MEDIATION BILLING REPORT

MEDIATOR

CASE STYLE

DATE OF SESSION

YYYY

RESULTS OF MEDIATION

Settled

Did Not Settle

Partial Settlement

Pending

Mediator Proposal Deadline (if applicable)

YYYY

Parties Requesting Second Session -- Possible Scheduling Dates (if applicable)

BILLING PARTY CHANGES?

During the mediation, was there an agreement to change the responsible parties?

YES

If yes, please state billing changes

CLIENT BILLING

MATERIAL REVIEW (hours)

MEDIATION SESSION (hours)

Additional Billing Time & Explanation (if applicable)

TRAVEL BILLING (if applicable)

Travel Time (hours)

Total Mileage

Tolls ($)

Additional Travel Expenses ($)

ADDITIONAL COMMENTS?

Thank you! Please call the office (918-382-0300) or email Angel (Angel@drc-ok.com) if you think of any additional billing information.