UNITED STATES DISTRICT COURT FOR THE WESTERN DISTRICT OF PENNSYLVANIA _________________________________ _________________________________ _________________________________ Plaintiff(s), v. _________________________________ _________________________________ _________________________________ Defendant(s). ) ) ) ) ) ) ) ) ) Civil Action No. ___________________ STIPULATION SELECTING ADR PROCESS Counsel report that they have met and conferred regarding Alternative Dispute Resolution (ADR) and have reached the following stipulation pursuant to L.R. 16.2 and the Court's ADR Policies and Procedures. I. PROCESS Select one of the following processes: Mediation Early Neutral Evaluation (ENE) ______ Court sponsored Binding 1 Arbitration ______ Court sponsored Non-binding Arbitration Other (please identify process and provider)_____________________________ ________________________________________________________________ If you are utilizing a private ADR process, such as the American Arbitration Association, be advised that the case is still governed by the Court's ADR Policies and Procedures. It is the responsibility of counsel to ensure that all of the proper forms are timely submitted and filed, as required by Policies and Procedures. II. COSTS The parties have agreed to share the ADR costs as follows (do not complete percentages for Court sponsored arbitration. For that process, costs are paid by the Court in accordance with 28 USC �658.): % by Plaintiff(s) % by Defendant(s) If a dispute arises as to compensation and costs for the mediator/neutral evaluator/private arbitrator, the Court will set reasonable compensation and costs. 1 For binding arbitration, please complete form "Stipulation to Binding Arbitration" located on the Court's website at www.pawd.uscourts.gov American LegalNet, Inc. www.FormsWorkFlow.com III. NEUTRAL The parties hereby designate by agreement the following individual to serve as a Neutral in the above-styled action: Name of Neutral: Address of Neutral: Telephone & FAX Numbers: Email address of Neutral: Date of ADR Session: ____________________________________________ ____________________________________________ _____________________________________________ _____________________________________________ The parties represent that they have contacted the selected prospective neutral and have determined that the neutral is available to conduct the ADR session within the time prescribed by the Court's Policies and Procedures and that the neutral does not have a conflict. IV. PARTICIPANTS Name and title of the individual(s) who will be attending the mediation or early neutral evaluation session, in addition to counsel, in accordance with Section 2.7 (Attendance at Session) of the Court's ADR Policies and Procedures: For Plaintiff(s) ___________________ __________________________________________ Name and title __________________________________________ Name and title __________________________________________ Name and title For Defendant(s) ___________________ For 3rd party Deft(s)_________________ If there is insufficient space to list all parties who will be attending the session, please add additional sheets as necessary. Each party certifies that the representative(s) attending the ADR session on its behalf has full and complete settlement authority, as specified in sub-section (A)(1-3) of the above section of the Court's ADR Policies and Procedures. V. ACKNOWLEDGMENT We, the undersigned parties to this action, declare that this stipulation is both consensual and mutual. Dated: ______________________________________ Attorney for Plaintiff(s) ______________________________________ Attorney for Defendant(s) Rev. 2/2014 Dated: American LegalNet, Inc. www.FormsWorkFlow.com