Document:

petq_Ex102

		
			PETIQ, INC.
2017 Omnibus Incentive Plan
		

		
			RESTRICTED STOCK UNIT AGREEMENT FOR NON-EMPLOYEE DIRECTORS
		

		
			THIS RESTRICTED STOCK UNIT AGREEMENT (this “Agreement”) is made effective as of [________], 20[__] (the “Grant Date”) by and between PetIQ, Inc., a Delaware corporation (the “Company”), and [___________] (the “Participant”), pursuant to the PetIQ, Inc. 2017 Omnibus Incentive Plan, as in effect and as amended from time to time (the “Plan”). Capitalized terms that are not defined herein shall have the meanings given to such terms in the Plan.
		

		
			WHEREAS, the Company has adopted the Plan in order to grant Awards from time to time to certain key Employees, Directors and Consultants of the Company and its Subsidiaries or Affiliates; and
		

		
			WHEREAS, the Participant is an Eligible Recipient as contemplated by the Plan, and the Committee has determined that it is in the interest of the Company to grant this Award to the Participant.
		

		
			NOW, THEREFORE, in consideration of the premises and subject to the terms and conditions set forth herein and in the Plan, the parties hereto agree as follows:
		

			
	
			
				 1.
			Grant and Vesting of Restricted Stock Units.

			
	
			
				 (a)
			As of the Grant Date, the Participant will be credited with [_____] Restricted Stock Units. Each Restricted Stock Unit is a notional amount that represents the right to receive one Share, subject to the terms and conditions of the Plan and this Agreement,  if and when the Restricted Stock Unit vests.

			
	
			
				 (b)
			The Restricted Stock Units shall vest [FOR ANNUAL GRANTS: in full on the first (1st) anniversary of the Grant Date, subject to the Participant’s continuous service with the Company or a Subsidiary or Affiliate thereof, as applicable, as a Director (“Service”), from the Grant Date through such anniversary] [FOR NEW DIRECTOR GRANTS: in three (3) substantially equal annual installments on each of the first three (3) anniversaries of the Grant Date, subject to the Participant’s continuous service with the Company or a Subsidiary or Affiliate thereof, as applicable, as a Director (“Service”), from the Grant Date through each such anniversary].

			
	
			
				 2.
			Rights as a Stockholder. 

			
	
			
				 (a)
			Unless and until a Restricted Stock Unit has vested and the Share underlying it has been distributed to the Participant, the Participant will not be entitled to vote in respect of that Restricted Stock Unit or that Share.

			
	
			
				 (b)
			If the Company declares a cash dividend on its Shares, then, on the payment date of the dividend, the Participant will be credited with dividend equivalents equal to the amount of cash dividend per Share multiplied by the number of Restricted Stock Units credited to the Participant through the record date. The dollar amount credited to the Participant under the 

		 

		

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	preceding sentence will be credited to an account (“Account”) established for the Participant for bookkeeping purposes only on the books of the Company. The balance in the Account will be subject to the same terms regarding vesting and forfeiture as the Participant’s Restricted Stock Units awarded under this Agreement, and will be paid in cash in a single sum at the time that the Shares associated with the Participant’s Restricted Stock Units are delivered (or forfeited at the time that the Participant’s Restricted Stock Units are forfeited).

			
	
			
				 3.
			Termination of Service.

		
			[ANNUAL GRANTS: Upon a termination of Service occurring for any reason prior to the first (1st) anniversary of the Grant Date, the Participant shall forfeit all of the Restricted Stock Units.]
		

		
			[NEW DIRECTOR GRANTS: Upon a termination of Service occurring for any reason, the Participant shall forfeit any Restricted Stock Units that have not vested as of the date of such termination of Service.]
		

			
	
			
				 4.
			Timing and Form of Payment.

		
			Once a Restricted Stock Unit vests, the Participant will be entitled to receive a Share in its place. Delivery of the Share will be made as soon as administratively feasible following the vesting of the associated Restricted Stock Unit. Shares will be credited to an account established for the benefit of the Participant with the Company’s administrative agent. The Participant will have full legal and beneficial ownership of the Shares at that time.
		

			
	
			
				 5.
			Nontransferability of Restricted Stock Units. 

		
			The Restricted Stock Units granted hereunder may not be sold, transferred, pledged, assigned, encumbered or otherwise alienated or hypothecated, other than by will or by the laws of descent and distribution or, on such terms and conditions as the Committee shall establish, to a permitted transferee. 
		

			
	
			
				 6.
			Beneficiary Designation. 

		
			The Participant may from time to time name any beneficiary or beneficiaries (who may be named contingently or successively) by whom any right under the Plan and this Agreement is to be exercised in case of his or her death. Each designation will revoke all prior designations by the Participant, shall be in a form reasonably prescribed by the Committee, and will be effective only when filed by the Participant in writing with the Committee during his or her lifetime.
		

			
	
			
				 7.
			Requirements of Law.  

		
			The issuance of Shares following vesting of the Restricted Stock Units shall be subject to all applicable laws, rules and regulations, and to such approvals by any governmental agencies or national securities exchanges as may be required.  No Shares shall be issued upon vesting of any portion of the Restricted Stock Units granted hereunder, if such issuance would result in a violation of applicable law, including the U.S. federal securities laws and any applicable state or foreign securities laws.
		

		
			

		 

		

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				 8.
			No Guarantee of Continued Service.  

		
			Nothing in the Plan or in this Agreement shall interfere with or limit in any way the right of the Company or an Affiliate thereof to terminate the Participant’s Service at any time or confer upon the Participant any right to continued Service.
		

			
	
			
				 9.
			No Rights as a Stockholder.

		
			Except as provided in Section ‎2 above or as otherwise required by law, the Participant shall not have any rights as a stockholder with respect to any Shares covered by the Restricted Stock Units granted hereunder prior to the date on which he or she is recorded as the holder of those Shares on the records of the Company.
		

			
	
			
				 10.
			Interpretation; Construction.  

		
			Any determination or interpretation by the Committee under or pursuant to this Agreement shall be final and conclusive on all persons affected hereby. Except as otherwise expressly provided in the Plan, in the event of a conflict between any term of this Agreement and the terms of the Plan, the terms of the Plan shall control.
		

			
	
			
				 11.
			Amendments.  

		
			The Committee may, in its sole discretion, at any time and from time to time, alter or amend this Agreement and the terms and conditions of the unvested portion of the Restricted Stock Units (but not any portion of the Restricted Stock Units that has previously vested) in whole or in part, including without limitation, amending the criteria for vesting and exercisability set forth in Section 1 hereof and substituting alternative vesting criteria; provided that such alteration, amendment, suspension or termination shall not adversely alter or impair the rights of the Participant under the Restricted Stock Units without the Participant’s consent. The Company shall give written notice to the Participant of any such alteration or amendment of this Agreement as promptly as practicable after the adoption thereof.  This Agreement may also be amended by a writing signed by both the Company and the Participant.
		

			
	
			
				 12.
			Miscellaneous.

			
	
			
				 (a)
			Notices.  All notices, requests, demands, letters, waivers and other communications required or permitted to be given under this Agreement shall be in writing and shall be deemed to have been duly given if delivered personally, mailed, certified or registered mail with postage prepaid, sent by next-day or overnight mail or delivery, or sent by fax, as follows:

			
	
			
				 (i)
			

			
	
			
			If to the Company:

		
			PetIQ, Inc.
		

		
			923 S. Bridgeway Place
		

		
			Eagle, ID 83616
		

		
			Attention: General Counsel
		

		
			Phone: 208-939-8900
		

		
			

		 

		

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				 (ii)
			

			
	
			
			If to the Participant, to the Participant’s last known home address,

		
			or to such other person or address as any party shall specify by notice in writing to the Company.  All such notices, requests, demands, letters, waivers and other communications shall be deemed to have been received (w) if by personal delivery on the day after such delivery, (x) if by certified or registered mail, on the fifth business day after the mailing thereof, (y) if by next-day or overnight mail or delivery, on the day delivered, or (z) if by fax, on the day delivered, provided that such delivery is confirmed.
		

			
	
			
				 (b)
			Binding Effect; Benefits.  This Agreement shall be binding upon and inure to the benefit of the parties to this Agreement and their respective successors and assigns.  Nothing in this Agreement, express or implied, is intended or shall be construed to give any person other than the parties to this Agreement or their respective successors or assigns any legal or equitable right, remedy or claim under or in respect of any agreement or any provision contained herein.

			
	
			
				 (c)
			Waiver.  Either party hereto may by written notice to the other (i) extend the time for the performance of any of the obligations or other actions of the other under this Agreement, (ii) waive compliance with any of the conditions or covenants of the other contained in this Agreement and (iii) waive or modify performance of any of the obligations of the other under this Agreement.  Except as provided in the preceding sentence, no action taken pursuant to this Agreement, including, without limitation, any investigation by or on behalf of either party, shall be deemed to constitute a waiver by the party taking such action of compliance with any representations, warranties, covenants or agreements contained herein.  The waiver by either party hereto of a breach of any provision of this Agreement shall not operate or be construed as a waiver of any preceding or succeeding breach and no failure by either party to exercise any right or privilege hereunder shall be deemed a waiver of such party’s rights or privileges hereunder or shall be deemed a waiver of such party’s rights to exercise the same at any subsequent time or times hereunder.

			
	
			
				 (d)
			Entire Agreement.  This Agreement, together with the Plan, constitutes the entire obligation of the parties with respect to the subject matter of this Agreement and supersedes any prior written or oral expressions of intent or understanding with respect to such subject matter.

			
	
			
				 (e)
			Code Section 409A Compliance. The Restricted Stock Units are intended to be exempt from or comply with the requirements of Code Section 409A and this Agreement shall be interpreted accordingly. Notwithstanding any provision of this Agreement, to the extent that the Committee determines that any portion of the Restricted Stock Units granted under this Agreement is subject to Code Section 409A and fails to comply with the requirements of Code Section 409A, notwithstanding anything to the contrary contained in the Plan or in this Agreement, the Committee reserves the right to amend, restructure, terminate or replace such portion of the Restricted Stock Units in order to cause such portion of the Restricted Stock Units to either not be subject to Code Section 409A or to comply with the applicable provisions of such section.

			
	
			
				 (f)
			Applicable Law.  This Agreement shall be governed by and construed in accordance with the law of the State of Delaware, regardless of the law that might be applied under principles of conflict of laws.

		
			

		 

		

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				 (g)
			Section and Other Headings. The section and other headings contained in this Agreement are for reference purposes only and shall not affect the meaning or interpretation of this Agreement.

			
	
			
				 (h)
			Counterparts. This Agreement may be executed in any number of counterparts, each of which shall be deemed to be an original and all of which together shall be deemed to be one and the same instrument.

			
	
			
				 (i)
			Erroneously Awarded Compensation. Notwithstanding any provision in the Plan or in this Agreement to the contrary, this Award shall be subject to any compensation recovery and/or recoupment policy that may be adopted and amended from time to time by the Company to comply with applicable law, including, without limitation, the Dodd-Frank Wall Street Reform and Consumer Protection Act, or to comport with good corporate governance practices.

		
			[Signature Page Follows]
		

		
			

		 

		

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			IN WITNESS WHEREOF, the Company and the Participant have duly executed this Agreement as of the date first above written.
		

		
			 
		

		
			PETIQ, INC.
		

		
			By:
		

		
			Name:
		

		
			Title:
		

		
			 
		

		
			PARTICIPANT
		

		
			
Name: [_______]
		

		
			 
		

		
			 
		

		
			 
		

		
			 
		

		
			 
		

		
			 
		

		
			 
		

		
			 
		

		
			 
		

		
			 
		

		
			 
		

		
			 
		

		
			 
		

		
			 
		

		 

		

			[Signature Page to BOD RSU Agreement]Exhibit 10.17

 

UNITED
BUSINESS BANK

JOINT
BENEFICIARY AGREEMENT

(By and Between United Business Bank and
Mary Therese Curley)

 

	Insurer/Policy:	The Great-West Life Assurance Company Policy New York Life Insurance and Annuity Policy
	 	 
	Bank:	United Business Bank
	 	 
	Insured:	Mary Therese Curley
	 	 
	Relationship of Insured to Bank:	Executive
	 	 
	Effective Date:	July 31, 2018

 

The respective rights and duties of UNITED
BUSINESS BANK (hereinafter the “Bank”) and MARY THERESE CURLEY (hereinafter “Insured”) in the above-referenced
Policy(ies) shall be pursuant to the terms set forth below:

 

		1.	DEFINITIONS.

 

Refer to the Policy(ies’)
contract for the definition of any term in this Joint Beneficiary Agreement (hereinafter “Agreement”) that is not defined
herein. If the definition of a term in the Policy(ies) is inconsistent with the definition of a term in this Agreement, then the
definition of the term as set forth in this Agreement shall supersede and replace the definition of the terms as set forth in the
Policy(ies).

 

		1.1	Accelerated Benefit. The term “Accelerated Benefit” shall mean amounts requested
and received pursuant to any Policy(ies) rider permitting the policyowner or Insured access to portions of the eligible death benefit
in the event the Insured is diagnosed with a chronic or terminal illness [as required by the individual Policy(ies)].

 

		1.2	Beneficiary. “Beneficiary” shall mean one or more persons, trusts, estates or
other entities, designated in accordance with Paragraph 3 below that are entitled to receive benefits under this Plan upon the
death of Insured.

 

		1.3	Beneficiary Designation Form. “Beneficiary Designation Form” shall mean the
form established from time to time by the Bank and the Administrator, which an Insured completes, signs and returns in order to
designate one or more Beneficiaries.

 

     

     

    

 

		1.4	Board. “Board” means the Board of Directors
of the Bank.

 

		1.5	Claimant. “Claimant” shall have the meaning assigned to an individual who makes
a claim pursuant to the provisions of Paragraph 12 below.

 

		1.6	Code. The term the “Code” shall mean the Internal Revenue Code of 1986, as amended
from time to time.

 

		1.7	ERISA. The term "ERISA" shall mean the Employee Retirement Income Security Act
of 1974, as amended.

 

		1.8	Net Amount-at-Risk. The term “Net Amount-at-Risk” (hereinafter “NAR”)
shall be defined as the total proceeds of the Policy(ies) less the cash value of the Policy(ies).

 

		1.9	Plan. The term “Plan” refers to this arrangement, as evidenced by this Agreement,
whereby Insured (or Insured’s Beneficiary) is entitled to receive a benefit.

 

		1.10	Separation From Service. The term “Separation From Service” (or “Separates
From Service”) shall be read and interpreted consistent with Code Section 409A and any future notices or guidance related
thereto. In addition, for the purposes of this Agreement, Insured shall experience a Separation From Service only upon separating
as an executive of the Bank and a director on the Board, as applicable.

 

		2.	POLICY(IES) TITLE AND OWNERSHIP.

 

Title and ownership of the Policy(ies)
shall reside in the Bank for its use and for the use of the Insured all in accordance with this Agreement. The Bank, in its sole
discretion, may surrender or terminate the Policy(ies) at any time and for any reason. Where the Bank and Insured (or assignee,
with the consent of Insured) mutually agree to exercise the right to increase the coverage under the subject Policy(ies), then,
in such event, the rights, duties and benefits of the parties to such increased coverage shall continue to be subject to the terms
of this Agreement.

 

The Bank (or the trustee, in
the event of the establishment of a rabbi trust, at the direction of the Bank) may sell, surrender or transfer ownership of the
Policy to the Insurer or any third party, provided that, in the event of any such sale, surrender or transfer prior to termination
of this Agreement, the Bank (or Trustee) replaces the Policy with a life insurance policy or policies on the life of Insured providing
death benefits that are at least as much as that of the Policy(ies) being replaced. The rights, duties and benefits of the Bank,
the Insured or the trustee with respect to any such replacement policy shall be subject to the terms of this Agreement. At the
request of the Bank, Insured shall take any and all actions that the Bank determines may be reasonably necessary for the sale,
surrender or transfer of the Policy, the issuance of a replacement policy(ies), and subjecting the replacement policy(ies) to the
terms of this Agreement.

 

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		3.	BENEFICIARY DESIGNATION RIGHTS.

 

Insured (or assignee) shall have
the right and power to designate a “Beneficiary” or “Beneficiaries” to receive Insured’s share of
the proceeds payable upon the death of Insured, and to elect and change a payment option for such beneficiary, subject to any right
or interest the Bank may have in such proceeds, as provided in this Agreement.

 

A divorce will automatically
revoke the portion of a Beneficiary Designation Form designating the former spouse as a Beneficiary. The former spouse will be
a Beneficiary under this Agreement only if a new such Beneficiary Designation Form naming the former spouse as a Beneficiary is
filed after the date the dissolution decree is entered. In addition, if no primary or secondary beneficiary shall survive Insured
(or no trust has been designated), then the Beneficiary under this Agreement shall be deemed to be Insured’s estate.

 

		4.	PREMIUM PAYMENT METHOD.

 

Subject to the Bank’s absolute
right to surrender or terminate the Policy(ies) at any time and for any reason, the Bank shall pay the premium required for each
Policy as it becomes due.

 

		5.	TAXABLE BENEFIT.

 

Annually, Insured will receive
a taxable benefit equal to the assumed cost of insurance as required by the Internal Revenue Service. The Bank (or its administrator)
will report to Insured the amount of imputed income each year on Form W-2 or its equivalent.

 

		6.	DIVISION OF DEATH PROCEEDS.

 

Subject to Paragraphs 7 and 9
herein, the division of the death proceeds of the Policy(ies) is as follows:

 

		A.	In the event Insured has not yet Separated From Service at the time of death, then, upon the death
of Insured, Insured’s Beneficiary(ies) shall be entitled to receive an amount equal to Fifty Percent (50%) of the NAR of
the Policy(ies) subject to this Agreement.

 

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		B.	Should the Insured Separate From Service for any reason other than death (the circumstances of
which are governed by Paragraph 6A), then neither Insured nor Insured’s Beneficiary(ies) shall be entitled to receive any
amount of the Policy(ies) proceeds pursuant to this Agreement.

 

		C.	The Bank may select which Policy(ies) shall be used to pay benefits due under this Agreement.

 

		D.	The Bank and the Insured (or assignees) shall share in any interest due on the death proceeds on
a pro rata basis as the proceeds due each respectively bears to the total proceeds, excluding any such interest.

 

		E.	Any refund of unearned premium as provided in any Policy(ies) shall be paid to the Bank.

 

		7.	ACCELERATED BENEFIT IN THE EVENT OF TERMINAL OR CHRONIC ILLNESS (AS APPLICABLE) AND DIVISION
OF CASH SURRENDER VALUE OF THE POLICY(IES).

 

Provided Insured’s right
to receive benefits under this Agreement has not terminated pursuant to the provisions of Paragraph 9 herein, and provided the
Policy(ies) provides for such option through an accelerated benefit or living benefit rider (i.e., generally requiring that the
Insured is either terminally or chronically ill), Insured shall have the right to request, in writing, the full amount to which
he is entitled under this Agreement, and subject to any further limitation on dollar amounts imposed by the Policy(ies). Any Accelerated
Benefit paid to Insured hereunder shall be deducted from any amounts to which Insured or her Beneficiary(ies) is (or may be) entitled
pursuant to the provisions of Paragraph 6 above. Neither Bank nor Corrigan & Company (PFIS) make any representations or warranties
about the tax consequences of such a request for accelerated or living benefits.

 

In addition, and subject to the
forgoing, at all times prior to Insured’s death, the Bank shall be entitled to an amount equal to the Policy(ies)’s
cash value, as that term is defined in the Policy(ies) contract, less any Policy loans, accelerated benefits and unpaid interest
or cash withdrawals previously incurred by the Bank and any applicable surrender charges. Such cash value shall be determined as
of the date of surrender or death as the case may be.

 

		8.	RIGHTS OF PARTIES WHERE POLICY(IES) ENDOWMENT OR ANNUITY ELECTION EXISTS.

 

In the event the Policy(ies)
involves an endowment or annuity element, the Bank’s right and interest in any endowment proceeds or annuity benefits, on
expiration of the deferment period, shall be determined under the provisions of this Agreement by regarding such endowment proceeds
or the commuted value of such annuity benefits as the Policy’s cash value. Such endowment proceeds or annuity benefits shall
be considered to be like death proceeds for the purposes of division under this Agreement.

 

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		9.	TERMINATION.

 

This Agreement shall terminate
upon Insured’s Separation From Service, upon the mutual written agreement of the Bank and Insured, or upon distribution of
the death benefit proceeds in accordance with Paragraph 6 above. In addition, this Agreement shall also terminate in the event
Insured requests and receives an Accelerated Benefit in an amount equal to the amount she is (or may be) entitled to receive pursuant
to the provisions of Paragraph 6 above.

 

		10.	INSURED’S OR ASSIGNEE’S ASSIGNMENT RIGHTS.

 

The Insured may not, without
the written consent of the Bank, assign to any individual, trust or other organization, any right, title or interest in the subject
Policy(ies) nor any rights, options, privileges or duties created under this Agreement.

 

		11.	AGREEMENT BINDING UPON THE PARTIES.

 

This Agreement shall bind Insured
and the Bank, their heirs, successors, personal representatives and assigns.

 

		12.	ADMINISTRATIVE AND CLAIMS PROVISIONS. 

 

The following
provisions are part of this Agreement and are intended to satisfy the requirements of ERISA (when required):

 

		A.	Named Fiduciary and Plan Administrator.

 

The Named Fiduciary and Plan Administrator
(hereinafter “Administrator) of this Agreement shall be the Board of Directors of the Bank. The Administrator may designate
a replacement Administrator at any time, or may delegate to others certain aspects of the management and operation responsibilities
of the Plan, including the employment of advisors and the delegation of any ministerial duties to qualified individuals.

 

		B.	Dispute Over Benefits. 

 

In the event a dispute arises over
the benefits under this plan and benefits are not paid to Insured (or to Insured’s Beneficiary[ies], if applicable) and such
Claimants feel they are entitled to receive such benefits, then a written claim must be made to the Administrator named above in
accordance with the following procedures:

 

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		(i)	Written Claim. The Claimant may file a written request for such benefit to the Administrator.

 

		(ii)	Claim Decision. Upon receipt of such claim, the Administrator shall respond to such Claimant
within ninety (90) days after receiving the claim. If the Administrator determines that special circumstances require additional
time for processing the claim, the Administrator can extend the response period by an additional ninety (90) days for reasonable
cause by notifying the Claimant in writing, prior to the end of the initial ninety (90) day period, that an additional period is
required. The notice of extension must set forth the special circumstances and the date by which the Administrator expects to render
its decision.

 

If the claim
is denied in whole or in part, the Administrator shall notify the Claimant in writing of such denial. The Administrator shall write
the notification in a manner calculated to be understood by the Claimant. The notification shall set forth:

 

		(a)	The specific reasons for the denial;

		(b)	The specific reference to pertinent provisions of the Agreement on which the denial is based;

		(c)	A description of any additional information or material necessary for Claimant to perfect the claim
and an explanation of why such material or information is necessary;

		(d)	Appropriate information as to the steps to be taken if Claimant wishes to submit the claim for
review and the time limits applicable to such procedures; and

		(e)	A statement of Claimant’s right to bring a civil action under ERISA Section 502(a) following
an adverse benefit determination on review.

 

		(iii).	Request for Review. Within sixty (60) days after receiving notice from the Administrator
that a claim has been denied (in part or in its entirety), then Claimant (or their duly authorized representative) may file with
the Administrator, a written request for a full and fair review of the denial of the claim. In the case of disability benefits
where a medical judgment was part of the basis of the adverse benefit determination, the review shall include a consultation with
an independent health care professional.

 

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Claimant (or
his duly authorized representative) shall then have the opportunity to submit written comments, documents, records and other information
relating to the claim. The Administrator shall also provide Claimant, upon request and free of charge, reasonable access to, and
copies of, all documents, records and other information relevant (as defined in applicable ERISA regulations) to Claimant’s
claim for benefits.

 

		(iv).	Decision on Review. The Administrator shall respond in writing to such Claimant within sixty
(60) days after receiving the request for review. If the Administrator determines that special circumstances require an extension
of time for processing the claim, written notice of the extension shall be furnished to Claimant prior to the termination of the
initial sixty (60) day period. In no event shall such extension exceed a period of sixty (60) days from the end of the initial
period. The notice of extension must set forth the special circumstances requiring an extension of time and the date by which the
Administrator expects to render its decision.

 

In considering the review, the
Administrator shall take into account all materials and information Claimant submits relating to the claim, without regard to whether
such information was submitted or considered in the initial benefit determination.

 

The Administrator shall notify
Claimant in writing of its decision on review. The Administrator shall write the notification in a manner calculated to be understood
by Claimant. The notification shall set forth:

 

		(a)	The specific reasons for the denial;

		(b)	Reference the specific provisions of the Agreement on which the denial is based;

		(c)	A statement that Claimant is entitled to receive, upon request and free of charge, reasonable access
to, and copies of, all documents, records and other information relevant (as defined in applicable ERISA regulations) to Claimant’s
claim for benefits; and

		(d)	A statement of Claimant’s right to bring a civil action under ERISA Section 502(a).

 

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		(v)	Special Timing and Rules for Disability Claims. In the event a claim above is a claim for
disability benefits, then the applicable time periods for notifying Claimant regarding benefit determinations shall be reduced
as required by 29 CFR 2560.503-1 (within a reasonable period of time, but not to exceed 45 days, subject to no more than two (2)
thirty-day (30 day) extensions if necessary due to matters beyond control of the plan and subject to proper notice being given).
In the event any extension is required, then notice of such extension shall specify the standards on which the entitlement to a
benefit is based, all unresolved issues that prevent a decision on a claim, the additional information needed to resolve those
issues, and claimant shall be afforded at least forty-five (45) days in which to provide the specified information. Additionally,
all disability claims shall be handled in a manner which is compliant with the Department of Labor Rules,
including but not limited to the following:

 

		(a)	Claims and appeals will be adjudicated in a manner designed to ensure independence and impartiality
of the persons involved in making the benefit determination;

		(b)	All benefit denial notices shall contain a complete discussion of why the claim was denied and
the standards applied in reaching the decision, including the basis for disagreeing with the views of health care professionals,
vocational professionals, or the Social Security Administration;

		(c)	Claimant shall have the right to access to the entire claim file and other relevant documents,
and shall be guaranteed the right to present evidence and testimony in support of their claim during the review process;

		(d)	Claimant shall be given notice and a fair opportunity to respond before denials at the appeals
stage are based on new or additional evidence or rationales;

		(e)	Claimant is not prohibited from seeking court review of a claim denial based on a failure to exhaust
administrative remedies under the plan if the plan failed to comply with the claims procedure requirements (unless the violation
was the result of a minor error);

		(f)	Certain rescissions of coverage are to be treated as adverse benefit determinations triggering
the plan’s appeals procedures; and

		(g)	All required notices and disclosures issued hereunder shall be written in a culturally and linguistically
appropriate manner.

 

		13.	GENDER.

 

Whenever in this Agreement words
are used in the masculine, feminine or neuter gender, they shall be read and construed as in the masculine, feminine or neuter
gender, whenever they should so apply.

 

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		14.	INSURANCE COMPANY NOT A PARTY TO THIS AGREEMENT.

 

The Insurer shall not be deemed
a party to this Agreement, but will respect the rights of the parties as herein developed upon receiving an executed copy of this
Agreement. Payment or other performance in accordance with the Policy(ies) provisions shall fully discharge the Insurer from any
and all liability.

 

		15.	SEVERABILITY AND INTERPRETATION.

 

If a provision of this Agreement
is held to be invalid or unenforceable, the remaining provisions shall nonetheless be enforceable according to their terms. Further,
in the event that any provision is held to be overbroad as written such provision shall be deemed amended to narrow its application
to the extent necessary to make the provision enforceable according to law and enforced as amended.

 

		16.	APPLICABLE LAW.

 

The laws of the State of California
shall govern the validity and interpretation of this Agreement.

 

		17.	EFFECT OF THE LIFE INSURANCE POLICY’S CONTESTABILITY CLAUSES.

 

The parties herein understand
and agree that the payment of the benefits provided herein are subject to the life insurance Policy’s(ies’) suicide
and contestability clauses and other such clauses, and if such clauses preclude the Insurer from paying the full death proceeds,
then, in such event, no death benefits of whatever nature shall be payable to Insured’s (or Insured’s Assignee’s)
Beneficiary(ies) under this Agreement.

 

This Agreement
shall be effective as of the date first set forth above.

 

	UNITED BUSINESS BANK	 	 
	 	 	 	 	 
	By:	/s/ George J. Guarini	 	By:	/s/ Keary L. Colwell
	 	 	 	 	Insured
	 	 	 	 	 
	Title:	Chief Executive Officer	 	Date:  	August 13, 2017
	 	 	 	 	 
	Date: 	August 13, 2017	 	 	 

 

    	9

Source: [{"source": "alea-institute/alea-institute/kl3m-data-edgar-agreements/train-00286-of-00352.parquet"}, [{"source": "alea-institute/alea-institute/kl3m-data-edgar-agreements/train-00286-of-00352.parquet"}]]