Document:

Motorola Solutions, Inc. Amended Award

 Exhibit 10.5 
 MOTOROLA SOLUTIONS, INC. 
 AMENDED AWARD DOCUMENT 

For the 
 Motorola
Solutions Omnibus Incentive Plan of 2006 
 Terms and Conditions Related to Employee Nonqualified Stock Options 

 

							
	Recipient:	  	 Gregory Q. Brown
	  	Date of Expiration:	  	 February 22, 2021

				
	Commerce ID#:	  	  
	  	Amended Number of Options:	  	 48,489

				
	Date of Grant:	  	 February 22, 2011
	  	Exercise Price:	  	 $38.04

				
	Grant Amended:	  	 March 14, 2011
	  	Amendment Effective Date	  	 February 22, 2011

 Motorola Solutions, Inc. (“Motorola Solutions” or the “Company”) granted you options to purchase shares of Motorola Solutions common stock (“Options”) under the Motorola
Solutions Omnibus Incentive Plan of 2006 (the “Plan”) on February, 22, 2011 (the “Award”). The Award, consisting of 519,887 Options, is hereby amended in accordance with Sections 2 and 21 of the Plan as follows: (i) 471,398
Options are substituted with an equal amount of stock appreciation rights settled in shares of Common Stock of Motorola Solutions, Inc., subject to the terms and conditions set forth in the Motorola Solutions, Inc. Award Document attached hereto as
Addendum A; and (ii) 48,489 Options remain outstanding and subject to the terms and conditions of this Amended Award Document. All other terms and conditions remain unchanged, including the Date of Grant, Date of Expiration, and the Exercise
Price per Option, which was the Fair Market Value on the Date of Grant, all as stated above. Each Option entitles you to purchase one share of Motorola Solutions common stock on the terms described below and in the Plan. Reference is made to the
employment agreement (“Employment Agreement”) by and between Gregory Q. Brown and Motorola, Inc. dated as of the 27th day of August, 2008, as amended from time to time. 
 Vesting and Exercisability 
 You cannot exercise the Options until they have vested.

 Regular Vesting – The Options will vest in accordance with the following schedule (subject to the other terms hereof); provided that you
remain in the employee of the Company through each vesting date: 
  

					
	 Percentage of Options that Vest
	  	Vesting Date	 
	The later to occur of (i) the Milestone Date and (ii) the one year anniversary of the grant date.	  	 	33 1/3	% 
	The later to occur of (i) the Milestone Date and (ii) the two year anniversary of the grant date.	  	 	33 1/3	% 
	The later to occur of (i) the Milestone Date and (ii) the three year anniversary of the grant date.	  	 	Remainder	  

  
 -1-

 For purposes of this Option grant, “Milestone Date” shall mean the date on which the average
closing price of Company common stock for any fifteen consecutive trading days is 110% or greater than the average closing price of Company common stock for fifteen trading days immediately preceding the date of grant. 

Exercisability – In general, you may exercise Options at any time after they vest and before they expire as described below. The Employment
Agreement contains additional terms regarding the exercisability of your Options under certain circumstances. 
 Expiration

 All Options expire on the earlier of (1) the Date of Expiration as stated above or (2) such earlier date provided for under
the terms of the Employment Agreement. Once an Option expires, you no longer have the right to exercise it. 
 Employment Agreement

 The vesting, exercisability and forfeiture of your Options will be subject to the terms of Section 5 of the Employment Agreement.

 Leave of Absence/Temporary Layoff 
 If you take a Leave of Absence from Motorola Solutions or a Subsidiary that your employer has approved in writing in accordance with your employer’s Leave of Absence Policy and which does not
constitute a termination of employment as determined by Motorola Solutions or a Subsidiary or you are placed on Temporary Layoff (as defined below) by Motorola Solutions or a Subsidiary the following will apply: 

Vesting of Options – Options will continue to vest in accordance with the vesting schedule set forth above. 

Exercising Options – You may exercise Options that are vested or that vest during the Leave of Absence or Temporary Layoff. 

Effect of Termination of Employment or Service – If your employment or service is terminated during the Leave of Absence or Temporary Layoff,
the treatment of your Options will be determined in accordance with Section 5 of the Employment Agreement. 
 Other Terms

 Method of Exercising – You must follow the procedures for exercising options established by Motorola Solutions from time to time.
At the time of exercise, you must pay the Exercise Price for all of the Options being exercised and any taxes that are required to be withheld by Motorola Solutions or a Subsidiary in connection with the exercise. Options may not be exercised for
less than 50 shares unless the number of shares represented by the Option is less than 50 shares, in which case the Option must be exercised for the remaining amount. 
 Transferability – Unless the Committee provides, Options are not transferable other than by will or the laws of descent and distribution. 

  
 -2-

 Tax Withholding – Motorola Solutions or a Subsidiary is entitled to withhold an amount equal to the
required minimum statutory withholding taxes for the respective tax jurisdictions attributable to any share of common stock deliverable in connection with the exercise of the Options. You may satisfy any minimum withholding obligation and additional
withholding, if desired, by electing to have the plan administrator retain Option shares having a Fair Market Value on the date of exercise equal to the amount of the withholding obligation. 
 Definition of Terms 
 If a term is used but not defined, it has the meaning given
such term in the Plan. 
 “Fair Market Value” is the closing price for a share of Motorola Solutions common stock on the date of grant
or date of exercise, whichever is applicable. The official source for the closing price is the New York Stock Exchange Composite Transaction as reported in the Wall Street Journal at www.online.wsj.com. 

“Subsidiary” means an entity of which Motorola Solutions owns directly or indirectly at least 50% and that Motorola Solutions consolidates for
financial reporting purposes. 
 “Temporary Layoff” means a layoff or redundancy that is communicated as being for a period of up to
twelve months and as including a right to recall under defined circumstances. 
 Consent to Transfer Personal Data 

By accepting this award, you voluntarily acknowledge and consent to the collection, use, processing and transfer of personal data as described in this
paragraph. You are not obliged to consent to such collection, use, processing and transfer of personal data. However, failure to provide the consent may affect your ability to participate in the Plan. Motorola Solutions, its Subsidiaries and your
employer hold certain personal information about you, that may include your name, home address and telephone number, date of birth, social security number or other employee identification number, salary, salary grade, hire date, nationality, job
title, any shares of stock held in Motorola Solutions, or details of all options or any other entitlement to shares of stock awarded, canceled, purchased, vested, or unvested, for the purpose of managing and administering the Plan
(“Data”). Motorola Solutions and/or its Subsidiaries will transfer Data amongst themselves as necessary for the purpose of implementation, administration and management of your participation in the Plan, and Motorola Solutions and/or any
of its Subsidiaries may each further transfer Data to any third parties assisting Motorola Solutions in the implementation, administration and management of the Plan. These recipients may be located throughout the world, including the United States.
You authorize them to receive, possess, use, retain and transfer the Data, in electronic or other form, for the purposes of implementing, administering and managing your participation in the Plan, including any requisite transfer of such Data as may
be required for the administration of the Plan and/or the subsequent holding of shares of stock on your behalf to a broker or other third party with whom you may elect to deposit any shares of stock acquired pursuant to the Plan. You may, at any
time, review Data, require any necessary amendments to it or withdraw the consents herein in writing by contacting Motorola Solutions; however, withdrawing your consent may affect your ability to participate in the Plan. 

Acknowledgement of Discretionary Nature of the Plan; No Vested Rights 
 You acknowledge and agree that the Plan is discretionary in nature and limited in duration, and may be amended, cancelled, or terminated by Motorola Solutions or a Subsidiary, in its sole discretion, at
any time. The grant of awards under the Plan is a one-time benefit and 

  
 -3-

 
does not create any contractual or other right to receive an award in the future or to future employment. Nor shall this or any such grant interfere with your right or the Company’s right to
terminate such employment relationship at any time, with or without cause, to the extent permitted by applicable laws and any enforceable agreement between you and the Company. Future grants, if any, will be at the sole discretion of Motorola
Solutions, including, but not limited to, the timing of any grant, the amount of the award, vesting provisions, and the exercise price. 

No Relation to Other Benefits/Termination Indemnities 
 Your acceptance of this award and participation under the Plan is voluntary. The value of your stock option awarded herein is an extraordinary item of compensation. Except as provided in the Employment
Agreement, the stock option is not part of normal or expected compensation for purposes of calculating any severance, resignation, redundancy, end of service payments, bonuses, long-service awards, pension, or retirement benefits or similar
payments, notwithstanding any provision of any compensation, insurance agreement or benefit plan to the contrary. 
 Substitute Stock
Appreciation Right 
 Subject to compliance with Section 409A of the Internal Revenue Code of 1986, as amended, Motorola Solutions
reserves the right to substitute a Stock Appreciation Right for your Options in the event certain changes are made in the accounting treatment of stock options. Any substitute Stock Appreciation Right shall be applicable to the same number of shares
as your Option and shall have the same Date of Expiration, Exercise Price, and other terms and conditions. Any substitute Stock Appreciation Right may be settled only in common stock. 
 Acceptance of Terms and Conditions 
 By accepting the Options and stock appreciation
rights as subject to Addendum A, you agree to be bound by these terms and conditions, the Plan and the Stock Option Consideration Agreement. 

Other Information about Your Options and the Plan 
 You can find other information about options and the Plan on the Motorola Solutions website http://my.mot-solutions.com/go/EquityAwards. If you do not have access to the website, please contact
Motorola Solutions Global Rewards, 1303 E. Algonquin Road, Schaumburg, IL 60196 USA; GBLRW01@motorolasolutions.com; 847-576-7885; for an order form to request Plan documents. 

  
 -4-

 ADDENDUM A 
 MOTOROLA SOLUTIONS, INC. 
 AWARD DOCUMENT 

For the 
 Motorola
Solutions Omnibus Incentive Plan of 2006 
 Terms and Conditions Related to Substitute Employee Stock Appreciation Rights

  

							
	Recipient:	  	 Gregory Q. Brown
	  	Date of Expiration:	  	 February 22, 2021

				
	Commerce ID#:	  	  
	  	Number of Stock Appreciation Rights:	  	 471,398

				
	Date of Grant:	  	 February 22, 2011
	  	Exercise Price:	  	 $38.04

 Motorola Solutions, Inc. (“Motorola Solutions” or the “Company”) is pleased to substitute stock appreciation rights (“SARs”) with respect to 471,398 shares of Motorola
Solutions common stock under the Motorola Solutions Omnibus Incentive Plan of 2006 (the “Plan”) for 471,398 options to purchase shares of common stock of Motorola Solutions originally awarded on February 22, 2011. The number of SARs
awarded to you and the Exercise Price per share of Motorola Solutions common stock (the “Grant Date FMV”), which is the Fair Market Value on the Date of Grant, are stated above. Each SAR entitles you upon exercise to receive payment from
Motorola Solutions in an amount (the “Settlement Amount”) equal to the product of (1) the excess of the Fair Market Value of a share of Motorola Solutions common stock on the date of exercise (the “Exercise Date FMV”) over
the Grant Date FMV, multiplied by (2) the number of shares of Motorola Solutions common stock with respect to which the SAR is exercised, such payment to be made in a number of shares of Motorola Solutions common stock equal to the quotient of
(x) the Settlement Amount divided by (y) the Exercise Date FMV; provided that any fractional shares will be settled in cash based on the Exercise Date FMV. Reference is made to the employment agreement (“Employment Agreement”) by
and between Gregory Q. Brown and Motorola, Inc. dated as of the 27th day of August, 2008, as amended from time to time. 
 Vesting and
Exercisability 
 You cannot exercise a SAR until it has vested. 
 Regular Vesting – The SARs will vest in accordance with the following schedule (subject to the other terms hereof); provided that you remain an employee of the Company through each vesting date:

  

					
	 Percentage of SARs that Vest
	  	Vesting Date	 
	The later to occur of (i) the Milestone Date and (ii) the one year anniversary of the grant date.	  	 	33 1/3	% 
		
	The later to occur of (i) the Milestone Date and (ii) the two year anniversary of the grant date.	  	 	33 1/3	% 
		
	The later to occur of (i) the Milestone Date and (ii) the three year anniversary of the grant date.	  	 	Remainder	  

  
 -5-

 For purposes of this SAR grant, “Milestone Date” shall mean the date on which the average closing
price of Company common stock for any fifteen consecutive trading days is 110% or greater than the average closing price of Company common stock for fifteen trading days immediately preceding the date of grant. 

Exercisability – In general, you may exercise SARs at any time after they vest and before expire as described below. The Employment Agreement
contains additional terms regarding the exercisability of your SARs under certain circumstances. 
 Expiration 

All SARs expire on the earlier of (1) the Date of Expiration as stated above or (2) such earlier date provided for under the terms of the
Employment Agreement. Once the SAR expires, you no longer have the right to exercise it. 
 Employment Agreement 

The vesting, exercisability and forfeiture of your SARs will be subject to the terms of Section 5 of the Employment Agreement. 

Leave of Absence/Temporary Layoff 

If you take a Leave of Absence from Motorola Solutions or a Subsidiary that your employer has approved in writing in accordance with your employer’s
Leave of Absence Policy and which does not constitute a termination of employment as determined by Motorola Solutions or a Subsidiary or you are placed on Temporary Layoff (as defined below) by Motorola Solutions or a Subsidiary the following will
apply: 
 Vesting of SAR – SARs will continue to vest in accordance with the vesting schedule set forth above. 

Exercising the SAR – You may exercise SARs that are vested or that vest during the Leave of Absence or Temporary Layoff. 

Effect of Termination of Employment or Service – If your employment or service is terminated during the Leave of Absence or Temporary Layoff,
the treatment of your SAR will be determined in accordance with Section 5 of the Employment Agreement. 
 Other Terms

 Method of Exercising – You must follow the procedures for exercising stock appreciation rights established by Motorola Solutions
from time to time. At the time of exercise, you must pay any taxes that are required to be withheld by Motorola Solutions or a Subsidiary in connection with the exercise. SARs may not be exercised for less than 50 shares subject to the SAR unless
the number of shares remaining subject to the SAR is less than 50 shares, in which case the SAR must be exercised for the remaining amount. 

Transferability – Unless the Committee provides, SARs are not transferable other than by will or the laws of descent and distribution. 

Tax Withholding – Motorola Solutions or a Subsidiary is entitled to withhold an amount equal to the required minimum statutory withholding taxes for
the respective tax jurisdictions attributable to any share of common stock deliverable in connection with the exercise of the SARs. You may satisfy any minimum withholding obligation and additional withholding, if desired, by electing to have the
plan administrator retain shares of Motorola Solutions common stock having a Fair Market Value on the date of exercise equal to the amount of the withholding obligation. 

  
 -6-

 Definition of Terms 
 If a term is used but not defined, it has the meaning given such term in the Plan. 
 “Fair
Market Value” is the closing price for a share of Motorola Solutions common stock on the date of grant or date of exercise, whichever is applicable. The official source for the closing price is the New York Stock Exchange Composite Transaction
as reported in the Wall Street Journal at www.online.wsj.com. 
 “Subsidiary” means an entity of which Motorola Solutions owns
directly or indirectly at least 50% and that Motorola Solutions consolidates for financial reporting purposes. 
 “Temporary Layoff”
means a layoff or redundancy that is communicated as being for a period of up to twelve months and as including a right to recall under defined circumstances. 
 Consent to Transfer Personal Data 
 By accepting this award, you voluntarily
acknowledge and consent to the collection, use, processing and transfer of personal data as described in this paragraph. You are not obliged to consent to such collection, use, processing and transfer of personal data. However, failure to provide
the consent may affect your ability to participate in the Plan. Motorola Solutions, its Subsidiaries and your employer hold certain personal information about you, that may include your name, home address and telephone number, date of birth, social
security number or other employee identification number, salary, salary grade, hire date, nationality, job title, any shares of stock held in Motorola Solutions, or details of all options or any other entitlement to shares of stock awarded,
canceled, purchased, vested, or unvested, for the purpose of managing and administering the Plan (“Data”). Motorola Solutions and/or its Subsidiaries will transfer Data amongst themselves as necessary for the purpose of implementation,
administration and management of your participation in the Plan, and Motorola Solutions and/or any of its Subsidiaries may each further transfer Data to any third parties assisting Motorola Solutions in the implementation, administration and
management of the Plan. These recipients may be located throughout the world, including the United States. You authorize them to receive, possess, use, retain and transfer the Data, in electronic or other form, for the purposes of implementing,
administering and managing your participation in the Plan, including any requisite transfer of such Data as may be required for the administration of the Plan and/or the subsequent holding of shares of stock on your behalf to a broker or other third
party with whom you may elect to deposit any shares of stock acquired pursuant to the Plan. You may, at any time, review Data, require any necessary amendments to it or withdraw the consents herein in writing by contacting Motorola Solutions;
however, withdrawing your consent may affect your ability to participate in the Plan. 
 Acknowledgement of Discretionary Nature of the
Plan; No Vested Rights 
 You acknowledge and agree that the Plan is discretionary in nature and limited in duration, and may be amended,
cancelled, or terminated by Motorola Solutions or a Subsidiary, in its sole discretion, at any time. The grant of awards under the Plan is a one-time benefit and does not create any contractual or other right to receive an award in the future or to
future employment. Nor shall this or any such grant interfere with your right or the Company’s right to terminate such employment relationship at any time, with or without cause, to the extent permitted by applicable laws and any enforceable
agreement between you and the Company. Future grants, if any, will be at the sole discretion of Motorola Solutions, including, but not limited to, the timing of any grant, the amount of the award, vesting provisions, and the exercise price.

  
 -7-

 No Relation to Other Benefits/Termination Indemnities 

Your acceptance of this award and participation under the Plan is voluntary. The value of the SAR awarded herein is an extraordinary item of compensation.
Except as provided in the Employment Agreement, the SAR is not part of normal or expected compensation for purposes of calculating any severance, resignation, redundancy, end of service payments, bonuses, long-service awards, pension, or retirement
benefits or similar payments, notwithstanding any provision of any compensation, insurance agreement or benefit plan to the contrary. 

Acceptance of Terms and Conditions 

By accepting the SARs, you agree to be bound by these terms and conditions, the Plan and the Stock Option Consideration Agreement in connection with the
original award of stock options on February 22, 2011. 
 Other Information about Your SARs and the Plan 

You can find other information about stock appreciation rights and the Plan on the Motorola Solutions website
http://my.mot-solutions.com/go/EquityAwards. If you do not have access to the website, please contact Motorola Solutions Global Rewards, 1303 E. Algonquin Road, Schaumburg, IL 60196 USA; GBLRW01@motorolasolutions.com; 847-576-7885; for
an order form to request Plan documents. 

  
 -8-Description of Insurance covering non-employee directors

 Exhibit 10.6 

 

 

 Policyholder: Accident Benefits for Motorola Solutions, Inc. 

Policy Number: ADD N04156870 
 Term of Coverage: January 1, 2011 to January 1, 2012 
 You are a Covered Person
and eligible for coverage under the plan, if you are in the eligible class defined below. For benefits to be payable the Policy must be in force, the required premium must be paid and you must be engaging in one of the Covered Activities described
below. If you are not in Active Service on the date your insurance would otherwise be effective, it will go into effect on the date you return to Active Service. 
 Class Description: All Non-employee Directors of the Policyholder. 
 Your Dependents (your
lawful spouse and unmarried children, subject to the age limits shown in the Policy) are also covered, if they are traveling with you. 

Period of Coverage: You will be insured on the later of the Policy Effective Date or the date that you become eligible. Your coverage will end on
the earliest of the date: 1) the Policy terminates; 2) you are no longer eligible; or 3) the period ends for which the required premium is paid. Dependents coverage will end on the earliest of the date: 1) he or she is no longer a Dependent; 2) your
coverage ends; or 3) the period ends for which the required premium is paid. 
 Covered Activities 

Exposure & Disappearance - Coverage includes exposure to the elements after the forced landing, stranding, sinking, or wrecking of a
vehicle in which you were traveling. You are presumed dead if you are in a vehicle that disappears, sinks, or is stranded or wrecked on a trip covered by this Policy; and the body is not found within one year of the Covered Accident. 

24-Hour Coverage - We will pay the benefits described in the Policy when you suffer a Covered Accident any time while insured by the Policy.
Unless otherwise specified, We will pay benefits only once for a Covered Accident. 
 Business Travel - The Covered Accident must take
place while traveling: 1) on business for the Policyholder; and 2) in the course of the Policyholder’s business. This coverage does not include commuting between home and the place of work. 

This coverage will start at the actual start of the trip. It does not matter whether the trip starts at your home, place of work, or other place. It will
end on the first of the following dates to occur: 1) the date you return to your home; 2) the date you return to your place of work; or 3) the date your Personal Deviation is more than 14 day(s). “Personal Deviation” means: 1) an activity
that is not reasonably related to the Policyholder’s business; and 2) not incidental to the purpose of the trip. 
 Felonious Assault -
The Covered Accident must: 1) take place on the Policyholder’s premises; 2) be in the course of your job; and, 3) be caused by or result directly and independently from a Felonious Assault, as defined below. The assault must be inflicted by
a person other than another person covered by the Policy, your Immediate Family Member, or Household Member. A police report detailing the Felonious Assault must be provided. 
 The Covered Accident must occur during any of the following: 1) actual or attempted robbery or holdup; or 2) actual or attempted kidnapping; or 3) any other type of intentional assault that is a crime
classified as a felony by the governing statute or common law in the state where the assault occurred. “Felonious Assault” means a criminal act or an act of physical violence against a person covered by this Policy. “Immediate Family
Member” means your parent, sister, brother, husband, wife, or children. “Household Member” means a person who maintains residence at the same address as you. 
 Hijacking and Air Piracy - The Covered Accident must: 1) take place during the: a) hijacking of an Aircraft; b) air piracy; or c) unlawful seizure or attempted seizure of an Aircraft; and 2) take
place while you are in the course of the Policyholder’s business. Coverage begins with the onset of the hijacking or air piracy and continues while you are subject to the control of the person or persons responsible for the hijacking/air piracy
and during travel directly to your home or scheduled destinations. “Hijacking” or “Air Piracy,” as used here, means the unlawful seizure or wrongful exercise of control of an aircraft or conveyance, or the crew thereof, in which
you are traveling solely as a passenger. 

  

			
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 Owned, Leased, or Controlled Aircraft - The Covered Accident must take place while: 1) you are riding
in, or getting on or off of, a covered aircraft; or 2) as a result of you being struck by a covered aircraft. 3) away from the Policyholder’s premises in your city of permanent assignment; 4) on business for the Policyholder; and 5) in the
course of the Policyholder’s business. 
 This coverage will start at the actual start of the trip. It does not matter whether the trip
starts at your home, place of work, or other place. It will end on the first of the following dates to occur: 1) the date you return to your home; 2) the date you return to your place of work; or 3) the date your Personal Deviation is more than 14
day(s). “Personal Deviation” means: 1) an activity that is not reasonably related to the Policyholder’s business; and 2) not incidental to the purpose of the trip. An aircraft will be deemed “controlled” by the Policyholder
if the Policyholder may use it for more than 10 straight days, or more than 15 days in any year. 
 Aircraft Restrictions - If the
Covered Accident happens while you are riding in, or getting on or off of, an aircraft, We will pay benefits, but only if: 1) you are riding as a passenger only, and not as a pilot or member of the crew (except as provided by the Policy); and 2) the
aircraft has a valid certificate of airworthiness; and 3) the aircraft is flown by a pilot with a valid license; and 4) the aircraft is not being used for: (i) crop dusting, spraying, or seeding; firefighting; skywriting; skydiving or hang
gliding; pipeline or power line inspection; aerial photography or exploration; racing, endurance tests, stunt or acrobatic flying; or (ii) any operation which requires a special permit from the FAA, even if it is granted (this does not apply if
the permit is required only because of the territory flown over or landed on). 5) the aircraft is a military transport aircraft flown by the U.S. Military Airlift Command (MAC), or similar air transport service of another country. 

Relocation - The Covered Accident must take place while you are traveling on a Relocation Trip at the expense and direction of the Policyholder.
“Relocation Trip” means a trip in connection with your transfer or proposed transfer by the Policyholder to a new worksite. 
 This
coverage will start at the actual start of the trip. It does not matter whether the trip starts at your home, place of work, or other place. It will end on the first of the following dates to occur: 1) the date you return to your home; 2) the date
you return to your place of work; or 3) the date your Personal Deviation is more than 14 day(s). “Personal Deviation” means: 1) an activity that is not reasonably related to the Policyholder’s business; and 2) not incidental to the
purpose of the trip. 
 Terrorism - The Covered Accident must: 1) take place while you are on the Policyholder’s premises, or in the
course of a) the Policyholder’s business and/or b) your job; and, 2) be caused by or results directly and independently from Terrorism or Terrorist Act, as defined below. 
 “Terrorism or Terrorist Acts” means an activity that: 1) involves any violent act or any act dangerous to human life and that threatens or causes Injury to persons; and 2) appears to be in any
way intended to: a) intimidate or coerce a civilian population; or b) disrupt any segment of a nation’s economy; or c) influence the policy of a government by intimidation or coercion; or d) affect the conduct of a government by mass
destruction, assassination, kidnapping, or hostage taking; or e) respond to governmental action or policy. It includes any incident declared to be an act of terrorism by an official, department, or agency that has been specifically authorized by
federal statute to make such a determination. It shall also include the use of any nuclear weapon or device or the emission, discharge, dispersal, release, or escape of any solid liquid or gaseous chemical or biological agent. 

Description of Benefits 

Aggregate Limit - We will not pay more than per Covered Accident: $15,000,000; for all losses. If, in the absence of this provision, We
would pay more than this amount for all losses under the policy, then the benefits payable to each person with a valid claim will be reduced proportionately. 
 Accidental Death and Dismemberment Benefits - If your Injury results, within 365 days from the date of a Covered Accident, in any one of the losses shown below, We will pay the Benefit Amount shown
below for that loss. Your Principal Sum is $500,000. Your spouse’s Principal Sum is $50,000. Your child’s Principal Sum is $25,000. If multiple losses occur, only one Benefit Amount, the largest, will be paid for all losses due to the same
Covered Accident. 

  

			
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 Schedule of Covered Losses 

 

			
	Covered Loss	  	Benefit Amount

  

							
	 Life
	  	 	100	% 	 	of the Principal Sum
	 Two or more Members
	  	 	100	% 	 	of the Principal Sum
	 Quadriplegia
	  	 	100	% 	 	of the Principal Sum
	 One Member
	  	 	50	% 	 	of the Principal Sum
	 Hemiplegia
	  	 	75	% 	 	of the Principal Sum
	 Paraplegia
	  	 	75	% 	 	of the Principal Sum
	 Thumb and Index Finger of the Same Hand
	  	 	25	% 	 	of the Principal Sum

 “Quadriplegia” means total
Paralysis of both upper and lower limbs. “Hemiplegia” means total Paralysis of the upper and lower limbs on one side of the body. “Paraplegia” means total Paralysis of both lower limbs or both upper limbs. “Paralysis”
means total loss of use. A Doctor must determine the loss of use to be complete and not reversible at the time the claim is submitted. 

“Member” means Loss of Hand or Foot, Loss of Sight, Loss of Speech and Loss of Hearing. “Loss of Hand or Foot” means complete
Severance through or above the wrist or ankle joint. “Loss of Sight” means the total, permanent Loss of Sight of one eye. “Loss of Speech” means total and permanent loss of audible communication that is irrecoverable by natural,
surgical or artificial means. “Loss of Hearing” means total and permanent Loss of Hearing in both ears that is irrecoverable and cannot be corrected by any means. “Loss of a Thumb and Index Finger of the Same Hand” means complete
Severance through or above the metacarpophalangeal joints of the same hand (the joints between the fingers and the hand). “Severance” means the complete separation and dismemberment of the part from the body. 

Coma Benefit - We will pay 1% of the Principal Sum per month up to 11 months and thereafter in a lump sum of 100% of the Principal Sum if you
become Comatose within 31 days of a Covered Accident and remain in a Coma for at least 31 days. We reserve the right, at the end of the first 31 days of Coma, to require proof that you remain Comatose. This proof may include, but is not limited to,
requiring an independent medical examination at Our expense. Monthly payments will end on the first of the following dates: 1) the end of the month in which you die; 2) the end of the 11th month for which this benefit is payable; 3) the end of the
month in which you recover from the Coma. 
 You are deemed “Comatose” or in a “Coma” if you are in a profound stupor or
state of complete and total unconsciousness, as the result of a Covered Accident. 
 Disability Benefit (Permanent Total Disability) (Does
not apply to Dependents) - We will pay 100% of the Principal Sum if you are under age 70 and Permanently Totally Disabled as a direct result of, and from no other cause but, a Covered Accident. Permanent Total Disability must begin within 365
days from the date of your Covered Accident. Disability Benefits will begin when: 1) the applicable Benefit Waiting Period of 365 days is satisfied; and 2) you provide satisfactory proof of Permanent Total Disability to Us. 

“Total Disability” or “Totally Disabled” means, due to an Injury from a Covered Accident, you: 1) if employed, cannot do any work for
which you are, or may become, qualified by reason of education, experience or training; and 2) if not employed, cannot perform the normal and customary activities of a healthy person of like age and sex. “Permanent Total Disability” or
“Permanently Totally Disabled” means you are Totally Disabled and are expected to remain so disabled, as certified by a Doctor, for the rest of your life. Permanent Total Disability must be the result of the same Covered Accident that
caused the Total Disability. 
 Emergency Medical Benefits - We will pay up to $10,000 for Covered Expenses incurred for emergency
medical services to treat you if you: 1) suffer a Medical Emergency during the course of a Trip; and 2) are traveling 100 miles or more away from your place of permanent residence. Covered Expenses include expenses for guarantee of payment to a
medical provider, Hospital or treatment facility. Benefits for these Covered Expenses will not be payable unless the charges incurred: 1) are Medically Necessary and do not exceed the charges for similar treatment, services or supplies in the
locality where the expense is incurred; and 2) do not include charges that would not have been made if there were no insurance. Benefits will not be payable unless We authorize in writing, or by an authorized electronic or telephonic means, all
expenses in advance, and services are rendered by Our assistance provider. 
 Emergency Medical Evacuation Benefit - We will pay 100% of
Covered Expenses incurred for your medical evacuation if you: 1) suffer a Medical Emergency during the course of the Trip; 2) require Emergency Medical Evacuation; and 3) are traveling 100 miles or more away from your place of permanent residence.
Covered Expenses; 1) Medical Transport: expenses for transportation under medical supervision to a different hospital, treatment facility or to your place of residence for Medically Necessary treatment in the event of your Medical Emergency and upon
the request of the Doctor designated by 

  

			
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 Our assistance provider in consultation with the local attending Doctor. 2) Dispatch of a Doctor or
Specialist: the Doctor’s or specialist’s travel expenses and the medical services provided on location, if, based on the information available, your condition cannot be adequately assessed to evaluate the need for transport or evacuation
and a doctor or specialist is dispatched by Our service provider to your location to make the assessment. 3) Return of Dependent Child(ren): expenses to return each Dependent child who is under age 18 to his or her principal residence if a) you are
age 18 or older; and b) you are the only person traveling with the minor Dependent child(ren); and c) you suffer a Medical Emergency and must be confined in a Hospital. 4) Escort Services: expenses for an Immediate Family Member or companion who is
traveling with you to join you during your emergency medical evacuation to a different hospital, treatment facility or your place of residence. 

Benefits for these Covered Expenses will not be payable unless: 1) the Doctor ordering the Emergency Medical Evacuation certifies the severity of your
Medical Emergency requires an Emergency Medical Evacuation; 2) all transportation arrangements made for the Emergency Medical Evacuation are by the most direct and economical conveyance and route possible; 3) the charges incurred are Medically
Necessary and do not exceed the Usual and Customary Charges for similar transportation, treatment, services or supplies in the locality where the expense is incurred; and 4) do not include charges that would not have been made if there were no
insurance. 
 Benefits will not be payable unless We authorize in writing, or by an authorized electronic or telephonic means, all expenses in
advance, and services are rendered by Our assistance provider. In the event you refuse to be medically evacuated, we will not be liable for any medical expenses incurred after the date medical evacuation is recommended. 

Repatriation of Remains Benefit - We will pay 100% of Covered Expenses for preparation and return of your body to your home if you die as a result
of a Medical Emergency while traveling 100 miles or more away from your place of permanent residence. Covered expenses include: 1) expenses for embalming or cremation; 2) the least costly coffin or receptacle adequate for transporting the remains;
3) transporting the remains; and 4) Escort Services which include expenses for an Immediate Family Member or companion who is traveling with you to join your body during the repatriation to your place of residence. 

All transportation arrangements must be made by the most direct and economical route and conveyance possible and may not exceed the Usual and Customary
Charges for similar transportation in the locality where the expense is incurred. Benefits will not be payable unless We authorize in writing, or by an authorized electronic or telephonic means, all expenses in advance, and services are rendered by
Our assistance provider. 
 Special Adaptation Benefit - We will pay 10% of the Principal Sum up to $10,000, if you suffer a
“Presumptive Disability” and require a special housing adaptation or a special Vehicle to accommodate the disability. Benefits will not be payable unless your Doctor certifies them as necessary. “Presumptive Disability” means We
will presume you are Totally Disabled if you suffer the complete and irrecoverable loss of sight of both eyes, speech, hearing in both ears, or of any two limbs, hands or feet, provided the loss occurs within one year of the Covered Accident.
“Vehicle” means a private passenger land motor vehicle. It includes automobiles, vans, and four wheel drive vehicles. It does not include a vehicle used for farming, commercial business, racing or any type of competitive speed event.

 Special Counseling Benefit - We will pay $100 per session for up to 10 counseling sessions for mental health counseling to assist you
in dealing with a Covered Loss, if you suffer a Covered Loss for which benefits are payable; and obtain mental health counseling. The Maximum Amount for this benefit is $1,000 per Covered Loss. 

Exclusions and Limitations: We will not pay benefits for any loss or Injury that is caused by, or results from: 

 

	•	 	 intentionally self-inflicted Injury. 

  

	•	 	 suicide or attempted suicide. 

  

	•	 	 war or any act of war, whether declared or not (except as provided by the Policy). 

 

	•	 	 a Covered Accident that occurs while on active duty service in the military, naval or air force of any country or international organization. Upon Our
receipt of proof of service, We will refund any premium paid for this time. Reserve or National Guard active duty training is not excluded unless it extends beyond 31 days. 

 

	•	 	 sickness, disease, bodily or mental infirmity, bacterial or viral infection, or medical or surgical treatment thereof, except for any bacterial
infection resulting from an accidental external cut or wound or accidental ingestion of contaminated food. 

 This insurance
does not apply to the extent that trade or economic sanctions or regulations prohibit Us from providing insurance, including, but not limited to, the payment of claims. 
 War Risk Coverage: We will pay benefits for Covered Losses due to Covered Accidents resulting from war or acts of war anywhere in the world, except the following countries: 

  

			
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	•	 	 the United States 

  

	•	 	 The Covered Person’s Home Country 

  

	•	 	 The Covered Person’s Country of Permanent Assignment 

 The war exclusion is deleted to the extent coverage is provide by the terms and conditions of War Risk Coverage. 
 “Home Country” means a country from which you hold a passport. If you hold passports from more than one Country, your Home Country will be the country that you declared to Us in writing as your
Home Country. 
 “Country of Permanent Assignment” means a country, other than your Home Country, in which the Policyholder requires
you to work for a period of time that exceeds 180 continuous days. 
 We will not pay more than $15,000,000 per occurrence for war risk
benefits. This limit shall apply to Injuries sustained from all acts of war in a consecutive 72-hour period. If but for this limit We would pay more than $15,000,000, then the benefits We will pay to each Covered Person will be reduced in the same
proportion, so that the total amount We will pay for war risk coverage is $15,000,000. 
 Definitions: “Covered Accident” means
an accident that occurs while coverage is in force for you and results directly of all other causes in a loss or Injury covered by the Policy for which benefits are payable. “Covered Person” means any eligible person for whom
the required premium is paid. “Injury” means accidental bodily harm sustained by you that results directly from all other causes from a Covered Accident. All injuries sustained by one person in any one Covered Accident, including
all related conditions and recurrent symptoms of these injuries, are considered a single Injury. “Medical Emergency” means a condition caused by an Injury or Sickness that manifests itself by symptoms of sufficient severity
that a prudent lay person possessing an average knowledge of health and medicine would reasonably expect that failure to receive immediate medical attention would place the health of the person in serious jeopardy. “Sickness” means
an illness, disease or condition that causes a loss for which you incur medical expenses while covered under this Policy. All related conditions and recurrent symptoms of the same or similar condition will be considered one Sickness.
“Trip” means travel by air, land, or sea from your Home Country. “We, Our, Us” means the insurance company underwriting this insurance or its authorized agent. 

You must notify ACE USA within 90 days of an Accident or Loss. If notice cannot be given within that time, it must be given as soon as reasonably
possible. This notice should identify you, your employer, and the Policy Number. 
 Policy Number: ADD N04156870, Underwritten by ACE American
Insurance Company, 436 Walnut Street, Philadelphia, PA 19106 
 Contact Information: For customer service, eligibility verification,
plan information, or to file a claim, contact: ACE USA at 800-336-0627 (from inside the U.S.) or 302-476-6194 (from outside the U.S.); fax 302-467-6154 for claims or inquiries or e-mail diane.basa@acegroup.com. Mail claims to: ACE USA, PO Box
15417, Wilmington, DE 19850. For medical evacuation, repatriation, or other assistance services call: Europ Assistance at 800-243-6124 (inside the U.S.) or call collect 202-659-7803 (from outside the U.S.) or e-mail OPS@europassistance-usa.com.

 To access ACE’s Travel Assistance Website go to www.acetravelassistance.com and enter your user ID and password (shown on your
Travel Assistance ID card). 
 Travel Assistance Services: In addition to the insurance protection provided by this plan, ACE USA has
arranged with Europ Assistance USA to provide you with access to its travel assistance services around the world. These services include: 
  

	•	 	 Medical Assistance including referral to a doctor or medical specialist, medical monitoring when you are hospitalized, emergency medical evacuation to
an adequate facility, medically necessary repatriation, and return of mortal remains. 

  

	•	 	 Personal Assistance including pre-trip medical referral information and while you are on a trip: emergency medication, embassy and consular
information, lost document assistance, emergency referral to a lawyer, translator or interpreter access, medical benefits verification, and medical claims assistance. 

 

	•	 	 Travel Assistance including emergency travel arrangements, arrangements for the return of your traveling companion or dependents, and vehicle return.

  

	•	 	 Access to a secure, web-based system for tracking global threats and health or location based risk intelligence. 

 

	•	 	 Crisis hotline and on the ground security assistance to help address safety concerns or to secure immediate assistance while traveling.

 When you call, please be prepared with the following information: 1) name of caller, phone number, fax number, and
relationship to the Covered Person; 2) Covered Person’s name, age, sex, and the policy number for your insurance plan, and 

  

			
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 your Plan Number (01AH585); 3) a description of the insured’s condition; 4) name, location, and
telephone number of the hospital or other service provider; and 5) other insurance information including health insurance, workers’ compensation, or auto insurance if the insured was involved in an accident. 

This information provides you with a brief outline of the services available to you. These services are subject to the terms and conditions of the Policy
under which you are insured. A third party vendor may provide services to you. Europ Assistance makes every effort to refer you to appropriate medical and other service providers. It is not responsible for the quality or results of service provided
by independent providers. In all cases, the medical provider, facility, legal counsel, or other professional service provider suggested by Europ Assistance are not employees or agents of Europ Assistance and the choice of provider is yours alone.
Europ Assistance assumes no liability for the services provided to you under this arrangement, nor is it liable for any negligence or other wrongful acts or omissions of any of the legal or health care professionals providing services to you. Travel
assistance services are not available if your coverage under the Policy providing insurance benefits is not in effect. 
 This Description of
Coverage is a brief description of the important features of the insurance plan. It is not a contract of insurance. The terms and conditions of coverage are set forth in the Policy issued to your employer. The Policy is subject to the laws of the
state in which it was issued. Coverage may not be available in all states or certain terms or conditions may be different if required by state law. Please keep this information as a reference. 

  

			
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