Document:

exv4w1

 

Exhibit 4.1

	
STOCK CERTIFICATE
CUSIP: 45784P101

 

INSULET CORPORATION

THE COMPANY WILL FURNISH WITHOUT CHARGE TO EACH SHAREHOLDER WHO SO REQUESTS, A SUMMARY OF THE POWERS, DESIGNATIONS, PREFERENCES AND
RELATIVE, PARTICIPATING, OPTIONAL OR OTHER SPECIAL RIGHTS OF EACH CLASS OF STOCK OF THE COMPANY AND THE QUALIFICATIONS, LIMITATIONS
OR RESTRICTIONS OF SUCH PREFERENCES AND RIGHTS, AND THE VARIATIONS IN RIGHTS, PREFERENCES AND LIMITATIONS DETERMINED FOR EACH
SERIES, WHICH ARE FIXED BY THE ARTICLES OF INCORPORATION OF THE COMPANY, AS AMENDED, AND THE RESOLUTIONS OF THE BOARD OF DIRECTORS
OF THE COMPANY, AND THE AUTHORITY OF THE BOARD OF DIRECTORS TO DETERMINE VARIATIONS FOR FUTURE SERIES. SUCH REQUEST MAY BE MADE TO
THE OFFICE OF THE SECRETARY OF THE COMPANY OR TO THE TRANSFER AGENT. THE BOARD OF DIRECTORS MAY REQUIRE THE OWNER OF A LOST OR
DESTROYED STOCK CERTIFICATE, OR HIS LEGAL REPRESENTATIVES, TO GIVE THE COMPANY A BOND TO INDEMNIFY IT AND ITS TRANSFER AGENTS AND
REGISTRARS AGAINST ANY CLAIM THAT MAY BE MADE AGAINST THEM ON ACCOUNT OF THE ALLEGED LOSS OR DESTRUCTION OF ANY SUCH CERTIFICATE.

 

     The following abbreviations, when used in the inscription on the face of this certificate, shall be construed as though they were
written out in full according to applicable laws or regulations:

	 	 	 	 	 
	TEN COM	 	-
	 	as tenants in common

	 	 	 	 	 

	TEN ENT
	 	-
	 	as tenants by the entireties

	 	 	 	 	 

	JT TEN
	 	-
	 	as joint tenants with right of survivorship
and not as tenants in common

	 	 	 	 	 	 	 
	UNIF GIFT MIN ACT-

	 	                    	 	Custodian
	 	                    
	 
	 	(Cust)
	 	 	 	(Minor)

	 	 	 
	under Uniform Gifts to Minors Act
	 	                    
	 

	 	(State)

	 	 	 	 	 	 	 
	UNIF
TRF MIN ACT
	 	                                        
	 	Custodian
	 	(until age                     )                    
	 

	 	(Cust)
	 	 	 	(Minor)

	 	 	 
	under Uniform Gifts to Minors Act
	 	                    
	 

	 	(State)

Additional abbreviations may also be used though not in the above list.

 

PLEASE INSERT SOCIAL SECURITY OR OTHER IDENTIFYING

NUMBER OF ASSIGNEE

     For value received,                                                             
 hereby sell, assign and transfer unto
                                                                    

 

(PLEASE PRINT OR TYPEWRITE NAME AND ADDRESS, INCLUDING POSTAL ZIP CODE, OF ASSIGNEE)

 

 

 

Shares
of the common stock represented by the within Certificate, and do hereby irrevocably constitute and appoint

 

Attorney
to transfer the said stock on the books of the within-named Corporation with full power of substitution in the premises.

	 	 	 	 	 	 	 	 	 	 	 
	Dated:
	 	 	 	 	  20	 	 	 	 	Signature(s) Guaranteed: Medallion Guarantee Stamp
	 
	 	 	 	 	 	 	 	 
	 
	 	 	 	 	 	 	 	 	 	 
	Signature:
	 	 	 	THE SIGNATURE(S) SHOULD BE GUARANTEED BY AN
ELIGIBLE
	 
	 	 	 	GUARANTOR INSTITUTION (Banks, Stockbrokers, Savings and Loan Associations and
Credit Unions) WITH MEMBERSHIP IN AN APPROVED
SIGNATURE GUARANTEE MEDALLION PROGRAM, PURSUANT TO
S.E.C. RULE 17Ad-15.
	 
	 	 	 	 	 	 	 	 	 	 
	Signature:
	 	 	 	 	 	 	 	 	 	 
	 	 	 	 	 

	 	Notice: 	 	The signature to this assignment must correspond with the
name as written upon the face of the certificate, in every
particular, without alteration or enlargement, or any
change whatever.	 

SECURITY INSTRUCTIONS

THIS IS WATERMARKED PAPER. DO NOT ACCEPT WITHOUT NOTING WATERMARK. HOLD TO LIGHT
TO VERIFY WATERMARK.<PAGE>
                              Insulet Confidential                  Exhibit 10.4

                              INSULET CORPORATION

                      2000 STOCK OPTION AND INCENTIVE PLAN
                      ------------------------------------

1.     Purpose and Eligibility
       -----------------------

         The purpose of this 2000 Stock Option and Incentive Plan (the "Plan")
of Insulet Corporation (the "Company") is to provide stock options and other
equity interests in the Company (each an "Award") to employees, officers,
directors, consultants and advisors of the Company and its Subsidiaries, all of
whom are eligible to receive Awards under the Plan. Any person to whom an Award
has been granted under the Plan is called a "Participant". Additional
definitions are contained in Section 8.

2.     Administration
       --------------

         a.  Administration by Board of Directors.  The Plan will be
administered by the Board of Directors of the Company (the "Board"). The Board,
in its sole discretion, shall have the authority to grant and amend Awards, to
adopt, amend and repeal rules relating to the Plan and to interpret and correct
the provisions of the Plan and any Award. All decisions by the Board shall be
final and binding on all interested persons. Neither the Company nor any member
of the Board shall be liable for any action or determination relating to the
Plan.

         b.  Appointment of Committees.  To the extent permitted by applicable
law, the Board may delegate any or all of its powers under the Plan to one or
more committees or subcommittees of the Board (a "Committee"). All references in
the Plan to the "Board" shall mean such Committee or the Board.

         c.  Delegation to Executive Officers.  To the extent permitted by
applicable law, the Board may delegate to one or more executive officers of the
Company the power to grant Awards and exercise such other powers under the Plan
as the Board may determine, provided that the Board shall fix the maximum number
of Awards to be granted and the maximum number of shares issuable to any one
Participant pursuant to Awards granted by such executive officers.

3.     Stock Available for Awards
       --------------------------

         a.  Number of Shares.  Subject to adjustment under Section 3(c), the
aggregate number of shares of Common Stock of the Company (the "Common Stock")
that may be issued pursuant to the Plan is 8,107,060 shares. If any Award
expires, or is terminated, surrendered or forfeited, in whole or in part, the
unissued Common Stock covered by such Award shall again be available for the
grant of Awards under the Plan. If shares of Common Stock issued pursuant to the
Plan are repurchased by, or are surrendered or forfeited to, the Company at no
more than cost, such shares of Common Stock shall again be available for the
grant of Awards under the Plan; provided, however, that the cumulative number of
such shares that may be so reissued under the Plan will not exceed 7,107,060
shares. Shares issued under the Plan may consist in whole or in part of
authorized but unissued shares or treasury shares.

RAMADEJB/7708/2.3019725_1
<PAGE>

     b.     Per-Participant Limit.  Subject to adjustment under Section 3(c), no
participant may be granted Awards during any one fiscal year to purchase more
than 6,080,295 shares of Common Stock.

     c.     Adjustment of Common Stock.  In the event of any stock split, stock
dividend, extraordinary cash dividend, recapitalization, merger, consolidation,
combination, exchange of shares, liquidation, spin-off, split-up, or other
similar change in capitalization or event, (i) the number and class of
securities available for Awards under the Plan and the per-Participant share
limit, (ii) the number and class of securities, vesting schedule and exercise
price per share subject to each outstanding Option, (iii) the repurchase price
per security subject to repurchase, and (iv) the terms of each other outstanding
stock-based Award shall be adjusted by the Company (or substituted Awards may be
made) to the extent the Board shall determine, in good faith, that such an
adjustment (or substitution) is appropriate. If Section 7(e)(i) applies for any
event, this Section 3(c) shall not be applicable.

4.  Stock Options

     a.     General.  The Board may grant options to purchase Common Stock
(each, an "Option") and determine the number of shares of Common Stock to be
covered by each Option, the exercise price of each Option and the conditions and
limitations applicable to the exercise of each Option and the Common Stock
issued upon the exercise of each Option, including vesting provisions,
repurchase provisions and restrictions relating to applicable federal or state
securities laws, as it considers advisable.

     b.     Incentive Stock Options.  An Option that the Board intends to be an
"incentive stock option" as defined in Section 422 of the Code (an "Incentive
Stock Option") shall be granted only to employees of the Company and shall be
subject to and shall be construed consistently with the requirements of Section
422 of the Code. The Board and the Company shall have no liability if an Option
of any part thereof that is intended to be an Incentive Stock Option does not
qualify as such. An Option or any part thereof that does not qualify as an
Incentive Stock Option is referred to herein as a "Nonstatutory Stock Option".

     c.     Exercise Price.  The Board shall establish the exercise price (or
determine the method by which the exercise price shall be determined) at the
time each Option is granted and specify it in the applicable option agreement.

     d.     Duration of Options.  Each Option shall be exercisable at such times
and subject to such terms and conditions as the Board may specify in the
applicable option agreement.

     e.     Exercise of Option.  Options may be exercised only by delivery to
the Company of a written notice of exercise signed by the proper person together
with payment in full as specified in Section 4(f) for the number of shares for
which the Option is exercised.

     f.     Payment Upon Exercise.  Common Stock purchased upon the exercise of
an Option shall be paid for by one or any combination of the following forms of
payment:

                                      -2-
<PAGE>

                  (i)     by check payable to the order of the Company;

                  (ii)    except as otherwise explicitly provided in the
applicable option agreement, and only if the Common Stock is then publicly
traded, delivery of an irrevocable and unconditional undertaking by a
creditworthy broker to deliver promptly to the Company sufficient funds to pay
the exercise price, or delivery by the Participant to the Company of a copy of
irrevocable and unconditional instructions to a creditworthy broker to deliver
promptly to the Company cash or a check sufficient to pay the exercise price; or

                  (iii)   to the extent explicitly provided in the applicable
option agreement, by (x) delivery of shares of Common Stock owned by the
Participant valued at fair market value (as determined by the Board or as
determined pursuant to the applicable option agreement), (y) delivery of a
promissory note of the Participant to the Company (and delivery to the Company
by the Participant of a check in an amount equal to the par value of the shares
purchased), or (z) payment of such other lawful consideration as the Board may
determine.

5.       Restricted Stock

         a.     Grants.  The Board may grant Awards entitling recipients to
acquire shares of Common Stock, subject to (i) delivery to the Company by the
Participant of a check in an amount at least equal to the par value of the
shares purchased, and (ii) the right of the Company to repurchase all or part
of such shares at their issue price or other stated or formula price from the
Participant in the event that conditions specified by the Board in the
applicable Award are not satisfied prior to the end of the applicable
restriction period or periods established by the Board for such Award (each, a
"Restricted Stock Award").

         b.     Terms and Conditions.  The Board shall determine the terms and
conditions of any such Restricted Stock Award. Any stock certificates issued in
respect of a Restricted Stock Award shall be registered in the name of the
Participant and, unless otherwise determined by the Board, deposited by the
Participant, together with a stock power endorsed in blank, with the Company
(or its designee). After the expiration of the applicable restriction periods,
the Company (or such designee) shall deliver the certificates no longer subject
to such restrictions to the Participant or, if the Participant has died, to the
beneficiary designated by a Participant, in a manner determined by the Board,
to receive amounts due or exercise rights of the Participant in the event of
the Participant's death (the "Designated Beneficiary"). In the absence of an
effective designation by a Participant, Designated Beneficiary shall mean the
Participant's estate.

6.       Other Stock-Based Awards

         The Board shall have the right to grant other Awards based upon the
Common Stock having such terms and conditions as the Board may determine,
including, without limitation, the grant of shares based upon certain
conditions, the grant of securities convertible into Common Stock and the grant
of stock appreciation rights, phantom stock awards or stock units.

7.       General Provisions Applicable to Awards

                                      -3-
<PAGE>
                              Insulet Confidential

         a.  Transferability of Awards.  Except as the Board may otherwise
determine or provide in an Award, Awards shall not be sold, assigned,
transferred, pledged or otherwise encumbered by the person to whom they are
granted, either voluntarily or by operation of law, except by will or the laws
of descent and distribution, and, during the life of the Participant, shall be
exercisable only by the Participant. References to a Participant, to the extent
relevant in the context, shall include references to authorized transferees.

         b.  Documentation.  Each Award under the Plan shall be evidenced by a
written instrument in such form as the Board shall determine or as executed by
an officer of the Company pursuant to authority delegated by the Board. Each
Award may contain terms and conditions in addition to those set forth in the
Plan provided that such terms and conditions do not contravene the provisions on
the Plan.

         c.  Board Discretion.  The terms of each type of Award need not be
identical, and the Board need not treat Participants uniformly.

         d.  Termination of Status.  The Board shall determine the effect on an
Award of the disability, death, retirement, authorized leave of absence or other
change in the employment or other status of a Participant and the extent to
which, and the period during which, the Participant, or the Participant's legal
representative, conservator, guardian or Designated Beneficiary, may exercise
rights under the Award.

         e.  Acquisition of the Company

                  (i)  Consequences of an Acquisition.

                           (A)  Acquisition Intended to be Accounted for as a
                  Pooling-of-Interests.  With respect to an Acquisition intended
                  to be accounted for as a pooling-of-interests: (x) all
                  outstanding Options shall become exercisable in full
                  immediately prior to the consummation of the Acquisition; if
                  the shares of Common Stock subject to such Options are subject
                  to repurchase provisions, then such repurchase restrictions
                  shall lapse upon the consummation of the Acquisition; and all
                  outstanding Options shall remain the obligation of the Company
                  or be assumed by the surviving or acquiring entity, and there
                  shall be automatically substituted  for the shares of Common
                  Stock then subject to such Options the consideration payable
                  with respect to the outstanding shares of Common Stock in
                  connection with the Acquisition; (y) all Restricted Stock
                  Awards then outstanding shall become immediately free of all
                  repurchase provisions upon the consummation of the
                  Acquisition; and (z) all other stock-based Awards shall become
                  immediately exercisable, realizable or vested in full, or
                  shall be immediately free of all repurchase provisions, as the
                  case may be, upon the consummation of the Acquisition.

                           (B)  Acquisition Intended to be Accounted for under
                  the Purchase Method. Unless otherwise expressly provided in
                  the applicable Option or Award, upon the occurrence of an
                  Acquisition intended to be accounted for under the purchase
                  method, the Board or the board of directors of the surviving
                  or acquiring entity (as used in this Section 7(e)(i)(B), also
                  the "Board"), shall, as to outstanding Awards (on the same
                  basis or on different bases, as the Board shall specify), make
                  appropriate provision for the continuation of such Awards by
                  the

                                      -4-

RAMADEJB/7708/2.3019725_1

<PAGE>
                              Insulet Confidential

Company or the assumption of such Awards by surviving or acquiring entity and by
substituting on an equitable basis for the shares then subject to such Awards
either (a) the consideration payable with respect to the outstanding shares of
Common Stock in connection with the Acquisition, (b) shares of stock of the
surviving or acquiring corporation or (c) such other securities as the Board
deems appropriate, the fair market value of which (as determined by the Board in
its sole discretion) shall not materially differ from the fair market value of
the shares of Common Stock subject to such Awards immediately preceding the
Acquisition. In addition to or in lieu of the foregoing, with respect to
outstanding Options, the Board may, upon written notice to the affected
optionees, provide that one or more Options then outstanding shall become
immediately exercisable in full and that such Options must be exercised within a
specified number of days of the date of such notice, at the end of which period
such Options shall terminate; or provide that one or more Options then
outstanding shall become immediately exercisable in full and shall be terminated
in exchange for a cash payment equal to the excess of the fair market value (as
determined by the Board in its sole discretion) for the shares subject to such
Options over the exercise price thereof.

                           (C)      Acquisition Defined. An "Acquisition" shall
mean: (x) the sale of the Company by merger in which the shareholders of the
Company in their capacity as such no longer own a majority of the outstanding
equity securities of the Company (or its successor); or (y) any sale of all or
substantially all of the assets or capital stock of the Company (other than in a
spin-off or similar transaction) or (z) any other acquisition of the business of
the Company, as determined by the Board.

                  (ii)     Assumption of Options Upon Certain Events. In
connection with a merger or consolidation of an entity with the Company or the
acquisition by the Company of property or stock of an entity, the Board may
grant Awards under the Plan in substitution for stock and stock-based awards
issued by such entity or an affiliate thereof. The substitute Awards shall be
granted on such terms and conditions as the Board considers appropriate in the
circumstances.

                  (iii)    Pooling-of Interests-Accounting. If the Company
proposes to engage in an Acquisition intended to be accounted for as a
pooling-of-interests, and in the event that the provisions of this Plan or of
any Award hereunder, or any actions of the Board taken in connection with such
Acquisition, are determined by the Company's or the acquiring company's
independent public accountants to cause such Acquisition to fail to be accounted
for as a pooling-of-interests, then such provisions or actions shall be amended
or rescinded by the Board, without the consent of any Participant, to be
consistent with pooling-of-interests accounting treatment for such Acquisition.

                  (iv)     Parachute Awards. Notwithstanding the provisions of
Section 7(e)(i)(A), if, in connection with an Acquisition described therein, a
tax under Section 4999 of the Code would be imposed on the Participant (after
taking into account the exceptions set forth in Section 280G(b)(4) and
280G(b)(5) of the Code), then the number of Awards which shall become
exercisable, realizable or vested as provided in such section shall be reduced
(or delayed), to the minimum extent necessary, so that no such tax would be
imposed on the Participant (the Awards not becoming so accelerated, realizable
or vested, the "Parachute"

                                      -5-

<PAGE>
Awards"); provided, however, that if the "aggregate present value" of the
Parachute Awards would exceed the tax that, but for this sentence, would be
imposed on the Participant under Section 4999 of the Code in connection with the
Acquisition, then the Awards shall become immediately exercisable, realizable
and vested without regard to the provisions of this sentence. For purposes of
the preceding sentence, the "aggregate present value" of an Award shall be
calculated on an after-tax basis (other than taxes imposed by Section 4999 of
the Code) and shall be based on economic principles rather than the principles
set forth under Section 280G of the Code and the regulations promulgated
thereunder. All determinations required to be made under this Section 7(e)(iv)
shall be made by the Company.

     f.   Withholding. Each Participant shall pay to the Company, or make
provisions satisfactory to the Company for payment of, any taxes required by law
to be withheld in connection with Awards to such Participant no later than the
date of the event creating the tax liability. The Board may allow Participants
to satisfy such tax obligations in whole or in part by transferring shares of
Common Stock, including shares retained from the Award creating the tax
obligation, valued at their fair market value (as determined by the Board or as
determined pursuant to the applicable option agreement). The Company may, to the
extent permitted by law, deduct any such tax obligations from any payment of any
kind otherwise due to a Participant.

     g.   Amendment of Awards. The Board may amend, modify or terminate any
outstanding Award including, but not limited to, substituting therefor another
Award of the same or a different type, changing the date of exercise or
realization, and converting an Incentive Stock Option to a Nonstatutory Stock
Option, provided that, except as otherwise provided in Section 7(e)(iii), the
Participant's consent to such action shall be required unless the Board
determines that the action, taking into account any related action, would not
materially and adversely affect the Participant.

     h.   Conditions on Delivery of Stock. The Company will not be obligated to
deliver any shares of Common Stock pursuant to the Plan or to remove
restrictions from shares previously delivered under the Plan until (i) all
conditions of the Award have been met or removed to the satisfaction of the
Company, (ii) in the opinion of the Company's counsel, all other legal matters
in connection with the issuance and delivery of such shares have been satisfied,
including any applicable securities laws and any applicable stock exchange or
stock market rules and regulations, and (iii) the Participant has executed and
delivered to the Company such representations or agreements as the Company may
consider appropriate to satisfy the requirements of any applicable laws, rules
or regulations.

     i.   Acceleration. The Board may at any time provide that any Options shall
become immediately exercisable in full or in part, that any Restricted Stock
Awards shall be free of some or all restrictions, or that any other stock-based
Awards may become exercisable in full or in part or free of some or all
restrictions or conditions, or otherwise realizable in full or in part, as the
case may be, despite the fact that the foregoing actions may (i) cause the
application of Sections 280G and 4999 of the Code if a change in control of the
Company occurs, or (ii)disqualify all or part of the Option as an incentive
Stock Option.

                                      -6-
<PAGE>

8.     Miscellaneous.

       a.     Definitions.

             (i)     "Company", for purposes of eligibility under the Plan,
shall include any present or future subsidiary corporations of Insulet
Corporation, as defined in Section 424(f) of the Code (a "Subsidiary"), and any
present or future parent corporation of Insulet Corporation, as defined in
Section 424(e) of the Code. For purposes of Awards other than Incentive Stock
Options, the term "Company" shall include any other business venture in which
the Company has a direct or indirect significant interest, as determined by the
Board in its sole discretion.

             (ii)     "Code" means the Internal Revenue Code of 1986, as
amended, and any regulations promulgated thereunder.

             (iii)    "employee" for purposes of eligibility under the Plan
(but not for purposes of Section 4(b)) shall include a person to whom an offer
of employment has been extended by the Company.

       b.     No Right To Employment or Other Status.  No person shall have any
claim or right to be granted an Award, and the grant of an Award shall not be
construed as giving a Participant the right to continued employment or any other
relationship with the Company. The Company expressly reserves the right at any
time to dismiss or otherwise terminate its relationship with a Participant free
from any liability or claim under the Plan.

       c.     No Rights As Stockholder.  Subject to the provisions of the
applicable Award, no Participant or Designated Beneficiary shall have any rights
as a stockholder with respect to any shares of Common Stock to be distributed
with respect to an Award until becoming the record holder thereof.

       d.     Effective Date and Term of Plan.  The Plan shall become effective
on the date on which it is adopted by the Board. No Awards shall be granted
under the Plan after the completion of ten years from the date on which the Plan
was adopted by the Board, but Awards previously granted may extend beyond that
date.

       e.     Amendment of Plan.  The Board may amend, suspend or terminate the
Plan or any portion thereof at any time.

       f.     Governing Law.  The provisions of the Plan and all Awards made
hereunder shall be governed by and interpreted in accordance with the laws of
The Commonwealth of Massachusetts, without regard to any applicable conflicts of
law.

                                         Adopted by the Board of Directors on
                                         October 19, 2000

                                         Approved by the stockholders on
                                         October 19, 2000

                                      -7-

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