American Arbitration Association SUBMISSION TO RESOLUTION SERVICES The named parties hereby submit the following dispute for resolution, under the rules of the American Arbitration Association: Procedure Selected: Binding Arbitration Early Neutral Evaluation Mediation Mini-Trial Fact-Finding Other (describe) Rules to Apply: Commercial Construction International Employment Other (describe) Nature and Type of Dispute (attach additional sheets if necessary): Amount of Monetary Claim or Nature of Non-Monetary Claim: Type of Business: Claimant: Respondent: Place of Hearing or Conference: We agree that, if arbitration is selected, we will abide by and perform any award rendered hereunder and that a judgment may be entered on the award. To be completed and signed by all parties (attach additional sheets if necessary, please remember to obtain signatures) _________________________________________ __________________________________________ Name of Party Name of Party Address Address City, State and Zip Code City, State and Zip Code _________________________________________ _________________________________________ ( ____ ) _______________________________________ Telephone Fax ______________________________________________ Email address ______________________________________________ Name of the Party’s Attorney or Representative ______________________________________________ Name of Firm (if applicable) __________________________________________ __________________________________________ ( ___ ) ____________________________________ Telephone Fax _______________________________________________ Email address __________________________________________ Name of the Party’s Attorney or Representative __________________________________________ Name of Firm (if applicable) ______________________________________________ __________________________________________ Address Address ______________________________________________ __________________________________________ City, Sate and Zip Code City, Sate and Zip Code ( ____ ) _______________________________________ ( ___ ) ____________________________________ Telephone Fax ___________________________________________________ Email address Telephone Fax _______________________________________________ Email address ______________________________________________ ______________________________________ Signed† (may be signed by a representative) Title Signed† (may be signed by a representative) Title Date: ___________________________ Date: ____________________________ Please file two signed copies and the non-refundable filing fee with the AAA. For additional information, please visit our website at www.adr.org † SIGNATURES OF ALL PARTIES ARE REQUIRED. Form SRS 6/05 American LegalNet, Inc. www.USCourtForms.com