ContractLawyer Referral and Information Service Plan • September 12th, 2016
INSTRUCTIONS: Fill out this form completely, review Lawyer Referral and Information Service Plan and sign this agreement. ATTORNEY INFORMATION: Name: (Last) (First) (M.I.) Firm Name: Address: Phone: Fax: Email: BPR# Are you a member of the Tennessee State Employees Association (“TSEA”)? YES / NO CONDITIONS: As a condition of further participation in this program, I hereby swear and affirm: A. I have completed 15 hours of CLE this year. I did so by attending the following: (or attach a copy of your CLE report, which reflects compliance with above requirements.) B. I continue to carry professional liability insurance with limits not less than $100,000/$300,000. (A copy of the policy fact sheet is attached.) C. Unless I have litigated to judgment a similar matter, I agree to associate experienced co-counsel in any matter involving $10,000 or more. D. When applying for membership on the Experience Subject Matter Panels (Bankruptcy, Criminal Felony, Personal Injury and Workers Compensat
