Document:

Exhibit

Exhibit 10.4

BIOTELEMETRY, INC.
2017 OMNIBUS INCENTIVE PLAN
PERFORMANCE STOCK UNIT AGREEMENT
Pursuant to this Performance Stock Unit Agreement (this “Agreement”) and the grant details (the “Grant Summary”), which can be accessed on the Morgan Stanley StockPlan Connect Website at www.stockplanconnect.com or the website of any other stock plan administrator selected by BioTelemetry, Inc. (the “Company”) and in consideration of your services, the Company has awarded you Performance Stock Units, or PSUs (this “Award”), under its 2017 Omnibus Incentive Plan (the “Plan”) in the amount and on the Award Date as set forth in the Grant Summary.  Defined terms not explicitly defined in this Agreement but defined in the Plan shall have the same definitions as in the Plan.  
The details of this Award, in addition to those set forth in the Grant Summary and the Plan, are as follows:
1.GRANT OF THIS AWARD. This Award represents the right to be issued on a future date the number of shares of Stock as indicated in the Grant Summary. As of the Award Date, the Company will credit to a bookkeeping account maintained by the Company for your benefit (the “Account”) the Target Number of PSUs subject to this Award. This Award was granted in consideration of your services to the Company. Except as otherwise provided herein, you will not be required to make any payment to the Company (other than past and future services to the Company) with respect to your receipt of this Award, the vesting of the shares of Stock or the delivery of the underlying Stock.
2.VESTING. 
(a)    Subject to the limitations contained herein and provided that you remain in Service through the TSR Measurement Period (as defined below), this Award will vest, if at all, in accordance with this Section 2. Upon termination of your Service, the shares of Stock credited to the Account that were not vested on the date of such termination will be forfeited at no cost to the Company and you will have no further right, title or interest in or to such underlying shares of Stock.
(b)    PERFORMANCE REQUIREMENT.
		
	i.
	General.  The number of Performance Share Units granted to you pursuant to this Award, as specified in the Grant Summary, is referred to as the “Target Number of PSUs.”  The vesting of one-half of the Target Number of PSUs (the “Target Number of Revenue PSUs”) will be determined with reference to the revenue metric as provided in Section 2(b)(ii). The vesting of one-half of the Target Number of PSUs (the “Target Number of EBITDA PSUs”) will be determined with reference to the adjusted EBITDA metric as provided in Section 2(b)(iii).  The Target Number of PSUs is also subject to adjustment 

based on the Company’s TSR Percentile Rank as provided in Section 2(b)(iv).
		
	ii.
	Revenue Metric.  The Target Number of Revenue PSUs that shall vest will be based on Revenue (as defined below) during the Performance Period. No portion of the Target Number of Revenue PSUs shall vest unless the Committee determines that Revenue for the Performance Period is greater than or equal to $[ ] million.  If the Committee determines that Revenue for the Performance Period is greater than or equal to $[ ] million, the percentage of the Target Number of Revenue PSUs that shall vest will equal the Revenue Vested Percentage (as defined below) as adjusted pursuant to Section 2(b)(iv). 

		
	iii.
	Adjusted EBITDA Metric. The Target Number of EBITDA PSUs that shall vest will be based on Adjusted EBITDA (as defined below) during the Performance Period. No portion of the Target Number of EBITDA PSUs shall vest unless the Committee determines that Adjusted EBITDA for the Performance Period is greater than or equal to $[ ] million.  If the Committee determines that Adjusted EBITDA for the Performance Period is greater than or equal to $[ ] million, the percentage of the Target Number of EBITDA PSUs that shall vest will equal the EBITDA Vested Percentage (as defined below) as adjusted pursuant to Section 2(b)(iv).

		
	iv.
	TSR Adjustment. The PSUs that shall vest in accordance with Section 2(b)(ii) and (iii) shall be adjusted upward by [ ]% if the Company’s TSR Percentile Rank is equal to or greater than the [ ] percentile and shall be adjusted downward by [ ]% if the Company’s TSR Percentile Rank is equal to or less than the [ ]  percentile. [No adjustment shall be made if the Company’s TSR Percentile Rank is between the [ ]  and [ ]  percentile.] [Additionally, in no event shall an upward adjustment result in either the Target Number of Revenue PSUs or the Target Number of EBITDA PSUs vesting at greater than [ ]%.]

		
	v.
	Acquisitions and Divestitures.  The impact of acquisitions shall be included and the impact of divestitures shall be excluded when calculating the performance metrics; provided that no pro forma adjustments shall be made to account for any acquisition or divestiture. 

		
	vi.
	Determinations of the Committee regarding Adjusted EBITDA, Revenues, TSR, TSR Percentile Rank and the resulting vested PSUs, and related matters, will be final and binding on you. 

		
	vii.
	Definitions.

		
	A.
	“Adjusted EBITDA” shall mean adjusted earnings before interest, taxes, depreciation and amortization of the Company, as reported in 

the Company’s earnings release for the fiscal year ended [ ], as furnished to the U.S. Securities and Exchange Commission.  
		
	B.
	“EBITDA Vested Percentage” shall mean the amount between [ ]% and [ ]%, which is based on Adjusted EBITDA, as provided in the following table:

	
		
	Adjusted EBITDA (in millions)
	EBITDA Vested Percentage

	Greater than $[ ]million
	[ ]%

	$[ ] million
	[ ]%

	$[ ]million
	[ ]%

	$[ ] million
	[ ]%

	Less than $[ ] million
	[ ]%

[The EBITDA Vested Percentage will be interpolated on a straight-line basis between the respective levels.]
		
	C.
	“Peer Companies” shall mean [ ].

		
	D.
	“Performance Period” shall mean the period beginning on [ ], and ending on [ ]. 

		
	E.
	“Revenues” shall mean the Company’s reported total consolidated revenues.

		
	F.
	“Revenue Vested Percentage” shall mean the amount between [ ]% and [ ]%, which is based on Revenue, as provided in the following table:

	
		
	Revenue (in millions)
	Revenue Vested Percentage

	Greater than $[ ] million
	[ ]%

	$[ ] million
	[ ]%

	$[ ] million
	[ ]%

	$[ ] million
	[ ]%

	Less than $[ ] million
	[ ]%

[The Revenue Vested Percentage will be interpolated on a straight-line basis between the respective levels.] 
		
	G.
	“TSR” shall mean the change in the value, expressed as a percentage of a given dollar amount invested in a company's most widely publicly traded stock over the TSR Measurement Period, taking into account both stock price appreciation (or depreciation) and the reinvestment of dividends (including the cash value of non-cash 

dividends) in additional stock of the company. The [ten (10) trading-day average closing values] of the Company's Stock and the stock of the Peer Companies, as applicable [(i.e., average closing values over the period of 10 trading days ending on the beginning of the TSR Measurement Period and the final 10 trading days of the TSR Measurement Period)], shall be used to value the Company's Stock and the stock of the Peer Companies, as applicable, at the beginning and end of the TSR Measurement Period. Dividend reinvestment shall be calculated consistently for the Company and all Peer Companies. 
		
	H.
	“TSR Measurement Period” shall mean the three-year period beginning on [ ], and ending on [ ]. 

		
	I.
	“TSR Percentile Rank” shall mean the percentage of TSR values among Peer Companies during the TSR Measurement Period that are lower than the Company’s TSR during the TSR Measurement Period. For example, if the Company's TSR during the TSR Measurement Period is at the [ ] percentile, [ ]% of the Peer Companies had higher TSR during the TSR Measurement Period and [ ]% of the companies in the Peer Companies had equal or lower TSR during the TSR Measurement Period. For purposes of the TSR Percentile Rank calculation, the Company will be excluded from the group of Peer Companies.

3.NUMBER OF SHARES OF STOCK.
(a)    The number of shares of Stock subject to this Award may be adjusted from time to time as provided for in the Plan.
(b)    Any shares of Stock, cash or other property that becomes subject to this Award pursuant to this Section 3 and Section 7 of this Agreement, if any, shall be subject, in a manner determined by the Board, to the same forfeiture restrictions, restrictions on transferability, and time and manner of delivery as applicable to the other shares of Stock covered by this Award.
(c)    Notwithstanding the provisions of this Section 3, no fractional shares of Stock or rights for fractional shares of Stock shall be created pursuant to this Section 3. The Board shall, in its discretion, determine an equivalent benefit for any fractional shares of Stock or fractional shares of Stock that might be created by the adjustments referred to in this Section 3.
4.SECURITIES LAW COMPLIANCE. Notwithstanding anything to the contrary contained herein, you may not be issued any shares of Stock under this Award unless the shares of Stock issuable are then registered under the Securities Act or, if such shares of Stock are not then so registered, the Company has determined that such issuance would be exempt from the registration requirements of the Securities Act. The issuance of share of Stock also must comply with other applicable laws and regulations governing this Award, and you will not receive such shares of Stock 

if the Company determines that such receipt would not be in material compliance with such laws and regulations.
5.TRANSFERBILITY. This Award is not transferable, except by will or by the laws of descent and distribution. In addition to any other limitation on transfer created by applicable securities laws, you agree not to assign, hypothecate, donate, encumber or otherwise dispose of any interest in any of the shares of Stock subject to this Award until the shares of Stock are issued to you.  After the shares of Stock have been issued to you, you are free to assign, hypothecate, donate, encumber or otherwise dispose of any interest in such shares of Stock provided that any such actions are in compliance with the provisions herein and applicable securities laws.  Notwithstanding the foregoing, by delivering written notice to the Company, in a form satisfactory to the Company, you may designate a third party who, in the event of your death, shall thereafter be entitled to receive any distribution of Stock to which you were entitled at the time of your death pursuant to this Agreement.
		
	6.
	DATE OF ISSUANCE.

(a)    The Company will deliver to you a number of shares of Stock equal to the number of vested shares of Stock subject to this Award, including any additional shares of Stock received pursuant this Agreement that relate to those vested shares of Stock, within thirty (30) days following the date on which the shares of Stock subject to this Award vest as set forth in the Grant Summary for this Award (the “Settlement Date”). If the scheduled delivery date falls on a date that is not a business day, such delivery date shall instead fall on the next following business day.
(b)    If the Company determines that you are subject to its policy regarding insider trading of the Company’s Stock or you are otherwise prohibited from selling shares of Stock in the public market and any shares of Stock subject to this Award are scheduled to be delivered on a Settlement Date that does not occur during an open “window period” applicable to you, as determined by the Company in accordance with such policy, or a day when you are prohibited from selling shares of Stock in the public market and the Company elects not to satisfy its tax withholding obligations by withholding shares of Stock from your distribution, then such shares of Stock shall not be delivered on such Settlement Date and shall instead be delivered as soon as practicable on the first business day within the next open “window period” applicable to you pursuant to such policy or the next day when you are not prohibited from selling shares of Stock in the public market (regardless of whether you are still providing Services at such time); provided, however, that unless the delay until the next open window period or the next day when you are not prohibited from selling shares of Stock in the public market would not result in the imposition of any additional taxes under the Code (including section 409A of the Code), the delivery of the shares of Stock shall not be delayed pursuant to this provision beyond sixty (60) days following the selected Settlement Date.  The form of such delivery (e.g., a stock certificate or electronic entry evidencing such shares of Stock) shall be determined by the Company.
7.DIVIDENDS. You shall receive no benefit or adjustment to this Award with respect to any cash dividend, stock dividend or other distribution that does not result from a adjustments as provided in the Plan; provided, however, that this sentence shall not apply with respect to any 

shares of Stock that are delivered to you in connection with this Award after such shares of Stock have been delivered to you.
8.RESTRICTIVE LEGENDS. The shares of Stock issued under this Award shall be endorsed with appropriate legends determined by the Company.
		
	9.
	AWARD NOT A SERVICE CONTRACT.

(a)    Your Service with the Company or an Affiliate is not for any specified term and may be terminated by you or by the Company or an Affiliate at any time, for any reason, with or without Cause and with or without notice.  Nothing in this Agreement, the Plan or any covenant of good faith and fair dealing that may be found implicit in this Agreement or the Plan shall: (i) confer upon you any right to continue in the Services of, or affiliation with, the Company or an Affiliate; (ii) constitute any promise or commitment by the Company or an Affiliate regarding the fact or nature of future positions, future work assignments, future compensation or any other term or condition of Services or affiliation; (iii) confer any right or benefit under this Agreement or the Plan unless such right or benefit has specifically accrued under the terms of this Agreement or the Plan; or (iv) deprive the Company of the right to terminate you at will and without regard to any future vesting opportunity that you may have.
(b)    By accepting this Award, you acknowledge and agree that the right to continue vesting in this Award is earned only by continuing as an employee, director or consultant at the will of the Company (not through the act of being hired, being granted this Award or any other award or benefit) and that the Company has the right to reorganize, sell, spin-out or otherwise restructure one or more of its businesses or Affiliates at any time or from time to time, as it deems appropriate (a “reorganization”).  You further acknowledge and agree that such a reorganization could result in the termination of your Service, or the termination of Affiliate status of your employer and the loss of benefits available to you under this Agreement, including the termination of the right to continue vesting in this Award.  You further acknowledge and agree that this Agreement, the Plan, the transactions contemplated hereunder and the vesting schedule or any covenant of good faith and fair dealing that may be found implicit in any of them do not constitute an express or implied promise of continued engagement as an employee or consultant for the term of this Agreement, for any period, or at all, and shall not interfere in any way with your right or the Company’s right to terminate your Service at any time, with or without cause and with or without notice.
		
	10.
	WITHHOLDING OBLIGATIONS.

(a)    On or before the time you receive a distribution of the shares of Stock subject to this Award, or at any time thereafter as requested by the Company, you hereby authorize any required withholding from the Common Stock issuable to you and/or otherwise agree to make adequate provision in cash for any sums required to satisfy the federal, state, local and foreign tax withholding obligations of the Company or any Affiliate which arise in connection with this Award (the “Withholding Taxes”); provided, however, that the number of such shares of Stock so withheld to cover taxes shall not exceed the amount necessary to satisfy the Company’s required tax 

withholding obligations using the maximum statutory withholding rates for federal, state, local and foreign tax purposes, including payroll taxes, that are applicable to supplemental taxable income.
(b)    Unless the tax withholding obligations of the Company and/or any Affiliate are satisfied, the Company shall have no obligation to deliver to you any Stock.
(c)    In the event the Company’s obligation to withhold arises prior to the delivery to you of Stock or it is determined after the delivery of Stock to you that the amount of the Company’s withholding obligation was greater than the amount withheld by the Company, you agree to indemnify and hold the Company harmless from any failure by the Company to withhold the proper amount.
(d)    If specified in the Grant Summary, you may direct the Company to withhold shares of Stock with a Fair Market Value (measured as of the date shares of Stock are issued pursuant to Section 6 of this Agreement) equal to the amount of such Withholding Taxes; provided, however, that the number of such shares of Stock so withheld shall not exceed the amount necessary to satisfy the Company’s required tax withholding obligations using the maximum statutory withholding rates for federal, state, local and foreign tax purposes, including payroll taxes, that are applicable to supplemental taxable income.
11.UNSECURED OBLIGATION. This Award is unfunded, and as a holder of a vested Award, you shall be considered an unsecured creditor of the Company with respect to the Company’s obligation, if any, to issue shares of Stock pursuant to this Agreement.  Neither you nor any person claiming under or through you will have any of the rights or privileges of a stockholder of the Company in respect of any Stock deliverable hereunder unless and until certificates representing such Stock have been issued, recorded on the records of the Company or its transfer agents or registrars, and delivered to you. After such issuance, recordation and delivery, you will have all the rights of a stockholder of the Company with respect to such Stock, including voting and receipt of dividends and distributions on such Stock. Nothing contained in this Agreement, and no action taken pursuant to its provisions, shall create or be construed to create a trust of any kind or a fiduciary relationship between you and the Company or any other person.
12.NOTICES. Any notices provided for in this Award or the Plan shall be given in writing and shall be deemed effectively given upon receipt or, in the case of notices delivered by the Company to you, five (5) days after deposit in the United States mail, postage prepaid, addressed to you at the last address you provided to the Company.  Notwithstanding the foregoing, the Company may, in its sole discretion, decide to deliver any documents related to participation in the Plan and this Award by electronic means or to request your consent to participate in the Plan by electronic means. You hereby consent to receive such documents by electronic delivery and agree to participate in the Plan through an on-line or electronic system established and maintained by the Company or another third party designated by the Company.
13.MISCELLANEOUS.
(a)    The rights and obligations of the Company under this Award shall be transferable to any one or more persons or entities, and all covenants and agreements hereunder 

shall inure to the benefit of, and be enforceable by the Company’s successors and assigns. Your rights and obligations under this Award may only be assigned with the prior written consent of the Company.
(b)    You agree upon request to execute any further documents or instruments necessary or desirable in the sole determination of the Company to carry out the purposes or intent of this Award.
(c)    You acknowledge and agree that you have reviewed this Award in its entirety, have had an opportunity to obtain the advice of counsel prior to executing and accepting this Award, and fully understand all provisions of this Award.
(d)    This Agreement shall be subject to all applicable laws, rules, and regulations, and to such approvals by any governmental agencies or national securities exchanges as may be required.
(e)    All obligations of the Company under the Plan and this Agreement shall be binding on any successor to the Company, whether the existence of such successor is the result of a direct or indirect purchase, merger, consolidation, or otherwise, of all or substantially all of the business and/or assets of the Company.
14.GOVERNING PLAN DOCUMENT. This Award is subject to all the provisions of the Plan, the provisions of which are hereby made a part of this Award, and is further subject to all interpretations, amendments, rules and regulations that may from time to time be promulgated and adopted pursuant to the Plan.  In the event of any conflict between the provisions this Agreement and those of the Plan, the provisions of the Plan shall control.
15.SEVERABILITY. If all or any part of this Agreement or the Plan is declared by any court or governmental authority to be unlawful or invalid, such unlawfulness or invalidity shall not invalidate any portion of this Agreement or the Plan not declared to be unlawful or invalid. Any Section of this Agreement (or part of such a Section) so declared to be unlawful or invalid shall, if possible, be construed in a manner which will give effect to the terms of such Section or part of a Section to the fullest extent possible while remaining lawful and valid.
16.EFFECT ON OTHER EMPLOYEE BENEFIT PLANS. The value of this Award subject to this Agreement shall not be included as compensation, earnings, salaries, or other similar terms used when calculating your benefits under any employee benefit plan sponsored by the Company or any Affiliate, except as such plan otherwise expressly provides. The Company expressly reserves its rights to amend, modify, or terminate any of the Company’s or any Affiliate’s employee benefit plans.
17.CAPTIONS. Captions provided herein are for convenience only and are not to serve as a basis for interpretation or construction of this Agreement.
18.VENUE. For purposes of litigating any dispute that arises under this Agreement, the parties hereby submit to and consent to the jurisdiction of the Commonwealth of 

Pennsylvania, and agree that such litigation will be conducted solely in the courts of Chester County, Pennsylvania, or the federal courts for the United States for the Eastern District of Pennsylvania.
19.AMENDMENT. This Agreement may not be modified, amended or terminated except by an instrument in writing, signed by you and by a duly authorized representative of the Company. Notwithstanding the foregoing, this Agreement may be amended solely by the Board by a writing which specifically states that it is amending this Agreement, so long as a copy of such amendment is delivered to you, and provided that no such amendment adversely affecting your rights hereunder may be made without your written consent. Without limiting the foregoing, the Board reserves the right to change, by written notice to you, the provisions of this Agreement in any way it may deem necessary or advisable to carry out the purpose of the grant as a result of any change in applicable laws or regulations or any future law, regulation, ruling, or judicial decision, provided that any such change shall be applicable only to rights relating to that portion of this Award which is then subject to restrictions as provided herein.
20.SECTION 409A OF THE CODE. This Agreement and the shares of Stock subject to this Award issued hereunder are intended to be exempt from the requirements of section 409A of the Code by settling such shares of Stock within the short-term deferral exemption set forth in the regulations under section 409A of the Code, and this Agreement and such shares of Stock shall be interpreted on a basis consistent with such intent.  In no event shall the Participant, directly or indirectly, designate the calendar year of payment.
21.AGREEMENT. Your receipt of this Award and this Agreement constitutes your agreement to be bound by the terms and conditions of this Agreement, the Grant Summary and the Plan and sets forth the entire understanding between you and the Company regarding the acquisition of Stock in the Company and supersedes all prior oral and written agreements on that subject with the exception of equity previously granted and delivered to you and, if applicable, your employment agreement. Your signature is not required in order to make this Agreement effective.Exhibit

NOTICE OF GRANT OF RESTRICTED STOCK UNIT AWARD
UNDER TERMS AND CONDITIONS OF 2008 PERFORMANCE INCENTIVE PLAN

	
		
	Name of Grantee:
	 

	Total Number of Stock Units Subject to this Grant:1
	 

	Date of Grant:    
	 

This Notice evidences that you have been granted an award of stock units (the "Stock Units") of Microsemi Corporation (the "Corporation") as to the total number set forth above.  The Stock Units will vest and become nonforfeitable in accordance with the vesting requirements set forth in the Terms (as defined below). 
By your acceptance of the award, you agree that the award of Stock Units is granted under and governed by the terms and conditions of the Corporation's 2008 Performance Incentive Plan (as amended from time to time, the "Plan") and the Terms and Conditions of Restricted Stock Unit Award (the "Terms"), which are attached and incorporated herein by this reference.  This Notice of Grant of Restricted Stock Unit Award, together with the Terms, is referred to as the "Agreement" applicable to your award.  The award has been granted to you in addition to, and not in lieu of, any other form of compensation otherwise payable or to be paid to you.  Capitalized terms are defined in the Plan if not defined herein or in the Terms.  The Plan, the Terms, the Prospectus for the Plan and Prospectus Supplement with respect to Stock Unit awards under the Plan are available by calling the Corporation at (949) 380-6100.
By accepting this award, you agree to execute any documents and take such further actions that the Corporation may reasonably request in order to establish and/or maintain a brokerage account to hold the shares subject to this grant.  You also agree that your default election to settle your tax withholding obligation is to have the Corporation withhold a portion of the shares covered by this award as provided in Section 9 of the Terms.  You may change your default election during any period that you are not in blackout by notifying the Corporation and making alternative arrangements acceptable to the Corporation to provide for tax withholding as described in Section 9.

	
					
	MICROSEMI CORPORATION
	 
	ACCEPTED AND AGREED BY GRANTEE

	 
	 
	 
	 
	 

	By:
	 
	 
	By:
	 

	Name:
	James J. Peterson
	 
	Name:
	 

	Title:
	Chief Executive Officer
	 
	 
	 

1Subject to adjustment under Section 7.1 of the Plan

MICROSEMI CORPORATION
2008 PERFORMANCE INCENTIVE PLAN
TERMS AND CONDITIONS OF RESTRICTED STOCK UNIT AWARD
		
	1.
	General.

These Terms and Conditions of Restricted Stock Unit Award (these "Terms") apply to a particular grant of stock units under the Plan (the "Award") if incorporated by reference in the Notice of Grant of Restricted Stock Unit Award (the "Grant Notice") corresponding to that particular grant.  The recipient of the Award identified in the Grant Notice is referred to as the "Grantee."  The effective date of grant of the Award as set forth in the Grant Notice is referred to as the "Award Date."  The number of stock units covered by the Award is subject to adjustment under Section 7.1 of the Plan.
The Award was granted under and subject to the Microsemi Corporation 2008 Performance Incentive Plan (the "Plan").  Capitalized terms are defined in the Plan if not defined herein.  The Award has been granted to the Grantee in addition to, and not in lieu of, any other form of compensation otherwise payable or to be paid to the Grantee.  The Grant Notice and these Terms are collectively referred to as the "Agreement" applicable to the Award. 
As used in the Agreement, the term "stock unit" means a non-voting unit of measurement which is deemed for bookkeeping purposes to be the equivalent to one outstanding share of the Corporation’s Common Stock solely for purposes of the Plan and this Agreement.  The Stock Units shall be used solely as a device for the determination of the payment to eventually be made to the Grantee if such Stock Units vest pursuant to Section 2 of the Terms.  The Stock Units shall not be treated as property or as a trust fund of any kind. 
		
	2.
	Vesting.  

Subject to Section 3, the Award shall vest and become nonforfeitable with respect to 40% of the total number of Stock Units on September 30, 2019, and with respect to 30% of the total number of Stock Units on each of September 30, 2020 and September 30, 2021, subject in each case to adjustment under Section 7.1 of the Plan.
Notwithstanding the foregoing vesting schedule, if a Change in Control does not occur on or before the last day of the Corporation’s 2018 fiscal year, the Administrator may, in its sole discretion and prior to the occurrence of any Change in Control, provide that any or all of the Stock Units subject to the Award will be subject to performance-based vesting requirements as the Administrator shall prescribe.
3.    Effect of Termination of Employment or Services.  
3.1    General.  Except as otherwise expressly provided below in this Section 3, if the Grantee ceases to be employed by or ceases to provide services to the Corporation or one of its Subsidiaries (the date of such termination of employment or services is referred to as the Grantee’s "Severance Date"), the Grantee’s Stock Units shall terminate to the extent such units have not become vested pursuant to Section 2 or Section 8.2 hereof as of the Severance Date (regardless of the reason for such termination of employment or services, whether with or without cause, voluntarily or involuntarily).  If any unvested Stock Units are terminated pursuant to this Agreement, such Stock Units shall automatically terminate and be cancelled as of the applicable termination date without payment of any consideration by the Corporation and without any other action by the Grantee, or the Grantee’s beneficiary or personal representative, as the case may be.
3.2    Termination Without Cause or for Good Reason in Connection with a Change in Control.  Notwithstanding Section 3.1, if the Grantee’s employment with the Corporation or one of its Subsidiaries terminates prior to September 30, 2021 due to either (i) a termination by the Corporation or one of its Subsidiaries other than for Cause or (ii) a termination by the Grantee for Good Reason, in either case on or following the date of a Change in Control, then the Grantee’s Stock Units that are outstanding and otherwise unvested on the Severance Date shall be vested as of the Severance Date. 
     For purposes of the Award, "Cause" and "Change in Control" shall have the respective meanings given to such terms in that certain Executive Retention Agreement, dated as of [____________], by and between the Grantee and the Corporation (the "Retention Agreement"). 
 [For purposes of the Award, "Good Reason" shall have the meaning ascribed to such term in the Retention Agreement.] [Include for John W. Hohener only]

[For purposes of the Award, "Good Reason" shall mean the occurrence (without the Grantee’s consent) of any one or more of the following conditions:
(i)    any reduction in the Grantee’s base salary or total compensation opportunity in effect as of the date of the Change in Control;
(ii)    any change in assignment of the Grantee’s primary duties to a work location more than 50 miles from the Corporation’s principal executive office as in effect immediately prior to the Change in Control;
(iii)    any material reduction in the authorities, duties and responsibilities of the Grantee in effect as of immediately prior to the Change in Control;
(iv)    any material breach by the Corporation of any provision of this Agreement or any other written agreement between the Corporation and the Grantee; or
(v)    any failure by the Corporation to obtain the assumption by any successor or assign of the Corporation of the Retention Agreement, this Agreement or any other award agreement that evidences an equity-based award granted by the Corporation to the Grantee that is assumed by such successor or assign;
provided, however, that any such condition(s) shall not constitute Good Reason unless the Grantee provides notice to the Corporation of his or her termination within ninety (90) days following the date on which the Grantee becomes aware of any of the conditions claimed to constitute Good Reason; the Corporation fails to cure such condition within thirty (30) days of receiving such notice thereof; and the Grantee’s employment with the Corporation terminates within six (6) months after the occurrence of such condition.
The Grantee and the Corporation hereby expressly agree that, as of the date hereof, the definition of Good Reason set forth above will also apply to the Retention Agreement, and that the definition of "Good Reason" set forth in the Retention Agreement is hereby amended and restated in its entirety as set forth above.] [Include for Paul H. Pickle, Steven G. Litchfield, David Goren and Frederick C. Goerner only.] 
4.    Continuance of Employment/Service Required; No Employment Commitment.  
Except as expressly provided in Section 3 above, the vesting schedule requires continued employment or service through each applicable vesting date as a condition to the vesting of the applicable installment of the Award and the rights and benefits under this Agreement.  Except as expressly provided in Section 3 above, employment or service for only a portion of the vesting period, even if a substantial portion, will not entitle the Grantee to any proportionate vesting or avoid or mitigate a termination of rights and benefits upon or following a termination of employment or services as provided in Section 3 above or under the Plan.
Nothing contained in this Agreement or the Plan constitutes an employment or service commitment by the Corporation, affects the Grantee’s status as an employee at will who is subject to termination without cause, confers upon the Grantee any right to remain employed by or in service to the Corporation or any Subsidiary, interferes in any way with the right of the Corporation or any Subsidiary at any time to terminate such employment or services, or affects the right of the Corporation or any Subsidiary to increase or decrease the Grantee’s other compensation or benefits.  Nothing in this paragraph, however, is intended to adversely affect any independent contractual right of the Grantee without his consent thereto.
5.    Timing and Manner of Payment of Stock Units.  
On or as soon as administratively practical (and in all events not later than two and one-half months) following the vesting of all or a portion of the Stock Units, the Corporation shall deliver to the Grantee a number of shares of Common Stock (either by delivering one or more certificates for such shares or by entering such shares in book entry form, as determined by the Corporation in its discretion) equal (subject to adjustment pursuant to Section 7.1 of the Plan) to the number of Stock Units subject to this Award that vested.
However, to the extent the Grantee’s Stock Units vest pursuant to Section 3, in the first two and one-half months of the calendar quarter following the calendar quarter in which the Grantee’s Separation From Service occurs, the Corporation shall deliver to the Grantee a number of shares of Common Stock (either by delivering one or more certificates for such shares or by entering such shares in book entry form, as determined by the Corporation in its discretion) equal (subject to adjustment pursuant to Section 7.1 of the Plan) to the number of Stock Units subject to this Award that vested pursuant to Section 3 in connection with the Grantee’s termination of employment; provided, however, that if the Grantee is a "specified employee" (within the meaning of Treasury Regulation Section 1.409A-1(i)) 

on the date of Grantee’s Separation From Service, Grantee shall not be entitled to any payment of such Stock Units until the earlier of (i) the date which is six (6) months after Grantee’s Separation From Service with the Corporation for any reason other than death, or (ii) the date of Grantee’s death, if and to the extent such delay in payment is required to comply with Section 409A of the Code.  For purposes of the Award, "Separation From Service" shall mean a "separation from service" within the meaning of Treasury Regulation Section 1.409A-1(h)(1), without regard to the optional alternative definitions available thereunder.
The Corporation’s obligation to deliver shares of Common Stock or otherwise make payment with respect to vested Stock Units is subject to the condition precedent that the Grantee or other person entitled under the Plan to receive any shares with respect to the vested Stock Units deliver to the Corporation any representations or other documents or assurances required pursuant to Section 8.1 of the Plan.  The Grantee shall have no further rights with respect to any Stock Units that are so paid or that terminate pursuant to the terms hereof.
6.    Dividend and Voting Rights.
6.1    Limitations on Rights Associated with Units.  The Grantee shall have no rights as a stockholder of the Corporation, no dividend rights (except as expressly provided in Section 6.2 with respect to Dividend Equivalent Rights) and no voting rights, with respect to the Stock Units and any shares of Common Stock underlying or issuable in respect of such Stock Units until such shares of Common Stock are actually issued to and held of record by the Grantee.  No adjustments will be made for dividends or other rights of a holder for which the record date is prior to the date of issuance of the stock certificate.
6.2    Dividend Equivalent Rights Distributions.  As of any date that the Corporation pays an ordinary cash dividend on its Common Stock, the Corporation shall credit the Grantee with an additional number of Stock Units equal to (i) the per share cash dividend paid by the Corporation on its Common Stock on such date, multiplied by (ii) the Total Number of Stock Units which are then outstanding (including any dividend equivalents previously credited hereunder) (with such number adjusted pursuant to Section 7.1 of the Plan) subject to the Award as of the related dividend payment record date, divided by (iii) the fair market value of a share of Common Stock on the date of payment of such dividend (with the "fair market value" of such shares determined in accordance with the applicable provisions of the Plan).  Any Stock Units credited pursuant to the foregoing provisions of this Section 6.2 shall be subject to the same vesting, payment and other terms, conditions and restrictions as the original Stock Units to which they relate.  No crediting of Stock Units shall be made pursuant to this Section 6.2 with respect to any Stock Units which, as of such record date, have either been paid pursuant to Section 5 or terminated pursuant to the terms hereof.  
7.    Non-Transferability.  
Neither the Award, nor any interest therein or amount or shares payable in respect thereof may be sold, assigned, transferred, pledged or otherwise disposed of, alienated or encumbered, either voluntarily or involuntarily.  The transfer restrictions in the preceding sentence shall not apply to (a) transfers to the Corporation, or (b) transfers by will or the laws of descent and distribution.
8.    Adjustments.  
Upon the occurrence of certain events relating to the Corporation’s stock contemplated by Section 7.1 of the Plan (including, without limitation, an extraordinary cash dividend on such stock), the Administrator shall make adjustments in accordance with such section in the number of Stock Units then outstanding and the number and kind of securities that may be issued in respect of the Award.  No such adjustment shall be made with respect to any ordinary cash dividend for which dividend equivalents are credited pursuant to Section 6.2.
9.    Tax Withholding.  
The Corporation shall reasonably determine the amount of any federal, state, local or other income, employment, or other taxes which the Corporation or any of its Subsidiaries may reasonably be obligated to withhold with respect to the grant, vesting or other event with respect to the Stock Units.  The Grantee shall be solely responsible for the satisfaction of such withholding requirements.  If such withholding event occurs in connection with the distribution of shares of Common Stock in respect of the Stock Units and subject to compliance with all applicable laws, the Corporation shall automatically withhold and reacquire the appropriate number of whole shares, valued at their then fair market value (with the "fair market value" of such shares determined in accordance with the applicable provisions of the Plan), to satisfy any withholding obligations of the Corporation or its Subsidiaries with respect to such distribution; provided, however, that the Grantee may elect in advance, in accordance with such procedures as the Corporation may implement and subject to all applicable laws and Corporation policies (including insider-trading policies), to make 

alternative arrangements to provide for such withholding (which may include provision for a cash payment to the Corporation for the amount of such withholding obligations or a "sell-to-cover" arrangement with a broker to provide for the market sale of such shares to cover such withholding amount).  The Grantee shall execute such documents as may reasonably be requested by the Corporation or the broker, as applicable, in order to implement such transactions and shall otherwise comply with the administrative rules and procedures established by the Corporation with respect to such transactions.  If, however, any withholding event occurs with respect to the Stock Units other than in connection with the distribution of shares of Common Stock in respect of the Stock Units, or if the Corporation cannot legally satisfy such withholding obligations by such withholding and reacquisition of shares as described above, the Corporation shall be entitled to require a cash payment by or on behalf of the Grantee and/or to deduct from other compensation payable to the Grantee the amount of any such withholding obligations.
10.    Notices.  
Any notice to be given under the terms of this Agreement shall be in writing and addressed to the Corporation at its principal office to the attention of the Secretary, and to the Grantee at the Grantee’s last address reflected on the Corporation’s employment records.  Any notice shall be delivered in person or shall be enclosed in a properly sealed envelope, addressed as aforesaid, registered or certified, and deposited (postage and registry or certification fee prepaid) in a post office or branch post office regularly maintained by the United States Government or a courier of internationally recognized prominence.  Any such notice shall be given only when received, but if the Grantee is no longer an Eligible Person, shall be deemed to have been duly given five business days after the date mailed in accordance with the foregoing provisions of this Section 10.
11.    Plan.  
The Award and all rights of the Grantee under this Agreement are subject to the terms and conditions of the Plan, incorporated herein by this reference.  The Grantee agrees to be bound by the terms of the Plan and this Agreement.  The Grantee acknowledges having read and understanding the Plan, the Prospectus for the Plan, and this Agreement.  Unless otherwise expressly provided in other sections of this Agreement, provisions of the Plan that confer discretionary authority on the Board or the Administrator do not (and shall not be deemed to) create any rights in the Grantee unless such rights are expressly set forth herein or are otherwise in the sole discretion of the Board or the Administrator so conferred by appropriate action of the Board or the Administrator under the Plan after the date hereof.
12.    Amendments; Other Agreements.  
The Plan may be amended pursuant to Section 8.6 of the Plan.  This Agreement may be amended by the Administrator from time to time.  Any such amendment must be in writing and signed by the Corporation.  Any such amendment that adversely affects the Grantee’s rights under this Agreement requires the consent of the Grantee in order to be effective with respect to the Award.  The Corporation may, however, unilaterally waive any provision hereof in writing to the extent such waiver does not adversely affect the interests of the Grantee hereunder, but no such waiver shall operate as or be construed to be a subsequent waiver of the same provision or a waiver of any other provision hereof.
For clarity, the Retention Agreement [(with the Good Reason definition therein as amended by this Agreement)] [Include for Paul H. Pickle, Steven G. Litchfield, David Goren and Frederick C. Goerner only.] continues in effect in accordance with its terms.  For clarity, the Award is subject to a letter agreement by and between the Corporation and the Grantee dated on or about the date hereof with respect to Sections 280G and 4999 of the Code.
Any dispute regarding this Agreement after the occurrence of a Change in Control shall be subject to the provisions of Section [16] [Insert Section "17" for the grants to Paul H. Pickle and John W. Hohener only.] of the Retention Agreement.
13.    Limitation on Grantee’s Rights.  
Participation in the Plan confers no rights or interests other than as herein provided.  This Agreement creates only a contractual obligation on the part of the Corporation as to amounts payable and shall not be construed as creating a trust.  Neither the Plan nor any underlying program, in and of itself, has any assets.  The Grantee shall have only the rights of a general unsecured creditor of the Corporation with respect to amounts credited and benefits payable, if any, with respect to the Stock Units, and rights no greater than the right to receive the Common Stock as a general unsecured creditor with respect to Stock Units, as and when payable hereunder.  

14.    Counterparts.  
This Agreement may be executed simultaneously in any number of counterparts, each of which shall be deemed an original but all of which together shall constitute one and the same instrument.  
15.    Section Headings.  
The section headings of this Agreement are for convenience of reference only and shall not be deemed to alter or affect any provision hereof.
16.    Governing Law.  
This Agreement shall be governed by and construed and enforced in accordance with the laws of the State of Delaware without regard to conflict of law principles thereunder.
17.    Construction.  
It is intended that the terms of the Award will not result in the imposition of any tax liability pursuant to Section 409A of the Code.  This Agreement shall be construed and interpreted consistent with the foregoing intents.

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