B. List previous positions related to the arbitrator certification:

C. Professional License/Registrations or Business/Trade Associations:

D. Education/Related Training:

E. Arbitrator Experience

	Public Works	Private Const.	Other
# of Cases as Arbitrator
# of Cases as Counsel in Arbitration
# of Cases as Party in Arbitration

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	Hospital 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
   CurtainWall	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.
1. % of my practice is devoted to law Matters. Of this:
• % representing architects/engineers/designers.
• % representing general contractors.
• % representing subcontractors and specialty contractors.
• % representing lenders.
• % representing suppliers/manufacturers.
• % representing sureties/insurers.
• % representing others
2. My construction law practice generally categorized as:
• % public projects
• % commercial projects
• % heavy/highway projects
• % residential projects
• % private projects
• % industrial projects
• % institutional 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?

L. Have you ever been convicted of a crime or found to be in violation of any professional standards or regulations?

M. In the interest of maintaining an impartial panel of arbitrators, employees of public entities or employees or owners of construction companies will generally not be placed on the panel of arbitrators.

I am not now an employee of a public entity or an employee or owner of a construction company.

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.

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.