STATE OF NORTH CAROLINA

File No.

                                                    County

In The General Court of Justice

Superior Court Division

Name of Plaintiff(s)

DESIGNATION OF MEDIATOR IN

SUPERIOR COURT CIVIL ACTION

___________

NOTE TO ATTORNEYS

Plaintiff’s attorney should check and fill out only one of the three Sections, sign on the reverse, and return to the Senior Resident Judge within 21 days after the date of the Order for Mediated Settlement Conference.

G.S. 7A-38; Rules Of Mediated Settlement Conference

Name and Address of Plaintiff’s Attorney(or Pro Se Plaintiff)

Telephone Number

VERSUS

Name of Defendant(s)

Name and Address of Defendant’s Attorney(or Pro Se Defendant)

Telephone Number

Deadline For Completion of Mediation Settlement Conference (for court use only)

x

SECTION 1 – NOTICE OF SELECTION OF CERTIFIED MEDIATOR BY AGREEMENT

 The above named case was referred to a mediated settlement conference.  The parties have selected the mediator named below who has agreed to serve in this case and is certified pursuant to the Rules of Mediated Settlement Conferences.

Name and Address of Certified Mediator

J. Anderson Little            Please file original with the court

P.O. Box 16205               and send a copy to my office.

Chapel Hill, NC 27516                

Telephone

 (919) 967-6611    fax: (919) 967-3212

The parties and the mediator have agreed upon the mediator’s rate of compensation as follows:  

Administrative Fee: $185; Rate; $185/hr. with a 2-hour minimum for a ½ day mediation and a 4-hour minimum for a full day mediation.; Postponement/Cancellation Fee: 2-billable hours if scheduled for a ½ day. 4-billable hours if scheduled for a full day. No charge if cancelled with at least 30 days notice or if we can refill the date with another conference.

NOTE:     As an aid to mediator selection, the NC Dispute Resolution Commission maintains a list of certified superior court mediators on its web

site at http://www.ncdrc.org/.Click on “List of Mediators” from the left-hand menu then click on “Mediated Settlement Conference Program.”You may search for

mediators by name of mediator, by city, or by court district. Once a mediator’s name appears on your screen, click on it for a complete contact and

 availability listing.      

o

SECTION 2 – MOTION FOR COURT APPOINTMENT OF MEDIATOR

The above named case was referred to a mediated settlement conference.  After a full and frank discussion, the parties have been unable to agree upon the selection of a mediator and move

 the Senior Resident Superior Court Judge to appoint a certified mediator to conduct their conference. 

Date

Name of Plaintiff’s Attorney (Or Pro Se Plaintiff)

Signature of Plaintiff’s Attorney (Or Pro Se Plaintiff)

ORDER OF APPOINTMENT

 The parties having reported their failure to agree upon the selection of a mediator, or the parties having failed to notify the Court of their selection or nomination

of a mediator within twenty- one (21) days after this case was ordered to mediation, the Court appoints the following certified mediator to conduct the mediated settlement conference.

Name and Address of Mediator

Telephone No.

NOTICE TO MEDIATOR:      The mediator shall be responsible for reserving a place and making arrangements for the conference and giving timely notice

to all attorneys and unrepresented parties of the time and location of the conference.   The mediated settlement conference shall be completed by the completion deadline set forth above, and the mediator shall report the results of the conference to the Court within ten (10) days after the conference is completed.

Date

Name of Senior Resident Superior Court Judge (Type or Print)

Signature of Senior Resident Court Judge

                                                                          Original – File   Copy – Senior Resident Superior Court Judge

 AOC-CV-812, Rev. 2/06                                           Copy-Plaintiff    Copy – Defendant     Copy - Mediator

 © 2006 Administrative Office of the Courts                                                  (Over)

TENTATIVE CALENDARING NOTICE

[This section is optional, to be used at the discretion of the Senior Resident Superior Court Judge; however mediated settlement shall not delay other

proceedings, including trial (Rule 3E).]

Parties are notified of the following tentative calendaring schedule adopted by the Court. Final calendar notices will be provided through a published

calendar, should settlement not be reached.

Tentative Date for Hearing of Motion

 Aoc-CV-812, Side Two, Rev. 2/06

© 2006 Administrative Office of the Courts