Mediation agreement 1 party a: Zou XX, male, born on April 09xx 19xx, Han nationality, employee of Lanzhou xx co., ltd., now living. XX Road, Lanzhou City.
Party B: Lanzhou XX Hotel, address: XX Road, Lanzhou City.
Person in charge: Zhang XX, manager of this restaurant.
Party C: Lanzhou XX Property Management Co., Ltd.No. XX Road, Lanzhou City.
Legal Representative: Liu XX, chairman of the board of directors of this company.
In the early morning of XX, XX, employees of Lanzhou XX Restaurant Xiao XX, Zeng XX, Wang XX and Cao XX accidentally injured Zou XX who was eating in the restaurant, resulting in Zou XX's permanent blindness in his right eye. After the incident, four people, including Xiao XX, absconded and their whereabouts are still unknown. After mediation by the People's Mediation Committee, Party A, Party B and Party C reached the following agreement terms on Zou XX's compensation for injuries:
1. For Party A's accidental disability, Party B thinks that besides the direct perpetrator, it also has certain responsibilities and is willing to compensate Party A's disability.
2. The total compensation paid by Party B is RMB two hundred and fifteen thousand Yuan only, mainly including medical expenses, disability compensation and living expenses of dependents. Considering the specific situation of Party B, Party A is willing to give up other claims for compensation.
3. The payment method of Party B is: all cash payment. After this agreement comes into effect, Party A shall pay RMB to Party B.. } If the payment is overdue, Party B shall bear one thousandth of the unpaid liquidated damages every day.
Four. As the property management unit of Party B, Party C voluntarily guarantees the implementation of this agreement.
5. After compensation by Party B, Party A will not bring a lawsuit on this matter. If Party B breaches the contract, Party A has the right to bring a lawsuit.
6. Party B and the guarantor have the right to investigate the civil liabilities of multiple actors in this case. However, whether Party B pursues it or not will not affect the performance of this Agreement.
Seven. This agreement shall come into effect after being signed by Party A and sealed by Party B and Party C. ..
Eight. This agreement is made in quadruplicate, one for Party A, Party B and Party C respectively and one for the People's Mediation Committee, all of which have the same legal effect.
Party A (signature)
Party B (seal)
Party C (seal)
Mediator (signature)
People's Mediation Committee (Seal)
20xx year x month x day
Mediation Agreement II Party A: _ _ _ _ _ (ID number: _ _ _ _ _)
Party B: _ _ _ _ _ _ (ID number: _ _ _ _ _)
On a certain day in _ _ _ _ _ _ _ _
1. Party A and Party B reach a one-time compensation agreement according to the general principle of handling traffic accidents, and Party A pays Party B RMB18,000 Yuan (in words: eighteen thousand Yuan only) in one lump sum.
2. After Party A pays 65,438+08,000 yuan, Party B promises not to ask Party A for subsidies, compensation and other expenses in any name for any reason or in any form in the future, and all subsequent matters and expenses will be handled and borne by Party B. ..
3. After Party B receives the RMB 65,438+08,000 paid by Party A, the matter will be terminated, and both parties will no longer have any rights and obligations. Party B promises not to bring any lawsuit or arbitration on this matter, and at the same time, it will give up the right to bring any lawsuit against this agreement to the judicial authorities. In the future, the derivative results of this matter will also be borne by Party B itself, and Party A will no longer bear any responsibility for it.
Four. All terms of this agreement have been agreed by both parties through consultation, and both parties have read the full text and correctly understood it. Both parties fully understand the consequences involved in the contents of this agreement, both parties understand and respect the purpose achieved by this agreement, and both parties fully agree with this result.
5. When receiving the one-time compensation from Party A, Party B must also deliver all medical documents, medical records, other bills and related documents to Party A..
And ensure the authenticity of the bill materials. If Party A fails to claim compensation from the insurance company, Party B shall double the false part. When Party A claims from the insurance company, Party B has the obligation to assist Party A in providing relevant documents, bills and other materials.
This agreement is a one-time termination agreement. This agreement is the result of equal and voluntary consultation between both parties, and it is the expression of the true meaning of both parties. This agreement will take effect immediately after being signed and sealed by both parties.
Seven. This agreement is made in triplicate, one for each party and one for the traffic control department, all of which have the same legal effect.
Party A: _ _ _ _ _ _ Party B: _ _ _ _ _ _ Traffic Control Department: _ _ _ _ _ _ _
Signature time: _ _ _ _ _ _ _ _ _ _ _ _
Article 3 of the mediation agreement: Party A: Tian Jin, Class 3, Grade 3; Party B: Zhang Shuqi, Class 3, Grade 1.
Cause: 20xx 165438+ 10 65438+On the morning of April 20th, in the process of fetching water, Tian Jin and the thermos broke and accidentally burned Zhang Shuqi's right foot. After examination and treatment in Hui 'an Hospital of Huxian County, Zhang Shuqi has basically recovered.
According to the above situation, our school mediated the two parties in accordance with the Measures for Handling Serious Violations of Discipline in Huxian No.8 Middle School, and reached an agreement voluntarily through consultation between the parents of Party A and Party B:
1. Party A shall bear the medical expenses and nutrition expenses incurred by Party B's injury, and pay Party A 1000 medical expenses and 300 nutrition expenses in one lump sum;
2. This mediation is a one-time mediation, and both parties shall not provoke disputes under any pretext; 3. After mediation, there is no dispute between the two parties, and the mediation agreement will take effect after being signed by both parties.
Client of Party A: Guardian: Client of Party B: Guardian:
Mediator:
Huxian No.8 Middle School 20xx September 22nd
two
Parties (name, gender, age, nationality, occupation, unit or address of natural person, name and address of legal person and social organization, name and position of legal representative):
Applicant: ××××××××××××××××××××××××××××××××××××××××××××××××××××××××××××××××××××××××××××××××××××××××××××××××××××××××××××××××××××××××××××××××××××××××××××××××××××××××××××××××××××××××××××××
Respondent: XXX, male, born on XXX.
Brief description of the dispute: at about 7: 00 p.m., xx years × months × days × months × days × months × days × months × days × months × days × months × days × days × months × days × months × days × days × months × days × days × months × days × days × months × days × months × days × days × months × days × days × months × days × months × days × months × days
After mediation, the following agreement was reached voluntarily:
1) All medical expenses shall be borne by XXX;
2) ××××× one-time compensation ××× year ×× month × day× month× day× month× day× month× day× month× day× month× day× month× day× month× day× month× month× day× month× day× month× month× day× month× month× month × month× day× month× month × month× month × month× month × month × month × month × month × month × month × month × month × month × month × month ×
3) ××××××××××××××××××××××××××××××××××××××××××××××××××××××××××××××××××××××××××××××××××××××××××××××××××××××××××××××××××××××××××××××××××××××××××××××××××××××××××××××××××××××××××××××
Method, place and time limit for performance of the agreement: 1) When signing this agreement, XXX will pay the applicant in cash in one lump sum. 2) Before {\ f1 {\ f1.} {\ f1. }
This agreement is made in triplicate, one for each party and one for the People's Mediation Committee.
Party (signature or seal),
Mediator (signature)
Year, month and day (printed by People's Mediation Committee)
Article 4 of the Mediation Agreement Party A: Party B:
After the accident:
About _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ The above facts were confirmed by the Letter of Confirmation of Road Traffic Accidents issued by the Traffic Police Brigade of Yanji Public Security Bureau, which confirmed that Huang Xiannan was fully responsible for the accident and the victim was not at fault.
Party A and Party B have reached the following settlement agreement through full consultation:
1. On the date of signing this agreement, Party A shall first compensate Party B for all economic losses of RMB 100000 Yuan only (in words: one hundred thousand Yuan only) in one lump sum, which shall be transferred to the account designated by Party B (bank: _ _ _ _ _ _ _ _ _ _ _ _ _ _).
2. After this agreement is signed and fully performed, Party B recognizes that Party A has compensated the victims for all economic losses, and there are no other disputes between Party A and Party B, and Party B promises not to claim any rights from Party A for this traffic accident.
3. After receiving the above money, Party B shall issue a receipt to Party A or its agent. For the injuries caused by Party A in this accident, Party B agrees to issue a letter of understanding to Party A after receiving the above payment.
4. Before the above money is paid in full, Party A shall not transfer the property or evade execution, otherwise Party B shall have the right to request the court for compulsory execution and investigate the criminal responsibility of Party A. ..
5. Liability for breach of contract: After signing this agreement, both parties must perform it as agreed. In case of breach of contract, the breaching party shall pay the observant party a penalty of RMB 65,438+000,000 (in words: one hundred thousand yuan).
6. This agreement is made in triplicate, one for each party and one for the people's court, all of which have the same legal effect.
Party A: Party B:
Year, month, sun, moon, sun.
Article 5 of the mediation agreement: Tian _, female, Han nationality, aged 5 1, illiterate, a villager in Dachuanbu Village of Copper Factory Village Committee.
Zhao _, male, Han nationality, 30 years old, is a villager in Dachuanbu Village of Copper Factory Village Committee.
Zhao _, male, Han nationality, 24 years old, is a villager in Dachuanbu Village of Copper Factory Village Committee.
Dashuiza Coal Mine in Dahe Town
Cause of action: On June 65438+1October 10, 20, Zhao Shicheng, a boiler worker in Dashuizan Coal Mine, died unfortunately in the dormitory of the coal mine. Dahe police station rushed to the scene in time after receiving the report, and conducted a corpse examination on June 20xx 10. After examination, there were no scars and signs of poisoning, excluding human factors such as homicide, suicide and poisoning. After consulting the family members of the deceased, it was initially determined that he died unexpectedly due to illness. Dahe Town Police Station, Dahe Judicial Office and Copper Factory Village Committee called coal mine leaders and relatives to mediate at the coal mine site on 20xx 10 165438.
First, the aftermath of the deceased Zhao Shicheng was handled by Dashuizan Coal Mine actively cooperating with relatives;
Second, the deceased Zhao Shicheng worked in the coal mine for many years and unfortunately died in the dormitory of the coal mine. According to the compensation standard of industrial injury death and accidental death of Dahe coal mine enterprises, Dashuizan coal mine paid compensation of 7 1.6 million yuan (seven hundred and sixteen thousand yuan only) (burial, bag and other expenses);
Three, the two sides since the date of signing the agreement, by relatives from the mine, choose a day for burial;
4. The compensation will be paid in two installments: June 65438+1October 65438+1October 65438+1October 0, and the rest will be paid the next day after the deceased is buried. When the relatives of the deceased receive money, they should issue a copy of their ID cards and receipts as evidence;
5. This agreement shall come into effect as of the date of signing, and the family members and relatives of the deceased shall not interfere with or hinder the normal production and life of the coal mine for any reason in the future;
This agreement has legal effect after being signed by both parties;
Seven. This agreement is made in triplicate, one for Dahe Legal Aid Workstation and one for each party.
Signature of both parties:
Mediation Unit: _ Legal Aid Workstation
20_ year 65438+1October 65438+1October
Article 6 of the mediation agreement: Party A: _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
Party B (affected party): _ _ _ _ _ _ _ _ _ _ _
Basic information of the patient: name: _ _ _ _ _ _ _ Sex: _ _ _ _ _ Age: _ _ _ _ _ _ Address: _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ Patient _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ After _ _ _ _ days in hospital, the treatment results of patients are: death, disability, improvement and rehabilitation. Party B believes that _ _ _ _ _ _ _ _ _ _ _ _ was caused by Party A. Party A believes that _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _.
After mediation by the mediator, both parties voluntarily reached the following compensation agreement on this dispute:
1. Party A and Party B agree to settle the dispute through negotiation, without identifying the reasons and responsibilities of the dispute.
2. Party A voluntarily compensates Party B for medical expenses, lost time, hospital food allowance, escort fee, disability living allowance, living expenses of dependents, continuing treatment fee, death compensation, funeral expenses and mental damage compensation.
Three. Payment time of compensation: _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
Four. Party A and Party B waive all litigation rights based on the creditor-debtor relationship.
5. _ _ _ _ _ _ _ _ _ _ (Dead patient) The body stored in the mortuary must be transported out of the hospital on _ _ _ _ _ _ _ _ _.
Liability for breach of contract by intransitive verbs: This agreement is terminated once, and neither party can go back on its word. If one party goes back on its word, it shall pay the other party RMB as penalty.
Seven. This agreement shall come into force after being signed and sealed by both parties. This agreement is made in triplicate, one for each party and one for the Health Bureau.
Party A: _ _ _ _ _ _ _ _ _ _ _
Party B: _ _ _ _ _ _ _
Mediator: _ _ Law Firm
Attorney: _ _ _ _ _ _ _
_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
Article 7 of the Mediation Agreement Party A:-
Address:-Tel:-
Party B: Gender: Age: ID number:
Address: Tel:
Relationship with patients: postal code
□ Patient himself □ Legal guardian □ Entrusted agent □ Other immediate family members:
Through friendly negotiation, Party A and Party B voluntarily reached the following agreement regarding the patient (ID number:) being diagnosed in Party A's clinic on ………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………
I. XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX
2. Party A agrees to compensate Party B RMB in one lump sum and exempt Party B from the corresponding medical expenses of RMB in our hospital.
3. Within 10 days after the conciliation statement comes into effect, Party A shall pay all the compensation fees to Party B in one lump sum, and Party B shall issue a written receipt to Party A after receiving the compensation fees paid by Party A. This medical dispute is over.
Four. Party B promises that this dispute will be terminated after this agreement comes into effect and the RMB compensation paid by Party A is received. Party B will not make any demands on Party A for any reason, or ask any third party to hold Party A accountable, and promise not to engage in or spread any behavior that may affect Party A's reputation.
5. If Party A violates the provisions of this Agreement, it shall pay Party B a penalty of ten times the appeal compensation; If Party B violates the agreement in this Agreement, Party B shall not only return the compensation of RMB yuan obtained under this Agreement, but also pay Party A a penalty of 10 times of this fee.
6. This Agreement is made in duplicate, one for each party, and both copies have the same legal effect.
Seven. This agreement shall come into effect after being signed (sealed) by both parties.
Party A: (seal) Party B: (signature) (patient himself)
Year, month, year, month, year
Witness: (signature)
Date, year and month