Document:

exv4w1

 

	CUSIP 224122 10 1

 

	CRAFT BREWERS ALLIANCE, INC.
The Corporation will furnish without charge to each stockholder who so requests the powers,
designations, preferences and relative, participating, optional, or other special rights of each
class of stock or series thereof and the qualifications, limitations or restrictions of such
preferences and/or rights. Such request shall be made in writing to the Corporation’s Secretary at
the principal office of the Corporation.
The following abbreviations, when used in the inscription on the face of this certificate, shall be
construed as though they were written out in full according to applicable laws or regulations:
TEN COM — as tenants in common UNIF GIFT MIN ACT— Custodian
TEN ENT — as tenants by the entireties (Cust) (Minor) JT TEN — as joint tenants with right under
Uniform Gifts to Minors —of survivorship and not as tenants in common Act (State)
UNIF TRF MIN ACT— Custodian (until age) (Cust)
under Uniform Transfers (Minor) to Minors Act (State) Additional abbreviations may also be used
though not in the above list.
FOR VALUE RECEIVED, hereby sell, assign and transfer(s) unto
PLEASE INSERT SOCIAL SECURITY OR OTHER
IDENTIFYING NUMBER OF ASSIGNEE
(PLEASE PRINT OR TYPEWRITE NAME AND ADDRESS, INCLUDING ZIP CODE, OF ASSIGNEE)
Shares of the Common Stock represented by the within Certificate, and do(es) hereby irrevocably
constitute and appoint
Attorney to transfer the said stock on the books of the within named Corporation with full power of
substitution in the premises.
Dated X
X
NOTICE: THE SIGNATURE(S) TO THIS ASSIGNMENT MUST CORRESPOND
WITH THE NAME(S) AS WRITTEN UPON THE FACE OF THE CERTIFICATE IN EVERY PARTICULAR WITHOUT ALTERATION
OR ENLARGEMENT OR ANY CHANGE WHATEVER.
SIGNATURES GUARANTEED:
By
THE SIGNATURE(S) MUST BE GUARANTEED BY AN ELIGIBLE GUARANTOR INSTITUTION (BANKS, STOCKBROKERS,
SAVINGS AND LOAN ASSOCIATIONS AND CREDIT UNIONS WITH MEMBERSHIP IN AN APPROVED SIGNATURE GUARANTEE
MEDALLION PROGRAM), PURSUANT TO S.E.C. RULE 17Ad-15.exv10w4

 

Exhibit 10.4

Stock Option Agreement

     ADVENTRX Pharmaceuticals, Inc., a Delaware corporation (the “Company”), and the undersigned
person (“Optionee”) have entered into this Stock Option Agreement (this “Agreement”) effective as
of the Grant Date set forth below. The Company has granted to Optionee the option (the “Option”) to
purchase the number of shares (the “Shares”) of common stock, par value $0.001 per share, of the
Company (“Common Stock”) set forth below at the per Share purchase price (the “Exercise Price”) set
forth below, pursuant to the terms of this Agreement. The Option was granted under the Company’s
2005 Equity Incentive Plan (the “Plan”).

	 	 	 	 	 
	Optionee Name:
	 	 	 	 
	 
	 	 	 	 
	Grant Date:
	 	MM/DD/YYYY	 	 
	Vesting Commencement Date:
	 	MM/DD/YYYY	 	 
	Shares:
	 	X,XXX	 	 
	Exercise Price:
	 	$X.XX	 	 

1. Terms of Plan. All capitalized terms used in this Agreement and not otherwise defined shall
have the meanings ascribed thereto in the Plan. Optionee confirms and acknowledges that Optionee
has received and reviewed copies of the Plan and the Information Statement, dated                     ,
with respect to the Plan. Optionee and the Company agree that the terms and conditions of the Plan
are incorporated in this Agreement by this reference.

2. Nature of the Option. The Option has been granted as an incentive to Optionee’s Continuous
Service, and is in all respects subject to such Continuous Service and all other terms and
conditions of this Agreement. The Option is intended to be an [Incentive/Nonstatutory] Option
within the meaning of the Plan.

3. Vesting and Exercise of Option. The Option shall vest and become exercisable during its term in
accordance with the following provisions:

     (a) Vesting and Right of Exercise.

(i) The Option shall vest and become exercisable with respect to one-fifth of the
Shares at the first anniversary of the Vesting Commencement Date set forth in the
preamble of this Agreement and as to one-fifth of the Shares on each anniversary of
the Vesting Commencement Date thereafter until all of the Shares have vested,
subject to Optionee’s Continuous Service.

(ii) In the event of Optionee’s death, disability or other termination of
Optionee’s Continuous Service, the Option shall be exercisable in the manner and to
the extent provided in Section 6.3 of the Plan.

 

 

(iii) No fraction of a Share shall be purchasable or deliverable upon exercise of
the Option, but in the event any adjustment hereunder of the number of Shares shall
cause such number to include a fraction of a Share, such number of Shares shall be
rounded down to the nearest smaller whole number of Shares.

     (b) Method of Exercise. In order to exercise any portion of the Option which has vested,
Optionee shall notify the Company in writing of the election to exercise such vested portion of the
Option and the number of Shares in respect of which the Option is being exercised, by executing and
delivering the Notice of Exercise of Stock Option in the form attached hereto as Exhibit A (the
"Exercise Notice”). The certificate or certificates representing Shares as to which the Option has
been exercised shall be registered in the name of Optionee.

     (c) Restrictions on Exercise.

(i) Optionee may exercise the Option only with respect to Shares that have vested
in accordance with Section 3(a) of this Agreement.

(ii) Optionee may not exercise the Option if the issuance of the Shares upon such
exercise or the method of payment of consideration for such Shares would constitute
a violation of any applicable federal or state securities law or other law or
regulation.

(iii) The method and manner of payment of the Exercise Price will be subject to the
rules under Part 221 of Title 12 of the Code of Federal Regulations as promulgated
by the Federal Reserve Board if such rules apply to the Company at the date of
exercise.

(iv) As a condition to the exercise of the Option, the Company may require Optionee
to make any representation or warranty to the Company at the time of exercise of
the Option as in the opinion of legal counsel for the Company may be required by
any applicable law or regulation, including the execution and delivery of an
appropriate representation statement. Accordingly, the stock certificate(s) for the
Shares issued upon exercise of the Option may bear appropriate legends restricting
transfer.

(v) Optionee may only exercise the Option upon, and the obligations of the Company
under this Agreement to issue Shares to Optionee upon any exercise of the Option is
conditioned on, satisfaction of all federal, state, local or other withholding tax
obligations associated with such exercise (whether so required to secure for the
Company an otherwise available tax deduction or otherwise) (“Withholding
Obligations”). The Company reserves the right to require Optionee to remit to the
Company an amount sufficient to satisfy all Withholding Obligations prior to the
issuance of any Shares upon any exercise of the Option. Optionee

 

 

authorizes the Company to withhold in accordance with applicable law from any
compensation payable to Optionee any amounts necessary to meet any Withholding
Obligations.

4. Non-Transferability of Option. The Option may not be transferred in any manner other than by
will or by the laws of descent and distribution. The terms of this Agreement shall bind the
executors, administrators, heirs and successors of Optionee.

5. Method of Payment.

     (a) Upon exercise, Optionee shall pay the aggregate Exercise Price of the Shares purchased by
any of the following methods, or a combination thereof, at the election of Optionee:

(i) by cash;

(ii) by certified or bank cashier’s check;

(iii) if shares of Common Stock are traded on an established stock market or
exchange on the date of exercise, by surrender of whole shares of Common Stock
having a Market Value equal to the portion of the Exercise Price to be paid by such
surrender, provided that if such shares of Common Stock to be surrendered were
acquired upon exercise of an Incentive Option, Optionee must have first satisfied
the holding period requirements under Section 422(a)(1) of the Code; or

(iv) if shares of Common Stock are traded on an established stock market or
exchange on the date of exercise, pursuant to and under the terms and conditions of
any formal cashless exercise program authorized by the Company entailing the sale
of the Stock subject to an Option in a brokered transaction (other than to the
Company).

     (b) If Optionee shall pay all or a portion of the aggregate Exercise Price due upon an
exercise of the Option by surrendering shares of Common Stock pursuant to Section 5(a)(iii), then
Optionee:

(i) shall accompany the Exercise Notice with a duly endorsed blank stock power with
respect to the number of shares of Common Stock to be surrendered and shall deliver
the certificate(s) representing such surrendered shares to the Company at its
principal offices within two business days after the date of the Exercise Notice;

(ii) authorizes and directs the Secretary of the Company to transfer so
many of the shares of Common Stock represented by such certificate(s) as are necessary to pay
the aggregate Exercise Price in accordance with this Agreement;

 

 

(iii) agrees that Optionee may not surrender any fractional share as payment of any
portion of the Exercise Price; and

(iv) agrees that, notwithstanding any other provision in this Agreement, Optionee
may only surrender shares of Common Stock owned by Optionee as of the date of the
Exercise Notice in the manner and within the time periods allowed under Rule 16b-3
promulgated under the Exchange Act.

6. Adjustments to Option. Subject to any required action by the stockholders of the Company, the
number of Shares covered by the Option, and the Exercise Price, shall be proportionately adjusted
in accordance with and pursuant to Section 8.1 of the Plan. Such adjustments shall be made by the
Committee, whose determination in that respect shall be final, binding and conclusive. Except as
expressly provided in this Agreement, no issue by the Company of shares of stock of any class, or
securities convertible into shares of stock of any class, shall affect, and no adjustment by reason
thereof shall be made with respect to, the number of Shares or the Exercise Price.

7. Term of Option. The Option may not be exercised more than 10 years after the Grant Date, and
may be exercised during such term only in accordance with the terms of this Agreement.

8. Not Employment Contract. Nothing in this Agreement shall confer upon Optionee any right to
continue in the employ of the Company or shall interfere with or restrict in any way the rights of
the Company, which are hereby expressly reserved, to terminate Optionee’s Continuous Service at any
time for any reason whatsoever, with or without cause, subject to the provisions of applicable law.

9. Tax Consequences Generally. Optionee acknowledges that Optionee may suffer adverse tax
consequences as a result of Optionee’s exercise of the Option. Optionee acknowledges that the
Company advises that Optionee consult with Optionee’s tax advisers in connection with any exercise
of the Option or disposition of the Shares receivable upon exercise of the Option. Optionee agrees
that Optionee is not relying on the Company for any tax advice with respect to the acceptance or
exercise of the Option, the disposition of any Shares Optionee may acquire upon exercise of the
Option or otherwise. Any adverse consequences incurred by an Optionee with respect to the use of
shares of Common Stock to pay any part of the aggregate Exercise Price or of any tax in connection
with the exercise of an Option, including, without limitation, any adverse tax consequences arising
as a result of a disqualifying disposition within the meaning of Section 422 of the Code shall be
the sole responsibility of Optionee.

 

 

10. Adjustments in Acquisitions.

In accordance with the provisions of Section 8.2(a) of the Plan, the Option will Accelerate in full
in the event of an Acquisition constituting a Change of Control if Optionee remains employed by the
Company or one of its Affiliates as of the closing date of such Acquisition, and the Option is not
assumed or replaced by the successor or acquiring entity or the entity in control of such successor
or acquiring entity in accordance with Section 8.2 (referred to for purposes of this section as the
“Acquirer”). Otherwise, the Option will not Accelerate in the event of an Acquisition. In this
regard, if Optionee is offered employment or some other continuing role by or on behalf of the
Acquirer, including but not limited to, continuing employment with the Company, and in connection
therewith, the Acquirer offers to assume or replace the Option, the Option will not Accelerate if
Optionee does not accept the offer.

If, following a Change of Control in which the Option has been assumed by the successor or
acquiring entity as of the closing date of such Change of Control, in the event of Optionee’s
Involuntary Termination of employment within 24 months after the closing date of such Change of
Control the vesting of the assumed Option shall be accelerated such that the Option will so vest as
of the effective date of such Involuntary Termination with respect to all Shares that would have
become vested during such 24-month period but for the Change of Control and Involuntary Termination
(assuming Optionee’s Continuous Service). An “Involuntary Termination” is one that occurs by reason
of dismissal for any reason other than Misconduct or of voluntary resignation following: (i) a
change in position that materially reduces the level of Optionee’s responsibility, (ii) a material
reduction in Optionee’s base salary, or (iii) relocation by more than 50 miles; provided that (ii)
and (iii) will apply only if Optionee has not consented to the change or relocation. “Misconduct”
shall mean the commission of any act of fraud, embezzlement or dishonesty by Optionee, any
unauthorized use or disclosure by such person of confidential information or trade secrets of the
Company (or any Parent or Subsidiary), or any other intentional misconduct by such person adversely
affecting the business affairs of the Company (or any Parent or Subsidiary) in a material manner.
The foregoing definition shall not be deemed to be inclusive of all the acts or omissions which the
Company (or any Parent or Subsidiary) may consider as grounds for the dismissal or discharge of
Optionee.

11. Consent of Spouse/Domestic Partner. Optionee agrees that Optionee’s spouse’s or domestic
partner’s interest in the Option is subject to this Agreement and such spouse or domestic partner
is irrevocably bound by the terms and conditions of this Agreement. Optionee agrees that all
community property interests of Optionee and Optionee’s spouse or domestic partner in the Option,
if any, shall similarly be bound by this Agreement. Optionee agrees that this Agreement is binding
upon Optionee’s and Optionee’s spouse’s or domestic partner’s executors, administrators, heirs and
assigns. Optionee represents and warrants to the Company that Optionee has the authority to bind
Optionee’s spouse/domestic partner with respect to the Option. Optionee agrees to execute and
deliver such documents as may be necessary to carry out the intent of this Section 11 and the
consent of Optionee’s spouse/domestic partner.

 

 

     IN WITNESS WHEREOF, Optionee and the Company have entered into this Agreement as of the Grant
Date.

	 	 	 	 	 	 	 
	 	 	ADVENTRX Pharmaceuticals, Inc.
	 

	 	 	 	 	 	 
	[Optionee Name]

	 	By:	 	 	 	 
	 

	 	 

	 	 
	 

	 	Name:	 	 	 	 
	 

	 	 
	 	 
	 
	 

	 	Title:	 	 	 	 
	 

	 	 
	 	 

 

 

Exhibit A

Notice of Exercise of Stock Option

I                                                              (please print legibly) hereby elect to
exercise the
stock options(s) identified below (the “Option(s)”) granted to me by ADVENTRX
Pharmaceuticals, Inc. (the “Company”) under its 2005 Equity Incentive Plan (the
“Plan”) with respect to the number of shares of Common Stock of the Company set forth below
(the “Shares”). I represent that each Share is fully vested and exercisable and subject to
the Option(s). I acknowledge and agree that my exercise of the Option(s) is subject to the terms
and conditions of the Plan and the Stock Option Agreement(s) governing the Option(s).

1.                                          Shares at $                      per share (Grant date):                                         

2.                                          Shares at $                      per share (Grant date):                                         

3.                                          Shares at $                      per share (Grant date):                                         

4.                                          Shares at $                      per share (Grant date):                                         

I choose to pay for the exercise of the above option(s) as follows (please
circle applicable item numbers):

1. Cash: $                    

2. Check: $                     (please make checks payable to ADVENTRX Pharmaceuticals, Inc.)

3. Surrender of                      Shares:

Please deliver the stock certificate(s) representing the Shares to (please print legibly):

 

 
 

 
 

 
 

	 	 	 	 	 
	Name:
	 	 	 	 
	 

	 	 

(please print legibly)
	 	 

	 	 	 	 	 
	Signature:
	 	 	 	 
	 

	 	 

	 	 
	Date:
	 	 	 	 
	 

	 	 

	 	 
	Phone No:

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