Document:

Exhibit 10.15

 

TABULA RASA HEALTHCARE, INC.

 

2016 OMNIBUS INCENTIVE COMPENSATION PLAN(1)

 

Effective as of the Effective Date (as defined below), the Tabula Rasa HealthCare, Inc. 2016 Omnibus Incentive Compensation Plan (the “Plan”) is hereby established as a successor to the 2014 Equity Compensation Plan (the “2014 Plan”).  The 2014 Plan is hereby merged with and into this Plan effective as of the Effective Date, and no additional grants shall be made thereafter under the 2014 Plan.  Outstanding grants under the 2014 Plan shall continue in effect according to their terms as in effect before the Effective Date, consistent with the 2014 Plan, and the shares with respect to outstanding grants under the 2014 Plan shall be issued or transferred under this Plan.

 

The purpose of this Plan is (i) to provide employees of Tabula Rasa HealthCare, Inc. (the “Company”) and its subsidiaries, certain consultants and advisors who perform services for the Company or its subsidiaries, and non-employee members of the Board of Directors of the Company with the opportunity to receive grants of incentive stock options, nonqualified stock options, stock appreciation rights, stock awards, stock units, and other stock-based awards, and (ii) to provide selected executive employees with the opportunity to receive cash awards that are considered “qualified performance-based compensation” under section 162(m) of the Code (as defined below).

 

The Company believes that this Plan will encourage the participants to contribute materially to the growth of the Company, thereby benefitting the Company’s stockholders, and will align the economic interests of the participants with those of the stockholders.

 

Section 1.                                          Definitions

 

The following terms shall have the meanings set forth below for purposes of this Plan:

 

(a)                                 “Board” shall mean the Board of Directors of the Company.

 

(b)                                 “Cash Award” shall mean a cash incentive payment awarded under this Plan as described under Section 11.

 

(c)                                  “Cause” shall have the meaning given to that term in any written employment agreement, offer letter or severance agreement between the Employer and the Participant, or if no such agreement exists or if such term is not defined therein, and unless otherwise defined in the Grant Instrument, Cause shall mean a finding by the Committee that the Participant (i) has breached his or her employment or service contract with the Employer, (ii) has engaged in disloyalty to the Employer, including, without limitation, fraud, embezzlement, theft, commission of a felony or proven dishonesty, (iii) has disclosed trade secrets or confidential information of the Employer to persons not entitled to receive such information, (iv) has breached any written non-competition, non-solicitation, invention assignment or confidentiality agreement between the Participant and the Employer or (v) has engaged in such other behavior detrimental to the interests of the Employer as the Committee determines.

 

(1)   The share amounts included herein are after giving effect to the 1-for-1.94 reverse stock split of the Company’s common stock.

 

 

(d)                                 Unless otherwise set forth in a Grant Instrument, a “Change of Control” shall be deemed to have occurred if:

 

(i)                                     Any “person” (as such term is used in sections 13(d) and 14(d) of the Exchange Act) becomes a “beneficial owner” (as defined in Rule 13d-3 under the Exchange Act), directly or indirectly, of securities of the Company representing more than 50% of the voting power of the then outstanding securities of the Company; provided that a Change of Control shall not be deemed to occur as a result of a transaction in which the Company becomes a subsidiary of another corporation and in which the stockholders of the Company, immediately prior to the transaction, will beneficially own, immediately after the transaction, shares entitling such stockholders to more than 50% of all votes to which all stockholders of the parent corporation would be entitled in the election of directors.

 

(ii)                                  The consummation of (A) a merger or consolidation of the Company with another corporation where, immediately after the merger or consolidation,  the stockholders of the Company immediately prior to the merger or consolidation will not beneficially own, in substantially the same proportion as ownership immediately prior to the merger or consolidation, shares entitling such stockholders to more than 50% of all votes to which all stockholders of the surviving corporation would be entitled in the election of directors, or where the members of the Board, immediately prior to the merger or consolidation, will not, immediately after the merger or consolidation, constitute a majority of the board of directors of the surviving corporation, or (B) a sale or other disposition of all or substantially all of the assets of the Company.

 

(iii)                               A change in the composition of the Board over a period of 12 consecutive months or less such that a majority of the Board members ceases, by reason of one or more contested elections for Board membership, to be comprised of individuals who either (A) have been Board members continuously since the beginning of such period or (B) have been elected or nominated for election as Board members during such period by at least a majority of the Board members described in clause (A) who were still in office at the time the Board approved such election or nomination.

 

(iv)                              The approval by the stockholders of the Company of a plan of complete liquidation or dissolution of the Company.

 

The Committee may modify the definition of Change of Control for a particular Grant as the Committee deems appropriate to comply with section 409A of the Code or otherwise.  Notwithstanding the foregoing, if a Grant constitutes deferred compensation subject to section 409A of the Code and the Grant provides for payment upon a Change of Control, then no Change of Control shall be deemed to have occurred upon an event described in items (i) — (iv) above unless the event would also constitute a change in ownership or effective control of, or a change in the ownership of a substantial portion of the assets of, the Company under section 409A of the Code.

 

(e)                                  “CEO” shall mean the Chief Executive Officer of the Company.

 

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(f)                                   “Code” shall mean the Internal Revenue Code of 1986, as amended.

 

(g)                                  “Committee” shall mean the Compensation Committee of the Board or another committee appointed by the Board to administer this Plan.  With respect to Grants that are intended to be “qualified performance-based compensation” under section 162(m) of the Code, the Committee shall consist of two or more persons appointed by the Board, all of whom shall be “outside directors” as defined under section 162(m) of the Code.  The Committee shall consist of directors who are “non-employee directors” as defined under Rule 16b-3 promulgated under the Exchange Act and “independent directors,” as determined in accordance with the independence standards established by the stock exchange on which the Company Stock is at the time primarily traded.

 

(h)                                 “Company” shall mean Tabula Rasa HealthCare, Inc. and shall include its successors.

 

(i)                                     “Company Stock” shall mean common stock of the Company.

 

(j)                                    “Disability” or “Disabled” shall mean a Participant’s becoming disabled within the meaning of section 22(e)(3) of the Code, within the meaning of the Employer’s long-term disability plan applicable to the Participant or as otherwise determined by the Committee and set forth in the Grant Instrument.

 

(k)                                 “Dividend Equivalent” shall mean an amount determined by multiplying the number of shares of Company Stock subject to a Stock Unit or Other Stock-Based Award by the per-share cash dividend paid by the Company on its outstanding Company Stock, or the per-share Fair Market Value of any dividend paid on its outstanding Company Stock in consideration other than cash.  If interest is credited on accumulated divided equivalents, the term “Dividend Equivalent” shall include the accrued interest.

 

(l)                                     “Effective Date” shall mean the business day immediately preceding the date at which the registration statement for the initial public offering of the Company Stock is declared effective by the Securities and Exchange Commission and the Company Stock is priced for the initial public offering of such Company Stock, subject to approval of this Plan by the stockholders of the Company.

 

(m)                             “Employee” shall mean an employee of the Employer (including an officer or director who is also an employee), but excluding any person who is classified by the Employer as a “contractor” or “consultant,” no matter how characterized by the Internal Revenue Service, other governmental agency or a court.  Any change of characterization of an individual by the Internal Revenue Service or any court or government agency shall have no effect upon the classification of an individual as an Employee for purposes of this Plan, unless the Committee determines otherwise.

 

(n)                                 “Employed by, or providing service to, the Employer” shall mean employment or service as an Employee, Key Advisor or member of the Board (so that, for purposes of exercising Options and SARs and satisfying conditions with respect to Stock

 

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Awards, Stock Units, Other Stock-Based Awards and Cash Awards, a Participant shall not be considered to have terminated employment or service until the Participant ceases to be an Employee, Key Advisor and member of the Board), unless the Committee determines otherwise.

 

(o)                                 “Employer” shall mean the Company and its subsidiaries.

 

(p)                                 “Exchange Act” shall mean the Securities Exchange Act of 1934, as amended.

 

(q)                                 “Exercise Price” shall mean the per share price at which shares of Company Stock may be purchased under an Option, as designated by the Committee.

 

(r)                                    “Fair Market Value” shall mean:

 

(i)                                     If the Company Stock is publicly traded, the Fair Market Value per share shall be determined as follows: (A) if the principal trading market for the Company Stock is a national securities exchange, the closing sales price during regular trading hours on the relevant date or, if there were no trades on that date, the latest preceding date upon which a sale was reported, or (B) if the Company Stock is not principally traded on any such exchange, the last reported sale price of a share of Company Stock during regular trading hours on the relevant date, as reported by the OTC Bulletin Board.

 

(ii)                                  If the Company Stock is not publicly traded or, if publicly traded, is not subject to reported transactions as set forth above, the Fair Market Value per share shall be determined by the Committee through any reasonable valuation method authorized under the Code.

 

(iii)                               If a Grant is made effective on the date that the registration statement for the initial public offering of the Company Stock is declared effective by the Securities and Exchange Commission and the Company Stock is priced for the initial public offering of such Company Stock, then the Fair Market Value per share shall be equal to the per share price of Company Stock offered to the public in such initial public offering.

 

(s)                                   “GAAP” shall mean United States Generally Accepted Accounting Principles.

 

(t)                                    “Grant” shall mean an Option, SAR, Stock Award, Stock Unit, Other Stock-Based Award or Cash Award granted under this Plan.

 

(u)                                 “Grant Instrument” shall mean the written agreement that sets forth the terms and conditions of a Grant, including all amendments thereto.

 

(v)                                 “Incentive Stock Option” shall mean an Option that is intended to meet the requirements of an incentive stock option under section 422 of the Code.

 

(w)                               “Key Advisor” shall mean a consultant or advisor of the Employer.

 

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(x)                                 “Non-Employee Director” shall mean a member of the Board who is not an Employee.

 

(y)                                 “Nonqualified Stock Option” shall mean an Option that is not intended to be taxed as an incentive stock option under section 422 of the Code.

 

(z)                                  “Option” shall mean an option to purchase shares of Company Stock, as described in Section 6.

 

(aa)                          “Other Stock-Based Award” shall mean any Grant based on, measured by or payable in Company Stock (other than an Option, Stock Unit, Stock Award, or SAR), as described in Section 10.

 

(bb)                          “Participant” shall mean an Employee, Key Advisor or Non-Employee Director designated by the Committee to participate in this Plan.

 

(cc)                            “Performance-Based Grant” shall have the meaning given that term in Section 13.

 

(dd)                          “Plan” shall mean this Tabula Rasa HealthCare, Inc. 2016 Omnibus Incentive Compensation Plan, as in effect from time to time.

 

(ee)                            “Reliance Period” shall have the meaning given that term in Section 19(c)(i).

 

(ff)                              “Restriction Period” shall have the meaning given that term in Section 7(a).

 

(gg)                            “SAR” shall mean a stock appreciation right, as described in Section 9.

 

(hh)                          “Stock Award” shall mean an award of Company Stock, as described in Section 7.

 

(ii)                                  “Stock Unit” shall mean an award of a phantom unit representing a share of Company Stock, as described in Section 8.

 

(jj)                                “Substitute Awards” shall have the meaning given that term in Section 4(b).

 

Section 2.                                          Administration

 

(a)                                 Committee.  This Plan shall be administered and interpreted by the Committee; provided, however, that any Grants to members of the Board must be authorized by the Board.  The Committee may delegate authority to one or more subcommittees, as it deems appropriate.  To the extent that the Board, a subcommittee or the CEO, as described below,

 

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administers this Plan, references in this Plan to the “Committee” shall be deemed to refer to the Board or such subcommittee or the CEO.

 

(b)                                 Delegation to CEO.  Subject to compliance with applicable law and applicable stock exchange requirements, the Committee may delegate all or part of its authority and power to the CEO, as it deems appropriate, with respect to Grants to Employees or Key Advisors who are not executive officers under section 16 of the Exchange Act and provided the Grants are not intended to be Performance-Based Grants as described in Section 13.

 

(c)                                  Committee Authority.  The Committee shall have the sole authority to (i) determine the individuals to whom Grants shall be made under this Plan, (ii) determine the type, size, terms and conditions of the Grants to be made to each such individual, (iii) determine the time when the Grants will be made and the duration of any applicable exercise or restriction period, including the criteria for exercisability and the acceleration of exercisability, (v) amend the terms of any previously issued Grant, subject to the provisions of Section 19 below, and (vi) deal with any other matters arising under this Plan.

 

(d)                                 Committee Determinations.  The Committee shall have full power and express discretionary authority to administer and interpret this Plan, to make factual determinations and to adopt or amend such rules, regulations, agreements and instruments for implementing this Plan and for the conduct of its business as it deems necessary or advisable, in its sole discretion.  The Committee’s interpretations of this Plan and all determinations made by the Committee pursuant to the powers vested in it hereunder shall be conclusive and binding on all persons having any interest in this Plan or in any awards granted hereunder.  All powers of the Committee shall be executed in its sole discretion, in the best interest of the Company, not as a fiduciary, and in keeping with the objectives of this Plan and need not be uniform as to similarly situated individuals.

 

(e)                                  Indemnification.  No member of the Committee and no employee of the Company shall be liable for any act or failure to act with respect to this Plan, except in circumstances involving his or her bad faith or willful misconduct, or for any act or failure to act hereunder by any other member of the Committee or employee or by any agent to whom duties in connection with the administration of this Plan have been delegated.  The Company shall indemnify members of the Committee and any agent of the Committee who is an employee of the Company or a subsidiary against any and all liabilities or expenses to which they may be subjected by reason of any act or failure to act with respect to their duties on behalf of this Plan, except in circumstances involving such person’s bad faith or willful misconduct.

 

Section 3.                                          Grants

 

Grants under this Plan may consist of Options as described in Section 6, Stock Awards as described in Section 7, Stock Units as described in Section 8, SARs as described in Section 9, Other Stock-Based Awards as described in Section 10, and Cash Awards as described in Section 11.  All Grants shall be subject to the terms and conditions set forth herein and to such other terms and conditions consistent with this Plan as the Committee deems appropriate and as are

 

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specified in writing by the Committee to the individual in the Grant Instrument.  All Grants shall be made conditional upon the Participant’s acknowledgement, in writing or by acceptance of the Grant, that all decisions and determinations of the Committee shall be final and binding on the Participant, his or her beneficiaries and any other person having or claiming an interest under such Grant.  Grants under a particular Section of this Plan need not be uniform as among the Participants.

 

Section 4.                                          Shares Subject to this Plan

 

(a)                                 Shares Authorized.  Subject to adjustment as described below in Section 4(d), the aggregate number of shares of Company Stock that may be issued or transferred under this Plan shall be equal to the sum of the following: (i) 800,000 plus (ii) the number of shares of Company Stock subject to outstanding grants under the 2014 Plan as of the Effective Date; provided, however, that the aggregate number of shares of Company Stock that may be issued or transferred under this Plan pursuant to Incentive Stock Options shall not exceed 800,000 shares of Company Stock.  In addition, as of the first trading day of January during the term of this Plan, beginning with calendar year 2017, an additional positive number of shares of Company Stock shall be added to the number of shares of Company Stock authorized to be issued or transferred under this Plan and the number of shares authorized to be issued or transferred pursuant to Incentive Stock Options, equal to the lesser of 5% of the total number of shares of Company Stock outstanding on the last trading day in December of the immediately preceding calendar year or such other number set by the Board.

 

(b)                                 Source of Shares; Share Counting.  Shares issued or transferred under this Plan may be authorized but unissued shares of Company Stock or reacquired shares of Company Stock, including shares purchased by the Company on the open market for purposes of this Plan.  If and to the extent Options or SARs granted under this Plan (including options granted under the 2014 Plan) terminate, expire or are canceled, forfeited, exchanged or surrendered without having been exercised, or if any Stock Awards, Stock Units or Other Stock-Based Awards are forfeited, terminated or otherwise not paid in full, the shares subject to such Grants shall again be available for purposes of this Plan.  If shares of Company Stock otherwise issuable under this Plan are surrendered in payment of the Exercise Price of an Option, then the number of shares of Company Stock available for issuance under this Plan shall be reduced only by the net number of shares actually issued by the Company upon such exercise and not by the gross number of shares as to which such Option is exercised.  Upon the exercise of any SAR under this Plan, the number of shares of Company Stock available for issuance under this Plan shall be reduced by the net number of shares as to which such right is exercised, and not by the gross number of shares actually issued by the Company upon such exercise.  If shares of Company Stock otherwise issuable under this Plan are withheld by the Company in satisfaction of the withholding taxes incurred in connection with the issuance, vesting or exercise of any Grant or the issuance of Company Stock thereunder, then the number of shares of Company Stock available for issuance under this Plan shall be reduced by the net number of shares issued, vested or exercised under such Grant, calculated in each instance after payment of such share withholding.  Upon the exercise of an Option through the net exercise procedure under Section 6(g) or upon the exercise of a SAR, then for purposes of calculating the number of shares of Company Stock remaining

 

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available for exercise under such Option or SAR, the number of such shares shall be reduced by the net number of shares for which the Option or SAR is exercised, and without regard to any cash settlement of a SAR. To the extent any Grants are paid in cash, and not in shares of Company Stock, any shares previously subject to such Grants shall again be available for issuance or transfer under this Plan. In addition, (i) shares issued or transferred under Grants made pursuant to an assumption, substitution or exchange for previously granted awards of a company acquired by the Company in a transaction (“Substitute Awards”) shall not reduce the number of shares of Company Stock available under this Plan and (ii) available shares under a stockholder approved plan of an acquired company (as appropriately adjusted to reflect the transaction) may be used for Grants under this Plan and shall not reduce this Plan’s share reserve (subject to applicable stock exchange listing and Code requirements).

 

(c)                                  Individual Limits.  Subject to adjustment as described below in Section 4(d), the following Grant limitations shall apply:

 

(i)                                     With respect to Performance-Based Grants measured in shares of Company Stock (whether payable in Company Stock, cash or a combination of both), the maximum number of shares of Company Stock for which such Grants may be made to any Employee in any calendar year shall not exceed 375,000 shares of Company Stock in the aggregate.

 

(ii)                                  For Performance-Based Grants measured in cash dollars (whether payable in cash, Company Stock or a combination of both), including Cash Awards, the maximum dollar amount for which such Grants may be paid to any Employee with respect to each 12 month period within a performance period shall not exceed $3,000,000.  If a performance period includes more than one year, the amount payable with respect to each 12 month period shall be determined by dividing the total amount payable for the performance period by the number of years in the performance period.

 

(iii)                               For dividends with respect to Stock Awards that are Performance-Based Grants and Dividend Equivalents that are Performance-Based Grants, an Employee may not accrue an aggregate amount of dividends and Dividend Equivalents in excess of $1,000,000 in any calendar year.

 

(iv)                              The maximum grant date value of shares of Company Stock subject to Grants made to any Non-Employee Director during any calendar year, taken together with any cash fees earned by such Non-Employee Director for services rendered during the calendar year, shall not exceed $500,000 in total value, with the value of such Grants calculated based on the grant date fair value of such Grants for financial reporting purposes.

 

(v)                                 Notwithstanding the foregoing, the individual limits described in subsections (i), (ii) and (iii) shall be increased to two times the otherwise applicable limits with respect to Performance-Based Grants that are made on or around the date of hire to a newly hired Employee.

 

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(d)                                 Adjustments.  If there is any change in the number or kind of shares of Company Stock outstanding by reason of (i) a stock dividend, spinoff, recapitalization, stock split, or combination or exchange of shares, (ii) a merger, reorganization or consolidation, (iii) a reclassification or change in par value, or (iv) any other extraordinary or unusual event affecting the outstanding Company Stock as a class without the Company’s receipt of consideration, or if the value of outstanding shares of Company Stock is substantially reduced as a result of a spinoff or the Company’s payment of an extraordinary dividend or distribution, the maximum number and kind of shares of Company Stock available for issuance under this Plan, the maximum number and kind of shares of Company Stock for which any individual may receive Grants in any year, the kind and number of shares covered by outstanding Grants, the kind and number of shares issued and to be issued under this Plan, and the price per share or the applicable market value of such Grants shall be equitably adjusted by the Committee to reflect any increase or decrease in the number of, or change in the kind or value of, the issued shares of Company Stock to preclude, to the extent practicable, the enlargement or dilution of rights and benefits under this Plan and such outstanding Grants; provided, however, that any fractional shares resulting from such adjustment shall be eliminated.  In addition, in the event of a Change of Control, the provisions of Section 14 of this Plan shall apply.  Any adjustments to outstanding Grants shall be consistent with section 409A or 424 of the Code, to the extent applicable.  The adjustments of Grants under this Section 4(d) shall include adjustment of shares, Exercise Price of Stock Options, base amount of SARs, performance goals or other terms and conditions, as the Committee deems appropriate.  The Committee shall have the sole discretion and authority to determine what appropriate adjustments shall be made and any adjustments determined by the Committee shall be final, binding and conclusive.

 

Section 5.                                          Eligibility for Participation

 

(a)                                 Eligible Persons.  All Employees and Non-Employee Directors shall be eligible to participate in this Plan.  Key Advisors shall be eligible to participate in this Plan if the Key Advisors render bona fide services to the Employer, the services are not in connection with the offer and sale of securities in a capital-raising transaction, and the Key Advisors do not directly or indirectly promote or maintain a market for the Company’s securities.

 

(b)                                 Selection of Participants.  The Committee shall select the Employees, Non-Employee Directors and Key Advisors to receive Grants and shall determine the number of shares of Company Stock subject to a particular Grant in such manner as the Committee determines.

 

Section 6.                                          Options

 

The Committee may grant Options to an Employee, Non-Employee Director or Key Advisor upon such terms as the Committee deems appropriate.  The following provisions are applicable to Options:

 

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(a)                                 Number of Shares.  The Committee shall determine the number of shares of Company Stock that will be subject to each Grant of Options to Employees, Non-Employee Directors and Key Advisors.

 

(b)                                 Type of Option and Exercise Price.

 

(i)                                     The Committee may grant Incentive Stock Options or Nonqualified Stock Options or any combination of the two, all in accordance with the terms and conditions set forth herein.  Incentive Stock Options may be granted only to employees of the Company or its parent or subsidiary corporations, as defined in section 424 of the Code.  Nonqualified Stock Options may be granted to Employees, Non-Employee Directors and Key Advisors.

 

(ii)                                  The Exercise Price of Company Stock subject to an Option shall be determined by the Committee and shall be equal to or greater than the Fair Market Value of a share of Company Stock on the date the Option is granted.  However, an Incentive Stock Option may not be granted to an Employee who, at the time of grant, owns stock possessing more than 10% of the total combined voting power of all classes of stock of the Company, or any parent or subsidiary corporation of the Company, as defined in section 424 of the Code, unless the Exercise Price per share is not less than 110% of the Fair Market Value of a share of Company Stock on the date of grant.

 

(c)                                  Option Term.  The Committee shall determine the term of each Option.  The term of any Option shall not exceed ten years from the date of grant.  However, an Incentive Stock Option that is granted to an Employee who, at the time of grant, owns stock possessing more than 10% of the total combined voting power of all classes of stock of the Company, or any parent or subsidiary corporation of the Company, as defined in section 424 of the Code, may not have a term that exceeds five years from the date of grant.  Notwithstanding the foregoing, in the event that on the last business day of the term of an Option (other than an Incentive Stock Option), the exercise of the Option is prohibited by applicable law, including a prohibition on purchases or sales of Company Stock under the Company’s insider trading policy, the term of the Option shall be extended for a period of 30 days following the end of the legal prohibition, unless the Committee determines otherwise.

 

(d)                                 Exercisability of Options.  Options shall become exercisable in accordance with such terms and conditions, consistent with this Plan, as may be determined by the Committee and specified in the Grant Instrument.  The Committee may accelerate the exercisability of any or all outstanding Options at any time for any reason.

 

(e)                                  Grants to Non-Exempt Employees.  Notwithstanding the foregoing, Options granted to persons who are non-exempt employees under the Fair Labor Standards Act of 1938, as amended, may not be exercisable for at least six months after the date of grant (except that such Options may become exercisable, as determined by the Committee, upon the Participant’s death, Disability or retirement, or upon a Change of Control or other circumstances permitted by applicable regulations).

 

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(f)                                   Termination of Employment or Service.  Except as provided in the Grant Instrument, an Option may only be exercised while the Participant is employed by, or providing services to, the Employer.  The Committee shall determine in the Grant Instrument under what circumstances and during what time periods a Participant may exercise an Option after termination of employment or service.

 

(g)                                  Exercise of Options.  A Participant may exercise an Option that has become exercisable, in whole or in part, by delivering a notice of exercise to the Company.  The Participant shall pay the Exercise Price for an Option as specified by the Committee (i) in cash, (ii) unless the Committee determines otherwise, by delivering shares of Company Stock owned by the Participant and having a Fair Market Value on the date of exercise at least equal to the Exercise Price or by attestation (on a form prescribed by the Committee) to ownership of shares of Company Stock having a Fair Market Value on the date of exercise at least equal to the Exercise Price, (iii) by payment through a broker in accordance with procedures permitted by Regulation T of the Federal Reserve Board, (iv) by a net exercise through withholding shares of Company Stock subject to the exercisable Option, which have a Fair Market Value on the date of exercise equal to the aggregate Exercise Price of the shares of Company Stock subject to the Option, or (v) by such other method as the Committee may approve.  Shares of Company Stock used to exercise an Option shall have been held by the Participant for the requisite period of time necessary to avoid adverse accounting consequences to the Company with respect to the Option.  Payment for the shares to be issued or transferred pursuant to the Option, and any required withholding taxes, must be received by the Company by the time specified by the Committee depending on the type of payment being made, but in all cases prior to the issuance or transfer of such shares.

 

(h)                                 Limits on Incentive Stock Options.  Each Incentive Stock Option shall provide that, if the aggregate Fair Market Value of the Company Stock on the date of the grant with respect to which Incentive Stock Options are exercisable for the first time by a Participant during any calendar year, under this Plan or any other stock option plan of the Company or a parent or subsidiary, exceeds $100,000, then the Option, as to the excess, shall be treated as a Nonqualified Stock Option.

 

Section 7.                                          Stock Awards

 

The Committee may issue or transfer shares of Company Stock to an Employee, Non-Employee Director or Key Advisor under a Stock Award, upon such terms as the Committee deems appropriate.  The following provisions are applicable to Stock Awards:

 

(a)                                 General Requirements.  Shares of Company Stock issued or transferred pursuant to Stock Awards may be issued or transferred for consideration or for no consideration, and subject to restrictions or no restrictions, as determined by the Committee.  The Committee may, but shall not be required to, establish conditions under which restrictions on Stock Awards shall lapse over a period of time or according to such other criteria as the Committee deems appropriate, including, without limitation, restrictions based upon the achievement of specific performance goals.  The period of time during which the Stock Awards will remain subject to restrictions will be designated in the Grant Instrument as the “Restriction Period.”

 

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(b)                                 Number of Shares.  The Committee shall determine the number of shares of Company Stock to be issued or transferred pursuant to a Stock Award and the restrictions applicable to such shares.

 

(c)                                  Requirement of Employment or Service.  If the Participant ceases to be employed by, or provide service to, the Employer during a period designated in the Grant Instrument as the Restriction Period, or if other specified conditions are not met, the Stock Award shall terminate as to all shares covered by the Grant as to which the restrictions have not lapsed, and those shares of Company Stock must be immediately returned to the Company.  The Committee may, however, provide for complete or partial exceptions to this requirement as it deems appropriate.

 

(d)                                 Restrictions on Transfer and Legend on Stock Certificate.  During the Restriction Period, a Participant may not sell, assign, transfer, pledge or otherwise dispose of the shares of a Stock Award except under Section 17 below.  Unless otherwise determined by the Committee, the Company will retain possession of certificates for shares of Stock Awards until all restrictions on such shares have lapsed.  Each certificate for a Stock Award, unless held by the Company, shall contain a legend giving appropriate notice of the restrictions in the Grant.  The Participant shall be entitled to have the legend removed from the stock certificate covering the shares subject to restrictions when all restrictions on such shares have lapsed.  The Committee may determine that the Company will not issue certificates for Stock Awards until all restrictions on such shares have lapsed.

 

(e)                                  Right to Vote and to Receive Dividends.  Unless the Committee determines otherwise, during the Restriction Period, the Participant shall have the right to vote shares of Stock Awards and to receive any dividends or other distributions paid on such shares, subject to any restrictions deemed appropriate by the Committee, including, without limitation, the achievement of specific performance goals. Dividends with respect to Stock Awards that vest based on performance shall vest if and to the extent that the underlying Stock Award vests, as determined by the Committee.

 

(f)                                   Lapse of Restrictions.  All restrictions imposed on Stock Awards shall lapse upon the expiration of the applicable Restriction Period and the satisfaction of all conditions, if any, imposed by the Committee.  The Committee may determine, as to any or all Stock Awards, that the restrictions shall lapse without regard to any Restriction Period.

 

Section 8.                                          Stock Units

 

The Committee may grant Stock Units, each of which shall represent one hypothetical share of Company Stock, to an Employee, Non-Employee Director or Key Advisor upon such terms and conditions as the Committee deems appropriate.  The following provisions are applicable to Stock Units:

 

(a)                                 Crediting of Units.  Each Stock Unit shall represent the right of the Participant to receive a share of Company Stock or an amount of cash based on the value of a

 

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share of Company Stock, if and when specified conditions are met.  All Stock Units shall be credited to bookkeeping accounts established on the Company’s records for purposes of this Plan.

 

(b)                                 Terms of Stock Units.  The Committee may grant Stock Units that vest and are payable if specified performance goals or other conditions are met, or under other circumstances.  Stock Units may be paid at the end of a specified performance period or other period, or payment may be deferred to a date authorized by the Committee.  The Committee shall determine the number of Stock Units to be granted and the requirements applicable to such Stock Units.

 

(c)                                  Requirement of Employment or Service.  If the Participant ceases to be employed by, or provide service to, the Employer prior to the vesting of Stock Units, or if other conditions established by the Committee are not met, the Participant’s Stock Units shall be forfeited.  The Committee may, however, provide for complete or partial exceptions to this requirement as it deems appropriate.

 

(d)                                 Payment With Respect to Stock Units.  Payments with respect to Stock Units shall be made in cash, Company Stock or any combination of the foregoing, as the Committee shall determine.

 

Section 9.                                          Stock Appreciation Rights

 

The Committee may grant SARs to an Employee, Non-Employee Director or Key Advisor separately or in tandem with any Option.  The following provisions are applicable to SARs:

 

(a)                                 General Requirements.  The Committee may grant SARs to an Employee, Non-Employee Director or Key Advisor separately or in tandem with any Option (for all or a portion of the applicable Option).  Tandem SARs may be granted either at the time the Option is granted or at any time thereafter while the Option remains outstanding; provided, however, that, in the case of an Incentive Stock Option, SARs may be granted only at the time of the grant of the Incentive Stock Option.  The Committee shall establish the base amount of the SAR at the time the SAR is granted.  The base amount of each SAR shall be equal to or greater than the Fair Market Value of a share of Company Stock as of the date of grant of the SAR. The term of any SAR shall not exceed ten years from the date of grant.  Notwithstanding the foregoing, in the event that on the last business day of the term of a SAR, the exercise of the SAR is prohibited by applicable law, including a prohibition on purchases or sales of Company Stock under the Company’s insider trading policy, the term shall be extended for a period of 30 days following the end of the legal prohibition, unless the Committee determines otherwise.

 

(b)                                 Tandem SARs.  In the case of tandem SARs, the number of SARs granted to a Participant that shall be exercisable during a specified period shall not exceed the number of shares of Company Stock that the Participant may purchase upon the exercise of the related Option during such period.  Upon the exercise of an Option, the SARs relating to the Company

 

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Stock covered by such Option shall terminate.  Upon the exercise of SARs, the related Option shall terminate to the extent of an equal number of shares of Company Stock.

 

(c)                                  Exercisability.  An SAR shall be exercisable during the period specified by the Committee in the Grant Instrument and shall be subject to such vesting and other restrictions as may be specified in the Grant Instrument.  The Committee may accelerate the exercisability of any or all outstanding SARs at any time for any reason.  SARs may only be exercised while the Participant is employed by, or providing service to, the Employer or during the applicable period after termination of employment or service as specified by the Committee.  A tandem SAR shall be exercisable only during the period when the Option to which it is related is also exercisable.

 

(d)                                 Grants to Non-Exempt Employees.  Notwithstanding the foregoing, SARs granted to persons who are non-exempt employees under the Fair Labor Standards Act of 1938, as amended, may not be exercisable for at least six months after the date of grant (except that such SARs may become exercisable, as determined by the Committee, upon the Participant’s death, Disability or retirement, or upon a Change of Control or other circumstances permitted by applicable regulations).

 

(e)                                  Value of SARs.  When a Participant exercises SARs, the Participant shall receive in settlement of such SARs an amount equal to the value of the stock appreciation for the number of SARs exercised.  The stock appreciation for an SAR is the amount by which the Fair Market Value of the underlying Company Stock on the date of exercise of the SAR exceeds the base amount of the SAR as described in subsection (a).

 

(f)                                   Form of Payment.  The appreciation in an SAR shall be paid in shares of Company Stock, cash or any combination of the foregoing, as the Committee shall determine.  For purposes of calculating the number of shares of Company Stock to be received, shares of Company Stock shall be valued at their Fair Market Value on the date of exercise of the SAR.

 

Section 10.                                   Other Stock-Based Awards

 

The Committee may grant Other Stock-Based Awards, which are awards (other than those described in Sections 6, 7, 8 and 9 of this Plan) that are based on or measured by Company Stock, to any Employee, Non-Employee Director or Key Advisor, on such terms and conditions as the Committee shall determine.  Other Stock-Based Awards may be awarded subject to the achievement of performance goals or other conditions and may be payable in cash, Company Stock or any combination of the foregoing, as the Committee shall determine.

 

Section 11.                                   Cash Awards

 

The Committee may grant Cash Awards to Employees who are executive officers and other key employees of the Company.  The Committee shall determine the terms and conditions applicable to Cash Awards, including the criteria for the vesting and payment of Cash Awards. Cash Awards shall be based on such measures as the Committee deems appropriate and need not relate to the value of shares of Company Stock.

 

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Section 12.                                   Dividend Equivalents

 

The Committee may grant Dividend Equivalents in connection with Stock Units or Other Stock-Based Awards.  Dividend Equivalents may be paid currently or accrued as contingent cash obligations and may be payable in cash or shares of Company Stock, and upon such terms and conditions as the Committee shall determine.  Dividend Equivalents that vest based on performance shall vest and be paid only if and to the extent the underlying Stock Units or Other Stock-Based Awards vest and are paid, as determined by the Committee.

 

Section 13.                                   Qualified Performance-Based Compensation

 

The Committee may determine that Stock Awards, Stock Units, Other Stock-Based Awards, Cash Awards and Dividend Equivalents granted to an Employee shall be considered “qualified performance-based compensation” under section 162(m) of the Code (“Performance-Based Grants”).  The following provisions shall apply to Stock Awards, Stock Units, Other Stock-Based Awards, Cash Awards and Dividend Equivalents that are to be considered Performance-Based Grants:

 

(a)                                 Performance Goals.

 

(i)                                     When Performance-Based Grants are granted, the Committee shall establish in writing (A) the objective performance goals that must be met, (B) the performance period during which the performance will be measured, (C) the maximum amounts that may be paid if the performance goals are met, and (D) any other conditions that the Committee deems appropriate and consistent with this Plan and section 162(m) of the Code.

 

(ii)                                  The performance goals may be established on an absolute or relative basis and may be established on a corporate-wide basis or with respect to one or more business units, divisions, subsidiaries or business segments.  Relative performance may be measured against a group of peer companies, a financial market index or other objective and quantifiable indices.  The Committee shall use objectively determinable performance goals based on one or more of the following criteria: cash flow; earnings  (including gross margin, earnings before interest and taxes, earnings before taxes, earnings before interest, taxes, depreciation, amortization and charges for stock-based compensation, earnings before interest, taxes, depreciation and amortization, and net earnings); earnings per share; growth in earnings or earnings per share; stock price; return on equity or average stockholder equity; total stockholder return or growth in total stockholder return either directly or in relation to a comparative group; return on capital; return on assets or net assets; revenue, growth in revenue or return on sales; income or net income; operating income, net operating income or net operating income after tax; operating profit or net operating profit; operating margin; return on operating revenue or return on operating profit; regulatory filings; regulatory approvals, litigation and regulatory resolution goals; other operational, regulatory or departmental objectives; budget comparisons; growth in stockholder value relative to established indexes, or another peer group or peer group index; development and implementation of strategic plans and/or organizational restructuring goals; development and implementation of risk and crisis management programs; improvement in

 

15

 

workforce diversity; compliance requirements and compliance relief; safety goals; productivity goals; workforce management and succession planning goals; economic value added (including typical adjustments consistently applied from generally accepted accounting principles required to determine economic value added performance measures); measures of  customer satisfaction, employee satisfaction or staff development; development or marketing collaborations, formations of joint ventures or partnerships or the completion of other similar transactions intended to enhance the Corporation’s revenue or profitability or enhance its customer base; merger and acquisitions; and any other goal that is established at the discretion of the Committee other than with respect to Grants intended to meet the requirements of section 162(m) of the Code.  The Committee shall have sole discretion to determine specific targets within each category of performance goals.

 

(iii)                               In establishing performance goals, the Committee may, no later than the date on which such performance goals are to be established in accordance with Section 13(b) below, provide for the exclusion of the effects of items such as the following, to the extent identified in the audited financial statements of the Company, including footnotes, in the Management Discussion and Analysis of Financial Condition and Results of Operations accompanying such financial statements, or as otherwise specified by the Committee:  (A) restructurings, discontinued operations, extraordinary items, and other unusual, infrequent or non-recurring charges or events, (B) asset write-downs, (C) significant litigation or claim judgments or settlements, (D) acquisitions or divestitures, (E) any reorganization or change in the corporate structure or capital structure of the Company, (F) an event either not directly related to the operations of the Company, subsidiary, division, business segment or business unit or not within the reasonable control of management, (G) foreign exchange gains and losses, (H) a change in the fiscal year of the Company, (I) the cumulative effects of tax or accounting changes in accordance with GAAP, or (J) the effect of changes in other laws or regulatory rules affecting reported results.

 

(b)                                 Establishment of Goals.  The Committee shall establish the performance goals in writing either before the beginning of the performance period or during a period ending no later than the earlier of (i) 90 days after the beginning of the performance period or (ii) the date on which 25% of the performance period has been completed, or such other date as may be required or permitted under applicable regulations under section 162(m) of the Code.  The performance goals shall satisfy the requirements for “qualified performance-based compensation,” including the requirement that the achievement of the goals be substantially uncertain at the time they are established and that the goals be established in such a way that a third party with knowledge of the relevant facts could determine whether and to what extent the performance goals have been met.  The Committee shall not have discretion to increase the amount of compensation that is payable upon achievement of the designated performance goals.

 

(c)                                  Certification of Results.  The Committee shall certify achievement of the performance goals after the end of the applicable performance period.  If and to the extent that the Committee does not certify that the performance goals have been met, the Performance-Based Grants granted for the performance period shall be forfeited or shall not be made or paid, as applicable.

 

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(d)                                 Death, Disability or Other Circumstances.  The Committee may provide that Performance-Based Grants shall be payable or restrictions on such Grants shall lapse, in whole or in part, in the event of the Participant’s death or Disability, on or after a Change of Control, or under other circumstances consistent with the Treasury regulations and rulings under section 162(m) of the Code.

 

Section 14.                                   Consequences of a Change of Control

 

(a)                                 Assumption of Outstanding Grants.  Upon a Change of Control where the Company is not the surviving corporation (or survives only as a subsidiary of another corporation), unless the Committee determines otherwise, all outstanding Grants that are not exercised or paid at the time of the Change of Control shall be assumed by, or replaced with grants that have comparable terms by, the surviving corporation (or a parent or subsidiary of the surviving corporation).  After a Change of Control, references to the “Company” as they relate to employment matters shall include the successor employer in the transaction, subject to applicable law.

 

(b)                                 Vesting Upon Certain Terminations of Employment.  Unless the Grant Instrument provides otherwise, if a Participant’s employment is terminated by the Company without Cause upon or within 12 months following a Change of Control, the Participant’s outstanding Grants shall become fully vested as of the date of such termination; provided that if the vesting of any such Grants is based, in whole or in part, on performance, the applicable Grant Instrument shall specify how the portion of the Grant that becomes vested pursuant to this Section 14(b) shall be calculated.

 

(c)                                  Other Alternatives.  In the event of a Change of Control, if any outstanding Grants are not assumed by, or replaced with grants that have comparable terms by, the surviving corporation (or a parent or subsidiary of the surviving corporation), the Committee may take any of the following actions with respect to any or all outstanding Grants, without the consent of any Participant: (i) the Committee may determine that outstanding Stock Options and SARs shall automatically accelerate and become fully exercisable and the restrictions and conditions on outstanding Stock Awards, Stock Units, Cash Awards and Dividend Equivalents shall immediately lapse; (ii) the Committee may determine that Participants shall receive a payment in settlement of outstanding Stock Units, Cash Awards or Dividend Equivalents, in such amount and form as may be determined by the Committee; (ii) the Committee may require that Participants surrender their outstanding Stock Options and SARs in exchange for a payment by the Company, in cash or Company Stock as determined by the Committee, in an amount equal to the amount, if any, by which the then Fair Market Value of the shares of Company Stock subject to the Participant’s unexercised Stock Options and SARs exceeds the Stock Option Exercise Price or SAR base amount, and (iv) after giving Participants an opportunity to exercise all of their outstanding Stock Options and SARs, the Committee may terminate any or all unexercised Stock Options and SARs at such time as the Committee deems appropriate.  Such surrender, termination or payment shall take place as of the date of the Change of Control or such other date as the Committee may specify.  Without limiting the foregoing, if the per share Fair Market Value of the Company Stock does not exceed the per share Stock Option Exercise

 

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Price or SAR base amount, as applicable, the Company shall not be required to make any payment to the participant upon surrender of the Stock Option or SAR.

 

Section 15.                                   Deferrals

 

The Committee may permit or require a Participant to defer receipt of the payment of cash or the delivery of shares that would otherwise be due to such Participant in connection with any Grant.  If any such deferral election is permitted or required, the Committee shall establish rules and procedures for such deferrals and may provide for interest or other earnings to be paid on such deferrals.  The rules and procedures for any such deferrals shall be consistent with applicable requirements of section 409A of the Code.

 

Section 16.                                   Withholding of Taxes

 

(a)                                 Required Withholding.  All Grants under this Plan shall be subject to applicable United States federal (including FICA), state and local, foreign country or other tax withholding requirements.  The Employer may require that the Participant or other person receiving Grants or exercising Grants pay to the Employer an amount sufficient to satisfy such tax withholding requirements with respect to such Grants, or the Employer may deduct from other wages and compensation paid by the Employer the amount of any withholding taxes due with respect to such Grants.

 

(b)                                 Share Withholding.  The Committee may permit or require the Employer’s tax withholding obligation with respect to Grants paid in Company Stock to be satisfied by having shares withheld up to an amount that does not exceed the Participant’s applicable withholding tax rate for United States federal (including FICA), state and local tax liabilities.  The Committee may, in its discretion, and subject to such rules as the Committee may adopt, allow Participants to elect to have such share withholding applied to all or a portion of the tax withholding obligation arising in connection with any particular Grant.  Unless the Committee determines otherwise, share withholding for taxes shall not exceed the Participant’s minimum applicable tax withholding amount.

 

Section 17.                                   Transferability of Grants

 

(a)                                 Nontransferability of Grants.  Except as described in subsection (b) below, only the Participant may exercise rights under a Grant during the Participant’s lifetime.  A Participant may not transfer those rights except (i) by will or by the laws of descent and distribution or (ii) with respect to Grants other than Incentive Stock Options, pursuant to a domestic relations order.  When a Participant dies, the personal representative or other person entitled to succeed to the rights of the Participant may exercise such rights.  Any such successor must furnish proof satisfactory to the Company of his or her right to receive the Grant under the Participant’s will or under the applicable laws of descent and distribution.

 

(b)                                 Transfer of Nonqualified Stock Options.  Notwithstanding the foregoing, the Committee may provide, in a Grant Instrument, that a Participant may transfer Nonqualified Stock Options to family members, or one or more trusts or other entities for the benefit of or

 

18

 

owned by family members, consistent with the applicable securities laws, according to such terms as the Committee may determine; provided that the Participant receives no consideration for the transfer of an Option and the transferred Option shall continue to be subject to the same terms and conditions as were applicable to the Option immediately before the transfer.

 

Section 18.                                   Requirements for Issuance or Transfer of Shares

 

No Company Stock shall be issued or transferred in connection with any Grant hereunder unless and until all legal requirements applicable to the issuance or transfer of such Company Stock have been complied with to the satisfaction of the Committee.  The Committee shall have the right to condition any Grant on the Participant’s undertaking in writing to comply with such restrictions on his or her subsequent disposition of the shares of Company Stock as the Committee shall deem necessary or advisable, and certificates representing such shares may be legended to reflect any such restrictions.  Certificates representing shares of Company Stock issued or transferred under this Plan may be subject to such stop-transfer orders and other restrictions as the Committee deems appropriate to comply with applicable laws, regulations and interpretations, including any requirement that a legend be placed thereon.

 

Section 19.                                   Amendment and Termination of this Plan

 

(a)                                 Amendment.  The Board may amend or terminate this Plan at any time; provided, however, that the Board shall not amend this Plan without stockholder approval if such approval is required in order to comply with the Code or other applicable law, or to comply with applicable stock exchange requirements.

 

(b)                                 No Repricing of Options or SARs.  Except in connection with a corporate transaction involving the Company (including, without limitation, any stock dividend, distribution (whether in the form of cash, Company Stock, other securities or property), stock split, extraordinary cash dividend, recapitalization, change in control, reorganization, merger, consolidation, split-up, spin-off, combination, repurchase or exchange of shares of Company Stock or other securities, or similar transactions), the Company may not, without obtaining stockholder approval, (i) amend the terms of outstanding Stock Options or SARs to reduce the Exercise Price of such outstanding Stock Options or base price of such SARs, (ii) cancel outstanding Stock Options or SARs in exchange for Stock Options or SARs with an Exercise Price or base price, as applicable, that is less than the Exercise Price or base price of the original Stock Options or SARs or (iii) cancel outstanding Stock Options or SARs with an Exercise Price or base price, as applicable, above the current stock price in exchange for cash or other securities.

 

(c)                                  Stockholder Approval Requirements.

 

(i)                                     This Plan is intended to comply with the transition relief set forth at Treas. Reg. §1.162-27(f)(1) for companies that become publicly held in connection with an initial public offering, which applies until the first to occur of (A) the expiration of this Plan, (B) a material modification of this Plan within the meaning of section 162(m) and the regulations

 

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thereunder, (C) the issuance of all Company Stock authorized under this Plan, or (D) the first meeting of stockholders at which directors are to be elected that occurs after the close of the third calendar year following the calendar year in which the initial public offering occurs (the period commencing on the initial public offering and ending on the first to occur of the foregoing events shall be hereinafter referred to as the “Reliance Period”).

 

(ii)                                  Following the Reliance Period, if Grants are to be made as “qualified performance-based compensation” under section 162(m) of the Code, this Plan must be approved by the stockholders in accordance with section 162(m).  Following such stockholder approval, this Plan must be reapproved by the stockholders no later than the first stockholders meeting that occurs in the fifth year following the year in which the stockholders previously approved this Plan, if additional Grants are to be made as Performance-Based Grants under Section 13 and if required by section 162(m) of the Code or the regulations thereunder.

 

(d)                                 Termination of Plan.  This Plan shall terminate on the day immediately preceding the tenth anniversary of its Effective Date, unless this Plan is terminated earlier by the Board or is extended by the Board with the approval of the stockholders.

 

(e)                                  Termination and Amendment of Outstanding Grants.  A termination or amendment of this Plan that occurs after a Grant is made shall not materially impair the rights of a Participant unless the Participant consents or unless the Committee acts under Section 20(f) below.  The termination of this Plan shall not impair the power and authority of the Committee with respect to an outstanding Grant.  Whether or not this Plan has terminated, an outstanding Grant may be terminated or amended under Section 20(f) below or may be amended by agreement of the Company and the Participant consistent with this Plan.

 

Section 20.                                   Miscellaneous

 

(a)                                 Grants in Connection with Corporate Transactions and Otherwise.  Nothing contained in this Plan shall be construed to (i) limit the right of the Committee to make Grants under this Plan in connection with the acquisition, by purchase, lease, merger, consolidation or otherwise, of the business or assets of any corporation, firm or association, including Grants to employees thereof who become Employees, or (ii) limit the right of the Company to grant stock options or make other awards outside of this Plan.  The Committee may make a Grant to an employee of another corporation who becomes an Employee by reason of a corporate merger, consolidation, acquisition of stock or property, reorganization or liquidation involving the Company, in substitution for a stock option or stock awards grant made by such corporation.  Notwithstanding anything in this Plan to the contrary, the Committee may establish such terms and conditions of the new Grants as it deems appropriate, including setting the Exercise Price of Options or the base price of SARs at a price necessary to retain for the Participant the same economic value as the prior options or rights.

 

(b)                                 Governing Document.  This Plan shall be the controlling document.  No other statements, representations, explanatory materials or examples, oral or written, may amend

 

20

 

this Plan in any manner.  This Plan shall be binding upon and enforceable against the Company and its successors and assigns.

 

(c)                                  Funding of this Plan.  This Plan shall be unfunded.  The Company shall not be required to establish any special or separate fund or to make any other segregation of assets to assure the payment of any Grants under this Plan.

 

(d)                                 Rights of Participants.  Nothing in this Plan shall entitle any Employee, Non-Employee Director, Key Advisor or other person to any claim or right to receive a Grant under this Plan.  Neither this Plan nor any action taken hereunder shall be construed as giving any individual any rights to be retained by or in the employ of the Employer or any other employment rights.

 

(e)                                  No Fractional Shares.  No fractional shares of Company Stock shall be issued or delivered pursuant to this Plan or any Grant.  Except as otherwise provided under this Plan, the Committee shall determine whether cash, other awards or other property shall be issued or paid in lieu of such fractional shares or whether such fractional shares or any rights thereto shall be forfeited or otherwise eliminated.

 

(f)                                   Compliance with Law.

 

(i)                                     This Plan, the exercise of Options and SARs and the obligations of the Company to issue or transfer shares of Company Stock under Grants shall be subject to all applicable laws and regulations, and to approvals by any governmental or regulatory agency as may be required.  With respect to persons subject to section 16 of the Exchange Act, it is the intent of the Company that this Plan and all transactions under this Plan comply with all applicable provisions of Rule 16b-3 or its successors under the Exchange Act.  In addition, it is the intent of the Company that Incentive Stock Options comply with the applicable provisions of section 422 of the Code, that Grants of “qualified performance-based compensation” comply with the applicable provisions of section 162(m) of the Code and that, to the extent applicable, Grants comply with the requirements of section 409A of the Code.  To the extent that any legal requirement of section 16 of the Exchange Act or section 422, 162(m) or 409A of the Code as set forth in this Plan ceases to be required under section 16 of the Exchange Act or section 422, 162(m) or 409A of the Code, that Plan provision shall cease to apply.  The Committee may revoke any Grant if it is contrary to law or modify a Grant to bring it into compliance with any valid and mandatory government regulation.  The Committee may also adopt rules regarding the withholding of taxes on payments to Participants.  The Committee may, in its sole discretion, agree to limit its authority under this Section.

 

(ii)                                  This Plan is intended to comply with the requirements of section 409A of the Code, to the extent applicable.  Each Grant shall be construed and administered such that the Grant either (A) qualifies for an exemption from the requirements of section 409A of the Code or (B) satisfies the requirements of section 409A of the Code.  If a Grant is subject to section 409A of the Code, (I) distributions shall only be made in a manner and upon an event permitted under section 409A of the Code, (II) payments to be made upon a termination of

 

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employment or service shall only be made upon a “separation from service” under section 409A of the Code, (III) unless the Grant specifies otherwise, each installment payment shall be treated as a separate payment for purposes of section 409A of the Code, and (IV) in no event shall a Participant, directly or indirectly, designate the calendar year in which a distribution is made except in accordance with section 409A of the Code.

 

(iii)                               Any Grant that is subject to section 409A of the Code and that is to be distributed to a Key Employee (as defined below) upon separation from service shall be administered so that any distribution with respect to such Grant shall be postponed for six months following the date of the Participant’s separation from service, if required by section 409A of the Code.  If a distribution is delayed pursuant to section 409A of the Code, the distribution shall be paid within 15 days after the end of the six-month period.  If the Participant dies during such six-month period, any postponed amounts shall be paid within 90 days of the Participant’s death.  The determination of Key Employees, including the number and identity of persons considered Key Employees and the identification date, shall be made by the Committee or its delegate each year in accordance with section 416(i) of the Code and the “specified employee” requirements of section 409A of the Code.

 

(iv)                              Notwithstanding anything in this Plan or any Grant agreement to the contrary, each Participant shall be solely responsible for the tax consequences of Grants under this Plan, and in no event shall the Company or any subsidiary or affiliate of the Company have any responsibility or liability if a Grant does not meet any applicable requirements of section 409A of the Code.  Although the Company intends to administer this Plan to prevent taxation under section 409A of the Code, the Company does not represent or warrant that this Plan or any Grant complies with any provision of federal, state, local or other tax law.

 

(g)                                  Establishment of Subplans.  The Board may from time to time establish one or more sub-plans under this Plan for purposes of satisfying applicable blue sky, securities or tax laws of various jurisdictions.  The Board shall establish such sub-plans by adopting supplements to this Plan setting forth (i) such limitations on the Committee’s discretion under this Plan as the Board deems necessary or desirable and (ii) such additional terms and conditions not otherwise inconsistent with this Plan as the Board shall deem necessary or desirable.  All supplements adopted by the Board shall be deemed to be part of this Plan, but each supplement shall apply only to Participants within the affected jurisdiction and the Employer shall not be required to provide copies of any supplement to Participants in any jurisdiction that is not affected.

 

(h)                                 Clawback Rights.  Subject to the requirements of applicable law, the Committee may provide in any Grant Instrument that, if a Participant breaches any restrictive covenant agreement between the Participant and the Employer (which may be set forth in any Grant Instrument) or otherwise engages in activities that constitute Cause either while employed by, or providing service to, the Employer or within a specified period of time thereafter, all Grants held by the Participant shall terminate, and the Company may rescind any exercise of an Option or SAR and the vesting of any other Grant and delivery of shares upon such exercise or vesting (including pursuant to dividends and Dividend Equivalents), as applicable on such terms

 

22

 

as the Committee shall determine, including the right to require that in the event of any such rescission (i) the Participant shall return to the Company the shares received upon the exercise of any Option or SAR and/or the vesting and payment of any other Grant (including pursuant to dividends and Dividend Equivalents) or (ii) if the Participant no longer owns the shares, the Participant shall pay to the Company the amount of any gain realized or payment received as a result of any sale or other disposition of the shares  (or, in the event the Participant transfers the shares by gift or otherwise without consideration, the Fair Market Value of the shares on the date of the breach of the restrictive covenant agreement (including a Participant’s Grant Instrument containing restrictive covenants) or activity constituting Cause), net of the price originally paid by the Participant for the shares.  Payment by the Participant shall be made in such manner and on such terms and conditions as may be required by the Committee.  The Employer shall be entitled to set off against the amount of any such payment any amounts otherwise owed to the Participant by the Employer.  In addition, all Grants under this Plan shall be subject to any applicable clawback or recoupment policies, share trading policies and other policies that may be implemented by the Board from time to time.

 

(i)                                     Governing Law.  The validity, construction, interpretation and effect of this Plan and Grant Instruments issued under this Plan shall be governed and construed by and determined in accordance with the laws of the State of Delaware, without giving effect to the conflict of laws provisions thereof.

 

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TABULA RASA HEALTHCARE, INC.

2016 OMNIBUS INCENTIVE COMPENSATION PLAN

 

INCENTIVE STOCK OPTION SUMMARY OF GRANT

 

Tabula Rasa Healthcare, Inc., a Delaware corporation (the “Company”), pursuant to its 2016 Omnibus Incentive Compensation Plan (the “Plan”), hereby grants to the individual listed below (the “Participant”), an incentive stock option to purchase shares of common stock of the Company (“Company Stock”) that may become vested and exercisable as set forth below (the “Option”).  The Option is subject in all respects to the terms and conditions set forth herein, in the Incentive Stock Option Grant Agreement attached hereto as Exhibit A (the “Incentive Stock Option Grant Agreement”) and the Plan, each of which is incorporated herein by reference and made part hereof.  Unless otherwise defined herein, capitalized terms used in this Incentive Stock Option Summary of Grant (the “Summary of Grant”) and the Incentive Stock Option Grant Agreement shall have the meanings set forth in the Plan.

 

	
Participant:
    	
 
    	
[·]
    
	
Date of Grant:
    	
 
    	
[·]
    
	
Total Number of Shares Subject to Option:
    	
 
    	
[·]   shares of Company Stock
    
	
Exercise Price:
    	
 
    	
[·]
    
	
Exercisability of the Option:
    	
 
    	
Except as set forth herein, the Option shall vest and become   exercisable on the following dates (each, a “Vesting Date”), provided   that the Participant continues to be employed by, or provide service to, the   Employer from the Date of Grant through the applicable Vesting Date:

[·]

The Option shall be fully vested and exercisable on [·]   if the Participant is employed by, or providing services to, the Employer on   such date.
    
	
Vesting Upon Certain Termination and Other Events:
    	
 
    	
[·]
    
	
Term/Expiration Date:
    	
 
    	
[·]
    

 

Participant Acceptance:

 

By signing the acknowledgement below, the Participant agrees to be bound by the terms and conditions of the Plan, the Incentive Stock Option Grant Agreement and this Summary of Grant and accepts the Option.  The Participant accepts as binding, conclusive and final all decisions or interpretations of the Committee upon any questions arising under the Plan, this Summary of Grant or the Incentive Stock Option Grant Agreement.

 

1

 

The Participant acknowledges delivery of the Plan and the Plan prospectus together this with this Summary of Grant and the Incentive Stock Option Grant Agreement.  Additional copies of the Plan and the Plan prospectus are available by contacting [·] at [·].

 

	
 
    	
Agreed and accepted:
    
	
 
    	
 
    
	
 
    	
 
    
	
 
    	
Participant
    
	
 
    	
 
    
	
 
    	
 
    
	
 
    	
Date
    

 

2

 

EXHIBIT A

 

TABULA RASA HEALTHCARE, INC.

 

INCENTIVE STOCK OPTION GRANT AGREEMENT

(Pursuant to the 2016 Omnibus Incentive Compensation Plan)

 

This Incentive Stock Option Grant Agreement (this “Agreement”) is delivered by Tabula Rasa Healthcare, Inc., a Delaware corporation (the “Company”), pursuant to the Summary of Grant delivered with this Agreement to the individual named in the Summary of Grant (the “Participant”).  The Summary of Grant, which specifies the Participant, the date as of which the grant is made (the “Date of Grant”), the vesting schedule and other specific details of the grant is incorporated herein by reference.

 

1.                                      Option Grant.  Upon the terms and conditions set forth in this Agreement and in the Company’s 2016 Omnibus Incentive Compensation Plan (the “Plan”), the Company hereby grants to the Participant an incentive stock option to purchase the number of shares of common stock of the Company (“Company Stock”) set forth in the Summary of Grant (the “Option”). However, if and to the extent the Option exceeds the limits for an incentive stock option, as described in Section 5, the Option shall be a nonqualified stock option.  This Agreement is made pursuant to the Plan and is subject in its entirety to all applicable provisions of the Plan.  Capitalized terms used herein and not otherwise defined shall have the meanings set forth in the Plan.  The Participant agrees to be bound by all of the terms and conditions of the Plan.

 

2.                                      Exercisability of the Option.

 

(a)                                 The Option shall become vested and exercisable as set forth in the Summary of Grant, provided that the Participant continues to be employed by, or provide service to, the Employer through the Vesting Date (as defined in the Summary of Grant).

 

(b)                                 The exercisability of the Option is cumulative, but shall not exceed 100% of the shares of Company Stock subject to the Option.  If the schedule set forth in the Summary of Grant would produce fractional shares of Company Stock, the number of shares of Company Stock for which the Option becomes exercisable shall be rounded down to the nearest whole share of Company Stock.

 

3.                                      Term of Option.

 

(a)                                 The Option shall have a term of ten years from the Date of Grant and shall terminate at the expiration of that period, unless it is terminated at an earlier date pursuant to the provisions of this Agreement or the Plan.

 

(b)                                 The Option shall automatically terminate upon the happening of the first of the following events:

 

(i)                                     The expiration of the 90-day period after the Participant ceases to be employed by, or provide service to, the Employer, if the termination is for any reason other than Disability, death or Cause.

 

3

 

(ii)                                  The expiration of the one-year period after the Participant ceases to be employed by, or provide service to, the Employer on account of the Participant’s Disability.

 

(iii)                               The expiration of the one-year period after the Participant ceases to be employed by, or provide service to, the Employer, if the Participant dies while employed by, or providing service to, the Employer or within 90 days after the Participant ceases to be so employed or provide such services on account of a termination described in subsection (i) above.

 

(iv)                              The date on which the Participant ceases to be employed by, or provide service to, the Employer for Cause.  In addition, notwithstanding the prior provisions of this Section 3, if the Participant engages in conduct that constitutes Cause after the Participant’s employment or service terminates, the Option shall immediately terminate.

 

Notwithstanding the foregoing, in no event may the Option be exercised after the date that is immediately before the tenth anniversary of the Date of Grant; provided, however, that if the term of the Option is extended pursuant to Section 2(a) above, in no event may the Option be exercised after the date that is immediately before the expiration of the extended term of the Option.  Any portion of the Option that is not exercisable at the time the Participant ceases to be employed by, or provide service to, the Employer shall immediately terminate.

 

4.                                      Exercise Procedures.

 

(a)                                 Subject to the provisions of Sections 2 and 3 above, the Participant may exercise part or all of the exercisable Option by giving the Company written notice of intent to exercise in the manner provided in this Agreement, specifying the number of shares of Company Stock as to which the Option is to be exercised.  At such time as the Committee shall determine, the Participant shall pay the Exercise Price (i) in cash, (ii) with the approval of the Committee, by delivering shares of Company Stock owned by the Participant, which shall be valued at their Fair Market Value on the date of exercise, or by attestation (on a form prescribed by the Committee) to ownership of shares of Company Stock having a Fair Market Value on the date of exercise at least equal to the Exercise Price, (iii) by payment through a broker in accordance with procedures permitted by Regulation T of the Federal Reserve Board, (iv) with the approval of the Committee, by withholding shares of Company Stock subject to the exercisable Option, which have a Fair Market Value on the date of exercise equal to the Exercise Price, or (v) by such other method as the Committee may approve, to the extent permitted by applicable law.  The Committee may impose from time to time such limitations as it deems appropriate on the use of shares of Company Stock to exercise the Option.

 

(b)                                 The obligation of the Company to deliver shares of Company Stock upon exercise of the Option shall be subject to all applicable laws, rules, and regulations and such approvals by governmental agencies as may be deemed appropriate by the Committee, including such actions as Company counsel shall deem necessary or appropriate to comply with relevant securities laws and regulations.  The Company may require that the Participant (or other person exercising the Option after the Participant’s death) represent that the Participant is purchasing shares of Company Stock for the Participant’s own account and not with a view to or for sale in connection with any distribution of the shares of Company Stock, or such other representation as the Committee deems appropriate.

 

4

 

(c)                                  All obligations of the Company under this Agreement shall be subject to the rights of the Company as set forth in the Plan to withhold amounts required to be withheld for any taxes, if applicable.  Subject to Committee approval, the Participant may elect to satisfy any tax withholding obligation of the Employer with respect to the Option by having shares of Company Stock withheld up to an amount that does not exceed the applicable withholding tax rate for federal (including FICA), state and local tax liabilities.  Unless the Committee determines otherwise, share withholding for taxes shall not exceed the Participant’s minimum applicable tax withholding amount.

 

(d)                                 Upon exercise of the Option (or portion thereof), the Option (or portion thereof) shall terminate and cease to be outstanding.

 

5.                                      Designation as Incentive Stock Option.

 

(a)                                 This Option is designated an incentive stock option under Section 422 of the Internal Revenue Code of 1986, as amended (the “Code”).  If the aggregate fair market value of the stock on the date of the grant with respect to which incentive stock options are exercisable for the first time by the Participant during any calendar year, under the Plan or any other stock option plan of the Company or a parent or subsidiary, exceeds $100,000, then the Option, as to the excess, shall be treated as a nonqualified stock option that does not meet the requirements of Code section 422. If and to the extent that the Option fails to qualify as an incentive stock option under the Code, the Option shall remain outstanding according to its terms as a nonqualified stock option.

 

(b)                                 The Participant understands that favorable incentive stock option tax treatment is available only if the Option is exercised while the Participant is an employee of the Company or a parent or subsidiary of the Company or within a period of time specified in the Code after the Participant ceases to be an employee. The Participant understands that the Participant is responsible for the income tax consequences of the Option, and, among other tax consequences, the Participant understands that he or she may be subject to the alternative minimum tax under the Code in the year in which the Option is exercised. The Participant shall consult with his or her tax adviser regarding the tax consequences of the Option.

 

(c)                                  The Participant agrees that the Participant shall immediately notify the Company in writing if the Participant sells or otherwise disposes of any shares acquired upon the exercise of the Option and such sale or other disposition occurs on or before the later of (i) two years after the Date of Grant or (ii) one year after the exercise of the Option. The Participant also agrees to provide the Company with any information requested by the Company with respect to such sale or other disposition.

 

6.                                      No Stockholder Rights.  Neither the Participant, nor any person entitled to exercise the Participant’s rights in the event of the Participant’s death, shall have any of the rights and privileges of a stockholder with respect to the shares of Company Stock subject to the Option, until certificates for shares of Company Stock have been issued upon the exercise of the Option.

 

5

 

7.                                      Change of Control.  Unless otherwise set forth in the Summary of Grant, the provisions of the Plan applicable to a Change of Control shall apply to the Option, and, in the event of a Change of Control, the Committee may take such actions as it deems appropriate pursuant to the Plan.

 

8.                                      Restrictions on Exercise.  Except as the Committee may otherwise permit pursuant to the Plan, only the Participant may exercise the Option during the Participant’s lifetime and, after the Participant’s death, the Option shall be exercisable (subject to the limitations specified in the Plan) solely by the legal representatives of the Participant, or by the person who acquires the right to exercise the Option by shall or by the laws of descent and distribution, to the extent that the Option is exercisable pursuant to this Agreement.

 

9.                                      Entire Agreement.  This Agreement contains the entire agreement of the parties with respect to the Option granted hereby and may not be changed orally but only by an instrument in writing signed by the party against whom enforcement of any change, modification or extension is sought.

 

10.                               Grant Subject to Plan Provisions. This grant is made pursuant to the Plan, the terms of which are incorporated herein by reference, and in all respects shall be interpreted in accordance with the Plan.  This grant is subject to interpretations, regulations and determinations concerning the Plan established from time to time by the Committee in accordance with the provisions of the Plan, including, but not limited to, provisions pertaining to (a) rights and obligations with respect to withholding taxes, (b) the registration, qualification or listing of the shares, (c) changes in capitalization of the Company and (d) other requirements of applicable law.  The Committee shall have the authority to interpret and construe this grant pursuant to the terms of the Plan, and its decisions shall be conclusive as to any questions arising hereunder.

 

11.                               Assignment and Transfers.  Except as the Committee may otherwise permit pursuant to the Plan, the rights and interests of the Participant under this Agreement may not be sold, assigned, encumbered or otherwise transferred except, in the event of the death of the Participant, by shall or by the laws of descent and distribution.  In the event of any attempt by the Participant to alienate, assign, pledge, hypothecate, or otherwise dispose of the Option or any right hereunder, except as provided for in this Agreement, or in the event of the levy or any attachment, execution or similar process upon the rights or interests hereby conferred, the Company may terminate the Option by notice to the Participant, and the Option and all rights hereunder shall thereupon become null and void.  The rights and protections of the Company hereunder shall extend to any successors or assigns of the Company and to the Company’s parents, subsidiaries, and affiliates.  This Agreement may be assigned by the Company without the Participant’s consent.

 

12.                               No Employment or Other Rights.  This Agreement shall not confer upon the Participant any right to be retained in the employment of the Employer and shall not interfere in any way with the right of the Employer to terminate the Participant’s employment at any time.  The right of the Employer to terminate at will the Participant’s employment at any time for any reason is specifically reserved.

 

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13.                               Notice.  Any notice to the Company provided for in this instrument shall be addressed to the Company in care of the General Counsel at the Company’s corporate headquarters, and any notice to the Participant shall be addressed to such Participant at the current address shown on the payroll records of the Company, or to such other address as the Participant may designate to the Company in writing.  Any notice shall be delivered by hand, sent by telecopy or enclosed in a properly sealed envelope addressed as stated above, registered and deposited, postage prepaid, in a post office regularly maintained by the United States Postal Service.

 

14.                               Recoupment Policy.  The Participant agrees that, subject to the requirements of applicable law, if the Participant breaches any restrictive covenant agreement between the Participant and the Employer or otherwise engages in activities that constitute Cause either while employed by, or providing service to, the Employer or within two years thereafter, the Option shall terminate, and the Company may rescind any exercise of the Option and delivery of shares upon such exercise, as applicable on such terms as the Committee shall determine, including the right to require that in the event of any such rescission, (a) the Participant shall return to the Company the shares received upon the exercise of the Option or, (b) if the Participant no longer owns the shares, the Participant shall pay to the Company the amount of any gain realized or payment received as a result of any sale or other disposition of the shares (or, in the event the Participant transfers the shares by gift or otherwise without consideration, the Fair Market Value of the shares on the date of the breach of any restrictive covenant agreement or activity constituting Cause), net of the price originally paid by the Participant for the shares.  The Participant agrees that payment by the Participant shall be made in such manner and on such terms and conditions as may be required by the Committee and the Employer shall be entitled to set off against the amount of any such payment any amounts otherwise owed to the Participant by the Employer.  In addition, the Participant agrees that the Option shall be subject to any applicable clawback or recoupment policies, share trading policies and other policies that may be implemented by the Board from time to time.

 

15.                               Applicable Law.  The validity, construction, interpretation and effect of this Agreement shall be governed by and construed in accordance with the laws of the State of Delaware, without giving effect to the conflicts of laws provisions thereof.

 

16.                               Application of Section 409A of the Code.  This Agreement is intended to be exempt from section 409A of the Code and to the extent this Agreement is subject to section 409A of the Code, it shall in all respects be administered in accordance with section 409A of the Code.

 

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TABULA RASA HEALTHCARE, INC.

2016 OMNIBUS INCENTIVE COMPENSATION PLAN

 

NONQUALIFIED STOCK OPTION SUMMARY OF GRANT

 

Tabula Rasa Healthcare, Inc., a Delaware corporation (the “Company”), pursuant to its 2016 Omnibus Incentive Compensation Plan (the “Plan”), hereby grants to the individual listed below (the “Participant”), a nonqualified stock option to purchase shares of common stock of the Company (“Company Stock”) that may become vested and exercisable as set forth below (the “Option”).  The Option is subject in all respects to the terms and conditions set forth herein, in the Nonqualified Stock Option Grant Agreement attached hereto as Exhibit A (the “Nonqualified Stock Option Grant Agreement”) and the Plan, each of which is incorporated herein by reference and made part hereof.  Unless otherwise defined herein, capitalized terms used in this Nonqualified Stock Option Summary of Grant (the “Summary of Grant”) and the Nonqualified Stock Option Grant Agreement shall have the meanings set forth in the Plan.

 

	
Participant:
    	
 
    	
[·]
    
	
Date of Grant:
    	
 
    	
[·]
    
	
Total Number of Shares Subject to Option:
    	
 
    	
[·]   shares of Company Stock
    
	
Exercise Price:
    	
 
    	
[·]
    
	
Exercisability of the Option:
    	
 
    	
Except as set forth herein, the Option shall vest and become exercisable   on the following dates (each, a “Vesting Date”), provided that the   Participant continues to be employed by, or provide service to, the Employer   from the Date of Grant through the applicable Vesting Date:

[·]

The Option shall be fully vested and exercisable on [·]   if the Participant is employed by, or providing services to, the Employer on   such date.
    
	
Vesting Upon Certain Termination and Other Events:
    	
 
    	
[·]
    
	
Term/Expiration Date:
    	
 
    	
[·]
    

 

Participant Acceptance:

 

By signing the acknowledgement below, the Participant agrees to be bound by the terms and conditions of the Plan, the Nonqualified Stock Option Grant Agreement and this Summary of Grant and accepts the Option.  The Participant accepts as binding, conclusive and final all decisions or interpretations of the Committee upon any questions arising under the Plan, this Summary of Grant or the Nonqualified Stock Option Grant Agreement.

 

 

The Participant acknowledges delivery of the Plan and the Plan prospectus together this with this Summary of Grant and the Nonqualified Stock Option Grant Agreement.  Additional copies of the Plan and the Plan prospectus are available by contacting [·] at [·].

 

	
 
    	
Agreed and accepted:
    
	
 
    	
 
    
	
 
    	
 
    
	
 
    	
Participant
    
	
 
    	
 
    
	
 
    	
 
    
	
 
    	
Date
    

 

2

 

EXHIBIT A

 

TABULA RASA HEALTHCARE, INC.

 

NONQUALIFIED STOCK OPTION GRANT AGREEMENT

(Pursuant to the 2016 Omnibus Incentive Compensation Plan)

 

This Nonqualified Stock Option Grant Agreement (this “Agreement”) is delivered by Tabula Rasa Healthcare, Inc., a Delaware corporation (the “Company”), pursuant to the Summary of Grant delivered with this Agreement to the individual named in the Summary of Grant (the “Participant”).  The Summary of Grant, which specifies the Participant, the date as of which the grant is made (the “Date of Grant”), the vesting schedule and other specific details of the grant is incorporated herein by reference.

 

1.                                      Option Grant.  Upon the terms and conditions set forth in this Agreement and in the Company’s 2016 Omnibus Incentive Compensation Plan (the “Plan”), the Company hereby grants to the Participant a nonqualified stock option to purchase the number of shares of common stock of the Company (“Company Stock”) set forth in the Summary of Grant (the “Option”). This Agreement is made pursuant to the Plan and is subject in its entirety to all applicable provisions of the Plan.  Capitalized terms used herein and not otherwise defined shall have the meanings set forth in the Plan.  The Participant agrees to be bound by all of the terms and conditions of the Plan.

 

2.                                      Exercisability of the Option.

 

(a)                                 The Option shall become vested and exercisable as set forth in the Summary of Grant, provided that the Participant continues to be employed by, or provide service to, the Employer through the Vesting Date (as defined in the Summary of Grant).

 

(b)                                 The exercisability of the Option is cumulative, but shall not exceed 100% of the shares of Company Stock subject to the Option.  If the schedule set forth in the Summary of Grant would produce fractional shares of Company Stock, the number of shares of Company Stock for which the Option becomes exercisable shall be rounded down to the nearest whole share of Company Stock.

 

3.                                      Term of Option.

 

(a)                                 The Option shall have a term of ten years from the Date of Grant and shall terminate at the expiration of that period, unless it is terminated at an earlier date pursuant to the provisions of this Agreement or the Plan.  Notwithstanding the foregoing, in the event that on the last business day of the term of the Option, the exercise of the Option is prohibited by applicable law, including a prohibition on purchases or sales of Company Stock under the Company’s insider trading policy, the term of the Option shall be extended for a period of 30 days following the end of the legal prohibition, unless the Committee determines otherwise.

 

(b)                                 The Option shall automatically terminate upon the happening of the first of the following events:

 

3

 

(i)                                     The expiration of the 90-day period after the Participant ceases to be employed by, or provide service to, the Employer, if the termination is for any reason other than Disability, death or Cause.

 

(ii)                                  The expiration of the one-year period after the Participant ceases to be employed by, or provide service to, the Employer on account of the Participant’s Disability.

 

(iii)                               The expiration of the one-year period after the Participant ceases to be employed by, or provide service to, the Employer, if the Participant dies while employed by, or providing service to, the Employer or within 90 days after the Participant ceases to be so employed or provide such services on account of a termination described in subsection (i) above.

 

(iv)                              The date on which the Participant ceases to be employed by, or provide service to, the Employer for Cause.  In addition, notwithstanding the prior provisions of this Section 3, if the Participant engages in conduct that constitutes Cause after the Participant’s employment or service terminates, the Option shall immediately terminate.

 

Notwithstanding the foregoing, in no event may the Option be exercised after the date that is immediately before the tenth anniversary of the Date of Grant; provided, however, that if the term of the Option is extended pursuant to Section 2(a) above, in no event may the Option be exercised after the date that is immediately before the expiration of the extended term of the Option.  Any portion of the Option that is not exercisable at the time the Participant ceases to be employed by, or provide service to, the Employer shall immediately terminate.

 

4.                                      Exercise Procedures.

 

(a)                                 Subject to the provisions of Sections 2 and 3 above, the Participant may exercise part or all of the exercisable Option by giving the Company written notice of intent to exercise in the manner provided in this Agreement, specifying the number of shares of Company Stock as to which the Option is to be exercised.  At such time as the Committee shall determine, the Participant shall pay the Exercise Price (i) in cash, (ii) with the approval of the Committee, by delivering shares of Company Stock owned by the Participant, which shall be valued at their Fair Market Value on the date of exercise, or by attestation (on a form prescribed by the Committee) to ownership of shares of Company Stock having a Fair Market Value on the date of exercise at least equal to the Exercise Price, (iii) by payment through a broker in accordance with procedures permitted by Regulation T of the Federal Reserve Board, (iv) with the approval of the Committee, by withholding shares of Company Stock subject to the exercisable Option, which have a Fair Market Value on the date of exercise equal to the Exercise Price, or (v) by such other method as the Committee may approve, to the extent permitted by applicable law.  The Committee may impose from time to time such limitations as it deems appropriate on the use of shares of Company Stock to exercise the Option.

 

(b)                                 The obligation of the Company to deliver shares of Company Stock upon exercise of the Option shall be subject to all applicable laws, rules, and regulations and such approvals by governmental agencies as may be deemed appropriate by the Committee, including such actions as Company counsel shall deem necessary or appropriate to comply with relevant securities laws and regulations.  The Company may require that the Participant (or other person exercising the 

 

4

 

Option after the Participant’s death) represent that the Participant is purchasing shares of Company Stock for the Participant’s own account and not with a view to or for sale in connection with any distribution of the shares of Company Stock, or such other representation as the Committee deems appropriate.

 

(c)                                  All obligations of the Company under this Agreement shall be subject to the rights of the Company as set forth in the Plan to withhold amounts required to be withheld for any taxes, if applicable.  Subject to Committee approval, the Participant may elect to satisfy any tax withholding obligation of the Employer with respect to the Option by having shares of Company Stock withheld up to an amount that does not exceed the applicable withholding tax rate for federal (including FICA), state and local tax liabilities.  Unless the Committee determines otherwise, share withholding for taxes shall not exceed the Participant’s minimum applicable tax withholding amount.

 

(d)                                 Upon exercise of the Option (or portion thereof), the Option (or portion thereof) shall terminate and cease to be outstanding.

 

5.                                      No Stockholder Rights.  Neither the Participant, nor any person entitled to exercise the Participant’s rights in the event of the Participant’s death, shall have any of the rights and privileges of a stockholder with respect to the shares of Company Stock subject to the Option, until certificates for shares of Company Stock have been issued upon the exercise of the Option.

 

6.                                      Change of Control.  Unless otherwise set forth in the Summary of Grant, the provisions of the Plan applicable to a Change of Control shall apply to the Option, and, in the event of a Change of Control, the Committee may take such actions as it deems appropriate pursuant to the Plan.

 

7.                                      Restrictions on Exercise.  Except as the Committee may otherwise permit pursuant to the Plan, only the Participant may exercise the Option during the Participant’s lifetime and, after the Participant’s death, the Option shall be exercisable (subject to the limitations specified in the Plan) solely by the legal representatives of the Participant, or by the person who acquires the right to exercise the Option by shall or by the laws of descent and distribution, to the extent that the Option is exercisable pursuant to this Agreement.

 

8.                                      Entire Agreement.  This Agreement contains the entire agreement of the parties with respect to the Option granted hereby and may not be changed orally but only by an instrument in writing signed by the party against whom enforcement of any change, modification or extension is sought.

 

9.                                      Grant Subject to Plan Provisions. This grant is made pursuant to the Plan, the terms of which are incorporated herein by reference, and in all respects shall be interpreted in accordance with the Plan.  This grant is subject to interpretations, regulations and determinations concerning the Plan established from time to time by the Committee in accordance with the provisions of the Plan, including, but not limited to, provisions pertaining to (a) rights and obligations with respect to withholding taxes, (b) the registration, qualification or listing of the shares, (c) changes in capitalization of the Company and (d) other requirements of applicable 

 

5

 

law.  The Committee shall have the authority to interpret and construe this grant pursuant to the terms of the Plan, and its decisions shall be conclusive as to any questions arising hereunder.

 

10.                               Assignment and Transfers.  Except as the Committee may otherwise permit pursuant to the Plan, the rights and interests of the Participant under this Agreement may not be sold, assigned, encumbered or otherwise transferred except, in the event of the death of the Participant, by shall or by the laws of descent and distribution.  In the event of any attempt by the Participant to alienate, assign, pledge, hypothecate, or otherwise dispose of the Option or any right hereunder, except as provided for in this Agreement, or in the event of the levy or any attachment, execution or similar process upon the rights or interests hereby conferred, the Company may terminate the Option by notice to the Participant, and the Option and all rights hereunder shall thereupon become null and void.  The rights and protections of the Company hereunder shall extend to any successors or assigns of the Company and to the Company’s parents, subsidiaries, and affiliates.  This Agreement may be assigned by the Company without the Participant’s consent.

 

11.                               No Employment or Other Rights.  This Agreement shall not confer upon the Participant any right to be retained in the employment of the Employer and shall not interfere in any way with the right of the Employer to terminate the Participant’s employment at any time.  The right of the Employer to terminate at will the Participant’s employment at any time for any reason is specifically reserved.

 

12.                               Notice.  Any notice to the Company provided for in this instrument shall be addressed to the Company in care of the General Counsel at the Company’s corporate headquarters, and any notice to the Participant shall be addressed to such Participant at the current address shown on the payroll records of the Company, or to such other address as the Participant may designate to the Company in writing.  Any notice shall be delivered by hand, sent by telecopy or enclosed in a properly sealed envelope addressed as stated above, registered and deposited, postage prepaid, in a post office regularly maintained by the United States Postal Service.

 

13.                               Recoupment Policy.  The Participant agrees that, subject to the requirements of applicable law, if the Participant breaches any restrictive covenant agreement between the Participant and the Employer or otherwise engages in activities that constitute Cause either while employed by, or providing service to, the Employer or within two years thereafter, the Option shall terminate, and the Company may rescind any exercise of the Option and delivery of shares upon such exercise, as applicable on such terms as the Committee shall determine, including the right to require that in the event of any such rescission, (a) the Participant shall return to the Company the shares received upon the exercise of the Option or, (b) if the Participant no longer owns the shares, the Participant shall pay to the Company the amount of any gain realized or payment received as a result of any sale or other disposition of the shares (or, in the event the Participant transfers the shares by gift or otherwise without consideration, the Fair Market Value of the shares on the date of the breach of any restrictive covenant agreement or activity constituting Cause), net of the price originally paid by the Participant for the shares.  The Participant agrees that payment by the Participant shall be made in such manner and on such terms and conditions as may be required by the Committee and the Employer shall be entitled to set off against the amount of any such payment any amounts otherwise owed to the Participant 

 

6

 

by the Employer.  In addition, the Participant agrees that the Option shall be subject to any applicable clawback or recoupment policies, share trading policies and other policies that may be implemented by the Board from time to time.

 

14.                               Applicable Law.  The validity, construction, interpretation and effect of this Agreement shall be governed by and construed in accordance with the laws of the State of Delaware, without giving effect to the conflicts of laws provisions thereof.

 

15.                               Application of Section 409A of the Code.  This Agreement is intended to be exempt from section 409A of the Internal Revenue Code of 1986, as amended, (the “Code”) and to the extent this Agreement is subject to section 409A of the Code, it shall in all respects be administered in accordance with section 409A of the Code.

 

7

 

TABULA RASA HEALTHCARE, INC.

2016 OMNIBUS INCENTIVE COMPENSATION PLAN

 

RESTRICTED STOCK SUMMARY OF GRANT

 

Tabula Rasa Healthcare, Inc., a Delaware corporation (the “Company”), pursuant to its 2016 Omnibus Incentive Compensation Plan (the “Plan”), hereby grants to the individual listed below (the “Participant”), restricted stock of the Company (“Company Stock”) that may become vested as set forth below (the “Restricted Stock”).  The Restricted Stock is subject in all respects to the terms and conditions set forth herein, in the Restricted Stock Grant Agreement attached hereto as Exhibit A (the “Restricted Stock Grant Agreement”) and the Plan, each of which is incorporated herein by reference and made part hereof.  Unless otherwise defined herein, capitalized terms used in this Restricted Stock Summary of Grant (the “Summary of Grant”) and the Restricted Stock Grant Agreement shall have the meanings set forth in the Plan.

 

	
Participant:
    	
 
    	
[·]
    
	
Date of Grant:
    	
 
    	
[·]
    
	
Total Number of Shares Granted:
    	
 
    	
[·] shares of   Company Stock
    
	
Vesting Schedule:
    	
 
    	
Except as set forth herein, the Restricted Stock   shall vest on the following dates (each, a “Vesting Date”), provided   that the Participant continues to be employed by, or provide service to, the   Employer from the Date of Grant through the applicable Vesting Date:

[·]

The Restricted Stock shall be fully vested on [·] if the   Participant is employed by, or providing services to, the Employer on such   date.
    
	
Vesting Upon Certain Termination and Other Events:
    	
 
    	
[·]
    

 

Participant Acceptance:

 

By signing the acknowledgement below, the Participant agrees to be bound by the terms and conditions of the Plan, the Restricted Stock Grant Agreement and this Summary of Grant and accepts the Restricted Stock.  The Participant accepts as binding, conclusive and final all decisions or interpretations of the Committee upon any questions arising under the Plan, this Summary of Grant or the Restricted Stock Grant Agreement.

 

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The Participant acknowledges delivery of the Plan and the Plan prospectus together this with this Summary of Grant and the Restricted Stock Grant Agreement.  Additional copies of the Plan and the Plan prospectus are available by contacting [·] at [·].

 

	
 
    	
Agreed and accepted:
    
	
 
    	
 
    
	
 
    	
 
    
	
 
    	
Participant
    
	
 
    	
 
    
	
 
    	
 
    
	
 
    	
Date
    

 

9

 

EXHIBIT A

 

TABULA RASA HEALTHCARE, INC.

 

RESTRICTED STOCK GRANT AGREEMENT

(Pursuant to the 2016 Omnibus Incentive Compensation Plan)

 

This Restricted Stock Grant Agreement (this “Agreement”) is delivered by Tabula Rasa Healthcare, Inc., a Delaware corporation (the “Company”), pursuant to the Summary of Grant delivered with this Agreement to the individual named in the Summary of Grant (the “Participant”).  The Summary of Grant, which specifies the Participant, the date as of which the grant is made (the “Date of Grant”), the vesting schedule and other specific details of the grant is incorporated herein by reference.

 

1.                                      Restricted Stock Grant.  Upon the terms and conditions set forth in this Agreement and in the Company’s 2016 Omnibus Incentive Compensation Plan (the “Plan”), the Company hereby grants to the Participant shares of common stock of the Company (“Company Stock”) in the amount and on the terms set forth below, in the Summary of Grant, and in the Plan (the “Restricted Stock”). “). Shares of Restricted Stock may not be transferred by the Participant or subjected to any security interest until the shares have become vested pursuant to this Agreement and the Plan. This Agreement is made pursuant to the Plan and is subject in its entirety to all applicable provisions of the Plan.  Capitalized terms used herein and not otherwise defined shall have the meanings set forth in the Plan.  The Participant agrees to be bound by all of the terms and conditions of the Plan.

 

2.                                      Vesting and Nonassignability of Restricted Stock.

 

(a)                                 The shares of Restricted Stock shall become vested, and the restrictions described in Sections 2(b) and 2(c) shall lapse, upon the Participant’s satisfaction of the requirements of the Vesting Schedule set forth in the Summary of Grant.

 

(b)                                 If the Participant ceases to be employed by, or provide service to, the Employer for any reason before the Restricted Stock fully vests, the shares of Restricted Stock that are not then vested shall be forfeited and must be immediately returned to the Company.

 

(c)                                  During the period before the shares of Restricted Stock vest (the “Restriction Period”), the non-vested Restricted Stock may not be assigned, transferred, pledged or otherwise disposed of by the Participant. Any attempt to assign, transfer, pledge or otherwise dispose of the shares contrary to the provisions hereof, and the levy of any execution, attachment or similar process upon the shares, shall be null, void and without effect.

 

3.                                      Issuance of Certificate.

 

(a)                                 Stock certificates representing the Restricted Stock may be issued by the Company and held in escrow by the Company until the Restricted Stock vests, or the Company may hold non-certificated shares until the Restricted Stock vests. During the Restriction Period, the Participant shall receive any cash dividends with respect to the shares of Restricted Stock, may vote the shares of Restricted Stock and may participate in any distribution pursuant to a plan of dissolution or complete liquidation of the Company. In the event of a dividend or distribution 

 

10

 

payable in stock or other property or a reclassification, split up or similar event during the Restriction Period, the shares or other property issued or declared with respect to the non-vested shares of Restricted Stock shall be subject to the same terms and conditions relating to vesting as the shares to which they relate.

 

(b)                                 Except as set forth in the Summary of Grant, when the Participant obtains a vested right to shares of Restricted Stock, a certificate representing the vested shares shall be issued to the Participant, free of the restrictions under Section 2 of this Agreement.

 

(c)                                  The obligation of the Company to deliver shares upon the vesting of the Restricted Stock shall be subject to all applicable laws, rules, and regulations and such approvals by governmental agencies as may be deemed appropriately to comply with relevant securities laws and regulations.

 

4.                                      Change of Control.  Unless otherwise set forth in the Summary of Grant, the provisions of the Plan applicable to a Change of Control shall apply to the Restricted Stock, and, in the event of a Change of Control, the Committee may take such actions as it deems appropriate pursuant to the Plan.

 

5.                                      Grant Subject to Plan Provisions. This grant is made pursuant to the Plan, the terms of which are incorporated herein by reference, and in all respects shall be interpreted in accordance with the Plan.  This grant is subject to interpretations, regulations and determinations concerning the Plan established from time to time by the Committee in accordance with the provisions of the Plan, including, but not limited to, provisions pertaining to (a) rights and obligations with respect to withholding taxes, (b) the registration, qualification or listing of the shares, (c) changes in capitalization of the Company and (d) other requirements of applicable law.  The Committee shall have the authority to interpret and construe this grant pursuant to the terms of the Plan, and its decisions shall be conclusive as to any questions arising hereunder.

 

6.                                      Withholding.  All obligations of the Company under this Agreement shall be subject to the rights of the Company as set forth in the Plan to withhold amounts required to be withheld for any taxes, if applicable.  Subject to Committee approval, the Participant may elect to satisfy any tax withholding obligation of the Employer with respect to the Restricted Stock by having shares of Company Stock withheld up to an amount that does not exceed the applicable withholding tax rate for federal (including FICA), state and local tax liabilities.  Unless the Committee determines otherwise, share withholding for taxes shall not exceed the Participant’s minimum applicable tax withholding amount.

 

7.                                      Section 83(b) Election.  The Participant hereby acknowledges that the Participant has been informed that, with respect to the Restricted Stock, the Participant may file an election with the Internal Revenue Service, within 30 days of the execution of this Agreement, electing pursuant to Section 83(b) of the Internal Revenue Code of 1986, as amended, (the “Code”) to be taxed currently on any difference between the purchase price of the Restricted Stock and their fair market value on the date of purchase. Absent such an election, taxable income will be measured and recognized by the Participant at the time or times at which the forfeiture restrictions on the Restricted Stock lapse. The Participant is strongly encouraged to seek the advice of his own tax consultants in connection with the issuance of the Restricted Stock and the 

 

11

 

advisability of filing of the election under Section 83(b) of the Code. A form of Election under Section 83(b) is attached hereto as Exhibit B for reference.

 

THE PARTICIPANT ACKNOWLEDGES THAT IT IS NOT THE COMPANY’S, BUT RATHER THE PARTICIPANT’S SOLE RESPONSIBILITY TO FILE THE ELECTION UNDER SECTION 83(b) TIMELY.

 

8.                                      Entire Agreement.  This Agreement contains the entire agreement of the parties with respect to the Restricted Stock granted hereby and may not be changed orally but only by an instrument in writing signed by the party against whom enforcement of any change, modification or extension is sought.

 

9.                                      No Employment or Other Rights.  This Agreement shall not confer upon the Participant any right to be retained in the employment of the Employer and shall not interfere in any way with the right of the Employer to terminate the Participant’s employment at any time.  The right of the Employer to terminate at will the Participant’s employment at any time for any reason is specifically reserved.

 

10.                               Notice.  Any notice to the Company provided for in this instrument shall be addressed to the Company in care of the General Counsel at the Company’s corporate headquarters, and any notice to the Participant shall be addressed to such Participant at the current address shown on the payroll records of the Company, or to such other address as the Participant may designate to the Company in writing.  Any notice shall be delivered by hand, sent by telecopy or enclosed in a properly sealed envelope addressed as stated above, registered and deposited, postage prepaid, in a post office regularly maintained by the United States Postal Service.

 

11.                               Assignment by Company.  The rights and protections of the Company hereunder shall extend to any successors or assigns of the Company and to the Company’s parents, subsidiaries, and affiliates. This Agreement may be assigned by the Company without the Participant’s consent.

 

12.                               Recoupment Policy.  The Participant agrees that, subject to the requirements of applicable law, if the Participant breaches any restrictive covenant agreement between the Participant and the Employer or otherwise engages in activities that constitute Cause either while employed by, or providing service to, the Employer or within two years thereafter, the Company may require that the Participant forfeit any unvested Restricted Stock and/or return to the Company all, or such portion as the Committee may determine, of the vested Restricted Stock then held by the Participant, as applicable on such terms as the Committee shall determine; in the event that the Participant no longer owns the shares, the Participant shall pay to the Company the amount of any gain realized or payment received as a result of any sale or other disposition of the shares (or, in the event the Participant transfers the shares by gift or otherwise without consideration, the Fair Market Value of the shares on the date of the breach of any restrictive covenant agreement or activity constituting Cause).  The Participant agrees that payment by the Participant shall be made in such manner and on such terms and conditions as may be required by the Committee and the Employer shall be entitled to set off against the amount of any such payment any amounts otherwise owed to the Participant by the Employer.  In addition, the 

 

12

 

Participant agrees that the Restricted Stock shall be subject to any applicable clawback or recoupment policies, share trading policies and other policies that may be implemented by the Board from time to time.

 

13.                               Applicable Law.  The validity, construction, interpretation and effect of this Agreement shall be governed by and construed in accordance with the laws of the State of Delaware, without giving effect to the conflicts of laws provisions thereof.

 

14.                               Application of Section 409A of the Code.  This Agreement is intended to be exempt from section 409A of the Code and to the extent this Agreement is subject to section 409A of the Code, it shall in all respects be administered in accordance with section 409A of the Code.

 

13THE
SECURITIES TO WHICH THIS PRIVATE PLACEMENT SUBSCRIPTION AGREEMENT RELATES HAVE NOT BEEN REGISTERED WITH THE SECURITIES AND EXCHANGE
COMMISSION OR THE SECURITIES COMMISSION OF ANY STATE, AND WILL BE ISSUED IN RELIANCE UPON AN EXEMPTION FROM REGISTRATION UNDER
THE SECURITIES ACT OF 1933, AS AMENDED (THE “1933 ACT”).

 

NONE
OF THE SECURITIES TO WHICH THIS SUBSCRIPTION AGREEMENT RELATES HAVE BEEN REGISTERED UNDER THE 1933 ACT, OR ANY U.S. STATE SECURITIES
LAWS, AND, UNLESS SO REGISTERED, NONE MAY BE OFFERED, SOLD, PLEDGED OR OTHERWISE TRANSFERRED, DIRECTLY OR INDIRECTLY, IN THE UNITED
STATES OR TO, OR FOR THE ACCOUNT OR BENEFIT OF, U.S. PERSONS (AS DEFINED HEREIN), EXCEPT IN ACCORDANCE WITH THE PROVISIONS OF
REGULATION S UNDER THE 1933 ACT, PURSUANT TO AN EFFECTIVE REGISTRATION STATEMENT UNDER THE 1933 ACT, OR PURSUANT TO AN AVAILABLE
EXEMPTION FROM, OR IN A TRANSACTION NOT SUBJECT TO, THE REGISTRATION REQUIREMENTS OF THE 1933 ACT AND IN EACH CASE ONLY IN ACCORDANCE
WITH APPLICABLE U.S. STATE AND FOREIGN SECURITIES LAWS. HEDGING TRANSACTIONS INVOLVING THE SECURITIES MAY NOT BE CONDUCTED UNLESS
IN COMPLIANCE WITH THE 1933 ACT.

 

bBOOTH,
INC.

(the “Issuer”)

 

PRIVATE
PLACEMENT SUBSCRIPTION AGREEMENT

 

INSTRUCTIONS
TO SUBSCRIBER

 

	1.	You
    must complete all the information in the boxes on page 2 and sign where indicated with an “X”.
	 	 
	2.	If
    you are NOT a “U.S. Purchaser” (as defined in Exhibit B) and are resident in Canada, you must complete and sign
    Exhibit A, “Non-US Investor Questionnaire”, that starts on page 18. 
	 	 
	3.	If
    you are a “U.S. Purchaser” (as defined in Exhibit B), you must complete and sign Exhibit B, “U.S. Investor
    Questionnaire”, that starts on page 23.
	 	 
	4.	If
    you are paying for your subscription with funds drawn from a Canadian bank, you may pay by wire transfer to the Issuer,
    pursuant to the wiring instructions set out in Exhibit C that is on page 24. If the funds are wired or sent to the Issuer’s
    legal counsel, you irrevocably authorize such legal counsel to immediately deliver the funds to the Issuer. 

 

     

    	 	 - 2 -	 

    

 

bBOOTH,
INC.

 

PRIVATE
PLACEMENT SUBSCRIPTION AGREEMENT

 

The
undersigned (the “Subscriber”) hereby irrevocably subscribes for and agrees to purchase from bBooth, Inc. (the
“Issuer”) that number of shares of common stock in the capital of the Issuer (each, a “Share”)
as is set out below at a price of US$_____ per Share. The Subscriber agrees to be bound by the terms and conditions set forth
in the attached “Terms and Conditions of Subscription for Shares”.

 

	Subscriber
    Information  	 	Shares
    to be Purchased
	 	 	 
	 	 	 
	(Name
    of Subscriber)	 	 (Number
    of Shares)

 

	Account
    Reference (if applicable): 	 	 

 

	X	 	Total
    Subscription Price:	 
	(Signature
    of Subscriber – if the Subscriber is an Individual)	 	 	(the
    “Subscription Amount”, plus wire fees if applicable)

 

	X	 	 
	(Signature
    of Authorized Signatory – if the Subscriber is not an Individual)	 	Please
    complete if purchasing as agent or trustee for a principal (beneficial purchaser) (a “Disclosed Principal”) and
    not purchasing as trustee or agent for accounts fully managed by it.
	 	 	 
	(Name
    and Title of Authorized Signatory – if the Subscriber is not an Individual)	 	(Name
    of Disclosed Principal)
	 	 	 
	 	 	 
	(SIN,
    SSN, or other Tax Identification Number of the Subscriber)	 	(Address
    of Disclosed Principal)
	 	 	 
	 	 	 
	(Subscriber’s
    Address, including postal or zip code)	 	(Account
    Reference, if applicable)
	 	 	 
	 	 	 
	 	 	(SIN,
    SSN, or other Tax Identification Number of Disclosed Principal)
	(Telephone
    Number)                                          (Email
    Address)	 	 
	 	 	 
	Register
    the Shares as set forth below:	 	Deliver
    the Shares as set forth below:
	 	 	 
	 	 	 
	(Name
    to Appear on Share Certificate)	 	(Attention
    - Name)
	 	 	 
	 	 	 
	(Account
    Reference, if applicable)	 	(Account
    Reference, if applicable)
	 	 	 
	 	 	 
	(Address,
    including postal or zip code)	 	(Street
    Address, including postal or zip code – no PO Boxes permitted)
	 	 	 
	 	 	 
	 	 	(Telephone
    Number)
	 	 	 
	Number
    and kind of securities of the Issuer held, directly or indirectly, or over which control or direction is exercised by, the
    Subscriber, if any (i.e., shares, warrants, options):	 	 
	 	 	 
	 	 	 
	 	 	 
	 	 	 

 

     

    	 	 - 3 -	 

    

 

ACCEPTANCE

 

The
Issuer hereby accepts the Subscription (as defined herein) on the terms and conditions contained in this private placement subscription
agreement (this “Agreement”) as of the _____ day of _________________________, 2016.

 

bBOOTH,
INC.

 

	Per:
    	 	 
	 	Authorized
    Signatory	 

 

	Address:	346 S. Hauser Blvd., Suite 210	 
	 	Los Angeles, CA, USA 90036	 
	Phone:	855
    250-2300	 
	Fax:	(646)
    349-1623	 
	Email:
    	rory@bbooth.com	 
	Attention:	Rory
    J. Cutaia, CEO	 

 

     

    	 	 - 4 -	 

    

 

TERMS
AND CONDITIONS OF SUBSCRIPTION FOR SHARES 

 

	1.	Subscription

 

1.1       On
the basis of the representations and warranties, and subject to the terms and conditions, set forth in this Agreement, the Subscriber
hereby irrevocably subscribes for and agrees to purchase such number of Shares as is set forth on page 2 of this Agreement at
a price of $_____ per Share for the Subscription Amount shown on page 2 of this Agreement, which is tendered herewith (such subscription
and agreement to purchase being the “Subscription”), and the Issuer agrees to sell the Shares to the Subscriber,
effective upon the Issuer’s acceptance of this Agreement.

 

1.2       The
Subscriber acknowledges that the Shares have been offered to the Subscriber as part of an offering by the Issuer (the “Offering”).

 

1.3       All
dollar amounts referred to in this Agreement are in lawful money of the United States of America, unless otherwise indicated.

 

	2.	Payment

 

2.1       The
Subscription Amount must accompany this Subscription and will be paid: (i) if the Subscriber is drawing funds from a Canadian
bank to pay for this Subscription, by a certified check or bank draft drawn on a Canadian chartered bank or by wire transfer to
the Issuer pursuant to wiring instructions provided by the Issuer set out in Exhibit C annexed hereto; or (ii) if the Subscriber
is drawing funds from any source other than a Canadian chartered bank to pay for this Subscription, then by bank draft, certified
check or by wire transfer to the Issuer pursuant to wiring instructions provided by the Issuer set out in Exhibit C annexed hereto.
Any Subscription Amount received by the Issuer in advance of the Closing (as defined below) will be held in trust by the Issuer
for the Subscriber until the Closing and shall not bear interest.

 

2.2       The
completion of the purchase and sale of the Shares subscribed for hereunder and the issuance of the Shares subscribed for pursuant
to this Agreement (the “Closing”) will take place on such date or dates as determined by the Issuer. The Subscriber
acknowledges and agrees that this Agreement, the Subscription Amount and any other documents delivered in connection herewith
will be held by the Issuer in escrow until the first Closing. In the event that this Agreement is not accepted by the Issuer for
whatever reason, which the Issuer expressly reserves the right to do, the Issuer will return the Subscription Amount (without
interest thereon) to the Subscriber at the address of the Subscriber as set forth on page 2 of this Agreement, or as otherwise
directed by the Subscriber.

 

	3.	Documents
                                         Required from Subscriber

 

3.1       The
Subscriber must complete, sign and return to the Issuer the following documents:

 

	 	(a)	this
    Agreement;
	 	 	 
	 	(b)	if
    the Subscriber is not a U.S. Purchaser (as defined in Exhibit B) and is resident in Canada, the Non-U.S. Investor Questionnaire
    (the “Non-U.S. Questionnaire”) attached as Exhibit A that starts on page 18;
	 	 	 
	 	(c)	if
    the Subscriber is a U.S. Purchaser (as defined in Exhibit B), the U.S. Investor Questionnaire (the “U.S. Questionnaire”
    and, together with the Non-U.S. Questionnaire, the “Questionnaires”) attached as Exhibit B that starts
    on page 23; and
	 	 	 
	 	(d)	such
    other supporting documentation as the Issuer or the Issuer’s legal counsel (the “Issuer’s Counsel”)
    may request to establish the Subscriber’s qualification as a qualified investor,

 

     

    	 	 - 5 -	 

    

 

and
the Subscriber acknowledges and agrees that the Issuer will not consider the Subscription for acceptance unless the Subscriber
has provided all of such documents to the Issuer.

 

3.2       As
soon as practicable upon any request by the Issuer, the Subscriber will complete, sign and return to the Issuer any additional
documents, questionnaires, notices and undertakings as may be reasonably required by any regulatory authorities or applicable
laws.

 

3.3       The
Issuer and the Subscriber acknowledge and agree that the Issuer’s Counsel has acted as counsel only to the Issuer and is
not protecting the rights and interests of the Subscriber. The Subscriber acknowledges and agrees that the Issuer and the Issuer’s
Counsel have given the Subscriber the opportunity to seek, and are hereby recommending that the Subscriber obtain, independent
legal advice with respect to the subject matter of this Agreement and, further, the Subscriber hereby represents and warrants
to the Issuer and the Issuer’s Counsel that the Subscriber has sought independent legal advice or waives such advice.

 

	4.	Conditions
                                         and Closing

 

4.1       The
date of the Closing (the “Closing Date”) will occur on such date or dates as may be determined by the Issuer
in its sole discretion. The Issuer may, at its discretion, elect to close the Offering in one or more closings.

 

4.2       The
Closing will be conditional upon and subject to:

 

	 	(a)	the
    Issuer obtaining all necessary approvals and consents for the Offering; 
	 	 	 
	 	(b)	the
    Issuer receiving a completed copy of this Agreement, the applicable Questionnaires and the Subscription Amount; and
	 	 	 
	 	(c)	the
    issue and sale of the Shares being exempt from the requirement to file a prospectus and the requirement to deliver an offering
    memorandum under applicable securities laws relating to the sale of the Shares, or the Issuer having received such orders,
    consents or approvals as may be required to permit such sale without the requirement to file a prospectus or deliver an offering
    memorandum.

 

4.3       The
Subscriber acknowledges that a certificate representing the Shares will be available for delivery to the Subscriber within five
business days of the Closing Date.

 

	5.	Acknowledgements
                                         and Agreements of the Subscriber

 

5.1       The
Subscriber acknowledges and agrees that:

 

	 	(a)	none
    of the Shares have been or will be registered under the United States Securities Act of 1933, as amended, (the “1933
    Act”), or under any securities or “blue sky” laws of any state of the United States, and, unless so
    registered, may not be offered or sold in the United States or, directly or indirectly, to any U.S. Person (as defined in
    Regulation S promulgated under the 1933 Act (“Regulation S”)), except in accordance with the provisions
    of Regulation S, pursuant to an effective registration statement under the 1933 Act, or pursuant to an exemption from, or
    in a transaction not subject to, the registration requirements of the 1933 Act, and in each case only in accordance with applicable
    state, provincial and foreign securities laws; 

 

     

    	 	 - 6 -	 

    

 

	 	(b)	the
    Issuer has not undertaken, and will have no obligation, to register any of the Shares under the 1933 Act or any other applicable
    securities laws;
	 	 	 
	 	(c)	the
    Issuer will refuse to register the transfer of any of the Shares to a person in the United States, to a U.S. Person or to
    a person acting for the account or benefit of a U.S. Person not made pursuant to an effective registration statement under
    the 1933 Act or pursuant to an available exemption from the registration requirements of the 1933 Act and in each case in
    accordance with all applicable securities laws;
	 	 	 
	 	(d)	the
    Issuer and others will rely upon the truth and accuracy of the acknowledgements, representations, warranties, covenants and
    agreements of the Subscriber contained in this Agreement and the Questionnaires, as applicable, and agrees that if any of
    such acknowledgements, representations and agreements are no longer accurate or have been breached, the Subscriber will promptly
    notify the Issuer;
	 	 	 
	 	(e)	there
    are risks associated with the purchase of the Securities, including the risk that the Subscriber may lose the entire Subscription
    Amount;
	 	 	 
	 	(f)	the
    Subscriber and the Subscriber’s advisor(s) have had a reasonable opportunity to ask questions of, and receive answers
    from, the Issuer in connection with the distribution of the Shares hereunder, and to obtain additional information, to the
    extent possessed or obtainable without unreasonable effort or expense, necessary to verify the accuracy of the information
    about the Issuer;
	 	 	 
	 	(g)	finder’s
    fees or broker’s commissions may be payable by the Issuer to finders who introduce subscribers to the Issuer in connection
    with the Offering;
	 	 	 
	 	(h)	the
    books and records of the Issuer were available upon reasonable notice for inspection, subject to certain confidentiality restrictions,
    by the Subscriber during reasonable business hours at its principal place of business, and all documents, records and books
    in connection with the distribution of the Shares hereunder have been made available for inspection by the Subscriber and/or
    its advisor(s);
	 	 	 
	 	(i)	all
    of the information which the Subscriber has provided to the Issuer is correct and complete and if there should be any change
    in such information prior to the Closing, the Subscriber will immediately notify the Issuer, in writing, of the details of
    any such change;
	 	 	 
	 	(j)	the
    Issuer is entitled to rely on the representations and warranties of the Subscriber contained in this Agreement and the Questionnaires,
    as applicable, and the Subscriber will hold harmless the Issuer from any loss or damage it or they may suffer as a result
    of the Subscriber’s failure to correctly complete this Agreement or the Questionnaires;
	 	 	 
	 	(k)	any
    resale of the Shares by the Subscriber will be subject to resale restrictions contained in the securities laws applicable
    to the Issuer, the Subscriber and any proposed transferee, including resale restrictions imposed under United States and Canadian
    securities laws, and it is the responsibility of the Subscriber to find out what applicable resale restrictions are and to
    comply with such restrictions before selling any of the Shares;

 

     

    	 	 - 7 -	 

    

 

	 	(l)	the
    Subscriber has been advised to consult the Subscriber’s own legal, tax and other advisors with respect to the merits
    and risks of an investment in the Shares and with respect to applicable resale restrictions, and it is solely responsible
    (and the Issuer is not in any way responsible) for compliance with:

 

	 	(i)	any
    applicable laws of the jurisdiction in which the Subscriber is resident in connection with the distribution of the Shares
    hereunder, and
	 	 	 
	 	(ii)	applicable
    resale restrictions with respect to the Shares; 

 

	 	(m)	there
    may be material tax consequences to the Subscriber of an acquisition or disposition of the Shares, and the Issuer gives no
    opinion and makes no representation to the Subscriber with respect to the tax consequences to the Subscriber under federal,
    state, provincial, local or foreign tax laws that may apply to the Subscriber’s acquisition or disposition of the Shares;
    
	 	 	 
	 	(n)	the
    Issuer has advised the Subscriber that the Issuer is relying on an exemption from the requirements to provide the Subscriber
    with a prospectus and to sell the Shares through a person registered to sell securities under applicable securities laws,
    and, as a consequence of acquiring the Shares pursuant to such exemption, certain protections, rights and remedies provided
    by applicable securities laws, such as statutory rights of rescission or damages, will not be available to the Subscriber;
	 	 	 
	 	(o)	no
    documents in connection with the issuance of the Shares have been reviewed by the United States Securities and Exchange Commission
    (the “SEC”) or any other securities regulators;
	 	 	 
	 	(p)	neither
    the SEC nor any Canadian securities commissions or similar regulatory authorities in any other jurisdictions have reviewed
    or passed on the merits of any of the Shares; 
	 	 	 
	 	(q)	there
    is no government or other insurance covering any of the Shares;
	 	 	 
	 	(r)	the
    Shares are “restricted securities” as such term is defined under Rule 144 of the 1933 Act and will be subject
    to a hold period in relation to offers and sales of the Shares thereunder, which may be an indefinite period of time;
	 	 	 
	 	(s)	 if
    it decides to offer, sell, pledge or otherwise transfer, directly or indirectly, any of the Shares absent registration under
    the 1933 Act, it will not offer, sell, pledge or otherwise transfer, directly or indirectly, any of the Shares, except:

 

	 	(i)	to
    the Issuer, 
	 	 	 
	 	(ii)	outside
    the United States in an “offshore transaction” in compliance with the requirements of Rule 904 of Regulation S,
    if available, and in compliance with applicable local laws and regulations,
	 	 	 
	 	(iii)	in
    compliance with an exemption from registration under the 1933 Act provided by Rule 144 thereunder, if available, and in accordance
    with any applicable state securities laws, or

 

     

    	 	 - 8 -	 

    

 

	 	(iv)	in
    a transaction that does not require registration under the 1933 Act or any applicable state securities laws, and
	 	 	 
	 	(v)	in
    the case of subparagraph (iii) or (iv), it has furnished to the Issuer an opinion of counsel of recognized standing in form
    and substance reasonably satisfactory to counsel to the Issuer’s Counsel to such effect; and

 

	 	(t)	this
    Agreement is not enforceable by the Subscriber unless it has been accepted by the Issuer and the Issuer reserves the right
    to reject this Subscription for any reason.

 

	6.	Representations
                                         and Warranties of the Subscriber

 

6.1       The
Subscriber hereby represents and warrants to the Issuer (which representations and warranties will survive the Closing) that:

 

	 	(a)	the
    Subscriber is resident in the jurisdiction set out on page 2 of this Agreement;
	 	 	 
	 	(b)	unless
    the Subscriber has completed Exhibit B, in which case the Subscriber makes the representations and warranties contained therein:

 

	 	(i)	the
    Subscriber is not in the United States, is not a U.S. Person, is not purchasing the Shares for the account or benefit of a
    U.S. Person, did not receive the offer to buy the Shares while in the United States and it (or its authorized signatory) was
    outside of the United States at the time its buy order was placed and this Agreement was executed,
	 	 	 
	 	(ii)	offers
    and/or sales of any of the Shares prior to the expiration of the period specified in Regulation S (such period referred to
    herein as the “Distribution Compliance Period”) shall only be made in compliance with the safe harbor provisions
    set forth in Regulation S, pursuant to the registration provisions of the 1933 Act or pursuant to an exemption therefrom,
    and all offers and sales after the Distribution Compliance Period shall be made only in compliance with the registration provisions
    of the 1933 Act or an exemption therefrom, and in each case only in accordance with applicable state, provincial and foreign
    securities laws,
	 	 	 
	 	(iii)	it
    has not acquired the Shares as a result of, and will not itself engage in, any “directed selling efforts” (as
    defined in Regulation S) in the United States in respect of any of the Shares, which would include any activities undertaken
    for the purpose of, or that could reasonably be expected to have the effect of, conditioning the market in the United States
    for the sale of the Shares, and
	 	 	 
	 	(iv)	hedging
    transactions involving the Shares may not be conducted unless such transactions are in compliance with the provisions of the
    1933 Act and in each case only in accordance with applicable securities laws;

 

	 	(c)	if
    the Subscriber is resident outside of Canada and the United States:

 

	 	(i)	the
    Subscriber is knowledgeable of, or has been independently advised as to, the applicable securities laws having application
    in the jurisdiction in which the Subscriber is resident (the “International Jurisdiction”) which would
    apply to the offer and sale of the Shares,

 

     

    	 	 - 9 -	 

    

 

	 	(ii)	the
    Subscriber is purchasing the Shares pursuant to exemptions from prospectus or equivalent requirements under applicable laws
    or, if such is not applicable, the Subscriber is permitted to purchase the Shares under applicable securities laws of the
    International Jurisdiction without the need to rely on any exemptions,
	 	 	 
	 	(iii)	the
    applicable securities laws of the International Jurisdiction do not require the Issuer to make any filings or seek any approvals
    of any kind from any securities regulator of any kind in the International Jurisdiction in connection with the offer, issue,
    sale or resale of any of the Shares,
	 	 	 
	 	(iv)	the
    purchase of the Shares by the Subscriber does not trigger:

 

	 	A.	any
    obligation to prepare and file a prospectus or similar document, or any other report with respect to such purchase in the
    International Jurisdiction, or
	 	 	 
	 	B.	any
    continuous disclosure reporting obligation of the Issuer in the International Jurisdiction, and

 

	 	(v)	the
    Subscriber will, if requested by the Issuer, deliver to the Issuer a certificate or opinion of local counsel from the International
    Jurisdiction which will confirm the matters referred to in subparagraphs (ii), (iii) and (iv) above to the satisfaction of
    the Issuer, acting reasonably;

 

	 	(d)	the
    Subscriber: (i) has adequate net worth and means of providing for its current financial needs and possible personal contingences,
    (ii) has no need for liquidity in this investment, (iii) has such knowledge and experience in business matters as to be capable
    of evaluating the merits and risks of its prospective investment in the Shares, (iv) is able to bear the economic risks of
    an investment in the Shares for an indefinite period of time, and (v) can afford the complete loss of the Subscription Amount;
	 	 	 
	 	(e)	the
    Subscriber has the legal capacity and competence to enter into and execute this Agreement and to take all actions required
    pursuant hereto and, if the Subscriber is a corporate entity, it is duly incorporated and validly subsisting under the laws
    of its jurisdiction of incorporation and all necessary approvals by its directors, shareholders and others have been obtained
    to authorize execution and performance of this Agreement on behalf of the Subscriber;
	 	 	 
	 	(f)	the
    entering into of this Agreement and the transactions contemplated hereby do not result in the violation of any of the terms
    and provisions of any law applicable to, or, if applicable, the constating documents of, the Subscriber, or of any agreement,
    written or oral, to which the Subscriber may be a party or by which the Subscriber is or may be bound;
	 	 	 
	 	(g)	the
    Subscriber has duly executed and delivered this Agreement and it constitutes a valid and binding agreement of the Subscriber,
    enforceable against the Subscriber in accordance with its terms;
	 	 	 
	 	(h)	the
    Subscriber has received and carefully read this Agreement;
	 	 	 
	 	(i)	the
    Subscriber is aware that an investment in the Issuer is speculative and involves certain risks, including that the Subscriber
    could lose its entire investment;

 

     

    	 	 - 10 -	 

    

 

	 	(j)	the
    Subscriber has made an independent examination and investigation of an investment in the Shares and the Issuer and agrees
    that the Issuer will not be responsible in any way for the Subscriber’s decision to invest in the Shares;
	 	 	 
	 	(k)	the
    Subscriber is purchasing the Shares as principal for its own account for investment purposes only and not for the account
    of any other person, and not for distribution, assignment or resale to others, and no other person has a direct or indirect
    beneficial interest in the Shares, and the Subscriber has not subdivided its interest in any of the Shares with any other
    person;
	 	 	 
	 	(l)	the
    Subscriber is not an underwriter of, or dealer in, any of the Shares, nor is the Subscriber participating, pursuant to a contractual
    agreement or otherwise, in the distribution of the Shares;
	 	 	 
	 	(m)	the
    Subscriber is not aware of any advertisement of any of the Shares and is not acquiring the Shares as a result of any form
    of general solicitation or general advertising, including advertisements, articles, notices or other communications published
    in any newspaper, magazine or similar media, or broadcast over radio or television, or any seminar or meeting whose attendees
    have been invited by general solicitation or general advertising; 
	 	 	 
	 	(n)	no
    person has made to the Subscriber any written or oral representations:

 

	 	(i)	that
    any person will resell or repurchase any of the Shares,
	 	 	 
	 	(ii)	that
    any person will refund the purchase price of any of the Shares, or
	 	 	 
	 	(iii)	as
    to the future price or value of any of the Shares;

 

	 	(o)	the
    funds representing the Subscription Amount will not represent proceeds of crime for the purposes of the Uniting and Strengthening
    America by Providing Appropriate Tools Required to Intercept and Obstruct Terrorism Act (the “PATRIOT Act”)
    and the Subscriber acknowledges that the Issuer may in the future be required by law to disclose the Issuer’s name and
    other information relating to this Agreement and the Subscription, on a confidential basis, pursuant to the PATRIOT Act; 
	 	 	 
	 	(p)	no
    portion of the Subscription Amount to be provided by the Subscriber: (i) has been or will be derived from or related to any
    activity that is deemed criminal under the laws of the United States of America, or any other jurisdiction, or (ii) is being
    tendered on behalf of a person or entity who has not been identified to or by the Subscriber; and
	 	 	 
	 	(q)	the
    Subscriber shall promptly notify the Issuer if the Subscriber discovers that any of the foregoing representations ceases to
    be true and will provide the Issuer with appropriate information in connection therewith.

 

6.2       In
this Agreement, the term “U.S. Person” has the meaning ascribed thereto in Regulation S, and, for the purpose
of this Agreement, includes, but is not limited to: (a) any person in the United States; (b) any natural person resident in the
United States; (c) any partnership or corporation organized or incorporated under the laws of the United States; (d) any partnership
or corporation organized outside the United States by a U.S. Person principally for the purpose of investing in securities not
registered under the 1933 Act, unless it is organized or incorporated, and owned, by accredited investors who are not natural
persons, estates or trusts; or (e) any estate or trust of which any executor or administrator or trustee is a U.S. Person.

 

     

    	 	 - 11 -	 

    

 

	7.	Representations
                                         and Warranties will be Relied Upon by the Issuer

 

7.1       The
Subscriber acknowledges and agrees that the representations and warranties contained in this Agreement and the Questionnaires,
as applicable, are made by the Subscriber with the intention that such representations and warranties will be relied upon by the
Issuer and the Issuer’s Counsel in determining the Subscriber’s eligibility to purchase the Shares under applicable
laws, or, if applicable, the eligibility of others on whose behalf the Subscriber is contracting hereunder to purchase the Shares
under applicable laws. The Subscriber further agrees that, by accepting delivery of the certificate(s) representing the Shares,
it will be representing and warranting that the representations and warranties contained herein are true and correct at the time
of delivery with the same force and effect as if they had been made by the Subscriber at such time, and that they will survive
the purchase by the Subscriber of the Shares, and will continue in full force and effect thereafter for the benefit of the Issuer,
notwithstanding any subsequent disposition by the Subscriber of the Shares.

 

	8.	Legending
                                         of Shares

 

8.1       If
the Subscriber is a U.S. Person, the Subscriber acknowledges that, upon the issuance thereof, and until such time as the same
is no longer required under applicable securities laws, any certificates representing any of the Shares will bear a legend in
substantially the following form:

 

“NONE
OF THE SECURITIES REPRESENTED HEREBY HAVE BEEN REGISTERED UNDER THE UNITED STATES SECURITIES ACT OF 1933, AS AMENDED (THE “1933
ACT”), OR ANY U.S. STATE SECURITIES LAWS, AND, UNLESS SO REGISTERED, NONE MAY BE OFFERED, SOLD, PLEDGED OR OTHERWISE TRANSFERRED,
DIRECTLY OR INDIRECTLY, EXCEPT IN ACCORDANCE WITH THE PROVISIONS OF REGULATION S UNDER THE 1933 ACT, PURSUANT TO AN EFFECTIVE
REGISTRATION STATEMENT UNDER THE 1933 ACT, OR PURSUANT TO AN EXEMPTION FROM, OR IN A TRANSACTION NOT SUBJECT TO, THE REGISTRATION
REQUIREMENTS OF THE 1933 ACT AND IN EACH CASE ONLY IN ACCORDANCE WITH APPLICABLE SECURITIES LAWS.”.

 

8.2       If
the Subscriber is not a U.S. Person, the Subscriber hereby acknowledges that, upon the issuance thereof, and until such time as
the same is no longer required under applicable securities laws, any certificates representing any of the Shares will bear legends
in substantially the following form:

 

“THE
SECURITIES REPRESENTED HEREBY HAVE BEEN OFFERED IN AN OFFSHORE TRANSACTION TO PERSONS WHO ARE NOT IN THE UNITED STATES OR ARE
NOT U.S. PERSONS AND ARE NOT ACTING FOR THE ACCOUNT OR BENEFIT OF U.S. PERSONS PURSUANT TO REGULATION S UNDER THE UNITED STATES
SECURITIES ACT OF 1933, AS AMENDED (THE “1933 ACT”). 

 

NONE
OF THE SECURITIES REPRESENTED HEREBY HAVE BEEN REGISTERED UNDER THE 1933 ACT, OR ANY U.S. STATE SECURITIES LAWS, AND, UNLESS SO
REGISTERED, NONE MAY BE OFFERED, SOLD, PLEDGED OR OTHERWISE TRANSFERRED, DIRECTLY OR INDIRECTLY, EXCEPT IN ACCORDANCE WITH THE
PROVISIONS OF REGULATION S UNDER THE 1933 ACT, PURSUANT TO AN EFFECTIVE REGISTRATION STATEMENT UNDER THE 1933 ACT, OR PURSUANT
TO AN EXEMPTION FROM, OR IN A TRANSACTION NOT SUBJECT TO, THE REGISTRATION REQUIREMENTS OF THE 1933 ACT AND IN EACH CASE ONLY
IN ACCORDANCE WITH APPLICABLE SECURITIES LAWS. IN ADDITION, HEDGING TRANSACTIONS INVOLVING THE SECURITIES MAY NOT BE CONDUCTED
UNLESS IN COMPLIANCE WITH THE 1933 ACT.”

 

     

    	 	 - 12 -	 

    

 

8.3       If
the Subscriber is a resident of Canada, the Subscriber acknowledges that, upon the issuance thereof, and until such time as the
same is no longer required under applicable securities laws, any certificates representing any of the Shares will bear an additional
legend in substantially the following form:

 

“UNLESS
PERMITTED UNDER SECURITIES LEGISLATION, THE HOLDER OF THIS SECURITY MUST NOT TRADE THE SECURITY BEFORE THE DATE THAT IS FOUR MONTHS
AND A DAY AFTER THE LATER OF (I) [INSERT DISTRIBUTION DATE], AND (II) THE DATE THE ISSUER BECAME A REPORTING ISSUER IN ANY PROVINCE
OR TERRITORY.”

 

8.4       The
Subscriber hereby acknowledges and agrees to the Issuer making a notation on its records or giving instructions to the registrar
and transfer agent of the Issuer in order to implement the restrictions on transfer set forth and described in this Agreement.

 

8.5       The
Subscriber acknowledges that any applicable hold periods with respect to the Shares may be indefinite and the Subscriber may not
be able to trade or resell the Shares for an indefinite period.

 

	9.	Collection
                                         of Personal Information

 

9.1       The
Subscriber acknowledges and consents to the fact that the Issuer is collecting the Subscriber’s personal information for
the purpose of fulfilling this Agreement and completing the Offering. The Subscriber acknowledges that its personal information
(and, if applicable, the personal information of those on whose behalf the Subscriber is contracting hereunder) may be included
in record books in connection with the Offering and may be disclosed by the Issuer to: (a) stock exchanges or securities regulatory
authorities; (b) the Issuer’s registrar and transfer agent; (c) any tax authorities; (d) authorities pursuant to any money
laundering or terrorist financing legislation; and (e) any of the other parties involved in the Offering. By executing this Agreement,
the Subscriber is deemed to be consenting to the foregoing collection, use and disclosure of the Subscriber’s personal information
(and, if applicable, the personal information of those on whose behalf the Subscriber is contracting hereunder) for the foregoing
purposes and to the retention of such personal information for as long as permitted or required by applicable laws. Notwithstanding
that the Subscriber may be purchasing the Shares as agent on behalf of an undisclosed principal, the Subscriber agrees to provide,
on request, particulars as to the nature and identity of such undisclosed principal, and any interest that such undisclosed principal
has in the Issuer, all as may be required by the Issuer in order to comply with the foregoing.

 

9.2       The
Subscriber is hereby notified and agrees that:

 

	 	(a)	the
    Issuer may deliver to any securities commission having jurisdiction over the Issuer, the Subscriber or this Subscription,
    including any Canadian provincial securities commissions, the SEC and/or any state securities commissions (collectively, the
    “Commissions”), certain personal information pertaining to the Subscriber, including the Subscriber’s
    full name, residential address and telephone number, the number of Shares or other securities of the Issuer owned by the Subscriber,
    the number of Shares purchased by the Subscriber, the total Subscription Amount paid for the Shares, the prospectus exemption
    relied on by the Issuer and the date of distribution of the Shares;
	 	 	 
	 	(b)	such
    information is being collected indirectly by the Commissions under the authority granted to them in applicable securities
    laws;
	 	 	 
	 	(c)	such
    information is being collected for the purposes of the administration and enforcement of applicable securities laws; and

 

     

    	 	 - 13 -	 

    

 

	 	(d)	the
    Subscriber may contact the following public official in Ontario with respect to questions about the Ontario Securities Commission’s
    indirect collection of such information at the following address and telephone number:

 

Administrative
Assistant to the Director of Corporate Finance

Ontario Securities Commission

Suite 1903, Box 55

20 Queen Street West

Toronto, ON M5H 3S8

Telephone: (416) 593-8086.

 

	10.	Costs

 

10.1       The
Subscriber acknowledges and agrees that all costs and expenses incurred by the Subscriber (including any fees and disbursements
of any special counsel retained by the Subscriber) relating to the purchase of the Shares will be borne by the Subscriber.

 

	11.	Governing
                                         Law

 

11.1       This
Agreement is governed by the laws of the State of Nevada and the federal laws of the United States applicable therein. The Subscriber,
in its personal or corporate capacity and, if applicable, on behalf of each beneficial or undisclosed purchaser for whom it is
acting, irrevocably attorns to the exclusive jurisdiction of the courts of the State of Nevada.

 

	12.	Survival

 

12.1       This
Agreement, including, without limitation, the representations, warranties and covenants contained herein, will survive and continue
in full force and effect and be binding upon the Issuer and the Subscriber, notwithstanding the completion of the purchase of
the Shares by the Subscriber.

 

	13.	Assignment

 

13.1       This
Agreement is not transferable or assignable.

 

	14.	Severability

 

14.1       The
invalidity or unenforceability of any particular provision of this Agreement will not affect or limit the validity or enforceability
of the remaining provisions of this Agreement.

 

	15.	Entire
                                         Agreement

 

15.1       Except
as expressly provided in this Agreement and in the exhibits, agreements, instruments and other documents attached hereto or contemplated
or provided for herein, this Agreement contains the entire agreement between the parties with respect to the sale of the Shares
and there are no other terms, conditions, representations or warranties, whether expressed, implied, oral or written, by statute
or common law, by the Issuer or by anyone else.

 

	16.	Notices

 

16.1       All
notices and other communications hereunder will be in writing and will be deemed to have been duly given if mailed or transmitted
by any standard form of telecommunication, including facsimile, electronic mail or other means of electronic communication capable
of producing a printed copy. Notices to the Subscriber will be directed to the address of the Subscriber set forth on page 2 of
this Agreement and notices to the Issuer will be directed to it at the address of the Issuer set forth on page 3 of this Agreement.

 

     

    	 	 - 14 -	 

    

 

	17.	Counterparts
                                         and Electronic Means

 

17.1       This
Agreement may be executed in any number of counterparts, each of which, when so executed and delivered, will constitute an original
and all of which together will constitute one instrument. Delivery of an executed copy of this Agreement by electronic facsimile
transmission or other means of electronic communication capable of producing a printed copy will be deemed to be execution and
delivery of this Agreement as of the Closing Date.

 

	18.	Exhibits

 

18.1       The
exhibits attached hereto form part of this Agreement.

 

	19.	Indemnity

 

19.1       The
Subscriber will indemnify and hold harmless the Issuer and, where applicable, its directors, officers, employees, agents, advisors
and shareholders, from and against any and all loss, liability, claim, damage and expense whatsoever (including, but not limited
to, any and all fees, costs and expenses whatsoever reasonably incurred in investigating, preparing or defending against any claim,
lawsuit, administrative proceeding or investigation whether commenced or threatened) arising out of or based upon any representation
or warranty of the Subscriber contained in this Agreement, the applicable Questionnaire, or in any document furnished by the Subscriber
to the Issuer in connection herewith being untrue in any material respect, or any breach or failure by the Subscriber to comply
with any covenant or agreement made by the Subscriber to the Issuer in connection therewith.

 

     

    	 	 - 15 -	 

    

 

EXHIBIT
A

 

NON-U.S.
INVESTOR QUESTIONNAIRE

 

TO:bBOOTH,
INC. (the “Issuer”)

 

RE:Purchase
of Shares (the “Shares”) of the Issuer

 

 

 

Capitalized
terms used in this Non-U.S. Investor Questionnaire (this “Questionnaire”)
and not specifically defined have the meaning ascribed to them in the Private Placement Subscription Agreement between the Subscriber
(as defined herein) and the Issuer to which this Exhibit A is attached.

 

In
connection with the purchase by the Subscriber (being the undersigned, or if the undersigned is purchasing the Shares as agent
on behalf of a disclosed beneficial Subscriber, such beneficial Subscriber, will be referred herein as the “Subscriber”)
of the Shares, the Subscriber hereby represents, warrants and certifies (which representations, warranties, covenants and certifications
will survive the Closing) to the Issuer (and acknowledges that the Issuer is relying thereon) that the Subscriber:

 

		(i)	is
                                         purchasing the Shares as principal (or deemed principal under the terms of National Instrument
                                         45-106 - Prospectus and Registration Exemptions adopted by the Canadian Securities
                                         Administrators (“NI 45-106”)); and

 

		(ii)	(A)
                                         is resident in or is subject to the laws of one of the following (check one):

 

	 	[  ]
    Alberta	[  ]
    New Brunswick	[  ]
    Prince Edward Island
	 	 	 	 
	 	[  ]
    British Columbia	[  ]
    Nova Scotia	[  ]
    Quebec
	 	 	 	 
	 	[  ]
    Manitoba	[  ]
    Ontario	[  ]
    Saskatchewan
	 	 	 	 
	 	[  ]
    Newfoundland and Labrador

 

In
connection with the purchase of the Shares, the Subscriber hereby represents, warrants, covenants and certifies that the Subscriber
is an “accredited investor” within the meaning of NI 45-106, by virtue of satisfying one of the following criteria
(YOU MUST ALSO INITIAL OR PLACE A CHECK-MARK ON THE APPROPRIATE LINE BELOW):

 

	[  ]	(a)	a
    person registered under the securities legislation of a jurisdiction of Canada as an adviser or dealer, other than a person
    registered solely as a limited market dealer under one or both of the Securities Act (Ontario) or the Securities
    Act (Newfoundland and Labrador);
	 	 	 
	[  ]	(b)	an
    individual registered or formerly registered under the securities legislation of a jurisdiction of Canada as a representative
    of a person referred to in paragraph (a);
	 	 	 
	[  ]	(c)	an
    individual who, either alone or with a spouse, beneficially owns financial assets having an aggregate realizable value that
    before taxes, but net of any related liabilities, exceeds CDN$1,000,000;
	 	 	 
	[  ]	(d)	an
    individual whose net income before taxes exceeded CDN$200,000 in each of the 2 most recent calendar years or whose net income
    before taxes combined with that of a spouse exceeded CDN$300,000 in each of the 2 most recent calendar years and who, in either
    case, reasonably expects to exceed that net income level in the current calendar year;

 

     

    	 	 - 16 -	 

    

 

	[  ]	(e)	an
    individual who, either alone or with a spouse, has net assets of at least CDN$5,000,000;
	 	 	 
	[  ]	(f)	a
    person, other than an individual or investment fund, that has net assets of at least CDN$5,000,000 as shown on its most recently
    prepared financial statements and that has not been created or used solely to purchase or hold securities as an accredited
    investor as defined in this paragraph (f);
	 	 	 
	[  ]	(g)	an
    investment fund that distributes or has distributed its securities only to

 

	 	(i)	a
    person that is or was an accredited investor at the time of the distribution,
	 	 	 
	 	(ii)	a
    person that acquires or acquired securities in the circumstances referred to in sections 2.10 [Minimum amount investment]
    of NI 45-106, or 2.19 [Additional investment in investment funds] of NI 45-106, or
	 	 	 
	 	(iii)	a
    person described in paragraph (i) or (ii) that acquires or acquired securities under section 2.18 [Investment fund reinvestment]
    of NI 45-106;

 

	[  ]	(h)	an
    investment fund that distributes or has distributed securities under a prospectus in a jurisdiction of Canada for which the
    regulator or, in Québec, the securities regulatory authority, has issued a receipt;
	 	 	 
	[  ]	(i)	a
    trust company or trust company registered or authorized to carry on business under the Trust and Loan Companies Act
    (Canada) or under comparable legislation in a jurisdiction of Canada or a foreign jurisdiction, acting on behalf of a fully
    managed account managed by the trust company or trust company, as the case may be;
	 	 	 
	[  ]	(j)	a
    person acting on behalf of a fully managed account managed by that person, if that person

 

	 	(i)	is
    registered or authorized to carry on business as an adviser or the equivalent under the securities legislation of a jurisdiction
    of Canada or a foreign jurisdiction, and
	 	 	 
	 	(ii)
    	in
    Ontario, is purchasing a security that is not a security of an investment fund;

 

	[  ]	(k)	a
    registered charity under the Income Tax Act (Canada) that, in regard to the trade, has obtained advice from an eligibility
    adviser or an adviser registered under the securities legislation of the jurisdiction of the registered charity to give advice
    on the securities being traded,
	 	 	 
	[  ]	(l)	an
    entity organized in a foreign jurisdiction that is analogous to the entity referred to in paragraph (a) in form and function;
	 	 	 
	[  ]	(m)	a
    person in respect of which all of the owners of interests, direct, indirect or beneficial, except the voting securities required
    by law to be owned by directors, are persons that are accredited investors;
	 	 	 
	[  ]	(n)	an
    investment fund that is advised by a person registered as an adviser or a person that is exempt from registration as an adviser;
    or
	 	 	 
	[  ]	(o)	a
    person that is recognized or designated by the securities regulatory authority or, except in Ontario and Québec, the
    regulator as an accredited investor.

 

     

    	 	 - 17 -	 

    

 

For
the purposes hereof:

 

“control
person” means

 

	 	(i)	a
    person who holds a sufficient number of the voting rights attached to all outstanding voting securities of an issuer to affect
    materially the control of the issuer, or
	 	 	 
	 	(ii)	each
    person in a combination of persons, acting in concert by virtue of an agreement, arrangement, commitment or understanding,
    which holds in total a sufficient number of the voting rights attached to all outstanding voting securities of an issuer to
    affect materially the control of the issuer,

 

and,
if a person or combination of persons holds more than 20% of the voting rights attached to all outstanding voting securities of
an issuer, the person or combination of persons is deemed, in the absence of evidence to the contrary, to hold a sufficient number
of the voting rights to affect materially the control of the issuer;

 

“director”
means

 

	 	(i)	a
    member of the board of directors of a company or an individual who performs similar functions for a company, and 
	 	 	 
	 	(ii)	with
    respect to a person that is not a company, an individual who performs functions similar to those of a director of a company;

 

“eligibility
adviser” means

 

	 	(i)	a
    person that is registered as an investment dealer and authorized to give advice with respect to the type of security being
    distributed; and
	 	 	 
	 	(ii)	in
    Saskatchewan or Manitoba, also means a lawyer who is a practicing member in good standing with a law society of a jurisdiction
    of Canada or a public accountant who is a member in good standing of an institute or association of chartered accountants,
    certified general accountants or certified management accountants in a jurisdiction of Canada provided that the lawyer or
    public accountant must not: 

 

	 	(A)	have
    a professional, business or personal relationship with the issuer, or any of its directors, executive officers, founders or
    control persons, and 
	 	 	 
	 	(B)	have
    acted for or been retained personally or otherwise as an employee, executive officer, director, associate or partner of a
    person that has acted for or been retained by the issuer or any of its directors, executive officers, founders or control
    persons within the previous 12 months;

 

“executive
officer” means, for an issuer, an individual who is

 

	 	(i)	a
    chair, vice-chair or president, 
	 	 	 
	 	(ii)	a
    vice-president in charge of a principal business unit, division or function including sales, finance or production, or 
	 	 	 
	 	(iii)	performing
    a policy-making function in respect of the issuer; 

 

     

    	 	 - 18 -	 

    

 

“foreign
jurisdiction” means a country other than Canada or a political subdivision of a country other than Canada;

 

“founder”
means, in respect of an issuer, a person who,

 

	 	(i)	acting
    alone, in conjunction, or in concert with one or more persons, directly or indirectly, takes the initiative in founding, organizing
    or substantially reorganizing the business of the issuer, and 
	 	 	 
	 	(ii)	at
    the time of the distribution or trade is actively involved in the business of the issuer;

 

“financial
assets” means

 

	 	(i)	cash,
	 	 	 
	 	(ii)	securities,
    or
	 	 	 
	 	(iii)	a
    contract of insurance, a deposit or an evidence of a deposit that is not a security for the purposes of securities legislation;

 

“fully
managed account” means an account of a client for which a person makes the investment decisions if that person has full
discretion to trade in securities for the account without requiring the client’s express consent to a transaction;

 

“investment
fund” means a mutual fund or a non-redeemable investment fund, and, for great certainty in British Columbia, includes
an employee venture capital corporation and a venture capital corporation as such terms are defined in National Instrument 81-106
Investment Fund Continuous Disclosure;

 

“jurisdiction”
or “jurisdiction of Canada” means a province or territory of Canada except when used in the term foreign jurisdiction;

 

“non-redeemable
investment fund” means an issuer:

 

	 	(i)	whose
    primary purpose is to invest money provided by its securityholders;
	 	 	 
	 	(ii)	that
    does not invest

 

	 	(A)	for
    the purpose of exercising or seeking to exercise control of an issuer, other than an issuer that is a mutual fund or a non-redeemable
    investment fund, or
	 	 	 
	 	(B)	for
    the purpose of being actively involved in the management of any issuer in which it invests, other than an issuer that is a
    mutual fund or a non-redeemable investment fund, and

 

	 	(iii)	that
    is not a mutual fund;

 

“person”
includes

 

	 	(i)	an
    individual;
	 	 	 
	 	(ii)	a
    corporation;
	 	 	 
	 	(iii)	a
    partnership, trust, fund and an association, syndicate, organization or other organized group of persons, whether incorporated
    or not; and
	 	 	 
	 	(iv)	an
    individual or other person in that person’s capacity as a trustee, executor, administrator or personal or other legal
    representative;

 

“related
liabilities” means

 

	 	(i)	liabilities
    incurred or assumed for the purpose of financing the acquisition or ownership of financial assets, or
	 	 	 
	 	(ii)	liabilities
    that are secured by financial assets;

 

     

    	 	 - 19 -	 

    

 

“spouse”
means, an individual who,

 

	 	(i)	is
    married to another individual and is not living separate and apart within the meaning of the Divorce Act (Canada), from the
    other individual,
	 	 	 
	 	(ii)	is
    living with another individual in a marriage-like relationship, including a marriage-like relationship between individuals
    of the same gender, or
	 	 	 
	 	(iii)	in
    Alberta, is an individual referred to in paragraph (i) or (ii), or is an adult interdependent partner within the meaning of
    the Adult Interdependent Relationships Act (Alberta); and

 

“subsidiary”
means an issuer that is controlled directly or indirectly by another issuer and includes a subsidiary of that subsidiary.

 

The
Subscriber agrees that the above representations and warranties will be true and correct both as of the execution of this Questionnaire
and as of the Closing and that they will survive the completion of the issue of the Shares.

 

The
Subscriber acknowledges that the foregoing representations and warranties are made by the Subscriber with the intent that they
be relied upon in determining the suitability of the Subscriber to acquire the Shares and that this Questionnaire is incorporated
into and forms part of the Agreement, and the Subscriber undertakes to immediately notify the Issuer of any change in any statement
or other information relating to the Subscriber set forth herein which takes place prior to the Closing.

 

By
completing this Questionnaire, the Subscriber authorizes the indirect collection of this information by each applicable regulatory
authority or regulator and acknowledges that such information is made available to the public under applicable legislation. 

 

	DATED
    as of                day of                   ,
    2016.	 	 

 

	 	 
	 	Print Name of Subscriber (or person signing as agent)

 

	 	 	By:	 
	 	 	 	Signature
	 	 	 	 
	 	 	 	 
	 	 	 	Title

 

     

    	 	 - 20 -	 

    

 

EXHIBIT
B

 

U.S.
INVESTOR QUESTIONNAIRE

 

TO:bBOOTH,
INC. (the “Issuer”)

 

RE:Purchase
of Shares (the “Shares”) of the Issuer

 

 

 

Capitalized
terms used in this U.S. Investor Questionnaire (this “Questionnaire”)
and not specifically defined have the meaning ascribed to them in the Private Placement Subscription Agreement between the Subscriber
(as defined herein) and the Issuer to which this Exhibit B is attached.

 

This
Questionnaire applies only to persons that are U.S. Purchasers. A “U.S. Purchaser” is: (a) any U.S. Person,
(b) any person purchasing the Shares for the account or benefit of any U.S. Person, (c) any person that receives or received an
offer of the Shares while in the United States, or (d) any person that is (or whose authorized signatory is) in the United States
at the time the Subscriber’s buy order was made or this Agreement was executed or delivered.

 

In
connection with the purchase by the Subscriber (being the undersigned, or if the undersigned is purchasing the Shares as agent
on behalf of a disclosed beneficial Subscriber, such beneficial Subscriber, will be referred herein as the “Subscriber”)
of the Shares, the Subscriber hereby represents, warrants, covenants and certifies (which representations, warranties, covenants
and certifications will survive the Closing) to the Issuer (and acknowledges that the Issuer is relying thereon) that:

 

	1.	it
    is not resident in Canada;
	 	 
	2.	it
    has such knowledge and experience in financial and business matters as to be capable of evaluating the merits and risks of
    an investment in the Shares and it is able to bear the economic risk of loss of its entire investment;
	 	 
	3.	the
    Issuer has provided to it the opportunity to ask questions and receive answers concerning the terms and conditions of the
    Offering and it has had access to such information concerning the Issuer as it has considered necessary or appropriate in
    connection with its investment decision to acquire the Shares;
	 	 
	4.	it
    is acquiring the Shares for its own account, for investment purposes only and not with a view to any resale, distribution
    or other disposition of the Shares in violation of the United States securities laws;
	 	 
	5.	it
    (i) has adequate net worth and means of providing for its current financial needs and possible personal contingencies, (ii)
    has no need for liquidity in this investment, and (iii) is able to bear the economic risks of an investment in the Shares
    for an indefinite period of time;

 

     

    	 	 - 21 -	 

    

 

	6.	if
    the Subscriber is an individual (that is, a natural person and not a corporation, partnership, trust or other entity), then
    it satisfies one or more of the categories indicated below (please place an “X” on the appropriate lines):

 

	 	___________	a
    natural person whose individual net worth, or joint net worth with that person’s spouse, exceeds US$1,000,000. For purposes
    of this category, “net worth” means the excess of total assets at fair market value (including personal and real
    property, but excluding the estimated fair market value of a person’s primary home) over total liabilities. Total liabilities
    excludes any mortgage on the primary home in an amount of up to the home’s estimated fair market value as long as the
    mortgage was incurred more than 60 days before the Shares are purchased, but includes (i) any mortgage amount in excess of
    the home’s fair market value and (ii) any mortgage amount that was borrowed during the 60 day period before the Closing
    Date for the purpose of investing in the Shares,
	 	 	 
	 	___________	a
    natural person who had an individual income in excess of US$200,000 in each of the two most recent years, or joint income
    with their spouse in excess of US$300,000 in each of those years and has a reasonable expectation of reaching the same income
    level in the current year, or
	 	 	 
	 	___________	a
    director or executive officer of the Issuer;

 

	7.	if
    the Subscriber is a corporation, partnership, trust or other entity), then it satisfies one or more of the categories indicated
    below (please place an “X” on the appropriate lines):

 

	 	___________	an
    organization described in Section 501(c)(3) of the United States Internal Revenue Code, a corporation, a Massachusetts or
    similar business trust or partnership, not formed for the specific purpose of acquiring the Shares, with total assets in excess
    of US$5,000,000,
	 	 	 
	 	___________	a
    “bank” as defined under Section (3)(a)(2) of the 1933 Act or savings and loan association or other institution
    as defined in Section 3(a)(5)(A) of the 1933 Act acting in its individual or fiduciary capacity; a broker dealer registered
    pursuant to Section 15 of the Securities Exchange Act of 1934 (United States); an insurance company as defined in Section
    2(13) of the 1933 Act; an investment company registered under the Investment Company Act of 1940 (United States) or
    a business development company as defined in Section 2(a)(48) of such Act; a Small Business Investment Company licensed by
    the U.S. Small Business Administration under Section 301(c) or (d) of the Small Business Investment Act of 1958 (United
    States); a plan with total assets in excess of US$5,000,000 established and maintained by a state, a political subdivision
    thereof, or an agency or instrumentality of a state or a political subdivision thereof, for the benefit of its employees;
    an employee benefit plan within the meaning of the Employee Retirement Income Security Act of 1974 (United States)
    whose investment decisions are made by a plan fiduciary, as defined in Section 3(21) of such Act, which is either a bank,
    savings and loan association, insurance company or registered investment adviser, or if the employee benefit plan has total
    assets in excess of US$5,000,000, or, if a self-directed plan, whose investment decisions are made solely by persons that
    are accredited investors,
	 	 	 
	 	___________	a
    private business development company as defined in Section 202(a)(22) of the Investment Advisers Act of 1940 (United
    States),
	 	 	 
	 	___________	a
    trust with total assets in excess of US$5,000,000, not formed for the specific purpose of acquiring the Shares, whose purchase
    is directed by a sophisticated person as described in Rule 506(b)(2)(ii) under the 1933 Act, or
	 	 	 
	 	___________	an
    entity in which all of the equity owners satisfy the requirements of one or more of the categories set forth in Section 6
    of this Questionnaire;

 

     

    	 	 - 22 -	 

    

 

	8.	it
    has not purchased the Shares as a result of any form of general solicitation or general advertising (as those terms are used
    in Regulation D under the 1933 Act), including advertisements, articles, notices or other communications published in any
    newspaper, magazine or similar media or broadcast over radio, internet, television or other form of telecommunications, or
    any seminar or meeting whose attendees have been invited by general solicitation or general advertising;
	 	 
	9.	if
    the Subscriber decides to offer, sell or otherwise transfer any of the Shares, it will not offer, sell or otherwise transfer
    any of such Shares, directly or indirectly, unless:

 

	 	(a)	the
    sale is to the Issuer,
	 	 	 
	 	(b)	the
    sale is made outside the United States in a transaction meeting the requirements of Rule 904 of Regulation S under the 1933
    Act and in compliance with applicable local laws and regulations in which such sale is made,
	 	 	 
	 	(c)	the
    sale is made pursuant to the exemption from the registration requirements under the 1933 Act provided by Rule 144 thereunder
    and in accordance with any applicable state securities or “blue sky” laws, or
	 	 	 
	 	(d)	the
    Shares are sold in a transaction that does not require registration under the 1933 Act or any applicable state laws and regulations
    governing the offer and sale of securities, and
	 	 	 
	 	(e)	it
    has, prior to such sale pursuant to subsection (c) or (d), furnished to the Issuer an opinion of counsel of recognized standing
    reasonably satisfactory to the Issuer, to such effect;

 

	10.	it
    understands and agrees that there may be material tax consequences to the Subscriber of an acquisition or disposition of the
    Shares;
	 	 
	11.	it
    consents to the Issuer making a notation on its records or giving instructions to any transfer agent of the Issuer in order
    to implement the restrictions on transfer set forth and described in this Questionnaire and the Agreement;
	 	 
	12.	it
    is resident in the United States of America, its territories and possessions or any state of the United States or the District
    of Columbia (collectively the “United States”), is a U.S. Person, is acting for the account or benefit
    of a U.S. Person or was (or its authorized signatory was) in the United States at the time the Shares were offered or the
    Agreement was executed; and
	 	 
	13.	it
    understands that the Issuer has no obligation to register any of the Shares under the 1933 Act.

 

The
Subscriber agrees that the above representations and warranties will be true and correct both as of the execution of this Questionnaire
and as of the Closing and that they will survive the completion of the issue of the Shares.

 

The
Subscriber acknowledges that the foregoing representations and warranties are made by the Subscriber with the intent that they
be relied upon in determining the suitability of the Subscriber to acquire the Shares and that this Questionnaire is incorporated
into and forms part of the Agreement, and the Subscriber undertakes to immediately notify the Issuer of any change in any statement
or other information relating to the Subscriber set forth herein which takes place prior to the Closing.

 

     

    	 	 - 23 -	 

    

 

By
completing this Questionnaire, the Subscriber authorizes the indirect collection of this information by each applicable regulatory
authority or regulator and acknowledges that such information is made available to the public under applicable legislation. 

 

Dated
_____________________________, 2016.

 

	 	X
	 	Signature
    of individual (if Subscriber is an individual)
	 	 
	 	X
	 	Authorized
    signatory (if Subscriber is not an individual)
	 	 
	 	 
	 	Name
    of Subscriber (please print)
	 	 
	 	 
	 	Name
    of authorized signatory (please print)

 

     

    	 	 - 24 -	 

    

 

EXHIBIT
C

 

US
DOLLAR WIRE INSTRUCTIONS

 

TO
SEND A WIRE, YOU WILL NEED TO GIVE THE REMITTING BANK THE FOLLOWING INSTRUCTIONS:

 

	BENEFICIARY:
    	bBooth,
    Inc.
	 	346
    S. Hauser Blvd., Suite 210
	 	Los
    Angeles, CA 90036
	 	 
	BENEFICIARY
    BANK:	Bank
    of America 
	 	466
    N. La Brea Ave
	 	Los
    Angeles, CA 90036
	 	 
	BENEFICIARY
    ACCOUNT NUMBER:	501018819300
    
	 	 
	BANK
    TRANSIT NUMBER:	026009593
	 	 
	INTERMEDIARY
    BANK:	N/A
	 	 
	SWIFT
    CODE:	 026009593

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