Application to Appoint an Evaluator

1. First Party’s Details

Name:
Contact Person/Representative:
Address for Service of Notices and documents in relation to Early Neutral Evaluation:

Post Code:		Phone:
Fax:		Mobile:
Email:

2. Second Party’s Details

Name:
Contact Person/Representative:
Address for Service of Notices and documents in relation to Early Neutral Evaluation:

Post Code:		Phone:
Fax:		Mobile:
Email:

Add another Party

2a. Third Party’s Details

Name:
Contact Person/Representative:
Address for Service of Notices and documents in relation to Early Neutral Evaluation:

Post Code:		Phone:
Fax:		Mobile:
Email:

Add another Party

2b. Fourth Party’s Details

Name:
Contact Person/Representative:
Address for Service of Notices and documents in relation to Early Neutral Evaluation:

Post Code:		Phone:
Fax:		Mobile:
Email:

3. Applicant’s Details (Please complete only if different from First Party’s details)

Name:
Position/Role of the Applicant:
Address for Service of Notices and documents in relation to Early Neutral Evaluation:

Post Code:		Phone:
Fax:		Mobile:
Email:

4. Brief Description of the Nature of the Dispute

5. The Relief, Remedy, or Outcome that is sought

6. Agreement to Early Neutral Evaluation

A copy of the parties’ agreement to refer the dispute to Early Neutral Evaluation by an Evaluator appointed by the Tribunal is attached?

Yes No

7. Special Requests/Requirements of Early Neutral Evaluator

7.1 Please state any preferred expertise / knowledge / professional background (if any) of the person to be appointed as Evaluator:

7.2 Are the parties in agreement as to the preferred expertise?

Yes No

7.3 A copy of the document recording the parties’ agreement as to the Evaluator’s expertise is attached:

8. Panel of Evaluators

*Please advise whether the parties have reached agreement as to any person (or persons) on our Panel of Evaluators whom they wish to request the Tribunal to appoint as Evaluator in this matter (please note that the Tribunal will have regard to any such agreement but will not be bound by it, and any appointment will be at the sole discretion of the Registrar)

8.1 Are the parties in agreement as to whom they wish to act as Evaluator in this matter?

Yes No

8.2 Please name the person (or persons):

8.3 A copy of the document recording the parties’ agreement as to the Evaluator is attached:

9. Security Amount

Payment may be made by direct credit, cheque or credit card on the next page.

9.1 Please select Early Neutral Evaluation Code: (See Appendix 3 to the Agreement for Early Neutral Evaluation)

9.2 Please enter the amount in Dispute (inclusive of GST) (ie. Enter 98643.00 if the amount of your claim is $98,643.00)

Amount in Dispute: NZ$

Security Amount: NZ$

Calculate Security Amount

10. Agreement

I confirm that the information I have supplied is true and correct to the best of my knowledge and that I have read and accepted the terms and conditions of the Building Disputes Tribunal

Please print a copy of your application for your records

APPLICATION TOAPPOINT AN EVALUATOR

APPLICATION TO
APPOINT AN EVALUATOR