30-18 () IN THE CIRCUIT COURT OF THE STATE OF OREGON FOR THE COUNTY OF MULTNOMAH 1021 SW 4TH AVENUE, PORTLAND OR 97204 Case No. Plaintiff/Petitioner vs. Defendant/Respondent This report must be filed with the Award/Settlement Notice and served upon the parties. This case was resolved by: Settlement Hearing and Award Did any party have a fee deferral or waiver? (If so, complete a request for reimbursement) No Plaintiff Defendant The The Commission approved standard rate of $150 per hour up to hours or $1,500maximum. (Cases with a fee waiver or deferral must not exceed the commission standard rate). The parties agreed to a higher rate at the conclusion of the proceedings due to the complex nature of the case. (attached a copy of the rate agreement signed by all parties) The parties have not agreed to a higher rate and the arbitrator is requesting review of the fees by the arbitration judge. (File a request for review of the arbitration fees) Time spent ( p lease show actual hours): Pre - hearing Hours: Hearing Hours: Post Hearing Hours : Total Hours: Total Bill: Paid $ Due $ Refunded $ Due $ Refunded $ CERTIFICATION I hereby certify that the above information is accurate and that I have sent copies of this notice to all parties/attorneys of record. Date Arbitrator American LegalNet, Inc. www.FormsWorkFlow.com