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COLUMBIA JUDICIAL CIRCUIT ALTERNATIVE DISPUTE RESOLUTION PROGRAM CASE NUMBER: CAPTION: COUNTY: JUDGE: AGREEMENT FORM We, the undersigned, having participated in a mediation session on (date), and being satisfied that the provisions of the resolution of our dispute are fair and reasonable, hereby agree to abide by and fulfill the following: If any party is unrepresented or is represented by an attorney who is not present, we, the undersigned parties, understand that we will have an opportunity to have this agreement reviewed by an attorney. If there is no objection to the agreement within 10 calendar days following the mediation session, the agreement will be binding upon all parties enforceable as a settlement agreement. If there is an objection, the attorney objecting to the mediated agreement must notify opposing counsel and the Columbia Judicial Circuit Alternative Dispute Resolution Case Manager in writing within 10 calendar days of the mediation session. Plaintiff Defendant Plaintiff Defendant Plaintiff’s Counsel Defendant’s Counsel Plaintiff’s Counsel Defendant’s Counsel Mediator Page of ---PAGE BREAK--- Plaintiff Defendant Plaintiff Defendant Plaintiff’s Counsel Defendant’s Counsel Plaintiff’s Counsel Defendant’s Counsel Mediator Page of