APPENDIX E

IN THE SUPERIOR COURT OF THE STATE OF ARIZONA IN AND FOR THE COUNTY OF YUMA , CAUSE NO. Plaintiff(s), REQUEST TO PAY ARBITRATOR -v- (Assigned to Arbitration) , Defendant(s). I, ______________________________, having served as arbitrator in the above entitled proceeding and having rendered __________ days of services at a rate of $140.00 per day, payment of $ _______________ is hereby requested. DATED this _____ day of _______________, 20 ___. Arbitrator ORDER The Court having considered the request for payment of fees by the Arbitrator in this matter and good cause appearing; IT IS ORDERED that the County of Yuma, Arizona pay to ____________________, the Arbitrator assigned herein, the sum of $ _______________ for services rendered. DATED this _____ day of _______________, 20 ___. Judge of the Superior Court