Form 9 – RESPONSE TO NOMINATION TO SERVE AS MEDIATOR/CONCILIATOR/FACILITATOR/NEUTRAL EVALUATOR/EXPERT DETERMINATOR/ADJUDICATOR/ARBITRATOR

I confirm, based on the information available to me at the time of this response, that I can commit the time necessary to conduct this [matter] for the entire duration of the [dispute/case] as diligently, efficiently and expeditiously as possible in accordance with the time limits [in the law/rules/agreement, subject to any extensions granted by a competent court, pursuant to [the law/rules/agreement]. I understand that it is important that the matter be completed as promptly as is reasonably practicable and [that the duration may/will be considered when my fees are determined by the JAIAC]. My current professional engagements are set out below and I declare that my acceptance of this nomination will not be in conflict with any of my other current professional engagements.

Number of currently pending cases in which I am involved (i.e. arbitrations and activities pending now, not previous experience; additional details you wish to make known to the JAIAC and to the parties in relation to these matters can be provided on a separate sheet):

(Tick one box and provide the details below and/or, if necessary, on a separate sheet)

In considering which box to tick, you should determine whether there exist any past or present relation, direct or indirect, whether financial, professional or of any other kind, between you and any of the parties, their lawyers or other representatives, or related entities of individuals. Any doubts must be resolved in favour of disclosure. Any disclosure should be complete and specific, identifying relevant dates (both start and end dates), financial arrangements, details of companies and individuals, and all other relevant information. You should also consider any notes of evidence or other information about the parties hereunder and the dispute, that may be available to you at the time of disclosure.

I am independent and impartial, and intend to remain so. To the best of my knowledge, information and belief, and having made due enquiry, there are no facts or circumstances, past or present, that I should disclose because they might be of such a nature as to call into question my independence and/or impartiality. I further declare that currently, there are no circumstances that could give rise to reasonable doubts as to my independence and/or impartiality.

I am independent and impartial and intend to remain so. However, being cognizant of my obligation to disclose any facts or circumstances which might be of such a nature as to call into question my independence and/or impartiality or give rise to reasonable doubts as to my independence and/or impartiality, I disclose the matters listed below and/or detailed in the attached [Disclosure sheet].

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