Stanislaus — Mediator’s Fee Statement and Order for Payment of the Fee

Source: https://www.stanislaus.courts.ca.gov/system/files/250-mediators-fee-statement-and-order-payment-fee-323.pdf

STAN-250

(Mediator’s Name, Law firm, Address, and phone number)

E-MAIL ADDRESS (Optional):

MEDIATOR’S FEE STATEMENT AND ORDER FOR PAYMENT OF THE FEE

SUPERIOR COURT OF CALIFORNIA, STANISLAUS COUNTY
ADDRESS: 801 10th STREET 4TH FLOOR
CITY AND ZIP CODE: MODESTO, CA 95354

BRANCH NAME: MODESTO

Plaintiff, CASE NUMBER:

vs. MEDIATOR’S FEE STATEMENT AND ORDER FOR PAYMENT OF THE FEE Defendant.

Date of Mediation: ______________________

Time Spent on Mediation (to the nearest quarter hour): ________________________________

Date of Filing the Mediator’s Report: ______________________________________________

Mediator’s Signature: _________________________________ Date:__________________

ORDER FOR PAYMENT OF FEES

The Court is hereby ordered to draw his warrant in favor of the firm name _____________________________

for the sum of $400.00 for fee incurred while serving as a mediator for the Superior Court of the State of California

in the County of Stanislaus.

The box below is for court use only. Vendor Name: Vendor Number:

Trust Number ___________Amt. Trust Number ___________Amt.

Cost Functional Case Name

Amount Account Fund Center Area

938401 502233 1220 120001

Date Authorized Departmental Signature Approved/Posted by Date

July 1, 2006 MEDIATOR’S FEE STATEMENT AND ORDER FOR PAYMENT OF THE FEE