Document:

Exhibit
10.3

 

THIS
NOTE AND THE SECURITIES ISSUABLE UPON THE CONVERSION HEREOF HAVE NOT BEEN REGISTERED UNDER THE SECURITIES ACT OF 1933, AS AMENDED
(THE “ACT”), OR UNDER THE SECURITIES LAWS OF CERTAIN STATES. THESE SECURITIES MAY NOT BE OFFERED, SOLD OR OTHERWISE
TRANSFERRED, PLEDGED OR HYPOTHECATED EXCEPT AS PERMITTED UNDER THE ACT AND APPLICABLE STATE SECURITIES LAWS PURSUANT TO AN EFFECTIVE
REGISTRATION STATEMENT OR AN EXEMPTION THEREFROM. THE ISSUER OF THESE SECURITIES MAY REQUIRE AN OPINION OF COUNSEL REASONABLY
SATISFACTORY TO THE ISSUER THAT SUCH OFFER, SALE OR TRANSFER, PLEDGE OR HYPOTHECATION OTHERWISE COMPLIES WITH THE ACT AND ANY
APPLICABLE STATE SECURITIES LAWS.

 

BONE
BIOLOGICS CORPORATION

SECURED SUBORDINATED CONVERTIBLE PROMISSORY NOTE

 

	$1,000,000	February
    6, 2017

 

FOR
VALUE RECEIVED, Bone Biologics Corporation, a Delaware Corporation (the “Company”) promises to pay to
The Musculoskeletal Transplant Foundation (“Holder”), in lawful money of the United States of America,
the principal amount of One Million dollars ($1,000,000) (“Principal Amount”), upon the terms and subject
to the conditions set forth herein (this “Subordinated Note”). The following is a statement of the rights
of Holder and the conditions to which this Subordinated Note is subject, and to which Holder, by the acceptance of this Subordinated
Note, agrees:

 

1.       Maturity
Date; Prepayment. If not sooner paid or converted pursuant to the terms hereof, the outstanding Principal Amount plus all
accrued and unpaid interest thereon shall be due and payable on December 31, 2017 (“Maturity Date”).
The Subordinated Note may be prepaid at any time provided that the Company pays all accrued interest thereon.

 

2.       Interest.

 

(a)       Simple
Interest. Interest shall accrue on the unpaid Principal Amount from the date hereof until the date this Subordinated Note
is paid in full or converted at the rate of eight and one/half percent (81⁄2%) simple interest per year (“Interest
Rate”). All accrued interest shall be due and payable in full upon maturity or prepayment of this Note.

 

3.       Conversion.

 

(a)       Mandatory
Conversion Upon Qualified Financing. In the event of the sale or series of sales of securities to non-current stockholders
of Company, other than a note (the “HIC New Note”) issued concurrently herewith to Hankey Capital, LLC
(“HIC”), by the Company after the date hereof which results in gross proceeds to the Company in the
aggregate amount of at least five million dollars ($5,000,000) (a “Qualified Financing”), the outstanding
Principal Amount of this Subordinated Note together with any accrued but unpaid interest shall be converted into the same securities
issued in the Qualified Financing (the “QF Securities”) at a conversion price which will be the purchase
price per share or per unit based on the actual pre-money valuation used in determining the purchase price for the QF Securities.
The Company shall provide notice to Holder at least seven (7) days prior to the closing of a Qualified Financing as to the number
of shares or units Holder would receive. In conjunction with the conversion, Holder shall become a party to and shall execute
all definitive agreements subject to the Qualified Financing (as defined below) (the “Qualified Financing Agreements”).

 

(b)       Optional
Conversion Prior to Qualified Financing. At any time prior to the Maturity Date or a conversion pursuant to Section 3(a),
at the option of the Holder, the outstanding Principal Amount of this Subordinated Note and accrued interest may be converted
into shares of the Common Stock of the Company at a conversion price of $1.00 per share.

 

    	 	1	 

    	 

    

 

(c)       Other
Mandatory Conversion. If this Subordinated Note has not been paid or converted prior to the Maturity Date, the outstanding
Principal Amount of this Subordinated Note and accrued interest shall be automatically converted into shares of Common Stock of
the Company at a conversion price of $1.00 per share.

 

(d)       QF
Securities. In the case of a conversion pursuant to Section 3(a), if the QF Securities are senior securities, including Preferred
Stock, then the number of shares of such senior securities to be received shall be calculated based on the conversion price of
the senior securities.

 

(e)       Conversion
Procedure. Upon conversion, Holder shall surrender this Subordinated Note (or a notice to the effect that the original Subordinated
Note has been lost, stolen or destroyed and an agreement acceptable to the Company whereby the holder agrees to indemnify the
Company from any loss incurred by it in connection with this Subordinated Note). If the conversion is pursuant to Section 3(a),
Holder shall then execute and deliver to the Company the Qualified Financing Agreements. Upon conversion of this Subordinated
Note in full, the Company shall be forever released from all its obligations and liabilities under this Subordinated Note and
this Subordinated Note shall be deemed of no further force or effect, whether or not the original of this Subordinated Note has
been delivered to the Company for cancellation.

 

4.       Security
Interest. The Company hereby grants to Holder the security interest in all of the assets of the Company second in priority
only to the security interest granted to HIC in connection with the various secured convertible notes previously issued by the
Company to HIC and the HIC New Note (individually, an “HIC Note” and collectively, the “HIC
Notes”).

 

5.       Subordination;
Rank.

 

(a)       Agreement
to Subordinate. The payment of the principal of and interest on, and any other amounts due in respect of, this Subordinated
Note is subordinated in right of payment, to the extent and in the manner stated in this Section 5, to the prior payment of the
HIC Notes.

 

(b)       No
Payment on Note if Senior Notes are in Default. Notwithstanding anything in this Subordinated Note to the contrary, no payment
on account of principal of, interest on or other amounts due in respect of this Subordinated Note, shall be made by or on behalf
of the Company if, at the time of such payment, or immediately after giving effect thereto, there shall exist under any HIC Note
any default in the payment of all or any portion of principal of or interest thereon, which default shall have resulted in the
full amount of the such Note being declared due and payable and which default shall not have been cured or waived. The Company
shall notify Holder in writing promptly following the occurrence of the foregoing. In the event that, notwithstanding the provisions
of this Section 5, payments are made by or on behalf of the Company in contravention of the provisions of this Section 5, such
payments shall be held by the Company in trust for the benefit of, and shall be paid over to and delivered to, the holder of any
HIC Note so in default, for application to the payment of such Note remaining unpaid.

 

(c)       Obligation
of the Company Unconditional. Nothing contained in this Subordinated Note is intended to or shall impair, as between the Company
and Holder, the obligation of the Company, which is absolute and unconditional, to pay to Holder the principal of and interest
on this Subordinated Note as and when the same shall become due and payable in accordance with its terms, nor shall anything herein
prevent Holder from exercising all remedies otherwise permitted by applicable law upon an Event of Default, subject to the rights,
if any, under this Section 5, of the holder of any HIC Note in respect of cash received upon the exercise of any such remedy.

 

    	 	2	 

    	 

    

 

6.       Events
of Default. The occurrence of any of the following shall constitute an “Event of Default” under
this Subordinated Note:

 

(a)       Failure
to Pay. The Company shall fail to pay when due the principal amount and unpaid accrued interest due under this Subordinated
Note on the Maturity Date (provided, Holder must first give written notice to the Company of its failure to pay and the Company
shall have failed to cure such payment obligation within seven (7) business days of the date the notice was given); or

 

(b)       Voluntary
Bankruptcy or Insolvency Proceedings. The Company shall (i) apply for or consent to the appointment of a receiver, trustee,
liquidator or custodian of itself or of all or a substantial part of its property, (ii) admit in writing its inability to pay
its debts generally as they mature, (iii) make a general assignment for the benefit of its or any of its creditors, (iv) be dissolved
or liquidated, (v) commence a voluntary case or other proceeding seeking liquidation, reorganization or other relief with respect
to itself or its debts under any bankruptcy, insolvency or other similar law now or hereafter in effect or consent to any such
relief or to the appointment of or taking possession of its property by any official in an involuntary case or other proceeding
commenced against it, or (vi) take any action for the purpose of effecting any of the foregoing; or

 

(c)       Involuntary
Bankruptcy or Insolvency Proceedings. Proceedings for the appointment of a receiver, trustee, liquidator or custodian of the
Company, or of all or a substantial part of the property thereof, or an involuntary case or other proceedings seeking liquidation,
reorganization or other relief with respect to the Company or any of its Subsidiaries, if any, or the debts thereof under any
bankruptcy, insolvency or other similar law now or hereafter in effect shall be commenced and an order for relief entered or such
proceeding shall not be dismissed or discharged within 60 days of commencement.

 

7.       Rights
of Holder upon Default. Upon the occurrence of any Event of Default and at any time thereafter during the continuance of such
Event of Default, subject to Section 6, Holder may by written notice to the Company, declare all outstanding obligations payable
by the Company hereunder to be immediately due and payable without presentment, demand, protest or any other notice of any kind,
all of which are hereby expressly waived, anything contained herein to the contrary notwithstanding, and, subject to Section 6,
enforce its rights as secured party under the Uniform Commercial Code applicable to the Company.

 

8.       Representations
and Warranties of Holder. Holder represents and warrants to the Company upon the acquisition of the Subordinated Note as follows:

 

(a)       Binding
Obligation. Holder has full legal capacity, power and authority to execute and deliver this Agreement and to perform its obligations
hereunder. This Subordinated Note constitutes a valid and binding obligation of Holder, enforceable in accordance with its terms,
except as limited by bankruptcy, insolvency or other laws of general application relating to or affecting the enforcement of creditors’
rights generally and general principles of equity.

 

(b)       Securities
Law Compliance. Holder has been advised that the issuance of this Subordinated Note and the securities into which it may be
converted have not been registered under the Securities Act of 1933, as amended (the “Securities Act”), or
any state securities laws and, therefore, cannot be sold unless such sale or transfer is registered under the Securities Act and
applicable state securities laws or unless an exemption from such registration requirements is available. Holder is aware that
the Company is under no obligation to effect any such registration with respect to the Subordinated Note or the securities into
which it may be converted or to file for or comply with any exemption from registration. Holder has not been formed solely for
the purpose of making this loan and is investing in the Subordinated Note for its own account for investment, not as a nominee
or agent, and not with a view to, or for resale in connection with, the distribution thereof, and Holder has no present intention
of selling, granting any participation in, or otherwise distributing the same. Holder has such knowledge and experience in financial
and business matters that Holder is capable of evaluating the merits and risks of such investment, is able to incur a complete
loss of such investment without impairing Holder’s financial condition and is able to bear the economic risk of such investment
for an indefinite period of time. Holder is an accredited investor as such term is defined in Rule 501 of Regulation D under the
Securities Act and shall submit to the Company such further assurances of such status as may be reasonably requested by the Company.

 

    	 	3	 

    	 

    

 

9.       Representations
and Warranties of Company. The Company represents and warrants to the Holder upon the acquisition of the Subordinated Note
as follows:

 

(a)       Binding
Obligation. The Company has full legal capacity, power and authority to execute and deliver this Agreement and to perform
its obligations hereunder. This Subordinated Note constitutes a valid and binding obligation of the Company, enforceable in accordance
with its terms, except as limited by bankruptcy, insolvency or other laws of general application relating to or affecting the
enforcement of creditor’s rights generally and general principles of equity.

 

(b)       Insolvency.
No step has been taken to initiate any process for bankruptcy or other insolvency process of the Company, including (without limitation)
an appointment of an insolvency officer, an arrangement made with creditors either formally under a court or insolvency process
or informally or an enforcement of any third party security over any of the assets or undertaking of the Company.

 

(c)       Organization
and Qualification. The Company is duly organized, validly existing and in good standing under the laws of the State of Delaware,
with the requisite power and authority to own and use its properties and assets and to carry on its business as currently conducted.
The Company is not in violation of any of the provisions of its governing documents.

 

(d)       Issuance
of Investor Securities Upon Conversion. The potential issuance of the investor securities upon proper conversion of the Subordinated
Note is duly authorized and is free from all pre-emptive rights, liens and charges with respect to the issuance thereof.

 

(e)       No
Conflicts. The execution, delivery and performance of the Subordinated Note by the Company and the consummation by the Company
of the transactions contemplated herein do not and will not: (i) conflict with or violate any provision of the Company’s
charter documents, or (ii) conflict with, or constitute a default (or an event that with notice or lapse of time or both would
become a default) under, or give to others any rights of termination, amendment, acceleration or cancellation (with or without
notice, lapse of time or both) of, any agreement, credit facility, debt or other instrument (evidencing a Company debt or otherwise)
or other understanding to which the Company is a party or by which any property or asset of the Company is bound or affected,
except such as could not, individually or in the aggregate, have or result in a material adverse effect on the Company.

 

(f)       Access
to Information. Holder acknowledges that the Company has given Holder access to the corporate records and accounts of the
Company and has made its officers and representatives available for interview by Holder, and has furnished Holder with all documents
and other information required for Holder to make an informed decision with respect to the purchase of the Subordinated Note.

 

    	 	4	 

    	 

    

 

10.       Piggyback
Registration Statement. The Company hereby grants to Holder the right to include any common shares issued or issuable hereunder
in any registration statement filed by the Company with the Securities and Exchange Commission allowing the inclusion of such
shares subject to customary cutback provisions and giving priority to the Company and other holders of the Company securities
who have priority rights.

 

11.       Miscellaneous.

 

(a)       Successors
and Assigns; Certificate Representing this Subordinated Note or Securities Issuable on Conversion Hereof; Transfer of this Subordinated
Note or Securities Issuable on Conversion Hereof.

 

(i)       Subject
to the restrictions on transfer described in Section 8(b), the rights and obligations of the Company and Holder shall be binding
upon and benefit the successors, assigns, heirs, administrators and transferees of the parties.

 

(ii)       Each
certificate representing this Subordinated Note or the securities issuable upon conversion hereof shall bear a legend as to the
applicable restrictions on transferability in order to assure compliance with the Securities Act and applicable state securities
laws. The Company may issue stop transfer instructions to its transfer agent in connection with such restrictions.

 

(iii)       Holder
shall only be entitled to offer, sell or otherwise distribute this Note or the securities into which it may be converted with
the prior written consent of the Company, which may be given or withheld in the Company’s sole discretion. If an offer,
sale or other distribution is approved by the Company, Holder must provide the Company with a written opinion of Holder’s
counsel, or other evidence reasonably satisfactory to the Company, to the effect that such offer, sale or other distribution may
be effected without registration or qualification (under any federal or state law then in effect). Upon receiving such reasonably
satisfactory opinion, if so requested, or other evidence, the Company, as promptly as practicable, shall issue the appropriate
replacement note or securities. The Subordinated Note thus transferred and each certificate representing the securities thus transferred
shall bear a legend as to the applicable restrictions on transferability in order to ensure compliance with the Securities Act,
unless in the opinion of counsel for the Company such legend is not required in order to ensure compliance with the Securities
Act. The Company may issue stop transfer instructions to its transfer agent in connection with such restrictions. Subject to the
foregoing, transfers of this Note shall be registered upon registration books maintained for such purpose by or on behalf of the
Company. Prior to presentation of this Subordinated Note for registration of transfer, the Company shall treat the registered
holder hereof as the owner and holder of this Subordinated Note for the purpose of receiving all payments of principal and interest
hereon and for all other purposes whatsoever, whether or not this Note shall be overdue and the Company shall not be affected
by notice to the contrary.

 

(b)       Suitability.
Notwithstanding anything to the contrary, the Company shall have the absolute right to redeem this Subordinated Note and/or prohibit
conversion and sever its relationship with Holder at any time, if the Company determines in its sole discretion that its relationship
with Holder may jeopardize its state, federal, or other legal licenses, or otherwise jeopardize its ability to conduct business
in a highly regulated industry.

 

(c)       Waiver
and Amendment. Any provision of this Subordinated Note may be amended, waived or modified upon the written consent of the
Company and the Holder provided, however, that no such amendment, waiver or consent shall: (i) reduce the principal amount of
this Subordinated Note without Holder’s written consent, or (ii) reduce the rate of interest of this Note without Holder’s
written consent.

 

    	 	5	 

    	 

    

 

(d)       Notices.
All notices, requests, demands, consents, instructions or other communications required or permitted hereunder shall be in writing
and faxed, mailed or delivered to each party at the respective addresses of the parties, or at such other address or facsimile
number as the Company shall have furnished to Holder in writing. All such notices and communications will be deemed effectively
given the earlier of (i) when received, (ii) when delivered personally, (iii) one business day after being delivered by facsimile
(with receipt of appropriate confirmation), (iv) one business day after being deposited with an overnight courier service of recognized
standing or (v) four days after being deposited in the U.S. mail, first class with postage prepaid.

 

(e)       Payment.
Unless converted into the Company’s securities pursuant to the terms hereof, payment shall be made in lawful tender of the
United States.

 

(f)       Usury.
In the event any interest is paid on this Subordinated Note that is deemed to be in excess of the then legal maximum rate, then
that portion of the interest payment representing an amount in excess of the then legal maximum rate shall be deemed a payment
of principal and applied against the principal of this Subordinated Note.

 

(g)       Only
Company Liable. In no event shall any stockholder, officer, director or employee of the Company be liable for any amounts
due or payable pursuant to this Subordinated Note.

 

(h)       Governing
Law. This Subordinated Note and all actions arising out of or in connection with this Note shall be governed by and construed
in accordance with the laws of the State of California, without regard to the conflicts of law provisions of the State of California,
or of any other state.

 

(i)       Waiver
of Jury Trial; Judicial Reference. By acceptance of this Subordinated Note, Holder hereby agrees and the Company hereby agrees
to waive their respective rights to a jury trial of any claim or cause of action based upon or arising out of this Subordinated
Note.

 

Signature
on the following page.

 

    	 	6	 

    	 

    

 

The
Company has caused this Subordinated Note to be issued as of the date first written above.

 

	 	BONE BIOLOGICS CORPORATION
	 	 	 
	 	By:	           
	 	Name:	 
	 	Title:	 

 

	NAME
    OF HOLDER:	 
	THE
    MUSCULOSKELETAL TRANSPLANT FOUNDATION	 
	 	 	 
	By:	 	 
	 	 	 
	Name:	 	 
	 	 	 
	Title:	                      	 
	 	 	 
	Address:	 
	 	 	 
	 	 	 
	 	 	 
	 	 	 
	 	 	 

 

    	 	7Exhibit

Exhibit 10.1

Synergy Grant
Performance Share Agreement
WHEREAS, the Participant is a key associate of Diebold Nixdorf, Incorporated (hereinafter called the “Corporation”) or a Subsidiary; and
WHEREAS, the execution of a Synergy Grant Performance Share Agreement (hereinafter called the “Agreement”) substantially in the form hereof has been authorized by a resolution of the Compensation Committee (the “Committee”) of the Board of Directors of the Corporation (the “Board”).
NOW, THEREFORE, subject to the terms and conditions of the 1991 Equity and Performance Incentive Plan (As Amended and Restated as of February 12, 2014) (the “Plan”), and the terms and conditions described below, the Corporation hereby confirms to the Participant the grant, effective on the Grant Date, equal to the fixed number of Performance Shares listed as “Target Units” on the Grant Detail Page subject to the terms and conditions of the Plan and the terms and conditions described below, together with the opportunity to earn up to an additional [_____] of such number of Performance Shares for superior performance as described herein.
1.Definitions.
As used in this Agreement:
(a)“Interim Measurement Date” means each of December 31, 2017 and December 31, 2018.
(b)A “Change in Control” shall be deemed to have occurred if any of the following events shall occur:
(i)The acquisition by any individual, entity or group (within the meaning of Section 13(d)(3) or 14(d)(2) of the Securities Exchange Act of 1934, as amended (the “Exchange Act”)) (a “Person”) of beneficial ownership (within the meaning of Rule 13d-3 promulgated under the Exchange Act) of 30% or more of either: (A) the then-outstanding shares of common stock of the Corporation (the “Corporation Common Stock”) or (B) the combined voting power of the then-outstanding voting securities of the Corporation entitled to vote generally in the election of directors (“Voting Stock”); provided, however, that for purposes of this subsection (i), the following acquisitions shall not constitute a Change in Control: (1) any acquisition directly from the Corporation, (2) any acquisition by the Corporation, (3) any acquisition by any employee 

benefit plan (or related trust) sponsored or maintained by the Corporation or any Subsidiary of the Corporation, or (4) any acquisition by any Person pursuant to a transaction which complies with clauses (A), (B) and (C) of subsection (iii) of this Section 1(a); or
(ii)Individuals who, as to the date hereof, constitute the Board (as modified by this subsection (ii), the “Incumbent Board”) cease for any reason (other than death or disability) to constitute at least a majority of the Board; provided, however, that any individual becoming a director subsequent to the date hereof whose election, or nomination for election by the Corporation’s shareholders, was approved by a vote of at least a majority of the directors then comprising the Incumbent Board (either by a specific vote or by approval of the proxy statement of the Corporation in which such person is named as a nominee for director, without objection to such nomination) shall be considered as though such individual were a member of the Incumbent Board, but excluding for this purpose, any such individual whose initial assumption of office occurs as a result of an actual or threatened election contest with respect to the election or removal of directors or other actual or threatened solicitation of proxies or consents by or on behalf of a Person other than the Board; or
(iii)Consummation of a reorganization, merger or consolidation or sale or other disposition of all or substantially all of the assets of the Corporation (a “Business Combination”), in each case, unless, following such Business Combination, (A) all or substantially all of the individuals and entities who were the beneficial owners, respectively, of the Corporation Common Stock and Voting Stock immediately prior to such Business Combination beneficially own, directly or indirectly, more than 50% of, respectively, the then-outstanding shares of common stock and the combined voting power of the then-outstanding voting securities entitled to vote generally in the election of directors, as the case may be, of the entity resulting from such Business Combination (including, without limitation, an entity which as a result of such transaction owns the Corporation or all or substantially all of the Corporation’s assets either directly or through one or more subsidiaries) in substantially the same proportions relative to each other as their ownership, immediately prior to such Business Combination, of the Corporation Common Stock and Voting Stock of the Corporation, as the case may be, (B) no Person (excluding any entity resulting from such Business Combination or any employee benefit plan (or related trust) sponsored or maintained by the Corporation or such entity resulting from such Business Combination) beneficially owns, directly or indirectly, 15% or more of, respectively, the then-outstanding shares of common stock of the entity resulting from such Business Combination, or the combined voting power of the then-outstanding voting securities of such corporation except to the extent that such ownership existed prior to the Business Combination and (C) at least a 

majority of the members of the board of directors of the corporation resulting from such Business Combination were members of the Incumbent Board at the time of the execution of the initial agreement, or of the action of the Board providing for such Business Combination; or
(iv)Approval by the shareholders of the Corporation of a complete liquidation or dissolution of the Corporation.
(c)“Final Measurement Date” means December 31, 2019.
(d)“Management Objectives” means goals established by the Board for the Corporation for the Performance Period covered by this Agreement as described in Section 2 of this Agreement.
(e)“Measurement Date” means an Interim Measurement Date or the Final Measurement Date, as applicable.
(f)“Performance Period” means the period commencing on January 1, 2017 and ending on December 31, 2019.
(g)“Synergy Savings” shall have the meaning set forth on Exhibit A.
(h)“Termination for Good Cause” means the Participant’s termination of the Participant’s employment with the Corporation or a Subsidiary as a result of the occurrence of any of the following:
(i)a change in the Participant’s principal location of employment that is greater than fifty (50) miles from its location as of the date hereof without the Participant’s consent; provided, however, that the Participant hereby acknowledges that the Participant may be required to engage in travel in connection with the performance of the Participant’s duties hereunder and that such travel shall not constitute a change in the Participant’s principal location of employment for purposes hereof;
(ii)a material diminution in the Participant’s base compensation;
(iii)a change in the Participant’s position with the Corporation without the Participant’s consent such that there is a material diminution in the Participant’s authority, duties or responsibilities; or
(iv)any other action or inaction that constitutes a material breach by the Corporation of the agreement under which the Participant provides services.
Notwithstanding the foregoing, the Participant’s termination of the Participant’s employment with the Corporation as a result of the occurrence of any of the foregoing shall not constitute a “Termination For Good Cause” unless (A) the Participant gives the Corporation written notice of such occurrence within ninety (90) days of such occurrence and such occurrence is not cured by the Corporation within thirty (30) days of the date on which such written notice is received by the Corporation and (B) 

the Participant actually terminates his or her employment with the Corporation prior to the three hundred sixty-fifth (365th) day following such occurrence.
(i)Capitalized terms used herein without definition shall have the meanings assigned to them in the Plan.
2.Management Objectives.
The Management Objectives for the Performance Period covered by this Agreement and the potential Performance Shares that may be earned with respect to the Management Objectives are set forth on Exhibit A.  In no event shall the Participant be entitled to receive more than [_____] of the Performance Shares granted hereunder.
3.Grant of Performance Shares.
The Corporation hereby grants to the Participant the number of Performance Shares specified above, which may be earned by the Participant during the Performance Period as set forth in Section 4 of this Agreement.
4.Earned Shares.
(a)General.  
(i)The Performance Shares granted hereby shall be earned based on the level of the Corporation’s results with respect to the Management Objectives established for the Performance Period covered by this Agreement.   
(ii)The number of Performance Shares earned shall be determined based on the level of results of the Management Objectives. No additional Performance Shares shall be earned for results in excess of the maximum level of results for the Management Objectives. 
(iii)The level of achievement with respect to the Management Objectives will be assessed by the Committee as of each Interim Measurement Date and as of the Final Measurement Date, in each case as soon as practicable following the receipt of audited financial statements relating to the fiscal year ended as of such Measurement Date.  There will not be interpolation of performance achievement or payout as of any Interim Measurement Date; however, at the Final Measurement Date, if results for Synergy Savings are attained at an interim level of performance, a proportionate number of Performance Shares shall be earned, as determined by mathematical interpolation.
(b)Interim Measurement Dates.  As of any Interim Measurement Date:
(i)if the Synergy Savings achieved to date are below the Target level of performance, then (i) none of the potential Performance Shares granted hereby will be earned as 

of such Interim Measurement Date, and (ii) performance shall be assessed as of the next Measurement Date; and 
(ii)if the Synergy Savings achieved to date are at or above the Target level of performance, then (i) 50% of the potential Performance Shares granted hereby shall be earned at the Target level as of such Interim Measurement Date and paid out following such Interim Measurement Date in accordance with Section 5, and (ii) performance shall be assessed as of the Final Measurement Date with respect to the remaining potential Performance Shares.  For the avoidance of doubt, if any Performance Shares are earned as of and paid out following the December 31, 2017 Interim Measurement Date pursuant to this Section 4(b)(ii), no additional potential Performance Shares shall be earned as of the December 31, 2018 Interim Measurement Date.
(c)Final Measurement Date.  The final number of Performance Shares earned and to be paid out following the Final Measurement Date with respect to this Agreement, if any, shall be the number of Performance Shares earned at the level of cumulative Synergy Savings for the Performance Period per Exhibit A, with amounts interpolated as provided in Section 4(a)(iii), reduced by such number of Performance Shares, if any, that were earned as of and paid out following the Interim Measurement Dates.
5.Payment of Awards.
Payment shall be made in the form of the Corporation’s Common Shares. Amounts earned as of a Measurement Date shall be paid, less applicable taxes, as soon as practicable after the determination by the Committee of the level of attainment of the Management Objectives as of such Measurement Date, (but in all events by the last day of the fiscal year following such Measurement Date); provided, however, that in the event that Performance Shares become nonforfeitable pursuant to Section 6, the Performance Shares (except as otherwise required under Section 13) shall be payable within 30 days of becoming nonforfeitable.
Any payment of awards due pursuant to this Agreement to a deceased Participant shall be paid to the beneficiary designated by the Participant by the latest Designation of Death Beneficiary in the form attached as Exhibit B hereto filed by the Participant with the Corporation. If no such beneficiary has been designated or survives the Participant, payment shall be made to the Participant’s legal representative. A beneficiary designation may be changed or revoked by a Participant at any time, provided the change or revocation is filed with the Corporation.
Prior to payment, the Corporation shall only have an unfunded and unsecured obligation to make payment of earned awards to the Participant.

6.Effect of Change in Control.
In the event of a Change in Control after the Grant Date but prior to the end of the Performance Period, the Participant shall be deemed to have earned 100% of the Performance Shares granted hereunder as of the date of the Change in Control, and such earned Performance Shares, less such number of Performance Shares, if any, that were earned as of and paid out following an Interim Measurement Date(s) prior to such Change in Control, shall be payable in the form of Common Shares. The Performance Shares earned under this Section 6 shall be paid to the Participant as soon as practicable following the end of the Performance Period, but in all events by the last day of the fiscal year following the last fiscal year of the Performance Period, only if the Participant remains employed by the Corporation or a Subsidiary as of the end of the Performance Period, otherwise such earned Performance Shares shall be forfeited; provided, that if, prior to the end of the Performance Period, the Participant’s employment with the Corporation or a Subsidiary is terminated by the Participant as a “Termination for Good Cause,” the Participant is terminated by the Corporation other than as a “Termination for Cause,” or the Participant’s employment with the Corporation or a Subsidiary terminates under the circumstances set forth in Section 7(a) through 7(b) hereof, then the Performance Shares earned under this Section 6 shall become immediately nonforfeitable upon such termination. Notwithstanding anything in this Section 6 to the contrary, in connection with a Business Combination the result of which is that the Corporation Common Stock and Voting Stock is exchanged for or becomes exchangeable for securities of another entity, cash or a combination thereof, if the entity resulting from such Business Combination does not assume the Performance Shares evidenced hereby and the Corporation’s obligations hereunder, or replace the Performance Shares evidenced hereby with a substantially equivalent security of the entity resulting from such Business Combination, then the Performance Shares evidenced hereby shall become immediately nonforfeitable as of immediately prior to such Business Combination, if not previously earned as of and paid following an Interim Measurement Date(s).
7.Effect of Death or Disability.
If the Participant’s employment with the Corporation or one of its Subsidiaries should terminate under the circumstances set forth in Section 7(a) through 7(b) below, prior to the payment of an award, the extent to which the Performance Shares granted hereby shall be deemed to have been earned shall be determined as if the Participant’s employment had not terminated and the result shall be multiplied by a fraction, the numerator of which is the number of full months the Participant was employed during the Performance Period and the denominator of which is the total number of months in the Performance Period; provided, however, the Board, upon the recommendation of the Committee, may, in its discretion, increase payments made under the foregoing circumstances up to the full amount payable for service throughout the Performance Period; and provided, further, that the amount of Performance Shares, if any, 

earned under this Section 7 shall be reduced by such number of Performance Shares, if any, that were earned as of and paid out following an Interim Measurement Date(s) prior to such death or disability:
(a)because of death; or
(b)because of permanent disability.
Performance Shares payable pursuant to this Section 7 shall be paid in accordance with Section 5.
8.Effect of Other Terminations of Employment; Detrimental Activity.
In the event that the Participant’s employment shall terminate prior to the payment of an award in a manner other than any specified in Section 7 hereof or if the Participant shall at any time engage in any Detrimental Activity (as defined below), the Participant shall forfeit any rights he or she may have in any Performance Shares that have not been paid out to the Participant prior to the time of such termination; provided, however, that the Board, upon recommendation of the Committee, may order payment of an award in an amount determined as in Section 7 hereof for termination for the reasons set forth in Section 7 hereof, under circumstances which warrant such exceptional treatment in the judgment of the Committee and the Board.
9.Detrimental Activity.
If the Participant, either during employment by the Corporation or a Subsidiary or within one year after termination of such employment, shall engage in any Detrimental Activity, and the Board shall so find, and (except for any Detrimental Activity described in Section 9(d)(v)(B)) if the Participant shall not have ceased all Detrimental Activity within 30 days after notice of such finding given within one year after commencement of such Detrimental Activity, the Participant shall:
(a)Return to the Corporation all Performance Shares that the Participant has not disposed of and paid out pursuant to this Agreement within a period of one year prior to the date of the commencement of such Detrimental Activity, and
(b)With respect to any Performance Shares that the Participant has disposed of that were paid out pursuant to this Agreement within a period of one year prior to the date of the commencement of such Detrimental Activity, pay to the Corporation in cash the value of such Performance Shares on the date such Performance Shares were paid out.
(c)To the extent that the amounts referred to in Section 9(a) and 9(b) above are not paid to the Corporation, the Corporation may set off the amounts so payable to it against any amounts that may be owing from time to time by the Corporation or a Subsidiary to the Participant, whether as wages, deferred compensation or vacation pay or in the form of any other benefit or for any other reason.
(d)For purposes of this Agreement, the term “Detrimental Activity” shall include:

(i)Engaging in any activity, as an employee, principal, agent, or consultant for another entity, and in a capacity, that directly competes with the Corporation or any Subsidiary in any actual product, service or business activity (or in any product, service or business activity which was under active development while the Participant was employed by the Corporation if such development is being actively pursued by the Corporation during the one-year period first referred to in this Section 9) for which the Participant has had any direct responsibility and direct involvement during the last two years of his or her employment with the Corporation or a Subsidiary, in any territory in which the Corporation or a Subsidiary manufactures, sells, markets, services, or installs such product or service, or engages in such business activity.
(ii)Soliciting any employee of the Corporation or a Subsidiary to terminate his or her employment with the Corporation or a Subsidiary.
(iii)The disclosure to anyone outside the Corporation or a Subsidiary, or the use in other than the Corporation or a Subsidiary’s business, without prior written authorization from the Corporation, of any confidential, proprietary or trade secret information or material relating to the business of the Corporation and its Subsidiaries, acquired by the Participant during his or her employment with the Corporation or its Subsidiaries or while acting as a consultant for the Corporation or its Subsidiaries thereafter; provided, however, that nothing in this Agreement limits a Participant’s ability to file a charge or complaint or to communicate, including by providing documents or other information without notice to the Corporation, with the Securities and Exchange Commission or any other governmental agency or commission (“Government Agency”) or limits a Participant’s right to receive an award for information provided to any Government Agency.
(iv)The failure or refusal to disclose promptly and to assign to the Corporation upon request all right, title and interest in any invention or idea, patentable or not, made or conceived by the Participant during employment by the Corporation and any Subsidiary, relating in any manner to the actual or anticipated business, research or development work of the Corporation or any Subsidiary or the failure or refusal to do anything reasonably necessary to enable the Corporation or any Subsidiary to secure a patent where appropriate in the United States and in other countries.
(v)Activity that results in Termination for Cause. For the purposes of this Section 9 and Section 6, “Termination for Cause” shall mean a termination:
(A)due to the Participant’s willful and continuous gross neglect of his or her duties for which he or she is employed, or

(B)due to an act of dishonesty on the part of the Participant constituting a felony resulting or intended to result, directly or indirectly, in his or her gain for personal enrichment at the expense of the Corporation or a Subsidiary.
10.Shares Non-Transferable.
The Performance Shares granted hereby that have not yet been paid out are not transferable other than by will or the laws of descent and distribution.
11.Dilution and Other Adjustments.
In the event of any change in the aggregate number of outstanding Common Shares by reason of any stock dividend or stock split, recapitalization, reclassification, merger, consolidation, combination or exchange of shares or other similar corporate change, the Committee shall adjust the Management Objectives and/or the number of Performance Shares then held by the Participant. Such adjustments made by the Committee shall be conclusive and binding for all purposes of this Agreement.
12.Withholding Taxes.
To the extent that the Corporation is required to withhold federal, state, local or foreign taxes in connection with the delivery of Common Shares to the Participant or other person under this Agreement, and the amounts available to the Corporation for such withholding are insufficient, it shall be a condition to the receipt of such delivery that the Participant or such other person will make arrangements satisfactory to the Corporation for payment of the balance of such taxes required to be withheld, which arrangements (in the discretion of the Committee) may include relinquishment of a portion of such benefit. In no event, however, shall the Corporation accept Common Shares for payment of taxes in excess of required tax withholding rates, except that, in the discretion of the Committee, the Participant or such other person may surrender Common Shares owned for more than 6 months to satisfy any tax obligations resulting from any such transaction.
13.Compliance with Section 409A of the Code.
To the extent applicable, it is intended that this Agreement and the Plan comply with the provisions of Section 409A of the Code, so that the income inclusion provisions of Section 409A(a)(1) do not apply to the Participant. This Agreement and the Plan shall be administered in a manner consistent with this intent, and any provision that would cause the Agreement or the Plan to fail to satisfy Section 409A of the Code shall have no force and effect until amended to comply with Section 409A of the Code (which amendment may be retroactive to the extent permitted by Section 409A of the Code and may be made by the Corporation without the consent of the Participant). In particular, to the extent the Performance Shares become nonforfeitable pursuant to Section 6 and payment at such time would subject the Participant to penalties under Section 409A of the Code, then notwithstanding anything to the contrary in Section 5, 

payment will be made, to the extent necessary to comply with the provisions of Section 409A of the Code, to the Participant on the earlier of (a) the Participant’s “separation from service” with the Corporation (determined in accordance with Section 409A of the Code); provided, however, that if the Participant is a “specified employee” (within the meaning of Section 409A of the Code), the payment date shall be the date that is six months after the date of the Participant’s “separation of service” with the Corporation, (b) the date payment otherwise would have made under Section 5 above, or (c) the Participant’s death. Reference to Section 409A of the Code is to Section 409A of the Internal Revenue Code of 1986, as amended, and will also include any proposed, temporary or final regulations, or any other guidance, promulgated with respect to such Section by the U.S. Department of the Treasury or the Internal Revenue Service.
14.Employment Rights.
For purposes of this Agreement, the continuous employ of the Participant with the Corporation or a Subsidiary shall not be deemed interrupted, and the Participant shall not be deemed to have ceased to be an associate of the Corporation or any Subsidiary, by reason of the transfer of his or her employment among the Corporation and its Subsidiaries. This award is a voluntary, discretionary bonus being made on a one-time basis and it does not constitute a commitment to make any future awards. This award and any payments made hereunder will not be considered salary or other compensation for purposes of any severance pay or similar allowance, except as otherwise required by law. Nothing in this Agreement will give the Participant any right to continue employment with the Corporation or any Subsidiary, as the case may be, or interfere in any way with the right of the Corporation or a Subsidiary to terminate the employment of the Participant.
15.Data Protection.
Information about the Participant and the Participant’s participation in the Plan may be collected, recorded and held, used and disclosed for any purpose related to the administration of the Plan. The Participant understands that such processing of this information may need to be carried out by the Corporation and its Subsidiaries and by third party administrators whether such persons are located within the Participant’s country or elsewhere, including the United States of America. The Participant consents to the processing of information relating to the Participant and the Participant’s participation in the Plan in any one or more of the ways referred to above.
16.Amendments.
Any amendment to the Plan shall be deemed to be an amendment to this Agreement to the extent that the amendment is applicable hereto; provided, however, that no amendment shall adversely affect the rights of the Participant with respect to the Performance Shares without the Participant’s consent.

17.Plan and Capitalized Terms.
This Agreement is subject to the terms and conditions of the Plan. Capitalized terms used herein without definition shall have the meanings assigned to them in the Plan or on the Grant Detail Page (which is a part of this Agreement) as the context so requires.
18.Validity.
If any provision of this Agreement or the application of any provision hereof to any person or circumstances is held invalid, unenforceable or otherwise illegal, the remainder of this Agreement and the application of such provision to any other person or under any circumstances shall not be affected, and the provisions so held to be invalid, unenforceable or otherwise illegal shall be reformed to the extent (and only to the extent) necessary to make it enforceable, valid and legal.
19.Governing Law.
This Agreement is made under, and shall be construed in accordance with the internal substantive laws of the State of Ohio.

[Balance of this page intentionally left blank]

Executed as of the _______________.

	
		
	 
	DIEBOLD NIXDORF, INCORPORATED

	 
	 

The undersigned hereby acknowledges receipt of an executed original of this Agreement and accepts the Performance Shares granted hereunder on the terms and conditions set forth herein and in the Plan.

	
		
	 
	 

	Date:
	 

	 
	Participant

Source: [{"source": "alea-institute/alea-institute/kl3m-data-edgar-agreements/train-00266-of-00352.parquet"}, [{"source": "alea-institute/alea-institute/kl3m-data-edgar-agreements/train-00266-of-00352.parquet"}]]