SUPERIOR COURT OF CALIFORNIA, COUNTY OF SAN MATEO Civil Division 400 County Center Redwood City, CA 94063-1655 PLAINTIFF / PETITIONER: DEFENDANT / RESPONDENT: CASE NUMBER: STIPULATION AND [PROPOSED] ORDER TO MEDIATION IN LIEU OF COURT-ORDERED JUDICIAL ARBITRATION IT IS HEREBY STIPULATED AND AGREED by and between Plaintiff[s] ___________________ and Defendant[s]___________________ (collectively, "the Parties"), by and through their respective counsel, to be ordered by this Court to submit this action to mediation in lieu of previously Court-ordered, non-binding Judicial Arbitration. IT IS FURTHER STIPULATED AND AGREED by and between the Parties to request that the judicial arbitration set for___________________ [date] with the appointed judicial arbitrator ___________________ [name of judicial arbitrator] be canceled. The parties, through their respective counsel, have notified both the Judicial Arbitration Administrator and the ADR Program of this Court. Parties' request to proceed with mediation of this matter if the Court so approves. The mediation is currently scheduled for___________________ [date of the mediation session] with ___________________ [name of mediator]. The mediation will take place within five months of the previously scheduled judicial arbitration hearing. The parties understand that they are responsible for direct payment of mediation fees to the mediator. Parties, through their respective counsel ask this Court to set a trial date on ___________________. Such date is within six-months of the previously scheduled judicial arbitration hearing. Date: ______________ _______________________ PRINT NAME ___________________________________________ SIGNATURE OF PLAINTIFF OR ATTORNEY _______________________ PRINT NAME ___________________________________________ SIGNATURE OF PLAINTIFF OR ATTORNEY _______________________ PRINT NAME ___________________________________________ SIGNATURE OF DEFENDANT OR ATTORNEY _______________________ PRINT NAME ___________________________________________ SIGNATURE OF DEFENDANT OR ATTORNEY ORDER: Based upon, and in accordance with, the above Stipulation of the Parties, the Court hereby orders the Parties to submit the above-entitled action to Mediation in Lieu of Court-ordered, non-binding Judicial Arbitration. The Court further hereby sets this case for trial on___________________ [trial date] at 9:00 a.m. in the Department of the Presiding Judge. IT IS SO ORDERED. Date: ______________ Form ADR- CV-3 [Rev. Feb 2014] American LegalNet, Inc. www.FormsWorkFlow.com ___________________________________________ JUDGE OF THE SUPERIOR COURT