APPLICATION FOR THE (A) THE APPOINTMENT OF A CONCILIATOR [ ] (B) THE APPOINTMENT OF A MEDIATOR [ ]

Transcription

1 APPLICATION FOR THE (A) THE APPOINTMENT OF A CONCILIATOR [ ] OR (B) THE APPOINTMENT OF A MEDIATOR [ ] BY THE PRESIDENT OF THE SOCIETY OF CHARTERED SURVEYORS IRELAND IN RESPECT OF A CONSTRUCTION OR RELATED DISPUTE Office Use Reference No: Please complete in full; ticking boxes as appropriate. I/We Address acting as Principal/Authorised Agent hereby request the President of The Society of Chartered Surveyors Ireland to appoint/nominate an Arbitrator/Expert to act in the case details of which are set out below.

2 SECTION 1 RELEVANT DISPUTE REFERENCE CLAUSE/AGREEMENT The Society requests that you attach a copy of the relevant dispute resolution clause or agreement between the parties referring the appointment to the President of the Society of Chartered Surveyors Ireland. Has this been attached: (b) Is there a requirement in the dispute resolution clause/agreement to refer the dispute at first instance to other dispute processes such as mediation or other forms? (c) Have procedures as specified been complied with in accordance with the dispute resolution clause/agreement between the parties? SECTION 2 ISSUE IN DISPUTE Are there any issues in dispute that are likely to be raised, including any counterclaim? If yes, please give details:

3 SECTION 3 CURRENT PARTIES TO THE DISPUTE Name, address and contact number of First Disputant: Employer [ ] Client [ ] Main Contractor [ ] (b) Name, address and contact number of Second Disputant: Main Contractor [ ] Professional Consultant [ ] Sub Contractor[ ] (c) Name, address and contact number of any other Party who has agreed to be joined as a defendant to the dispute:

4 SECTION 4 RELEVANT CONTRACT DETAILS Address or detailed location of works which are the subject of the contract: (b) Type of contract: [ ] RIAI with quantities [ ] RIAI without quantities [ ] Public Works contract Employer Design [ ] Public Works contract Contractor Design [ ] Sub contract-standard CIF forms [ ] Professional Consultant appointments [ ] Other standard contract ; name: [ ] Non standard contract-give details: (c) Type of construction works: [ ] Building work [ ] Civil works [ ] Mechanical and/or electrical services [ ] Process Engineering [ ] Fee dispute [ ] Other type -please describe:

5 (d) Contract value: (e) Name, address of nominated architect/engineer/employer s representative appointed to administer the contract: (f) Name and address of Quantity surveyor nominated to the contract: (g) Name and address of legal representative of First Disputant (if relevant): (h) Name and address of legal representative of Second Disputant (if relevant):

6 SECTION 5 - VALUERS In order to avoid possible conflict of interest please state the names of any individuals considered unsuitable for this appointment on the grounds that their appointment would raise a real possibility of bias in the eyes of a reasonably minded person because of a present or previous connection with either party or with the subject contract. NAME: DETAILED REASON MUST BE STATED: SECTION 6 GENERAL/DECLARATION BY APPLICANT**: I/We undertake to be responsible for payment of the proper fees and costs of the person appointed. This undertaking is without prejudice to any right to recover all or part of such fees or costs from the other party to the dispute as I/we may have, pursuant to the provisions of the contract. I/We enclose a certified copy of the contract as executed (if existing). I/We enclose evidence of contract if no executed contract exists. I/We confirm payment of which is to cover administrative costs and is nonrefundable. ( in respect of each lease) by EFT to SCSI at Bank of Ireland Sort Code A/c IBAN: IE63 BOFI BIC: BOFIIE2D Lower Baggot St Branch, D2. The applicant is personally to confirm the following: I have read the subject reference and the application that is being made herewith is in accordance with the subject dispute resolution clause or agreement and I undertake and acknowledge that if there are any errors made on my part in relation to the completion of the form applying to the President of The Society of Chartered Surveyors Ireland for the appointment of an Arbitrator/Independent Expert, that I will be fully responsible for acknowledging any such errors and that any such mistakes on my part may lead to a fresh application being made to the President with all the associated costs and otherwise being incurred by the applicant.

7 Signed: Date: **Please note that the above declaration must be completed in all cases** Please return form to: Disputes Resolution The Society of Chartered Surveyors Ireland 38 Merrion Square Dublin 2 Tel: CHECK LIST APPLICANT SCS Contract enclosed [ ] [ ] Fee attached [ ] [ ] Confirmation that there is no [ ] [ ] alteration to the application form Confirmation that declaration of [ ] [ ] responsibility for correctness of information provided is signed