Dispute Appointment Service

Medical Devices Design of Appeal Request for Appointment of Adjudicator

Notes

Please note

For joint applications, please download and complete the selected application form and submit to das@ciarb.org.

If you wish to continue with the online application, please continue with the online form.

Your application will be processed on the basis that the appointment may be made on behalf of the President/Deputy President of the Chartered Institute of Arbitrators by one of their duly appointed agents.


The fee for this service is £900.00 (includes VAT).
Payment will be debited from your card or account when you complete the application.

You can download this form as a PDF or continue online.

Claimant & Respondent

Claimant/First Party*
Represented by*

Respondent/Second Party*
Represented by*

Case Details

Maximum 2,000 characters

Preferences


Preference for the requested party's background and skills

Party One*
Maximum 2,000 characters
Maximum 2,000 characters

Evidence


Accepted formats: DOCX, DOC, PDF, CSV.

Each document must be smaller than 5 MB.

You may only upload a maximum of five documents.

Declaration

Medical Devices Design of Appeal Request for Appointment of Adjudicator

Your application is accepted on the basis that the information you provide is both accurate and complete. Neither CIArb nor the appointed neutrals can accept liability in relation to the appointment, if the information provided is inaccurate or incomplete.

  • An agreement between the parties as attached, includes the provision that in the event of a dispute, either party may apply to the President or Deputy President of the Chartered Institute of Arbitrators to appointment an adjudicator in the matter.
  • Particulars of the said agreement and the said dispute are given in the “Notice of Adjudication”, which is attached and clearly marked.
  • Any condition precedent to the right of either party to make a unilateral application for the nomination of an adjudicator has been satisfied and particulars of this, if any, are attached.

It is agreed as a condition of such an appointment that the Applicant shall:

  • Pay the reasonable fees and expenses of the adjudicator, whether or not any decision is made; and
  • Provide adequate security for such payment if the adjudicator so requests; and
  • Make such payment within seven days of the date of communication of the decision to the parties; and
  • Inform the adjudicator in the event of the settlement of the dispute before any decision is made and state which party is to pay any fees and expenses due to the adjudicator.

Payment

Payment can be made by Credit/Debit card/BACS or Cheque.

Please select the relevant option below. If you require assistance from DAS, please contact DAS on DAS@ciarb.org


The fee for this service is £900.00 (includes VAT).
Payment will be debited from your card or account when you complete the application.


Card details complete, submit application to make payment.

Billing Address

Making payment by BACS

We note that payment of the application fee is to be made by bank transfer.

Once your payment has been processed, a receipted invoice shall follow.

Please ensure that a party name is provided as a reference.

CIArb bank details:

Bank: HSBC Bank, 31 Holborn, London, ECIN 2HR England
Sort code: 40 05 03
Account number: 31288784
International Bank Account number (IBAN): GB75HBUK40050331288784
Branch Identifier Code: HBUKGB4B

For any BAS cases please use the following bank details:

Bank: HSBC Bank, 31 Holborn, London, ECIN 2HR England
Bank Account Name: The Chartered Institute of Arbitrators DAS Holding Account
Sort code: 40-05-03
Account number: 73664678
International Bank Account number (IBAN): GB81HBUK40050373664678
Branch Identifier Code: HBUKGB4B

Making payment by Cheque

We note that payment of the application fee is to be made by cheque.

Once your payment has been processed, a receipted invoice shall follow.

Please make your cheque payable to 'The Chartered Institute of Arbitrators™.

Send it by post to our Dispute Appointment Service (DAS) Department at:

CIArb
12 Bloomsbury Square
London
WC1A 2LP

*Please do not send cash to CIArb by post*