Notice of Arbitration

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ADR CHAMBERS
NOTICE OF ARBITRATION


Please complete this form after reviewing Rule 3.1 of the ADR Chambers Arbitration Rules.

Return the completed form with the non-refundable filing fee of $500 to:

ADR Chambers
180 Duncan Mill Road, 4th Floor
Toronto, ON M3B 1Z6



Claimant

-and-


Respondent


Date

Claimant’s Representative or Claimant






TO: Respondent’s Representative or Respondent






AND TO: ADR Chambers
180 Duncan Mill Road, 4th Floor
Toronto, ON M3B 1Z6

NOTICE OF ARBITRATION

TO THE RESPONDENT:

The Claimant hereby gives notice to the Respondent of its intention to commence arbitration proceedings pursuant to the following arbitration clause or agreement or contract:





NATURE OF THE DISPUTE AND MATERIAL FACTS BEING RELIED ON:









ISSUES:









BASIS UPON WHICH ADR CHAMBERS HAS JURISDICTION TO DETERMINE DISPUTE:









REFLIEF CLAIMED:









PROPOSALS AS TO NUMBER OF ARBITRATORS, MEANS OF CONSTITUTING ARBITRAL TRIBUNAL, PLACE OF ARBITRATION, AND LANGUAGE OF ARBITRATION: