SUBMISSION TO DISPUTE RESOLUTION Please visit our website at www.adr.org if you would like to file this case online. AAA Customer Service can be reached at 800-778-7879. The named parties hereby submit the following dispute for resolution, under the rules of the American Arbitration Association. To be completed and signed by all parties (attach additional sheets if necessary). Rules Selected: Commercial Construction Employment Other: (please specify) Procedure Selected: Nature of Dispute: Binding Arbitration Mediation Other: (please specify) Dollar Amount of Claim: $ Other Relief Sought: Attorneys Fees Punitive/Exemplary Interest Other Arbitration Costs Please Describe Appropriate Qualifications for Arbitrator(s) to be appointed to hear this Dispute: Amount Enclosed: $ Hearing Locale Requested: In accordance with Fee Schedule: Flexible Fee Schedule Standard Fee Schedule Estimated Time Needed for Hearings Overall: hours or days We agree that, if arbitration is selected, we will abide by and perform any award rendered hereunder and that a judgment may be entered on the award. Name of Party: Address: Name of Party: Address: City: Phone No.: Email Address: Signature (required): Date: Name of Representative: Name of Firm (if applicable): State: Fax No.: Zip Code: City: Phone No.: Email Address: Signature (required): Date: Name of Representative: Name of Firm (if applicable): State: Fax No.: Zip Code: Address (to be used in connection with this case): Address (to be used in connection with this case): City: Phone No.: Email Address: State: Fax No.: Zip Code: City: Phone No.: Email Address: State: Fax No.: Zip Code: To begin proceedings, please send a copy of this Demand and the Arbitration Agreement, along with the filing fee as provided for in the Rules, to: American Arbitration Association, Case Filing Services, 1101 Laurel Oak Road, Suite 100, Voorhees, NJ 08043. Send the original Demand to the Respondent. American LegalNet, Inc. www.FormsWorkFlow.com