Arbitrator Application

PUBLIC WORKS CONTRACT ARBITRATION PROGRAM
(OAH Form 31; rev. 12/01)

APPLICATION QUESTIONNAIRE
For standards and qualifications for arbitrators, please see Guidelines for Applicants

All information, once submitted, becomes public knowledge. If certified by the panel, all infomation will be available on the internet for review by parties in arbitration.

If you receive an error message after submitting this application please contact Phoenix Vigil at 916 263-0584. Please note the error message that you received.


A. Personal Information
First Name: 

Title: 
 Last Name: 

Firm: 
Street Address: 

City: 
   State:   
Zip Code: 
Work Phone: 

Email: 
 Type of Business or Practice: 
Throughout this application "arbitrator" means arbitrator or judge and "arbitration" means arbitration or litigation.

WE URGE YOU TO GIVE COMPLETE AND DETAILED INFORMATION
 
B. List previous positions related to arbitrator certification:
    Please indicate firm name, position held, duties and dates (month/year).
 
C. Professional Licenses/Registrations or Business/Trade Associations:
    Please provide name or type, state, date, and number.
 
D. Education/Related Training:
    Please list degree, college/other school and dates.
 
E. Arbitration Experience

  Public
Works		 Private
Constr.		 Other Total
Cases
# of Cases as Arbitrator
# of Cases as Counsel in Arbitration
# of Cases as Party in Arbitration
Other (Please Explain)

 
 
F. Please provide the following information:
  1. To the extent that you have indicated experience above (in the Arbitrator Experience section), describe the five cases you feel are most indicative of your qualifications.
  2. For each of these cases explain:
    1. The approximate dates, complexity and duration of the construction dispute.
    2. Your role, or level of responsibility
    3. The approximate dollar figure of the project or the portion of the project under your responsibility.
    4. How many days of testimony were necessary to resolve the dispute.
    5. The type of work that was performed. (Refer to section H-2 for the examples or categories of construction.)
    6. The major issues in the dispute (e.g. delay, acceleration, extra work).

 
G. Teaching Experience/Articles Published
  Please provide the following information:
  1. Describe any relevant teaching experience you have. Please include information concerning the general content of the subject, the forum, the time frame of your experience, the number of classes taught, the duration of the classes and whether the classes were approved for any type of credit.
  2. List any relevant books or articles you published. Please include a description of the book or article content.
 
H. Construction Experience
1. Occupation
Architect Industrial Engineer Builder/Developer
Structural Engineer Electrical Engineer Planner/Developer
Civil Engineer GeoTechnical & Foundation Engineer Land Surveyor
Mechanical Engineer General Contractor Accountant
Chemical Engineer Construction Mgr. Supplier/Mfg.
Environmental Engineer Sub-/Specialty Contractor Owner Representative
Nuclear Engineer Designer  
Other (describe) 
 
2. Primary Types of Construction
Airports Bridges Dams
High-Rise Buildings Highways Hospitals & Nursing Homes
Light Industrial Low-Rise Dwellings Office Buildings
Sewers & Waterworks Power Plants Processing Plants
Renovations Schools Shopping Centers
Single-Family Dwellings Tunnels Aqueducts/Pipelines
Foundations Prisons Marine Structures
Site Preparation Pumping Plants Earth Retaining Structures
Other (describe) 
 
3. Sub-/and Specialty Contractors
Acoustical Carpentry Concrete
Curtain-Wall Demolition Drywall/Plastering
Electrical Excavation HVAC
Masonry Painting/Finishing Steel/Structural
Plumbing Roofing Steel/Ornamental
Paving Sitework/Landscaping  
Other (describe) 
 
I. Please provide the following information:
  1. To the extent that you have indicated experience above(in the Construction Experience section), describe the five projects you feel are most indicative of your qualifications.
  2. For each of these projects or activities explain:
    1. The approximate dates, complexity and duration of the project.
    2. Your role, or level of responsibility in the project.
    3. The approximate dollar figure of the project or portion of the project under your responsibility.
    4. The type of work that was performed.
    5. The major complexities of the project.
 
J. Attorneys/Judges Experience
1. Please list your law specialties and give percentage of practice devoted to each:

Law Specialty Percentage
%
%
%
%
%
%
%

2. Please summarize your experience focusing on the areas of law that you listed as specialties above, including significant activities that you have been involved in during the past five years.

3. If your practice in construction law is above 15%, please complete A and B.

A. % of my practice is devoted to construction law matters.
Of this,
% representing owners/developers/public agencies.
% representing architects/engineers/designers.
% representing general contractors.
% representing subcontractors and specialty contractors.
% representing lenders.
% representing suppliers/manufacturers.
% representing sureties/insurers.
% representing others ()
 
B. My construction law practice generally categorized as:
% public projects % private projects
% commericial projects % industrial projects
% heavy/highway projects % institutional projects
% residential projects % construction defects
% other projects ()

 
K. My hourly rate is $

If required to travel, you will be reimbursed for travel expenses and per diem in accordance with the Department of Personnel Administration (DPA) regulations, Title 2, and the State Administrative Manual (SAM) Sections 0700 and 4100. In addition to these reimbursements will you also charge the litigants for your travel time?

Yes, I will charge for travel time at $ per hour.
No, I will not charge for travel time.
 
L. Have you ever been convicted of a crime or found to be in violation of any professional standards or regulations?
Yes  No
If you answered "YES" to the above, please explain:

 
M. In the interest of maintaining an impartial panel of arbitrators, employees of public entities or employees or owners of construction companies are asked to indicate the following.
  1. I am not now an employee of a public entity or an employee or owner of a construction company.
  2. I am an employee of a public entity. Please explain in what capacity you are connected with the public entity and any other explanatory information that would indicate no potential conflict of interest.

  3. I am an employee or owner of a construction company. Please explain in what capacity you are connected with the company and any other explanatory information which would indicate no potential conflict of interest.
 

Professional References: Provide the name, mailing address and phone number of at least two individual references to attest to your professional experience in your area(s) of expertise and your suitability to perform as an arbitrator. References will be asked to verify the accuracy of application materials you submit, to the extent possible, and provide additional information about you.
Name: 
Address: 
Phone: 
Name: 
Address: 
Phone: 
Name: 
Address: 
Phone: 
Name: 
Address: 
Phone: 
Name: 
Address: 
Phone: 
 The information in this questionnaire is true and accurate to the best of my knowledge, information, and belief. (Must be checked to submit form)