Report And Award Of Arbitrators {30-210}

First Judicial District of Pennsylvania Philadelphia Court of Common Pleas (Month) Term, (Year) , (No.) Arbitration (Please indicate type of action) Motor Vehicle (Date of Accident) Versus Delay Damages (Prime Rate +1) Contract Delay Damages (Legal Rate = 6%) Assessment of Damages Other Report and Award of Arbitrators And Now, this day of , Year tors having been duly appointed and sworn, make the following award: , we the undersigned arbitra- Please name the parties if there are more than one plaintiff and/or defendant. Please address all counterclaims and cross claims. Please complete percentage of negligence on reverse side if applicable. Chairperson Please Print Name, Address and I.D. No. Arbitrator Please Print Name, Address and I.D. No. Arbitrator Please Print Name, Address and I.D. No. List Attorneys of Record and Unrepresented Parties Who: Appeared at the hearing: Did Not Appear at the Hearing: 30-210 (Rev. 2/09) American LegalNet, Inc. www.FormsWorkFlow.com Questions to be Answered by the Arbitrators in Negligence Cases Instructions: Taking the combined negligence that was a substantial factor in bringing about any or all of the plaintiff's injuries, damage or losses as 100%, answer the following questions and state in percentages the causal negligence attributed to each party you have found causally negligent. Do you find that any defendant or additional defendant was negligent? If so, state the name of the party and percentage of negligence attributable to that party. % % % % Do you find that any plaintiff was negligent? If so, state the name of the party and percentage of negligence attributable to that party. % % % % Total 100% Notice of Entry of Award And Now, this ______day of _____________, Year ______, at ___________________, ______.m., the above award was entered upon the docket and notice thereof given by mail to the parties or their attorneys. Prothonotary (Arbitration compensation to be paid on appeal $225.00) By: Separate Appeals must be filed with the Prothonotary pursuant to PA. R. Civ.P.No.1308, and the requisite fees paid, if two or more cases are consolidated for Trial and/or Discovery purposes. Only those cases which are appealed will be scheduled for a de novo hearing. Awards in cases not appealed will become final upon expiration of the appeal time. 30-210 (Rev. 2/09) American LegalNet, Inc. www.FormsWorkFlow.com