Medical dispute mediation agreement 15
In today's society, the frequency of the use of the agreement is on the rise, signed the agreement has a legal dependence. Then the format of the agreement, you mastered the following is my collection of mediation agreement on medical disputes, only for reference, I hope to be able to help you.
Medical Dispute Mediation Agreement 1
Name of the hospital: _______ hospital (Party A)
Head of the hospital: _______
The heirs of the deceased (Party B):
Agent of Party B:
Place of the agreement:
The deceased ______ in _____ ____ month _____ hospitalized in Party A due to illness, died suddenly on _____ ____ month ____ day, after Party B and Party A for the cause of death of the dispute, by mutual consent are willing to resolve the dispute through consultation; both parties in the spirit of voluntariness, equality, fairness, lawfulness, truthfulness and honesty, according to the relevant laws and regulations, after full consultation, now reach the following agreement by the two sides **** the same Compliance.
Article 1: The two parties do not object to the settlement of the medical dispute through independent negotiations.
Article 2: The hospital agreed to implement a one-time economic compensation to Party B: ___ (￥ _____ million), including the previously advanced ____ million. The above costs include death compensation, funeral expenses, moral consolation, dependent living expenses and all other compensation items stipulated by law.
Article 3: The medical party agrees to pay Party B a lump sum of _____ million yuan, the remaining amount stipulated in Article 2 of this Agreement, within the same day after the effective date of this Agreement.
Article 4: All expenses incurred by the deceased while hospitalized, such as medical and hospitalization fees, shall be borne by Party A, and those already paid by Party B shall be refunded by Party A. The medical party shall be responsible for all expenses incurred by the deceased while hospitalized.
Article 4: After the medical party pays all the money according to this agreement, all the disputes between the two parties caused by the deceased's medical problems will end, and Party B shall not claim the right from the medical party for any reason and in any way, otherwise Party B shall return all the money paid by the medical party unconditionally and shall not claim the right on the basis of this agreement.
Article 5: This agreement shall be executed in triplicate, one for each party and one for Party B's agent, and shall take effect from the date of signature or seal of both parties and Party B's agent.
Special agreement: if the heir of party B did not sign this agreement, there should be heir to party B agent authorized power of attorney, and party B agent promised to the authenticity of the signature of the principal on the power of attorney to assume legal responsibility, so that the cause of the dispute and then increase the party's losses by the agent of party B to compensate for the full amount of party B.
Article 5: This agreement is three copies of the two parties, one copy of which is signed by both parties and one copy of which is stamped.
Signature of the person in charge of the medical side:
Signature of the hospital: Signature of Party B: Signature of Party B's agent: Signature date: Month of the year
Mediation Agreement on Medical Disputes 2Party A: _____________ hospital
Party B: _______________
Risks are informed: the resolution of the dispute on medical malpractice, Three ways of medical disputes: First, the medical, the two sides of the patient to resolve their own consultations (encouragement to press this way to resolve), by the patient himself, the patient's death of his legal first heir or their written proxy to the medical side (the medical side of the medical representatives should be treated physicians, treated department director, the institution's medical department personnel) to put forward the views of the processing and explain the relevant reasons, the medical side agreed to the completion of the negotiations; the medical side disagrees with the medical side can be raised The medical side of the treatment opinion and explain the reasons, the affected party agrees to the completion of the consultation; the affected party does not agree with the new treatment opinion can be put forward and explain the reasons. During the period of medical, the affected party have the right to disagree to continue consultation, announced that the consultation fails, the other party can be dealt with in accordance with the other two ways. Second, according to the previous paragraph to apply for medical malpractice disputes. Third, directly to the people's court.
Given that the patient ________ had been treated in Party A from ____ ____ month ___ to ____ ___ month ___. A and B dispute over the patient's medical problems, but are willing to resolve through consultation; A and B in the spirit of equality, voluntariness, the principle of good faith, according to the "Regulations on the Treatment of Medical Accidents" and the relevant laws and regulations, after full consultation, up to the cost of the agreement is as follows, *** with the same to comply with the implementation.
Article I of this agreement related data are as follows:
A city of 200 × annual average wage of employees: ___________ yuan
A city of 200 × annual average cost of living of urban residents: _______________ yuan
A city of urban residents minimum subsistence allowance: ______________ Yuan
Article 2 Compensation Items and Calculation Methods
Article 3 Party A agrees to pay Party B the sums stipulated in Article 2 of this Agreement in one lump sum (or in installments) within _______ days after the effective date of this Agreement.
Article 4 After Party A pays all the money according to this agreement, all the disputes between Party A and Party B caused by the patient's medical problems will end, and Party B shall not claim the right from Party A for any reason and in any way, or else Party B shall unconditionally return all the money that Party A has paid, and shall not use this agreement as the basis for its claim.
Article V of this agreement in duplicate, Party A, Party B, each party to sign a copy, since the date of signature and seal (and notarized) by authorized representatives of both parties.
Party A: ______________ Party B _____________
Representative: _______________ Representative:______________
Date: ______________ Date: ______________
Medical Dispute Mediation Agreement 3Party A: ________ Hospital
Party B: ________
In view of the fact that the patient ________ had been treated at Party A from ____ ____ to ____ ____, Party A and Party B had a dispute over the patient's medical treatment, but both of them are willing to resolve the dispute through friendly consultation. In the spirit of equality, voluntariness, fairness, the principle of good faith, according to the "Regulations on the Treatment of Medical Accidents" and the provisions of relevant laws, with the participation of the Health Association, the two sides reached the following agreement, *** with the implementation of compliance.
I. Party B's basic information:
Name: _________
Gender: _____
Age: _____
ID card number: __________
II. Party A and Party B confirm the following basic facts:
III. Party A's entire treatment process All behaviors are in line with national laws and regulations and treatment routines, and Party B is aware of Party A's treatment plan and is willing to bear the corresponding risks on its own.
Fourth, taking into account the poor economic situation of Party B, Party A for humanitarian reasons to Party B for compensation as follows:
Give Party B a one-time compensation of 80,000 yuan, the compensation costs include:
Fifth, this agreement is the final solution to the dispute, in the Party in accordance with the agreement to pay all the money, the Party A, Party B due to the medical problems caused by all the disputes that are over, and you shall not have any reason for any other reason, and you shall not have any reason for any other reason. Party B shall not claim rights from Party A for any reason and in any way, otherwise Party B shall return all the money paid by Party A unconditionally, and shall not use this agreement as the basis for its rights.
Sixth, the two sides declare that Party A and Party B confirm that this agreement is based on equality and voluntariness of both parties after full consultation and communication, the content of the agreement has been fully understood.
VII, this agreement in duplicate, Party A, Party B, a copy, signed by both parties or stamped on the date of entry into force.
Party A: __________
Party B (or authorized agent): __________
Date: __________
Date: __________
Medical Dispute Mediation Agreement 4
Party A: ________ Hospital
Party B: ________
In view of the fact that the patient ________ had been treated at Party A from ____ to ____ on ____, both Party A and Party B had a dispute over the patient's medical treatment, but both of them are willing to resolve the dispute through friendly consultation. In the spirit of equality, voluntariness, fairness, the principle of good faith, according to the "Regulations on the Treatment of Medical Accidents" and the provisions of relevant laws, with the participation of the Health Association, the two sides reached the following agreement, *** with the implementation of compliance.
I. Party B's basic information:
Name: _________ Gender: _____ Age: _____ ID No.: __________
II. Party A and Party B confirm the following basic facts:
III. All the behaviors of Party A throughout the entire treatment process comply with the state's laws and regulations and treatment routines, and to the Party B is aware of Party A's treatment program and is willing to bear the corresponding risks.
Fourth, taking into account the poor economic situation of Party B, Party A for humanitarian reasons to Party B for compensation as follows:
To give Party B a one-time compensation of 80,000 yuan, the compensation costs include:
Fifth, this agreement is the final solution to the dispute, in the Party in accordance with the agreement to pay the full amount of money, the two sides due to the medical issue of all the disputes that will come to an end, and Party B shall not have any reason for any further disputes, and the two sides shall not have any reason for any further disputes. Party B shall not claim rights from Party A for any reason and in any way, otherwise Party B shall return all the money paid by Party A unconditionally, and shall not use this agreement as the basis for its rights.
Sixth, the two sides declare that Party A and Party B confirm that this agreement is based on equality and voluntariness of both parties after full consultation and communication, the content of the agreement has been fully understood.
VII, this agreement in duplicate, Party A, Party B, a copy, signed by both parties or stamped on the date of entry into force.
Party A: __________ Party B (or authorized agent): __________
Date: __________ Date: __________
Medical Dispute Mediation Agreement 5Name of the hospital: _______ Hospital (Party A), the person in charge of the hospital: _______
Deceased heir (Party B): Party B agent:
The deceased ______ in _____ ____ month _____ hospitalized in Party A due to illness, in _____ ____ month ____ suddenly died, after Party B and Party A for the cause of death of the dispute, the two sides agreed are willing to resolve the dispute through consultation; both sides in the spirit of voluntariness, equality, fairness, lawfulness, In the spirit of voluntary, equal, fair, legal, true and honest principle, according to the relevant laws and regulations, after full consultation, now reached the following agreement, by both parties *** with the implementation of compliance.
Article 1: The two parties have no objection to the settlement of the medical dispute through independent consultation.
Article 2: The hospital agrees to implement a one-time economic compensation to Party B: ___ (￥ _____ million), including the previously advanced ____ million. The above costs include death compensation, funeral expenses, moral consolation, dependent living expenses and all other compensation items stipulated by law.
Article 3: The medical party agrees to pay Party B a lump sum of _____ million yuan, the remaining amount stipulated in Article 2 of this Agreement, within the same day after the effective date of this Agreement.
Article 4: All expenses incurred by the deceased while hospitalized, such as medical and hospitalization fees, shall be borne by Party A, and those already paid by Party B shall be refunded by Party A. The medical party shall not be liable for any expenses incurred by the deceased while hospitalized.
Article 4: After the medical party pays all the money according to this agreement, all the disputes between the two parties caused by the deceased's medical problems will end, and Party B shall not claim the right from the medical party for any reason and in any way, otherwise Party B shall return all the money paid by the medical party unconditionally and shall not claim the right on the basis of this agreement.
Article 5: This agreement shall be signed in triplicate, one for each party and one for Party B's agent, and shall come into effect on the date of signing or sealing by both parties and Party B's agent.
Special agreement: If the heir of party B did not sign this agreement, there should be heir to party B's agent authorized power of attorney, and party B's agent promises to the authenticity of the principal's signature on the power of attorney to assume legal responsibility for the disputes arising from the cause of the increase in the party A's losses by party B's agent to compensate for the party A in full.
Signature of the person in charge of the medical party: Hospital Signature:
Signature of Party B: Signature of Party B's agent:
Signature Date: _________ Year ____ Month ____ Day
Medical Dispute Mediation Agreement 6Accident Time:
Year Month Day Time
Location of the accident:
City Road Party Situation Zhang San (pedestrian): name, gender, age, address, ID card, contact information Li Si (driver):
Accident: What year, what month, what day in what place due to what reason what traffic accidents, resulting in what consequences (the consequences should be as detailed as possible to describe). Both sides of the respective responsibility for how much. (For details, see the bus recognized word (200) No.) After mediation and negotiation, the two sides *** with the following agreement: the traffic accident caused by the pedestrian loss *** how much money, by Li Si when before a one-time compensation Zhang San.
Signature of the parties: month and year
Relevant legal knowledge:
The effectiveness of traffic accident mediation "Road Traffic Safety Law" Article 74 provides: "The dispute over compensation for damages in traffic accidents, the parties concerned may request the public security organs of the traffic management department to mediate, but also directly to the civil litigation. By the public security organs of the traffic management department mediation, the parties did not reach an agreement or mediation after the entry into force of the non-performance, the parties can to file a civil lawsuit." Visible, by the public security traffic management department mediation compensation, is not the settlement of traffic accident damages disputes must go through the procedure, also is not the litigation of the pre-procedure. Mediation agreement does not have the legal coercive force, rely on the two sides consciously fulfill, either party does not fulfill or incomplete fulfillment, the parties can to file a lawsuit. At the same time, according to "civil procedure law" article 207 and the highest "on the application of civil procedure law; a number of issues of opinion" article 254, article 256 of the provisions of the "legal instruments can apply for compulsory execution include: the occurrence of legally effective judgments, rulings, conciliations, orders to pay, and arbitration awards, debt instruments. And the conciliation refers to the effective conciliation by the production of the conciliation, and does not include the public security and traffic control department of the conciliation. In view of the above provisions, if the other party reverses the lawsuit to, you can submit the traffic accident mediation as evidence to, by the trial according to law. Settlement; A and B in the spirit of equality, voluntariness, the principle of good faith, according to the "Regulations on the Treatment of Medical Accidents" and related laws and regulations, after full consultation, up to the cost of the agreement is as follows, *** with the implementation of compliance.
The first agreement related data are as follows:
____ City 20 ____ annual average wage of employees: ____ yuan.
The average cost of living for urban residents in the City of ____ for the year 20____: ____.
____ City's minimum living allowance for urban residents: ____ yuan.
Article 2 Reimbursement Items and Calculation Methods(omitted)
Article 3 The Party agrees to pay to Party B the sums stipulated in Article 2 of this Agreement in one lump sum (or in installments) within ____ days after the effective date of this Agreement.
Article 4 After Party A pays all the money according to this agreement, all the disputes between Party A and Party B caused by the patient's medical problems will end, and Party B shall not claim the right from Party A for any reason and in any way, or else Party B shall return all the money paid by Party A unconditionally, and shall not use this agreement as the basis of its claim.
Article V agreement in duplicate, Party A, Party B, each party to sign a copy, since the date of signature and seal (and notarized) by authorized representatives of both parties.
Party A: __________ Hospital Party B: ________
Date: ________ Date: ________
Medical Dispute Mediation Agreement 8Party A (medical institution): __________;
Address: ________________
< p> Party B (patient): ________;Gender ____;
ID No.: ____________;
Address: ____________
Party B attended Party A's clinic on ____ on ____ due to ________, during which, due to Party A's During this period, Party A caused Party B's personal injury, which resulted in a dispute between Party A and Party B over medical compensation. Now Party A and Party B, in accordance with the principles of voluntariness, equality, fairness, lawfulness, truthfulness and honesty, and in accordance with the Regulations on the Handling of Medical Accidents and relevant laws and regulations, after full consultation, have reached the following agreement, which will be followed by Party A and Party B **** together. Article 1: A and B do not object to the independent negotiation to resolve the medical dispute.
Article 2: Party A agrees to pay Party B a one-time economic compensation: ￥ ________ (capitalized: RMB ________)
Article 3: Party A agrees to pay Party B a one-time payment as stipulated in Article 2 of the Agreement within ____ days after the effective date of this Agreement.
Article 4: After Party A pays all the money according to this agreement, all the disputes between Party A and Party B caused by the medical problems of Party B shall be ended, and Party B shall not claim the right from Party A for any reason and in any way, or Party B shall return all the money paid by Party A unconditionally, and shall not use this agreement as the basis of its claim.
Article 5: This agreement shall be signed in triplicate, one for each party, and the other one shall be submitted to the competent department of party A for record, and the agreement shall come into effect on the date of signing (or stamping) by the representatives of both parties.
Article 6: the agreement location ________.
Party A's representative (signature): ________
Party B's representative (signature): ________
____ year ____ month ____ day
_____ year ____ month ____ day
Medical Dispute Mediation Agreement 9Party A: _______________ Hospital Party B (the affected party): ____________ Basic information about the patient:
Name: ________ Gender: _______ Age: _______ Address: ______________________________
Hospitalization number: _______________________
Mediator: ______________ Law Firm Attorney: ______________________
Patient _______ was hospitalized in A on _____ ______ _______ with the diagnosis of (1) ___________ (2) ___________. Hospitalized for ____ days, the patient's treatment results: death, disability, improvement, recovery.
Party B believes ___________________ that Party A caused.
Party A believes _______________________________.
After mediation by the mediator, the two sides on the dispute voluntarily reached the following compensation agreement:
I. Party A and B agreed not to identify the cause of the dispute through the appraisal of the clear reasons and responsibilities of the case, to solve the problem by their own negotiation.
Second, Party A voluntarily compensated Party B for medical expenses, lost wages, hospital meal allowance, companion fee, disability living allowance, living expenses of dependents, continued treatment, death compensation, funeral expenses, moral damages and other **** counted ________.
Third, the compensation payment time: ____________________
Fourth, A and B waive all litigation rights based on the debt relationship.
V. ____________ (dead patients) stored in the morgue of the body must be ______ on _______ _______ from the hospital to dispose of their own.
VI. Liability for breach of contract: This agreement is a one-time treatment of the end, no party shall not renege. A party to renege, shall pay to the other party liquidated damages _________ dollars.
VII, this agreement by the A and B parties signed, stamped and entered into force. The text of the agreement in triplicate, A and B each party to implement a report _________ Health Bureau.
Party A: _______________ Party B: _______________ Mediator: ___ Law Firm Lawyer: ____________________ year _____ month _____ day
Medical Dispute Mediation Agreement 10Party A (medical institution):
Party B (patient) Party A (medical institution):
Gender:
Age:
ID card number:
Residential address:
Contact telephone number:
Party A and Party B on the patient (ID card number:)
on the month of January, 2012 due to the diagnosis and treatment of medical disputes occurring in the Party A during the outpatient (or inpatient) treatment, the two sides of the friendly consensus, voluntarily Reached the following agreement to *** with compliance.
1, after treatment:
2. Party A has informed Party B of the occurrence of medical disputes, its rights and all legal ways to resolve disputes, such as: *** with the commissioning of the local medical association for the technical appraisal of medical accidents, to the administrative department of health to apply for mediation, to the people's court to file a civil lawsuit, etc., but Party B voluntarily waive the right to enjoy the above on the medical dispute.
3. Amount of compensation and payment method:
Party A pays Party B a lump sum of RMB for the medical dispute
4. After the signing of the agreement between Party A and Party B, Party B will no longer put forward any request to Party A for any reason (including follow-up treatment, complications, etc.) for the medical dispute, or ask the third party to pursue Party A's responsibility.
5. This agreement is in two copies, one for each party and one for the patient, and one annex (for the authorization of the relationship between party B and the patient).
60. This agreement is effective from the date of signature and seal.
Party A: (seal)
Party B: (signature) (the patient himself)
Party A's representative: (signature)
(the patient's family)
Year month
year month
Medical Dispute Mediation Agreement 11
The applicant ****, female, *** October 15, born in Han ethnicity, ** city. She lives in ***.
Entrusted agent ***, male, born in December ***, Han nationality, ** city people, address as above, is the husband of the applicant.
Respondent a unit
Legal representative **, male, the head of the unit.
Entrusted agent ***, male, the hospital ** section chief, the agency authority for special authorization.
** City Medical Dispute Mediation Center (hereinafter referred to as the mediation center) on October 19, 20xx accepted the applicant ** and the respondent ** City Hospital medical dispute, according to law by the mediator ** presided over the ** participation in mediation. The applicant entrusted agent **, the respondent entrusted agent ** participated in the mediation. This case is now mediated.
Mediation identified: (a short description of the process of the condition and the hospital negotiation process), agreed to mediate in the mediation center.
In the mediation, the two sides in line with the principle of equality, voluntariness, mutual understanding and mutual accommodation, in accordance with the "People's Republic of China *** and the State People's Mediation Law," Article 3, the mediation, voluntarily reached the following agreement:
First, the applicant successive ** hospitalization costs *** counted ** yuan by the respondent.
Second, the respondent one-time compensation for the applicant's disability compensation, lost wages, nursing care, mental health care, treatment costs, living allowances, and other costs *** RMB *** (including the respondent's advance payment of medical expenses).
Third, the applicant voluntarily give up other requests, the two sides have no other disputes.
Fourth, after the mediation takes effect, all the disputes caused by the medical dispute will end, and the applicant shall not claim rights from the respondent for any reason or in any way.
V. This agreement shall enter into force on the date when it is signed or sealed by both parties, signed by the mediator and stamped with the seal of the Mediation Center, and shall be legally binding, and the parties shall fulfill it in accordance with the agreement.
Six, this agreement in three copies, the parties to one, the mediation center to retain a copy.
Signature of the applicant:
Signature of the respondent:
Mediator: Signature:
Medical Dispute Mediation Agreement 12Party A: _____ Hospital
Party B: ______ (the patient or his family members)
In view of the fact that Patient ___ had been hospitalized in Party A from _____ to _____. A and B dispute over the patient's medical problems, but are willing to resolve through consultation; therefore, A and B in the spirit of equality, voluntariness, the principle of good faith, according to the "Regulations on the Treatment of Medical Accidents" as well as the provisions of the relevant laws, after full consultation, up to the cost of the agreement is as follows, *** with the implementation of compliance.
Article 1 The relevant data of this agreement are as follows:
______ Average wage of employees: yuan
______ Average cost of living of urban residents: yuan
______ Minimum subsistence guarantee for urban residents: yuan
Article 2 Compensatory items and methods of calculation
Party A agrees to compensate Party B for the following amounts ： ______
Article 3 Party A agrees to pay Party B the sums stipulated in Article 2 of this Agreement in one lump sum (or in installments) within ___ days after the effective date of this Agreement.
Article 4 After Party A pays all the money according to this agreement, all the disputes between Party A and Party B caused by the patient's medical problems will end, and Party B shall not claim the right to Party A for any reason and in any way, or Party B shall return all the money paid by Party A unconditionally and shall not use this agreement as the basis of its claim.
Article V. This agreement shall be signed in duplicate by Party A and Party B, and shall enter into force on the date when it is signed and sealed (and notarized) by the authorized representatives of both parties.
Medical Dispute Mediation Agreement 13Party A (medical institution): __________; address: ________________
Party B (patient):________; gender ____; ID card number: ____________; address: ____________
Party B on ____ in ____ month ____ day due to ________ in Party A clinic, during which, due to Party A's reasons caused Party B personal injury, and thus Party A and Party B dispute over medical compensation. Now Party A and Party B in the spirit of voluntariness, equality, fairness, lawfulness, truthfulness and the principle of honesty and credit, according to the "Regulations on the Treatment of Medical Accidents" and relevant laws and regulations, after full consultation, now reach the following agreement, by Party A and Party B **** with the implementation of the same. Article 1: A and B do not object to the independent negotiation to resolve the medical dispute.
Article 2: Party A agrees to pay Party B a one-time economic compensation: ￥ ________ (capitalized: RMB ________)
Article 3: Party A agrees to pay Party B a one-time payment as stipulated in Article 2 of the Agreement within ____ days after the effective date of this Agreement.
Article 4: After Party A pays all the money according to this agreement, all the disputes between Party A and Party B caused by the medical problems of Party B shall be ended, and Party B shall not claim the right from Party A for any reason and in any way, or Party B shall return all the money paid by Party A unconditionally, and shall not use this agreement as the basis of its claim.
Article 5: This agreement shall be signed in triplicate, one for each party, and the other one shall be submitted to the competent department of party A for record, and the agreement shall come into effect on the date of signing (or stamping) by the representatives of both parties.
Article 6: the agreement location ________.
Party A's representative (signature): ________ Party B's representative (signature): ________
____ year ____ month ____ day _____ year ____ month ____ day
Medical Dispute Mediation Agreement 14Party A: Beijing __x Hospital
Party B: __x
In view of the patient __x had in 2014 x month x day to 2014 x month x day in the A side of the treatment, A, B parties due to the patient's medical treatment of unavoidable emergencies medical disputes, for the problem caused by the causes of the dispute, can not identify their respective responsibilities, but are willing to negotiate a solution; A, B parties in the spirit of equality, voluntariness, the principle of good faith, in accordance with the "Regulations on the Treatment of Medical Accidents and related laws and regulations, after full consultation with the immediate family, to reach this agreement as follows, both sides are willing to *** with the implementation.
Article 1 According to the data provided by the authority, the data related to this agreement are as follows:
The average salary of workers in a city in 2013: ___ yuan.
The average cost of living of urban residents in a certain city in the year 2013: __ dollars.
The minimum subsistence allowance for urban residents in a certain city: __ yuan.
Article 2 Compensation Items and Calculation Methods(omitted)
Article 3 Party A agrees to pay Party B the sums stipulated in Article 2 of this Agreement in a lump sum (or in installments) within x days after the effective date of this Agreement.
Article 4 After Party A pays all the money according to this agreement, all the disputes between Party A and Party B caused by the patient's medical problems will end, and Party B shall not claim the right from Party A for any reason and in any way, or Party B shall unconditionally return all the money that Party A has paid and shall not use this agreement as the basis for its claim.
Article V. This agreement is in duplicate, A, B each party, from the date of signature and seal of the authorized representatives of both parties (and notarized).
Party A: Beijing __x hospital (seal) B ID card number:
A representative signature: B signature:
Date: date:
Medical dispute mediation agreement 15Party A: ___ City, ___ City Trade Company
Address: ___ City, ___ Province, ___ Road, ___ No.
Legal representative: Wang ___, Manager
The legal representative: ___. Position: Manager
Party B: No. ___ Road, ___ County, ___ Province
Legal representative: Yu ___ Position: Manager
The parties voluntarily submit to the ___ Municipal Arbitration Commission to arbitrate the following disputes in accordance with the provisions of the "Arbitration Law of the People's Republic of China*** and the State of China"
The two parties signed a contract for the purchase and sale of fresh mushrooms in March, 20xx.
In the fulfillment of the contract, the buyer objected to the quality level of fresh mushrooms provided by the seller, resulting in a dispute between the two parties, which could not be negotiated.
The two sides agreed to choose the __ Municipal Arbitration Commission in accordance with the "Arbitration Law of the People's Republic of China" and the arbitration rules of the arbitration rules of the two sides of the contract involving the quality level of mushrooms and how to continue to fulfill the contract to make a decision.
Party A: ___ Trading Company (seal) Party B: ___ County ___ Company (seal)
Legal Representative: Wang ___ Legal Representative: Yu ___
Note:
Arbitration Agreement is a document concluded between two parties to indicate that they voluntarily submit to an arbitration institution contractual disputes and other disputes over property rights and interests that they have incurred or are likely to incur and can be resolved by arbitration in accordance with the law. Disputes over contractual and other property rights and interests, submitted to an arbitration institution for judgment and decision.
According to Article 21 of the Arbitration Law, parties applying for arbitration must conclude an arbitration agreement.
The arbitration agreement is a form of arbitration agreement.
Arbitration agreement is both the parties to the dispute request for arbitration of the written expression of meaning, but also the arbitration institution to resolve the dispute issues of the prerequisites.
Writing points
The first part:
1, title.
Centered: "Arbitration Agreement".
2. Brief description of the parties.
The parties are individuals, write a brief description of the individual, including name, gender, date of birth, occupation, work unit and position, address; is a legal person or other organization, write the name of the legal person or organization, premises, and separately write the name of the legal representative or person in charge of, premises, and separately write the name of the legal representative or person in charge of, and positions.
Designation, the parties can be used in the original contract title, can also be mainly re-labeled A B C D parties called.
Full text:
Full text focuses on the content of the arbitration clause, according to the "Arbitration Law," Article 16, paragraph 2, has the following three: one is the request for arbitration of the meaning of the expression; two is the arbitration matters; three is the selected arbitration committee,
Tail:
1, the two parties or parties to the signatures and seals.
2. Date of conclusion of the agreement.