Rev. 2/11 Kinnard Mediation Center PRIVATE MEDIATOR PROCEDURES FOR MEDIATION OF APPEALS CONTENTS 1. INTRODUCTION. .............................................................................................................. 1 2. 11 Cir. R. 33-1. ................................................................................................................... 1 3. APPEALS THAT MAY BE MEDIATED BY A PRIVATE MEDIATOR. .............................. 3 4. PRIVATE MEDIATOR SELECTION FORM. ..................................................................... 3 5. ASSISTANCE BY ASSIGNED CIRCUIT MEDIATOR....................................................... 4 6. INFORMATION FURNISHED TO PRIVATE MEDIATOR................................................. 4 7. CONDUCT OF MEDIATION. ............................................................................................. 5 8. CONFIDENTIALITY. .......................................................................................................... 6 9. BIAS, CONFLICTS OF INTEREST, AND DISQUALIFICATION. ..................................... 6 10. TIME PERIOD OF MEDIATION. ....................................................................................... 7 11. LOCATION OF MEDIATIONS. .......................................................................................... 7 12. EXTENSIONS OF TIME TO FILE BRIEFS. ...................................................................... 7 13. ADJUDICATION DURING MEDIATION. ......................................................................... 10 14. COMMUNICATIONS. ...................................................................................................... 10 American LegalNet, Inc. www.FormsWorkFlow.com 15. REPORT OF MEDIATION RESULTS. ............................................................................ 10 16. POST-SETTLEMENT DISMISSAL PROCEDURES. ...................................................... 11 17. EVALUATION PROCEDURES........................................................................................ 11 18. BILLINGS TO PARTIES. ................................................................................................. 11 19. QUESTIONS OR COMPLAINTS..................................................................................... 12 20. TRAINING PROGRAMS.................................................................................................. 12 APPENDIX OF FORMS A. REQUEST FOR USE OF A PRIVATE MEDIATOR B. PRIVATE MEDIATOR’S REPORT American LegalNet, Inc. www.FormsWorkFlow.com 1. INTRODUCTION 11th Cir. R. 33-1(g) provides that upon agreement of all parties, a private mediator may be employed by the parties to mediate an appeal that has been selected for mediation by the Kinnard Mediation Center (KMC). Persons employed as private mediators under the rule shall follow the private mediator procedures as set forth by the KMC. Those procedures are provided below along with other information that may be useful to private mediators conducting these mediations. Although specific procedures are set forth, private mediators employed under the rule are reminded that their conduct will reflect on the court. Therefore, their conduct should reflect the highest professional standards. 2. 11 th CIR. R. 33-1 The applicable portions of 11th Cir. R. 33-1 are as follows: (c) Mediation. (1) An active or senior judge of the court of appeals, a panel of judges (either before or after oral argument), or the Kinnard Mediation Center, by appointment of the court, may direct counsel and parties in an appeal to participate in mediation conducted by the court’s circuit mediators. Mediations are official court proceedings and the Kinnard Mediation Center circuit mediators act on behalf of the court. Counsel for any party may request mediation in an appeal in which a Civil Appeal Statement is required to be filed if he or she thinks it would be helpful. Such requests will not be disclosed by the Kinnard Mediation Center to opposing counsel without permission of the requesting party. The purposes of the mediation are to explore the possibility of settlement of the dispute, to prevent unnecessary motions or delay by attempting to resolve any procedural problems in the appeal, and to identify and clarify issues presented in the appeal. Mediation sessions are held in person or by telephone. Counsel must, except as waived by the mediator in advance of the mediation date, have the party available during the mediation. Should waiver of party availability be granted by the mediator, counsel must have the authority to respond to settlement proposals consistent with the party’s interests. The mediator may require the physical presence of the party at an in-person mediation or the telephone participation of the party in a telephone mediation. For a governmental or other entity for which settlement decisions must be made collectively, the availability, presence, or participation requirement may be satisfied by a representative authorized to negotiate on behalf of that entity and to make recommendations to it concerning settlement. Kinnard Mediation C enter/PR IVATE MED IATO R PR O C ED U R ES FO R MED IATIO N O F APPEALS/February 2011 Page 1 American LegalNet, Inc. www.FormsWorkFlow.com (2) A judge who participates in the mediation or becomes involved in the settlement discussions pursuant to this rule will not sit on a judicial panel that deals with that appeal. (3) Communications made during the mediation and any subsequent communications related thereto shall be confidential. Such communications shall not be disclosed by any party or participant in the mediation in motions, briefs, or argument to the Eleventh Circuit Court of Appeals or to any court or adjudicative body that might address the appeal's merits, except as necessary for enforcement of Rule 33-1 under paragraph (f)(2), nor shall such communications be disclosed to anyone not involved in the mediation or otherwise not entitled to be kept informed about the mediation by reason of a position or relationship with a party unless the written consent of each mediation participant is obtained. Counsel's motions, briefs, or argument to the court shall not contain any reference to the Kinnard Mediation Center. (d) Confidential Mediation Statement. The court requires, except as waived by the circuit mediator, that counsel in appeals selected for mediation send a confidential mediation statement assessing the appeal to the Kinnard Mediation Center before the mediation. The Kinnard Mediation Center will not share the confidential mediation statement with the other side, and it will not become part of the court file. (e) Filing Deadlines. The filing of a Civil Appeal Statement or the scheduling of mediation does not extend the time for ordering any necessary transcript (pursuant to 11th Cir. R. 10-1) or for filing briefs (pursuant to 11th Cir. R. 31-1). Such time may be extended by a circuit mediator to comply with these rules if there is a substantial probability the appeal will settle and the extension will prevent the unnecessary expenditure of time and resources by counsel, the parties, and the court. (f) Noncompliance Sanctions. (1) If the appellant or petitioner has not taken the action specified in paragraph (a) of this rule within the time specified, the appeal or petition may be dismissed by the clerk of the court of appeals after appropriate notice pursuant to 11th Cir. R. 42-1. (2) Upon failure of a party or attorney to comply with the provisions of this rule or the provisions of the court’s notice of mediation, the court may assess reasonable expenses caused by the failure, including attorney's fees; assess all or a portion of the appellate costs; dismiss the appeal; or take such other appropriate action as the circumstances may warrant. Kinnard Mediation C enter/PR IVATE MED IATO R PR O C ED U R ES FO R MED IATIO N O F APPEALS/February 2011 Page 2 American LegalNet, Inc. www.FormsWorkFlow.com (g) Use of Private Mediators. (1) Upon agreement of all parties, a private mediator may be employed by the parties, at their expense, to mediate an appeal that has been selected for mediation by the Kinnard Mediation Center. (2) Such private mediator (i) shall have been certified or registered as a mediator by either the State of Alabama, Florida, or Georgia for the preceding five years; (ii) shall have been admitted to practice law in either the State of Alabama, Florida, or Georgia for the preceding fifteen years and be currently in good standing; and (iii) shall be currently admitted to the bar of this court. (3) All persons while employed as private mediators shall follow the private mediator procedures as set forth by the Kinnard Mediation Center. (4) The provisions of this subsection (g) shall be in effect until discontinued by the Chief Circuit Mediator or by the court. 3. APPEALS THAT MAY BE MEDIATED BY A PRIVATE MEDIATOR Generally, all civil appeals are eligible for mediation conducted by the KMC. However, appeals or petitions in which any party is proceeding without the assistance of counsel or in which any party is incarcerated, appeals from habeas corpus actions, and immigration appeals are not eligible. A private mediator employed by the parties and who meets the qualifications required by the rule may be substituted for the assigned circuit mediator to conduct the KMC-selected mediation. Appeals specifically sent to mediation by the court may not be privately mediated. 4. PRIVATE MEDIATOR SELECTION FORM W hen parties desire to employ a private mediator in an appeal that has been selected for mediation by the KMC, they must complete a “Request for Use of a Private Mediator” form (Appendix Form A). The form must be signed by counsel for all parties and by the selected private mediator. The completed and executed form must then be submitted to the KMC within ten days of the date of the notice of mediation. Kinnard Mediation C enter/PR IVATE MED IATO R PR O C ED U R ES FO R MED IATIO N O F APPEALS/February 2011 Page 3 American LegalNet, Inc. www.FormsWorkFlow.com 5. ASSISTANCE BY ASSIGNED CIRCUIT MEDIATOR Even though the parties have decided to employ a private mediator to conduct the mediation of an appeal, the circuit mediator whose name appears on the court’s notice of mediation will remain assigned to the matter and is available to answer questions by the private mediator and parties and provide other assistance as needed. Further, no extension of time to file a brief (see paragraph 12) may be granted by a private mediator; only the assigned circuit mediator may authorize such extensions. 6. INFORMATION FURNISHED TO PRIVATE MEDIATOR Upon the filing of the Request for Use of a Private Mediator, the KMC will provide to the private mediator copies of the following materials: (a) the Civil Appeal Statement with required attachments and (b) a copy of the U.S.C.A. docket as of the date of the approved substitution. Thereafter the required confidential mediation statements and any courtesy copies of briefs or other documents shall be sent directly by the parties to the private mediator. Counsel are instructed to prepare their confidential mediation statement in letter format, preferably not more than five pages, and fax, mail, or email it to the private mediator so that the private mediator receives it at least one week before the mediation date. Counsel need not forward to the KMC copies of the confidential mediation statement. The statement is not shared with the other side and does not become part of the court file. In the statement, counsel should C Recite the circumstances that gave rise to the litigation, including facts underlying any procedural issues in the appeal. C Describe any matters pending in the lower court or in any related litigation. C Describe any recent developments that may affect the resolution of the appeal. C Describe the important factors (factual, legal, practical) counsel believes affect the terms and conditions upon which the appeal may reasonably be settled. C Describe any efforts to settle the issues, including offers or demands before and since the judgment or order appealed from. C Provide a candid assessment of the strengths and weaknesses of the major points of error of the appeal. C Describe the necessary terms in any settlement (i.e., confidentiality, date by which settlement must close, scope of release, disposition of related litigation, etc.). C Describe any additional information counsel’s client or the other party needs to settle the appeal and whether it is needed before the mediation. Kinnard Mediation C enter/PR IVATE MED IATO R PR O C ED U R ES FO R MED IATIO N O F APPEALS/February 2011 Page 4 American LegalNet, Inc. www.FormsWorkFlow.com C State whether counsel and counsel’s parties will participate in the mediation in good faith, with the intention of using their best efforts to settle the appeal, and explain if “no” as to any party. C State whether counsel and counsel’s parties will maintain confidentiality with respect to settlement communications made and received during and subsequent to the mediation, and explain if “no” as to any party. C If the appeal were remanded, describe the realistic range of outcomes upon further trial or disposition by the lower court, including monetary remedies, attorney’s fees, court costs, further appellate costs, and similar awards the lower court might have opportunity to consider awarding. C Provide the name, title, address, telephone number, and email address of each person who will be participating in the mediation with counsel and designate which persons will have settlement or negotiating authority. (As required in the Notice of Mediation, also provide this participant information to opposing counsel in a communication separate from this Confidential Mediation Statement, with a copy to the circuit mediator.) 7. CONDUCT OF MEDIATION The private mediator may begin the mediation session by describing the mediation process, discussing confidentiality, and inquiring whether any procedural questions or problems can be resolved by agreement. The parties and the private mediator then discuss, either jointly or separately, and in no particular order, (a) the legal issues and the appellate court’s decision-making process regarding these issues (e.g., preservation of error, waiver, standards of review); (b) any efforts to settle the appeal; (c) the parties’ underlying interests, preferences, motivations, and assumptions and new information or other changes that may have occurred since the decision below; (d) future events based upon the various outcomes; (e) how resolution of the appeal could affect the underlying problem; (f) cost-benefit and time considerations; and (g) any procedural alternatives possibly applicable to the appeal (e.g., vacatur, remand). The discussion is not limited to these topics and will vary considerably depending on the circumstances of each appeal. The private mediator also should attempt to generate offers and counteroffers and may conduct several follow-up mediation sessions by telephone or in person until the appeal settles or the private mediator reaches the conclusion that it will not settle. The private mediator should contact the assigned circuit mediator if he or she needs assistance or further information about the conduct of the mediation. Kinnard Mediation C enter/PR IVATE MED IATO R PR O C ED U R ES FO R MED IATIO N O F APPEALS/February 2011 Page 5 American LegalNet, Inc. www.FormsWorkFlow.com 8. CONFIDENTIALITY See Rule 33-1(c)(3) in paragraph 2 above, which specifically addresses confidentiality. The circuit mediator’s notes and counsel’s Confidential Mediation Statements do not become part of the court’s file. The KMC does not reveal any request by counsel for mediation without the requesting party’s permission. Ex parte communications are also confidential except to the extent disclosure is authorized. Parties, counsel, and private mediators shall neither contact nor disclose to third parties, the media, or the court and its employees, save the KMC, any of the contents of the mediation. Parties, counsel, and private mediators may disclose the contents of the mediation to clients, co-counsel, and other persons entitled to be kept informed about the mediation by reason of a position or relationship with a party. Parties, counsel, and private mediators may disclose the fact of the occurrence of the mediation. The confidentiality rule applies in all mediated appeals including those conducted by a private mediator. The court strictly enforces this rule. The private mediator should contact the assigned circuit mediator if he or she has any questions regarding confidentiality. 9. BIAS, CONFLICTS OF INTEREST, AND DISQUALIFICATION Private mediators shall govern their behavior under the standards of professional responsibility promulgated by the state bars of which they are members and the state mediation or alternative dispute resolution programs by which they are certified or registered. A private mediator may be disqualified from mediating KMC appeals or subject to other sanctions for the following: C Violating Rule 33-1, including KMC private mediation procedures. C Failure to remain in good standing with this court. C Failure to remain in good standing and abide by the standards of practice established by his or her state bar licensing authority. C Failure to remain in good standing and abide by the standards of practice established by his or her state ADR authority. C At the discretion of the chief judge of this court. Kinnard Mediation C enter/PR IVATE MED IATO R PR O C ED U R ES FO R MED IATIO N O F APPEALS/February 2011 Page 6 American LegalNet, Inc. www.FormsWorkFlow.com 10. TIME PERIOD OF MEDIATION Time is of the essence for conducting appellate mediations given the exigencies of brief writing and the process of appellate review. If the parties choose to employ a private mediator rather than use the assigned circuit mediator, they shall submit to the KMC a Request for Use of a Private Mediator within ten days of the date of the court’s notice of mediation. The private mediator shall conduct the first mediation session within 28 days of the date of the court’s notice of mediation. This time schedule allows the parties the opportunity to assess the settlement possibilities of the appeal, request an extension of time to file a brief if an extension would be appropriate, conduct follow-up sessions, and not preclude a settlement because of the court’s issuance of a decision. The private mediator should contact the assigned circuit mediator if he or she has any questions about the time period for mediation and shall immediately advise the assigned circuit mediator when the mediation has concluded and whether it ended by settlement or impasse. 11. LOCATION OF MEDIATIONS Mediations are to take place in a location that is conducive to discussion, provides security so confidentiality may be maintained, and is convenient for the parties, all in a manner appropriate to the dignity of the court. Mediations may be conducted in person or by telephone. Private mediations may not be conducted at the facilities of the United States District Courts or Court of Appeals. 12. EXTENSIONS OF TIME TO FILE BRIEFS The filing of a Civil Appeal Statement or the scheduling or rescheduling of a mediation conference does not stay appellate proceedings. The due-date for filing briefs, however, may be extended by the KMC circuit mediators if the conditions described below exist, there is substantial probability the appeal can settle via mediation, and the extension will prevent the unnecessary expenditure of time and resources by counsel, the parties, and the court. Private mediators cannot grant extensions of time to file briefs. Length of KMC Extensions. The KMC may grant extensions of time to file an appellant’s or appellee’s brief for not more than 30 days from the date of a scheduled initial mediation, and for additional periods of not more than 30 days, to facilitate the prospects of settlement. Also, if warranted, the KMC may grant extensions of time to file a reply brief for up to seven days. Kinnard Mediation C enter/PR IVATE MED IATO R PR O C ED U R ES FO R MED IATIO N O F APPEALS/February 2011 Page 7 American LegalNet, Inc. www.FormsWorkFlow.com Impasse. If after mediation negotiations are declared an impasse by the private mediator, the KMC may grant one extension of time to file a brief that is due within 14 days of the impasse date for up to 21 days past the impasse date so that counsel will have as much as three weeks to prepare the brief after participating in the mediation. Consent of opposing counsel is not necessary in this event. Counsel of record may request this extension by telephoning the circuit mediator after the declaration of impasse by the private mediator and then immediately following with an email as below. Assessment Conference. The KMC is without authority to grant any extension if an initial mediation is changed to an assessment conference. If during the assessment conference an initial mediation is scheduled, then going forward the KMC may grant extensions. Requirements. Counsel of record may request a KMC brief extension if the following requirements are met: (a) All parties agree to extend the due-date (not necessary in event of impasse). (b) The extension will (1) facilitate a productive mediation or (2) facilitate prospects of settlement or (3) allow counsel not more than 21 days to prepare the brief after having participated in an unsuccessful mediation. (c) The deadline for submitting the brief has not passed. (d) Counsel has not previously filed a motion for an extension of time. (e) The briefing schedule has not been established by court order. Appellees may not request an extension until receipt of the appellant’s brief is entered on the clerk’s docket. Requests received after 3 p.m. Eastern Time will be processed the next business day. Due-dates that are a Saturday, Sunday, or legal holiday will be set for the next business day. Kinnard Mediation C enter/PR IVATE MED IATO R PR O C ED U R ES FO R MED IATIO N O F APPEALS/February 2011 Page 8 American LegalNet, Inc. www.FormsWorkFlow.com Instructions. To make a request, counsel of record should email* the KMC's brief extension coordinator at KMC_Brief_Extensions@ca11.uscourts.gov, copying the circuit mediator, counsel for each party separately represented, and the private mediator using the format below. [Email] To: From: Cc: Subject: KMC_Brief_Extensions@ca11.uscourts.gov [counsel of record] [circuit mediator, counsel for each party separately represented, and the private mediator] Brief Extension Requested: [appeal number(s) and short caption] [Text] Circuit Mediator: Private Mediator: Initial mediation date: Brief of [Appellant(s) or Appellee(s)]: [name of party or parties] Current due date: New due date requested: I meet the requirements necessary to obtain a KMC Brief Extension and request the above extension of time. I understand that if the KMC grants the extension it will forward this email to the clerk, copying the circuit mediator, counsel for each party separately represented, and the private mediator, and the clerk will update the docket to reflect the new due date. Other Requests for Extensions. If counsel does not meet the requirements for a KMC extension, a first request for an extension of seven calendar days or less can be made by telephone or in writing to the clerk. A first request for an extension of more than seven calendar days must be made by written motion to the court (11th Cir. R. 31-2(a)). Counsel’s motion must not contain any reference to the KMC, as required by the confidentiality rules governing the program (11th Cir. R. 33-1(c)). *If email is not available to counsel, counsel should fax the request to the brief extension coordinator at 404-335-6270, copying all counsel and using the same text. Kinnard Mediation C enter/PR IVATE MED IATO R PR O C ED U R ES FO R MED IATIO N O F APPEALS/February 2011 Page 9 American LegalNet, Inc. www.FormsWorkFlow.com 13. ADJUDICATION DURING MEDIATION Because the mediation is proceeding on a contemporaneous track with the appellate court review, it may occur before the mediation is concluded that an appeal is dismissed for lack of prosecution or lack of jurisdiction or that the court may decide the appeal. If there is such a disposition of the appeal by the court, the parties may agree to further mediation efforts by the private mediator to reach a settlement of the dispute. Should a party not agree to such further mediation, the mediation shall be impassed. 14. COMMUNICATIONS The private mediator should communicate directly with the assigned circuit mediator regarding the administration and conduct of the mediation. Private mediators cannot directly contact either the clerk or the court regarding the appeal. Counsel may individually contact the private mediator and the assigned circuit mediator. If counsel have questions or concerns regarding the mediation, those questions should be first addressed to the private mediator then to the assigned circuit mediator. There is no prohibition on ex parte contacts in the mediation program. Parties, counsel, and private mediators cannot directly or indirectly contact judges or chambers’ staff. Parties and counsel should address questions to either the private mediator or the assigned circuit mediator, as appropriate. Counsel should discuss extensions of time to file briefs first with the private mediator for his or her approval then with the assigned circuit mediator. 15. REPORT OF MEDIATION RESULTS Upon request of the assigned circuit mediator, the private mediator shall report the status of the mediation. Upon conclusion of the mediation, the private mediator shall report immediately by telephone, email, or fax to the assigned circuit mediator whether the mediation ended at complete settlement, partial settlement, or impasse. In the event a settlement was reached, the private mediator must advise parties and counsel that the reporting of a settlement does not automatically stay any of the actions required under the rules to be timely performed, including ordering necessary transcripts and briefing. If some action will be due prior to a motion to dismiss being presented and decided, counsel should request an extension of time to complete that action. The private mediator shall complete and fax to the KMC a Mediator’s Report (Appendix Form B) within one week of the conclusion of the mediation. Kinnard Mediation C enter/PR IVATE MED IATO R PR O C ED U R ES FO R MED IATIO N O F APPEALS/February 2011 Page 10 American LegalNet, Inc. www.FormsWorkFlow.com 16. POST-SETTLEMENT DISMISSAL PROCEDURES W hen the parties have reached a settlement and all parties agree on the terms of settlement, they should file with the clerk a joint (or agreed) motion to dismiss under Fed. R. App. P. 42(b) and 11th Cir. R. 42-1(a). This motion should address the following: C W hether the dismissal pertains to all parties and claims on appeal. C W hether the appeal is to be dismissed without prejudice (which may be granted by the clerk) or with prejudice (which must be ruled upon by a panel of three judges). C W hether the parties are to bear their own costs or another agreed apportionment. The motion to dismiss either should be signed by all parties or, if submitted by one party, should contain an explicit statement that all other parties to the settlement agreement consent. If submitted by only one party, the motion should be submitted by the appellant. All motions must be accompanied by a certificate of service and a certificate of interested parties (Rule 27-1(a)). Settlement does not automatically stay any of the actions required under the rules to be timely performed, including ordering necessary transcripts and briefing. If counsel has a brief due prior to a motion to dismiss being presented and decided, counsel may request an extension of time to complete that action by following the procedures in Part 12, “Extensions of Time to File Briefs.” If the appeal is scheduled for oral argument, counsel should contact the court sessions unit of the clerk’s office at 404-335-6131 for further direction. 17. EVALUATION PROCEDURES At the conclusion of all mediation procedures, the KMC sends an evaluation questionnaire to counsel of record inviting their candid responses about the effectiveness of the Eleventh Circuit’s mediation program in assisting the parties to resolve issues on appeal. Counsel return their responses directly to the KMC’s Chief Circuit Mediator. 18. BILLINGS TO PARTIES The private mediator shall bill the parties based upon the rates and terms previously agreed to by the mediator and parties. It is not necessary to send copies of fee agreements or billings to the KMC. The parties are solely responsible for any billings by the private mediators. Neither the court nor the KMC will aid in the enforcement of the terms and conditions of the contract, including the collection of any outstanding fees, costs, and expenses. Kinnard Mediation C enter/PR IVATE MED IATO R PR O C ED U R ES FO R MED IATIO N O F APPEALS/February 2011 Page 11 American LegalNet, Inc. www.FormsWorkFlow.com It is highly recommended that the private mediator fully disclose and explain to the parties the basis of compensation, fee, and charges to the parties in advance of the mediation and that same be memorialized in a written contract. Generally fees are divided equally among the parties, although there can be exceptions. Further, such disclosures and explanations usually include the following: C The basis for and amount of any charges for services to be rendered, including minimum fees and travel time. C The amount charged for the postponement or cancellation of mediation sessions and the circumstances under which such charges will be assessed or waived. C The basis and amount of charges for any other items. C The parties pro rata share of mediation fees and costs if previously agreed to by the parties. 19. QUESTIONS OR COMPLAINTS Private mediator questions regarding the program or conduct of the mediation should be addressed to the assigned circuit mediator. Party or counsel questions regarding the program or conduct of the mediation may be addressed to either the private mediator or the assigned circuit mediator or both. Party or counsel complaints or concerns regarding the private mediator or the conduct of the mediation should first be addressed to the private mediator. If complaints and concerns still remain they should be addressed to the assigned circuit mediator. Any remaining complaints or concerns should be addressed to the Chief Circuit Mediator. Questions shall not be addressed to either the court or clerk’s office staff unless the party, counsel, or private mediator is so directed by the KMC. 20. TRAINING PROGRAMS The KMC reserves the right to establish such training programs as it may deem necessary from time to time. Private mediators must remain current with their state bar and state ADR agency licensing, certification, registration, and continuing education requirements to be eligible to perform Eleventh Circuit appellate mediations. Kinnard Mediation C enter/PR IVATE MED IATO R PR O C ED U R ES FO R MED IATIO N O F APPEALS/February 2011 Page 12 American LegalNet, Inc. www.FormsWorkFlow.com FORM A Rev. 2/11 Request for Use of a Private Mediator Date ______________________ Assigned Circuit Mediator _________________________ Appeal Caption _______________________________________________________________ Appeal Number(s) _____________________________________________________________ The undersigned parties in the above-captioned appeal(s) agree to employ the services of the private mediator identified below for the purpose of conducting a mediation. The parties are aware of the requirements for use of a private mediator as set forth in 11 th Cir. R. 33-1. ____________________________________________________________________________ (Signature of Counsel for Appellant) (Signature of Counsel for Appellee) Acceptance by Private Mediator: _________________________________________________ accepts the employment by the parties to conduct a mediation in the above-captioned appeal(s). Further, the mediator represents to the court that he or she (1) Has been certified or registered as a mediator by either the State of Alabama, Florida, or Georgia for the preceding five years. State of certification and certification date: _______________________________________________________________________ (2) Has been admitted to practice law in either the state of Alabama, Florida, or Georgia for the preceding fifteen years and is currently in good standing. State and date of admission: _______________________________________________________________________ (3) Is currently admitted to the bar of this court. Further, the undersigned mediator represents that he or she has read the “Private Mediator Procedures for Mediation of Appeals” and agrees to follow the procedures set forth therein. _____________________________________ _ _ _ _ _ _ _____________________________________ (Signature of Private Mediator) (Telephone) _____________________________________ _ _ _ _ _ _ _ _ _ _ ___________________________________ (Print Name) (Fax) _____________________________________ _ _ _____________________________________ _ (Address) (Email) Please fax this completed form to the Kinnard Mediation Center, 404-335-6270, within ten days of the date of the court’s notice of mediation. American LegalNet, Inc. www.FormsWorkFlow.com FORM B Rev. 2/11 Private Mediator’s Report Date ______________________ Assigned Circuit Mediator _________________________ Appeal Caption _______________________________________________________________ Appeal Number(s) _____________________________________________________________ Private Mediator ______________________________________________________________ Mediation Conferences __________________________________ 9 In Person 9 Telephone __________________________________ 9 In Person 9 Telephone __________________________________ 9 In Person 9 Telephone __________________________________ 9 In Person 9 Telephone __________________________________ 9 In Person 9 Telephone __________________________________ 9 In Person 9 Telephone Total: __________ In Person __________ Telephone W ho was lead counsel in the mediation for each side? _________________________________ ____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ 9 Full Settlement 9 Partial Settlement 9 Impasse Date: _________________________ If a settlement was reached, please describe the terms. ________________________________ ____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ Do you have any suggestions for the improvement of the mediation program? ______________ ____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ Please fax this completed form to the Kinnard Mediation Center, 404-335-6270, within one week after the mediation is concluded. 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