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MEDIATOR SIGN-OFF FORM <br />To be completed by the mediator at the conclusion of inediation services. <br />MEDIATOR NAME: Bruce Smith <br />CASE NAME: Dan Berrey v. Marion County and Salem Area Mass Transit District <br />RESULT OF MEDIATION: (~ Full Settlement () Partial Settlement () No Settlement <br />O Pending Follow up needed by USA&M? Yes No <br />BiLLING INSTRUCTIONS: 5plit equally between the three parties <br />TIME SPENT <br />Date Activity Time Snent (nearest .10) <br />5/ 2 8/ 97 Review documents and conference w/ 1. 50 <br />counsel to prepare for mediation <br />5/29/97 Travel to Salem (one-way) 1.20 <br />Prepare for and attend mediation 8.00 <br />Total Time Spent: 10 . 7 0 <br />EXPENSES <br />TYPE OF EXPENSE AMOUNT (Attach Receipts if Possible) <br />Mileage (Eugene-Salem) 144 miles @ 30~ _ $43.20 <br />Total Expenses: $ 4 3. 2 0 <br />:---_ <br />G - ~ - g~ <br />Date ediator Signature <br />