Between________________________________________ representing employers
and_____________________________________ representing workmen / workman
It is hereby agreed between the parties to refer the following dispute to the arbitration of _________________ (here specify the name(s) and address (es) of the arbitrator (s) :
(i) Specific matters in disputes;
(ii) Details of the parties to the dispute including the name and address of the establishment or undertaking involved;
(iii) Name of the workman in case he himself is involved in the dispute or the name of the Union, if any, representing the workmen or workman in question;
(iv) Total number of workmen employed in the undertaking affected;
(v) Estimated number of workmen affected or likely to be affected by the dispute.
We further agree that the majority decisions of the arbitrator (s) be binding on us / in case the arbitrator (s) are equally divided in their opinion, that they shall appoint another person as umpire whose award shall be binding on us.
The arbitrator(s) shall make his (their) award within a period of ___________________(here specify the period agreed upon by the parties) from the date of publication of this agreement in the official gazette by the appropriate gazette or within such further time as is extended by mutual agreement between us in writing. In case the award is not made within the period aforementioned, the reference to arbitration shall stand automatically cancelled and we shall be free to negotiate for fresh arbitration.
Copy to :-
(i) The Assistant Labor Commissioner (Central) __________________________________ ; (here enter office address of the Conciliation Officer in local area concerned);
(ii) The Regional Labor Commissioner (Central);
(iii) The Chief Labor Commissioner (Central); New Delhi
(iv) The Secretary to the Government of India, Ministry of Labor, Employment and Rehabilitation (Deptt. of Labor and Employment), New Delhi