Document:

adoption_agreement.htm

NONSTANDARDIZED ADOPTION AGREEMENT

PROTOTYPE CASH OR DEFERRED PROFIT-SHARING PLAN

Sponsored by

Wachovia Bank, National Association

The Employer named below hereby establishes a Cash or Deferred Profit-Sharing Plan for eligible Employees as provided in this Adoption Agreement and the accompanying Basic Plan Document #01.

I.           EMPLOYER INFORMATION

	
  

	
If more than one Employer is adopting the Plan, complete this section based on the lead Employer.  Additional Employers who are members of the same controlled group or affiliated service group may adopt this Plan by completing and executing a Participation Agreement that, once executed, will become part of this Adoption Agreement.

A.           Name And Address:

Connecticut Water Company

93 West Main Street

Clinton, CT 06413-1600

B.           Telephone Number:  860-669-8630

C.           Employer’s Tax ID Number:  06-0713930

	
  

	
D.

	
Form Of Business:

[ ]           1.           Sole Proprietor                                           [ ]           5.           Limited Liability Company

[ ]           2.           Partnership                                [ ]           6.           Limited Liability Partnership

[x]           3.           Corporation                                [ ]           7.                                                      

[ ]           4.           S Corporation

E.           Is The Employer Part Of A Controlled Group?                                                                                     [x]  YES                      [ ]  NO

Part Of An Affiliated Service Group?                                                                                     [ ]  YES                      [x]  NO

F.           Name Of Plan:  Savings Plan of the Connecticut Water Company

G.           Three Digit Plan Number:  003

H.           Employer’s Tax Year End: December 31

I.           Employer’s Business Code:  221300

II.           EFFECTIVE DATE

	
A.  

	
New Plan:

	
  

	
This is a new Plan having an Effective Date of __________________________.  The Effective Date may be no earlier than the Plan Year beginning after December 31, 2001 or if later, the first day of the Plan Year in which it is adopted.

	
B.  

	
Amended and Restated Plans:

This is an amendment and/or restatement of an existing Plan.  The initial Effective Date of the Plan was ________________________________________.  The Effective Date of this amendment and/or restatement is __________________________.  The Effective Date of the restated Plan may be no earlier than for Plan Years beginning after December 31, 2001.

	
C.  

	
Amended or Restated Plans for EGTRRA:

This is an amendment and/or restatement of an existing Plan to comply with the Economic Growth and Tax Relief Reconciliation Act of 2001, Pub. L. 107-17 (EGTRRA)]. The initial Effective Date of the Plan was January 1, 1985.  Except as provided for in the Plan, the Effective Date of this amendment and/or restatement is January 1, 2010. (The restatement date should be no earlier than the first day of the current Plan Year.  The Plan contains appropriate retroactive Effective Dates with respect to provisions of EGTRRA.)

Except to the extent permitted under Code Section 411(d)(6) and the Regulations issued thereunder, an Employer cannot reduce, eliminate or make subject to Employer discretion any Code Section 411(d)(6) protected benefit.  Where this Plan document is being adopted to amend another plan that contains a protected benefit not provided for in the Basic Plan Document #01, the Employer may complete Schedule A as an addendum to this Adoption Agreement.  Schedule A describes such protected benefits and shall become part of this Plan.  If a prior plan document contains a plan feature not provided for in the Basic Plan Document #01, the Employer may attach Schedule B describing such feature.  Provisions listed on Schedule B may not be covered by the IRS Opinion Letter issued with respect to the Basic Plan Document #01.

D.           Effective Date for Elective Deferrals:

If different from above, the Elective Deferral provisions shall be effective __________________________.

E. Effective Date for Safe Harbor 401(k) Contributions:

If different from above, this provision shall be effective January 1, 2009. This provision must be adopted prior to the first day of the Plan Year and remain in effect for an entire twelve (12) month period.

F. Effective Date for Roth Elective Deferrals:

If different from above, Roth Elective Deferral provisions shall be effective __________________________.  The Effective Date of this provision cannot be earlier than January 1, 2006.

	
  

	
G.

	
Frozen Plan:

This Plan was frozen effective __________________________.  For any period following this Effective Date, neither the Employer nor any Participant may contribute to this Plan, and no otherwise eligible Employee shall become a Participant in this Plan. All existing account balances will become fully vested as of the date specified above.

III.           DEFINITIONS

	
  

	
A.

	
“Compensation”

	
  

	
Select the definition of Compensation, the Compensation Computation Period, any Compensation Dollar Limitation and Exclusions from Compensation for each contribution type from the options listed below.  Enter the letter of the option selected on the lines provided below.  Leave the line blank if no election needs to be made. The Compensation Computation Period must be the same as the Limitation Year defined at Section III(E).

	
 

Employer

Contribution Type

	
 

Compensation

Definition

	
 Compensation

 Computation

 Period

	
 

Compensation

Dollar Limitation

	
Exclusions

From Compensation

	
All Contributions

	
d

	
a

	
$

	
b, c, d, g, j

	
Elective Deferrals (including Roth Elective Deferrals, if applicable)

	  	  	
$

	  

	
Employer

Contribution Type

	
Compensation

Definition

	
 Compensation

 Computation

 Period

	
Compensation

Dollar Limitation

	
Exclusions

From Compensation

	
Voluntary After-tax

	  	  	
$

	  
	
Required After-tax

	  	  	
$

	  
	
Matching Contribution

(Formula 1)

	  	  	
$

	  
	
Matching Contribution

(Formula 2)

	  	  	
$

	  
	
Non-Elective Contribution

(Formula 1)

	  	  	
$

	  
	
Non-Elective Contribution

(Formula 2)

	  	  	
$

	  
	
Safe Harbor Contribution

	  	  	
N/A

	
N/A

	
QNEC

	  	  	
$

	  
	
QMAC

	  	  	
$

	  
	
ADP/ACP Tests

	  	  	
N/A

	
N/A

1.           Compensation Definition:

	
  

	
a.

	
Code Section 3401(a) - W-2 Compensation subject to income tax withholding at the source, with all pre-tax contributions excluded.

	
  

	
b.

	
Code Section 3401(a) - W-2 Compensation subject to income tax withholding at the source, with all pre-tax contributions included [Plan defaults to this election].

	
c.  

	
Code Section 6041/6051 - Income reportable on Form W-2, with all pre-tax contributions excluded.

	
  

	
d.

	
Code Section 6041/6051 - Income reportable on Form W-2, with all pre-tax contributions included.

	
  

	
e.

	
Code Section 415 - All income received for services performed for the Employer, with all pre-tax contributions excluded.

	
  

	
f.

	
Code Section 415 - All income received for services performed for the Employer, with all pre-tax contributions included.

The selection of any of the above definitions of Compensation meets the Code Section 414(s) definition of Compensation.  The Code Section 415 definition shall always apply with respect to sole proprietors and partners.

	
  

	
[ ]

	
2.

	
Deemed Compensation from permitted waiver of group health coverage under a Cafeteria Plan Arrangement:  The Employer elects to include deemed Code Section 125 Compensation not available to a Participant in cash in lieu of group health coverage in the Plan’s definition of Compensation.

	
  

	
3.

	
Compensation Computation Period:

	
  

	
a.

	
Compensation paid during a Plan Year while a Participant [Plan defaults to this          election].

b.           Compensation paid during the entire Plan Year.

c.           Compensation paid during the Employer's fiscal year.

	
d.  

	
Compensation paid during the calendar year.

	
  

	
4.

	
Compensation Dollar Limitation: The dollar limitation section does not need to be completed unless Compensation of less than the Code Section 401(a)(17) limit of $200,000 is to be used. When an integrated allocation formula in Section VI is selected, Compensation cannot be limited to an amount less than the maximum amount under Code Section 401(a)(17).

5.           Exclusions from Compensation (non-integrated plans only):

	
  

	
a.

	
There will be no exclusions from Compensation under the Plan [Plan defaults to this safe harbor election].

	
  

	
b.

	
Overtime

c.           Bonuses

d.           Commissions

	
e.  

	
Exclusion applies only to Participants who are Highly Compensated Employees [safe harbor].

	
f.  

	
Holiday and vacation pay

	
g.  

	
Reimbursements or other expense allowances, fringe benefits (cash and non-cash), moving expenses, deferred compensation, and welfare benefits [safe harbor].

	
h.  

	
Post-severance payments, as described in paragraph 1.17(c)(6) of Basic Plan Document #01. (This exclusion may apply no earlier than the 2005 Limitation Year.)

	
i.  

	
Compensation in excess of $__________________________ for Highly Compensated Employees [safe harbor].

	
j.  

	
Other:  Employer’s cost for any public or private employee benefit plan

Any exclusion of Compensation except (a), (e), (g), (h) and (i) must satisfy the requirements of Section 1.401(a)(4) of the Income Tax Regulations and Code Section 414(s) and the Regulations thereunder.  These exclusions do not fall under the “safe harbor” modifications to Compensation and therefore must be tested to determine if the modified definition of Compensation satisfies Code Section 414(s).

	
  

	
B.

	
“Disability”

	
  

	
[x]

	
1.

	
As defined in the Basic Plan Document #01 [Plan defaults to this election].

	
  

	
[ ]

	
2.

	
As defined in the Employer’s Disability Insurance Plan.

	
  

	
[ ]

	
3.

	
An individual will be considered to be disabled if he or she is unable to engage in any substantial gainful activity by reason of any medically determinable physical or mental impairment which can be expected to result in death or to be of long, continued and indefinite duration.  An individual shall not be considered to be disabled unless he or she furnishes proof of the existence thereof in such form and manner as the Secretary of the Treasury may prescribe.

	
  

	
C.

	
“Highly Compensated Employees – Top-Paid Group Election”

	
  

	
1.

	
Top-Paid Group Election:  In determining who is a Highly Compensated Employee, the Employer may make the Top-Paid Group election.  The effect of this election is that an Employee (who is not a 5% owner at any time during the determination year or the look-back year) who earned more than $95,000, as indexed for the look-back year, is a Highly Compensated Employee if the Employee was in the Top-Paid Group for the look-back year.  This election is applicable for the Plan Year in which this Plan is effective.

[x]           a.           The Employer does not make the Top-Paid Group election.

	
  

	
[ ]

	
b.

	
The Employer makes the Top-Paid Group election [Plan defaults to this election].

	
  

	
[ ]

	
2.

	
Calendar Year Data Election:  If the Plan Year is not the calendar year, the prior year computation period for purposes of determining if an Employee earned more than $95,000, as indexed, is the calendar year beginning in the prior Plan Year.  This election is applicable for the Plan Year in which this Plan is effective.

	
  

	
D.

	
“Hours Of Service”

Hours shall be determined by the method selected below. The method selected shall be applied to all Employees:

	
  

	
[ ]

	
1.

	
Not applicable.  A Year of Service (Period of Service) is defined using the Elapsed Time method.

	
  

	
[x]

	
2.

	
On the basis of actual hours for which an Employee is paid or entitled to payment [Plan defaults to this election].

	
  

	
[ ]

	
3.

	
On the basis of days worked.  An Employee shall be credited with ten (10) Hours of Service if the Employee would be credited with at least one (1) Hour of Service during the day.

	
  

	
[ ]

	
4.

	
On the basis of weeks worked.  An Employee shall be credited with forty-five (45) Hours of Service if the Employee would be credited with at least one (1) Hour of Service during the week.

	
  

	
[ ]

	
5.

	
On the basis of semi-monthly payroll periods.  An Employee shall be credited with ninety-five (95) Hours of Service if the Employee would be credited with at least one (1) Hour of Service during the semi-monthly payroll period.

	
  

	
[ ]

	
6.

	
On the basis of months worked.  An Employee shall be credited with one-hundred-ninety (190) Hours of Service if the Employee would be credited with at least one (1) Hour of Service during the month.

	
  

	
E.

	
“Integration Level”

	
  

	
[x]

	
1.

	
Not applicable. Either the Plan's allocation formula is not integrated with Social Security or there are no Non-Elective Employer Contributions being made to the Plan [Plan defaults to this election].

	
  

	
[ ]

	
2.

	
The Taxable Wage Base.

	
  

	
[ ]

	
3.

	
________% (not more than 100%) of the Taxable Wage Base.

	
  

	
[ ]

	
4.

	
$________, provided that such amount is not in excess of the amount determined under paragraph (E)(2) above.

	
  

	
[ ]

	
5.

	
One dollar over 80% of the Taxable Wage Base.

	
  

	
[ ]

	
6.

	
20% of the Taxable Wage Base.

F.           “Limitation Year”

	
  

	
Unless elected otherwise below, the Limitation Year shall be the Plan Year.

	
  

	
The twelve (12) consecutive month period commencing on January 1 and ending on December 31.

If applicable, there will be a short Limitation Year commencing on ___________________________ and ending on ___________________________.  Thereafter, the Limitation Year shall end on the date specified above.

	
G.

	
“Net Profit”

	
  

	
[x]

	
1.

	
Not applicable.  Employer contributions to the Plan are not conditioned on profits [Plan defaults to this election].

	
  

	
[ ]

	
2.

	
Net Profits are required for making Employer contributions and are defined as follows:

	
  

	
[ ]

	
a.

	
As defined in the Basic Plan Document #01.

	
  

	
[ ]

	
b.

	
Net Profits will be defined in a uniform and nondiscriminatory manner which will not result in a deprivation of an eligible Participant of any Employer  Contribution.

	
  

	
c.

	
Net Profits are required for the following types of contributions:

[ ]           i.           Employer Matching Contributions (Formula 1).

[ ]           ii.           Employer Matching Contributions (Formula 2).

	
  

	
[ ]

	
iii.

	
Employer QNEC and QMAC Contributions.

[ ]           iv.           Non-Elective Employer Contributions (Formula 1).

[ ]           v.           Non-Elective Employer Contributions (Formula 2).

Elective Deferrals, Top-Heavy minimums (if required), and Safe Harbor Contributions (if applicable) must be contributed regardless of profits.

	
  

	
H.

	
“Plan Year”

	
  

	
The 12-consecutive month period commencing on January 1 and ending on December 31.

If applicable, there will be a short Plan Year commencing on ___________________________ and ending on ___________________________.  Thereafter, the Plan Year shall end on the date specified above.

I.           “QDRO Payment Date”

	
  

	
[x]

	
1.

	
The date the QDRO is determined to be qualified [Plan defaults to this election].

	
  

	
[ ]

	
2.

	
The statutory age fifty (50) requirement applies for purposes of making distribution to an alternate payee under the provisions of a QDRO.

	
  

	
J.

	
“Qualified Joint and Survivor Annuity”

	
  

	
[x]

	
1.

	
Not applicable.  The Plan is not subject to Qualified Joint and Survivor Annuity rules. The safe harbor provisions of paragraph 8.7 of the Basic Plan Document #01 apply.  The normal form of payment is a lump sum.  No annuities are offered under the Plan [Plan defaults to this election].

	
  

	
[ ]

	
2.

	
The normal form of payment is a lump sum.  The Plan does provide for annuities as an optional form of payment at Section XVI(D) of the Adoption Agreement. The Plan’s Joint and Survivor Annuity rules are avoided and the safe harbor provisions of paragraph 8.7 of the Basic Plan Document #01 will apply, unless the Participant elects to receive his or her distribution in the form of an annuity.  If this option is selected, Section III(K) below must also be completed.

	
  

	
[ ]

	
3.

	
The Joint and Survivor Annuity rules are applicable and the survivor annuity will be ________% (50%, 66-2/3%, 75% or 100%) of the annuity payable during the lives of the Participant and his or her Spouse.  If no selection is specified, 50% shall be deemed elected.

	
K.  

	
“Qualified Pre-Retirement Survivor Annuity”

Do not complete this section if paragraph (J)(1) was elected.

	
  

	
[ ]

	
1.

	
The Qualified Pre-Retirement Survivor Annuity shall be 100% of the Participant’s Vested Account Balance in the Plan as of the date of the Participant’s death.

	
  

	
[ ]

	
2.

	
The Qualified Pre-Retirement Survivor Annuity shall be 50% of the Participant’s Vested Account Balance in the Plan as of the date of the Participant’s death.

If this provision applies but no selection is made, the Qualified Pre-Retirement Survivor Annuity shall be 50%.

L.           “Valuation of Plan Assets”

	
  

	
The assets of the Plan shall be valued on the last day of the Plan Year and on the following Valuation Date(s):

[ ]           1.           There are no other mandatory Valuation Dates.

[x]           2.           The Valuation Dates are applicable for the contribution type specified below:

	
 

Contribution Type Valuation Date

	
 

Valuation Date

	
All Contributions

	
a

	
Elective Deferrals (including Roth Elective Deferrals, if applicable)

	  
	
Voluntary After-tax Contributions

	  
	
Required After-tax Contributions

	  
	
Deemed IRA Contribution

	  
	
Matching Contributions (Formula 1)

	  
	
Matching Contributions (Formula 2)

	  
	
Non-Elective Contributions (Formula 1)

	  
	
Non-Elective Contributions (Formula 2)

	  
	
Safe Harbor Contributions

	  
	
QNEC

	  
	
QMAC

	  

a.           Daily valued.

b.           The last day of each month.

c.           The last day of each quarter in the Plan Year.

d.           The last day of each semi-annual period in the Plan Year.

	
  

	
e.

	
Other:

	
.

(Note: Date must be at least once during the Plan Year.)

IV.           ELIGIBILITY REQUIREMENTS

Complete the following using the eligibility requirements as specified for each contribution type. To become a Participant in the Plan, the Employee must satisfy the following eligibility requirements.

	
 

 

Contribution Type

	
 

Minimum

Age

	
 

Service

Requirement

	
 

Class

Exclusions

	
Eligibility

Computation

Period

	
 

 

Entry Date

	
 

All Contributions

	  	  	  	  	  
	
 

Elective Deferrals (including Roth Elective Deferrals, if applicable)

	
1

	
3

	
6, 10 (a)

	  	
5

	
 

Voluntary After-tax Contributions

	  	  	  	  	  
	
 

Required After-tax Contributions

	  	  	  	  	  
	
 

Matching Contributions

(Formula 1)

	  	  	  	  	  
	
Matching Contributions

(Formula 2)

	  	  	  	  	  
	
Non-Elective Contributions (Formula 1)

	
1

	
3

	
6, 10 (a) + (b)

	  	
5

	
Non-Elective Contributions (Formula 2)

	  	  	  	  	  
	
Safe Harbor Contributions*

	
1

	
3

	
6, 10 (a)

	  	
5

	
 

QNECs

	  	  	  	  	  
	
 

QMACs

	  	  	  	  	  

	
  

	
*If any age or Service requirement selected is more restrictive than that which is imposed on any Employee contribution, that group of Employees will be subject to the ADP and/or ACP testing as prescribed under applicable IRS Regulations

A.           Age:

1.           No age requirement.

	
  

	
2.

	
Insert the applicable age in the chart above.  The age may not be more than twenty-one (21).

	
B.  

	
Service:

The maximum Service requirement for Elective Deferrals is one (1) year.  For all other contributions, the maximum is two (2) years.  If a Service requirement greater than one (1) year is selected, Participants must be 100% vested in that contribution.

	
  

	
1.

	
No Service requirement.

	
  

	
2.

	
Completion of _______ Days of Service. [No more than 730 Days of Service may be required; if more than 365 days are entered here, Participants must be 100% vested upon entering the Plan.]

	
  

	
3.

	
Completion of 6 months of Service [No more than twenty-four (24) months of Service may be required; if more than twelve (12) months are entered here, Participants must be 100% vested upon entering the Plan.]

	
  

	
4.

	
Completion of _______ months of Service [No more than twenty-four (24) months of Service may be required; if more than twelve (12) months are entered here, Participants must be 100% vested upon entering the Plan.]

	
  

	
5.

	
One (1) Year of Service or Period of Service.

	
  

	
6.

	
Two (2) Years of Service or Periods of Service.

	
  

	
7.

	
One (1) Expected Year of Service.  An Employee whose position is required as a condition of employment to work a Year of Service may enter after six (6) months of actual Service.

	
  

	
8.

	
One (1) Expected Year of Service.  An Employee whose position is required as a condition of employment to work a Year of Service may enter after __________ months of actual Service [must be twelve (12) months or less].

	
  

	
9.

	
One (1) Expected Year of Service.  An Employee whose position is required as a condition of employment to work a Year of Service may enter after __________ months of actual Service [must be twelve (12) months or less].

	
  

	
10.

	
Completion of ___________ Hours of Service (1,000 hours or less) within the ___________ month(s) time period [the monthly period must be a pro-ration of twelve (12) months or less] following an Employee's commencement of employment.  An Employee who is otherwise eligible who meets the statutory one (1) Year of Service requirement and any age requirement if applicable, shall participate in the Plan not later than the earlier of the first day of the first Plan Year after the Employee has met the statutory requirements or six (6) months after the day such requirements are met.

11.           Completion of ___________ Hours of Service (may not be more than 1,000 Hours).

	
  

	
C.

	
Method for Measuring Service Eligibility Period (do not enter this method in the table above):

	
  

	
A Year of Service for eligibility purposes is defined as follows (choose one):

	
  

	
[ ]

	
1.

	
Not applicable.

	
  

	
[x]

	
2.

	
Hours of Service method.  A Year of Service will be credited upon completion of 1000 Hours of Service.  A Year of Service for eligibility purposes may not be less than one (1) Hour of Service nor greater than 1,000 hours by operation of law.  If left blank, the Plan will use 1,000 hours.

	
  

	
[ ]

	
3.

	
Elapsed Time method

	
  

	
D.

	
Employee Class Exclusions:

The exclusion of any classification may cause the Plan to fail the ratio percentage test under Code Section 410(b)(1)(A) or (B) which may require the Plan to be tested under the average benefits test of Code Section 410(b)(1)(C).

	
1.  

	
Employees included in a unit of Employees covered by a collective bargaining agreement between the Employer and Employee Representatives, if benefits were the subject of good faith bargaining and if two percent or less of the Employees are covered pursuant to the agreement are professionals as defined in Regulations Section 1.410(b)-9, unless participation in this Plan is specifically provided for in the collective bargaining agreement.  For this purpose, the term “employee representative” does not include any organization more than half of whose members are owners, officers, or executives of the Employer.

	
  

	
2.

	
Employees who are non-resident aliens [within the meaning of Code Section 7701(b)(1)(B)] who receive no Earned Income [within the meaning of Code Section 911(d)(2)] from the Employer which constitutes income from sources within the United States [within the meaning of Code Section 861(a)(3)].

	
  

	
3.

	
Employees compensated on an hourly basis.

	
  

	
4.

	
Employees compensated on a salaried basis.

	
  

	
5.

	
Employees compensated on a commission basis.

	
  

	
6.

	
Leased Employees.

	
  

	
7.

	
Highly Compensated Employees.

	
  

	
8.

	
Key Employees.

	
  

	
9.

	
Employees of any member of the controlled and/or affiliated service group Employer whose Employer does not affirmatively adopt this Plan.

	
  

	
10.

	
The Plan shall exclude from participation any nondiscriminatory classification of Employees determined as follows (any exclusion must pass coverage and nondiscrimination testing):

	
(a)  

	
Those Employees of a Related Employer that has not executed a Related

Employer Participation Agreement.

	
(b)  

	
For purposes of the Non-Elective Employer Contribution set forth in

VI(K)(3), page 21, employees, other than newly eligible employees hired on

or after January 1, 2009, are excluded.

	
  

	
E.

	
Eligibility Computation Period:

	
  

	
The initial eligibility computation period shall commence on the date on which an Employee first performs an Hour of Service and end with the first anniversary thereof.  Each subsequent computation period shall commence on:

	
  

	
1.

	
Not applicable.  The Plan has a Service requirement of less than one (1) year or uses the Elapsed Time method to determine eligibility.

	
  

	
2.

	
The anniversary of the Employee’s employment commencement date and each subsequent twelve (12) consecutive month period thereafter.

	
  

	
3.

	
The first day of the Plan Year which commences prior to the first anniversary date of the Employee’s employment commencement date and each subsequent Plan Year thereafter.

	
  

	
F.

	
Entry Date:

	
  

	
1.

	
The Employee’s date of hire.

	
  

	
2.

	
The first day of the month coinciding with or next following the date on which an Employee meets the eligibility requirements.

	
  

	
3.

	
The first day of the payroll period coinciding with or next following the date on which an Employee meets the eligibility requirements, or as soon as administratively feasible thereafter.

	
  

	
4.

	
When the Days of Service method is selected at Section IV(B)(2), the Entry Date shall be the day the Employee meets the eligibility requirements, or as soon as administratively feasible thereafter.

	
  

	
5.

	
The earlier of the first day of the Plan Year, or the first day of the fourth, seventh or tenth month of the Plan Year coinciding with or next following the date on which an Employee meets the eligibility requirements.

	
  

	
6.

	
The earlier of the first day of the Plan Year or the first day of the seventh month of the Plan Year coinciding with or next following the date on which an Employee meets the eligibility requirements.

	
  

	
7.

	
The first day of the Plan Year following the date on which the Employee meets the eligibility requirements.  If this election is made, the Service waiting period cannot be greater than one-half year and the minimum age requirement may not be greater than age twenty and one-half (201⁄2).

	
  

	
8.

	
The first day of the Plan Year nearest the date on which an Employee meets the eligibility requirements.  This option can only be selected for Employer related contributions.

	
  

	
9.

	
The first day of the Plan Year during which the Employee meets the eligibility requirements.  This option can only be selected for Employer related contributions.

	
  

	
10.

	
Other: ________________________.

This option may not require an entry date more than two (2) months following the date on which an Employee meets the eligibility requirements.

	
  

	
G.

	
Employees on Effective Date:

If option (1) is selected, options (2) and (3) should not be selected.  Options (2) and (3) can be selected or just option (2) or (3).

	
  

	
[x]

	
1.

	
All Employees will be required to satisfy both the age and Service requirements specified above.

	
  

	
[ ]

	
2.

	
Employees employed on the Plan’s Effective Date do not have to satisfy the age requirement specified above.

	
  

	
[ ]

	
3.

	
Employees employed on the Plan's Effective Date do not have to satisfy the Service requirement specified above.

	
  

	
H.

	
Special Waiver of Eligibility Requirements:

	
  

	
The age and/or Service eligibility requirements specified above shall be waived for the eligible Employees specified below who are employed on the specified date for the contribution type(s) specified.  This waiver applies to either the age or Service requirement or both as elected below.

	
 

Waiver Date

	
Waiver of Age

Requirement

	
Waiver of Service

Requirement

	
 

Contribution Type

	  	  	  	
All Contributions

	  	  	  	
Elective Deferrals (including Roth Elective Deferrals, if applicable)

	  	  	  	
Matching Contribution (Formula 1)

	  	  	  	
Matching Contribution (Formula 2)

	  	  	  	
Non-Elective Contribution (Formula 1)

	  	  	  	
Non-Elective Contribution (Formula 2)

	  	  	  	
Safe Harbor Contribution

	  	  	  	
QNEC

	  	  	  	
QMAC

The waiver above applies to:

[ ]           1.           All eligible Employees employed on the specified date.

[ ]           2.           The indicated class of Employees employed on the specified date.

Note:  Any selection here may cause the Plan to be discriminatory in operation and therefore would have to be tested for nondiscrimination.

	
V.

	
RETIREMENT AGES

	
A.  

	
Normal Retirement:

Select option (1) or (2) and either (3)(a) or (3)(b).

	
  

	
[x]

	
1.

	
Normal Retirement Age shall be age 65 [not to exceed sixty-five (65)].

	
  

	
[ ]

	
2.

	
Normal Retirement Age shall be the later of attaining age ________ [not to exceed age sixty-five (65)] or the ________ (not to exceed the fifth) anniversary of the first day of the first Plan Year in which the Participant commenced participation in the Plan.

	
  

	
3.

	
The Normal Retirement Date shall be:

	
  

	
[x]

	
a.

	
as of the date the Participant attains Normal Retirement Age [Plan defaults to this election].

	
  

	
[ ]

	
b.

	
the first day of the month next following the Participant’s attainment of Normal Retirement Age.

B.           Early Retirement:

[ ]           1.           Not applicable.

	
  

	
[x]

	
2.

	
The Plan shall have an Early Retirement Age of 55 [not less than age fifty-five (55)] and completion of 1 Year of Service.

	
  

	
3.

	
The Early Retirement Date shall be:

	
  

	
[x]

	
a.

	
as of the date the Participant attains Early Retirement Age [Plan defaults to this election].

	
  

	
[ ]

	
b.

	
the first day of the month next following the Participant’s attainment of Early Retirement Age.

VI.           CONTRIBUTIONS TO THE PLAN

The Employer shall make contributions to the Plan in accordance with the formula or formulas selected below.  The Employer’s contribution shall be subject to the limitations contained in Articles III and X of the Basic Plan Document #01.  For this purpose, a contribution for a Plan Year shall be limited by Compensation earned in the Limitation Year that ends with or within such Plan Year. For Limitation Years beginning on or after January 1, 2002, except to the extent permitted under paragraph 4.6(h) of the Basic Plan Document #01 and under Code Section 414(v), the Annual Addition that may be contributed or allocated to a Participant’s account under the Plan for any Limitation Year beginning after December 31, 2001 shall not exceed the lesser of (a) $40,000, as adjusted for increases in the cost-of-living under Code Section 415(d), or (b) 100% of the Participant’s Compensation within the meaning of Code Section 415(c)(3), for the Limitation Year.

	
A.  

	
Elective Deferrals:

1.           Participants shall be permitted to make Elective Deferrals:

	
  

	
[ ]

	
a.

	
in any amount up to ____________% (may be no more than 100%) of Compensation.

	
  

	
[x]

	
b.

	
in any amount from a minimum of 1% (may be no less than 1%) to a maximum of 50% (may be no more than 100%) of their Compensation not to exceed $__________ [may be no more than the Code Section 402(g) limit and Code Section 414(v) limit, if applicable].

	
  

	
[x]

	
c.

	
in a flat dollar amount from a minimum of $500 (may be no less than $500) to a maximum of $_____________, [may be no more than the Code Section 402(g) limit and Code Section 414(v) limit, if applicable] not to exceed ______% (no more than 100%) of their Compensation.

	
  

	
[ ]

	
d.

	
in any amount up to the maximum percentage of Compensation and dollar amount permissible under Code Section 402(g) and 414(v) not to exceed the limits of Code Section 401(k), 404 and 415.

	
  

	
[ ]

	
e.

	
Highly Compensated Employees may defer any amount up to ____% (may be no more than 100%) of Compensation or $__________ [may be no more than the Code Section 402(g) limit and Code Section 414(v) limit, if applicable].

	
  

	
[x]

	
f.

	
Catch-up Contributions may be made by eligible Participants.

	
  

	
2.

	
Participants shall be permitted to terminate their Elective Deferrals (including Roth Elective Deferrals, if any) at any time upon proper and timely notice to the Employer.  Modifications and reinstatement of Participants’ Elective Deferrals will become effective as soon as administratively feasible on a prospective basis as provided for below:

	
Modifications

	
Reinstatement

	
Method

	
  

	
[ ]

	
[ ]

	
On a daily basis.

	
  

	
[x]

	
[x]

	
On the first day of each quarter.

	
  

	
[ ]

	
[ ]

	
On the first day of the next month.

	
  

	
[ ]

	
[ ]

	
The beginning of the next payroll period.

	
  

	
[ ]

	
[ ]

	
On the first day of the next semi-annual period.

	
  

	
[ ]

	
n/a

	
Upon _____ days notice to the Plan Administrator.

	
  

	
n/a

	
[ ]

	
Upon _____ days notice to the Plan Administrator.

	
[ ]

	
B.

	
Roth Elective Deferrals:

If Participants are permitted to make Elective Deferrals, they shall also be permitted to make Roth Elective Deferrals.  Roth Elective Deferrals may be treated as Catch-Up Contributions.

	
  

	
C.

	
Bonus Option:

	
  

	
[x]

	
1.

	
Not applicable. The Plan’s definition of Compensation excludes bonuses from deferrable Compensation for both Elective Deferrals and Roth Elective Deferrals.

	
  

	
[ ]

	
2.

	
Not applicable.  Participants are not permitted to make a separate deferral election and the Participant’s deferral amount elected on their Salary Deferral Agreement will also apply to any bonus received by the Participant for any Plan Year.

	
  

	
[ ]

	
3.

	
The Employer permits a Participant to amend his or her deferral election to defer to the Plan an amount not to exceed __________% (may be no more than 100%) or $_________ [may be no more than the Code Section 402(g) limit and Code Section 414(v) limit, if applicable] of any bonus received by the Participant for any Plan Year.

	
  

	
[ ]

	
D.

	
Automatic Enrollment:

The Employer elects the automatic enrollment provisions for Elective Deferrals as follows. Automatic enrollment in Roth Elective Deferrals is not permitted under the Plan.  The automatic enrollment provisions apply to all eligible Employees.  Employees and Participants shall have the right to amend the stated automatic Elective Deferral percentage or receive cash in lieu of deferral into the Plan.

1.           RESERVED

	
  

	
[ ]

	
2.

	
Automatic Deferrals:

	
  

	
a.

	
New Employees:  Employees who have not met the eligibility requirements shall have Elective Deferrals withheld in the amount of ________% (not more than 10%) of Compensation or $________ [may be no more than the Code Section 402(g) limit and Code Section 414(v) limit, if applicable] upon entering the Plan.

	
  

	 

	
  

	
[ ]

	
i.

	
On an annual basis the Elective Deferral limit under the Plan shall be increased up to a maximum amount determined by the Employer.

	
  

	
[ ]

	
ii.

	
After _____ Years of Service, the amount specified above shall increase to ____% (no more than 10%) or $______ [may be no more than the Code Section 402(g) limit and Code Section 414(v) limit, if applicable].

	
  

	
[ ]

	
This requirement is effective for Employees hired on or after ______________________.

	
  

	
[ ]

	
b.

	
Current Employees:  Employees who are eligible to participate but not deferring shall have Elective Deferrals withheld in the amount of ______ % (not more than 10%) of Compensation or $_________ [may be no more than the Code Section 402(g) limit and Code Section 414(v) limit, if applicable].

	
  

	
[ ]

	
i.

	
On an annual basis the Elective Deferral limit under the Plan shall be increased up to a maximum amount determined by the Employer.

	
  

	
[ ]

	
ii.

	
After _____ Years of Service, the amount specified above shall increase to _____% (no more than 10%) or $_______ [may be no more than the Code Section 402(g) limit and Code Section 414(v) limit, if applicable].

	
  

	
[ ]

	
c.

	
Current Participants:  Current Participants who are deferring at a percentage less than the amount selected herein shall have Elective Deferrals withheld in the amount of  ________% (not more than 10%) of Compensation or $________ [may be no more than the Code Section 402(g) limit and Code Section 414(v) limit, if applicable].

	
  

	
[ ]

	
i.

	
On an annual basis the Elective Deferral limit under the Plan shall be increased up to a maximum amount determined by the Employer.

	
  

	
[ ]

	
ii.

	
After _____ Years of Service, the amount specified above shall increase to _____% (no more than 10%) or $_______ [may be no more than the Code Section 402(g) limit and Code Section 414(v) limit, if applicable].

Employees and Participants shall have the right to amend the stated automatic Elective Deferral provisions or receive cash in lieu of deferral into the Plan.  For purposes of this provision, Employees returning an election form indicating a “zero” deferral amount shall be deemed “Current Participants”.

	
E.  

	
Voluntary After-tax Contributions:

If the Employer wishes to reserve the right to recharacterize Elective Deferrals as Voluntary After-tax Contributions in order to pass the ADP/ACP Test, this section must be completed.

	
  

	
[x]

	
1.

	
The Plan does not permit Voluntary After-tax Contributions.

	
  

	
[ ]

	
2.

	
Participants may make Voluntary After-tax Contributions in any amount from a minimum of ________% (may not be less than 1%) to a maximum of ______% (may be no more than 100%) of their Compensation or a flat dollar amount from a minimum of $____________ (may not be less than $1,000) to a maximum of $______________ [may be no more than the Code Section 402(g) limit and Code Section 414(v) limit, if applicable].

	
  

	
[ ]

	
3.

	
Participants may make Voluntary After-tax Contributions in any amount up to the maximum permitted by law.

	
  

	
[ ]

	
4.

	
The maximum combined limit of Elective Deferrals, Roth Elective Deferrals, and Voluntary After-tax Contributions will not exceed ______% (may be no more than 100%) of Compensation or $_______ [may be no more than the Code Section 402(g) limit and Code Section 414(v) limit, if applicable].

	
  

	
F.

	
Required After-tax Contributions (for Thrift Savings Plans only):

	
  

	
[x]

	
1.

	
The Plan does not permit Required After-tax Contributions.

	
  

	
[ ]

	
2.

	
Participants shall be required to make Required After-tax Contributions as follows:

[ ]           a.           ________% (may be no more than 100%) of Compensation.

	
  

	
[ ]

	
b.

	
A percentage determined by the Employee.

	
  

	
[ ]

	
c.

	
A flat dollar amount of $________ [may be no more than the Code Section 402(g) limit and Code Section 414(v) limit, if applicable].

	
  

	
[ ]

	
d.

	
The maximum combined limit of Elective Deferrals, Roth Elective Deferrals and Required After-tax Contributions will not exceed ______% (may be no more than 100%) of Compensation or $_______  [may be no more than the Code Section 402(g) limit and Code Section 414(v) limit, if applicable].

	
  

	
G.

	
Rollover Contributions:

	
  

	
[ ]

	
1.

	
The Plan does not accept Rollover Contributions.

	
  

	
[x]

	
2.

	
Rollover Contributions may be made:

	
  

	
[ ]

	
a.

	
after meeting the eligibility requirements for participation in the Plan.

	
  

	
[x]

	
b.

	
prior to meeting the eligibility requirements for participation in the Plan.

	
  

	
3.

	
The Plan will accept a Participant Rollover Contribution of an Eligible Rollover Distribution from (check only those that apply):

	
  

	
[x]

	
a.

	
A Qualified Plan described in Code Section 401(a) or 403(a).

	
  

	
[x]

	
b.

	
An annuity contract described in Code Section 403(b).

	
  

	
[ ]

	
c.

	
An eligible plan under Code Section 457(b) which is maintained by a state, political subdivision of a state, or any agency or instrumentality of a state or political subdivision of a state.

	
  

	
[ ]

	
d.

	
An Individual Retirement Account (which was not used as a conduit from a Qualified Plan) or Annuity described in Code Section 408(a) or 408(b) that is eligible to be rolled over and would otherwise be includable in gross income.

	
  

	
4.

	
The Plan will accept a Direct Rollover of an Eligible Rollover Distribution from (check only those that apply):

	
  

	
[x]

	
a.

	
A Qualified Plan described in Code Section 401(a) or 403(a), excluding Voluntary After-tax Contributions.

	
  

	
[ ]

	
b.

	
A Qualified Plan described in Code Section 401(a) or 403(a), including Voluntary After-tax Contributions.

	
  

	
[x]

	
c.

	
An annuity contract described in Code Section 403(b), excluding Voluntary After-tax Contributions.

	
  

	
[ ]

	
d.

	
An annuity contract described in Code Section 403(b), including Voluntary After-tax Contributions.

	
  

	
[ ]

	
e.

	
An eligible plan under Code Section 457(b) which is maintained by a state, political subdivision of a state, or an agency or instrumentality of a state or political subdivision of a state.

	
  

	
[ ]

	
f.

	
A Roth Elective Deferral Account if it is a Direct Rollover from another Roth Elective Deferral Account under a Qualified Plan described in Code Section 402A(e)(1) and only to the extent the rollover is permitted under Code Section 402(c).

	
  

	
H.

	
Deemed IRA Contributions/Reserved:

[x]           1.           The Plan does not accept any Deemed IRA contributions.

	
  

	
[ ]

	
2.

	
Deemed IRA contributions may be made to this Plan for Plan Years beginning ___________ (may be no earlier than January 1, 2003):

	
  

	
[ ]

	
a.

	
In accordance with the Traditional IRA rules as described in the Basic Plan Document #01.  An Individual must meet the eligibility requirements for participation in the Plan in order to make a “Deemed IRA” contribution.

	
  

	
[ ]

	
b.

	
In accordance with the Roth IRA rules as described in the Basic Plan Document #01.  An Individual must meet the eligibility requirements for participation in the Plan in order to make a “Deemed IRA” contribution.

	
[x]

	
I.

	
Safe Harbor Plan Provisions:

If the Safe Harbor Plan provisions are elected, the nondiscrimination tests at Article XI of the Basic Plan Document #01 are not applicable.  Safe Harbor Contributions made are subject to the withdrawal restrictions of Code Section 401(k)(2)(B) and Treasury Regulation Section 1.401(k)-1(d); such contributions (and earnings thereon) must not be distributable earlier than severance from employment, death, Disability, an event described in Code Section 401(k)(10), or in the case of a profit-sharing or stock bonus plan, the attainment of age 591⁄2. Safe Harbor Contributions are NOT available for Hardship withdrawals.

The ACP Test Safe Harbor is automatically satisfied if the only Matching Contribution to the Plan is either a Basic Matching Contribution or an Enhanced Matching Contribution that does not provide a match on Elective Deferrals in excess of 6% of Compensation. For Plans that allow Voluntary or Required After-tax Contributions, the ACP Test is applicable with regard to such contributions.

Employees eligible to make Elective Deferrals to this Plan must be eligible to receive the Safe Harbor Contribution in the Plan listed below, to the extent required by applicable IRS Regulations.

The Employer elects to comply with the Safe Harbor Cash or Deferred Arrangement provisions of Article XI of the Basic Plan Document #01 and elects one of the following contribution formulas:

1.           Safe Harbor Tests:

	
  

	
[ ]

	
a.

	
Only the ADP Test Safe Harbor provisions are applicable.  A formula in paragraphs (3), (4) or (5) below has been selected and the ADP Safe Harbor has been satisfied.

	
  

	
[ ]

	
b.

	
Only the ACP Test Safe Harbor provisions are applicable.   No additional Matching Contributions would be needed in order to satisfy the ACP Safe Harbor if the Plans satisfies the Basic or Enhanced Match.

	
  

	 	
[x]

	
c.

	
Both the ADP and ACP Test Safe Harbor provisions are applicable.  If both ADP and ACP provisions are applicable:

	
  

	
[x]

	
i.

	
No additional Matching Contributions will be made in any Plan Year in which the Safe Harbor provisions are used.

	
  

	
[ ]

	
ii.

	
The Employer may make Matching Contributions in addition to any Safe Harbor Matching Contributions elected below.  [Complete provisions in Section VI(J) regarding Matching Contributions that will be made in addition to those Safe Harbor Matching Contributions made below.]

Safe Harbor Contributions cannot be subject to an Hours of Service or employment on the last day of the Plan Year requirement.

	
  

	
[ ]

	
2.

	
Designation of Alternate Plan to Receive Safe Harbor Contribution:  If the Safe Harbor Contribution as elected below is not being made to this Plan, the name of the other plan that will receive the Safe Harbor Contribution is:

	
.

	
  

	
[ ]

	
3.

	
Basic Matching Contribution Formula:  Matching Contributions will be made on behalf of Participants in an amount equal to 100% of the amount of the Eligible Participant’s Elective Deferrals that do not exceed 3% of the Participant’s Compensation and 50% of the amount of the Participant’s Elective Deferrals that exceed 3% of the Participant’s Compensation but that do not exceed 5% of the Participant’s Compensation.

	
  

	
[ ]

	
4.

	
Enhanced Matching Contribution Formula:  Matching Contributions will be made in an amount equal to the sum of:

	
  

	
a.

	
_________% of the Participant’s Elective Deferrals that do not exceed _________% of the Participant’s Compensation [insert a number that is three (3) or greater but not greater than six (6); if a number greater than six (6) is inserted or if left blank, this will not qualify as an Enhanced Matching Contribution Formula and the ADP test will apply], plus

	
  

	
[ ]

	
b.

	
_________% of the Participant’s Elective Deferrals that exceed _________% of the Participant’s Compensation but do not exceed _________% of the Participant’s Compensation [insert a number that is three (3) or greater but not greater than six (6) in the second blank.  Both blanks should be completed so that at any rate of Elective Deferrals, the Matching Contribution is at least equal to the Matching Contribution receivable if the Employer were making a Basic Matching Contribution.  The rate of match cannot increase as Elective Deferrals increase.  If a number greater than six (6) is inserted or if left blank, this will not qualify as an Enhanced Matching Contribution Formula and the ACP Test will apply.]

If an additional discretionary Matching Contribution is made, the dollar amount of that contribution may not exceed 4% of eligible Plan Compensation.

	
  

	
[x]

	
5.

	
Guaranteed Non-Elective Contribution Formula:  The Employer shall make a Non-Elective Contribution equal to 3% (not less than 3%) of the Compensation of each Eligible Participant.

	
  

	
[ ]

	
6.

	
Flexible Non-Elective Contribution Formula:  This provision provides the Employer with the ability to amend the Plan to comply with the Safe Harbor provisions during the Plan Year.  To provide such option, the Employer must amend the Plan and indicate on Schedule C that the Safe Harbor Non-Elective Contribution (not less than 3%) will be made for the specified Plan Year.  Such election must comply with all the applicable notice requirements.

Additional non-Safe Harbor Contributions may be made to the Plan pursuant to Section VI(J) hereof.  Any additional contributions may be subject to nondiscrimination testing.

	
  

	
7.

	
Limitations on Safe Harbor Matching Contributions:  If a Safe Harbor Matching Contribution is made to the Plan:

	
  

	
[ ]

	
a.

	
The Employer elects to match Safe Harbor Matching Contributions on an annual basis.

	
  

	
[ ]

	
b.

	
The Employer elects to match actual Elective Deferrals made:

	
  

	
[ ]

	
i.

	
on a payroll basis [Plan defaults to this election].

	
  

	
[ ]

	
ii.

	
on a monthly basis.

	
  

	
[ ]

	
iii.

	
on a Plan Year quarterly basis.

	
  

	
[ ]

	
iv.

	
The Employer elects to true up Safe Harbor Matching Contributions made to the Plan on the above basis.

If one of the Matching Contribution calculation periods at paragraph (7)(b) above is selected, Matching Contributions must be deposited to the Plan not later than the last day of the calendar quarter next following the quarter to which they relate.

	
  

	
[ ]

	
c.

	
The Employer will only contribute the Safe Harbor Contribution to Non-Highly Compensated Employees.

	
[ ]

	
J.

	
Matching Employer Contribution:

Do not complete this section of the Adoption Agreement if the Plan only offers a Safe Harbor Contribution. A Plan that offers both a Safe Harbor Contribution as well as an additional Employer Contribution that is specified below, must complete both Sections VI(I) and VI(J) of this Adoption Agreement.

Select the Matching Contribution Formula, Computation Period and special Limitations for each contribution type from the options listed below.  Enter the letter of the option(s) selected on the lines provided.  Leave the line blank if no election is required.

	
  

	
[ ]

	
The Matching Contribution(s) selected below will be deemed an additional discretionary ACP Test Safe Harbor Matching Contribution in accordance with the selection made at Section VI(I).  The allocation of any additional Matching Contribution made by the Employer will not exceed 4% of eligible Compensation.

	
  

	
[ ]

	
The Matching Contribution(s) selected below will be deemed a discretionary contribution that will be subject to nondiscrimination testing.

	
 

 

Type of

Contribution

	
 

Matching Contribution (Formula 1)

	
 

Matching

Computation Period

	
 

 

 

Limitations

	
 

Matching Contribution (Formula 2)

	
 

Matching

Computation

Period

	
 

 

 

Limitations

	
Elective Deferrals (including Roth Elective Deferrals, if applicable)

	  	  	  	  	  	  
	
Voluntary After-tax

	  	  	  	  	  	  
	
Required

After-tax

	  	  	  	  	  	  
	
403(b) Deferrals

	  	  	  	  	  	  

	
  

	
If any election is made with respect to “403(b) Deferrals” above, and if this Plan is used to fund any Employer Contributions, Employer Contributions will be based on the Elective Deferrals made to an existing 403(b) plan sponsored by the Employer.

	
  

	
Name of corresponding 403(b) plan, as applicable:

If the Matching Contribution formula selected by the Employer is 100% vested and may not be distributed to the Participant before the earlier of the date the Participant has a severance from employment, retires, becomes disabled, attains 591⁄2, or dies, it may be treated as a Qualified Matching Contribution.

Matching Contribution Formulas may be subject to a minimum or maximum dollar or percentage limit.

1.           Matching Contribution Formulas:

	
  

	
Matching Contribution Formulas for Elective Deferrals and Roth Elective Deferrals:

	
a.  

	
Percentage of Deferral Match:  The Employer shall contribute to each eligible Participant's account an amount equal to _________% (no more than 500%) of the Participant's Elective Deferrals up to a maximum of _________% (no more than the Annual Addition limit for the Plan Year) of Compensation or $_________  [no more than the Annual Addition limit for the Plan Year].

	
b.  

	
Uniform Dollar Match:  The Employer shall contribute to each eligible Participant’s account $________ (no more than the Annual Addition limit for the Plan Year) if the Participant contributes at least ________% (no more than 100%) of Compensation or $__________ [may be no more than the Code Section 402(g) limit and Code Section 414(v) limit, if applicable].  The Employer’s contribution will be made up to a maximum of _____% (no more than the Annual Addition limit for the Plan Year) of Compensation.

	
  

	
c.

	
Discretionary Match:  The Employer shall have the right to make a Discretionary Matching Contribution.  The Employer's Matching Contribution shall be determined by the Employer with respect to each Plan Year’s eligible Participants.  Such contribution shall be in the amount specified and allocated as follows:

	
  

	
d.

	
Tiered Match:  The Employer shall contribute to each eligible Participant's account an amount equal to:

________% of the first ________% (no more than 500%) of the Participant's Compensation contributed, and

	
  

	
________% of the next ________% (no more than 400%) of the Participant's Compensation contributed, and

	
  

	
________% of the next ________% (no more than 300%) of the Participant's Compensation contributed.

The Employer’s contribution will be made up to the [ ] greater of (may be no more than 500%) [ ] lesser of (may be no less than 1%) _________% of Compensation, or $__________ (no more than the Annual Addition limit for the Plan Year).

	
  

	
The percentages specified above may not increase as the rate of Elective Deferrals or Employee Contributions increase.  This formula must meet Code Section 401(a)(4) and the ACP Test.

	
  

	
e.

	
Percentage of Compensation Match:  The Employer shall contribute to each eligible Participant’s account ________% (no less than 1%) of Compensation if the eligible Participant contributes at least ________% (no more than 100%)  of Compensation.

The Employer’s contribution will be made up to the [ ] greater of (may be no more than 500%) [ ] lesser of  (may be no less than 1%) _________% of Compensation or $__________ (no more than the Annual Addition limit for the Plan Year).

This formula must meet Code Section 401(a)(4) and the ACP Test.

	
  

	
f.

	
Proportionate Compensation Match:  The Employer shall contribute to each eligible Participant who defers at least ________% (may be no more than 100%) of Compensation, an amount determined by multiplying such Employer Matching Contribution by a fraction, the numerator of which is the Participant's Compensation and the denominator of which is the Compensation of all Participants eligible to receive such an allocation.

The Employer’s contribution will be made up to the [ ] greater of (may be no more than 500%) [ ] lesser of  (may be no less than 1%) _________% of Compensation or $__________ (no more than the Annual Addition limit for the Plan Year).

This formula must meet Code Section 401(a)(4) and the ACP Test.

	
  

	
[ ]

	
g.

	
Catch-Up Contributions:  The Employer elects to match Catch-Up Contributions under the same formula or formulas as elected above.

	
  

	
In the event that an Excess Contribution is recharacterized as a Catch-up Contribution, any Matching Contribution made thereon may remain in the Plan if the Matching Contribution Formula is not otherwise exceeded.

	
  

	
Additional Matching Contribution Formulas for Voluntary After-tax Contributions:

	
  

	
h.

	
Percentage of Deferral Match: The Employer shall contribute to each eligible Participant's account an amount equal to ______% (no less than 1%) of the Participant's Contribution up to a maximum of ______% (may be no more than 500%) of Compensation or $__________ [may be no more than the Code Section 402(g) limit and Code Section 414(v) limit, if applicable].

	
  

	
i.

	
Uniform Dollar Match: The Employer shall contribute to each eligible Participant’s account $________ (no more than the Annual Addition limit for the Plan Year) if the Participant contributes at least ________% (may be no more than 100%) of Compensation or $________ [may be no more than the Code Section 402(g) limit and Code Section 414(v) limit, if applicable].  The Employer’s contribution will be made up to the maximum of _____% (may be no more than 500%) of Compensation.

	
  

	
j.

	
Discretionary Match: The Employer shall have the right to make a Discretionary Matching Contribution. The Employer's Matching Contribution shall be determined by the Employer with respect to each Plan Year’s eligible Participants.  Such contribution shall be in the amount specified and allocated as follows:

	
  

	
Additional Matching Contribution Formulas for Required After-tax Contributions:

	
  

	
k.

	
Percentage of Deferral Match: The Employer shall contribute to each eligible Participant's account an amount equal to ________% no less than 1%) of the Participant's Contribution up to a maximum of ________% (may be no more than 500%) of Compensation or $__________ [may be no more than the Code Section 402(g) limit and Code Section 414(v) limit, if applicable].

	
  

	
l.

	
Uniform Dollar Match: The Employer shall contribute to each eligible Participant’s account $________ (no more than the Annual Addition limit for the Plan Year) if the Participant contributes at least _______% (may be no more than 100%) of Compensation or $__________ [may be no more than the Code Section 402(g) limit and Code Section 414(v) limit, if applicable].  The Employer’s contribution will be made up to the maximum of ______% (may be no more than 500%) of Compensation.

	
  

	
m.

	
Discretionary Match: The Employer shall have the right to make a Discretionary Matching Contribution.  The Employer's Matching Contribution shall be determined by the Employer with respect to each Plan Year’s eligible Participants.  Such contribution shall be in the amount specified and allocated as follows: 

	
  

	
Additional Matching Contribution Formulas for 403(b) Deferrals:

	
  

	
n.

	
Percentage of Deferral Match: The Employer shall contribute to each eligible Participant's account an amount equal to ________% (no less than 1%) of the Participant's deferral up to a maximum of ________% (may be no more than 500%) of Compensation or $__________ [may be no more than the Code Section 402(g) limit and Code Section 414(v) limit, if applicable].

	
  

	
o.

	
Uniform Dollar Match: The Employer shall contribute to each eligible Participant's account $________ (no more than the Annual Addition limit for the Plan Year) if the Participant contributes at least ______% (may be no more than 100%) of Compensation or $___________ [may be no more than the Code Section 402(g) limit and Code Section 414(v) limit, if applicable].  The Employer’s contribution will be made up to the maximum of ______% (may be no more than 500%) of Compensation.

	
  

	
p.

	
Discretionary Match: The Employer shall have the right to make a Discretionary Matching Contribution. The Employer's Matching Contribution shall be determined by the Employer with respect to each Plan Year’s eligible Participants.  Such contribution shall be in the amount specified and allocated as follows: 

	
  

	
2.

	
Matching Contribution Computation Period: The Compensation or any dollar limitation imposed in calculating the Matching Contribution will be based on the period selected below. Matching Contributions will be calculated on the following basis:

	
a.  

	
Payroll Based                                                      e.           Monthly

b.           Weekly                                                      f.           Quarterly

c.           Bi-weekly                                           g.           Semi-annually

d.           Semi-monthly                                                      h.           Annually

The calculation of Matching Contributions based on the Computation Period selected above has no applicability as to when the Employer remits Matching Contributions to the Trust.

	
3.  

	
Limitations on Matching Formulas:

	
a.  

	
Contributions to Participants who are not Highly Compensated Employees: Contribution of the Employer’s Matching Contribution will be made only to eligible Participants who are Non-Highly Compensated Employees.

 

 

	
  

	
b.

	
Deferrals withdrawn prior to the end of the Matching Computation Period:  Matching Contributions (whether or not Qualified) will not be made on Employee contributions withdrawn prior to the end of the [ ] Matching Computation Period, or [ ] Plan Year.

	
  

	
[ ]

	
If elected, this requirement shall apply in the event of a withdrawal occurring as the result of a termination of employment for reasons of retirement, Disability or death.

	
  

	
c.

	
Maximum Plan Limit for Matching Contributions: In no event will Matching Contributions exceed ______% (no more than 500%) of Compensation, or $_______ (no more than the Annual Addition limit for the Plan Year).

	
  

	
[ ]

	
If elected, this limitation applies to the total of all Elective Deferrals, Roth Elective Deferrals, Catch-Up Contributions, Voluntary After-tax Contributions,  Required After-tax Contributions and 403(b) Deferrals made to the Plan for the Plan Year.

	
  

	
d.

	
True Up of Matching Contributions:  The Employer elects to true up Matching Contributions made to the Plan.

	
[x]

	
K.

	
Non-Elective Employer Contributions:

The Employer shall have the right to make a discretionary contribution.  If a discretionary contribution is made, the Employer’s contribution for the Plan Year shall be allocated to the accounts of eligible Participants as follows (enter the number of the allocation method being used by the Plan):

	
Type of Contribution

	
Allocation Method

	
Non-Elective Formula 1

	
3

	
Non-Elective Formula 2

	  

	
  

	
1.

	
Pro-Rata Formula:  The Employer’s contribution for the Plan Year shall be allocated to each eligible Participant on a pro-rata basis based on the Compensation of the Participant to the total Compensation of all Participants.

	
2.  

	
Uniform Percentage Formula: The Employer’s contribution shall be allocated to each eligible Participant as a uniform percentage of the Employer’s Net Profit.

	
3.  

	
Percentage of Compensation Formula:  The Employer’s contribution shall be 1.5% of

	
  

	
each Participant’s Compensation allocated on a  pro-rata basis based on the Compensation of the Participant to the total Compensation of all Participants.

	
  

	
4.

	
Hours of Service Formula:  The Employer’s contribution shall be a discretionary amount

	
allocated in the same dollar amount to each eligible Participant based on each Hour of

	
Service performed or each day that the Participant is entitled to Compensation.

	 	
5.

	
Uniform Dollar Amount Formula:  The Employer shall contribute and allocate to the account of each eligible Participant an equal dollar amount.

	
  

	
6.

	
Excess Integrated Contribution Formula:  The Employer’s contribution shall be allocated as an amount taking into consideration amounts contributed to Social Security using the four-step Excess Integrated Allocation Formula as described in the Basic Plan Document #01; the Integration Level is defined at Section III(E) of this Adoption Agreement.

	
  

	
7.

	
Base Integrated Contribution Formula:  The Employer’s contribution shall be allocated as an amount taking into consideration amounts contributed to Social Security using the two-step Base Integrated Allocation Formula as described in the Basic Plan Document #01; Employer Contributions shall be allocated as follows: _____% of each eligible Participant's Compensation, plus _____% of Compensation in excess of the Integration Level defined at Section III(E) hereof.  If the Integration Level selected in Section III(E) is other than the Taxable Wage Base, the maximum disparity rate will be adjusted as follows: (a) if the Integration Level selected is greater than zero (0) but not more than the greater of $10,000 or 20% of the Taxable Wage Base, the maximum disparity rate will be 5.7%; (b) if the Integration Level selected is more than the greater of $10,000 or 20% but not more than 80% of the Taxable Wage Base, the maximum disparity rate will be 4.3%; (c) if the Integration Level selected is more than 80% of the Taxable Wage Base, but not more than any amount more than 80% of the Taxable Wage Base, but less than 100% of the Taxable Wage Base, the maximum disparity rate will be 5.4%.

Only one Plan maintained by the Employer may be integrated with Social Security.  Any Plan utilizing a Safe Harbor formula as provided in Section VI(I) of this Adoption Agreement may not apply the Safe Harbor Contributions to the integrated allocation formula.

	
  

	
8.

	
Uniform Points Contribution Formula: The allocation for each eligible Participant will be determined by a uniform points method. Each eligible Participant’s allocation shall bear the same relationship to the Employer contribution as the Participant’s total points bears to all points awarded.  The Employer must grant points for at least age or Service.  Each eligible Participant will receive _____ points for each of the following:

	
  

	
[ ]

	
a.

	
_____ year(s) of age.

	
  

	
[ ]

	
b.

	
_____ Year(s) of Service determined:

	
  

	
[ ]

	
i.

	
In the same manner as determined for eligibility.

	
  

	
[ ]

	
ii.

	
In the same manner as determined for vesting.

	
  

	
[ ]

	
iii.

	
Points will not be awarded with respect to Year(s) of Service in excess of _____.

[ ]           c.           $_________ (not to exceed $200) of Compensation.

	
  

	
The contribution formulas must satisfy the design-based safe harbors described in the Regulations under Code Section 401(a)(4).

	
  

	
L.

	
Qualified Matching (QMAC) and Qualified Non-Elective (QNEC) Employer Contribution Formulas:

	
  

	
[ ]

	
1.

	
QMAC Contribution Formula:  The Employer may contribute to each eligible Participant’s Qualified Matching Contribution account an amount equal to (select one or more of the following):

	
  

	
[ ]           a.

	
$_________ or ______% of the Participant’s Elective Deferrals (including Roth Elective Deferrals, if applicable).

	
  

	
[ ]           b.

	
$_________ or ______% of the Participant’s Elective Deferrals (including Roth                                                                                                                                                        Elective Deferrals, if applicable) not to exceed ______% of Compensation.

	
  

	
[ ]

	
c.

	
$_________ or ______% of the Participant's Voluntary After-tax Contributions.

	
  

	
[ ]

	
d.

	
$_________ or ______% of the Participant’s Required After-tax Contributions.

	
  

	
[ ]

	
2.

	
Discretionary QMAC Contribution Formula:  The Employer shall have the right to make a discretionary QMAC contribution.  The Employer's Matching Contribution shall be determined by the Employer with respect to each Plan Year’s eligible Participants.  Such contribution shall be in the amount specified and allocated as follows:

	
  

	
This part of the Employer's contribution shall be fully vested when made.

	
  

	
[ ]

	
3.

	
QNEC Contribution Formula: The Employer may contribute to each eligible Participant’s Qualified Non-Elective Contribution account an amount equal to (select one or more of the following):

	
  

	
[ ]

	
a.

	
_____% of Compensation of all eligible Participants. This part of the Employer’s contributions shall be fully vested when made.

	
  

	
[ ]

	
b.

	
$__________ not to exceed ___% of Compensation. This part of the Employer’s contribution shall be fully vested when made and subject to the limitations specified in the Basic Plan Document #01.

	
  

	
[ ]

	
4.

	
Discretionary Percentage QNEC Contribution Formula:  The Employer shall have the right to make a discretionary QNEC contribution which shall be allocated to each eligible Participant’s account in proportion to his or her Compensation as a percentage of the Compensation of all eligible Participants.  This part of the Employer's contribution shall be fully vested when made.  This contribution will be made to:

[ ]           a.           All eligible Participants.

	
  

	
[ ]

	
b.

	
Only eligible Participants who are Non-Highly Compensated Employees.

	
  

	
[ ]

	
5.

	
Discretionary Uniform Dollar QNEC Contribution Formula: The Employer shall have the right to make a discretionary QNEC contribution which shall be allocated to each eligible Participant’s account in a uniform dollar amount to be determined by the Employer and allocated in a nondiscriminatory manner.  This part of the Employer’s contribution shall be fully vested when made. This contribution will be made to:

[ ]           a.           All eligible Participants.

	
  

	
[ ]

	
b.

	
Only eligible Participants who are Non-Highly Compensated Employees.

	
  

	
[ ]

	
6.

	
Corrective QNEC Contribution Formula:  The Employer shall have the right to make a QNEC contribution in the amount necessary to pass the ADP/ACP Test or the maximum permitted under Code Section 415. This contribution will be allocated to some or all Non-Highly Compensated Participants designated by the Plan Administrator. The allocation will be the lesser of the amount required to pass the ADP/ACP Test, or the maximum permitted under Code Section 415. This part of the Employer's contribution shall be fully vested when made.

	
  

	
[ ]

	
7.

	
Qualified Matching Contributions (QMAC):

	
  

	
[ ]

	
a.

	
For purposes of the ADP and ACP Tests, all Matching Contributions made to the Plan will be deemed “Qualified” for purposes of calculating the Actual Deferral Percentage and/or Actual Contribution Percentage.  All Matching Contributions must be fully vested when made.

	
  

	
[ ]

	
b.

	
For purposes of the ADP and ACP Tests, only Matching Contributions made to the Plan that are needed to meet the Actual Deferral Percentage or Actual Contribution Percentage Test will be deemed “Qualified” for purposes of calculating the Actual Deferral Percentage and/or Actual Contribution Percentage. All such Matching Contributions used must be fully vested when made.

	
  

	 

[ ]           8.           Qualified Non-Elective Contributions (QNEC):

	
  

	
[ ]

	
a.

	
For purposes of the ADP and  ACP Tests, all Non-Elective Contributions made to the Plan will be deemed “Qualified” for purposes of calculating the Actual Deferral Percentage and/or Actual Contribution Percentage. All Non-Elective Contributions must be fully vested when made.

	
  

	
[ ]

	
b.

	
For purposes of the ADP and ACP Tests, only the Non-Elective Contributions made to the Plan that are needed to meet the Actual Deferral Percentage or Actual Contribution Percentage Test will  be deemed “Qualified” for purposes of calculating the Actual Deferral Percentage and/or Actual Contribution Percentage. All such Non-Elective Contributions used must be fully vested when made.

[x]           M.           Additional Adopting Employers:

	
  

	
[x]

	
1.

	
All participating Employers’ contributions and forfeitures, if applicable, attributable to each specific contribution source made by such Employer shall be pooled together and allocated uniformly among all eligible Participants.

	
  

	
[ ]

	
2.

	
Each participating Employer’s contribution and forfeitures, if applicable, attributable to each specific contribution source made by such Employer shall be allocated only to eligible Participants of the participating Employer.

Where contributions and forfeitures are to be allocated to eligible Participants by participating Employers, each such Employer must maintain data demonstrating that the allocations by group satisfy the nondiscrimination rules under Code Section 401(a)(4).

	
  

	 

VII.           ALLOCATIONS TO PARTICIPANTS

A.           Allocation Accrual Requirements:

No Hours of Service or last day requirement may be imposed on any Employer contribution that is subject to the Safe Harbor Plan rules.

	
  

	
[x]

	
1.

	
There are no allocation requirements for Participants to receive any contribution made to the Plan; however, a Participant must have received Compensation from the Employer to be entitled to an allocation of contributions.

	
  

	
[ ]

	
2.

	
Employer contributions will be allocated to all Participants employed on the last day of the Plan Year regardless of hours worked.

	
  

	
[ ]

	
3.

	
The Plan is using the Elapsed Time method; contributions will be allocated to all Participants who have completed _____ [not more than twelve (12)] months of Service regardless of the hours credited.  If left blank, the Plan will use twelve (12) months.

	
  

	
[ ]

	
4.

	
Employer contributions for a Plan Year will be allocated to all Participants upon completion of the hours and/or employment requirements below.

	
  

	
a.

	
A Year of Service for allocation accrual purposes cannot be less than one (1) Hour of Service nor greater than 1,000 hours by operation of law. If left blank, the Plan will use 1,000 hours.  Enter whole digit numbers only.

	
Contribution Type

	
          Hours

	
All contributions

	  
	
Matching Contribution (Formula 1)

	  
	
Matching Contribution (Formula 2)

	  
	
Non-Elective Contribution (Formula 1)

	  
	
Non-Elective Contribution (Formula 2)

	  
	
QNEC

	  
	
QMAC

	  

	
  

	
b.

	
Participants must be employed on the last day of each quarter of the Plan Year in order to receive the following contribution(s):

	
  

	
[ ]

	
All contributions

	
  

	
[ ]

	
Matching Contribution (Formula 1)

	
  

	
[ ]

	
Matching Contribution (Formula 2)

	
  

	
[ ]

	
Non-Elective Contribution (Formula 1)

	
  

	
[ ]

	
Non-Elective Contribution (Formula 2)

	
  

	
[ ]

	
QNEC

	
  

	
[ ]

	
QMAC

Note: Use of this subsection (b) requires that no more than one (1) Hour of Service be required in subsection (a) above for the contribution types selected.

	
  

	
c.

	
Participants must be employed on the last day of the Plan Year in order to receive the following contribution(s):

	
  

	
[ ]

	
All contributions

	
  

	
[ ]

	
Matching Contribution (Formula 1)

	
  

	
[ ]

	
Matching Contribution (Formula 2)

	
  

	
[ ]

	
Non-Elective Contribution (Formula 1)

	
  

	
[ ]

	
Non-Elective Contribution (Formula 2)

	
  

	
[ ]

	
QNEC

	
  

	
[ ]

	
QMAC

	
  

	
[ ]

	
d.

	
Participants must complete the Hours of Service indicated above or be employed on the last day of the Plan Year to receive the Employer Contribution(s) selected above.

	
  

	
5.

	
Employer Contributions for a Plan Year will be allocated to terminated Participants who have met the following allocation accrual requirements (check all applicable boxes):

All               Match                Match    Non-Elective Non-Elective

             Contributions  Formula 1  Formula 2    Formula 1     Formula 2    QNEC    QMAC

a.        The Hours of Service or Period of

Service requirement above will be

waived if termination is due to:

i.      Retirement                           [ ]                 [ ]               [ ]               [ ]               [ ]              [ ]              [ ]

ii.      Disability                                 [ ]                          [ ]               [ ]               [ ]              [ ]        [ ]                 [ ]

iii.      Death                           [ ]                 [ ]               [ ]               [ ]               [ ]              [ ]              [ ]

	
iv.  

	
Other (must be non-

Discriminatory in

operation):

                            [ ]                 [ ]               [ ]               [ ]               [ ]              [ ]              [ ]

	
  

	
b.

	
The last day of employment

	
  

	
requirement above will be

	
  

	
waived if termination is due to:

i.      Retirement                           [ ]                 [ ]               [ ]               [ ]               [ ]              [ ]              [ ]

ii.      Disability                           [ ]                 [ ]               [ ]               [ ]               [ ]              [ ]              [ ]

iii.      Death                           [ ]                 [ ]               [ ]               [ ]               [ ]              [ ]              [ ]

	
iv.  

	
Other (must be non-

Discriminatory in

operation):

                           [ ]                 [ ]               [ ]               [ ]               [ ]              [ ]              [ ]

	
[ ]

	
B.

	
Contributions to Disabled Participants:

	
  

	
The Employer will make contributions on behalf of a Participant who is permanently and totally disabled. These contributions will be based on the Compensation each such Participant would have received for the Limitation Year if the Participant had been paid at the rate of Compensation paid immediately before becoming permanently and totally disabled.  Such imputed Compensation for the disabled Participant may be taken into account only if the Participant is not a Highly Compensated Employee.  These contributions will be 100% vested when made.

	
VIII.

	
DISPOSITION OF FORFEITURES

A.           Forfeiture Allocation Alternatives:

	
[x]

	
1.

	
Not applicable; all contributions are fully vested.

	
  

	
[ ]

	
2.

	
Select one or more methods in which forfeitures associated with the contribution type will be allocated (number each item in order of use):

	
  

	
Employer Contribution Type

All Non-Safe Harbor                                           All Other

	
Disposition Method

	
Matching Contributions

	
Contributions

	
  

	
a.

	
Restoration of Participant’s forfeitures.

	 	 	 	 	 	 

	
  

	
b.

	
Used to offset Plan expenses.

	
      __________

	
______________

	
  

	
c.

	
Used to reduce the Employer’s

	
Non-Elective Contribution.

	 	 	 	 	 	 

d.      Used to reduce the Employer’s

	
Matching Contribution.

	 	 	 	 	 	 

	
  

	
e.

	
Added to the Employer’s contribution

	
  

	
(other than Matching Contributions or

	
Base Integration Formula) under the Plan.

	 	 	 	 	 	 

f.      Added to the Employer’s Matching

	
  

	
Contribution under the Plan (these

	
       contributions will be subject to ACP Testing).

	
___

	
_________           _____________

	
  

	
g.

	
Allocate to all Participants

	
  

	
eligible to share in the allocations

	
  

	
in the same proportion that each

	
  

	
Participant’s Compensation for the

	
  

	
year bears to the Compensation of all

	
other Participant’s for such year.

	
N/A

	 	 	 	 	 

h.      Allocate to all NHCEs eligible to share

in the allocations in proportion to each such

	
Participant’s Compensation for the year.

	
N/A

	 	 	 	 	 

i.      Allocate to all NHCEs eligible to share in the

allocations in proportion to each such

	
Participant’s Elective Deferrals for the year.

	 	 	 	 	
N/A

	 

j.      Allocate to all Participants eligible to share in

the allocations in the same proportion that

each Participant’s Elective Deferrals for the year

bears to the Elective Deferrals of all Participants

	
for such year.

	 	 	
N/A

	 	 	 

Participants eligible to share in the allocation of other Employer contributions under Section VI shall be eligible to share in the allocation of forfeitures.  The selection of (i) or (j) may require that the Plan be tested for nondiscrimination using a general test described in Regulations Section 1.410(b).

B.           Timing of Allocation of Forfeitures:

	
  

	
If no timely distribution or deemed distribution [pursuant to paragraph 6.5(c) of the Basic Plan Document #01] has been made to a former Participant, non-vested portions shall be forfeited at the end of the Plan Year during which the former Participant incurs his or her fifth consecutive one (1) year Break in Service or Period of Severance for Plans that use the Elapsed Time Method.

	
  

	
If a former Participant has received the full amount of his or her Vested Account Balance, the non-vested portion of his or her account shall be forfeited and be disposed of:

	
  

	
[ ]

	
1.

	
during the Plan Year following the Plan Year in which the forfeiture arose.

	
  

	
[ ]

	
2.

	
as of any Valuation or Allocation Date during the Plan Year (or as soon as administratively feasible following the close of the Plan Year) in which the former Participant receives full payment of his or her vested benefit.

	
  

	
[ ]

	
3.

	
as of the end of the Plan Year during which the former Participant receives full payment of his or her vested benefit.

	
  

	
[ ]

	
4.

	
as of the earlier of the first day of the Plan Year, or the first day of the seventh month of the Plan Year following the date on which the former Participant has received full payment of his or her vested benefit.

	
  

	
[ ]

	
5.

	
as of the next Valuation or Allocation Date following the date on which the former Participant receives full payment of his or her vested benefit.

	
IX.

	
MULTIPLE PLANS MAINTAINED BY THE EMPLOYER AND TOP-HEAVY CONTRIBUTIONS

	
[x]

	
A.

	
Plans Maintained By The Employer:

The Employer does maintain another Plan [including a Welfare Benefit Fund or an individual medical account as defined in Code Section 415(l)(2)], under which amounts are treated as Annual Additions and has completed the proper sections below.  If the Participant is covered under another qualified Defined Contribution Plan maintained by the Employer, other than a Master or Prototype Plan [option (1) below shall automatically apply if the other plan is a Master or Prototype Plan]:

	
  

	
[x]          1.

	
The provisions of Article X of the Basic Plan Document #01 will apply as if the other plan were   a Master or Prototype Plan.

	
  

	
[ ]

	
2.

	
The Employer has specified below the method under which the plans will limit total Annual  Additions to the Maximum Permissible Amount, and will properly reduce any Excess Amounts in a manner that precludes Employer discretion:

 

 

B.           Top-Heavy Provisions:

	
  

	
In the event the Plan is or becomes Top-Heavy, the minimum contribution or benefit required under Code Section 416 and paragraph 14.3 of the Basic Plan Document #01 relating to Top-Heavy Plans shall be satisfied in the elected manner:

	
  

	
[x]

	
1.

	
The minimum contribution will be satisfied by this Plan.

	
  

	
[ ]

	
2.

	
The minimum contribution will be satisfied by (name of other Qualified Plan):  ________

	
  

	
Minimum contribution or benefit to be provided (specify interest rates and mortality table, if applicable):

	
  

	
3.

	
For any Plan Year during which the Plan is Top-Heavy, the sum of the contributions (excluding Elective Deferrals) allocated to non-Key Employees shall not be less than the amount required under the Basic Plan Document #01.  Top-Heavy minimums will be allocated to:

[x]           a.           all eligible Participants [Plan defaults to this election].

	
[ ]

	
b.

	
only eligible non-Key Employees who are Participants.

	
  

	
[ ]

	
4.

	
Matching Contributions shall not  be included when satisfying Top-Heavy minimum contributions.

X.           NONDISCRIMINATION TESTING

A Plan may use different testing methods for the ADP and ACP Tests provided the Plan does not permit recharacterization of Excess Contributions, Elective Deferrals to be used in the ACP Test, or Qualified Matching Contributions to be used in the ADP Test.

If no election is made, the Plan will use the Current Year testing method for both the ADP and ACP Tests.

	
A.  

	
Testing Elections:

	
  

	
[x]

	
1.

	
The Plan is not subject to ADP or ACP testing.  The Plan does not offer Voluntary After-tax  or Required After-tax Contributions and it either meets the Safe Harbor provisions of Section VI(I) of this Adoption Agreement, or it does not benefit any Highly Compensated Employees.

	
  

	
[ ]

	
2.

	
This Plan is using the Current Year testing method for purposes of the ADP Test.

	
  

	
[ ]

	
3.

	
This Plan is using the Current Year testing method for purposes of the ACP Test.

	
  

	
[ ]

	
4.

	
This Plan is using the Prior Year testing method for purposes of the ADP Test.

	
  

	
[ ]

	
5.

	
This Plan is using the Prior Year testing method for purposes of the ACP Test.

B.           Testing Elections for the First Plan Year:

	
  

	
Complete only when Prior Year testing method election is made and the Employer is not using the “deemed 3%” rule.

	
  

	
[ ]

	
1.

	
If this is not a successor Plan, then for the first Plan Year this Plan permits any Participant to make Elective Deferrals, the ADP used in the ADP Test for Participants who are Non-Highly Compensated Employees shall be such first Plan Year’s ADP.

	
  

	
[ ]

	
2.

	
If this is not a successor Plan, then for the first Plan Year this Plan permits (a) any Participant to make Employee contributions, (b) provides for Matching Contributions or (c) both, the ACP used in the ACP Test for Participants who are Non-Highly Compensated Employees shall be such first Plan Year’s ACP.

	
[ ]

	
C.

	
Recharacterization:

Elective Deferrals may be recharacterized as Voluntary After-tax Contributions to the extent so provided by this Plan, to satisfy the ADP Test.  The Employer must have elected to permit Voluntary After-tax Contributions in the Plan for this election to be operable.

[ ]           D.           Forfeitures of Vested Excess Aggregate Contributions Resulting from ADP Test Failure:

	
  

	
Forfeitures of Excess Aggregate Contributions resulting from failure of the ADP Test and the inability to distribute corresponding Matching Contributions will be allocated to the Matching Contribution accounts of Non-Highly Compensated Employees instead of being used to reduce Employer Contributions for the Plan Year in which the failure occurred.

	
XI.

	
VESTING

Participants shall always have a fully vested and nonforfeitable interest in their Employee contributions (including Elective Deferrals, Catch-Up Contributions, Roth Elective Deferrals, Deemed IRA Contributions, Required After-tax Contributions, and Voluntary After-tax Contributions), Qualified Matching Contributions (“QMACs”), Qualified Non-Elective Contributions (“QNECs”) or Safe Harbor Contributions, and their investment earnings.

Each Participant shall acquire a vested and nonforfeitable percentage in his or her account balance attributable to Employer contributions and their earnings under the schedule(s) selected below.

A. Vesting Computation Period:

A Year of Service for vesting will be determined on the basis of the (choose one):

	
[x]

	
1.

	
Not applicable.  All contributions are fully vested.

	
[ ]

	
2.

	
Elapsed Time method.

	
  

	
[ ]

	
3.

	
Hours of Service method.  A Year of Service will be credited upon completion of __________ Hours of Service.  A Year of Service for vesting purposes will not be less than one (1) Hour of Service nor greater than 1,000 hours by operation of law.  [If left blank, the Plan will use 1,000 hours.]

The computation period for purposes of determining Years of Service and Breaks in Service for purposes of computing a Participant's nonforfeitable right to his or her account balance derived from Employer contributions:

	
  

	
[ ]

	
a.

	
shall commence on the date on which an Employee first performs an Hour of Service for the Employer and each subsequent twelve (12) consecutive month period shall commence on the anniversary thereof.

	
  

	
[ ]

	
b.

	
shall commence on the first day of the Plan Year during which an Employee first performs an Hour of Service for the Employer and each subsequent twelve (12) consecutive month period shall commence on the anniversary thereof.

A Participant shall receive credit for a Year of Service if he or she completes the number of hours specified above at any time during the twelve (12) consecutive month computation period.  A Year of Service may be earned prior to the end of the twelve (12) consecutive month computation period and the Participant need not be employed at the end of the twelve (12) consecutive month computation period to receive credit for a Year of Service.

B.           Vesting Schedules:

The Employer must select either the two-twenty vesting schedule option [(B)(4)] or the three-year cliff vesting schedule [(B)(3)] to apply in any Plan Year in which the Plan is Top-Heavy.   The percentages selected for option (B)(5) may not be less for any year than the percentages shown at option (B)(4).   Any switch to a Top-Heavy schedule will remain in effect even if the Plan later falls out of Top-Heavy status unless the Employer executes an amendment to this Adoption Agreement.  If a Participant has at least three (3) Years of Service for vesting purposes at the time of the amendment, the Plan must provide that Participant the option of remaining on the vesting schedule in effect prior to such amendment.

Select the appropriate schedule for each contribution type and complete the blank vesting percentages from the list below and insert the option number in the vesting schedule chart below.  Employer Contributions that are not Safe Harbor Contributions may only choose option (3) or (4) or a schedule where amounts vest faster than at option (4).

Years of Service                                                        

 1            2            3            4            5            6

1.           Full and immediate Vesting

2.           ___%           100%

3.           ___%           ___%           100%

4.           ___%             20%             40%             60%             80%          100%

5.           ___%           ___%           ___%           ___%           ___%           100%

Vesting Schedule Chart                                                                Employer Contribution Type

1                      All Employer Contributions

                      Matching Contribution (Formula 1)

                      Matching Contribution (Formula 2)

                      Match on Voluntary After-tax Contributions

                      Match on Required After-tax Contributions

                      Match on 403(b) Deferrals

1                      Non-Elective Contribution (Formula 1)

1                      Non-Elective Contribution (Formula 2)

1                      Top-Heavy Minimum Contribution

If a different Vesting Schedule than that entered above applies to Employer Contributions made prior to the first day of the Plan’s 2007 Plan Year, it should be entered in Schedule B of this Adoption Agreement.

C.           Service Disregarded for Vesting:

	
  

	
[x]

	
1.

	
Not applicable.  All Service is recognized.

	
  

	
[ ]

	
2.

	
Service prior to the Effective Date of this Plan or a predecessor plan is disregarded when computing a Participant's vested and nonforfeitable interest.

	
  

	
[ ]            3.

	
Service prior to a Participant having attained age eighteen (18) is disregarded when computing a Participant's vested and nonforfeitable interest.

	
[ ]

	
D.

	
Full Vesting of Employer Contributions for Current Participants:

	
  

	
Notwithstanding the elections above, all Employer contributions made to a Participant’s account shall be 100% fully vested if the Participant is employed on the Effective Date of the Plan (or such other date as entered herein): _________________.  The operation of this provision may not result in the discrimination in favor of Highly Compensated Employees.

	
XII.  

	
SERVICE WITH PREDECESSOR ORGANIZATION

This option only applies in the situation where the Employer does not or did not maintain the plan of a Predecessor Organization.

	
[ ]

	
A.

	
Not applicable.  The Employer does not maintain the plan of a Predecessor Organization.

	
[ ]

	
B.

	
The Plan will recognize Service with all Predecessor Organizations.

	
[x]

	
C.

	
Service with the following organization(s) will be recognized for the Plan purpose indicated:

Allocation

Eligibility                  Accrual               Vesting

	
The Gallup Water Service, Inc.

	
[x]

	
[ ]

	
[x]

	
The Barnstable Water Company

	
[x]

	
[ ]

	
[x]

	
The Crystal Water Company

	
[x]

	
[ ]

	
[x]

	  	
[ ]

	
[ ]

	
[ ]

	  	
[ ]

	
[ ]

	
[ ]

Attach additional pages as necessary.

	
  

	
[ ]

	
D.

	
The Plan shall recognize _____ Years of Service with the Employer(s) named in Section XII(C) above.

	
XIII.

	
IN-SERVICE WITHDRAWALS

Distribution restrictions apply in the case of Elective Deferrals (including Roth Elective Deferrals, if applicable), Safe Harbor Contributions, Qualified Matching Contributions and Qualified Non-Elective Contributions, including the withdrawal restrictions prior to attainment of age 591⁄2.

If the Participant could withdraw his or her account in the past, this right may not be taken away.

A.           In-Service Withdrawals:

[ ]           1.           In-service withdrawals are not permitted in the Plan.

	
  

	
[x]

	
2.

	
In-service withdrawals are permitted in the Plan.  Participants may withdraw the following contribution types after meeting the following requirements (select one or more of the following options):

Withdrawal Restrictions

Contribution Types                                                        A         B         C         D         E         F         G         H      

a.      All Contributions                                                   n/a         n/a         n/a         [ ]         [ ]          n/a         n/a         n/a

b.      Elective Deferrals                                                   [ ]         n/a         n/a         [ ]         [x]          n/a         n/a         n/a

c.      Roth Elective Deferrals                                           [ ]         n/a         n/a         [ ]         [ ]         n/a         n/a         n/a

d.      Voluntary After-tax Contributions                                                           [ ]         [ ]         [ ]         [ ]         [ ]         n/a         n/a                 n/a

e.      Required After-tax Contributions                                                           [ ]         [ ]         [ ]         [ ]         [ ]          n/a         n/a                 n/a

f.      Rollover                           Contributions                                [ ]         [x]         [ ]         [ ]         [ ]         n/a         n/a                 n/a

g.      Vested Matching (Formula 1)                                                           [ ]         n/a         [ ]         [ ]         [ ]          [ ]         [ ]      [ ]

h.      Vested Matching (Formula 2)                                                           [ ]         n/a         [ ]         [ ]         [ ]          [ ]         [ ]      [ ]

i.      Vested Non-Elective (Formula 1)                                                           [ ]         n/a         [ ]         [ ]         [ ]          [ ]         [ ]      [ ]

j.      Vested Non-Elective (Formula 2)                                                           [ ]         n/a         [ ]         [ ]         [ ]          [ ]         [ ]      [ ]

k.      Safe Harbor Matching                                           [ ]         n/a         n/a         [ ]         [ ]         n/a         n/a         n/a

l.      Safe Harbor Non-Elective                                                   [ ]         n/a         n/a         [ ]         [ ]         n/a         n/a         n/a

m.      Qualified Non-Elective                                           [ ]         n/a         n/a         [ ]         [ ]         n/a         n/a         n/a

n.      Qualified Matching                                           [ ]         n/a         n/a         [ ]         [ ]          n/a         n/a         n/a

Withdrawal Restriction Key

A.           Not available for in-service withdrawals.

B.           Available for in-service withdrawals without restrictions.

	
  

	
C.

	
Participants having completed five (5) years of Plan participation may elect to withdraw all or any part of their Vested Account Balance.

	
  

	
D.

	
Participants may withdraw all or any part of their Account Balance after having attained the Plan’s Normal Retirement Age (Normal Retirement Age cannot be less than age 591⁄2 for in-service withdrawal of Elective Deferrals, Roth Elective Deferrals, Safe Harbor Contributions, QMACs or QNECs).

	
  

	
E.

	
Participants may withdraw all or any part of their Vested Account Balance after having attained age 59.5 (not less than age 591⁄2).

	
  

	
F.

	
Participants may elect to withdraw all or any part of their Vested Account Balance which has been credited to their account for a period in excess of two (2) years.

	
  

	
G.

	
Available for withdrawal only if the Participant is 100% vested  (an election at (C), (D), (E) or (F) must also be made).

	
H.  

	
All requirements selected in (C) through (G) above must be satisfied prior to a distribution being made from the Plan.

[x]           3.           In-service withdrawals may be made to Participants who have attained age 701⁄2.

B.           Hardship Withdrawals:

Prior to age 591⁄2, a Participant may withdraw balances attributable to Elective Deferrals (including Roth Elective Deferrals, if applicable) for reason of Hardship only.  Safe Harbor Contributions, Qualified Matching Contributions, and Qualified Non-Elective Contributions are not available for Hardship distributions.

	
  

	
[ ]

	
1.

	
Hardship withdrawals are not permitted in the Plan.

	
  

	
[x]

	
2.

	
Hardship withdrawals are permitted in the Plan and will be taken from the Participant’s account as follows (select one or more of these options): 

	
  

	
[x]

	
a.

	
Participants may withdraw Elective Deferrals.

	
  

	
[ ]            b.

	
Participants may withdraw Elective Deferrals and any earnings credited as of December 31, 1988 (or if later, the end of the last Plan Year ending before July 1, 1989).

	
  

	
[ ]

	
c.

	
Participants may withdraw Roth Elective Deferrals.

	
  

	
[ ]

	
d.

	
Participants may withdraw Rollover Contributions plus their earnings.

	
  

	
[ ]

	
e.

	
Participants may withdraw vested Non-Elective Contributions (Formula 1) plus their earnings.

	
  

	
[ ]

	
f.

	
Participants may withdraw vested Non-Elective Contributions (Formula 2) plus their earnings.

	
  

	
[ ]

	
g.

	
Participants may withdraw fully vested Non-Elective Contributions (Formula 1) plus their earnings.

	
  

	
[ ]

	
h.

	
Participants may withdraw fully vested Non-Elective Contributions (Formula 2) plus their earnings.

	
  

	
[ ]

	
i.

	
Participants may withdraw vested Employer Matching Contributions (Formula 1) plus their earnings.

	
  

	
[ ]

	
j.

	
Participants may withdraw vested Employer Matching Contributions (Formula 2) plus their earnings.

	
  

	
[ ]

	
k.

	
Participants may withdraw Qualified Matching Contributions and Qualified Non-Elective Contributions plus their earnings, and the earnings on Elective Deferrals which have been credited to the Participant’s account as of December 31, 1988 (or if later, the end of the last Plan Year ending before July 1, 1989).

	
XIV.

	
LOAN PROVISIONS

	
[ ]

	
A.

	
Participant loans are not available from the Plan.

	
[x]

	
B.

	
Participant loans are permitted in accordance with the Employer’s established loan procedures.

	
  

	
[ ]

	
C.

	
Loan payments will be suspended under the Plan as permitted under Code Section 414(u) in compliance with the Uniformed Services Employment and Reemployment Rights Act of 1994.

	
XV.

	
INVESTMENT MANAGEMENT

A.           Investment Management Responsibility:

	
  

	
[ ]

	
1.

	
The Employer shall appoint a discretionary Trustee to manage the assets of the Plan.

	
  

	
[ ]

	
2.

	
The Employer shall retain investment management responsibility and/or authority.  Unless otherwise appointed, the Trustee shall act in a nondiscretionary capacity.

	
  

	
[x]

	
3.

	
The party designated below shall be responsible for the investment of the Participant’s account. By selecting a box, the Employer is making a designation as to who will have authority to issue investment directives with respect to the specified contribution type (check all applicable boxes):

Trustee                                        Employer Participant

	
.

	
a.

	
All Contributions

	
n/a

	
n/a

	
[x]

	
  

	
b.

	
Elective Deferrals/Roth Elective Deferrals

	
[ ]

	
[ ]

	
[ ]

	
  

	
c.

	
Voluntary After-tax Contributions

	
         [ ]

	
       [ ]

	
  [ ]

	
  

	
d.

	
Required After-tax Contributions

	
[ ]

	
[ ]

	
[ ]

	
  

	
e.

	
Safe Harbor Contributions

	
[ ]

	
[ ]

	
[ ]

	
  

	
f.

	
Matching Contributions (Formula 1)

	
[ ]

	
[ ]

	
[ ]

	
  

	
g.

	
Matching Contributions (Formula 2)

	
[ ]

	
[ ]

	
[ ]

	
  

	
h.

	
QMACs

	
[ ]

	
[ ]

	
[ ]

	
  

	
i.

	
QNECs

	
[ ]

	
[ ]

	
[ ]

	
  

	
j.

	
Non-Elective Contributions (Formula 1)

	
[ ]

	
[ ]

	
[ ]

	
  

	
k.

	
Non-Elective Contributions (Formula 2)

	
[ ]

	
[ ]

	
[ ]

	
  

	
l.

	
Rollover Contributions

	
[ ]

	
[ ]

	
[ ]

	
  

	
m.

	
Deemed IRA Contributions

	
[ ]

	
[ ]

	
[ ]

	
  

	
To the extent that Participant self-direction was previously permitted, the Employer shall have the right to either make the assets part of the general fund, or leave them as self-directed subject to the provisions of the Basic Plan Document #01.

	
B.  

	
Limitations on Participant Directed Investments:

	
  

	
[x]

	
1.

	
Participants are permitted to invest among only those investment alternatives made available by the Employer under the Plan.

	
  

	
[ ]

	
2.

	
Participants are permitted to invest in any investment alternative permitted under the Basic Plan Document #01

	
[ ]

	
C.

	
Insurance:

The Plan permits life insurance as an investment alternative.

	
XVI.

	
DISTRIBUTION OPTIONS

	
  

	
A.

	
Timing of Distributions [both (1) and (2) must be completed]:

	
  

	
1.

	
Distributions payable as a result of termination for reasons other than death, Disability or retirement shall be paid c [select from the list at (A)(3) below].

	
  

	
2.

	
Distributions payable as a result of termination for death, Disability or retirement shall be paid c [select from the list at (A)(3) below].

	
  

	
3.

	
Distribution Options:

	
  

	
a.

	
As soon as administratively feasible on or after the Valuation Date following the date on which a distribution is requested or is otherwise payable.

	
  

	
b.

	
As soon as administratively feasible following the close of the Plan Year during which a distribution is requested or is otherwise payable.

	
  

	
c.

	
As soon as administratively feasible following the date on which a distribution is requested or is otherwise payable. (This option is recommended for daily valuation plans.)

	
  

	
d.

	
As soon as administratively feasible after the close of the Plan Year during which the Participant incurs ___________ [cannot be more than five (5)] consecutive one (1) year Breaks in Service.

	
  

	
e.

	
Only after the Participant has attained the Plan's Normal Retirement Age or Early Retirement Age, if applicable.

B.           Required Beginning Date:

	
  

	
The Required Beginning Date of a Participant with respect to the Plan is (select one from below):

	
  

	
[ ]            1.

	
The April 1 of the calendar year following the calendar year in which the Participant attains age 701⁄2

	
  

	
[ ]            2.

	
The April 1 of the calendar year following the calendar year in which the Participant attains age 701⁄2 except that distributions to a Participant (other than a 5% owner) with respect to benefits accrued after the later of the adoption of this Plan or Effective Date of the amendment of this Plan must commence no later than the April 1 of the calendar year following the later of the calendar year in which the Participant attains age 701⁄2 or the calendar year in which the Participant retires.

	
  

	
[x]            3.

	
The later of the April 1 of the calendar year following the calendar year in which the Participant attains age 701⁄2 or retires except that distributions to a 5% owner must commence by the April 1 of the calendar year following the calendar year in which the Participant attains age 701⁄2.

	
  

	
Option (3) may only be elected if (i) it corresponds to an amendment previously made to the Plan pursuant to Regulations Section 1.411(d)-4, Q&A-10(b), or (ii) it does not eliminate an age 701⁄2 distribution option as described in the preceding Regulations because either (A) the Plan is a new Plan or (B) Section XIII(A)(3) is checked or the Plan already offers a pre-retirement distribution at least as generous as Section XIII(A)(3).

	
C.  

	
Minimum Distribution Requirements:

	
  

	
[ ]          1.

	
Election to Apply Five (5) Year Rule to Distributions to Designated Beneficiaries:  If the Participant dies before distributions begin and there is a Designated Beneficiary, distribution to the Designated Beneficiary is not required to begin by the date specified in the Basic Plan Document #01 but the Participant’s entire interest will be distributed to the Designated Beneficiary by December 31 of the calendar year containing the fifth anniversary of the Participant’s death.

	
  

	
[ ]          2.

	
Election to Allow Participants or Beneficiaries to Elect Five (5) Year Rule:  Participants or Beneficiaries may elect on an individual basis whether the five (5) year rule or the life expectancy rule described in the Basic Plan Document #01 applies to distributions after the death of a Participant who has a Designated Beneficiary.  The election must be made no later than the earlier of September 30 of the calendar year in which distribution would be required to begin under the Plan, or by September 30 of the calendar year which contains the fifth anniversary of the Participant’s (or, if applicable, surviving Spouse’s) death.  If neither the Participant nor Beneficiary makes an election under this paragraph, distributions will be made in accordance with Article VII of the Basic Plan Document #01 and, if applicable, the elections in Section XVI(C)(1) above.

D.           Forms of Payment (select all that apply):

	
  

	
The normal form of payment is determined at Section III(J) of this Adoption Agreement.  If option (1) or no selection is made in Section III(J), then options (4), (5) and (6) in this section cannot be selected.

	
  

	
[x]

	
1.

	
Lump sum.

	
  

	
[x]

	
2.

	
Installment payments.

	
  

	
[ ]

	
3.

	
Partial payments; the minimum amount will be $___________.

	
  

	
[ ]

	
4.

	
Life annuity.

	
  

	
[ ]            5.

	
Term certain annuity with payments guaranteed for ________ years [not to  exceed twenty (20)].

	
  

	
[ ]

	
6.

	
Joint and [ ] 50%, [ ] 66-2/3%, [ ] 75% or [ ] 100% survivor annuity.

E.           Type of Payment (select all that apply):

	
  

	
[x]

	
1.

	
Cash.

	
  

	
[x ]

	
2.

	
Employer securities.

	
  

	
[ ]

	
3.

	
Other marketable securities.

[ ]           4.           Other:                                                                                                             (fill in

                                           the blank with the type of other in-kind distributions allowed under the Plan).

F.           Application of Involuntary Cash-out Provisions:

	
  

	
[ ]

	
1.

	
The Plan shall not make involuntary cash-outs to any terminated vested Participant.        Distributions will only be made with the consent of the Participant.

	
  

	
[x]

	
2.

	
The Plan shall make involuntary cash-outs to a terminated vested Participant as follows:

	
  

	
[ ]            a.

	
The Plan shall make involuntary cash-out distributions of Vested Account Balances of less than $200.  Distribution of amounts $200 or greater shall only be made with the consent of the Participant.

	
  

	
[x]            b.

	
The Plan shall make involuntary cash-out distributions of Vested Account   Balances of $1,000 or less.  Distribution of amounts greater than $1,000 shall only be made with the consent of the Participant.

	
  

	
3.

	
When determining the value of the Participant’s nonforfeitable account balance for purposes of the Plan’s involuntary cash-out rules, the Plan elects to:

	
  

	
[ ]           a.

	
exclude Rollover Contributions.

	
  

	
[x]

	
b.

	
include Rollover Contributions.

If no selection is made, the Plan will exclude Rollover Contributions when determining the value of the Participant’s nonforfeitable account balance for involuntary cash-out purposes. Rollover Contributions, if any, will always be included when determining whether the $1,000 threshold has been exceeded.

	
  

	
G.

	
Automatic Rollovers:

	
  

	
Do not complete if a selection has been made at Section XVI(F)(1) or (2) above.

	
  

	
[ ]            1.

	
The Plan shall make automatic rollovers of Vested Account Balances that are greater than $1,000 but are not more than $5,000 in accordance with the provisions of Article VI of the Basic Plan Document #01.

	
  

	
[ ]

	
2.

	
The Plan shall make automatic rollovers of Vested Account Balances that are not more than $5,000 in accordance with the provisions of Article VI of the Basic Plan Document #01.

H.           Distribution Upon Severance from Employment:

	
  

	
[ ]

	
1.

	
Not applicable.

	
  

	
[x]          2.

	
Distribution upon severance from employment as described in the Basic Plan Document #01 shall apply for distributions after December 31, 2001 regardless of when the severance from employment occurred.

	
  

	
[ ]

	
3.

	
Distribution upon severance from employment as described in the Basic Plan Document #01 shall apply for distributions after ___________________ (no earlier than December 31, 2001) for severance from employment occurring after December 31, 2001 (enter the Effective Date if different than the Effective Date above).

XVII.           SPONSOR INFORMATION AND ACCEPTANCE

	
  

	
This Plan may not be used and shall not be deemed to be a Prototype Plan unless an authorized representative of the Sponsor has acknowledged the use of the Plan.  Such acknowledgment that the Employer is using the Plan does not represent that the Adoption Agreement (as completed) and Basic Plan Document #01 have been reviewed by a representative of the Sponsor or constitute a qualified retirement plan.

	
  

	
Acknowledged and accepted by the Sponsor this __________ day of ________________, __________.

	
Name:

	
Elizabeth H. Festa

	
  

	
Title:

	
Vice President

	
  

	
Signature:

	 	 

	
  

	
Questions concerning the language contained in and qualification of the Prototype should be addressed to:

Elizabeth H. Festa

	
(Position): Vice President

	
(Phone Number):

	
203-736-3053

In the event that the Sponsor amends, discontinues or abandons this Prototype Plan, notification will be provided to the Employer's address provided on the first page of this Adoption Agreement.

XVIII.           SIGNATURES

Completion of this Adoption Agreement requires consideration of complex tax and legal issues.  The Employer should consult with or should obtain the advice of its legal counsel and/or tax advisor before executing this Adoption Agreement.  By executing this Adoption Agreement, the Employer acknowledges that it is a legal document with significant tax and legal ramifications.  The Employer understands that its failure to properly complete or amend this Adoption Agreement may result in failure of the Plan to qualify or in disqualification of the Plan.  Neither the Sponsor nor any of its agents or affiliates assumes any responsibility for the completion and operation of the Plan established under this Adoption Agreement and Basic Plan Document #01.

	
  

	
A.

	
Employer:

	
  

	
This Adoption Agreement and the corresponding provisions of Basic Plan Document #01 are adopted by the Employer this__________ day of _____________________, ___________.

	
Executed on behalf of the Employer by:

	
Kristen A Johnson

	
  

	
Title:

	
Vice President, Human Resources

	
  

	
Signature:

	 	 

Employer's Reliance: The adopting Employer may rely on an Opinion Letter issued by the Internal Revenue Service as evidence that the Plan is qualified under Code Section 401 except to the extent provided in Revenue Procedure 2005-16. The Employer may not rely on the Opinion Letter in certain other circumstances or with respect to certain qualification requirements, which are specified in the Opinion Letter issued with respect to the Plan and in Revenue Procedure 2005-16. In order to have reliance in such circumstances or with respect to such qualification requirements, application for a determination letter must be made to Employee Plans Determinations of the Internal Revenue Service.  This Adoption Agreement may only be used in conjunction with Basic Plan Document #01.

B.           Trust Agreement/Custodial Agreement:

[ ]           Plan assets will be invested in group annuity contracts and the terms of the contract(s) will apply.

	
  

	
[x]

	
Plan assets are held in a tax qualified Trust.  The Trust provisions used will be as contained in the Basic Plan Document #01.

	
  

	
[ ]

	
Plan assets are held in a tax qualified Trust.  The Trust provisions used will be as contained in the accompanying pre-approved executed Trust Agreement between the Employer and the Trustee attached hereto.

	
  

	
[ ]

	
Plan assets are being held in a Custodial Account arrangement.  The Custodial Account provisions used will be as contained in the Basic Plan Document #01.

	
  

	
[ ]

	
Plan assets are being held in a Custodial Account arrangement.  The Custodial Account provisions used will be as contained in the accompanying pre-approved executed Custodial Account Agreement between the Employer and the Custodian attached hereto.

	
  

	
C.

	
Trustee:

	
  

	
[ ]

	
The Trustee appointed shall act in the capacity of a non-discretionary directed Trustee.

	
  

	
[x]

	
The Trustee appointed shall act in the capacity of a discretionary Trustee.

	
  

	
Name and address of Trustee:

Wachovia Bank, NA

1525 West W. T. Harris Blvd

Charlotte, NC   28662

	
  

	
The Employer's Plan as contained herein is accepted by the Trustee this ____________ day of ____________________, ___________.

	
  

	
Accepted on behalf of the Trustee by:

	
Elizabeth H. Festa

	
  

	
Title:

	
Vice President

	
  

	
Signature:

	 	 

	
  

	
Accepted on behalf of the Trustee by:

	 	 

	
  

	
Title:

	 	 

	
  

	
Signature:

	 	 

	
  

	
Accepted on behalf of the Trustee by:

	 	 

	
Title:

	 	
_________

	 

	
Signature:

	
_____

	 

	
  

	 

	
  

	 

	
  

	 

  

  

  

	
  

	
D.

	
Custodian:

	
  

	
Name and address of Custodian:

                                                                                                                     

	
  

	
The Employer's Plan as contained herein is accepted by the Custodian this __________ day of ________________, __________.

	
  

	
Accepted on behalf of the Custodian by:

	
  

	
Title:

	 	 

	
Signature:

	
_____

	 

  

  

  

PARTICIPATION AGREEMENT

Each Participating Employer must execute a separate Participation Agreement. If not applicable, do not complete this Participation Agreement.

By executing this Participation Agreement, the undersigned Employer elects to become a Participating Employer in the Plan and accompanying Adoption Agreement as if the Participating Employer were a signatory to the Adoption Agreement.  The Participating Employer accepts, and agrees to be bound by, all of the elections granted under the provisions of the Prototype Plan as made by the signatory sponsoring Employer in Section XVIII(A) of the Adoption Agreement. Further, the Participating Employer hereby appoints the signatory sponsoring Employer as its attorney in fact for the purpose of adopting on its behalf of all future amendments whether required or voluntary and any applicable corresponding documents (e.g., Loan Policy, QDRO procedures, Trust Agreement).  This includes the adoption of all future Model Amendments to this Prototype Plan which are required by the U.S. Department of the Treasury or the Internal Revenue Service as a result of a modification or amendment of applicable Federal laws or regulations that become effective subsequent to the execution of this Participation Agreement.

A.           PARTICIPATING EMPLOYER:

	
  

	
Name and address of any Participating Employer.

Connecticut Water Service

 93 West Main Street

Clinton, CT    06413

Phone Number:  (860) 669-8630                                                                Tax ID Number: 06-0739839

EFFECTIVE DATE:

The Effective Date of the Plan for the Participating Employer is:.

[ ]           This is an adoption of a new plan by the Participating Employer.

	
[x]

	
This is an adoption of an amendment and/or restatement of a plan currently maintained by the Participating Employer identified as follows:

Name of Plan:  Savings Plan of the Connecticut Water Company

Original Effective Date:   January 1, 1985

C.           SIGNATURES:

Executed on behalf of the Participating Employer by:  Daniel J. Meaney

Title:                                                                Corporate Secretary Director of Corporate

Communications

Signature:                 /s/ Daniel J. Meaney                                               

Executed on behalf of the Signatory Sponsoring

Employer by:                                                                      Kristen A Johnson

Title:                                                                Vice President, Human Resources

Signature:            /s/ Kristen A Johnson                                                    

Executed on behalf of the Trustee by:                                                                           Elizabeth H. Festa

Title:                                                                Vice President

Signature:                      /s/ Elizabeth H. Festa                                          

  

  

  

	
  

	
SCHEDULE A

PROTECTED BENEFITS

This Schedule describes Code Section 411(d)(6) protected benefits included in the adopting Employer’s prior plan document that are not available in this Prototype Defined Contribution Plan, Basic Plan Document #01.  Complete as applicable.

1.           Plan Provision:

                                                                                                                                

Effective Date:                                                                                                           

2.           Plan Provision:

                                                                                                                                

Effective Date:                                                                                                           

3.           Plan Provision:

                                                                                                                                

Effective Date:                                                                                                           

	
  

	
4.

	
Plan Provision:

                                                                                                                                

Effective Date:                                                                                                           

5.           Plan Provision:

                                                                                                                                

Effective Date:                                                                                                           

  

  

  

	
  

	
SCHEDULE B

PRIOR PLAN PROVISIONS

This Schedule should be used by the adopting Employer if a prior plan contains provisions not found in this Prototype Defined Contribution Plan, Basic Plan Document #01, or where the Employer wishes to document transactions or historical provisions of the Employer’s Plan.

	
1.  

	
Plan Provision:

                                                                                                                                

Effective Date:                                                                                                           

	
2.  

	
Plan Provision:

                                                                                                                                

Effective Date:                                                                                                           

	
3.  

	
Plan Provision:

                                                                                                                                

Effective Date:                                                                                                           

	
4.  

	
Plan Provision:

                                                                                                                                

Effective Date:                                                                                                           

	
5.  

	
Plan Provision:

                                                                                                                                

	
Effective Date:

	 	 

  

  

  

SCHEDULE C

SAFE HARBOR ELECTIONS FOR FLEXIBLE NON-ELECTIVE CONTRIBUTION

The following elections are made with regard to the Plan’s Safe Harbor status pursuant to Section VII herein.  For Plan Years indicated below, the Plan hereby invokes a Safe Harbor status in accordance with IRS Notices 98-52 and 2000-3.

For all Plan Years in which this Safe Harbor election is being made, the limitations and restrictions found in Section VII herein apply.

	
1.  

	
For the Plan Year beginning _____ and ending _____, the Employer hereby invokes a Safe Harbor status as provided in IRS Notice 2000-3.  The Safe Harbor Contribution will be an amount equal to _____% (not less than 3%) of Compensation.  This election is made on this _____ day of _____, _____ (date may not be later than 30 days prior to the end of the Plan Year in which such election is being made).

	
2.  

	
For the Plan Year beginning _____ and ending _____, the Employer hereby invokes a Safe Harbor status as provided in IRS Notice 2000-3.  The Safe Harbor Contribution will be an amount equal to _____% (not less than 3%) of Compensation.  This election is made on this _____ day of _____, _____ (date may not be later than 30 days prior to the end of the Plan Year in which such election is being made).

	
3.  

	
For the Plan Year beginning _____ and ending _____, the Employer hereby invokes a Safe Harbor status as provided in IRS Notice 2000-3.  The Safe Harbor Contribution will be an amount equal to _____% (not less than 3%) of Compensation.  This election is made on this _____ day of _____, _____ (date may not be later than 30 days prior to the end of the Plan Year in which such election is being made).

	
4.  

	
For the Plan Year beginning _____ and ending _____, the Employer hereby invokes a Safe Harbor status as provided in IRS Notice 2000-3.  The Safe Harbor Contribution will be an amount equal to _____% (not less than 3%) of Compensation.  This election is made on this _____ day of _____, _____ (date may not be later than 30 days prior to the end of the Plan Year in which such election is being made).

	
5.  

	
For the Plan Year beginning _____ and ending _____, the Employer hereby invokes a Safe Harbor status as provided in IRS Notice 2000-3.  The Safe Harbor Contribution will be an amount equal to _____% (not less than 3%) of Compensation.  This election is made on this _____ day of _____, _____ (date may not be later than 30 days prior to the end of the Plan Year in which such election is being made).

  

  

  

SCHEDULE D

COLLECTIVE AND COMMINGLED FUNDS

The Trustee is authorized to invest all or any part of the Fund in the following Collective and Commingled Funds as provided for in the Basic Plan Document #01:

1.

2.

3.

4.

5.

6.

7.

8.

9.

10.

  

  

  

	
  

	
SCHEDULE E

	
  

	
MISCELLANEOUS ADMINISTRATIVE ELECTIONS

The following elections are made with regard to the administration of the Plan:

	
  

	
[  ]

	
1.

	
ERISA Section 404(c):  The Employer intends to be covered by the fiduciary liability provisions with respect to Participant-directed investments under ERISA Section 404(c).  Under the terms of this Plan, Participants (or their Beneficiaries) have a reasonable opportunity to give instructions to the Plan Administrator in accordance with the policy set by the Plan Administrator (whether written, oral, or in electronic form) regarding the choice of investment of their account balance. The Plan Administrator is obligated to comply with the Participant’s or Beneficiary’s investment instructions unless complying with such instructions would result in a prohibited transaction under the Code, ERISA or the Department of Labor, violate the Plan document, or jeopardize the Plan’s tax-qualified status.

	
  

	
[x]

	
2.

	
Fees:  Listed below are the charges your account will incur as a condition of the receipt of a benefit under the Plan, depending upon the transaction involved.

	
  

	
[x]

	
a.

	
Participants have the ability to take a loan from the Plan.  [x] There will be a loan set-up fee of $80.00 paid from the account prior to obtaining a loan from the Plan.  [  ] $_____ will be charged on an annual basis until the loan is paid in full.  [x] The loan set-up charge is deducted from the Participant’s account.  All other costs of administering the Plan will be paid by the Employer or from Plan assets.

	
  

	
[  ]

	
b.

	
The costs of administering the Plan are shared between Participants and the Employer.

	
  

	
[  ]

	
c.

	
A service fee equal to $___ / ___% of a Participant’s account balance will be charged per [  ] Plan quarter [  ] Plan Year.

	
  

	
[  ]

	
d.

	
All costs of administering the Plan will be paid by the Employer or from Plan assets.

	
  

	
[  ]

	
e.

	
In order to maintain a self-directed brokerage option, Participants will be charged an initial fee of  $_______ [  ] and annual fee of $_________.

	
  

	
[  ]

	
f.

	
To obtain a Hardship distribution, Participants will incur a charge of $_________.

	
  

	
[  ]

	
g.

	
Qualified Domestic Relations Order (QDRO) presented to the Plan for payment will be charged $_______ to the Participant’s/Alternate Payee’s account for processing.

	
  

	
 [  ]

	
h.

	
Other:

	  

	
  

	 

	
  

	
[  ]

	
3.

	
Automatic Rollover Of Distributions:  If a Plan Participant does not elect to take a distribution and include it in income or have the distribution rolled over to either a qualified retirement plan or an Individual Retirement Account (“IRA”), the Plan is required to make a Direct Rollover of the distribution to an IRA.  The Employer as Plan Sponsor has the authority to execute the documents necessary to establish the IRA account, and once established, the Trustee/Issuer of the IRA will provide the Participant with a Disclosure Statement detailing the terms and conditions as well as any fees imposed on the IRA, including the procedures regarding the seven (7) day revocation period.  The Plan has selected the following IRA Trustee/Issuer:

Name:                      

	  

Address:                      

Phone:                      

The initial IRA setup fee shall be:

The initial IRA setup fee shall be paid by:

The IRA Provider’s annual fee shall be:

	  

The IRA funds shall be invested in:ex10_1.htm

 

 

Exhibit 10.1

 

 

INDEMNIFICATION AGREEMENT dated as of __________________________, 2011 between

 

 

Apco Oil and Gas International Inc.

 

 

(the “Company”), and _______________________________ (“Indemnitee”)

 

 

WHEREAS, the Board of Directors has determined that the inability to attract and retain qualified persons as directors is detrimental to the best interests of the Company’s shareholders and that the Company should act to assure such persons that there will be adequate certainty of protection through insurance and indemnification against risks of claims and actions against them arising out of their service to and activities on behalf of the Company; and

 

WHEREAS, the Company has adopted provisions in its Memorandum of Association and Articles of Association (the “Governing Documents”) providing for indemnification of its directors under certain circumstances, and the Company wishes to clarify and enhance the rights and obligations of the Company and Indemnitee with respect to indemnification; and

 

WHEREAS, in order to induce and encourage highly experienced and capable persons such as Indemnitee to serve and continue to serve as directors of the Company and in any other capacity at the request of the Company, and to otherwise promote the desirable end that such persons will resist what they consider unjustified lawsuits and claims made against them in connection with the good faith performance of their duties to the Company, with the knowledge that certain costs, judgments, penalties, fines, liabilities and expenses incurred by them in their defense of such litigation are to be borne by the Company and they will receive the maximum protection against such risks and liabilities as may be afforded by law to the extent they act in good faith and in a manner they reasonably believe to be in or not opposed to the best interests of the Company or an Other Enterprise, and, with respect to any criminal Proceeding, have no reasonable cause to believe their conduct was unlawful, and, with respect to any Proceeding brought by or in the name of the Company or an Other Enterprise, have not been adjudged to be liable for negligence or misconduct in the performance of their duty to the Company or such Other Enterprise, the Board of Directors of the Company has determined that the following Agreement is reasonable and prudent to promote and ensure the best interests of the Company and its shareholders; and

 

WHEREAS, the Company desires to have Indemnitee continue to serve as a director of the Company and in such other capacities as the Company may request, as the case may be, free from undue concern for unpredictable, inappropriate or unreasonable legal risks and personal liabilities by reason of Indemnitee acting in good faith in the performance of Indemnitee’s duties; and Indemnitee desires to continue so to serve, provided, and on the express condition, that he or she is furnished with the indemnity set forth hereinafter.

 

  

1

  

 

Now, therefore, in consideration of Indemnitee’s continued service as a director of the Company, the parties hereto agree as follows:

 

1.           Service by Indemnitee.  Indemnitee will serve and/or continue to serve as a director of the Company and, if applicable, as a director (including elected or appointed positions that are equivalent to director and for all purposes in this Agreement such positions shall be included within the term “director”) of another corporation, partnership, joint venture, trust, or other enterprise, including service with respect to an employee benefit plan (collectively, an “Other Enterprise”) faithfully and to the best of Indemnitee’s ability so long as Indemnitee is duly elected or appointed and until such time as Indemnitee is removed as permitted by law or tenders a resignation in writing.

 

2.           Indemnification.  To the extent Indemnitee acts in good faith and in a manner Indemnitee reasonably believes to be in or not opposed to the best interests of the Company or an Other Enterprise, and, with respect to any criminal Proceeding, has no reasonable cause to believe his or her conduct was unlawful, and, with respect to any Proceeding brought by or in the name of the Company or an Other Enterprise, has not been adjudged to be liable for negligence or misconduct in the performance of his or her duty to the Company or such Other Enterprise, the Company shall indemnify Indemnitee to the fullest extent permitted by applicable law.  Without diminishing the scope of the indemnification provided by this Section, the rights of indemnification of Indemnitee provided hereunder shall include but shall not be limited to those rights hereinafter set forth, except that no indemnification shall be paid to Indemnitee:

 

(a)           to the extent expressly prohibited by applicable law or the Governing Documents;

 

(b)           for which payment is actually made to Indemnitee under a valid and collectible insurance policy or under a valid and enforceable indemnity clause, Governing Document provision or agreement of the Company or an Other Enterprise on whose board Indemnitee serves at the request of the Company, except in respect of any indemnity exceeding the payment under such insurance, clause, provision or agreement;

 

(c)           in connection with an action, suit or proceeding, or part thereof (including claims and counterclaims) initiated by Indemnitee, except a judicial proceeding or arbitration pursuant to Section 9 to enforce rights under this Agreement, unless the action, suit or proceeding (or part thereof) was authorized by the Board of Directors of the Company or an Other Enterprise, as appropriate; and

 

(d)           with respect to any Proceeding brought by or in the name of the Company or an Other Enterprise against Indemnitee that is authorized by the Board of Directors of the Company or such Other Enterprise, as the case may be, except as provided in Sections 4 and 5 below.

 

3.           Action or Proceedings Other than an Action by or in the Right of the Company or an Other Enterprise.  Except as limited by Section 2 above, Indemnitee shall be entitled to the indemnification rights provided in this Section if Indemnitee is a party or is threatened to be made a party to any Proceeding (other than an action by or in the name of the Company or an Other Enterprise) by reason of the fact that Indemnitee is or was a director of the Company, or is or was serving at the request of the Company as a director of an Other Enterprise); or by reason of anything done or not done by Indemnitee in any such capacity.  Pursuant to this Section, Indemnitee shall be indemnified against all costs, judgments, penalties, fines, liabilities, amounts paid in settlement by or on behalf of Indemnitee, and Expenses (defined below) actually and reasonably incurred by Indemnitee in connection with such Proceeding, if Indemnitee acted in good faith and in a manner he reasonably believed to be in or not opposed to the best interests of the Company or such Other Enterprise, as the case may be, and with respect to any criminal Proceeding, had no reasonable cause to believe his or her conduct was unlawful.

 

  

2

  

 

4.           Indemnity in Proceedings by or in the Name of the Company or an Other Enterprise.  Except as limited by Section 2 above, Indemnitee shall be entitled to the indemnification rights provided in this Section if Indemnitee was or is a party or is threatened to be made a party to any Proceeding brought by or in the name of the Company or an Other Enterprise to procure a judgment in its favor by reason of the fact that Indemnitee is or was a director of the Company or such Other Enterprise, or by reason of anything done or not done by Indemnitee in any such capacity.  Pursuant to this Section, Indemnitee shall be indemnified against all costs, judgments, penalties, fines, liabilities, amounts paid in settlement by or on behalf of Indemnitee, and Expenses actually and reasonably incurred by Indemnitee in connection with such Proceeding if Indemnitee acted in good faith and in a manner Indemnitee reasonably believed to be in or not opposed to the best interests of the Company or such Other Enterprise; provided, however, that no such indemnification shall be made in respect of any claim, issue, or matter as to which Indemnitee shall have been adjudged to be liable for negligence or misconduct in the performance of his duty to the Company or such Other Enterprise.

 

5.           Partial Indemnification.  If Indemnitee is entitled under any provision of this Agreement to indemnification by the Company for some or a portion of the costs, judgments, penalties, fines, liabilities or Expenses actually and reasonably incurred in connection with any action, suit or proceeding (including an action, suit or proceeding brought by or on behalf of the Company or an Other Enterprise), but not, however, for all of the total amount thereof, the Company shall nevertheless indemnify Indemnitee for the portion of such costs, judgments, penalties, fines, liabilities and Expenses actually and reasonably incurred to which Indemnitee is entitled.

 

6.           Indemnification for Expenses of a Witness.  Notwithstanding any other provision of this Agreement, to the maximum extent permitted by applicable law, Indemnitee shall be entitled to indemnification against all Expenses actually and reasonably incurred or suffered by Indemnitee or on Indemnitee’s behalf if Indemnitee appears as a witness or otherwise incurs legal expenses as a result of or related to Indemnitee’s service as a director of the Company or an Other Enterprise, in any threatened, pending or completed legal, administrative, investigative or other proceeding or matter to which Indemnitee neither is, nor is threatened to be made, a party.

 

7.           Determination of Entitlement to Indemnification.  Upon written request by Indemnitee for indemnification pursuant to Sections 3, 4, 5 or 6, the entitlement of Indemnitee to indemnification, to the extent not provided pursuant to the terms of this Agreement, shall be determined by the following person or persons who shall be empowered to make such determination:  (a) the Board of Directors of the Company by a majority vote of Disinterested Directors (defined below), whether or not such majority constitutes a quorum; (b) a committee of Disinterested Directors designated by a majority vote of such directors, whether or not such majority constitutes a quorum; (c) if there are no Disinterested Directors, or if the Disinterested Directors so direct, by Independent Counsel (defined below) in a written opinion to the Board of Directors, a copy of which shall be delivered to Indemnitee; (d) the shareholders of the Company; or (e) in the event that a Change in Control (defined below) has occurred, Independent Counsel in a written opinion to the Board of Directors, a copy of which shall be delivered to Indemnitee.  Such Independent Counsel shall be selected by the Board of Directors and approved by Indemnitee, except as noted below.  Upon failure of the Board so to select such Independent Counsel or upon failure of Indemnitee so to approve, such Independent Counsel shall be selected upon application to a court of competent jurisdiction.  Notwithstanding the foregoing, if a Change in Control has occurred, Independent Counsel shall be selected by Indemnitee and approved by the Company.  A determination of entitlement to indemnification shall be made, and such indemnification shall be paid, not later than 60 calendar days after receipt by the Company of a written request for indemnification.  Such request shall include documentation or information which is necessary for such determination and which is reasonably available to Indemnitee.  Subject to Section 2, any Expenses incurred by Indemnitee in connection with a request for indemnification or payment of Expenses hereunder, under any other agreement, any provision of the Governing Documents, or any directors’ and officers’ liability insurance, shall be borne by the Company, and the Company hereby indemnifies Indemnitee for any such Expense and agrees to hold Indemnitee harmless therefrom.  If the person making such determination shall determine that Indemnitee is entitled to indemnification as to part (but not all) of the application for indemnification, such person shall reasonably prorate such partial indemnification among the claims, issues or matters at issue at the time of the determination.

 

  

3

  

 

8.           Presumptions and Effect of Certain Proceedings.  The Secretary of the Company shall, promptly upon receipt of Indemnitee’s request for indemnification, advise in writing the Board of Directors or such other person or persons empowered to make the determination as provided in Section 7 that Indemnitee has made such request for indemnification.  Upon making such request for indemnification, Indemnitee shall be presumed to be entitled to indemnification hereunder and the Company shall have the burden of proof in making any determination contrary to such presumption.  If the person or persons so empowered to make such determination shall have failed to make the requested determination with respect to indemnification within 60 calendar days after receipt by the Company of such request, a requisite determination of entitlement to indemnification shall be deemed to have been made and Indemnitee shall be absolutely entitled to such indemnification, absent actual and material fraud in the request for indemnification.  The termination of any Proceeding described in Sections 3 or 4 by judgment, order, settlement or conviction, or upon a plea of nolo contendere or its equivalent, shall not, of itself:  (a) create a presumption that Indemnitee did not act in good faith and in a manner which Indemnitee reasonably believed to be in or not opposed to the best interests of the Company or the Other Enterprise, as the case may be, or, with respect to any criminal Proceeding, that Indemnitee had reasonable cause to believe that Indemnitee’s conduct was unlawful; or (b) otherwise adversely affect the rights of Indemnitee to indemnification except as may be provided herein.

 

9.           Remedies of Indemnitee in Cases of Determination not to Indemnify or to Pay Expenses.  In the event that a determination is made that Indemnitee is not entitled to indemnification hereunder or if payment has not been timely made following a determination of entitlement to indemnification pursuant to Sections 7 and 8, or if Expenses are not paid pursuant to Section 14, Indemnitee shall be entitled to final adjudication in a court of competent jurisdiction of entitlement to such indemnification or payment.  Alternatively, Indemnitee at Indemnitee’s option may seek an award in an arbitration to be conducted by a single arbitrator pursuant to the rules of the American Arbitration Association, such award to be made within 60 calendar days following the filing of the demand for arbitration.  The Company shall not oppose Indemnitee’s right to seek any such adjudication or award in arbitration or any other claim.  The determination in any such judicial proceeding or arbitration shall be made de novo and Indemnitee shall not be prejudiced by reason of a determination (if so made) pursuant to Sections 7 or 8 that Indemnitee is not entitled to indemnification.  If a determination is made or deemed to have been made pursuant to the terms of Section 7 or 8 that Indemnitee is entitled to indemnification, the Company shall be bound by such determination and is precluded from asserting that such determination has not been made or that the procedure by which such determination was made is not valid, binding and enforceable.  The Company further agrees to stipulate in any such court or before any such arbitrator that the Company is bound by all the provisions of this Agreement and is precluded from making any assertions to the contrary.  If the court or arbitrator shall determine that Indemnitee is entitled to any indemnification or payment of Expenses hereunder, the Company shall pay all Expenses actually and reasonably incurred by Indemnitee in connection with such adjudication or award in arbitration (including, but not limited to, any appellate proceedings).  In any suit brought by an Indemnitee to enforce a right to indemnification or to payment of Expenses hereunder, or brought by the Company to recover a payment of Expenses pursuant to the terms of an undertaking, the burden of proving that Indemnitee is not entitled to be indemnified, or to be paid such Expenses, shall be on the Company.

 

10.           Other Rights to Indemnification.  Indemnification and payment of Expenses provided by this Agreement shall not be deemed exclusive of any other rights to which Indemnitee may now or in the future be entitled under any provision of the Governing Documents or other organizational documents of the Company, vote of shareholders or Disinterested Directors, provision of law, agreement or otherwise.

 

  

4

  

 

11.           Expenses to Enforce Agreement.  In the event that Indemnitee is subject to or intervenes in any Proceeding in which the validity or enforceability of this Agreement is at issue or seeks an adjudication or award in arbitration to enforce Indemnitee’s rights under, or to recover damages for breach of, this Agreement, Indemnitee, if Indemnitee prevails in whole or in part in such action, shall be entitled to recover from the Company and shall be indemnified by the Company against any actual Expenses incurred by Indemnitee.

 

12.           Continuation of Indemnity.  All agreements and obligations of the Company contained herein shall continue during the period Indemnitee is a director of the Company or is serving at the request of the Company as a director of an Other Enterprise and shall continue thereafter with respect to any possible claims based on the fact that Indemnitee held any such position.  This Agreement shall be binding upon all successors and assigns of the Company (including any transferee of all or substantially all of its assets and any successor by merger or operation of law) and shall inure to the benefit of the heirs, personal representatives and estate of Indemnitee.

 

13.           Notification and Defense of Claim.  Promptly after receipt by Indemnitee of notice of any Proceeding, Indemnitee will, if a claim in respect thereof is to be made against the Company under this Agreement, notify the Company in writing of the commencement thereof; but the omission so to notify the Company will not relieve it from any liability that it may have to Indemnitee.  Notwithstanding any other provision of this Agreement, with respect to any such Proceeding of which Indemnitee notifies the Company:

 

(a)           The Company shall be entitled to participate therein at its own expense; and

 

(b)           Except as otherwise provided in this Section 13(b), to the extent that it may wish, the Company, jointly with any other indemnifying party similarly notified, shall be entitled to assume the defense thereof, with counsel satisfactory to Indemnitee.  After notice from the Company to Indemnitee of its election so to assume the defense thereof, the Company shall not be liable to Indemnitee under this Agreement for any expenses of counsel subsequently incurred by Indemnitee in connection with the defense thereof except as otherwise provided below.  Indemnitee shall have the right to employ Indemnitee’s own counsel in such Proceeding, but the fees and expenses of such counsel incurred after notice from the Company of its assumption of the defense thereof shall be at the expense of Indemnitee unless (i) the employment of counsel by Indemnitee has been authorized by the Company, (ii) Indemnitee shall have reasonably concluded that there may be a conflict of interest between the Company and Indemnitee in the conduct of the defense of such action or (iii) the Company shall not within 60 calendar days of receipt of notice from Indemnitee in fact have employed counsel to assume the defense of the action, in each of which cases the fees and expenses of Indemnitee’s counsel shall be at the expense of the Company.  The Company shall not be entitled to assume the defense of any Proceeding brought by or on behalf of the Company or as to which Indemnitee shall have made the conclusion provided for in (ii) above.

 

14.           Payment of Expenses.  All Expenses incurred by Indemnitee in advance of the final disposition of any Proceeding shall be paid by the Company at the request of Indemnitee, each such payment to be made within 20 calendar days after the receipt by the Company of a statement or statements from Indemnitee requesting such payment or payments from time to time.  Indemnitee’s entitlement to such Expenses shall include those incurred in connection with any proceeding by Indemnitee seeking a judgment in court or an adjudication or award in arbitration pursuant to this Agreement (including the enforcement of this provision).  Such statement or statements shall reasonably evidence the expenses and costs incurred by Indemnitee in connection therewith and shall include or be accompanied by an undertaking, in substantially the form attached as Exhibit 1, by or on behalf of Indemnitee to reimburse such amount if it is ultimately determined, by a final adjudication from which there is no further right to appeal, that Indemnitee is not entitled to be indemnified against such Expenses by the Company as provided by this Agreement or otherwise.  Indemnitee’s undertaking to reimburse any such amounts is not required to be secured.

 

  

5

  

 

15.           Separability; Prior Indemnification Agreements.  If any provision or provisions of this Agreement shall be held to be invalid, illegal or unenforceable for any reason whatsoever (a) the validity, legality and enforceability of the remaining provisions of this Agreement (including without limitation, all portions of any paragraphs of this Agreement containing any such provision held to be invalid, illegal or unenforceable, that are not by themselves invalid, illegal or unenforceable) shall not in any way be affected or impaired thereby, and (b) to the fullest extent possible, the provisions of this Agreement (including, without limitation, all portions of any paragraph of this Agreement containing any such provision held to be invalid, illegal or unenforceable, that are not themselves invalid, illegal or unenforceable) shall be construed so as to give effect to the intent of the parties that the Company provide protection to Indemnitee to the fullest enforceable extent.  This Agreement shall supersede and replace any prior indemnification agreements entered into by and between the Company and Indemnitee and any such prior agreements shall be terminated upon execution of this Agreement.

 

16.           Consent to Settlement.  The Company shall not be liable to indemnify Indemnitee under this Agreement for any amounts paid in settlement of any Proceeding effected without the Company’s written consent, which consent shall not be unreasonably withheld, or for any judicial award if the Company was not given a reasonable and timely opportunity, at its expense, to participate in the defense of such Proceeding in accordance with Section 13 above.

 

17.           Definitions.  For purposes of this Agreement:

 

(a)           “Change in Control” means a change in control of the Company of a nature that would be required to be reported in response to Item 5.01 of Form 8-K (or in response to any similar item on any similar schedule or form) promulgated under the Securities Exchange Act of 1934 or any similar successor statute whether or not the Company is then subject to this reporting requirement; provided, however, that a Change in Control shall be deemed to have occurred if:  (i) any individual or entity becomes the beneficial owner (as defined in Rule 13d-3 under Securities Exchange Act of 1934), directly or indirectly, of securities of the Company representing 30% or more of the total voting power of the Company’s then-outstanding voting securities without the prior approval of at least two-thirds of the members of the Board of Directors in office immediately prior to such individual or entity attaining such percentage, (ii) the Company is a party to a merger, consolidation, sale of assets or other reorganization, or a proxy contest, as a consequence of which members of the Board of Directors in office immediately prior to such transaction or event constitute less than a majority of the Board of Directors thereafter, or (iii) during any period of two consecutive years, individuals who at the beginning of such period constituted the Board of Directors (including for this purpose any new director whose election or nomination for election by the Company’s shareholders was approved by a vote of at least two-thirds of the directors then still in office who were directors at the beginning of such period) cease for any reason to constitute at least a majority of the Board of Directors. Notwithstanding the foregoing, a Change in Control shall be deemed not to have occurred in the event The Williams Companies, Inc., a Delaware corporation, transfers its ownership interest in the Company to WPX Energy, Inc., a Delaware corporation.

 

(b)           “Disinterested Director” means a director of the Company who is not or was not a party to the Proceeding in respect of which indemnification is being sought by Indemnitee.

 

(c)           “Expenses” includes, without limitation, expenses incurred in connection with the defense or settlement of any and all investigations, judicial or administrative proceedings or appeals, attorneys’ fees, witness fees and expenses, fees and expenses of accountants and other advisors, retainers and disbursements and advances thereon, the premium, security for, and other costs relating to any bond (including cost bonds, appraisal bonds or their equivalents), and any expenses of establishing a right to indemnification under Sections 7, 9 and 11 above but shall not include the amount of judgments, fines or penalties actually levied against Indemnitee.

 

  

6

  

 

(d)           “Independent Counsel” means a law firm or a member of a law firm that neither is presently nor in the past five years has been retained to represent:  (i) the Company or Indemnitee in any matter material to either such party, or (ii) any other party to the Proceeding giving rise to a claim for indemnification hereunder.  Notwithstanding the foregoing, the term “Independent Counsel” shall not include any person who, under the applicable standards of professional conduct then prevailing, would have a conflict of interest in representing either the Company or Indemnitee in an action to determine Indemnitee’s right to indemnification under this Agreement.

 

(e)           “Proceeding” includes any threatened, pending or completed action, suit, arbitration, alternative dispute resolution mechanism, inquiry, administrative or legislative hearing, investigation or other any other actual, threatened or completed proceeding (including any and all appeals), whether brought in the name of the Company or otherwise, against Indemnitee, whether of a civil, criminal, administrative, investigative or legislative nature, including, but not limited to, actions, suits or proceedings in which Indemnitee may be or may have been involved as a party or otherwise, by reason of the fact that Indemnitee is or was a director of the Company, or is or was serving, at the request of the Company, as a director of an Other Enterprise, or by reason of anything done or not done by Indemnitee in any such capacity, whether or not Indemnitee is serving in such capacity at the time any liability or expense is incurred for which indemnification or reimbursement can be provided under this Agreement.

 

18.           Other Provisions.

 

(a)           This Agreement shall be interpreted and enforced in accordance with the laws of Delaware.

 

(b)           This Agreement may be executed in one or more counterparts, each of which shall for all purposes be deemed to be an original but all of which together shall constitute one and the same Agreement.  Only one such counterpart signed by the party against whom enforceability is sought needs to be produced as evidence of the existence of this Agreement.

 

(c)           This agreement shall not be deemed an employment contract between the Company or an Other Enterprise and any Indemnitee, and, Indemnitee specifically acknowledges that Indemnitee may be discharged at any time for any reason, with or without cause, and with or without severance compensation, except as may be otherwise provided in a separate written contract between Indemnitee and the Company or such Other Enterprise.

 

(d)           Upon a payment to Indemnitee under this Agreement, the Company shall be subrogated to the extent of such payment to all of the rights of Indemnitee to recover against any person for such liability, and Indemnitee shall execute all documents and instruments required and shall take such other actions as may be necessary to secure such rights, including the execution of such documents as may be necessary for the Company to bring suit to enforce such rights.

 

(e)           No supplement, modification or amendment of this Agreement shall be binding unless executed in writing by both parties hereto.  No waiver of any of the provisions of this Agreement shall be deemed or shall constitute a waiver of any other provisions hereof (whether or not similar) nor shall such waiver constitute a continuing waiver.

 

 

IN WITNESS WHEREOF, the parties hereto have executed this Agreement on and as of the day and year first above written.

 

 

APCO OIL AND GAS INTERNATIONAL INC.

 

 

 

By:  _________________________________                                                                

 

        Name:

 

        Title:

                        

                     _________________________________

                     Indemnitee

 

 

 

  

7

  

 

EXHIBIT 1

 

 

 

UNDERTAKING TO REPAY INDEMNIFICATION EXPENSES

I ___________________________________________________, agree to reimburse the Company for all expenses paid to me by the Company in connection with any Proceeding (as defined in the Indemnification Agreement dated as of ___________ between me and the Company), in the event, and to the extent that it shall ultimately be determined by a final adjudication from which there is no further right to appeal that I am not entitled to be indemnified by the Company for such expenses.

Signature _____________________________

Typed Name __________________________

Office _______________________________

  

8

Source: [{"source": "alea-institute/alea-institute/kl3m-data-edgar-agreements/train-00189-of-00352.parquet"}, [{"source": "alea-institute/alea-institute/kl3m-data-edgar-agreements/train-00189-of-00352.parquet"}]]