Fillable ACKNOWLEDGMENT OF CONFIDENTIALITY MEDIATION SESSION (The Superior Court of California - County of Orange)

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ACKNOWLEDGMENT OF CONFIDENTIALITY MEDIATION SESSION (The Superior Court of California - County of Orange)

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ADR NEUTRAL NAME, ADDRESS, TELEPHONE, FAX AND EMAIL:
PLAINTIFF/PETITIONER:
DEFENDANT/RESPONDENT:
ACKNOWLEDGMENT OF CONFIDENTIALITY
MEDIATION SESSION
CASE NUMBER:
(DO NOT FILE WITH THE COURT)
This form is provided to offer mediators a convenient means to inform participants of the applicable ethical and other rules.
The participants in the mediation proceeding of this case agree that:
1. The mediation proceeding will be confidential, in accordance with California Evidence Code sections 703.5 and
1115 through 1128.
2. This agreement does not affect the admissibility of a written settlement agreement reached as a result of this
mediation proceeding in an action to enforce that settlement.
3. This agreement will not preclude a report of information to the ADR Administrator or an inquiry by the
Administrator regarding complaints against a neutral pursuant to California Rules of Court, rules 3.850 through
3.863.
Dated:___________________________ ____________________________________________________
Neutral
_______________________________________________________ ____________________________________________________
Party Party
_______________________________________________________ ____________________________________________________
Attorney Attorney
_______________________________________________________ ____________________________________________________
Party Party
_______________________________________________________ ____________________________________________________
Attorney Attorney
_______________________________________________________ ____________________________________________________
Other Participant Other Participant
_______________________________________________________ ____________________________________________________
Title Title
_______________________________________________________ ____________________________________________________
Representing (specify party) Representing (specify party)
Additional pages attached (number) _______
ACKNOWLEDGMENT OF CONFIDENTIALITY – MEDIATION SESSION
Adopted for Mandatory Use EC §703, 1115, et seq, CCP §1175.10
L2754 (New February 2008) California Rules of Court rule 3.850 et seq
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ACKNOWLEDGMENT OF CONFIDENTIALITY MEDIATION SESSION (The Superior Court of California - County of Orange)

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Completed 8 February 2021

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