CONSTRUCTION INDUSTRY ARBITRATION RULES Answering Statement MEDIATION: If you would like the AAA to contact the other parties and attempt to arrange mediation, please check this box. There is no additional administrative fee for this service. Name of Claimant Name of Representative (if known) Address: Name of Firm (if applicable) Representative’s Address: City State City Fax No. Phone No. Zip Code Phone No. Email Address: State Zip Code Fax No. Email Address: AAA CASE # (if known) RESPONDENT ANSWERS CLAIMANT DEMAND FOR ARBITRATION AS FOLLOWS: Dollar Amount of Claim $ Other Relief Sought: Arbitration Costs Attorneys Fees Interest Punitive/ Exemplary Other ____________ AMOUNT OF FILING FEE ENCLOSED WITH THIS DEMAND (please refer to the fee schedule in the rules for the appropriate fee) $ PLEASE DESCRIBE APPROPRIATE QUALIFICATIONS FOR ARBITRATOR(S) TO BE APPOINTED TO HEAR THIS DISPUTE: Hearing locale________________________ (check one) Estimated time needed for hearings overall: Requested by Respondent Locale provision included in the contract __________hours or ___________days Signature (may be signed by a representative) Date: Name of Representative Name of Respondent Name of Firm (if applicable) Address (to be used in connection with this case) Representative’s Address: City Zip Code City Fax No. Phone No. Phone No. Email Address: State State Zip Code Fax No. Email Address: PLEASE SEND TWO COPIES OF THIS ANSWERING STATEMENT, WITH THE FILING FEE FOR ANY COUNTERCLAIM, AS PROVIDED FOR IN THE RULES, TO THE AAA. SEND THE ORIGINAL ANSWERING STATEMENT TO THE CLAIMANT. Please visit our website at www.adr.org if you would like to file this counterclaim online. AAA Customer Service can be reached at 800-778-7879 American LegalNet, Inc. www.USCourtForms.com