Contra Costa — ADR-203 Panel Update Form

Source: https://contracosta.courts.ca.gov/system/files/adr203-panelupdateform.pdf

CONTRA COSTA COURT ADR PANEL MEMBER UPDATE Return completed form by email adrweb@contracosta.courts.ca.gov or fax (925) 608-2109

Name: ___________________________________________________________________________ First Middle Last Office Address: ____________________________________________________________________ Street City State Zip Office Phone: ______________________________ Office Fax: __________________________

E-Mail Address: ____________________________ Website: ____________________________

Assistant Name: ____________________________ E-Mail: _____________________________

Hourly fees charged for service as an ADR Panel Member (required per Rules of Court 10.781) $ _______

Calif. State Bar No.: _______________ Other License No. (specify): __________________________

You must meet the CEU requirements every three years; commencing January 1, 2006 or following appointment as a mediator to the court ADR panel.

Local Court Rules, Rule 3.201(c)(3) require mediation panel members to attend at least four hours of continuing education related to the practice of mediation. At least 2 hour(s) of that education or training must address

mediator ethics, fairness, and bias issues; 1 hour must address issues that may arise for mediators when parties are self-represented, and 1 hour must address general mediation issues (from the mediator’s perspective.)

Hours Meets this requirement MEDIATION MEDIATION Education Date
(per (please check one)
Trainer Course Title mm/dd/yy requirement) General SRL Ethics

AREAS OF EXPERTISE

Auto Tort Contract Provisionally Complex Civil Litigation Auto (Personal Injury) Breach of contract / warranty Antitrust / Trade regulation Uninsured motorist Collections (e.g., money owed, Construction defect open book accounts) Mass tort Other PI/PD/WD (Personal Injury/ Insurance coverage Securities litigation Property Damage/Wrongful Death) Tort Other contract Toxic / Environmental tort Asbestos Insurance coverage claims arising Product liability Real Property from the above listed provisionally Medical malpractice Eminent domain / inverse complex case types Other PI / PD / WD condemnation Wrongful eviction Enforcement of Judgment Non-PI/PD/WD (Other) Tort Other real property (e.g., quiet title) Enforcement of judgment Business tort/unfair business Unlawful Detainer practice Miscellaneous Civil Complaint Commercial Civil rights (e.g., discrimination, false RICO Residential arrest, disability) Other complaint (not listed above) Drugs Defamation (e.g., slander, libel) Fraud Judicial Review Miscellaneous Civil Petition Intellectual property Asset forfeiture Partnership and corporate Professional negligence (e.g., legal Petition re: arbitration award governance malpractice) Writ of mandate Other petition (not listed above) Other non-PI / PD / WD tort Other judicial review Miscellaneous Other Employment Other Elder Abuse Wrongful termination Probate / Will Contest / Family False Imprisonment Other employment Conservatorship of Estate Family Law Conservatorship of Person Lemon Law Guardianship of Estate Mechanics Lien Guardianship of Person Sexual Harassment Property or Tax Issues Trust Issues Will Contest

ADR-203 Rev. 10/14/16