Document:

Amended and Restated (2022) Separation Benefits Plan (00103078-7).DOCX

Exhibit 10.1

SEPARATION BENEFITS PLAN
(AND SUMMARY PLAN DESCRIPTION)
EFFECTIVE JULY 24, 2018
(As Amended and Restated July 26, 2022)
Waste Connections US, Inc. (the “Company”) has established this Plan to provide for severance and change in control benefits to certain eligible executives of the Company in the event that employment with the Company is involuntarily terminated.  This Plan is hereby amended and restated as of the Effective Date.  This Plan is intended to be an unfunded “top hat” welfare plan subject to the ERISA.  This Plan document is also the summary plan description of this Plan.  This Plan is amended and restated effective July 26, 2022.
	1.	General Eligibility.  An executive is eligible for the benefits provided under this Plan only if (i) the Compensation Committee designates the executive as a Participant in the Plan, and (ii) the Company, through a duly authorized officer of the Company, and the executive execute a Letter Agreement confirming the executive’s eligibility for, and participation in, the Plan.  A Participant’s Letter Agreement shall designate his or her status as a “President/EVP Participant,” an “SVP Participant” or a “VP Participant”.  

	2.	Position and Responsibilities. The Participant’s position and responsibilities shall be as set forth in his or her Letter Agreement. The Participant shall devote such time and attention to his or her duties as are necessary to the proper discharge of his or her responsibilities hereunder. The Participant agrees to perform all duties consistent with (i) policies established from time to time by the Company, and (ii) all applicable legal requirements. 

	3.	Term. The period of this Plan shall commence on the Effective Date and shall continue through to the third anniversary of the Effective Date (the “Term”).  On each anniversary of the Effective Date, this Plan shall be extended automatically an additional year, thus extending the Term of this Plan to three years from such date for each Participant in the Plan, unless the Company shall have given Notice of Termination or non-renewal hereof to the Participant or the Participant shall have given Notice of Termination to the Company, as provided herein. 

	4.	Compensation and Benefits. The Participant’s Base Salary, Bonus, equity grant eligibility, benefits, and participation level shall be as set forth in his or her Letter Agreement. 

	5.	Confidentiality. During the Employment Period and at all times thereafter, the Participant shall not, without the prior written consent of the Company, divulge to any third party or use for his or her own benefit or the benefit of any third party or for any purpose other than the exclusive benefit of the Company, any confidential or proprietary business or technical information revealed, obtained or developed in the course of his or her employment with the Company and which is otherwise the property of the Company or any of its affiliated entities, including, but not limited to, trade secrets, customer lists, formulae and business processes; provided, however, that nothing herein contained shall restrict the Participant’s ability to make such disclosures during the course of his or her employment as may be necessary or appropriate to the effective and efficient discharge of his or her duties to the Company. 

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	6.	Property. Both during the Employment Period and thereafter, the Participant shall not remove from the Company’s offices or premises any Company documents, records, notebooks, files, correspondence, reports, memoranda and similar materials or property of any kind unless necessary in accordance with the duties and responsibilities of his or her employment. In the event that any such material or property is removed, it shall be returned to its proper file or place of safekeeping as promptly as possible. The Participant shall not make, retain, remove or distribute any copies, or divulge to any third person the nature or contents of any of the foregoing or of any other oral or written information to which he may have access, except as disclosure shall be necessary in the performance of his or her assigned duties. On the termination of his or her employment with the Company, the Participant shall leave with or return to the Company all originals and copies of the foregoing then in his or her possession or subject to his or her control, whether prepared by the Participant or by others. 

	7.	Termination By Company. 

		a.	Termination for Cause. The employment of the Participant may be terminated for Cause at any time by the Board on delivery to the Participant of a written Notice of Termination; provided, however, that before the Board may terminate the employment of a President/EVP Participant for Cause, the Board shall first send the Participant written notice of its intention to terminate the Participant’s employment with the Company for Cause, specifying in such notice the reasons for such Cause and those conditions that, if satisfied by the Participant, would cure the reasons for such Cause. 

Immediately on termination of employment pursuant to this Section 7(a), the Company shall pay to the Participant in a lump sum his or her then current Base Salary on a prorated basis to the Date of Termination. For the avoidance of doubt, upon termination of employment for Cause, the Participant shall be subject to the non-competition and non-solicitation provisions of Section 13.  On the Participant’s termination of employment pursuant to this Section 7(a), the Participant (i) shall not be entitled to any additional benefits or compensation above accrued but unpaid amounts, except to the extent required by applicable law, (ii) shall forfeit his or her Bonus for the year in which such termination occurs, and (iii) shall forfeit all outstanding but unvested Equity Awards.  
		b.	Termination Without Cause. The employment of the Participant may be terminated without Cause at any time by the Board on delivery to the Participant of a written Notice of Termination.  On a termination of the Participant’s employment without Cause, in lieu of any payments under Section 4 for the remainder of the Term, the Company shall make the following payments to the Participant:

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		1.	Severance Payment.  The Company shall pay to the Participant an amount equal to the Severance Amount.  Unless otherwise provided for in the Participant’s Letter Agreement, provided that the Participant has complied with the provisions of Section 13 hereof as of the date a payment is scheduled to be paid, the Severance Amount shall be paid as follows: (i) for 

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			a President/EVP Participant, one-third on the Date of Termination and one-third on each of the first and second anniversaries of the Date of Termination, and (ii) for an SVP Participant or a VP Participant, in installments during the twelve month period following his or her Date of Termination in accordance with the Company’s normal payroll practices. 

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		2.	Accelerated Vesting.  On termination of the Participant under this Section 7(b), the Accelerated Vesting Benefit shall apply to the Participant’s then outstanding Equity Awards.  

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		3.	Additional Benefits.  If the Participant is an SVP Participant, the Company also shall provide the Health Insurance Benefit and the Outplacement Benefit to the Participant.

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		c.	Termination on Disability. If during the Term the Participant becomes Disabled, the Board shall have the right, on written Notice of Termination delivered to the Participant, to terminate the Participant’s employment under this Plan. During the period that the Participant shall have been incapacitated due to Disability, the Participant shall continue to receive the full Base Salary at the rate then in effect until the Date of Termination pursuant to this Section 7(c).  On a termination of the Participant’s employment due to Disability, in lieu of any payments under Section 4 for the remainder of the Term, the Company shall make each of the payments to the Participant as would be made if the Participant’s employment had been terminated by the Company without Cause under Section 7(b); provided, however, that (i) the Participant shall not receive the Outplacement Benefit, and (ii) if, following the Participant’s termination of employment pursuant to this Section 7(c), the Participant dies or becomes disabled (as such term is defined under Treasury Regulation Section 1.409A-3(i)(4)), any unpaid portion of the Severance Amount shall be paid to the Participant or, if applicable, the Participant’s heirs, executors, administrators, legatees, beneficiaries or assigns, in a single lump sum payment as soon as administratively practicable after the date  on which such death or disability occurs. 

		d.	Death. If the Participant dies during the Term, the Company shall pay to the Participant’s estate each of the payments the Company would have paid if the Participant’s employment had been terminated by the Company without Cause under Section 7(b); provided, however, that the Participant’s estate shall not receive the Health Insurance Benefit or the Outplacement Benefit.  The provisions of this Section 7(d) shall not affect the entitlements of the Participant’s heirs, executors, administrators, legatees, beneficiaries or assigns under any employee benefit plan, fund or program of the WCI Group.

		e.	Release.  As a condition to the payment of any amount under this Section 7, including the acceleration of vesting or payment for any Equity Awards, the Participant (or the Participant’s executor, legal guardian, or other legal representative in the case of the Participant’s death or Disability) shall execute and not revoke a waiver and release of all claims against the WCI Group in a form 

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			reasonably acceptable to the Company within 21 days following the Participant’s receipt of the release agreement; provided, however, that if the Participant’s employment is terminated due to his death or Disability, such release shall not apply to any claims the Participant or his estate may have against the Company or the Parent for wrongful death or gross negligence.

	8.	Termination By Participant. 

		a.	Termination for Good Reason. Unless otherwise provided for in the Participant’s Letter Agreement, in the event the Participant terminates his or her employment with the Company for Good Reason, in lieu of any payments under Section 4 for the remainder of the Term, the Company shall make each of the payments to the Participant as would be made if the Participant’s employment had been terminated by the Company without Cause under Section 7(b).  For the avoidance of doubt, a Participant may not terminate his or her employment with the Company for Good Reason unless such Participant is, on his or her Date of Termination, eligible to terminate his or her employment with the Company for Good Reason. 

		b.	Termination Without Good Reason. The Participant may terminate his or her employment hereunder without Good Reason on written Notice of Termination delivered to the Company.  If the Participant terminates his or her employment without Good Reason, he or she shall be entitled to receive, and the Company agrees to pay on the Date of Termination, his or her current Base Salary on a prorated basis to such Date of Termination.  For the avoidance of doubt, upon termination of employment without Good Reason, the Participant shall be subject to the non-competition and non-solicitation provisions of Section 13.  On the Participant’s termination of employment pursuant to this Section 8(b), the Participant shall not be entitled to any additional benefits or compensation above accrued but unpaid amounts, except to the extent required by applicable law; and, the Participant shall forfeit his or her Bonus for the year in which such termination occurs. In addition, the Participant shall forfeit all outstanding but unvested Equity Awards.  

		c.	Release.  As a condition to the payment of any benefit related to the termination of employment under Section 8(a), a Participant shall execute and not revoke a waiver and release of all claims against the WCI Group in a form reasonably acceptable to the Company within 21 days following the Participant’s receipt of the release agreement.

	9.	Provisions Applicable to Termination of Employment. 

		a.	Notice of Termination. Any purported termination of Participant’s employment by the Company pursuant to Section 7 shall be communicated by delivery of a Notice of Termination to the Participant.  If the Participant terminates under Section 8, he or she shall give the Company a Notice of Termination.  

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		b.	Benefits on Termination. Except as otherwise provided herein, on termination of the Participant’s employment by the Company pursuant to Section 7 or by the Participant pursuant to Section 8, all profit-sharing, deferred compensation and other retirement benefits payable to the Participant under benefit plans in which the Participant then participated shall be paid to the Participant in accordance with the provisions of the respective plans. 

		c.	Required Payment Delay.  Notwithstanding anything to the contrary in this Plan, no compensation or benefits payable by reason of the Participant’s termination of employment that are deemed non-qualified deferred compensation subject to Section 409A shall be payable by reason of the Participant’s termination of employment pursuant to this Plan unless such termination of employment constitutes a “separation from service” with the Company (“Separation from Service”) within the meaning of Section 409A.  If the Participant is deemed to be a “specified employee” (as determined by the Company in accordance with Section 409A) at the time of the Participant’s Separation from Service, to the extent delayed commencement of any portion of the benefits to which the Participant is entitled under this Plan is required in order to avoid a prohibited distribution under Section 409A, such portion of the Participant’s benefits shall not be provided to the Participant prior to the first business day following the expiration of the six-month period measured from the date of the Participant’s Separation from Service (or such earlier date upon which such amount can be paid under Section 409A without resulting in a prohibited distribution, including as a result of Participant’s death).  Upon the first business day following the expiration of the applicable period described in the foregoing sentence, all payments deferred pursuant to this Section shall be paid in a lump sum to the Participant, and any remaining payments due under this Plan shall be paid as otherwise provided herein. 

		d.	Non-Renewal of Plan.  For the avoidance of doubt, the Company’s notice of its intent not to extend the Term of this Plan with respect to a Participant shall be treated as a termination of the Participant by the Company without Cause.    

	10.	Fixed Term Participant Status.  

		a.	Application Process.  A Participant who satisfies the criteria described in Section 10(c) below may submit an application to Parent’s Chief Executive Officer (the “CEO”) for designation as a Fixed Term Participant.  An application for Fixed Term Participant status must be submitted not later than December 31st of the calendar year immediately preceding the calendar year of the desired effective date of the change in status.  The CEO shall review each application and, in his or her sole discretion, will either (i) approve such designation, or (ii) for any Participant who is a Section 16 officer, recommend that the Compensation Committee approve such designation; provided, however, that the CEO may, in his or her sole discretion, decline to approve or recommend approval of, as applicable, a Participant’s application under this Section 10 and, in such event, that decision and any subsequent decision by the Compensation Committee declining to approve an application (including any denial of a request for waiver of one or more eligibility 

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			criteria by the CEO or the Compensation Committee, as applicable, under Section 8(c) below) will not be considered a basis for the Participant to terminate his or her employment with the Company for Good Reason.

		b.	Written Agreement.  If a Participant’s application for designation as a Fixed Term Participant is approved, the Participant will enter into an amended and restated Letter Agreement with the Company (“Fixed Term Agreement”) that will include: (i) the effective date of the change in status, which shall not be earlier than six (6) months or later than twelve (12) months after the date the request is made; (ii) a reduced level of Base Salary; (iii) the Participant’s new title and service location; (iv) the Participant’s fixed period of continued employment, which shall be not less than three (3) years from the effective date of the change in status, unless a shorter period of continued service is approved by the CEO or, if applicable, the Compensation Committee, at the time Fixed Term Participant status is granted; and (v) an acknowledgment by the Participant of the applicability of the policies established from time to time by the Company and Parent, including the Code of Conduct and Ethics, to the Participant’s continued employment during his or her Fixed Term Participant status.

		c.	Eligibility.  A Participant is eligible to apply for Fixed Term Participant status if the Participant has: (i) completed at least fifteen (15) years of continuous service with the Company (including its subsidiaries and affiliates); (ii) attained the age of sixty (60); and (iii) completed at least ten (10) years as a Participant.  A Participant may include  in his or her application a request for a waiver from the CEO or, if applicable, the Compensation Committee, of one or more of the criteria listed in this Section 10(c).  Any waiver of an application criteria shall be made in the sole discretion of the CEO or, if applicable, the Compensation Committee.

		d.	Additional Terms.  Notwithstanding any provision of this Plan to the contrary, the following shall apply to any Fixed Term Participant upon the effective date of the change in status specified in his or her Fixed Term Agreement: (i) the Participant will retain his or her prior status designation pursuant to Section 1 until the Participant’s Date of Termination; (ii) the Participant will retain all then outstanding Equity Awards, which shall continue to be administered in accordance with their terms; (iii) the Participant will not be eligible to Terminate his or her employment with the Company for Good Reason under this Plan or under any other compensation program sponsored by the WCI Group; and (iv) the Participant will not, in the ordinary course of business, receive any additional Bonuses, Equity Awards, grants or awards under the WCI Group’s performance bonus plan, equity compensation plan, or similar incentive compensation programs.

	11.	Change In Control. 

		a.	Payments on Change in Control. Subject to Section 9(c) above, if a Change in Control occurs during the Term and the Participant’s employment with the Company is terminated by the Company without Cause or by the Participant for Good Reason, in each case within two (2) years after the effective date of the 

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			Change in Control, then (i) the Participant shall be entitled to receive and the Company agrees to pay to the Participant, in lieu of payments under Section 4 for the remainder of the Term, the amount payable under Section 7(b) or Section 8(a), as applicable, provided the Participant executes the associated waiver in Section 7(e) or Section 8(c), as applicable; and (ii) such amount shall be paid in a lump sum on or within 60 days following the Date of Termination.  

		b.	Section 409A Limitation.  No benefits deemed non-qualified deferred compensation subject to Section 409A shall be payable upon a Change in Control pursuant to this Plan unless such Change in Control constitutes a “change in control event” with respect to the Company within the meaning of Section 409A.

	12.	Limitation on Payments. Notwithstanding any other provisions of this Plan, in the event that any payment or benefit received or to be received by the Participant, whether pursuant to the terms of this Plan or any other plan, arrangement or agreement (all such payments and benefits being hereinafter referred to as the “Total Payments”), would be subject (in whole or part), to the excise tax imposed under Section 4999 of the Code (the “Excise Tax”), then, after taking into account any reduction in the Total Payments provided by reason of Section 280G of the Code in such other plan, arrangement or agreement, the Total Payments shall be reduced as set forth herein, to the extent necessary so that no portion of the Total Payments is subject to the Excise Tax but only if (i) the net amount of such Total Payments, as so reduced (and after subtracting the amount of all federal, state and local income and employment taxes payable with respect to the foregoing calculated at the maximum marginal income tax rate for each year in which the foregoing shall be paid to the Participant (based on the rate in effect for such year as set forth in the Code as in effect at the time of the first payment of the foregoing) on such reduced Total Payments and after taking into account the phase out of itemized deductions and personal exemptions attributable to such reduced Total Payments) is greater than or equal to (ii) the net amount of such Total Payments without such reduction (but after subtracting the amount of all federal, state and local income and employment taxes payable with respect to the foregoing calculated at the maximum marginal income tax rate for each year in which the foregoing shall be paid to the Participant (based on the rate in effect for such year as set forth in the Code as in effect at the time of the first payment of the foregoing) on such Total Payments and the amount of Excise Tax to which the Participant would be subject in respect of such unreduced Total Payments and after taking into account the phase out of itemized deductions and personal exemptions attributable to such unreduced Total Payments).  The Total Payments shall be reduced by the Company in its reasonable discretion in the following order: (A) reduction of any cash severance payments otherwise payable to the Participant that are exempt from Section 409A, (B) reduction of any other cash payments or benefits otherwise payable to the Participant that are exempt from Section 409A, but excluding any payment attributable to the acceleration of vesting or payment with respect to any Equity Award that is exempt from Section 409A, (C) reduction of any other payments or benefits otherwise payable to the Participant on a pro-rata basis or such other manner that complies with Section 409A, but excluding any payment attributable to the acceleration of vesting and payment with respect to any Equity Award that is exempt from Section 409A, and (D) reduction of any payments attributable to the acceleration of vesting or payment with respect to any Equity Award that is exempt from Section 409A.  For 

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		purposes of determining whether and the extent to which the Total Payments will be subject to the Excise Tax, (i) no portion of the Total Payments the receipt or enjoyment of which the Participant shall have waived at such time and in such manner as not to constitute a “payment” within the meaning of Section 280G(b) of the Code shall be taken into account, (ii) no portion of the Total Payments shall be taken into account which, in the opinion of independent counsel, consultants or advisors of nationally recognized standing (“Independent Advisors”) selected by the Company, does not constitute a “parachute payment” within the meaning of Section 280G(b)(2) of the Code (including by reason of Section 280G(b)(4)(A) of the Code) and, in calculating the Excise Tax, no portion of such Total Payments shall be taken into account which, in the opinion of Independent Advisors, constitutes reasonable compensation for services actually rendered, within the meaning of Section 280G(b)(4)(B) of the Code, in excess of the Base Amount (as defined in Section 280G(b)(3) of the Code) allocable to such reasonable compensation, and (iii) the value of any non-cash benefit or any deferred payment or benefit included in the Total Payments shall be determined by the Independent Advisors in accordance with the principles of Sections 280G(d)(3) and (4) of the Code. 

	13.	Non-Competition and Non-Solicitation. 

a.The Participant acknowledges that in his or her employment with the Company, the Participant occupies a position of trust and confidence.  The Participant agrees that the consideration and other benefits being given to him or her by the WCI Group clearly justify the following restrictions which, in any event, given the Participant’s skills and ability, will not prevent the Participant from earning a living.  The Participant acknowledges that all restrictions contained in this Section 13 are reasonable and valid as to time, geographical area, and scope of activity to be restrained for the adequate protection of the legitimate business interests and goodwill of the WCI Group, and are no broader than is necessary to protect such interests and goodwill.  The Participant agrees and acknowledges that due to the high-level nature of his or her duties for the WCI Group, the Participant’s key role within the Parent and the Company, and the nature and depth of the Confidential Information that the WCI Group shares with the Participant, it is reasonable for the Parent and the Company to expect the Participant not to engage in competition (as set forth in this Section 13(a)) anywhere in any county of any U.S. state, or any province or territory in Canada, in which the Participant provides services to the WCI Group, or about which the Participant has access to Confidential Information relating to the WCI Group’s current or planned operations in such county, province or territory (the “Restricted Territory”).1  In consideration of the provisions hereof, during the Employment Period and for the twelve (12)-month period following the 

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	Within the state of Louisiana, the Restricted Territory shall include the following parishes: Caddo, Bossier, Webster, Bienville, Lincoln, Jackson, Union, Morehouse, West Carroll, East Carroll, Madison, Richland, Franklin, Tensas, Quachita, Winn, Caldwell, Red River, Desoto, Sabine, Natchitoches, Grant, LaSalle, Avoyelles, Beauregard, Allen, Evangeline, St Landry, Lafayette, Point Coupee, East Baton Rouge, West Baton Rouge, Iberville, Assumption, St. Martin, St. Mary, Calcasieu, Jeff Davis, Allen, Acadia, Vermillion, Cameron, Iberia, Terrebonne, Lafourche, Ascension, St John, St James, St Charles, Jefferson, St Tammany, Orleans, St Bernard, Plaquemines, and Tangipahoa.

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Date of Termination (the “Restricted Period”), the Participant will not, except as specifically provided below and/or for the benefit of the WCI Group, anywhere in the Restricted Territory, directly or indirectly, acting individually or as the owner, shareholder, partner or management employee of any entity (whether current or planned to be formed), or as a consultant to any such entity, (i) engage or prepare to engage in any business principally focusing on liquid, semi-solid or solid waste collection, transportation, disposal, recycling and/or composting, including disposal or treatment of exempt and non-exempt oil field wastes derived from the exploration and production of hydrocarbons, and the operation of transfer stations, recycling facilities, materials recovery facilities or landfills, and/or any other business engaged in by the WCI Group (collectively the “Restricted Business”); or (ii) enter the employ of, or render any personal services to or for the benefit of, or assist in or facilitate the solicitation of customers for, or receive remuneration in the form of management salary, commissions or otherwise from, or act as a consultant or in any other advisory role, whether paid or unpaid, to any Restricted Business; or (iii) receive or purchase a financial interest in, make a loan to, make a gift in support of, or otherwise provide financial support to any Restricted Business in any capacity, including without limitation, as a sole proprietor, partner, shareholder, officer, director, principal agent or trustee.  The term “solicit” and related terms such as “soliciting” or “solicitation” mean to knowingly engage in acts or communications, in person or through others, that are intended or can reasonably be expected to induce or encourage a particular responsive action (such as buying a good or service), regardless of which party first initiates the contact or communication or whether the communication is in response to an inquiry or not.  Provided, that the Participant may own, directly or indirectly, solely as an investment, securities of any business traded on any national securities exchange or quoted on any NASDAQ market, provided the Participant is not a controlling person of, or a member of a group which controls, such business and further provided that the Participant does not, in the aggregate, directly or indirectly, own Two Percent (2%) or more of any class of securities of such business.
b.During the Restricted Period, the Participant shall not (i) solicit any customer of the WCI Group to whom any such the WCI Group entity provides service pursuant to a franchise agreement with a public entity in the Restricted Territory, (ii) solicit on behalf of a competitor any customer of the WCI Group to enter into a relationship involving the Restricted Business with a competitor of the WCI Group in the Restricted Territory, (iii) solicit on behalf of a competitor any public entity with which the WCI Group has a franchise agreement to enter into a franchise agreement involving the Restricted Business with a competitor of the WCI Group in the Restricted Territory, (iv) solicit any officer or employee of the WCI Group to enter into employment with a competitor of the WCI Group, or otherwise interfere in any such relationship, or (v) solicit on behalf of a competitor of the WCI Group any prospective customer of the WCI Group in the Restricted Territory that the Participant called on or was involved in soliciting on behalf of the WCI Group during the Employment Period.

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c.If a court of competent jurisdiction declares that any term or provision of this Section 13 is invalid or unenforceable, the parties agree that the court making the determination of invalidity or unenforceability shall have the power to reduce the scope, duration or area of the term or provision, to delete specified words or phrases or to replace any invalid or unenforceable term or provision with a term or provision that is valid and enforceable and that comes closest to expressing the intention of the invalid or unenforceable term or provision.
	14.	Indemnification. As an officer, employee and/or agent of the WCI Group, the Participant shall be indemnified by Parent and/or Company to the fullest extent permitted by applicable law in connection with his employment hereunder, unless Participant is asserting claims against the WCI Group or any member entity thereof.  The indemnification provided under this Section 14 shall be in addition to, and shall not limit in any manner, any indemnification available to the Participant from the WCI Group under any other agreement, program or provision.  

	15.	Survival of Provisions. The obligations of the Participant under Sections 5, 6 and 13 of this Plan and of the Company under Section 14 of this Plan shall survive both the termination of the Participant’s employment and this Plan. 

	16.	ERISA Matters.  

		a.	Generally.  This Plan is intended to be an unfunded “top hat” welfare plan within the meaning of US Department of Labor Regulation Section 2540.104-24 (a “Top Hat Plan”), and, to the extent applicable, shall be subject to ERISA.

		b.	Funding.  This Plan shall be maintained in a manner to be considered “unfunded” for purposes of ERISA.  The Company shall be required to make payments only as benefits become due and payable.  No person shall have any right, other than the right of an unsecured general creditor against the Company, with respect to the benefits payable hereunder, or which may be payable hereunder, to any Participant, surviving spouse or beneficiary hereunder.  If the Company, acting in its sole discretion, establishes a reserve or other fund associated with this Plan, no person shall have any right to or interest in any specific amount or asset of such reserve or fund by reason of amounts which may be payable to such person under this Plan, nor shall such person have any right to receive any payment under this Plan except as and to the extent expressly provided in this Plan.  The assets in any such reserve or fund shall be part of the general assets of the Company, subject to the control of the Company.

		c.	Claims Procedures.

		1.	Participant does not normally need to present a formal claim to receive benefits payable under this Plan.

		2.	If any person (the “Claimant”) believes that benefits are being denied improperly, that the Plan is not being operated properly, that fiduciaries of 

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			the Plan have breached their duties, or that the Claimant’s legal rights are being violated with respect to the Plan, the Claimant must file a formal claim, in writing, with the Board.  This requirement applies to all claims that any Claimant has with respect to the Plan, including claims against fiduciaries and former fiduciaries, except to the extent the Board determines, in its sole discretion, that it does not have the power to grant all relief reasonably being sought by the Claimant.

		3.	A formal claim must be filed within 90 days after the date the Claimant first knew or should have known of the facts on which the claim is based, unless Board in writing consents otherwise.  The Board will provide a Claimant, on request, with a copy of the claims procedures established under subsection (d).

		4.	The Board has adopted procedures for considering claims (which are set forth in Appendix A), which it may amend from time to time, as it sees fit.  These procedures will comply with all applicable legal requirements.  These procedures may provide that final and binding arbitration will be the ultimate means of contesting a denied claim (even if the Board or its delegates have failed to follow the prescribed procedures with respect to the claim).  The right to receive benefits under this Plan is contingent on a Claimant using the prescribed claims procedures to resolve any claim.

		d.	Rights Under ERISA.  Appendix B sets forth certain rights and information to which the Participant is entitled under ERISA.

	17.	Section 409A Matters.  

		a.	To the extent applicable, this Plan shall be interpreted and applied consistent and in accordance with or exempt from Section 409A.  Notwithstanding any provision of this Plan to the contrary, if the Company determines that any compensation or benefits payable under this Plan may not either be exempt from or compliant with Section 409A, the Company may, with the Participant’s prior written consent, adopt such amendments to this Plan or adopt other policies and procedures (including amendments, policies and procedures with retroactive effect), or take any other actions, that the Company determines are necessary or appropriate to (i) exempt the compensation and benefits payable under this Plan from Section 409A and/or preserve the intended tax treatment of such compensation and benefits, or (ii) comply with the requirements of Section 409A; provided, however, that this Section 17(a) does not create an obligation on the part of the Company to adopt any such amendment, policy or procedure or take any such other action, and in any event, no such action shall reduce the amount of compensation that is owed to the Participant under this Plan without the Participant’s prior written consent.

		b.	To the extent permitted under Section 409A, any separate payment or benefit under this Plan or otherwise shall not be deemed “nonqualified deferred compensation” subject to Section 409A to the extent provided in the exceptions in Treasury 

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			Regulation Section 1.409A-1(b)(4), Section 1.409A-1(b)(9) or any other applicable exception or provision of Section 409A.

		c.	To the extent that any payments or reimbursements provided to the Participant under this Plan are deemed to constitute compensation to which Treasury Regulation Section 1.409A-3(i)(1)(iv) would apply, such amounts shall be paid or reimbursed to the Participant reasonably promptly, but not later than December 31 of the year following the year in which the expense was incurred.  The amount of any such payments eligible for reimbursement in one year shall not affect the payments or expenses that are eligible for payment or reimbursement in any other taxable year, and the Participant’s right to such payments or reimbursement shall not be subject to liquidation or exchange for any other benefit.

		d.	For purposes of Section 409A, the Participant’s right to receive any installment payments under this Plan shall be treated as a right to receive a series of separate payments and, accordingly, each such installment payment shall at all times be considered a separate and distinct payment.

		e.	In the event that the Participant is required to execute a release to receive any payments from the Company that constitute nonqualified deferred compensation under Section 409A, payment of such amounts shall not be made or commence until the sixtieth (60th) day following the Participant’s Date of Termination.  Any payments that are suspended during the sixty (60) day period shall be paid on the date the first regular payroll is made immediately following the end of such period.

	18.	No Duty to Mitigate; No Offset. The Participant shall not be required to mitigate damages or the amount of any payment contemplated by this Plan, nor shall any such payment be reduced by any earnings that the Participant may receive from any other sources or offset against any other payments made to the Participant or required to be made to him or her pursuant to this Plan. 

	19.	Assignment; Binding Plan. The Company, at the direction of the Board, may assign this Plan to any parent, subsidiary, affiliate or successor of the Company. This Plan is not assignable by the Participant and is binding on the Participant and his or her executors and other legal representatives. This Plan shall bind the Company and its successors and assigns and inure to the benefit of the Participant and his or her heirs, executors, administrators, personal representatives, legatees or devisees.  

	20.	Notice. Any written notice under this Plan shall be personally delivered to the other party or sent by certified or registered mail, return receipt requested and postage prepaid, to such party at the address set forth in the records of the Company or to such other address as either party may from time to time specify by written notice. 

	21.	Entire Plan; Amendments. This Plan contains the entire agreement of the parties relating to the Participant’s employment and supersedes all oral or written prior discussions, agreements and understandings of every nature between them. This Plan may not be amended except by an agreement in writing signed by the Company and the Participant.  

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		The provisions of this Plan which have been adopted on July 26, 2022 shall apply to (i) any individual who is designated as a Participant on or after such date, and (ii) any Participant who agrees to be subject to such provisions in a separate written acknowledgement, which may be in the form of an addendum or amendment to his or her Letter Agreement.

	22.	Waiver. The waiver of a breach of any provision of this Plan shall not operate as or be construed to be a waiver of any other provision or subsequent breach of this Plan. 

	23.	Governing Law and Jurisdictional Agreement. This Plan is intended to be a Top Hat Plan and shall be interpreted, administered and enforced in accordance with ERISA.  It is expressly intended that ERISA preempt the application of state laws to this Plan to the maximum extent permitted by Section 514 of ERISA.  To the extent that state law is applicable, the statutes and common law of the State of Texas shall apply, excluding any that mandate the use of another jurisdiction’s laws. Except as otherwise provided in Appendix A, the parties irrevocably and unconditionally submit to the jurisdiction and venue of any court, federal or state, situated within Harris County, Texas, for the purpose of any suit, action or other proceeding arising out of, or relating to or in connection with, the Plan. 

	24.	Severability. In case any one or more of the provisions contained in this Plan is, for any reason, held invalid in any respect, such invalidity shall not affect the validity of any other provision of this Plan, and such provision shall be deemed modified to the extent necessary to make it enforceable. 

	25.	Enforcement. It is agreed that it is impossible to measure fully, in money, the damage which will accrue to the WCI Group in the event of a breach or threatened breach of Section 5, 6 or 13 of this Plan, and, in any action or proceeding to enforce the provisions of Section 5, 6 or 13 hereof, the Participant waives the claim or defense that the WCI Group has an adequate remedy at law and will not assert the claim or defense that such a remedy at law exists. Notwithstanding any claim procedure or arbitration requirement as set forth in Appendix A, the Company is entitled to injunctive relief to enforce the provisions of such sections as well as any and all other remedies available to it at law or in equity without the posting of any bond and the Company and the Participant hereby agree that the Company is entitled to seek such remedies in the jurisdiction set forth in Section 23 hereof. The Participant agrees that if the Participant breaches any provision of Section 13, the Company and the Parent may discontinue and terminate all severance payments and benefits under Sections 7 and 8 of this Plan, as applicable, and recover as partial damages all profits realized by the Participant at any time prior to such recovery arising from the acceleration of any Equity Award in connection with the Participant’s termination of employment, including the subsequent sale of common shares of the Parent received in connection with vesting of such awards, and may also cancel any or all outstanding Equity Awards held by the Participant.

	26.	Counterparts. This Plan may be executed in counterparts, each of which shall be deemed an original and both of which together shall constitute one and the same instrument. 

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	27.	Due Authorization. The execution of this Plan has been duly authorized by the Company by all necessary corporate action. 

	28.	Definitions.  Capitalized terms not otherwise defined herein shall have the following meanings unless specifically stated otherwise in a Participant’s Letter Agreement.

		a.	“Accelerated Vesting Benefit” shall mean, with respect to a Participant’s Equity Awards, the following:

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		1.	all outstanding but unvested Equity Awards for which, on the Participant’s Date of Termination, only time-based vesting is applicable, shall, on the Participant’s Date of Termination (i) for Options, immediately vest and become exercisable, and (ii) for all other Equity Awards, any and all restrictions thereon shall immediately lapse and such Equity Awards shall become fully vested and settled as soon as administratively practicable thereafter; 

		2.	all outstanding but unvested Equity Awards for which, on the Participant’s Date of Termination, performance-based vesting is applicable, the designated performance goals for such awards shall be deemed to have been satisfied (and, for any award with different levels of potential payment, such performance shall be deemed to be at the target level) and any remaining vesting conditions shall be deemed to be satisfied on the Participant’s Date of Termination and such Equity Awards shall be settled as soon as administratively practicable thereafter; and

		3.	the term of any Options shall be extended to the earlier of (i) the third anniversary of the Participant’s Date of Termination (or such other date, as provided for in the Participant’s Letter Agreement) or (ii) the expiration of the original term of such Options.  

By executing a Letter Agreement, a Participant acknowledges that extending the term of any incentive share option to which the Accelerated Vesting Benefit applies could cause such Equity Award to lose its tax-qualified status under the Code, and agrees that the Company shall have no obligation to compensate the Participant or, if applicable the Participant’s heirs, executors, administrators, legatees, beneficiaries or assigns the for any additional taxes incurred as a result of such extension.  
		b.	“Base Salary” means the Participant’s annual base salary from the Company.

		c.	“Board” means the Board of Directors of the Parent.

		d.	“Bonus” means the annual bonus that the Participant is eligible to receive under the WCI Group’s then current performance bonus plan.

		e.	“Cause”, for purposes of this Plan, shall mean:

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		1.	gross negligence or willful misconduct of a material nature in connection with the performance of the Participant’s duties;

		2.	the Participant’s conviction of (or pleading guilty or pleading no contest or nolo contendere to) a felony;

		3.	a non-de minimis intentional act of dishonesty or misappropriation (or attempted misappropriation) of property belonging to the Company or any member of the WCI Group (other than a good faith expense account dispute related to a business expense);

		4.	a material breach by the Participant of any of the obligations under this Agreement or any other agreement with the Company or any member of the WCI Group or any policy of the WCI Group; or 

		5.	a breach (material or otherwise) of any of the provisions of Sections 5, 6 or 13.  

For a Participant who is a President/EVP Participant, he or she shall receive written notice of an opportunity to cure such failure or breach, to the extent such failure or breach is curable, during the sixty (60) day period which begins upon receipt of such written notice.  If such the failure or breach is cured within such sixty (60)-day period, the Board shall so advise the Participant in writing.  If such failure or breach is not cured within such sixty (60)-day period, the Board may thereafter terminate the Participant’s employment with the Company for Cause on written Notice of Termination delivered to the Participant describing with specificity the grounds for termination.
		f.	“Change in Control” means the occurrence of one of the following events: 

		1.	there shall be consummated (i) any reorganization, liquidation or consolidation of Parent, or any merger or other business combination of Parent with any other corporation, other than any such merger or other combination that would result in the voting securities of Parent outstanding immediately prior thereto continuing to represent (either by remaining outstanding or by being converted into voting securities of the surviving entity) at least fifty percent (50%) of the total voting power represented by the voting securities of Parent or such surviving entity outstanding immediately after such transaction, or (ii) any sale, lease, exchange or other transfer (in one transaction or a series of related transactions) of all, or substantially all, of the assets of Parent, or 

		2.	any “person” (as defined in Section 13(d) and 14(d) of the Securities Exchange Act of 1934, as amended (the “Exchange Act”)), shall become the “beneficial owner” (as defined in Rule 13d-3 under the Exchange Act), directly or indirectly, of fifty percent (50%) or more of the Parent’s outstanding voting securities; or 

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		3.	during any period of two consecutive years, individuals who at the beginning of such period constituted the entire Board shall cease for any reason to constitute at least one-half of the membership thereof unless the election, or the nomination for election by Parent’s shareholders, of each new director was approved by a vote of at least one-half of the directors then still in office who were directors at the beginning of the period.  

		g.	“Code” means the Internal Revenue Code of 1986, as amended.

		h.	“Compensation Committee” means the Compensation Committee of the Board.

		i.	“Date of Termination” means: (i) if the Participant’s employment is terminated by the Board for Disability, thirty (30) days after Notice of Termination is given to the Participant (provided the Participant has not returned to duty on a full-time basis during such 30-day period); (ii) if the Participant’s employment is terminated by the Board for any reason other than Disability, the date specified in the Notice of Termination; (iii) if the Participant’s employment is terminated due to the Participant’s death, the date such death occurred; and (iv) if the Participant’s employment is terminated by the Participant for any reason, the date specified in the Notice of Termination which shall be within 30 days of the date such Notice of Termination is given.  

		j.	“Disabled” or “Disability” means a Participant is unable to perform his or her duties to the Company on account of physical or mental illness or other incapacity which the Board shall in good faith determine renders the Participant incapable of performing his or her duties to the Company, and such illness or other incapacity shall continue for a period of more than six (6) consecutive months.

		k.	“Effective Date” means July 26, 2022.  The Plan’s original effective date was February 13, 2012.

		l.	“Employment Period” means the term of a Participant’s employment with the Company.

		m.	“ERISA” means the Employee Retirement Income Security Act of 1974, as amended.

		n.	“Equity Award” means an award of restricted share units, performance share units, restricted shares, share options (“Options”), or any other unvested equity awards related to the common shares of the Parent.

		o.	“Good Reason”, for purposes of this Plan, shall mean, (i) for periods prior to a Change in Control, with respect to any Participant who is designated as a President/EVP Participant, and (ii) during the twenty-four (24) month period commencing on the date a Change in Control occurs, with respect to any Participant:

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		1.	assignment to the Participant of duties inconsistent with and resulting in a diminution of his or her position (including status, offices, titles, responsibilities and reporting requirements), authority, duties or responsibilities as they existed on the Effective Date of this Plan; or any other action by the Company which results in a diminution in such position, authority, duties or responsibilities; a substantial alteration in the title(s) of the Participant (so long as the existing corporate structure of the WCI Group is maintained); provided, however, that the Participant’s failure to serve in the same position (including status, offices, titles, responsibilities and reporting requirements) with the ultimate parent of the Company shall constitute “Good Reason”;

		2.	the relocation of the Participant’s principal place of employment to a location more than fifty (50) miles from its present location without the Participant’s prior approval; 

		3.	a material reduction by the Company, without the Participant’s prior approval, (i) for periods prior to a Change in Control, in the Participant’s total annual cash compensation, defined as Base Salary and target Bonus; and (ii) for periods on or after a Change in Control, in the Participant’s total annual compensation, defined as Base Salary, target Bonus and equity incentive compensation opportunities;  

		4.	a failure by the WCI Group to continue in effect, without substantial change, any benefit plan or arrangement in which the Participant was participating or the taking of any action by the WCI Group which would adversely affect the Participant’s participation in or materially reduce his or her benefits under any benefit plan (unless such changes apply equally to all other management employees of Company); 

		5.	any material breach by the Company of any provision of this Plan without the Participant having committed any material breach of his or her obligations hereunder, which breach is not cured within twenty (20) days following written notice thereof to the Company of such breach; or 

		6.	the failure of the Parent to obtain the assumption of this Plan by any successor employer of the Participant which results from any reorganization of the WCI Group or a Change in Control or similar transaction which causes the Participant to be employed by an entity that is not a member of the WCI Group.

		p.	“Health Insurance Benefit” means a series of payments from the Company to the Participant during the one (1) year period immediately following the Participant’s Date of Termination during which the Company shall pay to the Participant an amount equal to the Company’s portion (but not the Participant’s portion) of the cost of medical insurance at the rate in effect on the Participant’s Date of Termination, which shall be paid in installments in accordance with the Company’s 

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			normal payroll practices.  If the Company determines, in its sole discretion, that the payment of the Health Insurance Benefit will result in a potential violation of applicable law, or would potentially cause the Company or the Participant to incur penalties, excise taxes or fees pursuant to the Code and the Department of Treasury regulations promulgated thereunder (including, without limitation, Section 2716 of the Public Health Service Act), the Health Insurance Benefit shall immediately terminate and the Participant shall not have any further rights to receive such payments.  

		q.	“Letter Agreement” means a written agreement between the Company and an executive documenting the executive’s status as a Participant under the Plan.  The Letter Agreement shall be in the form attached hereto (which form may be amended from time to time in the sole discretion of the Plan Administrator) and shall designate the Participant as a President/EVP Participant, an SVP Participant, or a VP Participant, where applicable, for purposes of this Plan.

		r.	“Notice of Termination” means written notice delivered by the Board or the Participant, as applicable, which states that the Participant’s employment with the Company is being terminated and, to the extent applicable, cites the specific termination provisions in this Plan relied on and set forth in reasonable detail the facts and circumstances claimed to provide a basis for termination of the Participant’s employment.  The Notice of Termination shall specify the Participant’s Date of Termination.

		s.	“Outplacement Benefit” means reimbursement by the Company of the Participant’s post-termination expenses for career counseling and resume development; provided, however, that (i) such amount shall not exceed Fifteen Thousand Dollars ($15,000), and (ii) such expenses shall be incurred within twelve (12) months after the Participant’s Date of Termination.  

		t.	“Parent” means Waste Connections, Inc., an Ontario corporation (f/k/a Progressive Waste Solutions Ltd.).

		u.	“Plan” means the Waste Connections US, Inc. Separation Benefits Plan, which shall be documented with respect to each Participant through (i) this plan document, and (ii) the individual Letter Agreement executed between the Company and such Participant.

		v.	“Plan Administrator” means the Compensation Committee of the Board.

		w.	“Section 409A” means Section 409A of the Code and the Department of Treasury regulations and other guidance promulgated thereunder.

		x.	“Severance Amount” means (i) for a President/EVP Participant, an amount as set forth in the Participant’s Letter Agreement; (ii) for an SVP Participant, the sum of (1) one year of the Participant’s then applicable Base Salary amount, plus (2) the target Bonus available to the Participant under Section 4 for the year in which the 

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			termination occurs; and (iii) for a VP Participant, the sum of (1) one year of the Participant’s then applicable Base Salary amount, plus (2) a pro-rated portion of the target Bonus available to the Participant under Section 4 for the year in which the termination occurs.  

		y.	“WCI Group” means the Parent, the Company and each of their subsidiaries and affiliates.

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APPENDIX A
Detailed Claims And Arbitration Procedures
1.Claims Procedure
Initial Claims
All claims shall be presented to the Plan Administrator in writing.  Within ninety (90) days after receiving a claim, a claims official appointed by the Plan Administrator shall consider the claim and issue his or her determination thereon in writing.  If the Plan Administrator or claims official determines that an extension of time is necessary, the claims official may extend the determination period for up to an additional ninety (90) days by giving the Claimant written notice indicating the special circumstances requiring the extension of time prior to the termination of the initial ninety (90) day period.  Any claims that the Claimant does not pursue in good faith through the initial claims stage shall be treated as having been irrevocably waived.  
Claims Decisions
If the claim is granted, the benefits or relief the Claimant seeks shall be provided.  If the claim is wholly or partially denied, the claims official shall, within ninety (90) days (or a longer period, as described above), provide the Claimant with written notice of the denial, setting forth, in a manner calculated to be understood by the Claimant: (1) the specific reason or reasons for the denial; (2) specific references to the provisions on which the denial is based; (3) a description of any additional material or information necessary for the Claimant to perfect the claim, together with an explanation of why the material or information is necessary; and (4) an explanation of the procedures for appealing denied claims.  If the Claimant can establish that the claims official has failed to respond to the claim in a timely manner, the Claimant may treat the claim as having been denied by the claims official.
Appeals of Denied Claims
Each Claimant shall have the opportunity to appeal the claims official’s denial of a claim in writing to an appeals official appointed by the Plan Administrator (which may be a person, committee, or other entity).  A Claimant must appeal a denied claim within sixty (60) days after receipt of written notice of denial of the claim, or within sixty (60) days after it was due if the Claimant did not receive it by its due date.  The Claimant shall have the opportunity to submit written comments, documents, records and other information relating to the Claimant’s claim.  The Claimant (or the Claimant’s duly authorized representative) shall be provided upon request and free of charge, reasonable access to, and copies of, all documents, records and other information relevant to the Claimant’s claim.  The appeals official shall take into account during its review all comments, documents, records and other information submitted by the Claimant relating to the claim, without regard to whether such information was submitted or considered in the initial benefits review.  Any claims that the Claimant does not pursue in good faith through the appeals stage, such as by failing to file a timely appeal request, shall be treated as having been irrevocably waived.

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Appendix A-1
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Appeals Decisions
The decision by the appeals official shall be made not later than sixty (60) days after the written appeal is received by the Plan Administrator, however, if the appeals official determines that an extension of time is necessary, the appeals official may extend the determination period for up to an additional sixty (60) days by giving the Claimant written notice indicating the special circumstances requiring the extension of time prior to the termination of the initial sixty (60) day period.  The appeal decision shall be in writing, shall be set forth in a manner calculated to be understood by the Claimant and shall include the following: (1) the specific reason or reasons for the denial; (2) specific references to the provisions on which the denial is based; (3) a statement that the Claimant is entitled to receive, upon request and free of charge, reasonable access to, and copies of, all documents, records and other information relevant to the Claimant’s claim.  If a Claimant does not receive the appeal decision by the date it is due, the Claimant may deem the appeal to have been denied.
Procedures
The Plan Administrator shall adopt procedures by which initial claims shall be considered and appeals shall be resolved; different procedures may be established for different claims.  All procedures shall be designed to afford a Claimant full and fair consideration of his or her claim.
Additional Disability Claims Procedures
Notwithstanding anything to the contrary above, disability claims and appeals under this Plan shall comply with the following requirements (in addition to any requirements above):
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Initial Claims
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Within forty-five (45) days after receiving a claim, a claims official appointed by the Plan Administrator shall consider the claim and issue his or her determination thereon in writing.  If the Plan Administrator or claims official determines that an extension of time is necessary, the claims official may extend the determination period twice by thirty (30) days by giving the Claimant prior written notice indicating the special circumstances requiring the extension of time and the date by which we expect to render a decision.  If such an extension is necessary due to the Claimant’s failure to submit the information necessary to decide the claim, the notice of extension will specifically describe the required information, and the Claimant will be afforded at least forty-five (45) days within which to provide the specified information.  If the Claimant delivers the requested information within the time specified, any thirty (30)-day extension period will begin after the Claimant has provided that information.
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Appendix A-2
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Appeals
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A Claimant must appeal a denied claim within one hundred eighty (180) days after receipt of written notice of denial of the claim.  The decision by the appeals official shall be made not later than forty-five (45) days after the written appeal is received by the Plan Administrator, however, if the appeals official determines that an extension of time is necessary, the appeals official may extend the determination period for up to an additional forty-five (45) days by giving the Claimant written notice indicating the special circumstances requiring the extension of time prior to the termination of the initial forty-five (45) day period.  If an extension is necessary due to the Claimant’s failure to submit the information necessary to decide the appeal, the notice of extension will specifically describe the required information, and the Claimant will be afforded at least forty-five (45) days to provide the specified information.  If the Claimant delivers the requested information within the time specified, the forty-five (45) day extension of the appeal period will begin after the Claimant has provided that information.  
Effective as of April 1, 2018, the following provisions apply with respect to a claim for disability benefits under this Plan.  The claims requirements above shall apply as the internal claims process except as provided under DOL Reg. 2650.503-1 and any superseding guidance.
(1)Independent and Impartial Review.  The Plan must meet the conflict of interest requirements under DOL Reg. 2560.503-1(b)(7).  All claims and appeals for disability benefits must be adjudicated in a manner designed to ensure the independence and impartiality of the persons involved in making the decision. Accordingly, decisions regarding hiring, compensation, termination, promotion, or other similar matters with respect to any individual (such as a claims adjudicator or medical or vocational expert) must not be made based upon the likelihood that the individual will support the denial of benefits.
(2)Adverse Benefit Determination. An adverse benefit determination also includes any rescission of coverage as described in DOL Reg. 2560.503-1(m)(4)(ii).
(3)Full and Fair Review. A Claimant must be allowed to review the file and present evidence and testimony as part of the appeals process. Claimants must be provided, free of charge, with any new or additional evidence considered, relied upon or generated by the Plan in connection with the claim sufficiently in advance of the final adverse benefit determination to give the Claimant a reasonable opportunity to respond prior to that date in accordance with DOL Reg. 2560.503-1(h)(4). 
(4)Deemed Exhaustion of Claims Process. If the Plan fails to adhere to the requirements of DOL Reg. 2560.503-1, except as provided under DOL Reg. 2560.503-1(l)(2)(ii), the Claimant may bring an action under section 502(a) of ERISA as provided in DOL Reg. 2560.503-1(l)(2)(i) and any superseding guidance.  
(5)Notices. A notice of adverse benefit determination must include the information required under DOL Reg. 2560.503-1(g)(vii), (j)(4) and (j)(6), as applicable. The notice of adverse benefit determination must include a discussion of the decision, including an explanation of the basis for disagreeing with or not following:

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Appendix A-3
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(A)The views presented by the Claimant to the Plan of health care professionals treating the Claimant and vocational professionals who evaluated the claimant;
(B)The views of medical or vocational experts whose advice was obtained on behalf of the plan in connection with a Claimant’s adverse benefit determination, without regard to whether the advice was relied upon in making the benefit determination; and
(C)A disability determination regarding the claimant presented by the Claimant to the Plan made by the Social Security Administration;
If the adverse benefit determination is based on a medical necessity or experimental treatment or similar exclusion or limit, the notice should contain an explanation of the scientific or clinical judgment for the determination, applying the terms of the Plan to the Claimant’s medical circumstances, or a statement that such explanation will be provided free of change upon request.  In addition, if any specific internal rules, guidelines, protocols, standards or other similar criteria of the plan were relied upon in making the adverse determination, the notice should describe such criteria or, alternatively, a statement that such rules, guidelines, protocols, standards or other similar criteria of the plan do not exist.
The notice must be provided in a culturally and linguistically appropriate manner as provided under DOL Reg. 2560.503-1(g)(viii), (j)(7), and (o).  If the Plan maintains a contractual deadline to file a civil action under section 502(a) of ERISA, the notice of adverse benefit determination shall disclose the specific deadline, including the calendar date on which the Claimant’s rights expire, as required by DOL Reg. 2560.503-1(j)(4)(ii).
Arbitration of Rejected Appeals
If a Claimant has pursued a claim through the appeal stage of these claims procedures, the Claimant may contest the actual or deemed denial of that claim through arbitration, as described below.  In no event shall any denied claim be subject to resolution by any means (such as in a court of law) other than arbitration in accordance with the following provisions.
2.Arbitration Procedure
Request for Arbitration
A Claimant must submit a request for arbitration to the Plan Administrator within 60 days after receipt of the written denial of an appeal (or within sixty (60) days after he or she should have received the determination). The Claimant or the Plan Administrator may bring an action in any court of appropriate jurisdiction to compel arbitration in accordance with these procedures.
Applicable Arbitration Rules
If the Claimant has entered into a separate and valid arbitration agreement with the Company, the arbitration shall be conducted in accordance with that agreement.  If not, the rules set forth in the balance of this Appendix shall apply: The arbitration shall be held under the auspices of the American Arbitration Association (“AAA”).  Except as provided below, the arbitration shall be in accordance with the AAA’s then-current employment dispute resolution 

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Appendix A-4
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rules.  The Arbitrator shall apply the Federal Rules of Evidence and shall have the authority to entertain a motion to dismiss or a motion for summary judgment by any party and shall apply the standards governing such motions under the Federal Rules of Civil Procedure.  The Federal Arbitration Act shall govern all arbitrations that take place under these Detailed Claims and Arbitration Procedures (or that are required to take place under them), and shall govern the interpretation or enforcement of these Procedures or any arbitration award.  To the extent that the Federal Arbitration Act is inapplicable, Texas law pertaining to arbitration agreements shall apply.
Arbitrator
The arbitrator (the “Arbitrator”) shall be an attorney familiar with employee benefit matters who is licensed to practice law in the state in which the arbitration is convened.  The Arbitrator shall be selected in the following manner from a list of eleven arbitrators drawn by the sponsoring organization under whose auspices the arbitration is being conducted and taken from its panel of labor and employment arbitrators.  Each party shall designate all arbitrators on the list whom they find acceptable; the parties shall then alternately strike arbitrators from the list of arbitrators acceptable to both parties, with the party who did not initiate the arbitration striking first.  If only one arbitrator is acceptable to both parties, he or she will be the Arbitrator.  If none of the arbitrators is acceptable to both parties, a new panel of arbitrators shall be obtained from the sponsoring organization and the selection process shall be repeated.
Location
The arbitration will take place in or near the city in which the Claimant is or was last employed by the Company or in which the Plan is principally administered, whichever is specified by the Plan Administrator, or in such other location as may be acceptable to both the Claimant and the Plan Administrator.
Authority of Arbitrator
The Arbitrator shall have the authority to resolve any factual or legal claim relating to the Plan or relating to the interpretation, applicability, or enforceability of these arbitration procedures, including, but not limited to, any claim that these procedures are void or voidable.  The Arbitrator may grant a Claimant’s claim only if the Arbitrator determines that it is justified because: (1) the appeals official erred on an issue of law; or (2) the appeals official’s findings of fact, if applicable, were not supported by substantial evidence.  The arbitration shall be final and binding on all parties.
Limitation on Scope of Arbitration
The Claimant may not present any evidence, facts, arguments, or theories at the arbitration that the Claimant did not pursue in his or her appeal, except in response to new evidence, facts, arguments, or theories presented on behalf of the other parties to the arbitration.  However, an arbitrator may permit a Claimant to present additional evidence or theories if the Arbitrator determines that the Claimant was precluded from presenting them during the claim and appeal procedures due to procedural errors of the Plan Administrator or its delegates.

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Appendix A-5
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Administrative Record
The Plan Administrator shall submit to the Arbitrator a certified copy of the record on which the appeals official’s decision was made.
Experts, Depositions, and Discovery
Except as otherwise permitted by the Arbitrator on a showing of substantial need, either party may: (1) designate one expert witness; (2) take the deposition of one individual and the other party’s expert witness; (3) propound requests for production of documents; and (4) subpoena witnesses and documents relating to the discovery permitted in this paragraph.
Pre-Hearing Procedures
At least thirty (30) days before the arbitration hearing, the parties must exchange lists of witnesses, including any expert witnesses, and copies of all exhibits intended to be used at the hearing.  The Arbitrator shall have jurisdiction to hear and rule on pre-hearing disputes and is authorized to hold pre-hearing conferences by telephone or in person, as the Arbitrator deems necessary.
Transcripts
Either party may arrange for a court reporter to provide a stenographic record of the proceedings at the party’s own cost.
Post-Hearing Procedures
Either party, on request at the close of the hearing, may be given leave to file a post-hearing brief within the time limits established by the Arbitrator.
Costs and Attorneys’ Fees
The prevailing party shall be entitled to reasonable attorneys’ fees, costs and necessary disbursements in addition to any other relief to which such party may be entitled, except as required by applicable law.
Procedure for Collecting Costs From Claimant
Before the arbitration commences, the Claimant must deposit with the Plan Administrator a payment equal to the amount of any fees that he or she would pay to file a claim in court. The Company shall pay any portion of the anticipated fees and costs of the Arbitrator in excess of that amount.  In the event the Company is the prevailing party in any arbitration, the Arbitrator shall be permitted to reallocate the fees and costs associated with the arbitration from the Company to the Participant and in such event the Participant shall be obligated to reimburse the Company for such fees and costs within 10 days after such determination is made.  

​
Appendix A-6
 ​

​

Arbitration Award
The Arbitrator shall render an award and opinion in the form typically rendered in labor arbitrations.  Within twenty (20) days after issuance of the Arbitrator’s award and opinion, either party may file with the Arbitrator a motion to reconsider, which shall be accompanied by a supporting brief.  If such a motion is filed, the other party shall have twenty (20) days from the date of the motion to respond, after which the Arbitrator shall reconsider the issues raised by the motion and either promptly confirm or promptly change his or her decision.  The decision shall then be final and conclusive on the parties.  Arbitrator fees and other costs of a motion for reconsideration shall be borne by the losing party, unless the Arbitrator orders otherwise.  Either party may bring an action in any court of appropriate jurisdiction to enforce an arbitration award.  A party opposing enforcement of an arbitration award may not do so in an enforcement proceeding, but must bring a separate action in a court of competent jurisdiction to set aside the award.  In any such action, the standard of review shall be the same as that applied by an appellate court reviewing the decision of a trial court in a nonjury trial.
Severability
The invalidity or unenforceability of any part of these arbitration procedures shall not affect the validity of the rest of the procedures.
​

​
Appendix A-7
 ​

​

APPENDIX B
ADDITIONAL INFORMATION
Rights under ERISA
As a participant in the Plan, you are entitled to certain rights and protections under ERISA.  ERISA provides that all Plan participants will be entitled to:
Receive Information About Your Plan and Benefits
1.Examine, without charge, at the Company’s headquarters, all documents governing the Plan including collective bargaining agreements, if any, and annual reports and Plan descriptions.
2.Obtain, upon written request to the Plan administrator, copies of documents governing the operation of the Plan, including collective bargaining agreements, if any, and copies of the latest annual report (Form 5500 Series) and summary plan description.  The Plan Administrator may make a reasonable charge for the copies.
3.Receive a summary of the Plan’s annual financial report, if any.  The Plan administrator is required by law to furnish each participant with a copy of this summary annual report.
Prudent Actions by Plan Fiduciaries
In addition to creating rights for Plan participants, ERISA imposes duties upon the people who are responsible for the operation of the employee benefit plan. The people who operate your Plan, called “fiduciaries” of the Plan, have a duty to do so prudently and in the interest of you and other Plan participants and beneficiaries.  No one, including the Company, your union, or any other person, may fire you or otherwise discriminate against you in any way to prevent you from obtaining a welfare benefit or exercising your right under ERISA.
Enforce Your Rights
If your claim for a welfare benefit is denied or ignored, in whole or in part, you have a right to know why this was done, to obtain copies of documents relating to the decision without charge, and to appeal any denial, all within certain time schedules.  Under ERISA, there are steps you can take to enforce the above rights.  For instance, if you request a copy of plan documents or the latest annual report from the Plan and do not receive them within thirty (30) days, you may file suit in a Federal court.  In such a case, the court may require the Plan Administrator to provide the materials and pay you up to $110 a day until you receive the materials, unless the materials were not sent because of reasons beyond the control of the Plan administrator.  If you have a claim for benefits, which is denied or ignored, in whole or in part, you may file suit in a state or Federal court.  In addition, if you disagree with the Plan’s decision or lack thereof concerning the qualified status of a domestic relations order or a medical child support order, you may file suit in Federal court.  If it should happen that Plan fiduciaries misuse the Plan’s money, or if you are discriminated against for asserting your rights, you may seek assistance from the U.S. Department of Labor, or you may file suit in a federal court.  The court will decide who should pay court costs and legal fees.  If you are successful, the court may order the person you have sued to pay these costs and fees.  If you 

Appendix B-1
 ​

​

lose, the court may order you to pay these costs and fees, for example, if it finds your claim is frivolous.
Assistance with Your Questions
If you have any questions about your Plan, you should contact the Plan Administrator.  If you should have any questions about this statement or about your rights under ERISA, or if you need assistance in obtaining documents from the Plan Administrator, you should contact the nearest office of the Employee Benefits Security Administration, U.S. Department of Labor, listed in your telephone directory or the Division of Technical Assistance and Inquiries, Employee Benefits Security Administration, U.S. Department of Labor, 200 Constitution Avenue N. W., Washington, D. C. 20210.  You may also obtain certain publications about your rights and responsibilities under ERISA by calling the publications hotline of the Employee Benefits Security Administration.
	ADMINISTRATIVE INFORMATION

	Name of Plan:
	Separation Benefits Plan

	Plan Administrator and Sponsor:
	Compensation Committee of the Board of Directors
Waste Connections, Inc. 
3 Waterway Square Place, Suite 110
The Woodlands, TX 77380
Tel: (832) 442-2200
Fax: (832) 442-2290

	Type of Administration:
	Self-Administered

	Type of Plan:
	Severance Pay “Top Hat” Welfare Benefit Plan

	Employer Identification Number:
	94-3283464  

	Direct Questions Regarding the Plan to:
	Compensation Committee of the Board of Directors
Waste Connections, Inc. 
3 Waterway Square Place, Suite 110
The Woodlands, TX 77380
Tel: (832) 442-2200
Fax: (832) 442-2290

	Agent for Service of Legal Process:
	Corporate Secretary
Waste Connections, Inc. 
3 Waterway Square Place, Suite 110
The Woodlands, TX 77380
Tel: (832) 442-2200
Fax: (832) 442-2290
Service of Legal Process may also be made upon the Plan Administrator

	Plan Year End:
	December 31

	Plan Number:
	502

​

Appendix B-2
 ​Exhibit 4.1

 

NEITHER THE ISSUANCE AND SALE OF THE SECURITIES
REPRESENTED BY THIS CERTIFICATE NOR THE SECURITIES INTO WHICH THESE SECURITIES ARE CONVERTIBLE HAVE BEEN REGISTERED UNDER THE SECURITIES
ACT OF 1933, AS AMENDED, OR APPLICABLE STATE SECURITIES LAWS. THE SECURITIES MAY NOT BE OFFERED FOR SALE, SOLD, TRANSFERRED OR ASSIGNED
(I) IN THE ABSENCE OF (A) AN EFFECTIVE REGISTRATION STATEMENT FOR THE SECURITIES UNDER THE SECURITIES ACT OF 1933, AS AMENDED, OR (B)
AN OPINION OF COUNSEL (WHICH COUNSEL SHALL BE SELECTED BY THE HOLDER), IN A GENERALLY ACCEPTABLE FORM, THAT REGISTRATION IS NOT REQUIRED
UNDER SAID ACT OR (II) UNLESS SOLD PURSUANT TO RULE 144 OR RULE 144A UNDER SAID ACT OR OTHER APPLICABLE EXEMPTION. NOTWITHSTANDING THE
FOREGOING, THE SECURITIES MAY BE PLEDGED IN CONNECTION WITH A BONA FIDE MARGIN ACCOUNT OR OTHER LOAN OR FINANCING ARRANGEMENT SECURED
BY THE SECURITIES.

 

	Principal Amount: US$195,000.00	Issue Date: July 26, 2022
	Purchase Price: US$176,000.00	 

 

PROMISSORY NOTE

 

FOR VALUE RECEIVED,
C-BOND SYSTEMS INC., a Colorado corporation (hereinafter called the “Borrower”) (Trading Symbol: CBNT), hereby promises
to pay to the order of GS CAPITAL PARTNERS, LLC, a Nevada limited liability company, or registered assigns (the “Holder”)
the sum of US$195,000.00 (the “Principal”) together with guaranteed interest (the “Interest”) on the Principal
balance hereof in the amount of eight percent (8%) (the “Interest Rate”) per calendar year from the date hereof (the “Issue
Date”). All Principal and Interest owing hereunder, along with any and all other amounts, to the extent not paid earlier as set
forth herein, shall be due and owing on the first annual anniversary of the Issue Date as set forth above (the “Maturity Date”).
This note (the “Note”) shall contain an original issue discount of $19,000 resulting in a purchase price of $176,000. Principal
payments shall be made in ten (10) installments each in the amount of US$21,060.00 plus accrued interest to such payment date, commencing
on the ninetieth (90th) day anniversary following the Issue Date and continuing thereafter each thirty (30) days for nine (9)
months. Notwithstanding the forgoing, the final payment of Principal and Interest shall be due on the Maturity Date. This Note may be
prepaid in whole or in part as set forth herein. Any amount of Principal or Interest on this Note which is not paid when due shall bear
interest at the rate of the lesser of (i) twenty-four percent (24%) per annum and (ii) the maximum amount permitted under law from the
due date thereof until the same is paid (the “Default Interest”). Default Interest shall commence accruing upon an Event of
Default and shall be computed on the basis of a 360-day year and the actual number of days elapsed. All payments due hereunder (to the
extent not converted into common stock, par value $0.001 per share, of the Borrower (the “Common Stock”) in accordance with
the terms hereof) shall be made in lawful money of the United States of America. All payments shall be made at such address as the Holder
shall hereafter give to the Borrower by written notice made in accordance with the provisions of this Note. Whenever any amount expressed
to be due by the terms of this Note is due on any day which is not a business day, the same shall instead be due on the next succeeding
day which is a business day and, in the case of any interest payment date which is not the date on which this Note is paid in full, the
extension of the due date thereof shall not be taken into account for purposes of determining the amount of interest due on such date.
As used in this Note, the term “business day” shall mean any day other than a Saturday, Sunday or a day on which commercial
banks in the city of New York, New York are authorized or required by law or executive order to remain closed. Each capitalized term used
herein, and not otherwise defined, shall have the meaning ascribed thereto in that certain Securities Purchase Agreement dated the date
hereof, pursuant to which this Note was originally issued (the “Purchase Agreement”). The Borrower and the Holder may be referred
to herein individually as a “Party” and collectively as the “Parties”.

 

     

     

    

 

This Note is free from all
taxes, liens, claims and encumbrances with respect to the issue thereof and shall not be subject to preemptive rights or other similar
rights of shareholders of the Borrower and will not impose personal liability upon the holder thereof.

 

The following terms shall
also apply to this Note:

 

Article
I. CONVERSION RIGHTS

 

1.1 Conversion
Right. The Holder shall have the right from time to time, and at any time following an Event of Default (as defined below), and ending
on the date of payment of the Default Amount (as defined in Article III) pursuant to Section 1.6(a) or Article III, each in respect of
the remaining outstanding principal amount of this Note to convert all or any part of the outstanding and unpaid principal, interest,
penalties, and all other amounts under this Note into fully paid and non-assessable shares of Common Stock, as such Common Stock exists
on the Issue Date, or any shares of capital stock or other securities of the Borrower into which such Common Stock shall hereafter be
changed or reclassified, at the Conversion Price (as defined below) determined as provided herein (a “Conversion”); provided,
however, that in no event shall the Holder be entitled to convert any portion of this Note in excess of that portion of this Note
upon conversion of which the sum of (1) the number of shares of Common Stock beneficially owned by the Holder and its affiliates (other
than shares of Common Stock which may be deemed beneficially owned through the ownership of the unconverted portion of this Note or the
unexercised or unconverted portion of any other security of the Borrower subject to a limitation on conversion or exercise analogous to
the limitations contained herein) and (2) the number of shares of Common Stock issuable upon the conversion of the portion of this Note
with respect to which the determination of this proviso is being made, would result in beneficial ownership by the Holder and its affiliates
of more than 4.99% of the outstanding shares of Common Stock. For purposes of the proviso to the immediately preceding sentence, beneficial
ownership shall be determined in accordance with Section 13(d) of the Securities Exchange Act of 1934, as amended (the “Exchange
Act”), and Regulations 13D-G thereunder, except as otherwise provided in clause (1) of such proviso. The number of shares of Common
Stock to be issued upon each conversion of this Note shall be determined by dividing the Conversion Amount (as defined below) by the applicable
Conversion Price then in effect on the date specified in the notice of conversion, in the form attached hereto as Exhibit A (the “Notice
of Conversion”), delivered to the Borrower or Borrower’s transfer agent by the Holder in accordance with Section 1.4; provided
that the Notice of Conversion is submitted by facsimile or e-mail (or by other means resulting in, or reasonably expected to result in,
notice) to the Borrower or Borrower’s transfer agent before 11:59 p.m., New York, New York time on such conversion date (the “Conversion
Date”). The term “Conversion Amount” means, with respect to any conversion of this Note, the sum of (1) the principal
amount of this Note to be converted in such conversion plus (2) at the Holder’s option, accrued and unpaid interest, if any,
on such principal amount at the interest rates provided in this Note to the Conversion Date, provided however, that the Borrower shall
have the right to pay any or all interest in cash plus (3) at the Holder’s option, Default Interest, if any, on the amounts
referred to in the immediately preceding clauses (1) and/or (2) plus (4) at the Holder’s option, any amounts owed to the
Holder pursuant to Section 1.3 and Section 1.4(g).

 

    2

     

    

 

1.2 Conversion
Price.

 

(a) Calculation
of Conversion Price. Subject to the adjustments described herein, the conversion price shall be equal to $0.011 per share (the “Conversion
Price”). Provided, however that in the event that following the Issue Date the closing trading price of the Common Stock on the
OTC Pink, OTCQB or on the principal securities exchange or other securities market on which the Common Stock is then being traded (as
applicable, the “Trading Market”) is below $0.011 per share (the “Base Value”) for more than ten (10)
consecutive Trading Days (as defined below), then the Conversion Price shall be equal to $0.004 per share. To the extent the Conversion
Price is less than the par value per share of the Common Stock, the Borrower will take all
steps necessary to solicit the consent of the stockholders to reduce the par value to the lowest value possible under law. To the extent
permitted by applicable law, the Borrower agrees to honor all conversions submitted pending this adjustment. If the shares of the Common
Stock have not been delivered within three (3) business days to the Borrower or Borrower’s transfer agent, the Notice of Conversion
may be rescinded. If the Trading Price cannot be calculated for such security on such date in the manner provided above, the Trading Price
shall be the fair market value as mutually determined by the Borrower and the Holder. “Trading Day” shall mean any day on
which the Common Stock is tradable for any period on the Trading Marker. The Borrower shall be responsible for the fees of its transfer
agent and all DTC fees associated with any such issuance. Holder shall be entitled to deduct $750.00 from the conversion amount in each
Notice of Conversion to cover Holder’s deposit fees associated with each Notice of Conversion. The Conversion Price and the Base
Value shall be subject to equitable adjustments for stock splits and stock dividends by the Borrower relating to the Common Stock, combinations,
recapitalization, reclassifications, extraordinary distributions and similar events that occur on or after the Issue Date. By way of example
and not limitation, in the event of forward split of the Common Stock following the Issue Date in which each share of Common Stock is
converted into two shares of Common Stock, the Conversion Price shall be reduced by 50%, and in the event of a reverse split of the Common
Stock following the Issue Date in which each two shares of Common Stock are converted into one share of Common Stock, the Conversion Price
shall be increased by 100%. Such adjustments shall be undertaken each time such an event occurs.

 

(b) Conversion
Price During Major Announcements. Notwithstanding anything contained in Section 1.2(a) to the contrary, in the event the Borrower
(i) makes a public announcement that it intends to consolidate or merge with any other corporation (other than a merger in which the Borrower
is the surviving or continuing corporation and its capital stock is unchanged) or sell or transfer all or substantially all of the assets
of the Borrower or (ii) any person, group or entity (including the Borrower) publicly announces a tender offer to purchase 50% or more
of the Borrower’s Common Stock (or any other takeover scheme) (the date of the announcement referred to in clause (i) or (ii) is
hereinafter referred to as the “Announcement Date”), then the Conversion Price shall, effective upon the Announcement Date
and continuing through the Adjusted Conversion Price Termination Date (as defined below), be equal to the lower of (x) the Conversion
Price which would have been applicable for a Conversion occurring on the Announcement Date and (y) the Conversion Price that would otherwise
be in effect. From and after the Adjusted Conversion Price Termination Date, the Conversion Price shall be determined as set forth in
Section 1.2(a). For purposes hereof, “Adjusted Conversion Price Termination Date” shall mean, with respect to any proposed
transaction or tender offer (or takeover scheme) for which a public announcement as contemplated by this Section 1.2(b) has been made,
the date upon which the Borrower (in the case of clause (i) above) or the person, group or entity (in the case of clause (ii) above) consummates
or publicly announces the termination or abandonment of the proposed transaction or tender offer (or takeover scheme) which caused this
Section 1.2(b) to become operative.

 

    3

     

    

 

(c) Pro
Rata Conversion; Disputes. In the event of a dispute as to the number of shares of Common Stock issuable to the Holder in connection
with a conversion of this Note, the Borrower shall issue to the Holder the number of shares of Common Stock not in dispute and resolve
such dispute in accordance with Section 4.13.1

 

(d) If
at any time the Conversion Price as determined hereunder for any conversion would be less than the par value of the Common Stock, then
the Conversion Price hereunder shall equal such par value for such conversion and the Conversion Amount for such conversion shall be increased
to include Additional Principal, where “Additional Principal” means such additional amount to be added to the Conversion Amount
to the extent necessary to cause the number of conversion shares issuable upon such conversion to equal the same number of conversion
shares as would have been issued had the Conversion Price not been subject to the minimum price set forth in this Section 1.2(c).

 

1.3 Authorized
Shares. Subject to the terms and conditions herein, the Borrower covenants that during the period while any outstanding balance is
owing hereunder, the Borrower will reserve from its authorized and unissued Common Stock a sufficient number of shares, free from preemptive
rights, to provide for the issuance of Common Stock upon the full conversion of this Note. Subject to the terms and conditions herein,
the Borrower is required at all times to have authorized and reserved four (4) times the number of shares that is actually issuable upon
full conversion of the Note (based on the Conversion Price of this Note in effect from time to time) initially 70,909,090 shares (the
“Reserved Amount”). The Reserved Amount shall be increased from time to time by written instructions of the Holder upon notice
to the Borrower’s transfer agent and the Borrower, provided that the Holder shall not have the right to increase the Reserved Amount
more than two (2) times in any calendar month period. The Borrower represents that upon issuance, such shares will be duly and validly
issued, fully paid and non-assessable. In addition, if the Borrower shall issue any securities or make any change to its capital structure
which would change the number of shares of Common Stock into which this Note shall be convertible at the then-current Conversion Price,
the Borrower shall at the same time make proper provision so that thereafter there shall be a sufficient number of shares of Common Stock
authorized and reserved, free from preemptive rights, for conversion of the outstanding portion of this Note. The Borrower (i) acknowledges
that it has irrevocably instructed its transfer agent to issue certificates for the Common Stock issuable upon conversion of this Note,
and (ii) agrees that its issuance of this Note shall constitute full authority to its officers and agents who are charged with the
duty of executing stock certificates to execute and issue the necessary certificates for shares of Common Stock in accordance with the
terms and conditions of this Note. If, at any time the Borrower does not maintain or replenish the Reserved Amount, as required herein.
within three (3) business days of the request of the Holder at a time when Borrower is required to adjust the Reserved Amount herein,
the principal amount of this Note shall increase by Five Thousand and No/100 United States Dollars ($5,000) (under Holder’s and
Borrower’s expectation that any principal amount increase will tack back to the Issue Date) per occurrence. Notwithstanding anything
to the contrary herein, Borrower shall not be required to increase the Reserved Amount more than two (2) times in any calendar month period.

 

 

		1	Section below deleted since conversion price being below
par value is addressed above.

 

    4

     

    

 

1.4 Method
of Conversion.

 

(a) Mechanics
of Conversion. Subject to Section 1.1, this Note may be converted by the Holder in whole or in part at any time from time to time
after an Event of Default, by (A) submitting to the Borrower a Notice of Conversion (by facsimile, e-mail or other reasonable means
of communication dispatched on the Conversion Date prior to 11:59 p.m., New York, New York time) and (B) subject to Section 1.4(b),
surrendering this Note at the principal office of the Borrower.

 

(b) Surrender
of Note Upon Conversion. Notwithstanding anything to the contrary set forth herein, upon conversion of this Note in accordance with
the terms hereof, the Holder shall not be required to physically surrender this Note to the Borrower unless the entire unpaid principal
amount of this Note is so converted. The Holder and the Borrower shall maintain records showing the principal amount so converted and
the dates of such conversions or shall use such other method, reasonably satisfactory to the Holder and the Borrower, so as not to require
physical surrender of this Note upon each such conversion. In the event of any dispute or discrepancy, such records of the Borrower shall,
prima facie, be controlling and determinative in the absence
of manifest error. Notwithstanding the foregoing, if any portion of this Note is converted as aforesaid, the Holder may not transfer this
Note unless the Holder first physically surrenders this Note to the Borrower, whereupon the Borrower will forthwith issue and deliver
upon the order of the Holder a new Note of like tenor, registered as the Holder (upon payment by the Holder of any applicable transfer
taxes) may request, representing in the aggregate the remaining unpaid principal amount of this Note. The Holder and any assignee, by
acceptance of this Note, acknowledge and agree that, by reason of the provisions of this paragraph, following conversion of a portion
of this Note, the unpaid and unconverted principal amount of this Note represented by this Note may be less than the amount stated on
the face hereof.

 

(c) Payment
of Taxes. The Borrower shall not be required to pay any tax which may be payable in respect of any transfer involved in the issue
and delivery of shares of Common Stock or other securities or property on conversion of this Note in a name other than that of the Holder
(or in street name), and the Borrower shall not be required to issue or deliver any such shares or other securities or property unless
and until the person or persons (other than the Holder or the custodian in whose street name such shares are to be held for the Holder’s
account) requesting the issuance thereof shall have paid to the Borrower the amount of any such tax or shall have established to the satisfaction
of the Borrower that such tax has been paid.

 

    5

     

    

 

(d) Delivery
of Common Stock Upon Conversion. Upon receipt by the Borrower from the Holder of a facsimile transmission or e-mail (or other reasonable
means of communication) of a Notice of Conversion meeting the requirements for conversion as provided in this Section 1.4, the Borrower
shall issue and deliver or cause to be issued and delivered to or upon the order of the Holder certificates for the Common Stock issuable
upon such conversion within three (3) business days after such receipt (the “Deadline”) (and, solely in the case of conversion
of the entire unpaid principal amount hereof, surrender of this Note) in accordance with the terms hereof and the Purchase Agreement.

 

(e) Obligation
of Borrower to Deliver Common Stock. Upon receipt by the Borrower of a Notice of Conversion, the Holder shall be deemed to be the
holder of record of the Common Stock issuable upon such conversion, the outstanding principal amount and the amount of accrued and unpaid
interest on this Note shall be reduced to reflect such conversion, and, unless the Borrower defaults on its obligations under this Article
I, all rights with respect to the portion of this Note being so converted shall forthwith terminate except the right to receive the Common
Stock or other securities, cash or other assets, as herein provided, on such conversion. If the Holder shall have given a Notice of Conversion
as provided herein, the Borrower’s obligation to issue and deliver the certificates for Common Stock shall be absolute and unconditional,
irrespective of the absence of any action by the Holder to enforce the same, any waiver or consent with respect to any provision thereof,
the recovery of any judgment against any person or any action to enforce the same, any failure or delay in the enforcement of any other
obligation of the Borrower to the holder of record, or any setoff, counterclaim, recoupment, limitation or termination, or any breach
or alleged breach by the Holder of any obligation to the Borrower, and irrespective of any other circumstance which might otherwise limit
such obligation of the Borrower to the Holder in connection with such conversion. The Conversion Date specified in the Notice of Conversion
shall be the Conversion Date so long as the Notice of Conversion is received by the Borrower before 11:59 p.m., New York, New York time,
on such date.

 

(f) Delivery
of Common Stock by Electronic Transfer. In lieu of delivering physical certificates representing the Common Stock issuable upon conversion,
provided the Borrower is participating in the Depository Trust Company (“DTC”) Fast Automated Securities Transfer (“FAST”)
program, upon request of the Holder and its compliance with the provisions contained in Section 1.1 and in this Section 1.4, the Borrower
shall use its commercially reasonable best efforts to cause its transfer agent to electronically transmit the Common Stock issuable upon
conversion to the Holder by crediting the account of Holder’s Prime Broker with DTC through its Deposit Withdrawal At Custodian
(“DWAC”) system.

 

(g) DTC
Eligibility & Market Loss. If the Borrower fails to maintain its status as “DTC Eligible” for any reason, the principal
amount of the Note shall increase by Fifteen Thousand and No/100 United States Dollars ($15,000) (under Holder’s and Borrower’s
expectation that any principal amount increase will tack back to the Issue Date).

 

(h) Failure
to Deliver Common Stock Prior to Delivery Deadline. Without in any way limiting the Holder’s right to pursue other remedies,
including actual damages and/or equitable relief, the Parties agree that if delivery of the Common Stock issuable upon conversion of this
Note is not delivered by the Deadline (other than a failure due to the circumstances described in Section 1.3, which failure shall be
governed by such Section 1.3) the Borrower shall pay to the Holder $2,000 per day in cash, for each day beyond the Deadline that the Borrower
fails to deliver such Common Stock until the Borrower issues and delivers a certificate to the Holder or credit the Holder’s balance account
with OTC for the number of shares of Common Stock to which the Holder is entitled upon such Holder’s conversion of any Conversion Amount
(under Holder’s and Borrower’s expectation that any damages will tack back to the Issue Date). Such cash amount shall be paid to Holder
by the fifth day of the month following the month in which it has accrued or, at the option of the Holder (by written notice to the Borrower
by the first day of the month following the month in which it has accrued), shall be added to the principal amount of this Note, in which
event interest shall accrue thereon in accordance with the terms of this Note and such additional principal amount shall be convertible
into Common Stock in accordance with the terms of this Note. The Borrower agrees that the right to convert is a valuable right to the
Holder. The damages resulting from a failure, attempt to frustrate, interference with such conversion right are difficult if not impossible
to qualify. Accordingly, the Parties acknowledge that the liquidated damages provision contained in this Section 1.4(h) are justified.

 

    6

     

    

 

(i) Rescindment
of a Notice of Conversion. If (i) the Borrower fails to respond to Holder within one (1) business day from the Conversion Date confirming
the details of Notice of Conversion, (ii) the Borrower fails to provide any of the shares of the Borrower’s Common Stock requested
in the Notice of Conversion by the Deadline, (iii) the Holder is unable to procure a legal opinion required to have the shares of the
Common Stock issued hereunder unrestricted and/or deposited to sell for any reason related to the Borrower’s standing, (iv) the
Holder is unable to deposit the shares of the Common Stock requested in the Notice of Conversion for any reason related to the Borrower’s
standing, (v) at any time after a missed Deadline, at the Holder’s sole discretion, or (vi) if OTC Markets changes the Borrower’s
designation to ‘Limited Information’ (Yield), ‘No Information’ (Stop Sign), ‘Caveat Emptor’ (Skull
& Crossbones), ‘OTC’, ‘Other OTC’ or ‘Grey Market’ (Exclamation Mark Sign) or other trading restriction
on the day of or any day after the Conversion Date, then Holder maintains the option and sole discretion to rescind the Notice of Conversion.

 

1.5 Concerning
the Shares. The shares of Common Stock issuable upon conversion of this Note may not be sold or transferred unless (i) such shares
are sold pursuant to an effective registration statement under the Securities Act of 1933, as amended (the “Securities Act”)
or (ii) the Borrower or its transfer agent shall have been furnished with an opinion of counsel (which opinion shall be in form, substance
and scope customary for opinions of counsel in comparable transactions) to the effect that the shares to be sold or transferred may be
sold or transferred pursuant to an exemption from such registration or (iii) such shares are sold or transferred pursuant to Rule
144 under the Securities Act (or a successor rule) (“Rule 144”) or other applicable exemption or (iv) such shares are transferred
to an “affiliate” (as defined in Rule 144) of the Borrower who agrees to sell or otherwise transfer the shares only in accordance
with this Section 1.5 and who is an Accredited Investor (as defined in the Purchase Agreement). Except as otherwise provided in the Purchase
Agreement (and subject to the removal provisions set forth below), until such time as the shares of Common Stock issuable upon conversion
of this Note have been registered under the Securities Act or otherwise may be sold pursuant to Rule 144 or other applicable exemption
without any restriction as to the number of securities as of a particular date that can then be immediately sold, each certificate for
shares of Common Stock issuable upon conversion of this Note that has not been so included in an effective registration statement or that
has not been sold pursuant to an effective registration statement or an exemption that permits removal of the legend, shall bear a legend
substantially in the following form, as appropriate: “NEITHER THE ISSUANCE AND SALE OF THE SECURITIES
REPRESENTED BY THIS CERTIFICATE NOR THE SECURITIES INTO WHICH THESE SECURITIES ARE EXERCISABLE HAVE BEEN REGISTERED UNDER THE SECURITIES
ACT OF 1933, AS AMENDED, OR APPLICABLE STATE SECURITIES LAWS. THE SECURITIES MAY NOT BE OFFERED FOR SALE, SOLD, TRANSFERRED OR ASSIGNED
(I) IN THE ABSENCE OF (A) AN EFFECTIVE REGISTRATION STATEMENT FOR THE SECURITIES UNDER THE SECURITIES ACT OF 1933, AS AMENDED, OR (B)
AN OPINION OF COUNSEL (WHICH COUNSEL SHALL BE SELECTED BY THE HOLDER), IN A GENERALLY ACCEPTABLE FORM, THAT REGISTRATION IS NOT REQUIRED
UNDER SAID ACT OR (II) UNLESS SOLD PURSUANT TO RULE 144 OR RULE 144A UNDER SAID ACT OR OTHER APPLICABLE EXEMPTION. NOTWITHSTANDING THE
FOREGOING, THE SECURITIES MAY BE PLEDGED IN CONNECTION WITH A BONA FIDE MARGIN ACCOUNT OR OTHER LOAN OR FINANCING ARRANGEMENT SECURED
BY THE SECURITIES.” The legend set forth above shall be removed and the Borrower shall issue to the Holder a new certificate
therefore free of any transfer legend if (i) the Borrower or its transfer agent shall have received an opinion of counsel, in form, substance
and scope customary for opinions of counsel in comparable transactions, to the effect that a public sale or transfer of such Common Stock
may be made without registration under the Securities Act, which opinion shall be reasonably accepted by the Borrower so that the sale
or transfer is effected or (ii) in the case of the Common Stock issuable upon conversion of this Note, such security is registered for
sale by the Holder under an effective registration statement filed under the Securities Act or otherwise may be sold pursuant to Rule
144 or other applicable exemption without any restriction as to the number of securities as of a particular date that can then be immediately
sold. In the event that the Borrower unreasonably rejects the opinion of counsel provided by the Buyer with respect to the transfer of
shares of Common Stock issuable hereunder pursuant to an exemption from registration, such as Rule 144 or Regulation S, at the Deadline,
it will be considered an Event of Default pursuant to Section 3.2.

 

    7

     

    

 

1.6 Effect
of Certain Events.

 

(a) Effect
of Merger, Consolidation, Etc. At the option of the Holder, the sale, conveyance or disposition of all or substantially all of the
assets of the Borrower, the effectuation by the Borrower of a transaction or series of related transactions in which more than 50% of
the voting power of the Borrower is disposed of, or the consolidation, merger or other business combination of the Borrower with or into
any other Person (as defined below) or Persons when the Borrower is not the survivor shall either: (i) be deemed to be an Event of Default
(as defined in Article III) pursuant to which the Borrower shall be required to pay to the Holder upon the consummation of and as a condition
to such transaction an amount equal to the Default Amount (as defined in Article III) or (ii) be treated pursuant to Section 1.6(b). “Person”
shall mean any individual, corporation, limited liability company, partnership, association, trust or other entity or organization.

 

(b) Adjustment
Due to Merger, Consolidation, Etc. If, at any time when this Note is issued and outstanding and prior to conversion of all of this
Note, there shall be any merger, consolidation, exchange of shares, recapitalization, reorganization, or other similar event, as a result
of which shares of Common Stock shall be changed into the same or a different number of shares of another class or classes of stock or
securities of the Borrower or another entity, or in case of any sale or conveyance of all or substantially all of the assets of the Borrower
other than in connection with a plan of complete liquidation of the Borrower, then the Holder shall thereafter have the right to receive
upon conversion of this Note, upon the basis and upon the terms and conditions specified herein and in lieu of the shares of Common Stock
immediately theretofore issuable upon conversion, such stock, securities or assets which the Holder would have been entitled to receive
in such transaction had this Note been converted in full immediately prior to such transaction (without regard to any limitations on conversion
set forth herein), and in any such case appropriate provisions shall be made with respect to the rights and interests of the Holder of
this Note to the end that the provisions hereof (including, without limitation, provisions for adjustment of the Conversion Price and
of the number of shares of Common Stock issuable upon conversion of the Note) shall thereafter be applicable, as nearly as may be practicable
in relation to any securities or assets thereafter deliverable upon the conversion hereof. The Borrower shall not affect any transaction
described in this Section 1.6(b) unless (a) it first gives, to the extent practicable, thirty (30) days prior written notice (but in any
event at least fifteen (15) days prior written notice) of the record date of the special meeting of shareholders to approve, or if there
is no such record date, the consummation of, such merger, consolidation, exchange of shares, recapitalization, reorganization or other
similar event or sale of assets (during which time the Holder shall be entitled to convert this Note) and (b) the resulting successor
or acquiring entity (if not the Borrower) assumes by written instrument the obligations of this Section 1.6(b). The above provisions shall
similarly apply to successive consolidations, mergers, sales, transfers or share exchanges.

 

(c) Adjustment
Due to Distribution. If, at any time when this Note is issued and outstanding and prior to conversion of all of this Note, the Borrower
shall declare or make any distribution of its assets (or rights to acquire its assets) to holders of Common Stock as a dividend, stock
repurchase, by way of return of capital or otherwise (including any dividend or distribution to the Borrower’s shareholders in cash
or shares (or rights to acquire shares) of capital stock of a subsidiary (i.e., a spin-off)) (a “Distribution”), then the
Holder shall be entitled, upon any conversion of this Note after the date of record for determining shareholders entitled to such Distribution,
to receive the amount of such assets which would have been payable to the Holder with respect to the shares of Common Stock issuable upon
such conversion had such Holder been the holder of such shares of Common Stock on the record date for the determination of shareholders
entitled to such Distribution.

 

    8

     

    

 

(d) Purchase
Rights. If, at any time when this Note is issued and outstanding and prior to conversion of all of this Note, the Borrower issues
any convertible securities or rights to purchase stock, warrants, securities or other property (the “Purchase Rights”) pro
rata to the record holders of any class of Common Stock, then the Holder will be entitled to acquire, upon the terms applicable to such
Purchase Rights, the aggregate Purchase Rights which such Holder could have acquired if such Holder had held the number of shares of Common
Stock acquirable upon complete conversion of this Note (without regard to any limitations on conversion contained herein) immediately
before the date on which a record is taken for the grant, issuance or sale of such Purchase Rights or, if no such record is taken, the
date as of which the record holders of Common Stock are to be determined for the grant, issue or sale of such Purchase Rights.

 

(e) Notice
of Adjustments. Upon the occurrence of each adjustment or readjustment of the Conversion Price as a result of the events described
in this Section 1.6, the Borrower, at its expense, shall promptly compute such adjustment or readjustment and prepare and furnish to the
Holder a certificate setting forth such adjustment or readjustment and showing in detail the facts upon which such adjustment or readjustment
is based. The Borrower shall, upon the written request at any time of the Holder, furnish to such Holder a like certificate setting forth
(i) such adjustment or readjustment, (ii) the Conversion Price at the time in effect and (iii) the number of shares of Common Stock and
the amount, if any, of other securities or property which at the time would be received upon conversion of the Note.

 

1.7 Status
as Shareholder. Upon submission of a Notice of Conversion by Holder, (i) the portion of this Note and the portion of the Principal
Amount and interest as set forth in the Notice of Conversion shall be deemed converted into shares of Common Stock and (ii) the Holder’s
rights as a holder of such converted portion of this Note shall cease and terminate, excepting only the right to receive certificates
for such shares of Common Stock and to any remedies provided herein or otherwise available at law or in equity to Holder because of a
failure by the Borrower to comply with the terms of this Note. Notwithstanding the foregoing, if Holder has not received certificates
for all shares of Common Stock prior to the tenth (10th) business day after the expiration of the Deadline with respect to a conversion
of any portion of this Note for any reason, then (unless the Holder otherwise elects to retain its status as a holder of Common Stock
by so notifying the Borrower) the Holder shall regain the rights of a holder of this Note with respect to such unconverted portions of
this Note and the Borrower shall, as soon as practicable, return such unconverted Note to the Holder or, if the Note has not been surrendered,
adjust its records to reflect that such portion of this Note has not been converted. In all cases, the Holder shall retain all of its
rights and remedies (including, without limitation, (i) the right to receive Conversion Default Payments pursuant to Section 1.3 to the
extent required thereby for such Conversion Default and any subsequent Conversion Default and (ii) the right to have the Conversion Price
with respect to subsequent conversions determined in accordance with Section 1.3) for the Borrower’s failure to convert this Note.

 

1.8 Prepayment.
Provided that an Event of Default has not occurred under this Note, the Borrower may prepay the amounts outstanding hereunder by paying
an amount equal to the sum of (w) the then outstanding principal amount of this Note plus (x) accrued and unpaid interest
on the unpaid principal amount of this Note plus (y) Default Interest, if any. Any notice of prepayment hereunder (an “Optional
Prepayment Notice”) shall be delivered to the Holder of the Note pursuant to the notice provisions herein and shall state: (1) that
the Borrower has elected to prepay this Note, and (2) the date of the prepayment, which shall be not more than three (3) business days
from the date of the Optional Prepayment Notice. On the date fixed for prepayment (the “Optional Prepayment Date”), the Borrower
shall make payment of the applicable prepayment amount to the Holder. If the Borrower delivers an Optional Prepayment Notice, and Borrower
fails to pay the applicable prepayment amount due to the Holder prior to the date which is two (2) business days following the Optional
Prepayment Date, the Borrower shall forever forfeit its right to prepay this Note pursuant to this Section 1.8.

 

    9

     

    

 

Article
II. CERTAIN COVENANTS

 

2.1 Distributions
on Capital Stock. So long as the Borrower shall have any obligation under this Note, the Borrower shall not without the Holder’s
written consent, such consent not to be unreasonably withheld, conditioned or delayed, (a) pay, declare or set apart for such payment,
any dividend or other distribution (whether in cash, property or other securities) on shares of capital stock other than dividends on
shares of Common Stock solely in the form of additional shares of Common Stock or (b) directly or indirectly or through any subsidiary
make any other payment or distribution in respect of its capital stock except for distributions pursuant to any shareholders’ rights
plan which is approved by a majority of the Borrower’s disinterested directors.

 

2.2 Restriction
on Stock Repurchases. So long as the Borrower shall have any obligation under this Note, the Borrower shall not without the Holder’s
written consent redeem, repurchase or otherwise acquire (whether for cash or in exchange for property or other securities or otherwise)
in any one transaction or series of related transactions any shares of capital stock of the Borrower or any warrants, rights or options
to purchase or acquire any such shares.

 

2.3 Most
Favored Nations Beginning on the Issuance Date of this Note, so long as the Borrower shall have any obligation under this Note, the
Conversion Price and other terms will be adjusted on a ratchet basis if the Borrower offers a more favorable term such as Conversion Price,
Interest Rate, (whether through a straight discount or in combination with an original issue discount) or other more favorable term to
another party.

 

2.4 Borrowings.
So long as the Borrower shall have any obligation under this Note, the Borrower shall not, without the Holder’s written consent,
such consent not to be unreasonably withheld, conditioned or delayed, create, incur, assume guarantee, endorse, contingently agree to
purchase or otherwise become liable upon the obligation of any person, firm, partnership, joint venture or corporation, except by the
endorsement of negotiable instruments for deposit or collection, or suffer to exist any liability for borrowed money, except (a) borrowings
in existence or committed on the date hereof and of which the Borrower has informed Holder in writing prior to the date hereof, or (b)
indebtedness to trade creditors financial institutions or other lenders incurred in the ordinary course of business.2

 

2.5 Sale
of Assets. So long as the Borrower shall have any obligation under this Note, the Borrower shall not, without the Holder’s written
consent, such consent not to be unreasonably withheld, conditioned or delayed, sell, lease or otherwise dispose of any significant portion
of its assets outside the ordinary course of business.

 

2.6 Advances
and Loans. So long as the Borrower shall have any obligation under this Note, the Borrower shall not, without the Holder’s written
consent, such consent not to be unreasonably withheld, conditioned or delayed, lend money, give credit or make advances to any person,
firm, joint venture or corporation, including, without limitation, officers, directors, employees, subsidiaries and affiliates of the
Borrower, except loans, credits or advances (a) in existence or committed on the date hereof and which the Borrower has informed Holder
in writing prior to the date hereof, (b) made in the ordinary course of business or (c) not in excess of $100,000.

 

2.7 Section
3(a)(9) or 3(a)(10) Transaction. So long as this Note is outstanding, the Borrower shall not enter into any transaction or arrangement
structured in accordance with, based upon, or related or pursuant to, in whole or in part, either Section 3(a)(9) of the Securities Act
(a “3(a)(9) Transaction”) or Section 3(a)(l0) of the Securities Act (a “3(a)(l0) Transaction”). In the event that
the Borrower does enter into, or makes any issuance of Common Stock related to a 3(a)(9) Transaction or a 3(a)(l0) Transaction while this
note is outstanding, a liquidated damages charge of 25% of the outstanding principal balance of this Note, but not less than Fifteen Thousand
Dollars $15,000, will be assessed and will become immediately due and payable to the Holder at its election in the form of cash payment
or addition to the balance of this Note.

 

 

 

		2	Please see changes in use of proceeds section below.

 

    10

     

    

 

2.8 Preservation
of Existence, etc. The Borrower shall maintain and preserve, and cause each of its subsidiaries to maintain and preserve, its existence,
rights and privileges, and become or remain, and cause each of its subsidiaries (other than dormant subsidiaries that have no or minimum
assets) to become or remain, duly qualified and in good standing in each jurisdiction in which the character of the properties owned or
leased by it or in which the transaction of its business makes such qualification necessary.

 

2.9 Non-circumvention.
The Borrower hereby covenants and agrees that the Borrower will not, by amendment of its Certificate or Articles of Incorporation or Bylaws,
or through any reorganization, transfer of assets, consolidation, merger, scheme of arrangement, dissolution, issue or sale of securities,
or any other voluntary action, avoid or seek to avoid the observance or performance of any of the terms of this Note, and will at all
times in good faith carry out all the provisions of this Note and take all action as may be required to protect the rights of the Holder.

 

Article
III. EVENTS OF DEFAULT

 

3.1 Events
of Default. If any of following events in this Section 3.1 occur, it shall be an “Event of Default” hereunder:

 

(a) Failure
to Pay Principal or Interest. The Borrower fails to pay the principal hereof or interest thereon when due on this Note, whether at
maturity, upon acceleration or otherwise, and such failure is not cured within three (3) business days of notice thereof from the Holder
to the Borrower.

 

(b) Conversion
and the Shares. The Borrower (i) fails to issue shares of Common Stock to the Holder (or announces or threatens in writing that it
will not honor its obligation to do so) upon exercise by the Holder of the conversion rights of the Holder in accordance with the terms
of this Note, (ii) fails to transfer or cause its transfer agent to transfer (issue) (electronically or in certificated form) any certificate
for shares of Common Stock issued to the Holder upon conversion of or otherwise pursuant to this Note as and when required by this Note,
(iii) directs its transfer agent not to transfer or delays, impairs, and/or hinders its transfer agent in transferring (or issuing) (electronically
or in certificated form) any certificate for shares of Common Stock to be issued to the Holder upon conversion of or otherwise pursuant
to this Note as and when required by this Note, (iv) fails to remove (or directs its transfer agent not to remove or impairs, delays,
and/or hinders its transfer agent from removing) any restrictive legend (or to withdraw any stop transfer instructions in respect thereof)
on any certificate for any shares of Common Stock issued to the Holder upon conversion of or otherwise pursuant to this Note as and when
required by this Note (or makes any written announcement, statement or threat that it does not intend to honor the obligations described
in this paragraph) and any such failure shall continue uncured (or any written announcement, statement or threat not to honor its obligations
shall not be rescinded in writing) for three (3) business days after the Holder shall have delivered a Notice of Conversion, (v) fails
to remain current in its obligations to its transfer agent, (vi) causes a conversion of this Note is delayed, hindered or frustrated due
to a balance owed by the Borrower to its transfer agent, (vii) fails to repay Holder, within forty eight (48) hours of a demand from the
Holder, any amount of funds advanced by Holder to Borrower’s transfer agent in order to process a conversion, (viii) fails to reserve
sufficient amount of shares of common stock to satisfy the Reserved Amount at all times, (ix) fails to provide a Rule 144 opinion letter
from the Borrower’s legal counsel to the Holder, covering the Holder’s resale into the public market of the respective conversion
shares under this Note, within two (2) business days of the Holder’s submission of a Notice of Conversion to the Borrower (provided
that the Holder must request the opinion from the Borrower at the time that Holder submits the respective Notice of Conversion and the
date of the respective Notice of Conversion must be on or after the date which is six (6) months after the date that the Holder funded
the Purchase Price under this Note), and/or (x) an exemption under Rule 144 is unavailable for the Holder’s deposit into Holder’s
brokerage account and resale into the public market of any of the conversion shares under this Note at any time after the date which is
six (6) months after the date that the Holder funded the Purchase Price under this Note, and in the case of each of the forgoing, such
failure or event is not cured within three (3) business days of notice thereof from the Holder to the Borrower.

 

    11

     

    

 

(c) Breach
of Covenants. The Borrower breaches any material covenant or other material term or condition contained in this Note and any collateral
documents including but not limited to the Purchase Agreement and such breach continues for a period of ten (10) days after written notice
thereof to the Borrower from the Holder.

 

(d) Breach
of Representations and Warranties. Any representation or warranty of the Borrower made herein or in any agreement, statement or certificate
given in writing pursuant hereto or in connection herewith (including, without limitation, the Purchase Agreement), shall be false or
misleading in any material respect when made and the breach of which has (or with the passage of time will have) a material adverse effect
on the rights of the Holder with respect to this Note or the Purchase Agreement.

 

(e) Receiver
or Trustee. The Borrower or any subsidiary of the Borrower shall make an assignment for the benefit of creditors or commence proceedings
for its dissolution, or apply for or consent to the appointment of a receiver or trustee for it or for a substantial part of its property
or business, or such a receiver or trustee shall otherwise be appointed for the Borrower or for a substantial part of its property or
business without its consent and shall not be discharged within sixty (60) days after such appointment.

 

(f) Judgments.
Any money judgment, writ or similar process shall be entered or filed against the Borrower or any subsidiary of the Borrower or any of
its property or other assets for more than $50,000, and shall remain unvacated, unbonded or unstayed for a period of twenty (20) days
unless otherwise consented to by the Holder, which consent will not be unreasonably withheld.

 

(g) Bankruptcy.
Bankruptcy, insolvency, reorganization or liquidation proceedings or other proceedings, voluntary or involuntary, for relief under any
bankruptcy law or any law for the relief of debtors shall be instituted by or against the Borrower or any subsidiary of the Borrower,
or the Borrower admits in writing its inability to pay its debts generally as they mature, or have filed against it an involuntary petition
for bankruptcy relief, all under federal or state laws as applicable or the Borrower admits in writing its inability to pay its debts
generally as they mature, or have filed against it an involuntary petition for bankruptcy relief, all under international, federal or
state laws as applicable.

 

(h) Delisting
of Common Stock. The Borrower shall fail to maintain the listing of the Common Stock on at least one of the OTC Pink, OTCQB, Nasdaq
National Market, Nasdaq Small Cap Market, New York Stock Exchange, NYSE MKT, or an equivalent replacement exchange.

 

(i) Failure
to Comply with the Exchange Act. The Borrower shall fail to comply with the reporting requirements of the Exchange Act (including
but not limited to becoming delinquent in its filings); and/or the Borrower shall cease to be subject to the reporting requirements of
the Exchange Act.

 

    12

     

    

 

(j) Liquidation.
Any dissolution, liquidation, or winding up of Borrower or any substantial portion of its business occurs.

 

(k) Cessation
of Operations. Any cessation of operations by Borrower occurs or Borrower admits it is otherwise generally unable to pay its debts
as such debts become due, provided, however, that any disclosure of the Borrower’s ability to continue as a “going concern”
shall not be an admission that the Borrower cannot pay its debts as they become due.

 

(l) Maintenance
of Assets. The failure by Borrower to maintain any material intellectual property rights, personal, real property or other assets
which are necessary to conduct its business (whether now or in the future), or any disposition or conveyance of any material asset of
the Borrower.

 

(m)Financial Statement
Restatement.The restatement of any financial statements filed by the Borrower with the SEC for any date or period from two years
prior to the Issue Date of this Note and until this Note is no longer outstanding, if the result of such restatement would, by comparison
to the un-restated financial statement, have constituted a material adverse effect on the rights of the Holder with respect to this Note
or the Purchase Agreement. The foregoing shall be inapplicable if the restatement is not due to any act(s) by the Borrower, but rather
is an issue of the Borrower’s auditor choosing to use a different accounting method then was originally reported.

 

(n) Reverse
Splits. The Borrower effectuates a reverse split of its Common Stock without twenty (20) days’ prior written notice to the Holder.

 

(o) Replacement
of Transfer Agent. In the event that the Borrower proposes to replace its transfer agent, the Borrower fails to provide, prior to
the effective date of such replacement, a fully executed Irrevocable Transfer Agent Instructions in a form as initially delivered pursuant
to the Purchase Agreement (including but not limited to the provision to irrevocably reserve shares of Common Stock in the Reserved Amount)
signed by the successor transfer agent to Borrower and the Borrower.

 

(p) Cessation
of Trading. Any cessation of trading of the Common Stock on at least one of the OTC Pink, OTCQB, Nasdaq National Market, Nasdaq Small
Cap Market, New York Stock Exchange, NYSE MKT, or an equivalent replacement exchange occurs, and such cessation of trading shall continue
for a period of five consecutive (5) Trading Days.

 

(q) Cross-Default.
Notwithstanding anything to the contrary contained in this Note or the other related or companion documents, a breach or default by the
Borrower of any covenant or other term or condition contained in any of the Other Agreements (as defined herein), after the passage of
all applicable notice and cure or grace periods, shall, at the option of the Holder, be considered a default under this Note and the Other
Agreements, in which event the Holder shall be entitled (but in no event required) to apply all rights and remedies of the Holder under
the terms of this Note and the Other Agreements by reason of a default under said Other Agreement or hereunder.
“Other Agreements” means, collectively, all agreements and instruments between, among or by the Borrower, on the one
hand, and the Holder or and any affiliate of the Holder on the other hand, including, without limitation, promissory notes, provided,
however, the term “Other Agreements” shall not include the agreements and instruments defined as the Documents (as defined
in the Purchase Agreement).

 

    13

     

    

 

(r) Bid
Price. The Borrower shall lose the “bid” price for its Common Stock ($0.0001 on the “Ask” with zero market
makers on the “Bid” per Level 2) and/or a market (including the OTC Pink, OTCQB or an equivalent replacement exchange).

 

(s) OTC
Markets Designation. OTC Markets changes the Borrower’s designation to ‘Caveat Emptor’ (Skull and Crossbones), or
‘OTC’, ‘Other OTC’ or ‘Grey Market’ (Exclamation Mark Sign).

 

(t) Inside
Information. The Borrower or its officers, directors, and/or affiliates transmits, conveys or discloses material non-public information
concerning the Borrower, to the Holder or its successors and assigns, which is not immediately cured by Borrower’s filing of a Form
8-K pursuant to Regulation FD on that same date, or the immediately following business day if such date or time is not a business day.

 

(u) Unavailability
of Rule 144. If, at any time on or after the date which is six (6) months after the Issue Date, the Holder is unable to (i) obtain
a standard “144 legal opinion letter” from an attorney reasonably acceptable to the Holder, the Borrower, the Holder’s
brokerage firm (and respective clearing firm), and the Borrower’s transfer agent in order to facilitate the Holder’s conversion
of any portion of the Note into free trading shares of the Borrower’s Common Stock pursuant to Rule 144, and (ii) thereupon deposit
such shares into the Holder’s brokerage account.

 

(v) Delisting
or Suspension of Trading of Common Stock. If, at any time on or after the Issue Date, the Borrower’s Common Stock (i) is suspended
from trading, (ii) halted from trading, and/or (iii) fails to be quoted or listed (as applicable) on any level of the OTC Markets, any
tier of the NASDAQ Stock Market, the New York Stock Exchange, or the NYSE American.

 

3.2 Consequences
of an Event of Default. UPON THE OCCURRENCE OF ANY EVENT OF DEFAULT SPECIFIED IN Article III OF THIS NOTE, THIS NOTE SHALL BECOME
IMMEDIATELY AND AUTOMATICALLY DUE AND PAYABLE WITHOUT DEMAND, PRESENTMENT, OR NOTICE AND THE BORROWER SHALL PAY TO THE HOLDER, IN FULL
SATISFACTION OF ITS OBLIGATIONS HEREUNDER, AN AMOUNT EQUAL TO: (A) the then outstanding principal
amount of this Note plus (B) accrued and unpaid interest on the unpaid principal amount of this Note to the date of payment (the
“Mandatory Prepayment Date”) plus (y) Default Interest, if any, on the amounts referred to in clauses (A) and (B),
MULTIPLIED BY ONE point two (120%). The Holder shall have the right at any time after an Event of Default occurs under this Note
and prior to full payment of this Note as set forth herein, to require the Borrower, to immediately issue, in lieu of the payments of
the amounts as set forth in this Section 3.2 (the “Default Amount”), the number of shares of Common Stock of the Borrower
equal to the Default Amount divided by the Conversion Price then in effect, pursuant to the terms of this Note (including but not limited
to any beneficial ownership limitations contained herein).3
In the event that the Holder elects to convert a portion of this Note and the Principal Amount and accrued interest into shares of Common
Stock as set forth herein following an Event of Default, such portion of this Note and the Principal Amount and accrued interest shall
be so converted and the remaining Default Amount to be paid by the Borrower shall be appropriately reduced.

 

 

 

		3	Attorney fees covered below.

 

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Article
IV. MISCELLANEOUS

 

4.1 Failure
or Indulgence Not Waiver. No failure or delay on the part of the Holder in the exercise of any power, right or privilege hereunder
shall operate as a waiver thereof, nor shall any single or partial exercise of any such power, right or privilege preclude other or further
exercise thereof or of any other right, power or privileges. All rights and remedies existing hereunder are cumulative to, and not exclusive
of, any rights or remedies otherwise available.

 

4.2 Notices.
All notices, demands, requests, consents, approvals, and other communications required or permitted hereunder shall be in writing and,
unless otherwise specified herein, shall be (i) personally served, (ii) deposited in the mail, registered or certified, return receipt
requested, postage prepaid, (iii) delivered by reputable air courier service with charges prepaid, or (iv) transmitted by hand delivery,
telegram, electronic mail, or facsimile, addressed as set forth below or to such other address as such Party shall have specified most
recently by written notice. Any notice or other communication required or permitted to be given hereunder shall be deemed effective (a)
upon hand delivery or delivery by electronic mail or facsimile, with accurate confirmation generated by the transmitting facsimile machine,
at the address or number designated below (if delivered on a business day during normal business hours where such notice is to be received),
or the first business day following such delivery (if delivered other than on a business day during normal business hours where such notice
is to be received) or (b) on the second business day following the date of mailing by express courier service, fully prepaid, addressed
to such address, or upon actual receipt of such mailing, whichever shall first occur. The addresses for such communications shall be:

 

If to the Borrower,
to:

 

C-BOND SYSTEMS INC

6035 South Loop East

Houston, TX 77033

Attn: Scott R. Silverman

 

If to the Holder:

 

GS CAPITAL PARTNERS, LLC

1 East Liberty Street
Suite 600

Reno, Nevada 89501

Attn: Gabe Sayegh

 

4.3 Amendments.
This Note and any provision hereof may only be amended by an instrument in writing signed by the Borrower and the Holder. The term “Note”
and all reference thereto, as used throughout this instrument, shall mean this instrument as originally executed, or if later amended
or supplemented, then as so amended or supplemented.

 

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4.4 Assignability.
This Note shall be binding upon the Borrower and its successors and assigns and shall inure to be the benefit of the Holder and its successors
and assigns. Neither the Borrower nor the Holder shall assign this Note or any rights or obligations hereunder without the prior written
consent of the other. Notwithstanding the foregoing, the Holder may assign its rights hereunder to any “accredited investor”
(as defined in Rule 501(a) of the Securities Act) in a private transaction from the Holder or to any of its “affiliates”,
as that term is defined under the Exchange Act, without the consent of the Borrower. Notwithstanding anything in this Note to the contrary,
this Note may be pledged as collateral in connection with a bona fide margin account or other lending arrangement. The Holder and
any assignee, by acceptance of this Note, acknowledge and agree that following conversion of a portion of this Note, the unpaid and unconverted
principal amount of this Note represented by this Note may be less than the amount stated on the face hereof.

 

4.5 Cost
of Collection. If the Holder shall commence an action or proceeding to enforce any provisions of this Note, including, without limitation,
engaging an attorney the Holder shall be reimbursed by the Borrower for its attorneys’ fees and other costs and expenses incurred
in the investigation, preparation and prosecution of such action or proceeding.

 

4.6 Governing
Law. This Note shall be governed by and construed in accordance with the laws of the State of Nevada without regard to principles
of conflicts of laws. Any action brought by either Party against the other concerning the transactions contemplated by this Agreement
shall be brought only in the state courts of Nevada or in the federal courts located in the state Nevada and county or city of either
Washoe County, Nevada or Clark County, Nevada. The Parties hereby irrevocably waive any objection to jurisdiction and venue of any action
instituted hereunder and shall not assert any defense based on lack of jurisdiction or venue or based upon forum non conveniens.
EACH PARTY HEREBY IRREVOCABLY WAIVES ANY RIGHT IT MAY HAVE TO, AND AGREES NOT TO REQUEST, A JURY TRIAL FOR THE ADJUDICATION OF ANY
DISPUTE HEREUNDER OR IN CONNECTION WITH OR ARISING OUT OF THIS NOTE OR ANY TRANSACTIONS CONTEMPLATED HEREBY. The prevailing Party
shall be entitled to recover from the other Party its reasonable attorney’s fees and costs. In the event that any provision of this Note
or any other agreement delivered in connection herewith is invalid or unenforceable under any applicable statute or rule of law, then
such provision shall be deemed inoperative to the extent that it may conflict therewith and shall be deemed modified to conform with such
statute or rule of law. Any such provision which may prove invalid or unenforceable under any law shall not affect the validity or enforceability
of any other provision of any agreement. Each Party hereby irrevocably waives personal service of process and consents to process being
served in any suit, action or proceeding in connection with this Agreement or any other Transaction Document by mailing a copy thereof
via registered or certified mail or overnight delivery (with evidence of delivery) to such Party at the address in effect for notices
to it under this Agreement and agrees that such service shall constitute good and sufficient service of process and notice thereof. Nothing
contained herein shall be deemed to limit in any way any right to serve process in any other manner permitted by law.

 

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4.7 Certain
Amounts. Whenever pursuant to this Note the Borrower is required to pay an amount in excess of the outstanding principal amount (or
the portion thereof required to be paid at that time) plus accrued and unpaid interest plus Default Interest on such interest, the Borrower
and the Holder agree that the actual damages to the Holder from the receipt of cash payment on this Note may be difficult to determine
and the amount to be so paid by the Borrower represents stipulated damages and not a penalty and is intended to compensate the Holder
in part for loss of the opportunity to convert this Note and to earn a return from the sale of shares of Common Stock acquired upon conversion
of this Note at a price in excess of the price paid for such shares pursuant to this Note. The Borrower and the Holder hereby agree that
such amount of stipulated damages is not plainly disproportionate to the possible loss to the Holder from the receipt of a cash payment
without the opportunity to convert this Note into shares of Common Stock.

 

4.8 Purchase
Agreement. By its acceptance of this Note, each Party agrees to be bound by the applicable terms of the Purchase Agreement.

 

4.9 Notice
of Corporate Events. Except as otherwise provided below, the Holder of this Note shall have no rights as a holder of Common Stock
unless and only to the extent that it converts this Note into Common Stock. The Borrower shall provide the Holder with prior notification
of any meeting of the Borrower’s shareholders (and copies of proxy materials and other information sent to shareholders). In the
event of any taking by the Borrower of a record of its shareholders for the purpose of determining shareholders who are entitled to receive
payment of any dividend or other distribution, any right to subscribe for, purchase or otherwise acquire (including by way of merger,
consolidation, reclassification or recapitalization) any share of any class or any other securities or property, or to receive any other
right, or for the purpose of determining shareholders who are entitled to vote in connection with any proposed sale, lease or conveyance
of all or substantially all of the assets of the Borrower or any proposed liquidation, dissolution or winding up of the Borrower, the
Borrower shall mail a notice to the Holder, at least twenty (20) days prior to the record date specified therein (or thirty (30) days
prior to the consummation of the transaction or event, whichever is earlier), of the date on which any such record is to be taken for
the purpose of such dividend, distribution, right or other event, and a brief statement regarding the amount and character of such dividend,
distribution, right or other event to the extent known at such time. The Borrower shall make a public announcement of any event requiring
notification to the Holder hereunder substantially simultaneously with the notification to the Holder in accordance with the terms of
this Section 4.9 including, but not limited to, name changes, recapitalizations, etc. as soon as possible under law.

 

4.10 Usury.
If it shall be found that any interest or other amount deemed interest due hereunder violates the applicable law governing usury, the
applicable provision shall automatically be revised to equal the maximum rate of interest or other amount deemed interest permitted under
applicable law. The Borrower covenants (to the extent that it may lawfully do so) that it will not seek to claim or take advantage of
any law that would prohibit or forgive the Borrower from paying all or a portion of the principal or interest on this Note.

 

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4.11 Remedies.
The Borrower acknowledges that a breach by it of its obligations hereunder will cause irreparable harm to the Holder, by vitiating the
intent and purpose of the transaction contemplated hereby. Accordingly, the Borrower acknowledges that the remedy at law for a breach
of its obligations under this Note will be inadequate and agrees, in the event of a breach or threatened breach by the Borrower of the
provisions of this Note, that the Holder shall be entitled, in addition to all other available remedies at law or in equity, and in addition
to the penalties assessable herein, to an injunction or injunctions restraining, preventing or curing any breach of this Note and to enforce
specifically the terms and provisions thereof, without the necessity of showing economic loss and without any bond or other security being
required. No provision of this Note shall alter or impair the obligation of the Borrower, which is absolute and unconditional, to pay
the principal of, and interest on, this Note at the time, place, and rate, and in the form, herein prescribed.

 

4.12 Severability.
In the event that any provision of this Note is invalid or unenforceable under any applicable statute or rule of law, then such provision
shall be deemed inoperative to the extent that it may conflict therewith and shall be deemed modified to conform with such statute or
rule of law. Any provision hereof which may prove invalid or unenforceable under any law shall not affect the validity or enforceability
of any other provision hereof.

 

4.13 Dispute
Resolution. In the case of a dispute as to the determination of the Conversion Price, Conversion Amount, any prepayment amount or
Default Amount or Maturity Date, the closing bid price, or fair market value (as the case may be) or the arithmetic calculation of the
Conversion Price or the applicable prepayment amount(s) (as the case may be), the Borrower or the Holder shall submit the disputed determinations
or arithmetic calculations via facsimile (i) within two (2) Business Days after receipt of the applicable notice giving rise to such dispute
to the Borrower or the Holder or (ii) if no notice gave rise to such dispute, at any time after the Holder learned of the circumstances
giving rise to such dispute. If the Holder and the Borrower are unable to agree upon such determination or calculation within two (2)
Business Days of such disputed determination or arithmetic calculation (as the case may be) being submitted to the Borrower or the Holder,
then the Borrower shall, within two (2) Business Days, submit via facsimile (a) the disputed determination of the Conversion Price, the
closing bid price, the or fair market value (as the case may be) to an independent, reputable investment bank selected by the Borrower
and approved by the Holder or (b) the disputed arithmetic calculation of the Conversion Price, Conversion Amount, any prepayment amount
or Default Amount, to an independent, outside accountant selected by the Holder that is reasonably acceptable to the Borrower. The Borrower
shall cause at its expense the investment bank or the accountant to perform the determinations or calculations and notify the Borrower
and the Holder of the results no later than ten (10) Business Days from the time it receives such disputed determinations or calculations.
Such investment bank’s or accountant’s determination or calculation shall be binding upon all Parties absent demonstrable
error.

 

4.14 Future
Raises; Repayment from Proceeds. Until the Note is satisfied in full, if the Borrower receives cash proceeds from any source or series
of related or unrelated sources, including but not limited to, from the issuance of equity and/or debt securities, the conversion of outstanding
warrants of the Borrower, the issuance of securities pursuant to an equity line of credit of the Borrower or the sale of assets, the Borrower
shall, within one (1) business day of Borrower’s receipt of such proceeds, inform the Holder of such receipt, following which the
Holder shall have the right in its sole discretion to require the Borrower to immediately apply up to 50% of such proceeds of such capital
raise to repay amounts due under this this Note. Failure of the Borrower to comply with this provision shall constitute an Event of Default
under Section 3.4 of the Note.

 

[signature page follows]

 

    18

     

    

 

IN WITNESS WHEREOF, Borrower
has caused this Note to be signed in its name by its duly authorized officer as of the date first above written.

 

	 	C-BOND SYSTEMS INC.
	 	 
	 	By:	/s/ Scott R. Silverman
	 	Name:  	Scott R. Silverman
	 	Title: 	Chief Executive Officer

 

	Agreed and accepted:	 
	 	 	 
	GS Capital Partners, LLC	 
	 	 	 
	By:	/s/ Gabe Sayegh	 
	Name:  	Gabe Sayegh	 
	Title:	Manager	 

 

    19

     

    

 

EXHIBIT A

NOTICE OF CONVERSION

 

The undersigned hereby elects
to convert $_________________principal amount of the Note (defined below) together with $________________ of accrued and unpaid interest
thereto, totaling $_____________ into that number of shares of Common Stock to be issued pursuant
to the conversion of the Note (“Common Stock”) as set forth below, of C-Bond Systems Inc., a Colorado corporation (the
“Borrower”), according to the conditions of the convertible note of the Borrower dated as of ____________ (the “Note”),
as of the date written below. No fee will be charged to the Holder for any conversion, except for transfer taxes, if any.

 

Box Checked as to applicable
instructions:

 

		☐	The Borrower shall electronically transmit the Common
Stock issuable pursuant to this Notice of Conversion to the account of the undersigned or its nominee with DTC through its Deposit Withdrawal
At Custodian system (“DWAC Transfer”).

 

Name of DTC Prime Broker:

Account Number:

 

		☐	The undersigned hereby requests that the Borrower issue a
certificate or certificates for the number of shares of Common Stock set forth below (which numbers are based on the Holder’s calculation
attached hereto) in the name(s) specified immediately below or, if additional space is necessary, on an attachment hereto:

 

Name: [NAME]

Address: [ADDRESS]

 

Date of Conversion:                           _____________

Applicable Conversion Price:                           $____________

Number of Shares of Common Stock to be
Issued

Pursuant to Conversion of the Note:                           ______________

Amount of Principal Balance Due remaining

Under the Note after this conversion:
                          ______________

Accrued
and unpaid interest remaining:                           ______________

 

[HOLDER]

 

	 	By:	 	 
	 	Name: [NAME]	 
	 	Title: [TITLE]	 
	 	Date: [DATE]

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