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Arbitration Proceeding Nr. 200/2016/SEC7<br />

Conflict of Interest and Availability Questionnaire<br />

Arbitration and Mediation Center<br />

Brazil-Canada Chamber of Commerce (CAM-CCBC)<br />

The Questionnaire was drafted by CAM-CCBC’s Executive Committee and the<br />

Advisory Committee with the purpose of guiding the arbitrators in fulfilling their<br />

obligation to reveal information about their impartiality and independence,<br />

pursuant to the Rules and the Code of Ethics.<br />

Parties<br />

Claimant: Wright Ltd<br />

Attorney: Horace Fasttrack<br />

Respondent: SantosD KG<br />

Attorney: Joseph Langweiler<br />

1. Appointed Arbitrator<br />

name: Ronald O Zagallo<br />

qualification: Lawyer<br />

address: 17b Horizont Road, Vindobona, Danubia<br />

2. Did you, under any circumstance or capacity, act as council to any of the parties<br />

in the proceeding for which you are being appointed to act as arbitrator?<br />

No (X) Yes ( )<br />

Observations:<br />

3. Have you ever been employed by, or did you act as consultant, judicial or<br />

extrajudicial expert for any of the parties in this proceeding?<br />

No (X) Yes ( )<br />

35

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