Document:

Executive Severance Policy dated as of December 16, 2008

  

 

 

  
 Exhibit 10.1 

 

			
	 Title:
	  	Executive Severance Policy
	Functional Area:	  	Human Resources
	Policy Number:	  	N/A

 SCOPE 

This policy applies only to executive employees (limited to Management Level 1, 2 and 3) of American Water Works Company, Inc. and its regulated
subsidiaries, including, for purposes of this policy, American Water Works Service Company, Inc. (together “American Water” or the “Company”) who receive a written notification of eligibility from the Senior Vice President of
Human Resources and who are not otherwise covered by an agreement that provides for severance benefits in the event of a covered termination. For purposes of this policy, employees who have received such notice and are not covered by an agreement
that provides for severance benefits, will be referred to as “Eligible Executive.” 
 POLICY STATEMENT 

Business Objective: 
 The purpose of this
Executive Severance Policy (this “Policy”) is to set forth the severance benefits that will be provided to eligible executive employees of American Water Works Company, Inc. and any of its subsidiaries (collectively referred to as the
“Company”). The Company specifically reserves its right to amend, modify or terminate this Policy at any time (with or without notice) and at its sole discretion. 
 Statement: 
 An Eligible Executive shall be entitled to the severance benefits provided for
under this Policy in the event the Eligible Executive’s employment with the Company is involuntarily terminated by the Company and said termination is not for “Cause”. For purposes of this Policy, the determination of whether an
Eligible Executive’s employment was terminated for “Cause” shall be determined at the sole discretion of the Board and the decision of the Board shall be final and binding. An Eligible Executive shall not be entitled to any benefits
under this Policy in the event his or her employment with the Company is terminated for any reason other than an involuntary termination by the Company not for Cause, such as, but not limited to, terminations for Cause, terminations resulting from
death, disability, voluntary resignations or constructive terminations. 
 Before an Eligible Executive receives any severance benefits provided
for under this Policy, the Eligible Executive will be required to execute a Severance Agreement and General Release (“Release”) waiving any claims against the Company and agreeing to restrictive covenants dealing with confidentiality,
non-solicitation and non-competition. The Company shall have no obligation to an Eligible Executive under this Policy unless and until the Eligible Executive timely executes a Release and any applicable revocation period has expired without the
Eligible Executive revoking such Release. 

  
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 For purposes of this Policy, an
Eligible Executive whose employment is involuntarily terminated by the Company not for Cause and who executes (and does not revoke) the required Release will be referred to as a “Participant.” 

This Policy supersedes and hereby voids any prior severance policy covering Eligible Executives. The Board of Directors of American Water Works Company,
Inc. (the “Board”) shall have complete authority, in its sole discretion (subject to the express provisions of this Policy) to interpret this Policy and to make any determinations necessary or advisable for the administration of this
Policy. 
 Severance Pay 
 Each
Participant shall receive severance pay, which shall be paid to such Participant in the form of base salary continuation for the duration of the Severance Period based on the Participant’s annual base salary in effect as of the Termination
Date. For purposes of this Policy, the “Termination Date” shall refer to the effective date of a Participant’s termination of employment with the Company, which shall be the last day the Participant is employed by the Company.

 Payments made under this policy shall be made in regular payroll installments, net of applicable taxes and other deductions, for the duration
of the Severance Period, as defined below, commencing within 60 days following the Participant’s Termination Date, unless delay is required as described below. 
 The Severance Period 
 The “Severance Period” for Eligible Executives under this
Policy is as follows: 
  

			
	 Management Level (Grade)
	  	 Severance Period

	 Management Level - 1
	  	18 months
	 Management Level - 2 and 3
	  	12 months

 Annual Incentive Plan (AIP) 

Each Participant shall receive a pro rata AIP award for the year in which the Termination Date occurs to the extent such payment is provided for
under the terms of the applicable AIP. AIP eligibility terminates on the Termination Date, and therefore, no AIP award shall be earned or accrued during the Severance Period. 
 Equity Grants 
 The terms and conditions set forth in a Participant’s equity awards for
shares of the common stock of the Company shall govern with respect to the consequence the Participant’s termination of employment shall have on such awards after the Participant’s Termination Date. 

Health, Dental and Vision Coverage 

Provided the Release is executed and not revoked, a Participant will receive Company-paid COBRA benefits consistent with the chart below. 

  
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	Salary Level	 	  	  	 Minimum

Company-paid

COBRA Benefits
	 	  	  	 At least 5 yrs of

service, but less
 than 10 yrs
	 	  	  	 10 or more
years of
 service

	ML1 –L3	 	 	  	8 weeks	 	 	  	12 weeks	 	 	  	16 weeks

At the end of the period of Company-paid COBRA benefits, COBRA coverage may be continued by the Participant at his or her own expense, for the remaining
balance of the statutory coverage period. 
 If a Participant is otherwise eligible to retire at the time of termination, he or she may, if
eligible for retiree healthcare, begin retiree healthcare at the appropriate contribution levels after the Company-paid COBRA period expires. 

Nonqualified Deferred Compensation Plans/Qualified Retirement Plans 
 A Participant shall be deemed to have accrued service as of his or her Termination Date equivalent to his or her Severance Period under any applicable nonqualified defined benefit retirement plans in
which he or she participated as of the Termination Date solely for purposes of determining whether the Participant is vested (e.g., 5 years of service), but not for any other purpose. A Participant will not accrue additional service for any purpose
under any of the Company’s qualified defined benefit pension plans at any time after the Termination Date or receive any Company contributions under such plans after the Termination Date. The timing of payment of the Participant’s benefit
under all nonqualified deferred compensation plans and qualified plans in which he or she participated prior to the Termination Date shall be governed by the terms of such plan. 
 Life Insurance 
 During the Severance Period, a Participant shall continue to participate in
any employee life insurance plan sponsored by Company under which he or she was covered as of the Termination Date, subject to the same terms and conditions as are applicable to then-current active employees of the Company during the Severance
Period. 
 Employee Assistance Plan 
 During the Severance Period, a Participant shall continue to be eligible to participate in the Employee Assistance Plan provided by Company, subject to the same terms and conditions as are applicable to
then-current active employees of the Company during the Severance Period. 
 Perquisites 

All executive perquisites shall terminate effective as of the Participant’s Termination Date. 

Outplacement Services 
 Each Participant
shall be entitled to outplacement services through a designated provider arranged by the Company for a period of twelve (12) months following the Termination Date. All outplacement services provided by the Company shall be subject to terms and
conditions as 

  
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shall be determined at the sole discretion of the Company. No cash shall be paid in lieu of outplacement services. 
 409A 
 Notwithstanding anything to the contrary in this Policy, if any payments and benefits
provided to a Participant under this Policy are deemed to constitute deferred compensation subject to the requirements of Section 409A of the Internal Revenue Code of 1986, as amended (the “Code”), then if on the Participant’s
Termination Date the Participant is deemed to be a “specified employee” for purposes of Section 409A(a)(2)(B)(i) of the Code, any payments and benefits due to the Participant under this Policy that are subject to such requirements
that would otherwise have been payable at any time during the six-month period immediately following the Participant’s Termination Date shall not be paid to the Participant during such 6 month period, but instead shall be paid to the
Participant in a lump sum within 30 days following the expiration of such six-month period. 
 This Policy is intended to comply with
Section 409A of the Internal Revenue Code of 1986, as amended (the “Code”). To this end, the Company’s 409A Compliance Practice is incorporated herein, and to the extent any payments under this Policy are subject to
Section 409A of the Code, the terms of the 409A Compliance Practice will supersede this Policy. 
 MONITORING 

The Senior Vice President of Human Resources and the Director of Compensation and Benefits are responsible for assuring compliance with this policy.

 REPORTING/METRICS 

The Senior Vice President of Human Resources and the Director of Compensation shall advise the Board timely of any actions taken under this policy.

 CONSEQUENCE OF NON-COMPLIANCE 
 Any employee who violates or circumvents this policy may be subject to disciplinary action up to and including termination. 
 WAIVER 
 Any deviation or waiver from or exception to this policy requires the prior
written approval of the Chair of the Board Compensation Committee. 
 REFERENCES 

Section 409 A Compliance Practice (pending). 
 DEFINITIONS 
 None. 

  
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 REVIEW/UPDATE

 Review of this policy will not exceed three years – 12/16/2011. 

 
  
 Approved by: 
 Board of Directors of American Water Works Co., Inc. 

 

			
	 Original Adopted:
	  	06/14/2006
	 Revised Adopted:
	  	12/16/2008
	 Date of Last Review:
	  	12/16/2008
	 Effective Date:
	  	12/16/2008
	 Prepared By:
	  	Human Resources                   
             

  

	
	  
 Disclaimer
  
 American Water reserves the right to change, revise or discontinue this Policy for any reason or no reason whatsoever. No employee, manager or other agent of American Water, other than the Service Company
Board (and, if applicable, the executive having authority to approve this Policy) has the authority to enter into any agreement contrary to this Policy.
  

This policy is not intended to create any contractual rights or duties and will be applied at the Company’s sole
discretion.
  
 Employment with the Company is
“at-will”. That means that either you or the Company can terminate employment at any time, for any reason or no reason at all, with or without cause or notice.

 
 Neither this policy nor any oral statement will create a right
of continued employment. Any employment contract must be in writing and must be signed by the President of American Water, or his or her designee.
  

This Policy supersedes and voids all previous policies and practices, which may be inconsistent in any way with that stated
herein.
  

  
 5 of 52007 Omnibus Equity Compensation Plan Sept 2010 Form of Stock Unit Grant

  
 Exhibit 10.2

 FORM FOR NON-EMPLOYEE DIRECTORS 
 SEPTEMBER 2010 GRANT 
 AMERICAN WATER WORKS COMPANY, INC. 

2007 OMNIBUS EQUITY COMPENSATION PLAN 
 STOCK UNIT GRANT 
 This STOCK UNIT GRANT, dated as of
                     (the “Date of Grant”), is delivered by American Water Works Company, Inc. (the
“Company”) to                      (the “Participant”). 

RECITALS 
 WHEREAS, the
Committee (as defined in the American Water Works Company, Inc. 2007 Omnibus Equity Compensation Plan) has determined to grant each non-employee member of the Board of Directors of the Company (the “Board”) who is a non-employee
director of the Company a stock unit grant that will be converted to shares of common stock of the Company, par value $0.01 per share, (the “Company Stock”) at a later date; 
 WHEREAS, the Participant is a non-employee director on the Board; and 
 WHEREAS, the Committee has
determined that the stock unit grant granted to the Participant shall be issued under the American Water Works Company, Inc. 2007 Omnibus Equity Compensation Plan (the “Plan”) and the terms and conditions of such stock unit shall be
memorialized in this grant (the “Grant”). 
 NOW, THEREFORE, the parties to this Grant, intending to be legally bound hereby,
agree as follows: 
 1.    Grant of Stock Units. Subject to the terms and conditions set forth in this Grant and the
Plan, the Company hereby grants to the Participant              units (the “Stock Units”). Each Stock Unit shall be a phantom right and shall be equivalent to one
share of Company Stock on the applicable distribution date, as described in Paragraph 4 below. 
 2.    Stock Unit
Account. The Company shall establish and maintain a Stock Unit account as a bookkeeping account on its records (the “Stock Unit Account”) for the Participant and shall record in such Stock Unit Account the number of Stock Units
granted to the Participant. The Participant shall not have any interest in any fund or specific assets of the Company by reason of this grant or the Stock Unit Account established for the Participant. 

  

3.    Vesting. The Participant shall be fully vested in the Stock Units credited to the Participant’s Stock Unit Account
pursuant to this Grant on the Date of Grant. 
 4.    Distribution. Unless an election is made pursuant to Paragraph
5 below, the Stock Units shall be converted to shares of Company Stock and distributed by the Company within thirty (30) days following the earlier of (i) October 15, 2011 (the “Specified Date”) (or, if applicable,
the Deferred Date, as defined in Paragraph 5 below), (ii) the Participant’s separation from service (within the meaning of section 409A of the Internal Revenue Code of 1986, as amended (the “Code”)) with the Company (the
“Separation from Service Date”), or (iii) the date of a Change of Control (as defined below) (the “Change of Control Date”). At the time of distribution, all Stock Units shall be converted to an equivalent
number of shares of Company Stock, and the Participant shall receive a single sum distribution of such shares of Company Stock, which shall be issued under the Plan. For purposes of this Grant, the term “Change of Control” shall mean as
such term is defined in the Plan, except that a Change of Control shall not be deemed to have occurred for purposes of this Grant unless the event constituting the Change of Control constitutes a change in ownership or effective control of the
Company, or in the ownership of a substantial portion of the assets of the Company, within the meaning of section 409A of the Code and its corresponding regulations 
 5.    Deferrals. The Participant may make an irrevocable election to defer the Specified Date (or further defer the Deferred Date (as defined below), if applicable) of
all of the Stock Units, plus dividend equivalents earned on such Stock Units as described in Paragraph 6 below, to a later date, provided that (i) the election shall not take effect until at least twelve (12) months after the date on which
the election is made, (ii) the deferred Specified Date cannot be earlier than five (5) years from the original Specified Date under Paragraph 4 (or five (5) years from the applicable Deferred Date, if a subsequent deferral of a
Deferred Date is being made), and (iii) the election must be made no less than twelve (12) months prior to the date of the Specified Date (or twelve (12) months prior to the previously applicable Deferred Date, if a subsequent
deferral of a Deferred Date is being made). To defer the Specified Date, the Participant must elect to defer 100% of the Stock Units, including corresponding dividend equivalents, granted to the Participant under this Grant and complete the deferral
election form provided to the Participant by the Committee, in the form attached hereto as Exhibit A or as may subsequently modified in the discretion of the Committee. If the Participant desires to make a further deferral, the Participant must
make such election on a separate form provided by the Committee for such purpose. Any such election shall be made in accordance with section 409A of the Code and any corresponding guidance and regulations issued under section 409A of the Code.
Notwithstanding a Participant’s election pursuant to this Paragraph, if the Separation from Service Date or Change of Control Date occurs prior to the Deferred Date, the distribution of the Participant’s Stock Units, plus corresponding
dividend equivalents, will be the occurrence of the Separation from Service Date or Change of Control Date, whichever is earlier. If a Specified Date is delayed one or more times pursuant to this Paragraph 6, the new Specified Date shall be referred
to as the “Deferred Date.” 
 6.    Dividend Equivalents. Until the earlier of the Specified Date (or the
Deferred Date, if elected), Separation from Service Date or Change of Control Date, if any dividends are declared with respect to the shares of Company Stock, the Company shall credit to a dividend equivalent account (the “Dividend
Equivalent Account”) the value of the dividends that would have been 

  
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distributed if the Stock Units credited to the Participant’s Stock Unit Account at the time of the declaration of the dividend were shares of Company Stock. At the same time that the Stock
Units are converted to shares of Company Stock and distributed to the Participant, the Company shall pay to the Participant a lump sum cash payment equal to the value of the dividends credited to the Participant’s Dividend Equivalent Account.
No interest shall accrue on any dividend equivalents credited to the Participant’s Dividend Equivalent Account. 

7.    Change of Control. Except as set forth above, the provisions set forth in the Plan applicable to a Change of Control (as
defined in the Plan) shall apply to the Stock Units, and, in the event of a Change of Control, the Committee may take such actions as it deems appropriate pursuant to the Plan and is consistent with the requirements of section 409A of the Code.

 8.    Acknowledgment by Participant. By accepting this Grant, the Participant acknowledges that with respect to
any right to distribution pursuant to this Grant, the Participant is and shall be an unsecured general creditor of the Company without any preference as against other unsecured general creditors of the Company, and the Participant hereby covenants
for himself or herself, and anyone at any time claiming through or under the Participant not to claim any such preference, and hereby disclaims and waives any such preference which may at any time be at issue, to the fullest extent permitted by
applicable law. The Participant also hereby agrees to be bound by the terms and conditions of the Plan and this Grant. The Participant further agrees to be bound by the determinations and decisions of the Committee with respect to this Grant and the
Plan and the Participant’s rights to benefits under this Grant and the Plan, and agrees that all such determinations and decisions of the Committee shall be binding on the Participant, his or her beneficiaries and any other person having or
claiming an interest under this Grant and the Plan on behalf of the Participant. 
 9.    Restrictions on Issuance or
Transfer of Shares of Company Stock. 
 (a) The obligation of the Company to deliver shares of Company Stock upon the
distribution of the Stock Units shall be subject to the condition that if at any time the Committee shall determine in its discretion that the listing, registration or qualification of the shares of Company Stock upon any securities exchange or
under any state or federal law, or the consent or approval of any governmental regulatory body is necessary or desirable as a condition of, or in connection with, the issuance of shares of Company Stock, the shares of Company Stock may not be issued
in whole or in part unless such listing, registration, qualification, consent or approval shall have been effected or obtained free of any conditions not acceptable to the Committee. The issuance of shares of Company Stock and the payment of cash to
the Participant pursuant to this Grant is subject to any applicable taxes and other laws or regulations of the United States or of any state having jurisdiction thereof. 
 (b) As a condition to receive any shares of Company Stock upon conversion of the Stock Units, the Participant agrees: 

(i) to be bound by the Company’s policies regarding the limitations on the transfer of such shares, and understands
that there may be certain times during the year that the Participant will be prohibited from selling, transferring, pledging, donating, assigning, mortgaging, hypothecating or otherwise encumbering the shares; and 

  
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 (ii)
that the shares of Company Stock obtained by the Participant upon the distribution of the Stock Units shall not be tradeable until the Participant owns enough shares, measured using the average price per share of all shares of Company Stock the
Participant owns outright, stock or stock units held in deferred compensation plans, including tax-qualified retirement plans, and time-based restricted stock, to meet or exceed 300% of the Participant’s annual retainer. 

10.    Grant Subject to Plan Provisions. This Grant is made pursuant to the Plan, the terms of which are incorporated herein
by reference, and in all respects shall be interpreted in accordance with the Plan. In the event of any contradiction, distinction or difference between this Grant and the terms of the Plan, the terms of the Plan will control. Except as otherwise
defined in this Grant, capitalized terms used in this Grant shall have the meanings set forth in the Plan. This Grant is subject to the interpretations, regulations and determinations concerning the Plan established from time to time by the
Committee in accordance with the provisions of the Plan, including, but not limited to, provisions pertaining to (i) rights and obligations with respect to withholding taxes, (ii) the registration, qualification or listing of the shares of
Company Stock, (iii) changes in capitalization of the Company, and (iv) other requirements of applicable law. The Committee shall have the authority to interpret and construe this Grant pursuant to the terms of the Plan, its decisions
shall be conclusive as to any questions arising hereunder and the Participant’s acceptance of this Grant is the Participant’s agreement to be bound by the interpretations and decisions of the Committee with respect to this Grant and the
Plan. 
 11.    No Rights as Stockholder. The Participant shall not have any rights as a stockholder of the Company,
including the right to any cash dividends (except as provided in Paragraph 6), or the right to vote, with respect to any Stock Units. 

12.    No Rights to Continued Employment or Service. This Grant shall not confer upon the Participant any right to be retained
in the employment or service of the Employer (as defined in the Plan) and shall not interfere in any way with the right to terminate the Participant’s employment or service at any time. The right to terminate at will the Participant’s
employment or service at any time for any reason is specifically reserved. 
 13.    Assignment and Transfers. No
Stock Units or dividend equivalents awarded to the Participant under this Grant may be transferred, assigned, pledged, or encumbered by the Participant and the Stock Units and dividend equivalents shall be distributed during the lifetime of the
Participant only for the benefit of the Participant. Any attempt to transfer, assign, pledge, or encumber the Stock Units or dividend equivalents under this Grant by the Participant shall be null, void and without effect. The rights and protections
of the Company hereunder shall extend to any successors or assigns of the Company. This Grant may be assigned by the Company without the Participant’s consent. 
 14.    Withholding. To the extent required by applicable law, the Participant shall be required to pay to the Company, or make other arrangements satisfactory to the Company to
provide for the payment of, any federal, state, local or other taxes that the Company is required to withhold with respect to the Grant, vesting or distribution of the Stock Units and dividend equivalents. 

  
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 15.    Effect
on Other Benefits. The value of shares of Company Stock and dividend equivalents distributed with respect to the Stock Units shall not be considered eligible earnings for purposes of any other plans maintained by the Employer. Neither shall such
value be considered part of the Participant’s compensation for purposes of determining or calculating other benefits that are based on compensation, such as life insurance. 
 16.    Applicable Law. The validity, construction, interpretation and effect of this Grant shall be governed by and construed in accordance with the laws of the State of
Delaware, without giving effect to the conflicts of laws provisions thereof. 
 17.    Notice. Any notice to the
Company provided for in this instrument shall be addressed to the Company in care of the General Counsel at the Company’s corporate headquarters, and any notice to the Participant shall be addressed to such Participant at the current address
shown on the records of the Company, or to such other address as the Participant may designate to the Company in writing. Any notice shall be delivered by hand, sent by telecopy or enclosed in a properly sealed envelope addressed as stated above,
registered and deposited, postage prepaid, in a post office regularly maintained by the United States Postal Service. 

18.    Section 409A of the Code. 
 (a) This Grant is intended to comply with the requirements of section 409A of the Code and shall be interpreted and administered to avoid any penalty sanctions under section 409A of the Code. If any
distribution cannot be provided or made at the time specified herein or as elected by the Participant, then such distribution shall be provided in full at the earliest time thereafter when such sanctions cannot be imposed. Unless a valid election is
made pursuant to Paragraph 5 above, in no event may the Participant designate the calendar year of distribution. 
 (b)
Notwithstanding any provision to the contrary in this Grant, if any of the distributions under this Grant are payable to the Participant upon separation from service (within the meaning of section 409A of the Code) from the Employer, then if at the
time of the Participant’s separation from service the Participant is a “specified employee” (as such term is defined in section 409A(2)(B)(i) of the Code and its corresponding regulations) as determined by the Company (or any
successor thereto) in its sole discretion in accordance with its specified employee determination policy, then all distributions to the Participant pursuant to this Grant shall be postponed for a period of six (6) months following the
Participant’s separation from service from the Employer. The postponed amounts shall be distributed to the Participant in a lump sum within thirty (30) days after the date that is six (6) months following the Participant’s
separation from service from the Employer, and any amounts distributable to the Participant after the expiration of such six (6) month period under this Grant shall continue to be distributed to the Participant in accordance with the terms of
this Grant. If the Participant dies during such six-month period and prior to the distribution of the postponed amounts hereunder, the amounts delayed on account of section 409A of the Code shall be distributed to the personal representative of the
Participant’s estate within sixty (60) days after the date of the Participant’s death, and any amounts not delayed shall be distributed to the personal representative of the Participant’s estate in accordance with the terms of
this Grant. 
 [SIGNATURE PAGE FOLLOWS] 

  
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 IN WITNESS WHEREOF,
the Company has caused its duly authorized officer to execute this Grant, effective as of the Date of Grant. 
 AMERICAN WATER WORKS COMPANY,
INC. 
 By: Jeffry E. Sterba 

Its: President and CEO 

  
 6 

  
 EXHIBIT A

 SUBSEQUENT DEFERRAL ELECTION FORM 
 PART A. TIME OF DISTRIBUTION 
 I,
                    , (the “Participant”) hereby irrevocably elect to have all of the Stock Units, plus corresponding
dividend equivalents, (the “Deferred Units”) granted to me pursuant to the Stock Unit Grant, dated as of             
            , 20    , (the “Grant”) under the American Water Works Company, Inc. 2007 Omnibus Equity Compensation Plan (the
“Plan”) that would have been distributed by American Water Works Company, Inc. to me on the Specified Date (as defined in the Grant), instead be distributed to me on the deferred date designated below (the “Deferred
Date”), which date must be at least five (5) years later than the Specified Date, and this election is at least twelve (12) months prior to the Specified Date (to make this deferral election you must defer all of the Stock Units,
plus corresponding dividend equivalents, granted to you pursuant the Grant, meaning there is no partial deferral): 
  

					
	 Number of Stock

Units, and Dividend
 Equivalents, to be
 Further Deferred

(All Must Be

Deferred)
	 	 Original Specified Date

(Election Must Be Made at
 Least 12 Months Prior to the
 Specified Date)
	 	 Deferred Date

(Must be a date that is at least
 five years later than the
 Original Specified
Date)

	 100%
	 	October 15, 2011	 	

 PART B. ACKNOWLEDGMENT 
 I understand and expressly agree that (i) the Deferred Date for the Deferred Units shall be the date I specified in Part A above (which is a date that is at least five (5) years later than the
original Specified Date), and (ii) I will not be entitled to receive distribution of the Deferred Units on an earlier date, except in the event that the Separation from Service Date (as defined in the Grant) or the Change of Control Date (as
defined in the Grant) occurs prior to the Deferred Date. I also understand and expressly agree that this deferral election is irrevocable, is being made at least twelve (12) months prior to the original Specified Date, and shall not take effect
until twelve (12) months after the date on which I make this election. Lastly, I understand and agree that this deferral election applies to 100% of the Stock Units, and corresponding dividend equivalents, granted to me pursuant to the Grant.

  

			
	 PARTICIPANT SIGNATURE
	  	
		
	
Participant:                      
                      
	  	Date:                            

		
	Receipt Acknowledged:	  	
		
	By:                             
       	  	
		
	
Title:                       
           
	  	Date:                            

  
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