Fill and Sign the 7a 383a 3a Prelitigation Mediation of Insurance Claims Form

STATE OF NORTH CAROLINA County File No. Name And Address Of Party Requesting Prelitigation Mediation Of Farm Dispute Telephone No. Of Requesting Party Date Of Request Date Mailed Name And Address Of Party To The Dispute Name And Address Of Party To The Dispute Email Address Of Requesting Party Signature Of Party Requesting Prelitigation Mediation Name And Address Of Party To The Dispute Name And Address Of Party To The Dispute Signature Of Party Requesting Prelitigation Mediation Name Of Person, Entity Or Agency From Whom Records Are Sought Original-File REQUEST FOR PRELITIGATION MEDIATION OF FARM NUISANCE DISPUTE G.S. 7A-38.3; Rule 1 of the Rules Implementing the Prelitigation Farm Nuisance Mediation Program The undersigned party requests, pursuant to G.S. 7A-38.3, that the parti\ es named below meet with the undersigned and a duly selected or appointed mediator, to conduct a prelitigation mediation of their farm nuisance dispute as\ described below: (Please briefly describe below the nature of the farm nuisance and any other factors underlying this dispute.) In accordance with G.S. 7A-38.3, the Rules Implementing Mediated Settlem\ ent Conferences, and the Rules Implementing the Prelitigation Farm Nuisance Mediation Program, the parties shall have twenty-one (21) days from the date of the filing of this request in which to select a mediator. The mediator shall be a certified superior court mediator selected from the list maintained by the NC Dispute Resolution Commission and available through the Clerk or the Commission’\ s website at www.ncdrc.org. If the parties cannot agree on a mediator, the party filing this Request shall make that fact known to the Clerk. A mediator selected by the parties shall be compensated at a rate agreed \ on between the parties and the mediator. If the parties cannot agree on a mediator and a mediator must be appointed, then the mediator \ shall be compensated at the rate of $150 per hour for mediation services and a one time, per case $150 administrative fee. Unl\ ess otherwise agreed to by the parties, all mediator fees shall be paid directly to the mediator at the conclusion of mediation. Fees sh\ all be paid pursuant to Rule 6.E of these Rules. It shall be the responsibility of the mediator; to schedule the mediatio\ n; notify the parties of the date, time, and location of the mediation; conduct the mediation; prepare a certificate stating the results of the mediation which the mediator shall file with the Clerk and serve on the parties. Pursuant to G.S. 7A-38.3, the parties may agree to waive prelitigation m\ ediation of their dispute by informing the mediator in writing of the waiver. No mediator fee shall be assessed against any party if all parties wai\ ve mediation prior to the initial mediation session. The undersigned certifies that a copy of this Request has been mailed by certified mail, return receipt requested, to each of the parties named below. REQUEST CERTIFICATE OF SERVICE AOC-CV-820, Rev. 7/14