Exhibit 4

Case: 1:20-cv-05075 Document #: 6-4 Filed: 08/29/20 Page 1 of 6 PageID #:135
MUTUAL AGREEMENT TO ARBITRATE

1. Voluntary Mutual Agreement to Arbitrate Claims. Chicago Lakeshore

Hospital and all of its parents, subsidiaries, and related entities or corporations

(collectively, the “Company”) and Employee voluntarily agree to the resolution by

arbitration of all claims, disputes, and/or controversies (collectively “claims”), whether or

not arising out ofEmployee’s employment or its termination, that Company may have

against Employee or that Employee may have against Company, its subsidiaries or

affiliated entities, or against its current or former employees or agents in their capacity.

The claims covered by this Arbitration Agreement include, but are not limited to, claims

for wages or other compensation due; claims for breach of any contract or covenant

(express or implied); tort claims; claimsfor discrimination or harassment, including, but

not limited to, any federal orstate civil rights laws, ordinances, regulations or orders,

based on charges of discrimination or harassment on account ofrace, color, religion, sex,

sexual orientation, age, citizenship, national origin, mental or physical disability, medical

condition, genetic predisposition, marital status, pregnancy or any other discrimination

prohibited by such laws, ordinances, regulations or orders; claimsfor benefits (except

where an employee benefit orretirement plan specifies that its claims procedures shall

culminate in an arbitration procedure different from this), and claims for violation of any

federal, state, or other governmental law, statute, regulation or ordinance, except claims

excluded below..

2. Class and Representative Action Waiver. Except as otherwise required

under applicable law. Employee and Company expressly intend and agree that each will

also forego pursuing any covered dispute on a class, collective, or representative basis

and will not assert class, collective, orrepresentative action claims against die other in

arbitration or otherwise. Nor will class or collective action procedures apply pursuant to

this Agreement. Employee and Company shall only submit their own, individual claims

in arbitration, and shall be entitled to seek dismissal of any such class, collective, or

representative claims and otherwise assert this Agreement as a defense in any proceeding.

This waiver does not apply to any class, collective, or representative claims that cannot

be waived as a matter oflaw. The Company and Employee further agree that any

question regarding class or collective arbitrability shall be decided by a court oflaw and

not an arbitrator.

3. Claims Not Covered by the Agreement Claims that Employee may have

for workers’ compensation or for unemployment compensation benefits, or that Company

or Employee may have for injunctive relief are not covered by this Agreement. If either

Company or Employee have more than one claim against the other, one ormore ofwhich

is not covered by this Agreement such claims shall be determined separately in the

appropriate forum for resolution ofthose claims. Nothing in this Agreement shall

preclude the parties from agreeing to resolve claims not covered by this Agreement

pursuant to the provisions ofthis Agreement.

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This Agreement does not cover and is inapplicable to claims which have been

filed as civil lawsuits in any court priorto the execution ofthis Agreement.

4. Required Notice of Claims. All statutory claims for or related to

employment discrimination or harassment must be filed with the federal Equal

Employment Opportunity Commission and/or the Illinois Human Rights Commission, or

the state civil rights agency that is located in Employee’s state of employment, within the

time limitsset forth by applicable state and federal law, prior to being submitted to

arbitration, orsuch claims are waived.

IfEmployee or Company does not make a written request for arbitration within

the limitations period applicable to a claim under applicable federal or state law, the party

has waived its right to raise that claim, in any forum, arising out ofthat issue or dispute.

Written notice of a claim against Company, its subsidiaries, affiliated entities,

officers, directors, employees or agents shall be sent to the then-current Company agent

located at Chicago Lakeshore Hospital, 4840 N. Marine Drive, Chicago, IL 773-878-

9700. Written notice of a claim against Employee shall be sent to Employee.

5. Arbitration Procedure, Company and Employee agree that, except as

provided in this Agreement, any arbitration shall be in accordance with the Federal

Arbitration Act (FAA), 9 U.S.C. § 1, etseq., in conformity with the procedures ofthe

JAMS Employment ArbitrationRules and Procedures, unless otherwise stated in this

Agreement. The JAMS Employment ArbitrationRules and Procedures can be found at

h r a copy may be requested from

the Company.

ttps.7/www.iamsadr.com/rules-emp!ovment-arbitration/o

Employee shall initiate the arbitration process by the delivery of a demand for

arbitration on the then-current Company representative located at Chicago Lakeshore

Hospital, 4840 N. Marine Drive, Chicago, IL 773-878-9700, via certified mail return

receipt and within the time limits which would apply to the filing of a civil complaint in

court. Company shall initiate the arbitration process by the delivery of a demand for

arbitration on Employee via certified mail return receipt and within the time limits which

would apply to the filing of a civil complaint in court. A late request will be void.

6. Selection of Arbitrator. The Arbitrator shall be selected as follows: The

parties shall first attempt to select a neutral arbitrator by mutual agreement. Ifthe parties

are unable to come to an agreement, the arbitrator shall be appointed consistent with the

process setforth in the JAMS Employment Arbitration Rules and Procedures, Rule 15. If

the Parties do not agree on an Arbitrator, JAMS shall send the Parties a list of at least five

(5) Arbitrator candidates in the case of a sole Arbitrator and ten (10) Arbitrator

candidates in the case of a tripartite panel. JAMS shall also provide each Party with a

brief description ofthe background and experience of each Arbitrator candidate. JAMS

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may replace any or all names on the list ofArbitrator candidates forreasonable cause at

any time before the Parties have submitted their choice pursuant to the paragraph below.

Within seven (7) calendar days ofservice by the Parties ofthe list ofnames, each Party

may strike two (2) names in the case of a sole Arbitrator and three (3) names in the case

of a tripartite panel, and shall rank the remaining Arbitrator candidates in order of

preference. The remaining Arbitrator candidate with the highest composite ranking shall

be appointed the Arbitrator. JAMS may grant a reasonable extension ofthe time to strike

and rank the Arbitrator candidates to any Party without the consent ofthe other Parties.

If this process does not yield an Arbitrator or a complete panel, JAMS shall designate the

sole Arbitrator or as many members ofthe tripartite panel as are necessary to complete

the panel.

If a Party fails to respond to a list ofArbitrator candidates within seven (7) calendar days

after its service, or fails to respond according to the instructions provided by JAMS,

JAMS shall deem that Party to have accepted all ofthe Arbitrator candidates.

7. Governing Law. The Arbitrator shall apply the substantive law (and the law

of remedies, if applicable) ofIllinois, or federal law, or both, as applicable to the claim(s)

asserted. The Arbitrator shall have die authority to award all remedies and reliefthat

would otherwise have been available ifthe claim had been brought by way of a civil

complaint in court The arbitration shall be final and binding upon the parties.

The Arbitrator should utilize the Federal Rules ofEvidence as a guide to the

admissibility of evidence. The parties retain the right to conduct a reasonable amount of

discovery guided by the Federal Rules ofCivil Procedure, and the Arbitratorshall have

the powerto decide any discovery disputes between the parties.

Either party, upon request at the close ofhearing, shall be given leave to file a

post-hearing brief. The time forfiling such a briefshall be set by the Arbitrator.

8. Location of Arbitration, The parties agree that any arbitration shall take

place in the State of Illinois in the county in which Employee works or worked for

Company, unless such venue is inconvenient to the majority of witnesses expected to be

necessary to the case or unless the parties agree to some other locale.

9. Arbitration Award. Within ninety (90) days following the hearing and the

submission ofthe matter to the Arbitrator, the Arbitratorshall issue a written opinion and

award which shall be signed and dated. The Arbitrator’s award shall include factual

findings and the reasons upon which the award is based.

Either party may bring an action in any court of competentjurisdiction to compel 

arbitration under this Agreement and to enforce an arbitration award.

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10. Arbitration Fees and Costs. The cost ofthe Arbitrator and other incidental

costs of arbitration shall be borne by Company. The parties shall each bear their own

costs for legal representation in any arbitration proceeding, provided, however, that the

Arbitrator shall have the authority to require either party to pay the fee for the other

party’s representation during the arbitration, as is otherwise permitted underfederal or

state law, as part of any remedy that may be ordered.

11. Requirements for Modification or Revocation, The Agreement to arbitrate

shall survive the termination ofEmployee’s employment. It can only be revoked or

modified by a writing signed by the parties that specifically states an intent to revoke or

modify this Arbitration Agreement.

12. Sole and Entire Agreement This is the complete Agreement ofthe parties

on the subject of arbitration of disputes, except for any arbitration agreement in

connection with any retirement or benefit plan. This Arbitration Agreement supersedes

any prior or contemporaneous oral or written understanding on the subject. No party is

relying on any representations, oral or written, on the subject ofthe effect, enforceability

or meaning ofthis Arbitration Agreement, except as specifically set forth in this

Arbitration Agreement.

13. Construction, If any provision ofthis Agreement is adjudged to be void or

otherwise unenforceable, in whole or in part, such adjudication shall not affect the

validity ofthe remainder ofthe Agreement

14. Not an Employment Agreement This Arbitration Agreement is not, and

shall not be construed to create, any contract of employment, express or implied. Nor

does this Agreement in any way alter the “at-will” status ofEmployee’s employment.

15. Voluntary Agreement, Employee acknowledge that Employee have

carefully read this Arbitration Agreement, that Employee understand its terms, that all

understandings and agreements between Company and Employee relating to the subjects ' 

covered in the Agreement are contained in it, and that Employee have entered into the

Agreement voluntarily and not in reliance on any promises or representations by

Company other than those contained in this Agreement.

EMPLOYEE UNDERSTAND THAT BY SIGNING THIS AGREEMENT, COMPANY

AND EMPLOYEE HAVE BOTH WAIVED THEIR RIGHTTO A JURY TRIAL AND

THEIR RIGHT TO APPEAL WITH RESPECT TO ALL CLAIMS COVERED BY

THIS AGREEMENT.

Employee initials:

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EMPLOYEE FURTHER ACKNOWLEDGES THAT EMPLOYEE HAS BEEN GIVEN

THE OPPORTUNITY TO DISCUSS THIS AGREEMENT WITH EMPLOYEE’S

PRIVATE LEGAL COUNSEL AND HAS AVAILED HIMSELF OR HERSELF OF

THAT OPPORTUNITY TO THE EXTENT EMPLOYEE WISHES TO DO SO.

Employee:

Print Name ofEmployee

Date

Company:

Representative

Title of Representative

//■ V77

Date

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