ATTORNEY OR PARTY WITHOUT ATTORNEY (Name and Address) For Court Use Only TELEPHONE NO: ATTORNEY FOR (Name) SUPERIOR COURT OF CALIFORNIA, COUNTY OF EL DORADO STREET ADDRESS: MAILING ADDRESS: CITY AND ZIP CODE: PLAINTIFF: DEFENDANT: CASE NUMBER: STIPULATION AND ORDER TO PARTICIPATE IN ALTERNATIVE DISPUTE RESOLUTION (ADR) Pursuant to CRC §3.221, all parties stipulate to the following alternative dispute resolution (ADR) process. Judicial Arbitration, Mediation or Private Arbitration services shall be paid for by the parties pursuant to a separate ADR Fee Agreement with the neutral selected. Judicial Arbitration Mediation Dispute Resolution Conference (DRC) The parties further stipulate: That ______________________________________________________________ be appointed as the neutral. Address:______________________________________________________________ City, State, Zip:_________________________________________________________ Phone Number:_________________________________________________________ Attach additional sheets if needed. It is understood that the Judicial Council ADR Information Form (ADR-101) and if DRC is selected, the Dispute Resolution Conference Report (Local Form C-3) must be submitted by the parties and counsel at the conclusion of the ADR process. Attorney(s) signing on behalf of their client(s) have been given the authority to stipulate to alternative dispute resolution. __________________ Date __________________ Date _______________________________ _______________________________ Type or Print Name Signature of Party or Attorney for Party _______________________________ _______________________________ Type or Print Name Signature of Party or Attorney for Party Attach additional sheets if needed. Private Arbitration either binding or non-binding APPROVED: Alternative Dispute Resolution Hearing to be completed 30 days prior to the Mandatory Settlement Conference. 3321 Cameron Park Drive, Cameron Park, CA 95682 DATED:_______________ 1354 Johnson Blvd., South Lake Tahoe, CA 96150 _____________________________________ JUDGE OF THE SUPERIOR COURT CRC 3.221 Local Form C-45 for Optional use El Dorado County Superior Court 07/01/13 (New) STIPULATION AND ORDER TO PARTICIPATE IN ADR American LegalNet, Inc. www.FormsWorkFlow.com