Attachment F
The terms of this Settlement Agreement were arrived at through mediation conducted on (date), and are in full settlement of all issues involved in the matters set forth in the (matter, grievance, complaint) initiated on (date), by the (Complainant, Disputant, Griever), (Name and Title), Department of Veterans Affairs. (Name) also attended the mediation session.
(Name and Title) was the Management Representative with full authority to bind the agency in this matter. (Name and Title) also attended the mediation session.
The Terms of the Settlement Agreement are as follows:
1. The parties agree that when executed this Settlement Agreement shall be binding upon all parties to the Agreement.
2. The parties agree that the (Complainant, Disputant, Griever), and the Management Representative will (state terms):
3. The Complainant agrees upon execution of this Settlement Agreement to immediately withdraw his/her Complaint. By doing so, the Complainant waives all further remedies, all right to further administrative processing and all right to file a civil action in connection with the above identified Complaint.
4. The parties agree this Agreement has been entered into freely by both parties.
5. The parties agree that this Agreement does not constitute an admission of guilt, fault, or wrongdoing by either party.
6. The parties agree neither party will subpoena the mediators or any documents prepared by or submitted to the mediators. In no event will the mediators voluntarily testify on behalf of any party or submit any type of report in connection with this mediation.
7. The parties agree to keep the terms of this Settlement Agreement private and confidential and not discuss them with other persons within the Department of Veterans Affairs, except to authorized EEO officials or other officials responsible for implementing the Settlement Agreement.
8. The parties agree this Agreement shall not serve as a precedent for resolving any other complaints, which have been or may be filed by the (Complainant, Disputant, Griever), or any other person.
9. The parties agree that this Agreement constitutes the entire Agreement and there are no other terms to this Agreement except those specified herein. No other promises or agreements shall be binding unless placed in writing and signed by all the parties.
10. If for any reason not due to Complainant’s acts or conduct, the Department of Veterans Affairs fails to fulfill the terms of this Settlement Agreement, the Complainant retains the right to request reinstatement of the withdrawn complaint at the point previous processing ceased.
11. Prior to reinstating the Complaint, the parties agree to submit the matter to mediation.
BY SIGNATURE BELOW, WE ACKNOWLEDGE THAT WE HAVE READ, UNDERSTAND, AND AGREE TO THIS SETTLEMENT AGREEMENT.
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(Complainant, Disputant, Griever) Date
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Representative Date
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Management Representative Date
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Co-mediator Date
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Co-mediator Date
