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CONSENT TO IRREVOCABLE WAIVER <br />AND <br />RELINQUISHMENT OF RIGHTS <br />I, , an elected official of the City of Colton, holding the position <br />of , do hereby irrevocably waiver and relinquish forever, for <br />myself, my spouse and any affected dependent, any rights I or they may have under the <br />provisions of Resolution No. R-115-91 to post-retirement employment benefits provided by the <br />City of Colton. <br />This irrevocable waiver and relinquishment of rights is entered into knowingly and with full <br />understanding of the rights to continued employment benefits that currently exist under the <br />provisions of Resolution No. R-115-91 for myself and my spouse and affected dependents. I <br />have executed this irrevocable waiver and relinquishment of rights voluntarily, without undue <br />pressure or duress from any person or from the City of Colton as an expression of my belief that <br />elected officials who are no longer providing service to the citizens of Colton should not receive <br />post-retirement benefits at the expense of the taxpayers. <br />EXECUTED on this day of , 1996, in the City of Colton, <br />County of San Bernardino, State of California. <br />Signature of Elected Official <br />[Notary Required] <br />Agenda Iter No. 19 <br />