Document:

EX-10.26.24

 Exhibit 10.26.24 
 

 
 PERFORMANCE SHARE PROGRAM 

FEBRUARY 16, 2016 
 TARGET
AWARD FOR PERFORMANCE PERIOD XIV 
 PERFORMANCE SHARE UNIT 

AWARD TERMS AND CONDITIONS 
 FOR
ELIGIBLE EMPLOYEES ON THE CANADA PAYROLL 
 These Performance Share Unit Award Terms and Conditions describe terms and conditions of Performance Share
Unit Awards, as part of the ConocoPhillips Performance Share Program (Program), granted under the 2014 Omnibus Stock and Performance Incentive Plan of ConocoPhillips (referred to as the Plan) by ConocoPhillips (Company) to you as an eligible
employee (Employee). These Terms and Conditions, together with the Award Summary given to each Employee receiving an Award, form the Award Agreement (the Agreement) relating to the Awards described. Subject to the Plan and this Agreement, the
Company grants to the Employee Performance Share Units. Individual awards will be as set forth in the Award Summary given to each Employee to whom an Award is granted. The Award Summary for each Employee is made a part of this Agreement with regard
to such Employee. The Award Summary may be modified at any time to reflect increased or decreased amounts of the Award due to promotion or demotion of the Employee and due to decisions made with regard to this Performance Period XIV of the Program,
including adjustments related to the performance of the Company and adjustments related to the performance of the Employee; provided, however, that after a Change of Control occurs, there shall be no decrease in the number of PSUs granted, except
pursuant to the section titled “Detrimental Activities” below. Multiple book entry accounts may be used to reflect the total shares awarded under these Terms and Conditions. This and any other administrative activities shall not be
construed to alter these Terms and Conditions. 
  

	AWARD:	 Performance Share Unit (PSU) Award granted by the Authorized Party under the provisions of the Plan. The PSUs will be noted in a book entry account
created for the Employee. 

  

	PSU:	 A unit evidencing the right to receive either one share of ConocoPhillips Stock, $0.01 par value, or the Fair Market Value thereof under the
circumstances described in these Terms and Conditions. 

 VOTING RIGHTS: The named owner of
the PSUs has no voting rights for the units, but is considered the beneficial owner for all purposes including ownership and control reports such as the annual proxy statement. 

DIVIDEND EQUIVALENTS: Dividend equivalent payment, equal to the regular dividend payment as declared by the Board of
Directors on an equivalent number of common stock from time to time, will be made to the named owner of the units beginning after 2018. No such dividend equivalent payments shall be made prior to 2019, nor shall such dividend

  
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equivalent payments accrue or be owed with regard to any time prior to 2019. Under current tax law, these payments are taxable as compensation in the year distributed. 

RETIREMENT PLAN EARNINGS: The issuance of these PSUs does not constitute earnings under any retirement plan
sponsored by a ConocoPhillips company. The value of the units at the time restrictions lapse also does not constitute earnings under any retirement plan sponsored by a ConocoPhillips company. Neither the issuance of nor lapsing of restrictions on
PSUs will have any impact on any retirement plans or any other compensation plan sponsored by a ConocoPhillips company. 

TAX INFORMATION: For an Employee subject to U.S. tax laws, this matter is more thoroughly covered in the document
entitled “Tax Aspects of Performance Share Units.” Other Employees should consult their tax advisors. However, in general terms, under current tax law, the value of these units is not considered taxable income until the restrictions lapse.

 BENEFICIARY: In the event of the death of the named owner of these units prior to the lapsing of restrictions
for other reasons, such restrictions will lapse and shares of unrestricted common stock equal in number to the PSUs will be issued to the beneficiary designated by the named owner of the units. 

CHANGE OF CONTROL: Upon a Change of Control, the following shall apply to the PSUs: 

	 	1.	 Each Employee shall immediately become fully vested in such PSUs that are not assumed, or substituted for, by the an acquirer in connection with
the Change of Control, and such PSUs shall not thereafter be forfeitable for any reason, except as set forth in the section titled “Detrimental Activities” below. 

	 	2.	 With regard to any other PSUs, each Employee shall become fully vested in such PSUs upon incurring a Severance following such Change of Control,
and such PSUs shall not thereafter be forfeitable for any reason, except as set forth in the section titled “Detrimental Activities” below. 

	 	3.	 In the event of vesting of PSUs pursuant to either paragraph 1 or 2 above, all restrictions and other limitations applicable to the PSUs shall
lapse and the PSUs shall be settled in unrestricted Stock or cash at the same times and upon the same events as it would otherwise have been made in accordance with the settlement provisions below. 

RESTRICTIONS: The following restrictions relate to the PSUs: 

The PSUs will be held in escrow for the Employee. As provided herein, the Employee will have all rights of economic ownership
to such unit including the right to receive dividend equivalents, except that the Employee shall not have the right to sell, transfer, assign, or otherwise dispose of such units until the escrow is terminated (such restrictions being known as the
“Transfer Restrictions”). 
 Unless postponed pursuant to an effective election, as described in the sections
titled “Initial Election” and “Subsequent Election” below, the escrow shall end on the earliest of any of the following occurrences, with Transfer Restrictions to lapse and settlement be made as set forth in the section titled
“Settlement” below: 

  
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	 	1.	 The Termination of the Employee’s employment as a result of Layoff of the Employee; 

	 	2.	 The Termination of the Employee’s employment after attainment of age 55 and completion of 5 years of service with the Company or its
subsidiaries; 

	 	3.	 The Termination of the Employee’s employment due to death; 

	 	4.	 The Termination of the Employee’s employment following Disability of the Employee; 

	 	5.	 The Termination of the Employee’s employment following a Change of Control; or 

	 	6.	 February 19, 2019. 

In the absence of an effective election, as described in the sections titled “Initial Election” and
“Subsequent Election” below, the Transfer Restrictions shall lapse and the PSUs (including any such that are awarded after the Separation from Service of the Employee) shall be settled in unrestricted Stock on the date that is the later of
(a) the end of the escrow period and (b) the earliest of the Employee’s death, February 19, 2019, or six months after the date of the Employee’s Separation from Service for a reason other than death; provided, however, that
settlement shall not be made before February 19, 2019. 
 INITIAL ELECTION: The Employee may elect on an
election form delivered to the Plan Administrator at a time set by the Plan Administrator (which shall be on or before December 31, 2015) to have the escrow for the PSUs continue and the Transfer Restrictions applicable to these PSUs continue
and settlement in unrestricted Stock postponed and made in either: 
  

	 	1.	 one lump sum payment settled six months after Separation from Service with the Company and its subsidiaries, or 

	 	2.	 in a series of annual installments, using a declining balance method, over a period of three, five, ten, or fifteen years after Separation from
Service with the Company and its subsidiaries. 

 In the absence of such an election, the escrow will end
and settlement shall be made in one lump sum payment in unrestricted Stock at the time set forth in the section titled “Restrictions” above. 

SUBSEQUENT ELECTION: The Employee may make an election to change the time or form of payment elected under the
Initial Election section above or the payment to be made under the Restrictions section above, but only if the following rules are satisfied: 

	 	1.	 The election to change the time or form of payment may not take effect until at least twelve months after the date on which such election is made;

	 	2.	 Payment under such election may not be made earlier than at least five years from the date the payment would have otherwise been made or commenced;

	 	3.	 An election may provide for either a lump sum payment or installment payments; 

	 	4.	 An election to receive payments in installments shall be treated as a single payment for purposes of these rules; 

	 	5.	 Installment payments may be made only annually, over a period of from one to fifteen years as elected; 

  
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	 	6.	 The election may not result in an impermissible acceleration of payment prohibited under section 409A of the Internal Revenue Code;

	 	7.	 No more than four such elections shall be permitted with respect to the PSUs subject to this Award; and 

	 	8.	 No payment may be made after the date that is twenty (20) years after the date of the Employee’s Separation from Service.

 If an election under this section becomes effective, the escrow and the Transfer Restrictions
applicable to the PSUs shall continue until the time set in the election for the settlement of the PSUs in as unrestricted Stock. 

SETTLEMENT: The Company shall, at the time stated above, register in the name of the Employee shares of Stock, free
of any restriction, equal to the number of the PSUs, and the related PSUs shall be canceled. In all cases the Employee will be responsible to pay all required withholding taxes associated with the Award. The Employee must pay any required
withholding taxes by having shares equal in value to the applicable withholding taxes withheld by the Company (or such other method as the Company, in its sole discretion, allows). The value of the shares withheld for this purpose shall be an amount
consistent with the applicable laws and regulations. With regard to any fractional shares of Stock that might arise, the Company may deliver to the Employee cash equal to the Fair Market Value of such fractional shares. If Australian tax law applies
to the Employee, then an Award is a scheme to which Subdivision 83A-C of the Income Tax Assessment Act 1997 of Australia applies (subject to the conditions in that Act). 

The Fair Market Value of the Award received by the Employee shall be determined in accordance with the definition and
principles set forth in the Plan. 
 FORFEITURE: An Employee’s right, title, and interest in Performance
Share Units awarded under the PSP or derived from such Performance Share Units, or the ownership thereof, shall be forfeited if the Employee terminates employment prior to termination of the escrow period; provided, however, any transfer between the
Company and any Subsidiary, or between Subsidiaries at the request of the Company or such Subsidiaries, shall not result in forfeiture. 

DETRIMENTAL ACTIVITIES: If the Authorized Party determines that, subsequent to the grant of any Award but prior to
any Change of Control, the Employee has engaged or is engaging in any activity which, in the sole judgment of the Authorized Party, is or may be detrimental to the Company or a subsidiary, the Authorized Party may cancel all or part of the PSUs held
in escrow pursuant to the Award granted to that Employee. Upon any Change of Control, the Authorized Party may cancel all or part of the PSUs held in escrow pursuant to the Award granted to that Employee only upon a determination by the Authorized
Party that the Employee has given the Company Cause for such cancellation. 
 If the Authorized Party, in its or his sole
discretion, determines that the lapsing of restrictions on PSUs held in escrow pursuant to any Award has the possibility of violating any law, regulation, or decree pertaining to the Company, any of its subsidiaries, or the Employee, the Authorized
Party may freeze or suspend the Employee’s right to settlement or payout of the Award until such time as the lapse of restrictions would no 

  
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longer, in the sole discretion of the Authorized Party, have the possibility of violating such law, regulation, or decree. 

Notwithstanding anything herein to the contrary, this Award is subject to forfeiture or recoupment, in whole or in part,
under applicable law, including the Sarbanes-Oxley Act and the Dodd-Frank Act. 
 RECAPITALIZATION: Upon any
change in the outstanding stock of the Company by reason of any stock dividend, stock split, reverse stock split, recapitalization, reclassification, or other similar change, the Committee shall make corresponding adjustments to the PSUs. 

  
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 DEFINITIONS: 

Capitalized terms not defined below shall have the meanings set forth in the Plan under which the Award is granted. 

“Authorized Party” means the person who is authorized to approve an Award, exercise discretion, or take
action under the Administrative Procedure for the Performance Share Program and pursuant to the Program. With regard to Senior Officers, the Committee is the Authorized Party. With regard to other Employees, the Chief Executive Officer, acting as
the Special Equity Award Committee of the Board of Directors of the Company, is the Authorized Party, although the Committee may act concurrently as the Authorized Party. 

“Award” means any Performance Share Units granted to an Employee pursuant to such applicable terms, conditions, and
limitations as the Authorized Party may establish in order to fulfill the objectives of the Program. 
 “Cause”
means “Cause” as that term is defined in the Key Employee Change in Control Severance Plan of ConocoPhillips applied as if an Employee were a participant under such plan. 

“Change of Control” has the meaning set forth in Annex A to these Terms and Conditions. 

“Committee” means the Human Resources and Compensation Committee of the Board of Directors of the Company, or any
successor committee to it. 
 “Company” means ConocoPhillips, a Delaware corporation. 

“Disability” means a disability for which the employee in question has been determined to be entitled to either
(i) benefits under the applicable plan of long-term disability of the Company or its subsidiaries or (ii) disability benefits under the Social Security Act. In the absence of any such determination, the Authorized Party may make a
determination that the employee has a Disability. 
 “Fair Market Value” means, as of a particular date, the mean
between the highest and lowest sales price per share of such Stock on the consolidated transaction reporting system for the principal national securities exchange on which shares of Stock are listed on that date, or, if there shall have been no such
sale so reported on that date, on the next preceding date on which such a sale was so reported, or, at the discretion of the Committee, the price prevailing on the exchange at a designated time. 

“Good Reason” means “Good Reason” as that term is defined in the Key Employee Change in
Control Severance Plan of ConocoPhillips applied as if an Employee were a participant under such plan. 
 “Grant
Price” means the Fair Market Value for one share of Stock as of the date of the grant of an Award. Grant price is not adjusted for any restrictions applicable to the Award. 

“Key Employee Change in Control Severance Plan of ConocoPhillips” means the plan of that name (or a successor plan to
the plan of that name) in effect on an applicable Change of Control. If no plan of that name (or successor plan to the plan of that name) is in effect on an applicable Change of Control, it shall mean instead the plan of that name in effect on the
date of the Award. 

  
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 “Layoff” means an applicable Termination of Employment due
to layoff under the ConocoPhillips Severance Pay Plan, the ConocoPhillips Executive Severance Plan, or the ConocoPhillips Key Employee Change in Control Severance Plan, or layoff or redundancy under any similar layoff or redundancy plan which the
Company or its subsidiaries may adopt from time to time. If all or any portion of the benefits under the redundancy or layoff plan are contingent on the employee’s signing a general release of liability, such Termination shall not be considered
as a “Layoff” for purposes of this Award unless the employee executes and does not revoke a general release of liability, acceptable to the Company, under the terms of such layoff or redundancy plan. In order to be considered a layoff for
purposes of this Award, the Termination of Employment must also be considered a Separation from Service. 
 “Participating
Company” includes ConocoPhillips and its 100% owned subsidiaries, including both those directly owned and those owned through subsidiaries, whose participation has been approved by the Authorized Party. 

“Performance Share Unit” or “PSU” means the type of restricted stock unit issued under the
Performance Share Program (as determined by the Authorized Party) that is subject to forfeiture provisions or that has certain restrictions attached to the ownership thereof. 

“Restricted Stock Unit” means a unit equal to one share of Stock (as determined by the Authorized Party)
that is subject to forfeiture provisions or that has certain restrictions attached to the ownership thereof. 

“Retirement” means Termination at age 55 or older with a minimum of 5 years of service with a
Participating Company; provided, however, that with regard to an Employee not on the United States payroll, the CEO may approve the use of a different definition. Service is defined by the policies of the Participating Company. 

“Senior Officer” means the Chairman of the Board, the CEO, all other executive officers of the Company
(determined in accordance with the Company’s custom and practice pursuant to section 16(b) of the Securities Exchange Act of 1934, as amended), all other employees of the Company who report directly to the CEO and whose salary grade is 23 or
higher, and all other employees of the Company whose salary grade is 26 or higher. 
 “Severance” means
“Severance” as that term is defined in the Key Employee Change in Control Severance Plan of ConocoPhillips applied as if an Employee were a participant under such plan, and shall also incorporate the meaning of the terms “Cause”
and “Good Reason” contained in the definition of “Severance” in such plan. 
 “Stock” means shares
of common stock of the Company, par value $.01. Stock may also be referred to as “Common Stock.” 

“Termination,” “Termination of Employment,” and “Separation from Service” each mean
“separation from service” as that term is used in section 409A of the Internal Revenue Code. 

  
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 Attachment “A” 

“Change of Control” 

The following definitions apply to the Change of Control provision in Section 10 of the Plan. 

“Affiliate” shall have the meaning ascribed to such term in Rule 12b-2
of the General Rules and Regulations under the Exchange Act, as in effect at the time of determination. 

“Associate” shall mean, with reference to any Person, (a) any corporation, firm, partnership, association,
unincorporated organization or other entity (other than the Company or a subsidiary of the Company) of which such Person is an officer or general partner (or officer or general partner of a general partner) or is, directly or indirectly, the
Beneficial Owner of 10% or more of any class of equity securities, (b) any trust or other estate in which such Person has a substantial beneficial interest or as to which such Person serves as trustee or in a similar fiduciary capacity and
(c) any relative or spouse of such Person, or any relative of such spouse, who has the same home as such Person. 

“Beneficial Owner” shall mean, with reference to any securities, any Person if: 

(a) such Person or any of such Person’s Affiliates and Associates, directly or indirectly, is the
“beneficial owner” of (as determined pursuant to Rule 13d-3 of the General Rules and Regulations under the Exchange Act, as in effect at the time of determination) such securities or otherwise
has the right to vote or dispose of such securities; 
 (b) such Person or any of such Person’s
Affiliates and Associates, directly or indirectly, has the right or obligation to acquire such securities (whether such right or obligation is exercisable or effective immediately or only after the passage of time or the occurrence of an event)
pursuant to any agreement, arrangement or understanding (whether or not in writing) or upon the exercise of conversion rights, exchange rights, other rights, warrants or options, or otherwise; provided, however, that a Person shall not be deemed the
Beneficial Owner of, or to “beneficially own,” (i) securities tendered pursuant to a tender or exchange offer made by such Person or any of such Person’s Affiliates or Associates until such tendered securities are accepted for
purchase or exchange or (ii) securities issuable upon exercise of Exempt Rights; or 
 (c) such Person
or any of such Person’s Affiliates or Associates (i) has any agreement, arrangement or understanding (whether or not in writing) with any other Person (or any Affiliate or Associate thereof) that beneficially owns such securities for the
purpose of acquiring, holding, voting (except as set forth in the proviso to subsection (a) of this definition) or disposing of such securities or (ii) is a member of a group (as that term is used in
Rule 13d-5(b) of the General Rules and Regulations under the Exchange Act) that includes any other Person that beneficially owns such securities; 

provided, however, that nothing in this definition shall cause a Person engaged in business as an underwriter of securities to be the Beneficial Owner of, or
to “beneficially own,” any securities acquired through such Person’s participation in good faith in a firm commitment underwriting until the expiration of 40 days after the date of such acquisition. For purposes hereof,
“voting” a security shall include voting, granting a proxy, consenting or making a request or demand relating to corporate action (including, without limitation, a demand for a shareholder list, to call

  
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a shareholder meeting or to inspect corporate books and records) or otherwise giving an authorization (within the meaning of section 14(a) of the Exchange Act) in respect of such security.

 The terms “beneficially own” and “beneficially owning” shall have meanings that are correlative to
this definition of the term “Beneficial Owner.” 
 “Board” shall have the meaning set forth in the
Plan. 
 “Change of Control” shall mean any of the following occurring on or after January 1, 2016: 

(a) any Person (other than an Exempt Person) shall become the Beneficial Owner of 20% or more of the shares of
Common Stock then outstanding or 20% or more of the combined voting power of the Voting Stock of the Company then outstanding; provided, however, that no Change of Control shall be deemed to occur for purposes of this subsection (a) if such
Person shall become a Beneficial Owner of 20% or more of the shares of Common Stock then outstanding or 20% or more of the combined voting power of the Voting Stock of the Company then outstanding solely as a result of (i) any acquisition
directly from the Company or (ii) any acquisition by a Person pursuant to a transaction that complies with clauses (i), (ii), and (iii) of subsection (c) of this definition; 

(b) individuals who, as of January 1, 2016, constitute the Board (the “Incumbent Board”) cease
for any reason to constitute at least a majority of the Board; provided, however, that any individual becoming a director subsequent to January 1, 2016 whose election, or nomination for election by the Company’s shareholders, was approved
by a vote of at least a majority of the directors then comprising the Incumbent Board shall be considered as though such individual were a member of the Incumbent Board; provided, further, that there shall be excluded, for this purpose, any such
individual whose initial assumption of office occurs as a result of any 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; 
 (c) the Company shall consummate a reorganization, merger, statutory share
exchange, consolidation, or similar transaction involving the Company or any of its subsidiaries or sale or other disposition of all or substantially all of the assets of the Company, or the acquisition of assets or securities of another entity by
the Company or any of its subsidiaries (a “Business Combination”), in each case, unless, following such Business Combination, (i) 50% or more of the then outstanding shares of common stock of the corporation, or common equity
securities of an entity other than a corporation, resulting from such Business Combination and the combined voting power of the then outstanding Voting Stock of such corporation or other entity are beneficially owned, directly or indirectly, by all
or substantially all of the Persons who were the Beneficial Owners of the outstanding Common Stock immediately prior to such Business Combination in substantially the same proportions as their ownership, immediately prior to such Business
Combination, of the outstanding Common Stock, (ii) no Person (excluding any Exempt Person or any Person beneficially owning, immediately prior to such Business Combination, directly or indirectly, 20% or more of the Common Stock then
outstanding or 20% or more of the combined voting power of the Voting Stock of the Company then outstanding) beneficially owns, directly or indirectly, 20% or more of the then outstanding shares of common stock of the

  
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corporation, or common equity securities of an entity other than a corporation, resulting from such Business Combination or the combined voting power of the then outstanding Voting Stock of such
corporation or other entity, and (iii) at least a majority of the members of the board of directors of the corporation, or the body which is most analogous to the board of directors of a corporation if not a corporation, resulting from such
Business Combination were members of the Incumbent Board at the time of the initial agreement or initial action by the Board providing for such Business Combination; or 

(d) the shareholders of the Company shall approve a complete liquidation or dissolution of the Company unless
such liquidation or dissolution is approved as part of a transaction that complies with clauses (i), (ii), and (iii) of subsection (c) of this definition. 

“Common Stock” shall have the meaning set forth in the Plan. 

“Company” shall have the meaning set forth in the Plan. 

“Exchange Act” shall mean the Securities Exchange Act of 1934, as amended. 

“Exempt Person” shall mean any of the Company, any entity controlled by the Company, any employee benefit plan (or
related trust) sponsored or maintained by the Company or any entity controlled by the Company, and any Person organized, appointed, or established by the Company for or pursuant to the terms of any such employee benefit plan. 

“Exempt Rights” shall mean any rights to purchase shares of Common Stock or other Voting Stock of the Company if at
the time of the issuance thereof such rights are not separable from such Common Stock or other Voting Stock (i.e., are not transferable otherwise than in connection with a transfer of the underlying Common Stock or other Voting Stock), except
upon the occurrence of a contingency, whether such rights exist as of January 1, 2016 or are thereafter issued by the Company as a dividend on shares of Common Stock or other Voting Securities or otherwise. 

“Person” shall mean any individual, firm, corporation, partnership, association, trust, unincorporated
organization, or other entity. 
 “Voting Stock” shall mean, (1) with respect to a corporation, all
securities of such corporation of any class or series that are entitled to vote generally in the election of, or to appoint by contract, directors of such corporation (excluding any class or series that would be entitled so to vote by reason of the
occurrence of any contingency, so long as such contingency has not occurred) and (ii) with respect to an entity which is not a corporation, all securities of any class or series that are entitled to vote generally in the election of, or to
appoint by contract, members of the body which is most analogous to the board of directors of a corporation. 

  
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Policyholder: Accident Benefits for Motorola Solutions, Inc.

Policy Number: ADD N04156870

Term of Coverage: January 1, 2016 to January 1, 2017

You are a Covered Person and eligible for coverage under the plan, if you are in the eligible class defined below. For benefits to be payable the Policy must be in force, the required premium must be paid and you must be engaging in one of the Covered Activities described below. If you are not in Active Service on the date your insurance would otherwise be effective, it will go into effect on the date you return to Active Service.

Class Description:       All Non-employee Directors of the Policyholder.

Your Dependents (your lawful spouse and unmarried children, subject to the age limits shown in the Policy) are also covered, if they are traveling with you.

Period of Coverage: You will be insured on the later of the Policy Effective Date or the date that you become eligible. Your coverage will end on the earliest of the date: 1) the Policy terminates; 2) you are no longer eligible; or 3) the period ends for which the required premium is paid. Dependents coverage will end on the earliest of the date: 1) he or she is no longer a Dependent; 2) your coverage ends; or 3) the period ends for which the required premium is paid.

Covered Activities

Exposure & Disappearance - Coverage includes exposure to the elements after the forced landing, stranding, sinking, or wrecking of a vehicle in which you were traveling. You are presumed dead if you are in a vehicle that disappears, sinks, or is stranded or wrecked on a trip covered by this Policy; and the body is not found within one year of the Covered Accident.

24-Hour Coverage - We will pay the benefits described in the Policy when you suffer a Covered Accident any time while insured by the Policy. Unless otherwise specified, We will pay benefits only once for a Covered Accident.

Felonious Assault - The Covered Accident must: 1) take place on the Policyholder’s premises; 2) be in the course of your job; and, 3) be caused by or result directly and independently from a Felonious Assault, as defined below.  The assault must be inflicted by a person other than another person covered by the Policy, your Immediate Family Member, or Household Member. A police report detailing the Felonious Assault must be provided.

The Covered Accident must occur during any of the following: 1) actual or attempted robbery or holdup; or 2) actual or attempted kidnapping; or 3) any other type of intentional assault that is a crime classified as a felony by the governing statute or common law in the state where the assault occurred. “Felonious Assault” means a criminal act or an act of physical violence against a person covered by this Policy. “Immediate Family Member” means your parent, sister, brother, husband, wife, or children. “Household Member” means a person who maintains residence at the same address as you.

Hijacking and Air Piracy - The Covered Accident must: 1) take place during the: a) hijacking of an Aircraft; b) air piracy; or c) unlawful seizure or attempted seizure of an Aircraft; and 2) take place while you are in the course of the Policyholder’s business.  Coverage begins with the onset of the hijacking or air piracy and continues while you are subject to the control of the  person  or  persons  responsible for  the  hijacking/air piracy  and  during  travel  directly to  your  home  or  scheduled destinations.  “Hijacking” or “Air Piracy,” as used here, means the unlawful seizure or wrongful exercise of control of an aircraft or conveyance, or the crew thereof, in which you are traveling solely as a passenger.

Owned, Leased, or Controlled Aircraft - The Covered Accident must take place while: 1) you are riding in, or getting on or off of, a covered aircraft; or 2) as a result of you being struck by a covered aircraft. 3) away from the Policyholder's premises in your city of permanent assignment; 4) on business for the Policyholder; and 5) in the course of the Policyholder's business.

CL2                                                                                                                                                                              Page 1
EXHIBIT

This coverage will start at the actual start of the trip. It does not matter whether the trip starts at your home, place of work, or other place. It will end on the first of the following dates to occur: 1) the date you return to your home; 2) the date you return to your place of work; or 3) the date your Personal Deviation is more than 14 day(s).  “Personal Deviation” means: 1) an activity that is not reasonably related to the Policyholder's business; and 2) not incidental to the purpose of the trip. An aircraft will be deemed “controlled” by the Policyholder if the Policyholder may use it for more than 10 straight days, or more than 15 days in any year.

Aircraft Restrictions - If the Covered Accident happens while you are riding in, or getting on or off of, an aircraft, We will pay benefits, but only if: 1) you are riding as a passenger only, and not as a pilot or member of the crew (except as provided by the Policy); and 2) the aircraft has a valid certificate of airworthiness; and 3) the aircraft is flown by a pilot with a valid license; and   4) the aircraft is not being used for: (i) crop dusting, spraying, or seeding; firefighting; skywriting; skydiving or hang gliding; pipeline or power line inspection; aerial photography or exploration; racing, endurance tests, stunt or acrobatic flying; or (ii) any operation which requires a special permit from the FAA, even if it is granted (this does not apply if the permit is required only because of the territory flown over or landed on). 5) the aircraft is a military transport aircraft flown by the U.S. Military Airlift Command (MAC), or similar air transport service of another country.

Relocation - The Covered Accident must take place while you are traveling on a Relocation Trip at the expense and direction of the Policyholder. “Relocation Trip” means a trip in connection with your transfer or proposed transfer by the Policyholder to a new worksite.

This coverage will start at the actual start of the trip. It does not matter whether the trip starts at your home, place of work, or other place. It will end on the first of the following dates to occur: 1) the date you return to your home; 2) the date you return to your place of work; or 3) the date your Personal Deviation is more than 14 day(s).  “Personal Deviation” means: 1) an activity that is not reasonably related to the Policyholder’s business; and 2) not incidental to the purpose of the trip.

Terrorism - The Covered Accident must: 1) take place while you are on the Policyholder’s premises, or in the course of a) the Policyholder’s business and/or b) your job; and, 2) be caused by or results directly and independently from Terrorism or Terrorist Act, as defined below.

“Terrorism or Terrorist Acts” means an activity that: 1) involves any violent act or any act dangerous to human life and that threatens or causes Injury to persons; and 2) appears to be in any way intended to: a) intimidate or coerce a civilian population; or b) disrupt any segment of a nation's economy; or c) influence the policy of a government by intimidation or coercion; or d) affect the conduct of a government by mass destruction, assassination, kidnapping, or hostage taking; or e) respond to governmental action or policy. It includes any incident declared to be an act of terrorism by an official, department, or agency that has been specifically authorized by federal statute to make such a determination. It shall also include the use of any nuclear weapon or device or the emission, discharge, dispersal, release, or escape of any solid liquid or gaseous chemical or biological agent.

Description of Benefits

Aggregate Limit - We will not pay more than per Covered Accident: $15,000,000; for all losses.  If, in the absence of this provision, We would pay more than this amount for all losses under the policy, then the benefits payable to each person with a valid claim will be reduced proportionately.

Accidental Death and Dismemberment Benefits - If your Injury results, within 365 days from the date of a Covered Accident, in any one of the losses shown below, We will pay the Benefit Amount shown below for that loss.  Your Principal Sum is $500,000.  Your spouse’s Principal Sum is $50,000.  Your child’s Principal Sum is $25,000.  If multiple losses occur, only one Benefit Amount, the largest, will be paid for all losses due to the same Covered Accident.

Schedule of Covered Losses
Covered Loss                                                                                                                      Benefit Amount

Life ........................................................................................................................ 100% of the Principal Sum Two or more Members.......................................................................................... 100% of the Principal Sum Quadriplegia.......................................................................................................... 100% of the Principal Sum One Member ........................................................................................................... 50% of the Principal Sum Hemiplegia .............................................................................................................. 75% of the Principal Sum Paraplegia ............................................................................................................... 75% of the Principal Sum

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Thumb and Index Finger of the Same Hand .......................................................... 25% of the Principal Sum

“Quadriplegia” means total Paralysis of both upper and lower limbs.  “Hemiplegia” means total Paralysis of the upper and lower limbs on one side of the body.  “Paraplegia” means total Paralysis of both lower limbs or both upper limbs.  “Paralysis” means total loss of use.  A Doctor must determine the loss of use to be complete and not reversible at the time the claim is submitted.

“Member” means Loss of Hand or Foot, Loss of Sight, Loss of Speech and Loss of Hearing.  “Loss of Hand or Foot” means complete Severance through or above the wrist or ankle joint.  “Loss of Sight” means the total, permanent Loss of Sight of one eye. “Loss of Speech” means total and permanent loss of audible communication that is irrecoverable by natural, surgical or artificial means.  “Loss of Hearing” means total and permanent Loss of Hearing in both ears that is irrecoverable and cannot be corrected by any means. “Loss of a Thumb and Index Finger of the Same Hand” means complete Severance through or  above  the  metacarpophalangeal joints  of  the  same  hand  (the  joints  between the  fingers  and  the  hand). “Severance” means the complete separation and dismemberment of the part from the body.

Coma Benefit - We will pay 1% of the Principal Sum per month up to 11 months and thereafter in a lump sum of 100% of the Principal Sum if you become Comatose within 31 days of a Covered Accident and remain in a Coma for at least 31 days. We reserve the right, at the end of the first 31 days of Coma, to require proof that you remain Comatose. This proof may include, but is not limited to, requiring an independent medical examination at Our expense. Monthly payments will end on the first of the following dates: 1) the end of the month in which you die; 2) the end of the 11th month for which this benefit is payable; 3) the end of the month in which you recover from the Coma.

You are deemed “Comatose” or in a “Coma” if you are in a profound stupor or state of complete and total unconsciousness, as the result of a Covered Accident.

Disability Benefit (Partial Disability) - We will pay 1.5% of the lesser of Annual Salary or $1,000,000 for 50 weeks, if you are Partially Disabled as a direct result of, and from no other cause but, a Covered Accident.  Temporary Total Disability or Partial Disability must begin within 180 days from the date of your Covered Accident.  Disability Benefits will begin when: 1) the applicable Benefit Waiting Period of 7 days is satisfied; and 2) you provide satisfactory proof of Permanent Total Disability or Partially Disability to Us. Benefit Payments will end on the first of the following dates:  1) the date you die; or 2) the date you are no longer Partially Disabled; or 3) the date the Maximum Benefit Period of 365 days ends; or 4) the date you fail to submit satisfactory proof of continuing Partial Disability.

“Partial Disability” or “Partially Disabled” means you are able to work after a period for which Total Disability benefits are payable under the Policy, but are not: 1) able to perform all the material duties of your occupation; and 2) able to earn more than 60% in gross earnings per month.

Disability Benefit (Permanent Total Disability) (Does not apply to Dependents) - We will pay 100% of the Principal Sum if you are under age 70 and Permanently Totally Disabled as a direct result of, and from no other cause but, a Covered Accident.  Permanent Total Disability must begin within 365 days from the date of your Covered Accident.  Disability Benefits will begin when: 1) the applicable Benefit Waiting Period of 365 days is satisfied; and 2) you provide satisfactory proof of Permanent Total Disability to Us.

“Total Disability” or “Totally Disabled” means, due to an Injury from a Covered Accident, you: 1) if employed, cannot do any work for which you are, or may become, qualified by reason of education, experience or training; and 2) if not employed, cannot perform the normal and customary activities of a healthy person of like age and sex. “Permanent Total Disability” or “Permanently Totally Disabled” means you are Totally Disabled and are expected to remain so disabled, as certified by a Doctor, for the rest of your life. Permanent Total Disability must be the result of the same Covered Accident that caused the Total Disability.

Emergency Medical Benefits - We will pay up to $10,000 for Covered Expenses incurred for emergency medical services to treat you if you: 1) suffer a Medical Emergency during the course of a Trip; and 2) are traveling 100 miles or more away from your place of permanent residence. Covered Expenses include expenses for guarantee of payment to a medical provider, Hospital or treatment facility.  Benefits for these Covered Expenses will not be payable unless the charges incurred: 1) are Medically Necessary and do not exceed the charges for similar treatment, services or supplies in the locality where the expense is incurred; and 2) do not include charges that would not have been made if there were no insurance. Benefits will not be payable unless We authorize in writing, or by an authorized electronic or telephonic means, all expenses in advance, and services are rendered by Our assistance provider.

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Emergency Medical Evacuation Benefit - We will pay 100% of Covered Expenses incurred for your medical evacuation if you: 1) suffer a Medical Emergency during the course of the Trip; 2) require Emergency Medical Evacuation; and 3) are traveling 100 miles or more away from your place of permanent residence.   Covered Expenses; 1) Medical Transport: expenses for transportation under medical supervision to a different hospital, treatment facility or to your place of residence for Medically Necessary treatment in the event of your Medical Emergency and upon the request of the Doctor designated by Our assistance provider in consultation with the local attending Doctor.  2) Dispatch of a Doctor or Specialist: the Doctor’s or specialist’s travel expenses and the medical services provided on location, if, based on the information available, your condition cannot be adequately assessed to evaluate the need for transport or evacuation and a doctor or specialist is dispatched by Our service provider to your location to make the assessment.  3) Return of Dependent Child(ren): expenses to return each Dependent child who is under age 18 to his or her principal residence if a) you are age 18 or older; and b) you are the only person traveling with the minor Dependent child(ren); and c) you suffer a Medical Emergency and must be confined in a Hospital.  4) Escort Services: expenses for an Immediate Family Member or companion who is traveling with you to join you during your emergency medical evacuation to a different hospital, treatment facility or your place of residence.

Benefits for these Covered Expenses will not be payable unless: 1) the Doctor ordering the Emergency Medical Evacuation certifies the severity of your Medical Emergency requires an Emergency Medical Evacuation; 2) all transportation arrangements made for the Emergency Medical Evacuation are by the most direct and economical conveyance and route possible; 3) the charges incurred are Medically Necessary and do not exceed the Usual and Customary Charges for similar transportation, treatment, services or supplies in the locality where the expense is incurred; and 4) do not include charges that would not have been made if there were no insurance.

Benefits will not be payable unless We authorize in writing, or by an authorized electronic or telephonic means, all expenses in advance, and services are rendered by Our assistance provider.  In the event you refuse to be medically evacuated, we will not be liable for any medical expenses incurred after the date medical evacuation is recommended.

Rehabilitation Benefit - We will pay $50,000 if you suffer an Accidental Dismemberment covered under the Policy and you are participating in a Rehabilitation Program that is prescribed by a Doctor.  Benefits are payable for:  1) the facility providing the Rehabilitation Program in which you are participating; and 2) Immediate Family Members who incur expenses for travel to and from the location at which you are participating in a Rehabilitation Program provided actual receipts are submitted with the claim.

Benefits will end when the first of the following events occur: 1) the date you complete the Rehabilitation Program; and 2) the date you die.

“Immediate Family Member” means your parent, grandparent, spouse, child, brother, sister, or in-laws.   “Rehabilitation Program”  means  a  specialized,  intensive  program  for  rehabilitation  or  assimilation  at  an  accredited  medical  facility specializing in research, surgery, and training of persons with Accidental Dismemberment Covered Losses as outlined in the Schedule of Covered Losses.

Repatriation of Remains Benefit - We will pay 100% of Covered Expenses for preparation and return of your body to your home if you die as a result of a Medical Emergency while traveling 100 miles or more away from your place of permanent residence.  Covered expenses include: 1) expenses for embalming or cremation;  2) the least costly coffin or receptacle adequate for transporting the remains; 3) transporting the remains; and 4) Escort Services which include expenses for an Immediate Family Member or companion who is traveling with you to join your body during the repatriation to your place of residence.

All transportation arrangements must be made by the most direct and economical route and conveyance possible and may not exceed the Usual and Customary Charges for similar transportation in the locality where the expense is incurred. Benefits will not be payable unless We authorize in writing, or by an authorized electronic or telephonic means, all expenses in advance, and services are rendered by Our assistance provider.

Seatbelt and Airbag Benefit - We will pay $25,000 when you die or are dismembered from Injuries sustained while wearing a seatbelt and operating or riding as a passenger in an Automobile.  An additional $10,000 if you were also positioned in a seat protected by a properly-functioning and properly deployed Supplemental Restraint System (Airbag).   Verification of proper use of the seatbelt at the time of the Covered Accident and that the Supplemental Restraint System properly inflated upon impact must be a part of an official police report of the Covered Accident or be certified, in writing, by the investigating officer(s) and submitted with your claim to Us. If such certification or police report is not available or it is unclear whether you

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were wearing a seatbelt or positioned in a seat protected by a properly functioning and properly deployed Supplemental
Restraint System, We will pay $1,000 to your beneficiary.

In the case of a child, seatbelt means a child restraint, as required by state law and approved by the National Highway Traffic Safety Administration, properly secured and being used as recommended by its manufacturer for children of like age and weight at the time of the Covered Accident.  "Supplemental Restraint System" means an airbag that inflates upon impact for added protection to the head and chest areas.  "Automobile" means a self-propelled, private passenger motor vehicle with four or more wheels that is a type both designed and required to be licensed for use on the highway of any state or country. Automobile includes, but is not limited to, a sedan, station wagon, sport utility vehicle, or a motor vehicle of the pickup, van, camper, or motor-home type. Automobile does not include a mobile home or any motor vehicle that is used in mass or public transit.

Special Adaptation Benefit - We will pay 10% of the Principal Sum up to $10,000, if you suffer a “Presumptive Disability” and require a special housing adaptation or a special Vehicle to accommodate the disability. Benefits will not be payable unless your Doctor certifies them as necessary.  “Presumptive Disability” means We will presume you are Totally Disabled if you suffer the complete and irrecoverable loss of sight of both eyes, speech, hearing in both ears, or of any two limbs, hands or feet, provided the loss occurs within one year of the Covered Accident.  “Vehicle” means a private passenger land motor vehicle.   It includes automobiles, vans, and four wheel drive vehicles. It does not include a vehicle used for farming, commercial business, racing or any type of competitive speed event.

Special Counseling Benefit - We will pay $100 per session for up to 10 counseling sessions for mental health counseling to assist you in dealing with a Covered Loss, if you suffer a Covered Loss for which benefits are payable; and obtain mental health counseling. The Maximum Amount for this benefit is $1,000 per Covered Loss.

Exclusions and Limitations: We will not pay benefits for any loss or Injury that is caused by, or results from:
•    intentionally self-inflicted Injury.
•    suicide or attempted suicide.
•    war or any act of war, whether declared or not (except as provided by the Policy).
		
	•
	a Covered Accident that occurs while on active duty service in the military, naval or air force of  any country or international organization. Upon Our receipt of proof of service, We will refund any premium paid for this time. Reserve or National Guard active duty training is not excluded unless it extends beyond 31 days.

		
	•
	sickness, disease, bodily or mental infirmity, bacterial or viral infection, or medical or surgical treatment thereof, except for any bacterial infection resulting from an accidental external cut or wound or accidental ingestion of contaminated food.

This insurance does not apply to the extent that trade or economic sanctions or regulations prohibit Us from providing insurance, including, but not limited to, the payment of claims.

War Risk Coverage:  We will pay benefits for Covered Losses due to Covered Accidents resulting from war or acts of war anywhere in the world, except the following countries:
•         the United States
•         The Covered Person’s Home Country
•         The Covered Person’s Country of Permanent Assignment

The war exclusion is deleted to the extent coverage is provide by the terms and conditions of War Risk Coverage.

“Home Country” means a country from which you hold a passport. If you hold passports from more than one Country, your Home Country will be the country that you declared to Us in writing as your Home Country.

“Country of Permanent Assignment” means a country, other than your Home Country, in which the Policyholder requires you to work for a period of time that exceeds 180 continuous days.

We will not pay more than $15,000,000 per occurrence for war risk benefits.  This limit shall apply to Injuries sustained from all acts of war in a consecutive 72-hour period.  If but for this limit We would pay more than $15,000,000, then the benefits We will pay to each Covered Person will be reduced in the same proportion, so that the total amount We will pay for war risk coverage is $15,000,000.

Definitions: “Covered Accident” means an accident that occurs while coverage is in force for you and results directly of all other causes in a loss or Injury covered by the Policy for which benefits are payable. “Covered Person” means any eligible

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person for whom the required premium is paid. “Injury” means accidental bodily harm sustained by you that results directly from all other causes from a Covered Accident. All injuries sustained by one person in any one Covered Accident, including all related conditions and recurrent symptoms of these injuries, are considered a single Injury. “Medical Emergency” means a condition caused by an Injury or Sickness that manifests itself by symptoms of sufficient severity that a prudent lay person possessing an average knowledge of health and medicine would reasonably expect that failure to receive immediate medical attention would place the health of the person in serious jeopardy. “Sickness” means an illness, disease or condition that causes a loss for which you incur medical expenses while covered under this Policy.  All related conditions and recurrent symptoms of the same or similar condition will be considered one Sickness. “Trip” means travel by air, land, or sea from your Home Country. “We, Our, Us” means the insurance company underwriting this insurance or its authorized agent.

You must notify ACE USA within 90 days of an Accident or Loss. If notice cannot be given within that time, it must be given as soon as reasonably possible. This notice should identify you, your employer, and the Policy Number.
Policy Number: ADD N04156870, Underwritten by ACE American Insurance Company, 436 Walnut Street, Philadelphia, PA
19106

Contact Information: For customer service, eligibility verification, plan information, or to file a claim, contact: ACE USA at 800-336-0627 (from inside the U.S.) or 302-476-6194 (from outside the U.S.); fax 302-467-6154 for claims or inquiries or e-mail diane.basa@acegroup.com. Mail claims to: ACE USA, PO Box 15417, Wilmington, DE 19850. For medical evacuation, repatriation, or other assistance services call: Europ Assistance at 800-243-6124 (inside the U.S.) or call collect 202-659-7803 (from outside the U.S.) or e-mail OPS@europassistance-usa.com.

To  access  ACE’s Travel  Assistance Website go  to  www.acetravelassistance.com and  enter  your user ID  and password (shown on your Travel Assistance ID card).

Travel Assistance Services: In addition to the insurance protection provided by this plan, ACE USA has arranged with
Europ Assistance USA to provide you with access to its travel assistance services around the world. These services include:
		
	•
	Medical Assistance including referral to a doctor or medical specialist, medical monitoring when you are hospitalized, emergency medical evacuation to an adequate facility, medically necessary repatriation, and return of mortal remains.

		
	•
	Personal Assistance including pre-trip medical referral information and while you are on a trip: emergency medication, embassy and consular information, lost document assistance, emergency referral to a lawyer, translator or interpreter access, medical benefits verification, and medical claims assistance.

		
	•
	Travel Assistance including emergency travel arrangements, arrangements for the return of your traveling companion or dependents, and vehicle return.

•    Access to a secure, web-based system for tracking global threats and health or location based risk intelligence.
		
	•
	Crisis hotline and on the ground security assistance to help address safety concerns or to secure immediate assistance while traveling.

When you call, please be prepared with the following information: 1) name of caller, phone number, fax number, and relationship to the Covered Person; 2) Covered Person’s name, age, sex, and the policy number for your insurance plan, and your Plan Number (01AH585); 3) a description of the insured’s condition; 4) name, location, and telephone number of the hospital or other service provider; and 5) other insurance information including health insurance, workers’ compensation, or auto insurance if the insured was involved in an accident.

This information provides you with a brief outline of the services available to you. These services are subject to the terms and conditions of the Policy under which you are insured. A third party vendor may provide services to you. Europ Assistance makes every effort to refer you to appropriate medical and other service providers. It is not responsible for the quality or results of service provided by independent providers. In all cases, the medical provider, facility, legal counsel, or other professional service provider suggested by Europ Assistance are not employees or agents of Europ Assistance and the choice of  provider is  yours alone. Europ Assistance assumes no liability for  the services provided to  you under this arrangement, nor is it liable for any negligence or other wrongful acts or omissions of any of the legal or health care professionals providing services to you. Travel assistance services are not available if your coverage under the Policy providing insurance benefits is not in effect.

This Description of Coverage is a brief description of the important features of the insurance plan. It is not a contract of insurance. The terms and conditions of coverage are set forth in the Policy issued to your employer. The Policy is subject to the laws of the state in which it was issued. Coverage may not be available in all states or certain terms or conditions may be different if required by state law. Please keep this information as a reference.

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