ATTORNEY OR PARTY WITHOUT ATTORNEY (Name, state bar number, and address) FOR COURT USE ONLY TELEPHONE NO.: FAX NO. (Optional): E-MAIL ADDRESS (Optional): ATTORNEY FOR (Name): SUPERIOR COURT OF CALIFORNIA, COUNTY OF MERCED 627 W. 21st Street Merced, CA 95340 (209) 725-4111 PLAINTIFF/PETITIONER: DEFENDANT/RESPONDENT: STIPULATION AND ORDER REFERRING MATTER TO ALTERNATIVE DISPUTE RESOLUTION (Check one): UNLIMITED CASE (Amount demanded exceeds $25,000) LIMITED CASE (Amount demanded is $25,000 or less) CASE NUMBER: Assigned Judge: Case Category (please circle): I II III THIS ADR STIPULATION IS TO BE FILED WITH THE COURT WITHIN FIFTEEN (15) CALENDAR DAYS OF THE PARTIES' AGREEMENT TO PARTICIPATE IN ADR Pursuant to Cal. Rules of Court, Rule 3.221 and having met and conferred pursuant to Rules of Court, Rule 3.724, the parties hereby stipulate to refer the case to the following Alternate Dispute Resolution Process: Mediation Binding Private Arbitration Non-binding Private Arbitration Neutral Case Evaluation Private Settlement Conference Early Mediation (fee: $300)* The ADR process will be conducted by (name of individual):____________________________________________________________ Provider's Address: _______________________________________________________________________________________ Provider's Telephone: __________________________ Fax: _____________________ E-Mail:___________________________ The ADR process will be completed on, or before, (date):________________________________________________________________ The next Case Management Conference is scheduled for (date/time):_______________________________________________________ * Parties not already assigned to Early Mediation may execute and file this Stipulation as soon as the case is at issue. Upon filing this Stipulation, an early Case Management Conference will be scheduled by the Court and the parties will have the opportunity to attempt settlement before extensive costs and fees are undertaken. The fee for Early Mediation is $300, to be shared by the Parties and paid to the Court in full with the filing of this Stipulation. The $300 fee is not waived for successful Fee Waiver Applicants. [M-ADR2] [Rev. 02/13) STIPULATION AND ORDER REFERRING MATTER TO ADR Pages 1 of 2 American LegalNet, Inc. www.FormsWorkFlow.com The Parties further stipulate and agree that: 1. 2. 3. 4. All parties have reached agreement as to the payment of fees of the ADR provider; All Parties have been served and submit to the jurisdiction of the Court; All Parties have agreed to a specific discovery plan to make the ADR process meaningful; Copies of this Stipulation and self-addressed stamped envelopes are provided to the Court for returning file-stamped copies to counsel and the parties along with the $20.00 fee for filing a Stipulation with Order per Govt. Code �70617(c) (2); 5. 6. Early Mediation fee of $300 total is submitted with this Stipulation (if applicable); and All Parties are aware that a request for continuance of the ADR completion date established by this Stipulation and Order is discouraged, and the request may be denied by the Court. Type or print name of Plaintiff/Petitioner Party without attorney Attorney for (Date and Sign) Attorney or Party without attorney (Sign in blue ink) Defendant/Respondent/Contestant Type or print name of Plaintiff/Petitioner Party without attorney Attorney for (Date and Sign) Attorney or Party without attorney (Sign in blue ink) Defendant/Respondent/Contestant Type or print name of Plaintiff/Petitioner Party without attorney Attorney for (Date and Sign) Attorney or Party without attorney (Sign in blue ink) Defendant/Respondent/Contestant Type or print name of Plaintiff/Petitioner Party without attorney Attorney for (Date and Sign) Attorney or Party without attorney (Sign in blue ink) Defendant/Respondent/Contestant Additional signatures are attached Pursuant to the Stipulation of the parties, the above case is ordered to ADR as described and agreed to above. If applicable, an early Case Management Conference is set for _______________________________________. Dated:_____________________ ______________________________________ ___ DONALD J. PROIETTI, JUDGE BRIAN L. McCABE, JUDGE JEANNE SCHECHTER, COMMISSIONER DAVID FOSTER, TEMPORARY JUDGE [M-ADR2] [Rev. 02/13 STIPULATION AND ORDER REFERRING MATTER TO ADR Pages 2 of 2 American LegalNet, Inc. www.FormsWorkFlow.com