Mediation Application Form

The Dispute

Please indicate the type of dispute(Required)

Dispute over an amount of money only

Dispute over rights and obligations only

Dispute over an amount of money, rights and obligations

Amount in Dispute

Please enter the amount in dispute in NZD (inclusive of GST, value added tax, or any other similar tax which might apply). In calculating the amount in dispute, interest will not be taken into account unless the interest claimed by a Party exceeds the aggregate principal amount, in which case enter the value of the interest claim alone.

A Preliminary Payment fee is required as security for a Mediation of up to 8.0 hours per day. Payment instructions are included at the end of this application form.

$10,000

Please briefly describe the nature of the dispute(Required)

Applicant's Details

In which capacity is this Applicant acting?(Required)

As an individual(s) in their personal capacity

As a company or incorporated society

As an individual(s) in their capacity as a trustee of a trust

Applicant's Full Legal Name

First Last

Full Name of the Applicant's Company

Full Legal Names of all Trustees of the Trust

If more than one, please type the names separated with commas

Name of the Trust

Is this Applicant represented?(Required)

For the purpose of serving and receiving notices during the mediation process, please indicate if the applicant is self represented. If not, we will require you to provide the contact details of the person who is representing the applicant for the purpose of this mediation.

Self represented

Represented by a person authorised to act on the party's behalf

Phone Number

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Email Address

Representative's Full Legal Name

First Last

Phone number of representative

Address for service of representative

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Email address of representative

If someone else needs to receive communications on behalf of the party, please specify how many people

Enter additional email address here

Enter second additional email address here

Enter third additional email address here

Enter other additional email address/es here

If more than one, please separate addresses using commas

The Other Party's Details

In which capacity is the other Party acting?(Required)

As an individual(s) in their personal capacity

As a company or incorporated society

As an individual(s) in their capacity as a trustee of a trust

The Other Party's Full Legal Name

First Last

Full Name of the Other Party's Company

Full Legal Names of all Trustees of the Trust

If more than one, please type the names separated with commas

Name of the Trust

Is the Other Party represented?(Required)

Self represented

Represented by a person authorised to act on behalf of the respondent's behalf

The Other Party's phone number

The Other Party's address for service

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

The Other Party's email address

The Other Party's Representative's Full Legal Name

First Last

Address for service of The Other Party's representative

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Email address of The Other Party's representative

If someone else needs to receive communications on behalf of the Other Party, please specify how many people

Enter additional email address here

Enter second additional email address here

Enter third additional email address here

Enter other additional email address/es here

If more than one, please separate addresses using commas

The Mediator

Have the Parties agreed on a nominee to act as Mediator?(Required)

Yes

Is the Parties' nominee currently on the Panel of Building Disputes Tribunal?

Yes

Mediator's Full Legal Name

First Last

Company Name

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

If the parties have agreed on a preferred date or range of dates for the Mediation session to be scheduled, please specify them below

If the parties have agreed on a venue for the Mediation, please provide any details below

Preliminary Payment Required

When you click "Submit", you will be re-directed to the security payment options. If you wish to pay later, just select Direct Debit as your payment method.

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Overview of CCA Adjudication

Initiating CCA Adjudication

Cost of CCA Adjudication

CCA Adjudication Guides and Resources

Overview of Arbitration

Initiating Arbitration

Arbitration Model Clause

Arbitration Rules

Cost of Arbitration

Arbitration Guides and Resources

Overview of Mediation

Initiating Mediation

Mediation Model Clause

Mediation Rules

Mediation Protocol

Cost of Mediation

Mediation Guides and Resources

Overview of Arb-Med

Initiating Arb-Med

Arb-Med Model Clause

Arb-Med Rules

Cost of Arb-Med

Arb-Med Guides and Resources

Overview of Contractual Adjudication

Initiating Contractual Adjudication

Contractual Adjudication Model Clause

Contractual Adjudication Rules

Cost of Contractual Adjudication

Overview of Expert Determination

Initiating Expert Determination

Expert Determination Rules

Cost of Expert Determination

Expert Determination Guides and Resources

Painting Disputes

Plumbing Disputes

Building Disputes

Concrete Disputes

Joinery Disputes

Design Work Disputes

Engineering Disputes

Flooring Disputes

Electrical Disputes

Landscaping Disputes

QS Disputes

Drainage Disputes

Tiling Disputes

Roofing Disputes

Waterproofing Disputes

Apply online below to get the process started

The Dispute

The Parties

Applicant's Details

The Other Party's Details

The Agreement to Mediate

The Mediator

Mediation Application Form