By submitting this claim form, I certify under penalty of perjury that all of the information I have provided on this claim form is true, correct, and complete to the best of my knowledge.
General Waiver and Release
1. In consideration for my eligibility for payment, I (“Releasor”) hereby AGREE NOT TO SUE and RELEASE, WAIVE, and FOREVER DISCHARGE Drizly, LLC, its principals, agents, employees, or successors
(hereinafter referred to as “Releasees”) from any and all liability, claims, demands, actions, or causes of action whatsoever arising out of or related to any loss or damages sustained by me related
to or sustained as a consequence of the dispute detailed below.
2. The dispute occurred as a result of the allegations set forth by the District of Columbia that Drizly falsely represented to consumers that tips solicited through its platform between January 1, 2019
and November 14, 2022 (“the claim period”) were being distributed to drivers that made deliveries in the District of Columbia during the claim period when in fact, Drizly did not ensure that the retail
stores using the Drizly platform properly distributed tips to drivers. Drizly denies these allegations. Drizly did not take any money intended as tips for delivery persons, which were directly sent to
the alcohol retail stores for distribution to delivery persons. Although Drizly does not agree that it has violated any District of Columbia laws, it has agreed to settle this matter to avoid litigation.
By entering into the Settlement, Drizly does not concede the truth or validity of any of the claims against it.
3. The Releasor agrees that this Release is given with the express intention of terminating any right to sue related to the above dispute, regardless of WHETHER ANY DAMAGES WERE CAUSED BY THE NEGLIGENCE
OF RELEASEES, and with the intention of binding the Releasor’s spouse, heirs, executors, administrators, legal representatives, and assigns.
4. I hereby further agree that this Release shall be construed in accordance with the laws of the District of Columbia and that any mediation, suit, or other proceeding must be filed or entered into
only in the District of Columbia.
5. Any portion of this document deemed unlawful or unenforceable is severable and shall be stricken without any effect on the enforceability of the remaining provisions.
I ACKNOWLEDGE AND REPRESENT THAT I have read the foregoing General Waiver and Release, understand it and sign it voluntarily as my own free act and deed; no oral representations, statements, or
inducements, apart from the foregoing written agreement, have been made; I am at least eighteen (18) years of age and fully competent; and I execute this Release for full, adequate and complete
consideration fully intending to be bound by same.