Fill and Sign the Mediation Parties Form

Mediation Agreement between Private Parties Mediation agreement made ________________ (date) , between __________________ (name of first party) , hereinafter called First Party, of _________________________________ _______________________________________________ (address of first party) , and ___________________ (name of second party) , of __________________________________ ____________________________________________ (address of second party) , hereinafter called Second Party, said First Party and Second Party being jointly referred to as the Parties, and _____________________ (name of first mediator) of ____________________________ ______________________________________________________ (address of Mediator) (the Mediator ). Whereas, the Parties have entered into mediation with the Mediator with the intention of reaching a consensual settlement of their dispute regarding (set forth circumstances of dispute) ____________________________________________________________________ ____________________________________________________________________________ ___________________________________________________________________________; The Parties and the Mediator agree as follows: 1. Neutrality The Mediator is a neutral facilitator who will assist the Parties to reach their own settlement. He will not make decisions about "right" or "wrong" or tell the Parties what to do. 2. No Legal Advice The Mediator does not offer legal advice nor does he provide legal counsel. Each Party is advised to retain his or her own attorney in order to be properly counseled about his or her legal interests, rights and obligations. 3. Confidentiality The Parties understand that in order for mediation to work, open and honest communications are essential. Accordingly, all written and oral communications, negotiations and statements made in the course of mediation will be treated as privileged settlement discussions and are absolutely confidential. To this end the parties agree that: A. The Mediator will not reveal anything discussed in mediation without the permission of both Parties. B. The Parties agree that they will not at any time, before, during, or after mediation, call the Mediator or anyone associated with the Mediator as witnesses in any legal or administrative proceeding concerning this dispute. To the extent that they may have a right to call the Mediator or anyone associated with the Mediator as witnesses, the Parties waive this right. C. The Parties agree not to subpoena or demand the production of any records, notes, work product or the like of the Mediator in any legal or administrative proceeding concerning this dispute. To the extent that they may have a right to demand these documents, the Parties waive this right. D. If, at a later time, either Party decides to subpoena the Mediator, the Mediator will move to quash the subpoena. That Party agrees to reimburse the Mediator for whatever expenses they incur in such an action (including attorney's fees) plus (dollar amount) per hour per Mediator for all the time that is taken by this matter. E. The exception to the above is that this agreement to mediate and any written agreement made and signed by the Parties as a result of mediation may be used in any relevant proceeding, unless the Parties make a written agreement not to do so. 4. Full Disclosure The Parties understand that full disclosure of all relevant and pertinent information is essential to the mediation process. Accordingly, there will be a complete and honest disclosure by each of the Parties to the other and to the Mediator of all relevant information and documents. This includes providing each other and the Mediator with all information and documentation that usually would be available through the discovery process in a legal proceeding. If either Party fails to make full disclosure, the agreement reached in mediation may be set aside. 5. Withdrawal While both Parties intend to continue with mediation until a settlement agreement is reached, the Parties understand that either or both Parties may withdraw from mediation at any time. The Parties agree that if one or both Parties decide to withdraw from mediation, best efforts will be made to discuss this decision in the presence of both Parties and the Mediator. 6. Termination by Mediator If the Mediator determines that it is not possible to resolve the issues through mediation, the process can be terminated once this has been conveyed to the Parties and confirmed in writing. 7. Memorandum of Understanding When an agreement is reached, the Mediator will prepare a Memorandum of Understanding. Each Party is advised to review this with his or her own attorney before the agreement is placed in final form and signed. 8. Sharing of Costs The Parties agree to share the cost of mediation. 9. Rules and Procedures Additional rules and procedures for the mediation may be negotiated and agreed upon by the Mediator and the Parties at any time during the mediation process. 10. Governing Law This Agreement shall be governed by, construed, and enforced in accordance with the laws of the State of _______________. Each party hereby declares: I have read, understood and agreed to each provision of this agreement. WITNESS our signatures as of the day and date first above stated. ________________________ _________________________ (P rinted name) (P rinted name) ________________________ _________________________ (Signature of First Party) (Signature of Second Party)