Agreement to mediate

1234, Main Street
Boston, MA 02123

05 April, 2005

<Recipient Address Goes Here>


Agreement to Mediate

Case Name: <case name>

We, the undersigned participants, agree to utilize the mediation services of <name of mediator or mediation company> to facilitate a settlement of the dispute, and acknowledge and accept the following terms and conditions.

1. The parties consent to the appointment of ____________________ to act as mediator in this matter and elect to mediate their civil dispute under the terms and conditions of Evidence Code Section <insert pertinent section number(s) for your jurisdiction>. The mediator shall act as an advocate for the resolution and shall use his/her best good faith efforts to assist the parties in reaching a mutually acceptable agreement. The mediator will maintain impartiality toward all parties.

2. Mediation is a voluntary process for settlement negotiation. In this context, mediators act as impartial third parties exclusively and do not represent any disputant or otherwise practice law. The mediator will not give legal advice. Likewise, the mediator is not a judge, nor does the mediator have the power or authority to force a settlement on the parties. Participants are encouraged to consult with their own attorney regarding their legal rights and responsibilities.

3. All statements made during the mediation process are deemed to be privileged and inadmissible for any purpose in any proceedings. The parties will not subpoena or otherwise require the mediator to testify or produce records, reports, notes, or other documents reviewed, received, or prepared by the mediator during the course of the mediation process.

4. Additionally, the mediator may hold a private meeting or “caucus” with one participant. Information revealed in a private meeting is confidential and will not be disclosed by the mediator unless participant authorizes disclosure.

5. The mediator’s fee shall be <$hourly rate> per hour, plus a <$ administrative fee> per party. Unless otherwise agreed, the fee shall be divided among the parties on an equal basis; however, payment of all the fees and expenses remains a joint and several liability of all participants. Additional unpaid fees and expenses shall be paid within thirty (30) days of receipt of a billing statement. Cancellation of the mediation with less than ten (10) days advance notice will result in a <$ amount> cancellation fee to be paid by the canceling party.

6. This agreement incorporates all statutory provisions in the mediation process.


Party Date Counsel Date

_____________________________________ _______________________________________
Party Date Counsel Date

_____________________________________ _______________________________________
Party Date Counsel Date

_____________________________________ _______________________________________
Party Date Counsel Date


Robert Anderson

encl: <List of enclosed items goes here>

Download Agreement to mediate In Word Format

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