to
Subdivisions as defined therein.
4. By agreeing to the terms of the Janssen Settlement and becoming a Releasor,the
Governmental Entity is entitled to the benefits provided therein, including, if applicable,
monetary payments beginning after the Effective Date.
5. The Governmental Entity agrees to use any monies it receives through the Janssen
Settlement solely for the purposes provided therein.
6. The Governmental Entity submits to the jurisdiction of the court where the Consent
Judgment is filed for purposes limited to that court's role as provided in, and for resolving
disputes to the extent provided in,the Janssen Settlement.
7. The Governmental Entity, as a Participating Subdivision, hereby becomes a Releasor for all
purposes in the Janssen Settlement, including but not limited to all provisions of Section IV
(Release),and along with all departments, agencies, divisions, boards, commissions,
districts, instrumentalities of any kind and attorneys, and any person in their official capacity
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elected or appointed to serve any of the foregoing and any agency,person, or other entity
claiming by or through any of the foregoing, and any other entity identified in the definition
of Releasor, provides for a release to the fullest extent of its authority. As a Releasor,the
Governmental Entity hereby absolutely,unconditionally, and irrevocably covenants not to
bring, file, or claim, or to cause,assist or permit to be brought, filed, or claimed, or to
otherwise seek to establish liability for any Released Claims against any Released Entity in
any forum whatsoever. The releases provided for in the Janssen Settlement are intended by
the Parties to be broad and shall be interpreted so as to give the Released Entities the
broadest possible bar against any liability relating in any way to Released Claims and extend
to the full extent of the power of the Governmental Entity to release claims. The Janssen
Settlement shall be a complete bar to any Released Claim.
8. In connection with the releases provided for in the Janssen Settlement, each Governmental
Entity expressly waives, releases, and forever discharges any and all provisions, rights, and
benefits conferred by any law of any state or territory of the United States or other
jurisdiction, or principle of common law,which is similar,comparable, or equivalent to
§ 1542 of the California Civil Code,which reads:
General Release; extent. A general release does not extend to claims that
the creditor or releasing party does not know or suspect to exist in his or her
favor at the time of executing the release that, if known by him or her,would
have materially affected his or her settlement with the debtor or released
party.
A Releasor may hereafter discover facts other than or different from those which it knows,
believes, or assumes to be true with respect to the Released Claims, but each Governmental
Entity hereby expressly waives and fully, finally, and forever settles, releases and
discharges,upon the Effective Date, any and all Released Claims that may exist as of such
date but which Releasors do not know or suspect to exist,whether through ignorance,
oversight, error, negligence or through no fault whatsoever, and which, if known, would
materially affect the Governmental Entities' decision to participate in the Janssen
Settlement.
9. This Settlement Participation Form shall be deemed effective as of the Effective Date of the
Janssen Settlement.
10.Nothing herein is intended to modify in any way the terms of the Janssen Settlement,to
which Governmental Entity hereby agrees. To the extent this Election and Release is
interpreted differently from the Janssen Settlement in any respect,the Janssen Settlement
controls.
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I have all necessary power and authorization to execute this Election and Release on behalf of the
Governmental Entity.
Signature:
Name: QIK L1f6
Title: cptinNtil AL441474
Date: 51(,(
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