Document:

Exhibit 4.5

 

THIS WARRANT IS ONE OF TWO WARRANTS
ISSUED IN EXCHANGE FOR THE UNIT WARRANT THAT WAS ISSUED ON JULY 31, 2018, WHICH UNIT WARRANT IS CANCELLED IN ITS ENTIRETY

 

THIS WARRANT AND THE SHARES ISSUABLE
UPON THE EXERCISE OF THIS WARRANT HAVE NOT BEEN REGISTERED UNDER THE SECURITIES ACT OF 1933, AS AMENDED. EXCEPT AS OTHERWISE SET
FORTH HEREIN OR IN A SECURITIES PURCHASE AGREEMENT DATED AS OF FEBRUARY 22, 2018 (THE “SECURITIES PURCHASE AGREEMENT”),
NEITHER THIS WARRANT NOR ANY OF SUCH SHARES MAY BE SOLD, TRANSFERRED OR ASSIGNED IN THE ABSENCE OF AN EFFECTIVE REGISTRATION STATEMENT
FOR SUCH SECURITIES UNDER SAID ACT OR AN OPINION OF COUNSEL, IN FORM, SUBSTANCE AND SCOPE, CUSTOMARY FOR OPINIONS OF COUNSEL IN
COMPARABLE TRANSACTIONS, THAT REGISTRATION IS NOT REQUIRED UNDER SUCH ACT, THE SUBSTANCE OF WHICH OPINION SHALL BE REASONABLY ACCEPTABLE
TO THE COMPANY.

 

Right to Purchase [               
] shares of Common Stock, par value $0.001 per share

 

FORM OF STOCK PURCHASE WARRANT

 

THIS CERTIFIES THAT,
for value received, [            ] (“Holder”) or its assigns,
is entitled to purchase from Adial Pharmaceuticals, Inc., a Delaware corporation (the “Company”), at any time
or from time to time during the period specified in Paragraph 2 hereof and subject to adjustment as provided herein, [                     
] fully paid and nonassessable shares of the Company’s Common Stock, par value $0.001 per share (the “Common Stock”),
at an exercise price per share equal to $6.25 per share of Common Stock (the “Exercise Price”). The term “Warrant
Shares,” as used herein, refers to the shares of Common Stock purchasable hereunder. The Warrant Shares and the Exercise
Price are subject to adjustment as provided in Paragraph 4 hereof. The term “Warrant” means this Stock Purchase Warrant
issued pursuant to that certain Exchange Agreement, dated November 12, 2018, by and among the Company and Holder.

 

This Warrant is subject to the following
terms, provisions, and conditions:

 

1.
Manner of Exercise; Issuance of Certificates; Payment for Shares. Subject
to the provisions hereof, this Warrant may be exercised by the Holder, in whole or in part, by the surrender of this Warrant, together
with a completed exercise agreement in the form attached hereto (the “Exercise Agreement”), to the Company during normal
business hours on any business day at the Company’s principal executive offices (or such other office or agency of the Company
as it may designate by notice to the Holder), and upon payment to the Company in cash, by certified or official bank check or by
wire transfer for the account of the Company of the Exercise Price for the Warrant Shares specified in the Exercise Agreement or
by “cashless exercise” as provided below. The Warrant Shares so purchased shall be deemed to be issued to the Holder
or such Holder’s designee, as the record owner of such shares, as of the close of business on the date on which this Warrant
shall have been surrendered, the completed Exercise Agreement shall have been delivered, and payment shall have been made for such
shares as set forth above. Certificates for the Warrant Shares so purchased, representing the aggregate number of shares specified
in the Exercise Agreement, shall be delivered to the Holder within a reasonable time, not exceeding three (3) business days, after
this Warrant shall have been so exercised. If this Warrant shall have been exercised only in part, then, unless this Warrant has
expired, the Company shall, at its expense, at the time of delivery of such certificates, deliver to the Holder a new Warrant representing
the number of shares with respect to which this Warrant shall not then have been exercised. 

 

     

     

    

 

This Warrant may also
be exercised at such time by means of a “cashless exercise” in which the Holder shall be entitled to receive a certificate
for the number of Warrant Shares equal to the quotient obtained by dividing [(A-B) (X)] by (A), where:

 

		(A) =	 the average VWAP on the thirty (30) Trading Days immediately
preceding the date on which Holder elects to exercise this Warrant by means of a “cashless exercise,” as set forth
in the applicable Notice of Exercise;

 

		(B) =	the Exercise Price of this Warrant, as adjusted; and

 

		(X) =	the number of Warrant Shares issuable upon exercise of
this Warrant in accordance with the terms of this Warrant by means of a cash exercise rather than a cashless exercise.

 

“VWAP”
means, for any Trading Day, the price determined by the first of the following clauses that applies: (a) if Common Stock is then
traded or quoted on the Trading Market, the daily volume weighted average price of Common Stock for such Trading Day on the Trading
Market; (b) if Common Stock is not then traded or quoted on the Trading Market and if prices for Common Stock are then reported
in the “Pink Sheets” published by Pink Sheets, LLC (or a similar organization or agency succeeding to its functions
of reporting prices), the most recent bid price per share of Common Stock so reported as of such Trading Day; or (c) in all other
cases, the fair market value of a share of Common Stock as of such Trading Day, as determined by an independent appraiser selected
in good faith by the Holder and reasonably acceptable to the Company.

 

“Trading Day”
means, at any time, a day on which the Trading Market is open for the general trading or quotation of securities and Common Stock
is traded or quoted thereon or, if Common Stock is not then traded or quoted on the Trading Market, a business day.

 

“Trading Market”
means, at any time, the securities exchange, quotation system or over-the-counter trading facility on which Common Stock is principally
traded or quoted at such time.

 

Notwithstanding anything
in this Warrant to the contrary, in no event shall the Holder be entitled to exercise this Warrant, either in whole or in part,
to obtain a number of Warrant Shares that would result in beneficial ownership by the Holder and its affiliates of more than 4.9%
of the outstanding shares of Common Stock. For purposes of the immediately preceding sentence, beneficial ownership shall be determined
in accordance with Section 13(d) of the Securities Exchange Act of 1934, as amended, and Regulation 13D-G thereunder. Notwithstanding
anything to the contrary contained herein, the limitation on exercise of this Warrant set forth herein may not be amended without
(i) the written consent of the Holder and the Company and (ii) the approval of a majority of shareholders of the Company.

 

    	 	2	 

     

    

 

2.
Period of Exercise. This Warrant is
exercisable at any time or from time to time on or after the date on which this Warrant is issued and delivered pursuant to the
terms of the Securities Purchase Agreement and before 5:00 p.m., New York, New York time on July 31, 2023 (the “Exercise
Period”).   

 

3.
Certain Agreements of the Company. The
Company hereby covenants and agrees as follows:

 

(a) Shares to be
Fully Paid. All Warrant Shares will, upon issuance in accordance with the terms of this Warrant, be validly issued, fully
paid, and nonassessable and free from all taxes, liens, and charges with respect to the issue thereof.

 

(b) Reservation
of Shares. During the Exercise Period, the Company shall at all times have authorized, and reserved for the purpose of
issuance upon exercise of this Warrant, a sufficient number of shares of Common Stock to provide for the exercise in full of this
Warrant.

 

(c) Successors
and Assigns. This Warrant will be binding upon any entity succeeding to the Company by merger, consolidation, or acquisition
of all or substantially all the Company’s assets.

 

4.
Antidilution Provisions. During the
Exercise Period, the Exercise Price and the number of Warrant Shares shall be subject to adjustment from time to time as provided
in this Paragraph 4.

 

In the event that any
adjustment of the Exercise Price as required herein results in a fraction of a cent, such Exercise Price shall be rounded up to
the nearest cent.

 

(a) Subdivision
or Combination of Common Stock. If the Company at any time subdivides (by any stock split, stock dividend, recapitalization,
reorganization, reclassification or otherwise) the shares of Common Stock acquirable hereunder into a greater number of shares,
then, after the date of record for effecting such subdivision, the Exercise Price in effect immediately prior to such subdivision
will be proportionately reduced. If the Company at any time combines (by reverse stock split, recapitalization, reorganization,
reclassification or otherwise) the shares of Common Stock acquirable hereunder into a smaller number of shares, then, after the
date of record for effecting such combination, the Exercise Price in effect immediately prior to such combination will be proportionately
increased.

 

(b) Adjustment
in Number of Warrant Shares. Upon each adjustment of the Exercise Price pursuant to the provisions of this Paragraph 4,
the number of Warrant Shares issuable upon exercise of this Warrant shall be adjusted by multiplying a number equal to the Exercise
Price in effect immediately prior to such adjustment by the number of Warrant Shares issuable upon exercise of this Warrant immediately
prior to such adjustment and dividing the product so obtained by the adjusted Exercise Price.   

 

    	 	3	 

     

    

 

(c) Consolidation,
Merger or Sale. In case of any consolidation of the Company with, or merger of the Company into any other corporation or
other entity, or in case of any sale or conveyance of all or substantially all of the assets of the Company other than in connection
with a plan of complete liquidation of the Company, then as a condition of such consolidation, merger or sale or conveyance, adequate
provision will be made whereby the Holder of this Warrant will have the right to acquire and receive upon exercise of this Warrant
in lieu of the shares of Common Stock immediately theretofore acquirable upon the exercise of this Warrant, such shares of stock,
securities or assets as would be issued or payable with respect to or in exchange for the number of shares of Common Stock immediately
theretofore acquirable and receivable upon exercise of this Warrant in connection with such consolidation, merger or sale or conveyance.
In any such case, the Company will make appropriate provision to insure that the provisions of this Paragraph 4 hereof will thereafter
be applicable as nearly as may be in relation to any shares of stock or securities thereafter deliverable upon the exercise of
this Warrant. The Company will not effect any consolidation, merger or sale or conveyance unless prior to the consummation thereof,
the successor corporation or other entity (if other than the Company) assumes by written instrument the obligations under this
Paragraph 4(c) and the obligations to deliver to the Holder of this Warrant such shares of stock, securities or assets as, in accordance
with the foregoing provisions, the Holder may be entitled to acquire.

 

5.
Issue Tax. The issuance of certificates
for Warrant Shares upon the exercise of this Warrant shall be made without charge to the Holder of this Warrant or such shares
for any issuance tax or other costs in respect thereof, provided that the Company shall not be required to pay any tax which may
be payable in respect of any transfer involved in the issuance and delivery of any certificate in a name other than the Holder
of this Warrant.

 

6.
No Rights or Liabilities as a Shareholder. This
Warrant shall not entitle the Holder to any voting rights or other rights as a shareholder of the Company. No provision of this
Warrant, in the absence of affirmative action by the Holder to purchase Warrant Shares, and no mere enumeration herein of the rights
or privileges of the Holder, shall give rise to any liability of such Holder for the Exercise Price or as a shareholder of the
Company, whether such liability is asserted by the Company or by creditors of the Company.

 

7.
Transfer, Exchange, and Replacement of Warrant.

 

(a) Restriction
on Transfer. This Warrant and the rights granted to the Holder are transferable, in whole or in part, upon surrender of
this Warrant, together with a properly executed assignment in the form attached hereto, at the office or agency of the Company,
provided, however, that any transfer or assignment shall be subject to the conditions set forth in Paragraph 7(f) hereof. Until
due presentment for registration of transfer on the books of the Company, the Company may treat the registered Holder as the owner
and Holder for all purposes, and the Company shall not be affected by any notice to the contrary. Notwithstanding the above, Holder
may subdivide this warrant (i.e. transfer it in part) no more than 3 times without the written consent of the Company in its sole
discretion.

 

(b) Warrant Exchangeable
for Different Denominations. This Warrant is exchangeable, upon the surrender hereof by the Holder at the office or agency
of the Company, for new Warrants of like tenor representing in the aggregate the right to purchase the number of shares of Common
Stock which may be purchased hereunder, each of such new Warrants to represent the right to purchase such number of shares as shall
be designated by the Holder at the time of such surrender.

 

(c) Replacement
of Warrant. Upon receipt of evidence reasonably satisfactory to the Company of the loss, theft, destruction, or mutilation
of this Warrant and, in the case of any such loss, theft, or destruction, upon delivery of an indemnity agreement reasonably satisfactory
in form and amount to the Company, or, in the case of any such mutilation, upon surrender and cancellation of this Warrant, the
Company, at its expense, will execute and deliver, in lieu thereof, a new Warrant of like tenor.

 

    	 	4	 

     

    

 

(d) Cancellation;
Payment of Expenses. Upon the surrender of this Warrant in connection with any transfer, exchange, or replacement as provided
in this Paragraph 7, this Warrant shall be promptly canceled by the Company. The Company shall pay all taxes (other than securities
transfer taxes) and all other expenses (other than legal expenses, if any, incurred by the Holder or transferees) and charges payable
in connection with the preparation, execution, and delivery of Warrants pursuant to this Paragraph 7.

 

(e) Register.
The Company shall maintain, at its principal executive offices (or such other office or agency of the Company as it may designate
by notice to the Holder), a register for this Warrant, in which the Company shall record the name and address of the person in
whose name this Warrant has been issued, as well as the name and address of each transferee and each prior owner of this Warrant.

 

(f) Exercise or
Transfer Without Registration. If, at the time of the surrender of this Warrant in connection with any exercise, transfer,
or exchange of this Warrant, this Warrant (or, in the case of any exercise, the Warrant Shares issuable hereunder), shall not be
registered under the Securities Act of 1933, as amended (the “Securities Act”) and under applicable state securities
or blue sky laws, the Company may require, as a condition of allowing such exercise, transfer, or exchange, (i) that the Holder
or transferee of this Warrant, as the case may be, furnish to the Company a written opinion of counsel, which opinion and counsel
are reasonably acceptable to the Company, to the effect that such exercise, transfer, or exchange may be made without registration
under said Act and under applicable state securities or blue sky laws, (ii) that the Holder or transferee execute and deliver to
the Company an investment letter in form and substance acceptable to the Company and (iii) that the transferee be an “accredited
investor” as defined in Rule 501(a) promulgated under the Securities Act; provided that no such opinion, letter or status
as an “accredited investor” shall be required in connection with a transfer pursuant to Rule 144 under the Securities
Act. The first holder of this Warrant, by taking and holding the same, represents to the Company that such holder is acquiring
this Warrant for investment and not with a view to the distribution thereof. In no event shall the Holder be permitted to assign
the Warrant unless provided with express written consent by the Company.

 

8.
[Intentionally Omitted]

 

9.
Notices. All notices, requests, and
other communications required or permitted to be given or delivered hereunder to the Holder of this Warrant shall be in writing,
and shall be personally delivered, or shall be sent by certified or registered mail or by recognized overnight mail courier, postage
prepaid and addressed, to such holder at the address shown for such holder on the books of the Company, or at such other address
as shall have been furnished to the Company by notice from such holder. All notices, requests, and other communications required
or permitted to be given or delivered hereunder to the Company shall be in writing, and shall be personally delivered, or shall
be sent by certified or registered mail or by recognized overnight mail courier, postage prepaid and addressed, to the office of
the Company at the address set forth in the Securities Purchase Agreement, or at such other address as shall have been furnished
to the Holder of this Warrant by notice from the Company. Any such notice, request, or other communication may be sent by facsimile,
but shall in such case be subsequently confirmed by a writing personally delivered or sent by certified or registered mail or by
recognized overnight mail courier as provided above. All notices, requests, and other communications shall be deemed to have been
given either at the time of the receipt thereof by the person entitled to receive such notice at the address of such person for
purposes of this Paragraph 9, or, if mailed by registered or certified mail or with a recognized overnight mail courier upon deposit
with the United States Post Office or such overnight mail courier, if postage is prepaid and the mailing is properly addressed,
as the case may be.

 

    	 	5	 

     

    

 

10.
Governing Law. THIS WARRANT
SHALL BE ENFORCED, GOVERNED BY AND CONSTRUED IN ACCORDANCE WITH THE LAWS OF THE STATE OF DELAWARE APPLICABLE TO AGREEMENTS MADE
AND TO BE PERFORMED ENTIRELY WITHIN SUCH STATE, WITHOUT REGARD TO THE PRINCIPLES OF CONFLICT OF LAWS. THE PARTIES HERETO HEREBY
SUBMIT TO THE EXCLUSIVE JURISDICTION OF THE UNITED STATES FEDERAL COURTS LOCATED IN NEW YORK, NEW YORK WITH RESPECT TO ANY DISPUTE
ARISING UNDER THIS WARRANT, THE AGREEMENTS ENTERED INTO IN CONNECTION HEREWITH OR THE TRANSACTIONS CONTEMPLATED HEREBY OR THEREBY.
BOTH PARTIES IRREVOCABLY WAIVE THE DEFENSE OF AN INCONVENIENT FORUM TO THE MAINTENANCE OF SUCH SUIT OR PROCEEDING. BOTH PARTIES
FURTHER AGREE THAT SERVICE OF PROCESS UPON A PARTY MAILED BY FIRST CLASS MAIL SHALL BE DEEMED IN EVERY RESPECT EFFECTIVE SERVICE
OF PROCESS UPON THE PARTY IN ANY SUCH SUIT OR PROCEEDING. NOTHING HEREIN SHALL AFFECT EITHER PARTY’S RIGHT TO SERVE PROCESS
IN ANY OTHER MANNER PERMITTED BY LAW. BOTH PARTIES AGREE THAT A FINAL NON-APPEALABLE JUDGMENT IN ANY SUCH SUIT OR PROCEEDING SHALL
BE CONCLUSIVE AND MAY BE ENFORCED IN OTHER JURISDICTIONS BY SUIT ON SUCH JUDGMENT OR IN ANY OTHER LAWFUL MANNER. THE PARTY WHICH
DOES NOT PREVAIL IN ANY DISPUTE ARISING UNDER THIS WARRANT SHALL BE RESPONSIBLE FOR ALL FEES AND EXPENSES, INCLUDING ATTORNEYS’
FEES, INCURRED BY THE PREVAILING PARTY IN CONNECTION WITH SUCH DISPUTE.

 

11. Miscellaneous.

 

(a) Amendments;
Waivers. No purported amendment to any provision of this Warrant shall be binding on the parties unless each party has
duly executed and delivered to the other party a written instrument which states that it constitutes an amendment to this Warrant
and specifies the provision(s) hereof that are being amended. No purported waiver of any provision of this Warrant shall be binding
on any party unless it has duly executed and delivered to the other party a written instrument which states that it constitutes
a waiver of one or more provisions of this Warrant and specifies the provision(s) hereof that are being waived. Any such waiver
shall be effective only to the extent specifically set forth in such written instrument. No waiver of any right, power or remedy
of a party shall be deemed to be a waiver of any other right, power or remedy of such party or shall, except to the extent so waived,
impair, limit or restrict the exercise of such right, power or remedy.

 

(b) Descriptive
Headings. The descriptive headings of the several paragraphs of this Warrant are inserted for purposes of reference only,
and shall not affect the meaning or construction of any of the provisions hereof.

 

(c) Remedies.
The Company 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 Company acknowledges that the remedy at law for
a breach of its obligations under this Warrant will be inadequate and agrees, in the event of a breach or threatened breach by
the Company of the provisions of this Warrant, 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 Warrant 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.

 

[REMAINDER OF PAGE INTENTIONALLY LEFT BLANK]

 

    	 	6	 

     

    

 

IN WITNESS WHEREOF, the Company has
caused this Warrant to be signed by its duly authorized officer.

 

	 	ADIAL PHARMACEUTICALS, INC.
	 	 	 
	 	By:	 
	 	Name:	Joseph A. M. Truluck
	 	Title:	COO/CFO

 

AGREED AND ACKNOWLEDGED

 

This Warrant together with the warrant
to purchase [             ] shares of common stock at an exercise price
of $5.00 per share also issued on the below date replaces the Unit Warrant issued on July 31, 2018, which is cancelled.

 

[NAME OF INVESTOR]

 

	By:	 	 
	Name:	 	 
	Title:	 	 

 

Dated as of November 12, 2018

 

    	 	7	 

     

    

 

FORM OF EXERCISE AGREEMENT

 

Dated: ________ __, 20__

 

To: ______________________

 

The undersigned, pursuant to the provisions
set forth in the within Warrant, hereby agrees to purchase ________ shares of Common Stock covered by such Warrant. The undersigned
intends that payment of the Exercise Price shall be made as (check one):

 

____ “cash exercise” in the
amount of $_________

 

____ “cashless exercise” pursuant
to Section 1 of the Warrant.

 

Please issue a certificate or certificates
for such shares of Common Stock in the name of and pay any cash for any fractional share to:

 

	 	Name:	 
	 	 	 
	 	Signature: 	 
	 	 	 
	 	Address:	 
	 	 	 
	 	 	 
	 	 	 
	 	Note:	The above signature should correspond exactly with the name on the face of the within Warrant, if applicable.

 

    	 	8	 

     

    

 

FORM OF ASSIGNMENT

 

FOR VALUE RECEIVED,
the undersigned hereby sells, assigns, and transfers all the rights of the undersigned under the within Warrant, with respect to
the number of shares of Common Stock covered thereby set forth hereinbelow, to:

 

	Name of Assignee	 	Address	 	No of Shares
	 	 	 	 	 
	 	 	 	 	 
	 	 	 	 	 
	 	 	 	 	 

 

, and hereby irrevocably constitutes and appoints ___________________________________
as agent and attorney-in-fact to transfer said Warrant on the books of the within-named corporation, with full power of substitution
in the premises.

 

Dated: ________ __, 20__

 

	In the presence of:	 	 
	 	 	 
	 	Name:	 
	 	 	 
	 	Signature: 	 
	 	Title of Signing Officer or Agent (if any):
	 	 	 
	 	Address:	 
	 	 	 
	 	 	 
	 	 	 
	 	 	 
	 	 	 
	 	Note:	The above signature should correspond exactly with the name on the face of the within Warrant, if applicable.

 

    	 	9[Final
Form]

 

ECO-STIM
ENERGY SOLUTIONS, INC. 

2015
STOCK INCENTIVE PLAN

 

PERFORMANCE
SHARE UNIT GRANT NOTICE

 

Pursuant
to the terms and conditions of the Eco-Stim Energy Solutions, Inc. 2015 Stock Incentive Plan, as amended from time to time (the
“Plan”), Eco-Stim Energy Solutions, Inc. (the “Company”) hereby grants to
the individual listed below (“you” or the “Participant”) the number of performance
share units (the “PSUs”) set forth below. This award of PSUs (this “Award”)
is subject to the terms and conditions set forth herein and in the Performance Share Unit Agreement attached hereto as Exhibit
A (the “Agreement”) and the Plan, each of which is incorporated herein by reference. Capitalized
terms used but not defined herein shall have the meanings set forth in the Plan.

 

	Participant:	[●]

                                                                                 

	Date
    of Grant:	[●], 2018

                                                                               

	Award
    Type and Description:	Performance
                                         Award granted pursuant to Paragraph IX of the Plan. This Award represents the right to
                                         receive shares of Common Stock in an amount equal to 0% or 100% of the Base PSUs (defined
                                         below) plus 0% or 100% of the Stretch PSUs (defined below), subject to the terms and
                                         conditions set forth herein and in the Agreement.

         

        Your
        right to receive settlement of this Award shall vest and become earned and nonforfeitable upon (i) your satisfaction of
        the continued employment or service requirements described below under “Service Requirement” and (ii) the
        Committee’s certification of the level of achievement of the Performance Goal (defined below). The number of PSUs
        actually earned upon satisfaction of the foregoing requirements is referred to herein as the “Earned PSUs.”

         

	Number
    of PSUs:	[●] (the “Base PSUs”) and [●] (the “Stretch PSUs”).

                                                                               

	Performance
    Period:	[●], 2018 (the “Performance Period Commencement Date”) through December 31, 2018 (the “Performance Period End Date”).

                                                                               

	Performance
    Goals:	The
    “Performance Goal” is based on the Company’s adjusted earnings from its U.S. operations before
    interest, taxes, depreciation and amortization during the Performance Period, as more fully described in Exhibit B
    attached hereto. 

 

	Service
                                         Requirement:

         

         
	Except as expressly provided in Section 3 of the Agreement, you must remain continuously employed by, or continuously provide services to, the Company or an Affiliate, as applicable, from the Date of Grant through the date on which the Committee certifies the level of achievement of the Performance Goal (the “Certification Date”), which certification shall not be unreasonably delayed beyond the Performance Period End Date, to be eligible to receive payment of this Award, which payment is based on such achievement with respect to the Performance Goal.

                                                                                 

	Settlement:	Settlement
    of the Earned PSUs shall be made solely in shares of Common Stock, which shall be delivered to you in accordance with Section
    4 of the Agreement. 

 

    	 	 	 

    	 

    

 

By
your signature below, you agree to be bound by the terms and conditions of the Plan, the Agreement and this Performance Share
Unit Grant Notice (this “Grant Notice”). You acknowledge that you have reviewed the Agreement, the Plan
and this Grant Notice in their entirety and fully understand all provisions of the Agreement, the Plan and this Grant Notice.
You hereby agree to accept as binding, conclusive and final all decisions or interpretations of the Committee regarding any questions
or determinations that arise under the Agreement, the Plan or this Grant Notice. This Grant Notice may be executed in one or more
counterparts (including portable document format (.pdf) and facsimile counterparts), each of which shall be deemed to be an original,
but all of which together shall constitute one and the same agreement.

 

[Signature
Page Follows]

 

    	2

     

    

 

IN
WITNESS WHEREOF, the Company has caused this Grant Notice to be executed by an officer thereunto duly authorized, and the
Participant has executed this Grant Notice, effective for all purposes as provided above.

 

	 	COMPANY

	 	 	 
	 	Eco-Stim
    Energy Solutions, Inc.
	 	 	               
	 	By:	 
	 	Name:	 
	 	Its:	 
	 	 	 
	 	PARTICIPANT
	 	 	 
	 	Name:	 

 

Signature
Page to

Performance
Share Unit Grant Notice

 

    	 

     

    

 

EXHIBIT
A

 

PERFORMANCE
SHARE UNIT AGREEMENT

 

This
Performance Share Unit Agreement (together with the Grant Notice to which this Agreement is attached, this “Agreement”)
is made as of the Date of Grant set forth in the Grant Notice to which this Agreement is attached by and between Eco-Stim Energy
Solutions, Inc., a Nevada corporation (the “Company”), and __________ (the “Participant”).
Capitalized terms used but not specifically defined herein shall have the meanings specified in the Plan or the Grant Notice.

 

1.
Award. In consideration of the Participant’s past and/or continued employment with, or service to, the Company
or its Affiliates and for other good and valuable consideration, the receipt and sufficiency of which is hereby acknowledged,
effective as of the Date of Grant set forth in the Grant Notice (the “Date of Grant”), the Company hereby
grants to the Participant the number of Base PSUs and Stretch PSUs set forth in the Grant Notice on the terms and conditions set
forth in the Grant Notice, this Agreement and the Plan, which is incorporated herein by reference as a part of this Agreement.
In the event of any inconsistency between the Plan and this Agreement, the terms of the Plan shall control. To the extent earned
and vested, each PSU represents the right to receive one share of Common Stock, subject to the terms and conditions set forth
in the Grant Notice, this Agreement and the Plan; provided, however, that, depending on the level of performance determined to
be attained with respect to the Performance Goal, the number of shares of Common Stock that may be earned hereunder in respect
of this Award is equal to 0% or 100% of the Base PSUs plus 0% or 100% of the Stretch PSUs. Unless and until the PSUs have become
earned and vested in accordance with this Agreement, the Participant will have no right to receive any shares of Common Stock
or other payments in respect of the PSUs. Prior to settlement of this Award, the PSUs and this Award represent an unsecured obligation
of the Company, payable only from the general assets of the Company.

 

2.
Earning and Vesting of PSUs. Except as otherwise set forth in Section 3, the PSUs shall become Earned PSUs
based on the extent to which the Company has satisfied the Performance Goal set forth in the Grant Notice, which shall be determined
by the Committee in its sole discretion following the end of the Performance Period as described in Exhibit B attached
hereto. Any PSUs that do not become Earned PSUs shall be automatically forfeited. Once the number of Earned PSUs has been determined,
the Participant must satisfy the Service Requirement as set forth in the Grant Notice or pursuant to Section 3 in order
for such Earned PSUs to vest and become nonforfeitable. Any Earned PSUs that do not vest and become nonforfeitable shall automatically
be forfeited. Unless and until the PSUs have become Earned PSUs and the Service Requirement with respect to such Earned PSUs has
been satisfied in accordance with this Section 2 or Section 3, the Participant will have no right to receive any
dividends or other distribution with respect to the PSUs.

 

    	Exhibit A-1

     

    

 

3.
Effect of Termination of Employment or Service; Change of Control.

 

(a)
Termination of Employment or Service Relationship
due to Death or Disability. Upon the termination of the
Participant’s employment or other service relationship with the Company or an Affiliate due to the Participant’s “Disability”
(as defined in Section 3(d) below) or death that occurs prior to the Certification Date, then the Participant shall be
deemed to have satisfied the Service Requirement with respect to the Base PSUs and the Stretch PSUs and such PSUs shall remain
outstanding and shall become Earned PSUs based on the extent to which the Performance Goal is achieved, with any Earned PSUs being
eligible for settlement in accordance with Section 4. 

 

(b)
Other Termination of Employment or Service. Except as otherwise provided in Section 3(a), upon the termination
of the Participant’s employment or other service relationship with the Company or an Affiliate for any reason, any unearned
PSUs (and all rights arising from such PSUs and from being a holder thereof) and any Earned PSUs for which the Service Requirement
has not been satisfied will terminate automatically without any further action by the Company and will be forfeited without further
notice and at no cost to the Company.

 

(c)
Change of Control.

 

(i)
In the event a Change of Control (as defined
in Section 3(d) below) occurs prior to the Performance Period End Date, so long as the Participant has remained continuously
employed by, or has continuously provided services to, the Company or an Affiliate, as applicable, from the Date of Grant through
the date of such Change of Control, then a number of PSUs equal to 100% of the Base PSUs plus 100% of the Stretch PSUs shall be
deemed Earned PSUs and the Participant shall be deemed to have satisfied the Service Requirement with respect to such Earned PSUs
as of the date of such Change of Control, which Earned PSUs shall be eligible for settlement in accordance with Section 4
except that settlement shall occur within 60 days following the date of such Change of Control.

 

(ii)
In the event a Change of Control occurs following
the Performance Period End Date but prior to the Certification Date, so long as the Participant has remained continuously employed
by, or has continuously provided services to, the Company or an Affiliate, as applicable, from the Date of Grant through the date
of such Change of Control, then the Participant shall be deemed to have satisfied the Service Requirement with respect to the
Base PSUs and the Stretch PSUs and such PSUs shall remain outstanding and shall become Earned PSUs based on the extent to which
the Performance Goal is achieved, with any Earned PSUs being eligible for settlement in accordance with Section 4.

 

(d)
Certain Definitions. For purposes of this Agreement, the following terms shall have the meanings set forth below:

 

(i)
“Change of Control” shall mean the occurrence of any of the following events:

 

(1)
a merger of the Company with another entity, a consolidation involving the Company, or the sale of all or substantially all of
the assets of the Company to another entity if, in any such case, the holders of equity securities of the Company immediately
prior to such transaction or event do not beneficially own immediately after such transaction or event equity securities of the
resulting entity entitled to 50% or more of the votes then eligible to be cast in the election of directors generally (or comparable
governing body) of the resulting entity in substantially the same proportions that they owned the equity securities of the Company
immediately prior to such transaction or event;

 

    	Exhibit A-2

     

    

 

(2)
the dissolution or liquidation of the Company; or

 

(3)
the acquisition by any person or entity, including a “group” as contemplated by Section 13(d)(3) of the Exchange Act,
of ownership or control (including, without limitation, power to vote) of more than 50% of the combined voting power of the outstanding
securities of the Company.

 

For
purposes of the preceding sentence, (a) “resulting entity” in the context of a transaction or event that is a merger,
consolidation or sale of all or substantially all assets shall mean the surviving entity (or acquiring entity in the case of an
asset sale) unless the surviving entity (or acquiring entity in the case of an asset sale) is a subsidiary of another entity and
the holders of Common Stock of the Company receive capital stock of such other entity in such transaction or event, in which event
the resulting entity shall be such other entity, and (b) subsequent to the consummation of a merger or consolidation that does
not constitute a Change of Control, the term “Company” shall refer to the resulting entity and the term “Board”
shall refer to the board of directors (or comparable governing body) of the resulting entity.

 

(ii)
“Disability” shall mean the inability of the Participant to perform the essential duties and services
of the Participant’s position (after accounting for reasonable accommodation, if applicable) by reason of any physical or
mental impairment or other impairment that can be reasonably expected to result in death or to last for a continuous period of
not less than three (3) months. The Participant shall be considered to have a Disability if (i) the Participant is determined
to be totally disabled by the Social Security Administration or (ii) the Participant is determined to be disabled under the Company’s
long-term disability plan in which the Participant participates so long as such plan defines “disability” in a manner
that is consistent with the immediately preceding sentence.

 

4.
Settlement of Earned PSUs. As soon as administratively practicable following the Certification Date, but in no event
later than March 30 of the calendar year following the Performance Period End Date, the Company shall deliver to the Participant
(or the Participant’s permitted transferee, if applicable), a number of shares of Common Stock equal to the number of Earned
PSUs for which the Service Requirement has been satisfied. All shares of Common Stock, if any, issued hereunder shall be delivered
either by delivering one or more certificates for such shares of Common Stock to the Participant or by entering such shares of
Common Stock in book-entry form, as determined by the Committee in its sole discretion. The value of shares of Common Stock shall
not bear any interest owing to the passage of time. Neither this Section 4 nor any action taken pursuant to or in accordance
with this Agreement shall be construed to create a trust or a funded or secured obligation of any kind.

 

    	Exhibit A-3

     

    

 

5.
Tax Withholding. To the extent that the receipt, vesting or settlement of this Award results in compensation income
or wages to the Participant for federal, state, local and/or foreign tax purposes, the Participant shall make arrangements satisfactory
to the Company for the satisfaction of obligations for the payment of withholding taxes and other tax obligations relating to
this Award, which arrangements include the delivery of cash or cash equivalents, Common Stock (including previously owned Common
Stock, net settlement, a broker-assisted sale, or other cashless withholding or reduction of the shares of Common Stock otherwise
issuable or delivered pursuant to this Award), other property, or any other legal consideration the Committee deems appropriate.
If such tax obligations are satisfied through net settlement or the surrender of previously owned Common Stock, the maximum number
of shares of Common Stock that may be so withheld (or surrendered) shall be the number of shares of Common Stock that have an
aggregate Fair Market Value on the date of withholding or surrender equal to the aggregate amount of such tax liabilities determined
based on the greatest withholding rates for federal, state, local and/or foreign tax purposes, including payroll taxes, that may
be utilized without creating adverse accounting treatment for the Company with respect to this Award, as determined by the Committee.
The Participant acknowledges that there may be adverse tax consequences upon the receipt, vesting or settlement of this Award
or disposition of the underlying shares and that the Participant has been advised, and hereby is advised, to consult a tax advisor.
The Participant represents that the Participant is in no manner relying on the Board, the Committee, the Company or any of its
Affiliates or any of their respective managers, directors, officers, employees or authorized representatives (including, without
limitation, attorneys, accountants, consultants, bankers, lenders, prospective lenders and financial representatives) for tax
advice or an assessment of such tax consequences.

 

6.
FCPA. The Participant shall perform all duties as an employee, consultant, or other service provider on behalf of
the Company in strict compliance with the laws of the State of Texas and the United States of America in effect from time to time,
including without limitation, the Foreign Corrupt Practices Act of 1977 and amendments thereto (“FCPA”)
and the export control and anti-boycott laws and regulations of the United States in effect from time to time while this Agreement
is in effect. The Participant acknowledges having received and reviewed a copy of the Company’s FCPA compliance policy and
PowerPoint presentation concerning the terms and provisions of the FCPA in effect as of the date of this Agreement and the purposes
of the FCPA. The Participant acknowledges that the FCPA in general makes it a crime under United States law for a U.S. firm such
as the Company knowingly to make payments to a foreign governmental official, or political party or candidate, directly or indirectly,
in order to receive or retain business. Accordingly, the Participant shall not make on behalf of the Company any payments, loans
or gifts or promises or offers of payments, loans or gifts of any money or anything of value, directly or indirectly,

 

(a)
to or for the use or benefit of any official or employee of any United States or foreign government or the agency or instrumentalities
of any such government,

 

(b)
to any political party or official or candidate thereof,

 

(c)
to any other person if the Participant knows or has reason to suspect that any part of such payment, loan or gift will be directly
or indirectly given or paid to any such governmental official or political party or candidate or official thereof, or

 

(d)
to any other person or entity, the payment of which would violate either the laws or policies of United States any foreign country.

 

    	Exhibit A-4

     

    

 

The
Participant represents and warrants that on the date of this Agreement neither the Participant nor any family member living in
the Participant’s household is an official or employee of (i) any foreign government or an international organization covered
by the FCPA or similar laws, or any department, agency, or instrumentality thereof, (ii) a political party in any foreign country
or an official thereof, (iii) a candidate for political office in any foreign country, or (iv) a person acting in an official
capacity for or on behalf of any foreign government or any international organization covered by the FCPA or similar laws, or
any department, agency, or instrumentality thereof.

 

7.
Non-Transferability. During the lifetime of the Participant, the PSUs may not be sold, pledged, assigned or transferred
in any manner other than by will or the laws of descent and distribution, unless and until the shares of Common Stock underlying
the PSUs have been issued, and all restrictions applicable to such shares have lapsed. Neither the PSUs nor any interest or right
therein shall be liable for the debts, contracts or engagements of the Participant or his or her successors in interest or shall
be subject to disposition by transfer, alienation, anticipation, pledge, encumbrance, assignment or any other means, whether such
disposition be voluntary or involuntary or by operation of law by judgment, levy, attachment, garnishment or any other legal or
equitable proceedings (including bankruptcy), and any attempted disposition thereof shall be null and void and of no effect, except
to the extent that such disposition is permitted by the preceding sentence.

 

8.
Compliance with Applicable Law. Notwithstanding any provision of this Agreement to the contrary, the issuance of
shares of Common Stock hereunder will be subject to compliance with all applicable requirements of applicable law with respect
to such securities and with the requirements of any stock exchange or market system upon which the Common Stock may then be listed.
No shares of Common Stock will be issued hereunder if such issuance would constitute a violation of any applicable law or regulation
or the requirements of any stock exchange or market system upon which the Common Stock may then be listed. In addition, shares
of Common Stock will not be issued hereunder unless (a) a registration statement under the Securities Act of 1933, as amended,
is in effect at the time of such issuance with respect to the shares to be issued or (b) in the opinion of legal counsel to the
Company, the shares to be issued are permitted to be issued in accordance with the terms of an applicable exemption from the registration
requirements of the Securities Act of 1933, as amended. The inability of the Company to obtain from any regulatory body having
jurisdiction the authority, if any, deemed by the Company’s legal counsel to be necessary for the lawful issuance and sale
of any shares of Common Stock hereunder will relieve the Company of any liability in respect of the failure to issue such shares
as to which such requisite authority has not been obtained. As a condition to any issuance of Common Stock hereunder, the Company
may require the Participant to satisfy any requirements that may be necessary or appropriate to evidence compliance with any applicable
law or regulation and to make any representation or warranty with respect to such compliance as may be requested by the Company.

 

9.
Legends. If a stock certificate is issued with respect to shares of Common Stock issued hereunder, such certificate
shall bear such legend or legends as the Committee deems appropriate in order to reflect the restrictions set forth in this Agreement
and to ensure compliance with the terms and provisions of this Agreement, the rules, regulations and other requirements of the
Securities and Exchange Commission, any applicable laws or the requirements of any stock exchange on which the Common Stock is
then listed. If the shares of Common Stock issued hereunder are held in book-entry form, then such entry will reflect that the
shares are subject to the restrictions set forth in this Agreement.

 

    	Exhibit A-5

     

    

 

10.
Rights as a Stockholder; Stockholder Rights Agreement. The Participant shall have no rights as a stockholder of
the Company with respect to any shares of Common Stock that may become deliverable hereunder unless and until the Participant
has become the holder of record of such shares of Common Stock, and no adjustments shall be made for dividends in cash or other
property, distributions or other rights in respect of any such shares of Common Stock, except as otherwise specifically provided
for in the Plan or this Agreement. The Participant acknowledges that the shares of Common Stock delivered hereunder shall be subject
to the terms of the Company’s Amended and Restated Stockholder Rights Agreement (as amended from time to time), among the
Company and its stockholders.

 

11.
Execution of Receipts and Releases. Any issuance or transfer of shares of Common Stock or other property to the
Participant or the Participant’s legal representative, heir, legatee or distributee, in accordance with this Agreement shall
be in full satisfaction of all claims of such person hereunder. As a condition precedent to such payment or issuance, the Company
may require the Participant or the Participant’s legal representative, heir, legatee or distributee to execute (and not
revoke within any time provided to do so) a release and receipt therefor in such form as it shall determine appropriate; provided,
however, that any review period under such release will not modify the date of settlement with respect to Earned PSUs.

 

12.
No Right to Continued Employment, Service or Awards. Nothing in the adoption of the Plan, nor the award of the PSUs
thereunder pursuant to the Grant Notice and this Agreement, shall confer upon the Participant the right to continued employment
by, or a continued service relationship with, the Company or any Affiliate, or any other entity, or affect in any way the right
of the Company or any such Affiliate, or any other entity to terminate such employment or other service relationship at any time.
The grant of the PSUs is a one-time benefit and does not create any contractual or other right to receive a grant of Awards or
benefits in lieu of Awards in the future. Any future Awards will be granted at the sole discretion of the Company.

 

13.
Notices. Notices hereunder shall be mailed or delivered to the Company at its principal place of business and shall
be mailed or delivered to the Participant at the address for the Participant indicated on the signature page to this Agreement
(as such address may be updated by the Participant providing written notice to such effect to the Company). Any notice that is
delivered personally or by overnight courier or telecopier in the manner provided herein shall be deemed to have been duly given
to the Participant when it is mailed by the Company or, if such notice is not mailed to the Participant, upon receipt by the Participant.
Any notice that is addressed and mailed in the manner herein provided shall be conclusively presumed to have been given to the
party to whom it is addressed at the close of business, local time of the recipient, on the fourth day after the day it is so
placed in the mail.

 

    	Exhibit A-6

     

    

 

14.
Consent to Electronic Delivery; Electronic
Signature. In lieu of receiving documents in paper format,
the Participant agrees, to the fullest extent permitted by law, to accept electronic delivery of any documents that the Company
may be required to deliver (including, but not limited to, prospectuses, prospectus supplements, grant or award notifications
and agreements, account statements, annual and quarterly reports and all other forms of communications) in connection with this
and any other Award made or offered by the Company. Electronic delivery may be via a Company electronic mail system or by reference
to a location on a Company intranet to which the Participant has access. The Participant hereby consents to any and all procedures
the Company has established or may establish for an electronic signature system for delivery and acceptance of any such documents
that the Company may be required to deliver, and agrees that his or her electronic signature is the same as, and shall have the
same force and effect as, his or her manual signature.

 

15.
Agreement to Furnish Information. The Participant agrees to furnish to the Company all information requested by
the Company to enable it to comply with any reporting or other requirement imposed upon the Company by or under any applicable
statute or regulation.

 

16.
Entire Agreement; Amendment. This Agreement constitutes the entire agreement of the parties with regard to the subject
matter hereof, and contains all the covenants, promises, representations, warranties and agreements between the parties with respect
to the PSUs granted hereby; provided ̧ however, that the terms of this Agreement shall not modify and shall be subject to
the terms and conditions of any employment, consulting and/or severance agreement between the Company (or an Affiliate or other
entity) and the Participant in effect as of the date a determination is to be made under this Agreement. Without limiting the
scope of the preceding sentence, except as provided therein, all prior understandings and agreements, if any, among the parties
hereto relating to the subject matter hereof are hereby null and void and of no further force and effect. The Committee may, in
its sole discretion, amend this Agreement from time to time in any manner that is not inconsistent with the Plan; provided, however,
that except as otherwise provided in the Plan or this Agreement, any such amendment that materially reduces the rights of the
Participant shall be effective only if it is in writing and signed by both the Participant and an authorized officer of the Company.

 

17.
Severability; Waiver. If a court of competent jurisdiction determines that any provision of this Agreement is invalid
or unenforceable, then the invalidity or unenforceability of such provision shall not affect the validity or enforceability of
any other provision of this Agreement, and all other provisions shall remain in full force and effect. Waiver by any party of
any breach of this Agreement or failure to exercise any right hereunder shall not be deemed to be a waiver of any other breach
or right. The failure of any party to take action by reason of such breach or to exercise any such right shall not deprive the
party of the right to take action at any time while or after such breach or condition giving rise to such rights continues.

 

18.
Clawback. Notwithstanding any provision
in the Grant Notice, this Agreement or the Plan to the contrary, to the extent required by (a) applicable law, including, without
limitation, the requirements of the Dodd-Frank Wall Street Reform and Consumer Protection Act of 2010, any Securities and Exchange
Commission rule or any applicable securities exchange listing standards and/or (b) any policy that may be adopted or amended by
the Board from time to time, all shares of Common Stock issued hereunder shall be subject to forfeiture, repurchase, recoupment
and/or cancellation to the extent necessary to comply with such law(s) and/or policy.

 

19.
Governing Law. This Agreement shall be governed by and construed in accordance
with the laws of the State of TEXAS applicable to contracts made and to be performed therein, exclusive of the conflict of laws
provisions of TEXAS LAW.

 

    	Exhibit A-7

     

    

 

20.
Successors and Assigns. The Company
may assign any of its rights under this Agreement without the Participant’s consent. This Agreement will be binding upon
and inure to the benefit of the successors and assigns of the Company. Subject to the restrictions on transfer set forth herein
and in the Plan, this Agreement will be binding upon the Participant and the Participant's beneficiaries, executors, administrators
and the person(s) to whom the PSUs may be transferred by will or the laws of descent or distribution.

 

21.
Headings. The titles and headings of the various sections of this Agreement have been inserted for convenience of
reference only and shall not be deemed to be a part of this Agreement.

 

22.
Counterparts. The Grant Notice may be executed in one or more counterparts, each of which shall be deemed an original
and all of which together shall constitute one instrument. Delivery of an executed counterpart of the Grant Notice by facsimile
or portable document format (.pdf) attachment to electronic mail shall be effective as delivery of a manually executed counterpart
of the Grant Notice.

 

23.
Section 409A. Notwithstanding anything herein or in the Plan to the contrary, the PSUs granted pursuant to this
Agreement are intended to be exempt from the applicable requirements of Section 409A of the Code, as amended from time to time,
including the guidance and regulations promulgated thereunder and successor provisions, guidance and regulations thereto (the
“Nonqualified Deferred Compensation Rules”), and shall be construed and interpreted in accordance with
such intent. Nevertheless, to the extent that the Committee determines that the PSUs may not be exempt from the Nonqualified Deferred
Compensation Rules, then, if the Participant is deemed to be a “specified employee” within the meaning of the Nonqualified
Deferred Compensation Rules, as determined by the Committee, at a time when the Participant becomes eligible for settlement of
the PSUs upon his “separation from service” within the meaning of the Nonqualified Deferred Compensation Rules, then
to the extent necessary to prevent any accelerated or additional tax under the Nonqualified Deferred Compensation Rules, such
settlement will be delayed until the earlier of: (a) the date that is six months following the Participant’s separation
from service and (b) the Participant’s death. Notwithstanding the foregoing, the Company and its Affiliates make no representations
that the PSUs provided under this Agreement are exempt from or compliant with the Nonqualified Deferred Compensation Rules and
in no event shall the Company or any Affiliate be liable for all or any portion of any taxes, penalties, interest or other expenses
that may be incurred by the Participant on account of non-compliance with the Nonqualified Deferred Compensation Rules.

 

    	Exhibit A-8

     

    

 

EXHIBIT
B

 

PERFORMANCE
GOAL

 

The
performance goal for the Base PSUs and the Stretch PSUs shall be based on “Field Level Adjusted EBITDA” (as more specifically
defined below) during the Performance Period.

 

The
term “Field Level Adjusted EBITDA” shall (i) represent the revenues less cost of services (excluding corporate
SG&A) for the Company’s operations based out of Fairview, Oklahoma; (ii) include both frac and pump down revenue and
associated costs; and (iii) be calculated in the manner as reviewed weekly with the Company’s Chairman.

 

Base
PSUs

 

You
will earn a number of Base PSUs (i.e., the Earned PSUs) as determined in accordance with the table below. The Committee,
in its sole discretion, will review, analyze and certify the Company’s Field Level Adjusted EBITDA for the Performance Period
and will determine the number of Earned PSUs in accordance with the terms of this Agreement, the Grant Notice and the Plan.

 

	Field
    Level Adjusted EBITDA	 	Earned
    PSUs (% of Base PSUs)
	Less
    than $[●]	 	0%
	$[●]
    or greater	 	100%

 

Stretch
PSUs

 

You
will earn a number of Stretch PSUs (i.e., the Earned PSUs) as determined in accordance with the table below. The Committee, in
its sole discretion, will review, analyze and certify the Company’s Field Level Adjusted EBITDA for the Performance Period
and will determine the number of Earned PSUs in accordance with the terms of this Agreement, the Grant Notice and the Plan.

 

	Field
    Level Adjusted EBITDA	 	Earned
    PSUs (% of Stretch PSUs)
	Less
    than $[●]	 	0%
	$[●]
    or greater	 	100%

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