Document:

exv10wawxxii

Exhibit 10(a)(xxii)

COUSINS PROPERTIES INCORPORATED

2009 INCENTIVE STOCK PLAN

STOCK GRANT CERTIFICATE

GRANT

     This Stock Grant Certificate (the “Certificate”) evidences the grant by Cousins Properties
Incorporated (“CPI”), in accordance with the Cousins Properties Incorporated 2009 Incentive Stock
Plan (the “Plan”) and the terms and conditions below, of «NumberofShares» shares of common stock of
CPI (the “Stock”) to «KeyEmployee» (“Key Employee”). This Stock grant (the “Award”) is granted
effective as of «Date» which is referred to as the “Grant Date.”

	 	 	 	 	 
	 	COUSINS PROPERTIES INCORPORATED

 	 
	 	By:  	 	 
	 	 	Name:  	 	 
	 	 	Title:  	 	 
	 

TERMS AND CONDITIONS

     § 1 Plan and Grant Certificate. This Award is subject to all of the terms and
conditions in this Certificate and in the Plan. If a determination is made that any term or
condition in this Certificate is inconsistent with the Plan, the Plan will control. All of the
capitalized terms not otherwise defined in this Certificate will have the same meaning in this
Certificate as in the Plan. A copy of the Plan will be available to Key Employee upon written
request to the Secretary of CPI.

     § 2 Stockholder Rights. Key Employee will have (a) the right to receive all cash
dividends on all of the shares of Stock and (b) the right to vote the shares while the shares
remain subject to forfeiture under § 3. If Key Employee forfeits shares under § 3, Key Employee
will at the same time forfeit Key Employee’s right to vote the shares and to receive future cash
dividends paid with respect to the shares.

     Any stock dividends or other noncash distributions of property made with respect to shares
that remain subject to forfeiture under § 3 will be held by CPI, and Key Employee’s rights to
receive such stock dividends or other property will vest under § 3 at the same time as the shares
with respect to which the stock dividends or other property are attributable.

     Except for the right to receive cash dividends and vote described in this § 2, Key Employee
will have no rights as a stockholder with respect to any shares of Stock until those shares become
vested under § 3.

 

 

     § 3 Forfeiture and Vesting. Key Employee will vest in 100% of the shares of Stock on
the third anniversary of the Grant Date, provided Key Employee continuously remains an employee of
CPI or an Affiliate, Parent or Subsidiary of CPI from the Grant Date through the vesting date. In
addition, Key Employee shall become 100% vested in the shares of Stock upon death.

     If there is a Change in Control of CPI, Key Employee’s rights, if any, with respect to the
shares of Stock shall be determined in accordance with § 14 of the Plan. If Key Employee’s
employment terminates prior to the vesting date, Key Employee will forfeit all unvested shares. A
transfer of employment between or among CPI or an Affiliate, Parent or Subsidiary of CPI will not
be treated as a termination of employment under this § 3.

     If shares are forfeited, the shares (together with any stock dividends or other noncash
distributions made with respect to the shares that have been held by CPI) automatically will revert
back to CPI.

     § 4 Stock Certificates. CPI will issue a stock certificate (or at its election
establish a book entry account) for the shares of Stock in the name of Key Employee upon Key
Employee’s execution of the irrevocable stock power in favor of CPI attached hereto as Exhibit
A. If a physical stock certificate is issued, the Secretary of CPI will hold the stock
certificate representing such shares and any distributions made with respect to such shares (other
than cash dividends) until such time as the shares have vested or have been forfeited. As soon as
practicable after the vesting date, CPI will transfer to Key Employee or Key Employee’s delegate
physical custody of a stock certificate reflecting the shares that have vested and become
nonforfeitable on such date (together with any distributions made with respect to the shares that
have been held by CPI).

     § 5 No Transfer. Key Employee shall have no right to transfer or otherwise alienate
or assign Key Employee’s interest in any shares of Stock before Key Employee vests in the shares
under § 3.

     § 6 Withholding. Any amounts required to be withheld as a result of the transfer to
Key Employee of shares of Stock or any dividends or other payments made with respect to shares of
Stock shall be withheld from Key Employee’s regular cash compensation, from the shares of Stock,
from any cash dividend payable with respect to unvested shares of Stock, or pursuant to such other
means as CPI or an Affiliate, Parent or Subsidiary of CPI deems reasonable and appropriate under
the circumstances.

     § 7 Rule 16b-3. CPI shall have the right to amend this Stock grant to withhold or
otherwise restrict the transfer of the shares of Stock to Key Employee as CPI deems appropriate in
order to satisfy any condition or requirement under Rule 16b-3 to the extent Section 16 of the 1934
Act is applicable to the grant or transfer.

     § 8 Other Laws. CPI may refuse to transfer shares of Stock to Key Employee if the
transfer of such shares might violate any applicable law or regulation. Pending a

 - 2 - 

 

final determination as to whether a transfer would violate any applicable law or regulation,
CPI may refuse such transfer if it believes in good faith that such transfer might violate any
applicable law or regulation.

     § 9 No Right to Continue Employment. Neither the Plan, this Certificate, nor any
related material is intended to give Key Employee the right to continue in employment with CPI or
an Affiliate, Parent or Subsidiary of CPI or to adversely affect the right of CPI or an Affiliate,
Parent or Subsidiary of CPI to terminate Key Employee’s employment with or without cause at any
time.

     § 10 Governing Law. The Plan and this Certificate are governed by the laws of the
State of Georgia.

     § 11 Binding Effect. This Certificate is binding upon CPI, its Subsidiaries and
Affiliates, and Key Employee and their respective heirs, executors, administrators and successors.

     § 12 Headings and Sections. The headings contained in this Certificate are for
reference purposes only and shall not affect in any way the meaning or interpretation of this
Certificate. Any references to sections (§) in this Certificate shall be to sections (§) of this
Certificate unless otherwise expressly stated as part of such reference.

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Exhibit A

IRREVOCABLE STOCK POWER

     For value received, as a condition to the issuance to the undersigned of the «NumberofShares»
shares of common stock (the “Stock”) of Cousins Properties Incorporated (“CPI”) subject to that
certain Stock Grant Certificate dated as of «Date» (the “Certificate”), the undersigned hereby
assigns and transfers to CPI, effective upon the occurrence of any forfeiture event described in
the Certificate, any then-unvested shares of Stock for purposes of effecting any forfeiture called
for under § 3 of the Certificate, and does hereby irrevocably give CPI the power (without any
further action on the part of the undersigned) to transfer such shares of stock on the books of CPI
to effect any such forfeiture. This irrevocable stock power shall expire automatically with
respect to the shares of stock subject to such Stock grant on the date such shares of stock are no
longer subject to forfeiture under § 3 of the Certificate or, if earlier, immediately after such a
forfeiture has been effected with respect to such shares of stock.

	 	 	 
	 
	 
	 	 	 

	 	 	[Signature]

	 
	 	 	 

	 	 	 

	 	 	[Print Name]

	 
	 	 	 

	 	 	 

	 	 	[Date]exv10w00

Exhibit 10.00

FEDERAL SIGNAL CORPORATION

RELEASE AND SEVERANCE AGREEMENT

This Release and Severance Agreement (the “Agreement”) will confirm the understanding of
Federal Signal Corporation and David McConnaughey (“Employee”) in connection with the termination
of Employee’s employment with Federal Signal Corporation (the “Company”). We have reached
Agreement upon the following arrangements.

The effective date of Employee’s separation from employment with the Company will be December 31,
2009 (the “Separation Date”). The Company agrees to pay Employee the following severance benefits
(“Severance Benefits”) pursuant to the Company’s Executive General Severance Plan: (1) the sum of
$524,800 which is an amount equal to one times the sum of (i) the Employee’s Base Salary, and (ii)
the Employee’s target annual bonus; and (2) the sum of $196,800 which is an amount equal to the
Employee’s unpaid prorated target annual bonus for the plan year in which the Separation Date
occurs; in each case, less any applicable taxes including federal employment withholding
taxes that are payable in connection with this amount. In accordance with IRS Code provision 409A
final regulations, this amount will be paid to Employee in a lump sum when this Agreement becomes
binding upon the expiration of the revocation period referenced below.

In addition, the Company agrees to pay, on Employee’s behalf, up to $17,500 in executive
outplacement or executive coaching services, to one or more firms chosen by Employee and acceptable
to the Company. Employee understands that as a condition of receiving these Severance Benefits
under the Company’s Executive General Severance Plan, the Employee is required to sign the general
waiver and release in the form included in this Agreement. No Severance Benefits will be paid to
the Employee until the release contained herein becomes irrevocable in accordance with its terms.
Employee further understands that any vacation pay or other wages due to Employee will be paid
separately with appropriate employment taxes withheld and the receipt of such wages is in no way
contingent upon the signing of this Agreement. Nothing herein shall change or have an effect on any
wages, pension, retirement or other employee benefits Employee may be entitled to under any Company
retirement or benefit programs. Any monies owed the Company by Employee may be deducted from the
monies and the Severance Benefits, in accordance with applicable law. The Severance Benefits shall
not be considered or counted as “compensation” for purposes of any of the Company’s welfare or
pension benefit plans which provide benefits based, in any part, on compensation.

As further Severance Benefits, the Company also agrees to continue any applicable welfare benefits
of medical insurance, dental insurance and group term life insurance (life insurance continues for
Employee only) that Employee receives for 18 months following the Separation Date at the same
premium cost, and at the same coverage level, as were in effect as of the Employee’s Separation
Date, pursuant to the terms of the Company’s Executive General

REGENCY TOWERS, 1415 WEST 22nd STREET • OAK BROOK, ILLINOIS 60523 • PHONE (630) 954-2015 • FAX (630) 954-2030

 

 

Severance Plan and COBRA, and subject to inclusion in Employee’s gross income to the extent deemed
necessary by Company to comply with the requirements of Sections 105(h) and 409A of the Internal
Revenue Code. The American Recovery and Reinvestment Act of 2009 (“ARRA”) reduces the COBRA
premium in some cases. Eligibility for the ARRA subsidy is based on income (less than $125,000 (or
$250,000 for married couples filing a joint federal income tax return)). The Company believes you
are not entitled to the COBRA premium subsidy under ARRA, however if you believe you are eligible
for the COBRA premium subsidy, please contact the Company (630) 954-2026, Jennifer Sherman.
Payments required to be made by Employee in connection with COBRA are referred to herein as “COBRA
payments.” Employee will receive notification from and shall make monthly COBRA payments to Hewitt
Associates “Your Benefits Resource” in accordance with Hewitt’s administrative procedures, or any
successor thereto. If Employee fails to make COBRA payments, Employee’s COBRA coverage will be
cancelled. Employee must complete all necessary paperwork within the prescribed time period in
order to receive this benefit. Notwithstanding the foregoing, during the eighteen (18) months
the Company continues the welfare benefits at the active employee rate (or such other rate as
determined under ARRA between March 1, 2009 and December 31, 2009), in the event the premium cost
and/or level of coverage shall change for all employees of the Company, the cost and or coverage
level, likewise, shall change in a corresponding manner for Employee. In addition, the
continuation of these welfare benefits shall be discontinued prior to the end of the period
described above if any required premium is not paid in full on time, the employee becomes covered
under another group health plan, the employee becomes entitled to Medicare benefits (under Part A,
Part B, or both), or the Company ceases to provide any group health plan for its employees.
Continuation may also be terminated for any reason the plan providing such coverage would terminate
coverage of a participant or an eligible dependent.

The Company makes this Agreement to avoid the cost of defending any possible lawsuit. Employee
acknowledges that by making this Agreement the Company does not admit that it has done anything
wrong. Employee understands that he/she has a period of twenty-one (21) days following the
Separation Date to review and consider this Agreement before signing it. He/She may use as much of
this 21-day period as he/she wishes in making his/her decision. Employee further acknowledges that
he/she may revoke the signed Agreement within seven (7) days after its signing. Any such
revocation must be in writing and received by Jennifer Sherman in the Legal Department at Federal
Signal Corporation in Oak Brook, Illinois within the seven (7) day period. Payment of the
Severance Benefits described above will only begin after this Agreement becomes binding which takes
place when the revocation period runs out seven days after the date of Employee’s signature.

Employee is strongly encouraged to consult with an attorney before signing this Agreement, however,
whether he/she does so or not is his/her decision. Employee acknowledges that he/she has been
advised that he/she should be represented by an attorney throughout the negotiation of the terms of
this Agreement.

As further consideration of the Severance Benefits described above, Employee agrees to the
following terms and conditions:

     1. General Release. Employee, on behalf of himself/herself and his/her heirs,
executors, administrators, attorneys and assigns, hereby waives, releases and forever discharges
the Company and its subsidiaries, divisions and affiliates, whether direct or indirect, its and
their

 

 

joint ventures and joint venturers (including its and their respective directors, officers,
employees, shareholders, partners and agents, past, present, and future), and each of its and their
respective successors and assigns (hereinafter collectively referred to as “Releasees”), from any
and all known or unknown actions, causes of action, claims or liabilities of any kind which have
been or could be asserted against the Releasees arising out of or related to Employee’s employment
with and/or separation from employment with the Company and/or any of the other Releasees and/or
any other occurrence up to and including the date that Employee signs this Agreement, including but
not limited to:

	 	(a)	 	claims, actions, causes of action or liabilities arising under Title VII of the
Civil Rights Act, as amended, the Age Discrimination in Employment Act, as amended
(“ADEA”), the Employee Retirement Income Security Act, as amended, the Rehabilitation
Act, as amended, the Americans with Disabilities Act, the Family and Medical Leave Act
(to the extent permitted by law), and/or any other federal, state, municipal, or local
employment discrimination statutes (including, but not limited to, claims based on age,
sex, attainment of benefit plan rights, race, religion, national origin, marital
status, sexual orientation, ancestry, harassment, parental status, handicap,
disability, retaliation, and veteran status); and/or
	 
	 	(b)	 	claims, actions, causes of action or liabilities arising under any other
federal, state, municipal, or local statute, law, ordinance or regulation; and/or
	 
	 	(c)	 	any other claim whatsoever including, but not limited to, claims for severance
pay under any voluntary or involuntary severance/separation plan, policy or program
maintained by the Releasees, claims for bonus compensation under any incentive bonus
plan, claims for attorney’s fees, claims based upon breach of contract, wrongful
termination, defamation, intentional infliction of emotional distress, tort, personal
injury, invasion of privacy, violation of public policy, negligence and/or any other
common law, statutory or other claim whatsoever arising out of or relating to his/her
employment with and/or separation from employment with the Company and/or any of the
other Releasees.

Employee understands and agrees that he/she is releasing the Company from any and all claims by
which he/she is giving up the opportunity to recover any compensation, damages, or any other form
of relief in any proceeding brought by him/her or on his/her behalf. Notwithstanding the
foregoing, this Agreement is not intended to operate as a waiver of any retirement or pension
benefits that are vested, the eligibility and entitlement to which shall be governed by the terms
of the applicable plan. Nor shall this Agreement operate to waive or bar any claim or right which
— by express or unequivocal terms of law — may not under any circumstances be waived or barred.
Moreover, this Agreement shall not operate to waive rights, causes of action or claims under the
ADEA if those rights, causes of action or claims arise after the date Employee signs this
Agreement. Nor shall this Agreement preclude Employee from challenging the validity of the
Agreement under the ADEA.

     2. Covenant Not to Sue. Except for those claims, causes of action or rights
explicitly excluded from release in Paragraph 1 above, Employee agrees that he/she will never file
or accept anything of value from a lawsuit concerning any claim, issue, or matter relating to or
arising out of employment with the Company, the cessation of employment, the compensation or
benefits payable in connection with employment or termination of employment, or any other
interaction with the Company prior to the parties’ execution of this Agreement. Should

 

 

Employee violate any aspect of this Paragraph, Employee agrees: (a) that the lawsuit is null
and void, and must be summarily withdrawn and/or dismissed; (b) to pay all costs, expenses, and
damages incurred by the Company in responding to or as a result of any lawsuit brought by Employee
that breaches this Agreement, including reasonable attorneys’ fees; (c) to pay all costs and
expenses incurred by the Company in seeking enforcement of this Agreement, including reasonable
attorneys’ fees; and (d) to return the Severance Pay pursuant to this Agreement — save $500 -
within fourteen (14) days of written demand by the Company. In the event this reimbursement
provision is triggered, Employee agrees that the remaining provisions of this Agreement shall
remain in full force and effect.

     3. Further Release and Acknowledgment. To the extent permitted by law, Employee
further waives his/her right to any monetary recovery should any federal, state, or local
administrative agency pursue any claims on his/her behalf arising out of or related to his/her
employment with and/or separation from employment with the Company and/or any of the other
Releasees. Employee also acknowledges that he/she has not suffered any on-the-job injury for which
he/she has not already filed a claim. Employee acknowledges and agrees that the Company’s
provision of the severance benefits to him/her and his/her signing of the Agreement does not in any
way indicate that Employee has any viable claims against the Company or that the Company has or
admits any liability to Employee whatsoever.

     4. No Reinstatement. To the extent permitted by law, Employee further waives,
releases, and discharges Releasees from any reinstatement rights which he/she has or could have.

     5. Non-Disparagement, Confidentiality, Cooperation, Non-Competition, Non-Solicitation.
Employee will not make any legally impermissible statements or representations that disparage,
demean, or impugn the Company, including without limitation any legally impermissible statements
impugning the personal or professional character of any current or former director, officer,
employee or consultant for the Company.

Employee agrees from and after today to keep strictly confidential the existence and terms of this
Agreement, and further agrees that he/she will not disclose them to any person or entity, other
than to his/her immediate family, his/her attorney, and his/her financial advisor, or except as may
be required by law.

Employee acknowledges that after his/her Separation Date, he/she shall not represent
himself/herself to be an employee of the Company nor take any action which may bind the Company
with regard to any customer, supplier, vendor or any other party with whom Employee has had contact
while performing his/her duties as an employee or consultant of the Company.

Employee further agrees that for a period of one (1) year following Employee’s Separation Date,
Employee will not, without the prior written consent of the Company, engage directly or indirectly
(as an employee, consultant, independent contractor, officer, or in any other capacity) in any
business or enterprise which is in competition with the Company or its successors or assigns. A
business or enterprise will be deemed to be in competition if it is engaged in any significant
business activity of the Company or its subsidiaries within the United States of America.

For a one (1) year period following Employee’s Separation Date, he/she further agrees that he/she
will not, directly or indirectly, hire away or participate or assist in the hiring away of any
person employed by the Company or its affiliates on Employee’s Separation Date and he/she will

 

 

not solicit nor encourage any person employed by the Company or its affiliates on or after his/her
Separation Date to leave the employ of the Company or its affiliates.

In consideration for the Company’s payment of the outplacement and/or coaching services set forth
on page 1 of this Agreement, Employee agrees, at no cost to Company, to provide Company with
consulting services equal in value to the fees paid by Company on Employee’s behalf in connection
with such outplacement or executive services (maximum of 70 hours of consulting, based upon a
$250/hour consulting fee). Employee further agrees from and after today to make himself/herself
available to the Company and its legal counsel to provide reasonable cooperation and assistance to
the Company with respect to areas and matters in which Employee was involved during his/her
employment, including any threatened or actual investigation, regulatory matter and/or litigation
concerning the Company, and to provide to the Company, if requested, information and counsel
relating to ongoing matters of interest to the Company. The Company will, of course, take into
consideration Employee’s personal and business commitments, will give Employee as much advance
notice as reasonably possible, and ask that Employee be available at such time or times as are
reasonably convenient to Employee and the Company. The Company agrees to reimburse Employee for
the actual out-of-pocket expenses Employee incurs as a result of his/her complying with this
provision, subject to Employee’s submission to the Company of documentation substantiating such
expenses as the Company may require.

Proprietary information, confidential business information and trade secrets (hereinafter
collectively “Confidential Information”) which became known to Employee as an employee of the
Company remains the property of the Company. Such Confidential Information includes, but is not
limited to, materials, records, books, products, business plans, business proposals, software,
personnel information and data of the Company and its affiliates and its customers, but excludes
information which is generally known to the public or becomes known except through Employee’s
actions. Employee agrees from and after today that he/she will not at any time, directly or
indirectly, disclose Confidential Information to any third party or otherwise use such Confidential
Information for Employee’s own benefit or the benefit of others. Also, Employee acknowledges that
he/she remains bound by the terms and conditions of the applicable provisions of the Company’s Code
of Business Conduct.

Employee acknowledges that the provisions of this Paragraph 5 are reasonable and not unduly
restrictive of his/her rights as an individual and warrants that as of the date Employee signs this
Agreement, Employee has not breached any of the provisions of this Paragraph 5. Employee further
acknowledges that in the event that he/she breaches any of the provisions of this Paragraph 5, such
breach will result in immediate and irreparable harm to the business and goodwill of the Company
and that damages, if any, and remedies at law for such breach would be inadequate.

     6. Consequences of Breach of Non-Disparagement, Confidentiality, Cooperation,
Non-Competition and Non-Solicitation Provisions. Employee further acknowledges and agrees in
the event that he/she breaches the provisions of Paragraph 5 above, (a) the Company will be subject
to irreparable injury and shall be entitled to apply without bond for an injunction to restrain
such breach and for such further relief as the courts may deem just and proper, (b) the Company
shall not be obligated to continue the availability or payment of Severance Benefits to Employee,
and (c) Employee shall be obligated to pay to the Company its costs and expenses in enforcing the
Company’s non-disparagement, confidentiality, cooperation, non-competition,

 

 

non-solicitation provisions of this Agreement and the provisions of Paragraph 5 above
(including court costs, expenses and reasonable legal fees).

     7. Company Property/Expenses. Employee agrees to promptly return to the Company (no
later than the Separation Date) all Company property, including, but not limited to, Company car,
cell phone, information technology equipment, documents and records and other physical or personal
property of the Company in Employee’s possession or control, and agrees not to keep, transfer or
use copies or excerpts of the foregoing items. Employee agrees that all business expenses for
which he/she is entitled to reimbursement are documented and submitted for approval on a timely
basis and any final expenses are submitted within ten (10) days after the Separation Date.

     8. Time to Consider Agreement. Employee acknowledges that he/she has been given at
least twenty-one (21) days to consider this Agreement thoroughly and he/she was encouraged to
consult with his/her personal attorney at his/her own expense, if desired, before signing below.
He/She further agrees that any changes made to this Agreement will not restart the running of the
21-day period referenced herein.

     9. Time to Revoke Agreement. Employee understands that he/she may revoke this
Agreement within seven (7) days after its signing and that any revocation must be made in writing
and submitted within such seven day period to Jennifer Sherman, General Counsel, Federal Signal
Corporation, 1415 West 22nd Avenue, Suite 1100, Oak Brook, IL 60523. Employee further
understands that if he/she revokes this Agreement, he/she shall not receive the Severance Benefits.

     10. Consideration. Employee also understands that the Severance Benefits which he/she
will receive in exchange for signing and not later revoking this Agreement are in addition to
anything of value to which he/she is already entitled.

     11. RELEASE INCLUDES UNKNOWN CLAIMS. EMPLOYEE FURTHER UNDERSTANDS THAT THIS AGREEMENT
INCLUDES A RELEASE OF ALL KNOWN AND UNKNOWN CLAIMS.

     12. Severability. Employee acknowledges and agrees that if any provision of this
Agreement is found, held or deemed by a court of competent jurisdiction to be void, unlawful or
unenforceable under any applicable statute or controlling law, the remainder of this Agreement
shall continue in full force and effect.

     13. Governing Law. This Agreement is deemed made and entered into in the State of
Illinois, and in all respects shall be interpreted, enforced and governed under applicable federal
law and in the event reference shall be made to State law the internal laws of the State of
Illinois shall apply, without reference to its conflict of law provisions. Any dispute under this
Agreement shall be adjudicated by a court of competent jurisdiction in the State of Illinois.
Notwithstanding the foregoing, in accordance with Article 6.2 of the Executive General Severance
Plan dated October 2008 (the “Plan”), the parties shall have the right and option (in lieu of
litigation) to have any dispute or controversy arising under or in connection with the Plan settled
by arbitration, subject to the limitations set forth in Article 6.2.

     14. Knowing And Voluntary Waiver and Release. Employee further acknowledges and
agrees that he/she has carefully read and fully understands all of the provisions of this

 

 

Agreement and that he/she voluntarily enters into this Agreement by signing below. Employee
is encouraged to consult with an attorney of his/her choice at his/her own expense prior to signing
this Agreement.

     15. General Matters. Employee acknowledges and agrees that in signing this Agreement
he/she does not rely and has not relied on any representation or statement by the Company or by its
employees, agents, representatives, or attorneys with regard to the subject matter, basis or effect
of this Agreement.

     The language of all parts of this Agreement shall be construed according to its fair meaning,
and not strictly for or against either party. The provisions of this Agreement shall survive any
termination of this Agreement when necessary to effect the intent and terms of this Agreement
expressed herein.

     No modification of any provision of this Agreement shall be effective unless made in writing
and signed by Employee and a duly authorized senior executive of the Company. This Agreement shall
not be assignable by Employee.

	 	 	 	 	 
	 	 	
 	 	 
	 	 	(Signature) 	 	 
	 	 	 
	 	 	
 	 	 
	 	 	(Date) 	 	 
	 	 	 
	 	 	
 	 	 
	 	 	(Witness) 	 	 
	 	 	 	 	 
	 	 	
 	 	 
	 	 	(Company Representative) 	 	 
	 

 

 

	 	 	 	 	 	 	 
	STATE OF

	 	 	 	)	 
	 

	 	 	 	 	 	 
	 

	 	 	 	)	 
	COUNTY OF

	 	 	 	)	 
	 

	 	 	 	 	 	 

The undersigned, notary public in and for the above county and state, certifies that
                                                            , known to me to be the same person whose name is
subscribed to the foregoing Agreement, appeared before me in person and acknowledged signing and
delivering the instrument as his/her free and voluntary act, for the uses and purposes therein set
forth.

Dated:                     , 20___

	 	 	 	 	 
	 

	 	 

Notary Public
	 	 

	 	 	 	 	 
	Date Commission Expires:

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