ATTORNEY OR PARTY WITHOUT ATTORNEY (NAME, STATE BAR # AND ADDRESS): FOR COURT USE ONLY TELEPHONE NO. FAX NO. (Optional) EMAIL ADDRESS (Optional) ATTORNEY FOR (NAME): Superior Court of California, County of Sacramento 720 Ninth Street, Room 101 Sacramento, CA 95814-1380 (916) 874-5522--Website www.saccourt.ca.gov PLAINTIFF/PETITIONER: CASE MANAGEMENT CONFERENCE DATE: DEFENDANT/RESPONDENT: STIPULATION AND ORDER TO MEDIATION ­ UNLIMITED CIVIL CASE NUMBER: ASSIGNED DEPT.: The parties and their attorneys stipulate that the claims in this action shall be submitted to the following mediation process: Type of Mediation (select one): 1. Court Mediation. Mediators on the court's approved ADR Panel List have agreed to provide up to three (3) hours of pro-bono Mediation. In the event the Mediation extends beyond 3 hours and parties determine it would be beneficial to continue the Mediation process: the parties will independently be responsible for compensating the Mediator in an amount as set by the Mediator. 2. Court Mediation in lieu of previously ordered Arbitration. Mediator's on the court's approved ADR Panel List have agreed to provide up to three (3) hours of pro-bono Mediation. In the event the Mediation extends beyond 3 hours and parties determine it would be beneficial to continue the Mediation process: the parties will independently be responsible for compensating the Mediator in an amount as set by the Mediator. 3. Private Mediation. Per Local Rule 2.84 the cost of mediation must be borne by the parties equally unless the parties agree otherwise. Parties will be charged an amount as set by the Mediator. 4. Private Mediation in lieu of previously ordered Arbitration. Per Local Rule 2.84 the cost of mediation must be borne by the parties equally unless the parties agree otherwise. Parties will be charged an amount as set by the Mediator. Neutral Court Neutral Selected: (If type of Mediation selected above is option 1 or 2) Name___________________________________________________________ Name___________________________________________________________ Name___________________________________________________________ Name___________________________________________________________ Alternate Court Neutral Selected: (If type of Mediation selected above is option 1 or 2) Alternate Court Neutral Selected: (If type of Mediation selected above is option 1 or 2) Private Neutral Selected: (If type of Mediation selected above is option 3 or 4) Other Stipulations Discovery to remain open 30 days prior to trial. Additional Stipulations: _____________________________________________________________________________________ ______________________________________________________________________________________________________________ Stipulation and Order to Mediation ­ Unlimited Civil CV\E­MED­179 (Rev 01.01.14) Local Form Adopted for Mandatory Use Page 1 of 3 American LegalNet, Inc. www.FormsWorkFlow.com STIPULATION AND ORDER TO MEDIATION ­ UNLIMTED CIVIL PLAINTIFF/PETITIONER: ________________________________________ DEFENDANT/RESPONDENT: ____________________________________ _________________________________ Name of Party Stipulating ______________________________________ Name of Party or Attorney Executing Stipulation ______________________________________ Signature of Party or Attorney CASE NUMBER: _____________________ 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 ORDER The foregoing stipulation having been read and considered, and good cause appearing, now therefore: Stipulation and Order to Mediation deferred to Case Management Conference. The Court orders the parties to enter mediation as stipulated above, pursuant to Chapter Two ­ Part 5 of the Local Rules. Previously scheduled Case Management Conference is vacated. Previous order to Arbitration is vacated and appointment of Arbitrator rescinded. The case is ordered to the Trial-Setting Process. The Trial and Settlement Conference dates shall be selected no later than ________________________. Trial-Setting Conference is vacated. Time to Select Trial date and Mandatory Settlement Conference date is extended to ____________________________. Mediation Status Conference set for: Stipulation and Order to Mediation denied. It is further ordered that: ___________________________________________________________________________ ________________________________________________________________________________________________ Dated: ______________________________ Signed: __________________________________________________ Judge of the Superior Court ____________________ Date ____________________ Time __________________ Department Stipulation and Order to Mediation ­ Unlimited Civil CV\E­MED­179 (Rev 01.01.14) Local Form Adopted for Mandatory Use Page 2 of 3 American LegalNet, Inc. www.FormsWorkFlow.com STIPULATION AND ORDER TO MEDIATION (Additional Signature Page) PLAINTIFF/PETITIONER: ________________________________________ DEFENDANT/RESPONDENT: ____________________________________ CASE NUMBER: ____________________ _________________________________ 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: ___________________________________