exv10w2



 






Exhibit 10.2




OFFSHORE LOGISTICS, INC.

STOCK OPTION AGREEMENT




     THIS STOCK OPTION AGREEMENT (the “Agreement”) is made as of the       day of                     ,
20      , by and between Offshore Logistics, Inc., a Delaware corporation (the “Company”), and
                               (the “Grantee”) pursuant and subject to the provisions of the Offshore
Logistics, Inc. 2004 Stock Incentive Plan, as amended (the “2004 Plan”), a copy of which is
furnished to the Grantee.



     WHEREAS, the Company and its stockholders previously have approved and adopted the 2004 Plan,
pursuant to which the Company may, from time to time, make awards of options to purchase shares of
the Company’s common stock, par value $0.01 (“Common Stock”), to certain eligible officers
and employees of the Company and its subsidiaries; and



     WHEREAS, the 2004 Plan is administered by the Compensation Committee of the Company’s Board of
Directors (the “Committee”); and



     WHEREAS, the Grantee on the date hereof is an officer or employee of the Company and/or one of
its subsidiaries and the Grantee on the date hereof does not directly or indirectly own stock
representing more than ten percent of the combined voting power of all classes of stock of the
Company or one of its subsidiaries; and



     WHEREAS, the Committee, on                               , 20      (the “Date of Award”), has
authorized the granting of options to purchase a certain number of shares of the Company’s Common
Stock to the Grantee thereby allowing the Grantee to acquire a proprietary interest in the Company
in order that the Grantee will have further incentive for remaining with and increasing his or her
efforts on behalf of the Company or one of its subsidiaries; and



     WHEREAS, the Grantee has accepted the grant of stock options and agreed to the terms and
conditions stated herein and in the 2004 Plan.



     NOW THEREFORE, in consideration of the foregoing and of the mutual covenants hereinafter set
forth and other good and valuable consideration, the receipt and adequacy of which are hereby
acknowledged, the parties hereto hereby agree as follows:




	 	1.	 	Grant of Option. Pursuant to the 2004 Plan and on the
terms and subject to the conditions provided in this Agreement, the Committee
hereby grants to the Grantee, and the Grantee accepts, the right and option to
purchase all or any part of the number of shares of Common Stock indicated
below (the “Option”), at the exercise price per share stated below,
being at least the par value per share of the Common Stock on the Date of
Award:





	 	 	 	 	 
	 

	 	No. of Shares Subject to Option
	 	  ___
	 

	 	Exercise Price Per Share
	 	$___







	 	2.	 	Antidilution Adjustment. In the event of any merger,
reorganization, consolidation, recapitalization, stock dividend, stock split,
issuance or repurchase of stock or securities convertible into or exchangeable
for shares of Common Stock, grants of options, warrants or rights to purchase
the Common Stock (other than pursuant to the Plan), extraordinary distribution
with respect to the Common Stock, or other change in corporate structure
affecting the Common Stock, then the Committee may (a) make such substitution
or adjustments in the Number of Shares and/or the Exercise Price specified in
Paragraph 1 above, (b) make such other substitution or adjustments in the
consideration receivable by




 









 






	 	 	 	the Company upon exercise of the Option, or (c) take such other action as the
Committee may determine to be appropriate in its sole discretion; provided,
however, that the number of shares subject to the Option shall always be a
whole number.






	 	3.	 	Vesting. Unless sooner terminated in accordance with
the provisions of this Agreement and the 2004 Plan, the Option will vest in
annual installments of one-third each beginning on the first anniversary of the
Date of Award. Each Option, or portion thereof, that vests in conformity with
this Agreement is referred to as a “Vested Option.” Any Option, or
portion thereof, that has not yet vested is referred to as an “Unvested
Option.” All Options, or portions thereof, are either Vested or Unvested
Options.
	 
	 	4.	 	Accelerated Vesting. The Committee may decide, in its
absolute discretion, to accelerate the vesting of any or all Unvested Options;
provided, however, that the Committee shall not accelerate the vesting of any
Unvested Option if such acceleration would cause the Grantee to violate or
incur liability under Section 16 of the Securities Exchange Act of 1934
(“Section 16”). If so accelerated, such Options shall be considered to
have vested as of the date specified by the Committee. Additionally, all
Unvested Options shall become vested immediately upon a Change in Control of
the Company.
	 
	 	5.	 	Term. The term of the Option begins on the Date of
Award and shall expire on the date that is ten years after the Date of Award.
All Unvested Options shall terminate on the date of the Grantee’s Termination
of Employment. Except as otherwise expressly provided in the 2004 Plan and
this Agreement, any Option, the term of which has expired or that has otherwise
terminated under the provisions of the 2004 Plan or of this Agreement, shall
automatically have no further force or effect.
	 
	 	6.	 	Method of Exercise. Unvested Options shall not be
exercisable. Each Vested Option may be exercised only by the Grantee (or other
proper party in the event of the Grantee’s death or incapacity) at any time
during the option term by giving written notice of exercise to the Company
specifying the number of shares of Common Stock subject to the Vested Options
to be purchased. The aggregate exercise price of the Vested Options shall be
paid in full in cash (by certified or bank check or such other instrument as
the Company may accept) or may also be paid by one of the following: (i) in the
form of unrestricted Common Stock already owned by the Grantee based in any
such instance on the Fair Market Value of the Common Stock on the date the
Vested Option is exercised; (ii) by requesting the Company to withhold from the
number of shares of Common Stock otherwise issuable upon exercise of the Vested
Option that number of shares having an aggregate fair market value on the date
of exercise equal to the exercise price for all of the shares of Common Stock
subject to such exercise; or (iii) by a combination thereof (provided in each
case that adequate provision is made for withholding of applicable taxes). In
the discretion of the Committee, the payment of the aggregate exercise price of
the Vested Options may also be made in such other manner as may be authorized
from time to time by the Committee, including without limitation (i) payment in
the form of an installment note or (ii) payment made by delivering a properly
executed exercise notice to the Company, together with a copy of irrevocable
instructions to a broker to deliver promptly to the Company the amount of sale
or loan proceeds to pay the purchase price. No shares of Common Stock shall be
issued pursuant to this Agreement until full payment therefore has been made.
	 
	 	7.	 	Suspension of Exercisability. No shares shall be
issuable upon the exercise of an Option unless the Company determines that the
issuance complies with applicable law. Unless the shares of Common Stock
subject to the 2004 Plan have been registered under the Securities Act of 1933,
as amended, no shares shall be issuable upon the exercise of any Option unless
the Company determines that registration is unnecessary and, at the election of
the 





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Company, the Grantee has represented in writing that he or she is acquiring
the shares for his or her own account for investment and not with a view to,
or for sale in connection with, the distribution of any of the shares. The
Company may require that any certificates of shares issued upon the exercise
of any Option bear a legend restricting the transfer thereof on such terms as
the Company may determine, and the Company may instruct its transfer agent to
“stop transfer” as to any such shares on such terms as the Company deems
appropriate.




	 	8.	 	Exercise Following Termination of Employment for Cause.
If the Grantee incurs a Termination of Employment for Cause, then all
unexercised options, whether Vested Options or Unvested Options, shall
terminate effective as of the date of the Grantee’s Termination of Employment.
	 
	 	9.	 	Exercise Following Termination of Employment for Disability
or Retirement. If the Grantee incurs a Termination of Employment by reason
of his or her Disability or Retirement, then the Grantee may exercise his or
her Vested Options until the earlier of (A) the second anniversary of the date
of such Disability or Retirement (or such longer period as may be determined by
the Committee in its discretion before the expiration of such two-year period)
and (B) the expiration of such Vested Options in accordance with Paragraph 5
above.
	 
	 	10.	 	Exercise Following Termination of Employment for Reasons
Other Than Cause, Disability, Death or Retirement. If the Grantee incurs a
Termination of Employment by reason other than for Cause, Death, Disability, or
Retirement, then the Grantee may exercise his or her Vested Options until the
earlier of (A) the ninetieth day following such Grantee’s Termination of
Employment (or such longer period as may be determined by the Committee in its
discretion before the expiration of such ninety-day period) and (B) the
expiration of such Vested Options in accordance with Paragraph 5 above.
	 
	 	11.	 	Exercise Following the Grantee’s Death. If the Grantee
dies while in the employ of the Company or any subsidiary, any Option held by
the Grantee that was exercisable immediately before the Termination of
Employment may be exercised at any time until the earlier of (A) the second
anniversary of the date of such death (or such longer period as may be
determined by the Committee in its discretion before the expiration of such
two-year period) and (B) the expiration of such Vested Options in accordance
with Paragraph 5 above. Notwithstanding any of the foregoing, if the Grantee
dies (i) within the ninety-day period specified in Paragraph 10 above, or (ii)
within the two-year period specified in Paragraph 9 above, then the Grantee’s
Vested Options may be exercised until the later of (A) the earlier of (1) the
first anniversary of the date of such death and (2) the expiration of such
Vested Options in accordance with Paragraph 5 above and (B) the last date on
which such Vested Options would have been exercisable, absent this Paragraph
11. These Vested Options may be exercised only by the Grantee’s designated
beneficiary, or if no such beneficiary survives the Grantee, the person or
persons entitled to the Option under the Grantee’s will or, if the Grantee
shall fail to make testamentary disposition of the Option, his or her legal
representative. Any transferee exercising a Vested Option must furnish the
Company with (a) written notice of his or her status as transferee, (b)
evidence satisfactory to the Company to establish the validity of the transfer
and compliance with any laws or regulations pertaining to said transfer, and
(c) written acceptance of the terms and conditions of the Option as prescribed
in this Agreement.
	 
	 	12.	 	Special Change in Control Post-Termination Exercise
Rights. Notwithstanding any other provision in this Agreement, upon the
Termination of Employment of a Grantee, other than for Cause, during the
24-month period following a Change in Control, any Option held by






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the Grantee as of the date of the Change in Control that remains outstanding
as of the date of such Termination of Employment may thereafter be exercised,
until the later of (i) the last date on which such Option would be exercisable
in the absence of this Paragraph 12 and (ii) the earlier of (A) the third
anniversary of such Change in Control and (B) expiration of the Term of such
Option in accordance with Paragraph 5 above.




	 	13.	 	No Assignment of Benefits. Except by will or pursuant
to the laws of descent and distribution, no Option under this Agreement shall
be subject in any manner to alienation, sale, transfer, assignment, pledge,
encumbrance, or charge, and any attempt to alienate, sell, transfer, assign,
pledge, encumber, or charge any Option shall be void. No Option shall in any
manner be liable for or subject to the debts, contracts, liabilities,
engagements, or torts of any person, nor shall it be subject to attachment or
legal process.
	 
	 	14.	 	Purchase of Options. Notwithstanding Paragraph 13
above, on or before receipt of written notice of exercise of a Vested Option,
the Committee may elect to purchase all or any part of the shares of Common
Stock issuable upon the exercise of that Vested Option by paying to the Grantee
an amount, in cash or Common Stock, equal to the excess of the Fair Market
Value of the Company’s Common Stock (on the effective date of such purchase)
over the exercise price per share of the Vested Option, times the number of
shares of Common Stock for which the Vested Option is then being exercised.
Any purchase pursuant to this Paragraph 14 relating to Vested Options held by a
Grantee who is actually or potentially subject to Section 16(b) of the 1934 Act
with respect to any securities of the Company shall comply, to the extent
applicable, with provisions of Rule 16b-3, including the “window period”
provisions of Rule 16b-3(e).
	 
	 	15.	 	Rights as Stockholder. Neither the Grantee nor any
person claiming under or through the Grantee shall be, or have any of the
rights or privileges of, a stockholder of the Company in respect of any shares
issuable upon the exercise of an Option unless and until certificates
representing such shares shall have been issued, recorded on the records of the
Company or its transfer agents or registrars, and delivered to the Grantee.
Except as provided in the 2004 Plan and this Agreement, no adjustment for
dividends, or otherwise, shall be made if the record date for payment of
dividends is before the date of issuance of the certificate or certificates.
	 
	 	16.	 	No Effect on Employment. The Company or subsidiary
employing the Grantee, as the case may be, determines the terms of Grantee’s
employment and neither this Agreement nor this award of Options confers on the
Grantee any right with respect to continued employment, nor shall it interfere
in any way with the right of the Company or subsidiary to terminate the
employment of the Grantee at any time.
	 
	 	17.	 	Compliance with Governmental Regulations. This
Agreement, the grant and exercise of Options under this Agreement and the 2004
Plan, and the obligation of the Company to sell and deliver shares of the
Common Stock upon the exercise of Options, shall be subject to and shall be
administered and interpreted in order to comply with all applicable laws,
rules, and regulations of governmental or other authorities as amended from
time to time, including without limitation Section 16(b) of the Exchange Act
and the rules and regulations promulgated thereunder, with respect to persons
subject to Section 16. Further, to the extent any provision of the 2004 Plan
or this Agreement, or any action by the Committee (or its designee) fails to
comply with any rules promulgated pursuant to Section 16 (“Section 16
Rules”), it shall be deemed null and void to the extent required for the
2004 Plan or the Options granted under this Agreement to comply with the
Section 16 Rules. Moreover, if this Agreement does not include a provision
required by the Section






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	 	 	 	16 Rules to be stated herein, such provision shall be deemed automatically
incorporated by reference into the Agreement insofar as may be
required.
	 
	 	18.	 	Section 16. If the Grantee is required to file reports
under Section 16 at any time within the six months immediately after the Date
of Award, then notwithstanding any other provision of this Agreement to the
contrary, the Grantee shall not, without the prior written consent of the
Committee, sell or otherwise dispose of any Common Stock or other security
received by the Grantee upon the exercise of any Option within six months after
the Date of Award of such Option. The Company may make such provisions as the
Company in its discretion deems necessary or beneficial to the enforcement of
this restriction, including but not limited to (a) causing a legend or legends
reflecting this restriction to be placed upon any certificate or certificates
representing such Common Stock or other securities, (b) causing stop transfer
orders or other restrictions to be imposed with respect to such Common Stock or
other securities, or (c) requiring that the certificate or certificates
representing such Common Stock or other securities be held in escrow by the
Company or another party selected by the Company pending the expiration of such
six month period.
	 
	 	19.	 	Fractional Shares. Fractional shares shall not be
issuable under this Agreement, and, when any provision of this Agreement would
otherwise entitle the Grantee to purchase a fractional share, the fraction
shall be disregarded.
	 
	 	20.	 	Withholding Taxes. The Company may make such provision
as it may deem appropriate for the withholding of any taxes the Company
determines is required in connection with the grant or exercise of any Options
under this Agreement. If the Company is unable to withhold such federal and
state taxes, for whatever reason, the Grantee hereby agrees to pay to the
Company an amount equal to the amount the Company would otherwise be required
to withhold under federal or state law. The Committee, in its discretion, may
permit the Grantee to pay all or any portion of the taxes required to be
withheld by the Company or paid by the Grantee in connection with the exercise
of any Option under this Agreement (a) by electing to have the Company withhold
shares of Common Stock due to the Grantee upon exercise having a Fair Market
Value as of the date of exercise of the Options equal to the amount required to
be withheld or paid, or (b) by delivering previously owned shares of Common
Stock having a Fair Market Value as of the date certificates representing such
shares are delivered to the Company equal to the amount required to be withheld
or paid. If the Grantee is required to file reports under Section 16, then any
election made by the Grantee to have the Company withhold shares of Common
Stock due upon exercise (the “Stock Tax Withholding Election”): (a)
must be made on or before the date that the amount of tax to be withheld is
determined (the “Tax Date”); and (b) is subject to disapproval by the
Committee and must be (i) irrevocable and made six months or more before the
Tax Date, or (ii) made in a window period commencing on the third business day
following the Company’s release of a quarterly or annual summary statement of
sales and earnings and ending on the twelfth business day following such
release, provided that the exercise of the Option with respect to which such
Stock Tax Withholding Election applies also occurs during such window period,
or (iii) made at such other time and in such manner as is permitted with
respect to stock options granted under a plan that qualifies under Rule 16b-3
under the Securities Exchange Act of 1934.
	 
	 	21.	 	Committee Authority. The Committee shall have the
power to interpret the 2004 Plan and this Agreement and to adopt such rules for
the administration, interpretation, and application of the 2004 Plan as are
consistent therewith and to interpret or revoke any such rules. The Grantee
agrees that all actions taken and all interpretation and determinations made by
the Committee in good faith shall be final, conclusive, and binding upon the
Grantee and shall be given the maximum deference permitted by law. Any such






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interpretations or determinations need not be uniform and may be made
differently among persons receiving awards under the 2004 Plan. No member of
the Committee shall be personally liable for any action, determination, or
interpretation made in good faith with respect to the 2004 Plan or this
Agreement.




	 	22.	 	Notices. Any notice to be given to the Company under
the terms of this Agreement shall be addressed to the Company, in care of its
Secretary, at 224 Rue de Jean, Lafayette, Louisiana 70505, or at such other
address as the Company may hereafter designate in writing. Any notice to be
given to the Grantee shall be given to the Grantee at his or her usual work
location or his or her home address as indicated in the records of the Company.
Any such notice shall be deemed to have been duly given if and when enclosed
in a properly sealed envelope, addressed as aforesaid, registered or certified
and deposited, postage and registry fee prepaid, in a United States post
office.
	 
	 	23.	 	Captions. The captions provided herein are for
convenience only and are not to serve as a basis for any interpretation or
construction of this Agreement.
	 
	 	24.	 	Severability of Agreement. In the event that any
provision in this Agreement shall be held invalid or unenforceable, such
provision shall be severable from, and such invalidity or unenforceability
shall not be construed to have any effect on, the remaining provisions of this
Agreement.
	 
	 	25.	 	Plan Governs. This agreement is subject to all the
terms, conditions, and provisions of the 2004 Plan as in effect on the Date of
Award, which 2004 Plan is hereby incorporated herein in its entirety. In the
event of a conflict between one or more provisions of this Agreement and one or
more provisions of the 2004 Plan, the provisions of the 2004 Plan shall govern.
Terms used in this Agreement that are not defined in this Agreement shall have
the meaning set forth in the 2004 Plan. The Grantee hereby acknowledges
receipt of a copy of the 2004 Plan and agrees to be bound by the terms,
conditions, and provisions thereof.
	 
	 	26.	 	Amendments. Except as set forth above in Paragraph 25
above, this Agreement shall not be modified or amended except by the written
consent of the parties hereto. No waiver of either party of any default under
this Agreement shall be deemed a waiver of any subsequent default.
	 
	 	27.	 	Binding Agreement. Subject to the limitation on the
transferability of the Option, this Agreement shall be binding upon and inure
to the benefit of the heirs, legatees, legal representatives, successors, and
assigns of the parties hereto.
	 
	 	28.	 	Governing Law. This Agreement shall be construed under
the laws of the State of Delaware.





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	 	29.	 	Definitions.






	 	a.	 	“Cause” means (i) “Cause,” as that term is defined
in the current employment agreement between the Company and the Grantee
or (ii) if there is no employment agreement between the Company and the
Grantee or if it does not define Cause: (A) indictment or formal charge
of the Grantee for, or plea of guilty or nolo contendere to, a felony,
or a misdemeanor involving moral turpitude; provided that any indictment
or formal charge of a Grantee outside the United States shall not de
deemed “Cause” unless and until such foreign indictment or formal charge
results in the Grantee’s conviction for such offense, (B) dishonesty in
the course of fulfilling the Grantee’s employment duties, (C) willful and
deliberate failure on the part of the Grantee to perform such Grantee’s
employment duties in any material respect.
	 
	 	b.	 	“Change in Control” means “Change of Control,” as
that term is defined in the Change of Control Agreement between the
Company and the Grantee, or, if the Grantee has not executed a Change of
Control Agreement, the happening of any of the following events:






(i)      The acquisition by any individual, entity or group (within the
meaning of Section 13(d)(3) or 14(d)(2) of the Exchange Act) (a
“Person”) of beneficial ownership (within the meaning of Rule 13d-3
promulgated under the Exchange Act) of 20% or more of either (A) the
then outstanding shares of common stock of the Company (the
“Outstanding Company Common Stock”) or (B) the combined voting power of
the then outstanding voting securities of the Company entitled to vote
generally in the election of directors (the “Outstanding Company Voting
Securities”); provided, however, that for purposes of this definition,
the following acquisitions shall not constitute a Change in Control;
(1) any acquisition directly from the Company, (2) any acquisition by
the Company, (3) any acquisition by any employee benefit plan (or
related trust) sponsored or maintained by the Company or any
corporation controlled by the Company or (4) any acquisition by any
corporation pursuant to a transaction which complies with Sections
9(b)(iii)(A), 9(b)(iii)(B) and 9(b)(iii)(C) of the Plan; or




(ii)      Individuals who, as of the Effective Date, constitute the
Board (the “Incumbent Board”) cease for any reason to constitute at
least a majority of the Board; provided, however, that any individual
becoming a director subsequent to the Effective Date whose election, or
nomination for election by the Company’s stockholders, was approved by
a vote of at least a majority of the directors then comprising the
Incumbent Board shall be considered as though such individual were a
member of the Incumbent Board, but excluding, for this purpose, any
such individual whose initial assumption of office occurs as a result
of an actual or threatened election contest with respect to the
election or removal of directors or other actual or threatened
solicitation of proxies or consents by or on behalf of a Person other
than the Board; or



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(iii)      Consummation by the Company of a reorganization, merger or
consolidation or sale or other disposition of all or substantially all
of the assets of the Company or the acquisition of assets of another
corporation (a “Business Combination”), in each case, unless, following
such Business Combination, (A) all or substantially all of the
individuals and entities who were the beneficial owners, respectively,
of the Outstanding Company Common Stock and Outstanding Company Voting
Securities immediately prior to such Business Combination beneficially
own, directly or indirectly, more than 50.1% of, respectively, the then
outstanding shares of common stock and the combined voting power of the
then outstanding voting securities entitled to vote generally in the
election of directors, as the case may be, of the corporation resulting
from such Business Combination (including, without limitation, a
corporation which as a result of such transaction owns the Company or
all or substantially all of the Company’s assets either directly or
through one or more subsidiaries) in substantially the same proportions
as their ownership, immediately prior to such Business Combination of
the Outstanding Company Common Stock and Outstanding Company Voting
Securities, as the case may be, (B) no Person (excluding any employee
benefit plan (or related trust) of the Company or such corporation
resulting from such Business Combination) beneficially owns, directly
or indirectly, 20% or more of, respectively, the then outstanding
shares of common stock of the corporation resulting from such Business
Combination or the combined voting power of the then outstanding voting
securities of such corporation except to the extent that such ownership
existed prior to the Business Combination and (C) at least a majority
of the members of the board of directors of the corporation resulting
from such Business Combination were members of the Incumbent Board at
the time of the execution of the initial agreement, or of the action of
the Board, providing for such Business Combination; or




(iv)      Approval by the stockholders of the Company of a complete
liquidation or dissolution of the Company.




	 	c.	 	“Disability” means permanent and total disability
as defined in Section 22(e)(3) of the Internal Revenue Code, or such
definition as may be substituted therefore for purposes of Section 422 of
the Code, as amended from time to time.
	 
	 	d.	 	“Fair Market Value” means the mean between the
highest and lowest reported sales prices of the Common Stock on the New
York Stock Exchange or, if not listed on such exchange, on any other
national securities exchange on which the Common Stock is listed or on
NASDAQ, or, in the event that the Common Stock is not quoted on any such
system, the average of the closing bid prices per share of the Common
Stock as furnished by a professional marketmaker making a market in the
Common Stock designated by the Committee. If there is no regular public
trading market for the Common Stock, the Fair Market Value of the Common
Stock shall be determined by the Committee in good faith.
	 
	 	e.	 	“Retirement” shall mean a Termination of Employment
with the Company or any of its subsidiaries at or after age 65; provided,
however, that under no circumstances shall a Termination of Employment by
the Company for Cause be considered a Retirement.
	 
	 	f.	 	“Termination of Employment” means the termination
of the Grantee’s employment with the Company and any subsidiary. A
Grantee employed by a subsidiary shall also be deemed to incur a
Termination of Employment if the





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subsidiary ceases to be such a subsidiary, as the case may be, and the
Grantee does not immediately thereafter become an employee of the
Company or another subsidiary.



     IN WITNESS WHEREOF, the Company has caused this Stock Option Agreement to be executed, and the
Grantee has executed this Stock Option Agreement, as of the date first above written.



	 	 	 	 	 	 	 
	 	 	OFFSHORE LOGISTICS, INC.
	 
	 	 	 	 	 	 
	 
	 	 	 	 	 	 
	 

	 	By:	 	 	 	 
	 	 	 	 	 
	 

	 	 	 	 	 	Officer designated by the
	 

	 	 	 	 	 	Compensation Committee
	 
	 	 	 	 	 	 
	 
	 	 	 	 	 	 
	 	 	GRANTEE
	 
	 	 	 	 	 	 
	 
	 	 	 	 	 	 
	 	 	 
	 	 	< Insert Name of Grantee >








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