Santa Clara — CV-5062*

Source: https://santaclara.courts.ca.gov/system/files/forms/cv-5062.pdf

SUPERIOR COURT OF CALIFORNIA COUNTY OF SANTA CLARA CIVIL ARBITRATION Please note that all forms must be typed & E-Filed. From:

Law Firm/ Payable To:

Address: Phone #: -

To: Arbitration Office

Re: ARBITRATION CIVIL EARLY SETTLEMENT CONFERENCE

INVOICE AMOUNT: $150.00

Services Rendered For:

Case Name:

Case Number:

ADR Stipulation and Order (form CV-5008) Filed:

The hearing commenced on: and took Day(s)

Award was Rendered on Case Settled on

Notice of Settlement filed on Case Did not Settle

Vendor#: Claimant Signature Claimant Date

Approved By Approve Date:

A vendor number is required to process your payment. It is located on the top left-hand corner of the check stub if you have previously been paid by the Court. If you do not have a vendor number, you must submit a W-9 form so that one can be requested. If the Court doesn’t have a vendor number or W-9 form, your payment will be delayed until one is received.

(FOR ACCOUNTING ONLY)

GL ACCOUNT: 939102 COST CENTER: 434102 FA: 1220 FUND: 110001

CV-5062 REV 01/23/2023 Acctg. Proc. K 13.0