FORMS

GMXC SUBMISSION AGREEMENT

For Arbitration/Mediation For Disputes With No Pending litigation or arbitration

__________________________________________________

__________________________________________________,

Claimants

and

___________________________________________________

___________________________________________________’

Respondents

We hereby agree to submit all disputes relating to the Agreement between the parties dated ___________(attached) to arbitration/mediation in accordance with the Rules of the Global Exchange Mediation Center (GXMC) and with New Jersey New Jersey International Arbitration, Mediation, and Conciliation Act, NJ Stat. Ch. 2A:23E-2. We have attached a list and short description of the claims [and counterclaims] to this submission agreement.

We further agree that the above dispute shall be submitted to a sole arbitrator/mediator/arbitrator appointed by GXMC. We understand and agree that the arbitrator will act as a mediator and may conduct ex parte meetings with the parties (caucuses) and we incorporate in this submission agreement the GMXC Rules. We further agree that in the event that a mediated agreement is reached by the parties, the arbitrator shall complete a Consent Award enforceable under Ch. 2A: 23E-2 and the New York Convention that we shall faithfully observe this agreement and the Rules and that we shall abide by and perform any award rendered by the arbitrator. Judgment upon the award may be entered by any court having jurisdiction thereof. The seat of the arbitration shall be Jersey City, New Jersey. The language of the arbitration shall be English.

IT IS ACKNOWLEDGED, UNDERSTOOD AND AGREED THAT THE PARTIES WAIVE TO THE FULLEST EXTENT PERMITTED BY LAW, ANY RIGHT THEY MAY HAVE TO A TRIAL BY JUDGE OR JURY IN ANY LEGAL PROCEEDING DIRECTLY OR INDIRECTLY ARISING OUT OF OR RELATING TO THIS AGREEMENT, WHETHER BASED IN CONTRACT, TORT, STATUTE, CIVIL LAW, COMMON LAW, OR ANY OTHER LEGAL THEORY.

IT IS FUTHER ACKNOWLEDGED, UNDERSTOOD AND AGREED THAT ANY ARBITRATION WILL BE FINAL AND BINDING AND THAT BY AGREEING TO ARBITRATION, THE PARTIES ARE WAIVING THEIR RESPECTIVE RIGHTS TO SEEK ANY

FORM A

REMEDIES IN COURT OR JUDICIAL FORUM, INCLUDING THE RIGHT TO A TRIAL BY A JUDGE OR JURY AND INCLUDING INJUNCTIVE AND ANY AND ALL OTHER RELIEF.

THE ARBITRATOR’S AWARD IS NOT REQUIRED TO INCLUDE FACTUAL FINDINGS OR LEGAL REASONING AND ANY PARTY’S RIGHT TO APPEAL OR VACATE, OR SEEK MODIFICATION OF THE ARBITRATION AWARD IS STRICTLY LIMITED BY LAW.

In the event that no Consent Award is entered within 90 days of the appointment of the arbitrator/mediator/arbitrator or if the Consent Award does not resolve all disputes between the parties as set forth in the claims and counterclaims attached hereto, the parties agree that any of the unresolved claims or counterclaims shall be finally resolved by the arbitration[s] in accordance with the [International Dispute Resolution Procedures Commercial Arbitration Rules (AAA)] or the [International Institute for Conflict Prevention and Resolution (“CPR”) Rules for Administered Arbitration of International Disputes] [currently in effect OR in effect on the date of this Agreement], by [a sole arbitrator] [three arbitrators, of whom each party shall designate one, with the third arbitrator to be appointed by [AAA/ICDR or CPR] [three arbitrators, of whom each party shall designate one, with the third arbitrator to be designated by the two party-appointed arbitrators] [three arbitrators, none of whom shall be designated by either party]; Judgment upon the award rendered by the arbitrator(s) may be entered by any court having jurisdiction thereof. The seat of the arbitration shall be [city , country ]. The language of the arbitration shall be [ ].

To be completed and signed by all parties

Name of Party ________________________________________________

Address, City, State/Province, Country, Postal Code:

_____________________________________________________________

Telephone _______________________________

Facsimile ________________________________

E-Mail ________________________________

Name of Party’s Attorney or Representative________________________

Name of Firm (if applicable)______________________________________

Address, City, State/Province, Country, Postal Code:

______________________________________________________________

FORM A

Telephone ________________________________

Facsimile ________________________________

E-Mail ________________________________

Signed (may be signed by a representative)

__________________________________________

Title Date

Name of Party ________________________________________________

Address, City, State/Province, Country, Postal Code:

_____________________________________________________________

Telephone ________________________________

Facsimile ________________________________

E-Mail ________________________________

Name of Party’s Attorney or Representative________________________

Name of Firm (if applicable)_____________________________________

Address, City, State/Province, Country, Postal Code:

_____________________________________________________________

______________________________________________________________

Telephone ________________________________

Facsimile ________________________________

E-Mail ________________________________

Signed (may be signed by a representative)

__________________________________________

Title Date

FORM A

GMXC SUBMISSION AGREEMENT

For Arbitration/Mediation For Disputes With Pending Litigation Or Arbitration

We,

__________________________________________________

__________________________________________________,

Claimants

and

___________________________________________________

___________________________________________________’

Respondents

are party to an existing dispute pending before _____________________________[Court or arbitral administrative authority] Case No. _______________________________________.

We hereby agree to submit to this dispute (as further described in the attached claims and answers) to arbitration/mediation/arbitration in accordance with the Rules of the Global Exchange Mediation Center (GMXC) and with New Jersey New Jersey International Arbitration, Mediation, and Conciliation Act, NJ Stat. Ch. 2A:23E-2.

We further agree that the above dispute shall be submitted to a sole arbitrator/mediator/arbitrator appointed by GMXC. We understand and agree that the arbitrator will act as a mediator and may conduct ex parte meetings with the parties (caucuses) and we incorporate in this submission agreement the GMXC Rules. We further agree that in the event that a mediated agreement is reached by the parties, the arbitrator shall complete a Consent Award enforceable under Ch. 2A: 23E-2 and the New York Convention that we shall faithfully observe this agreement and the Rules and that we shall abide by and perform any award rendered by the arbitrator. Judgment upon the Award may be entered by any court having jurisdiction thereof. The seat of the arbitration shall be Jersey City, New Jersey. The language of the arbitration shall be English.

FORM B

IT IS FUTHER ACKNOWLEDGED, UNDERSTOOD AND AGREED THAT ANY ARBITRATION WILL BE FINAL AND BINDING AND THAT BY AGREEING TO ARBITRATION, THE PARTIES ARE WAIVING THEIR RESPECTIVE RIGHTS TO SEEK ANY REMEDIES IN COURT OR JUDICIAL FORUM, INCLUDING THE RIGHT TO A TRIAL BY A JUDGE OR JURY AND INCLUDING INJUNCTIVE AND ANY AND ALL OTHER RELIEF.

In the event that no consent award is entered within 90 days of the appointment of the arbitrator/mediator or if the consent award does not resolve all disputes between the parties as set forth in the claims and counterclaims attached hereto, the parties agree that any of the unresolved claims or counterclaims shall be finally resolved by [the arbitrator[s] in the pending arbitration] arbitration in accordance with the [AAA/ICDR Rules] or the [International Institute for Conflict Prevention and Resolution (“CPR”) Rules for Administered Arbitration of International Disputes] [currently in effect OR in effect on the date of this Agreement], by [a sole arbitrator] [three arbitrators, of whom each party shall designate one, with the third arbitrator to be appointed by [AAA/ICDR or CPR] [three arbitrators, of whom each party shall designate one, with the third arbitrator to be designated by the two party-appointed arbitrators] [three arbitrators, none of whom shall be designated by either party]; Judgment upon the award rendered by the arbitrator(s) may be entered by any court having jurisdiction thereof. The seat of the arbitration shall be (city, country). The language of the arbitration shall be (language).

To be completed and signed by all parties

Name of Party ________________________________________________

Address, City, State/Province, Country, Postal Code:

_____________________________________________________________

Telephone ________________________________

Facsimile ________________________________

E-Mail _________________________________

Name of Party’s Attorney or Representative________________________

Name of Firm (if applicable)______________________________________

FORM B

Address, City, State/Province, Country, Postal Code:

______________________________________________________________

Telephone _______________________________

Facsimile ________________________________

E-Mail ________________________________

Signed (may be signed by a representative)

__________________________________________

Title Date

Name of Party ________________________________________________

Address, City, State/Province, Country, Postal Code:

_____________________________________________________________

Telephone ________________________________

Facsimile _________________________________

E-Mail ___________________________________

Name of Party’s Attorney or Representative________________________

Name of Firm (if applicable)______________________________________

Address, City, State/Province, Country, Postal Code:

______________________________________________________________

Telephone ________________________________

Facsimile _________________________________

E-Mail _________________________________

Signed (may be signed by a representative)

__________________________________________

Title Date

FORM B

GMXC INTAKE FORM

To: Name(s) (of the party on which the request is to be served):·

Nationality:

Address:

Contact Information:

Name of Representative: (if known)

Name of Firm: (if applicable)

Address:

Contact Information:

The undersigned party to an agreement contained in a written contract, dated providing for mediation under the

D International Dispute Resolution Procedures

D Commercial Arbitration Rules and Mediation Procedures (AAA)

D Other (please specify):

hereby requests mediation.

Nature of the Dispute: (attach additional sheets, if necessary)

Name of Filing Party:

Nationality:

Address:

Contact Information:

Name of Representative: (if known)

Name of Firm: (if applicable)

Address:

Contact Information:

You are hereby notified that copies of our Mediation Agreement and this request are being filed with the Global Mediation Exchange Center, 30 Montgomery Street, Suite 990, Jersey City, New Jersey 07302, e-maiI:

To begin proceedings, please send two copies of this request and the Mediation Agreement, with the filing fee as provided for in the rules, to the GMXC. Send the original request to the responding party.

________________________________________________________________________________________________________________________________

Fees: $4,250 is payable in advance at the time of application by way of check or PayPal . This amount includes all fees and costs incurred including preparation time through a one day proceeding. If additional days are agreed to, the Neutral Panelist’s hourly rate will be charged.

Signature: (may be signed by a representative)

Title :

Date:

GLOBAL MEDIATION EXCHANGE CENTER

GMXC INTAKE FORM

If you have any questions, please contact the Global Mediation Exchange Center by email: info@gmxcmediation.com