Free Stipulation and Order to Mediation (CV\E-MED-179) - California

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: CASE NUMBER:

STIPULATION AND ORDER TO MEDIATION
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. Per Local Rule 12.23 Mediators on the court's approved panel have agreed to the court's payment schedule of $200 for 3 hours of mediation. In the event the mediation will extend beyond 3 hours, the parties will be responsible for compensating the Mediator in an amount as set by the Mediator. 2. Court Mediation in lieu of previously ordered Arbitration. Per Local Rule 12.23 Mediators on the court's approved panel have agreed to the court's payment schedule of $200 for 3 hours of mediation. In the event the mediation will extend beyond 3 hours, the parties will be responsible for compensating the Mediator in an amount as set by the Mediator. 3. Private Mediation. Per Local Rule 12.23 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 12.23 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
CV\E­MED­179 (Rev 02.13.09) Local Form Adopted for Mandatory Use

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STIPULATION AND ORDER TO MEDIATION
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 12 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: ____________________ Date ____________________ Time __________________ Department

Stipulation and Order to Mediation denied. It is further ordered that: ___________________________________________________________________________ ________________________________________________________________________________________________ Dated: ______________________________ Signed: __________________________________________________ Judge of the Superior Court

Stipulation and Order to Mediation
CV\E­MED­179 (Rev 02.13.09) Local Form Adopted for Mandatory Use

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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: ______________________________________

_________________________________ 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: ______________________________________

_________________________________ 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: ______________________________________
______________________________________ Signature of Party or Attorney

_________________________________ Name of Party Stipulating

______________________________________ Name of Party or Attorney Executing Stipulation

Bar # ______________________________ Address______________________________ ______________________________
Plaintiff Defendant Cross-Complainant Cross-Defendant Dated: ______________________________________

Stipulation and Order to Mediation
CV\E­MED­179 (Rev 02.13.09) Local Form Adopted for Mandatory Use

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