CLIENT NAME

CONTINGENCY FEE CONTRACT AND 

RETAINER AGREEMENT 

This is a legal contract between WEINSTEIN LEGAL (hereinafter the ) 

and myself __________________ (hereinafter "CLIENT"). The purpose of this contract 

is so that I may retain the legal services and advice of the FIRM in regards to 

a_______________________ that occurred on or about 

____________________________ 20___ . 

CLIENT HAS BEEN ADVISED and understands that the fee for legal 

representation in the above listed matter is based upon the gross amount of money which 

the FIRM recovers for me, in accordance with the guidelines and limits established by 

the Supreme Court of the State of Florida with regards to this type of case is as follows:

A. If settled before a lawsuit is filed or answered or before the demand for

appointment of arbitrators:

33 1/3 % of any amount up to $1,000,000.00; plus

30% of any portion of the recovery between $1,000,000.00 and 

$2,000,000.00; plus

20% of any portion of the recovery exceeding $2,000,000.00. 

It is agreed and understood that this employment is on a contingency fee basis. If 

no recovery is made, I will not be indebted to my attorney for any sum whatsoever as 

 EXHIBIT "A"

Case 19-23676-AJC Doc 26-1 Filed 01/17/20 Page 1 of 5
B. If settlement is achiever or recovery obtained after the filing of an answer or 

the demand for appointment of arbitrators through the entry of judgment; or 

if no answer is filed or no demand for appointment of arbitrators is made, and 

settlement is achieved or recovery obtained after the expiration of the time 

period provided to file an answer (20 days from the date the complaint is 

served) or demand for appointment of arbitrators: 

 40% of any recovery up to $1,000,000.00; plus

 30% of any portion of the recovery between $1,000,000.00 and $2,000,000.00; 

 plus

 20% of any portion of the recovery exceeding $2,000,000.00. 

 It is agreed and understood that this employment is on a contingency fee basis. If 

no recovery is made, I will not be indebted to my attorney for any sum whatsoever as to 

C. If all defendants admit liability at the time of the filing of their answers and 

request only a trial on damages: 

 33 1/3% of any recovery up to $1,000,000.00; plus

 20% of any portion of the recovery between $1,000,000.00 and 

 $2,000,000.00; plus

 15% of any portion of the recovery amount exceeding $2,000,000.00. 

 It is agreed and understood that this employment is on a contingency fee basis. If 

no recovery is made, I will not be indebted to my attorney for any sum whatsoever as to 

COSTS ASSOCIATES WITH THE CASE: I agree to pay for the costs of the 

investigation and evaluation and should it be necessary to institute suit, the court costs and 

associated costs of litigation, including but not limited to filing fees, depositions, service 

of process, legal research, xerox and photocopies, faxing, posting, expert witness fees, 

investigative services, nurse medical summaries, witnesses, medical records and report 

fees, medical and any other expert fees for trial testimony and depositions, and fees paid to 

third party vendors for medical timelining, CPT and billing, analysis and medical 

summaries of past and present medical records. 

may be owed at the conclusion of the case. I agree to reimburse the FIRM for these 

costs from any gross recovery at the conclusion of the case or termination of 

representation. In the event that no recovery of money damages is obtained, then the 

Case 19-23676-AJC Doc 26-1 Filed 01/17/20 Page 2 of 5
FIRM shall not seek reimbursement of costs, as repayment is contingent upon the 

outcome of the matter. 

PROBATE AND GAURDIANSHIP FEES: It may be necessary to retain the services of 

an additional law firm to handle either probate (estates) or guardianship matters. The FIRM 

does not perform those legal services. I hereby authorize the FIRM to retain the services of 

such other firm or firms as may be necessary for the proper handling of my case. I hereby 

as may be necessary for my case. I hereby authorize the FIRM to retain from the proceeds 

of my recovery all funds necessary to pay such fees and costs. 

RETAINING LIEN: In the event, for any reason, client chooses to end its representation 

and/or change representation to a different lawyer or law firm, the FIRM asserts a retaining 

lien on the file, so that the file shall not and will not be released to client or any third party 

until all costs incurred by the FIRM, up to the date of discharge, are paid in full. 

CLIENT COOPERATION 

CLIENT AGREES to cooperate fully and completely with the FIRM in the 

preparation of this case. 

 CLIENT AGREES not to do any act that impairs the value of the case.

 CLIENT AGREES not to settle the case without participation and 

consent.

 CLIENT AGREES not to speak to others or consult other lawyers about the case. 

POWER OF ATTORNEY 

CLIENT expressly grants power of attorney to the FIRM to endorse and deposit 

checks and transmit payment directly to medical providers who have rendered services to 

CLIENT, and further authorizes the undersigned FIRM to 

of recovery. Any unpaid bills or liens from hospitals, doctors, and other medical services 

not deducted from the recovery shall remai CLIENT authorizes 

the FIRM 

behalf of the CLIENT at the time funds are due to CLIENT. The FIRM shall not be liable 

for failure, if any, to pay said debts on behalf of CLIENT. 

CANCELLATION OF THIS AGREEMENT 

 This contract may be canceled by written notification to the FIRM at any time 

within 3 business days of the date the contract was signed, as shown below, and if canceled 

the CLIENT shall not be obligated to pay any fees to the FIRM for the work performed 

Case 19-23676-AJC Doc 26-1 Filed 01/17/20 Page 3 of 5
during that time. If the FIRM has advanced funds to others in representation of the 

CLIENT, the FIRM is entitled to be reimbursed for such amounts as the FIRM has 

reasonably advanced on behalf of the CLIENT. 

I understand that this type of litigation is extremely time consuming and can be 

problematic with regards to chances of success. I further understand that these cases may 

take months to analyze, gather information, and to study. For these reasons, I recognize the 

right of the FIRM to withdraw from the case and return the file to me at its discretion, 

whenever the FIRM is of the opinion that the chances for success do not justify going 

forward. 

CLIENT AGREES that from time-to-time it will be necessary for the FIRM to 

allow an attorney other than Justin Weinstein, Esq. or Danielle Zukowsky, Esq. to appear 

in Court. Also, that the FIRM may consult other counsel to perform any and all legal 

services as described in this agreement. CLIENT agrees that pleadings in this matter may 

list other law firms and/or attorneys as counsel of record. CLIENT also agrees that should 

the FIRM associate or consult with other counsel, fees earned will be shared based on 

agreement between the FIRM and other counsel. 

CLIENT AGREES that the FIRM cannot promise or guarantee a particular 

result and no promise or representations have been made by the FIRM to CLIENT relating 

to the outcome of this claim. Furthermore, upon investigation, should the FIRM at any time 

wish to withdraw from this Retainer, the FIRM will have the right to do so. 

 CLIENT acknowledges that he/she has been advised to seek independent counsel 

to review this Agreement and CLIENT represents and warrants that he/she has done so 

prior to signing it or have expressly chosen not to seek independent advice. 

ARBITRATION: In the event that a disagreement or controversy arises between the 

undersigned client(s) and the FIRM, and/or co-counsel, relating to their 

representation, the terms and provisions of this Contingency Fee Contract and 

Retainer Agreement, or any other aspect of the relationship, then such disagreement 

or controversy shall be settled by binding arbitration, in accordance with Chapter 

682 of the Florida Statutes, the Florida Arbitration Code. When such disagreement 

arises, any party may make a written demand for arbitration. In this event, each party 

will select an Arbitrator. The two Arbitrators will select a third. All Arbitrators shall 

be members in good standing of the Florida Bar. If the parties cannot agree within 

thirty (30) days as to the appointment of an Arbitrator, any party may request that 

the selection be made by a judge of the court having jurisdiction. Venue shall be in 

Broward County, Florida, and such application shall be made to a judge of the 17th

Judicial Circuit in and for Broward County, Florida. Each party will: (1) pay the 

expenses they incur, (2) bear the expenses of the third Arbitrator equally. Unless both 

parties agree otherwise, the arbitration will be held in Broward County, Florida and 

local rules of law as to procedure and evidence will apply. A decision agreed by two 

of the Arbitrators will be binding. 

Case 19-23676-AJC Doc 26-1 Filed 01/17/20 Page 4 of 5
FLORIDA BAR: Should you as a client make any formal or informal complaints about 

the services rendered by the law firm or its agents, servants or employees, and the bar 

concludes there is or was no probable cause for same, then you the client, will be 

responsible for paying all the expenses incurred by the FIRM in defense of same, including 

any costs or time, or attorn

 This agreement represents the full agreement between CLIENT and the FIRM. No 

other agreement, written or oral, exists, and discussions between CLIENT and the FIRM 

that are not set forth in this agreement are not part of this agreement. If CLIENT and the 

FIRM agree to change any term in this agreement, the agreed-to change must be in writing 

and signed by both parties. 

The undersigned CLIENT has, before signing this contract, received and read the 

CLIENT has signed that Statement and received a signed copy to refer to while being 

represented by the undersigned FIRM. 

THIS AGREEMENT HAS BEEN FULLY EXPLAINED TO CLIENT(S). 

CLIENT(S) HAS/HAVE READ AND FULLY UNDERSTAND THIS AGREEMENT. 

CLIENT HAS BEEN PROVIDED A COPY OF THIS SIGNED CONTRACT AS WELL 

. Entered into on this ________ day of______________, 20___. _________________________________________ CLIENT _________________________________________ CLIENT 

WEINSTEIN LEGAL ___ __________ By: Justin Weinstein 

For the Firm 

Case 19-23676-AJC Doc 26-1 Filed 01/17/20 Page 5 of 5