MEDIATION
PROCEDURE
MODEL MEDIATION
AGREEMENT
Date _________________
Parties
1: ___________________________________________________ ("Party A")
2: ___________________________________________________ ("Party B")
[3: _________________________________________________ ("Party C") etc.]
(jointly "the Parties") Add full names and addresses
[4:] _________________________________________________ ("the Mediator")
[5: ____________________________ ("the Student Mediator") ("the Mediator’s Advisor")]
(jointly and individually "the Mediator")
[6] The Canadian Foundation for Dispute Resolution,
12075, 237 Fourth Avenue S.W.,
Calgary, Alberta T2P 0H6 ("the Foundation")
Dispute ("The Dispute")
Brief description of the dispute.
Participation in a Mediation
- The
Parties will attempt to settle the Dispute by mediation ("the Mediation"). The
provisions of the Foundation’s Model Mediation Procedure ("the Model
Procedure") (a copy of which is attached) as supplemented and/or varied by this
agreement will apply to the Mediation and are incorporated in, and form part of, this
agreement. The definitions in the Model Procedure are used in this agreement.
The Mediator
- The
Mediator[s] will be
[The Student Mediator will be _____________________________ ]
The Mediator’s Advisor will be ____________________________ ]
The Representatives
- The
Representatives for the Parties at the Mediation will be: Add full names and corporate
titles
Party A: ________________________________________________
Party B: ________________________________________________
[Party C, etc.: ] ___________________________________________
(jointly "the Representatives")
A Party will immediately notify the other Party[ies] and the Mediator of any change to the
above.
Other Participants
- The
following, in addition to the Representatives, will be present on behalf of the Parties at
the Mediation
Party A: ________________________________________________
Party B: ________________________________________________
[Party C _______________________________________________ ]
A Party will immediately notify the other Party(ies) and the Mediator of any change to the
above.
Place and Time
- The
Mediation will take place
at: ____________________________________________________
on: ____________________________________________________
starting at: _________________________________________ o’clock
Disclosure and Confidentiality
- Each
Representative in signing this agreement is deemed to be agreeing to the disclosure and
confidentiality provisions of the Model Procedure (paragraphs 12 to 18) on behalf of the
Party he/she represents and all other persons present on behalf of that Party at the
Mediation.
Model Procedure Amendments
- Set
out amendments (if any) to the Model Procedure - see introduction to Model Procedure Guidance Notes.
Law and Jurisdiction
- For
wording see Model Procedure Guidance Notes. This paragraph
only necessary if the Dispute involves parties from different jurisdictions.
Signed: ________________________________________________
on behalf of [Party A] ______________________________________
Signed: ________________________________________________
on behalf of [Party B] [Party C] ________________________________
Signed: ________________________________________________
[the Mediator] [ [the Student Mediator]
[the Mediator’s Advisor] ____________________________________
Signed: ________________________________________________
on behalf of the Foundation ___________________________________
This Model Mediation Procedure have been
produced by The Canadian Foundation for Dispute Resolution. Any feedback or concerns on
the content of this document please contact CFDR at the addresses below.
The Canadian Foundation for Dispute Resolution
12075, 237 Fourth Avenue S.W., Calgary, Alberta T2P 0H6
Tel. (403) 237-2872 Fax. (403) 237-2753
112 Adelaide Street East, Toronto, Ontario M5C 1K9
Tel. (416) 307-0019 Fax. (416) 307-0011
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