ATTORNEY OR PARTY WITHOUT ATTORNEY (NAME, STATE BAR # AND ADDRESS): FOR COURT USE ONLY TELEPHONE NO. EMAIL ADDRESS (Optional): ATTORNEY FOR (NAME): 720 Ninth Street, Room 102 Sacramento, CA 95814-1380 Website: http://www.saccourt.ca.gov PLAINTIFF/PETITIONER: FAX NO. (Optional) Superior Court of California, County of Sacramento CASE NUMBER: DEFENDANT/RESPONDENT: STIPULATION AND ORDER TO ARBITRATION/MEDIATION LIMITED CIVIL CASES This form must be filed with or subsequent to a Limited Civil Case Status Memorandum (Form CV\E-202). The parties and their attorneys stipulate that the claims in this action shall be submitted to the following process (Select One): Arbitration: Parties stipulate to arbitration pursuant to Code of Civil Procedure 1141.12 Court Mediation: Parties stipulate to Court mediation pursuant to California Rule of Court 3.891 Arbitrator / Court Neutral (Must specify THREE PERSONS): Arbitrator / Court Neutral Selected: Arbitrator / Court Neutral Selected: Arbitrator / Court Neutral Selected: Other Stipulations Name___________________________________________________________ Name___________________________________________________________ Name___________________________________________________________ Discovery to remain open 30 days from the date ordered into Arbitration/Mediation. Additional Stipulations: _______________________________________________________________________________________ A Limited Civil Case Status Memorandum has already been filed. Date Filed: _______________________ Stipulation and Order to Arbitration/Mediation-Limited Civil Cases CV\E­203 (Rev 01.01.2014) Local Form Adopted for Mandatory Use Page 1 of 2 American LegalNet, Inc. www.FormsWorkFlow.com STIPULATION AND ORDER TO ARBITRATION / MEDIATION - LIMITED CIVIL CASES PLAINTIFF/PETITIONER:__________________________________ CASE NUMBER:__________________________ DEFENDANT/RESPONDENT: ______________________________ _________________________________ Name of Party Stipulating ______________________________________ Name of Party or Attorney Executing Stipulation ______________________________________ Signature of Party or Attorney Bar # ______________________________ Address______________________________ ______________________________ Plaintiff Defendant Cross-Complainant Cross-Defendant Dated: ______________________________________ _________________________________ Name of Party Stipulating ______________________________________ Name of Party or Attorney Executing Stipulation ______________________________________ Signature of Party or Attorney Bar # ______________________________ Address______________________________ ______________________________ Plaintiff Defendant Cross-Complainant Cross-Defendant Dated: ______________________________________ _________________________________ Name of Party Stipulating ______________________________________ Name of Party or Attorney Executing Stipulation ______________________________________ Signature of Party or Attorney Bar # ______________________________ Address______________________________ ______________________________ Plaintiff Defendant Cross-Complainant Cross-Defendant Dated: ______________________________________ Additional Signature Page(s) Attached - (Local Form CV\E-203A) ORDER The foregoing stipulation having been read and considered, and good cause appearing, now therefore: The Court orders the parties to arbitration as stipulated above. The Court orders the parties to enter mediation as stipulated above. Previous order to Arbitration is vacated and appointment of Arbitrator rescinded. Stipulation and Order to Arbitration denied. Stipulation and Order to Mediation denied. It is further ordered that: ___________________________________________________________________________ ________________________________________________________________________________________________ Dated: ______________________________ Signed: __________________________________________________ Judge of the Superior Court Stipulation and Order to Arbitration/Mediation-Limited Civil Cases CV\E­203 (Rev 01.01.2014) Local Form Adopted for Mandatory Use Page 2 of 2 American LegalNet, Inc. www.FormsWorkFlow.com