Stipulation to Mediate

______________________________________
Plaintiff(s)

vs.

______________________________________
Defendants(s)
_______________
Case No.

IT IS HEREBY STIPULATED by and between the undersigned parties, and their respective attorneys of record, that the above-captioned matter is hereby submitted mediation before ________________________, (Judge, Retired/Attorney at Law), hereinafter referred to as the "Mediator".

The Mediator shall conduct the proceedings in a manner designed to facilitate communication between the parties to assist them in reaching a mutually acceptable agreement.

In the event the Mediator initially chosen is unable to commence or complete the proceedings, then a replacement mediator shall be chosen from the panel offered by ADR Services, Inc. If the parties cannot agree upon a replacement mediator, ADR Services, Inc. is hereby empowered to choose the replacement mediator.

The Parties


Dated:  _______________


Dated:  _______________


Dated:  _______________


Dated:  _______________

______________________________
(print name)

______________________________
(print name)

______________________________
(print name)

______________________________
(print name)

Attorneys for the Parties


Dated:  _______________


Dated:  _______________


Dated:  _______________


Dated:  _______________

______________________________
(print name)

______________________________
(print name)

______________________________
(print name)

______________________________
(print name)

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Stipulation to Mediate


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