Fill and Sign the Alternative Dispute Resolutionvermont Natural Resources Form

STATE OF VERMONT ENVIRONMENTAL COURT Docket No.: Vtec Case Name ALTERNATIVE DISPUTE RESOLUTION REPORT Report due from mediator within 15 days of completion of mediation Date of ADR Session Starting Time Finishing Time 1. Please indicate the names and addresses of all persons partic ipating in the ADR Session. (If additional space is needed, please attach an additional sheet.) If any party is a corporation or other entity, please indicate the name and title of the representative. Identify with an as terisk the representative of each part y who had decision-making authority. Name Representative & Title If Applicable Mailing Address City, State & Zip Code Appellant/Plaintiff Appellant/Plaintiff’s Counsel Appellee/Defendant Appellee/Defendant’s Counsel Municipality/State Municipality/State’s Counsel Interested Parties/Other 2. Were all appropriate parties in attendance? If not, who failed to appear? Please summarize any substitute arrangement made regarding attendance at the ADR Session. 3. Was full or partial settlement reached at the session? If so, please summarize and append any agreement of the parties. ________________________________________________________________________________________________ ________________________________________________________________________________________________ ________________________________________________________________________________________________ M ed ia to r D ate