EMPLOYMENT AGREEMENT
THIS EMPLOYMENT AGREEMENT, made and entered into effective as of the first
day of January 2001 (the "EFFECTIVE DATE"), by and between Synagro Technologies,
Inc., a Delaware corporation (hereafter "COMPANY") and ▇▇▇▇▇▇▇ ▇. ▇▇▇▇▇▇
(hereafter "EXECUTIVE"), an individual;
W I T N E S S E T H:
- - - - - - - - - -
WHEREAS, Company wishes to secure the services of the Executive subject to
the terms and conditions hereafter set forth;
WHEREAS, the Executive is willing to enter into this Agreement upon the
terms and conditions hereafter set forth;
WHEREAS, GTCR Capital Partners, L.P., a Delaware limited partnership
("Capital Partners"), the Company and certain subsidiaries of the Company have
entered into a Senior Subordinated Loan Agreement dated January 27, 2000 (the
"Loan Agreement") pursuant to which, among other things, Capital Partners made a
loan to the Company on the date indicated and may make additional loans
hereafter from time to time in accordance with the terms thereof;
WHEREAS, GTCR FUND VII, L.P., a Delaware limited partnership ("Fund VII"
and together with Capital Partners, "GTCR") and the Company entered into a
Purchase Agreement on the date indicated (the "Purchase Agreement") pursuant to
which, among other things, Fund VII purchased the Company's convertible
preferred stock on the date indicated and may make additional purchases of
convertible preferred stock from time to time hereafter in accordance with the
terms thereof;
WHEREAS, the Company values Executive's contribution to Synagro's business
plan;
WHEREAS, Executive is currently employed under the Employment and
Confidentiality Agreement between Synagro of North Carolina - AMSCO, Inc. and
Executive dated April 30, 1999 (the "Prior Employment Contract");
WHEREAS, Executive and Company desire to replace the prior Employment
Contract, in its entirety, with this Agreement;
WHEREAS, GTCR, the Company and the Executive desire that any change of
control resulting from and the carrying out of the Loan Agreement and the
Purchase Agreement terms and the ownership and control granted to GTCR and its
affiliates thereunder shall not constitute a
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"change of control" for purposes of (1) any and all stock options for the
purchase of the Company's stock held by Executive and (2) for purposes of
Executive's Prior Employment Contract, this Agreement and any other agreement to
which the Executive is party which makes reference to a change of control of the
Company or its subsidiaries.
NOW, THEREFORE, in consideration of the mutual promises and agreements set
forth herein, the parties hereto agree as follows:
1. EMPLOYMENT. During the Employment Period (as defined in Section 4
hereof), the Company shall employ Executive, and Executive shall serve, as
President and Chief Operating Officer of the Operations Division of the Company.
Executive's principal place of employment shall be at the Company's principal
corporate offices in Houston, Texas during the Employment Period.
2. COMPENSATION. The Company shall pay or cause to be paid to Executive
during the Employment Period an annual base salary for his services under this
Agreement of not less than $175,000, payable in equal semi-monthly installments
in accordance with the Company's normal payroll procedures. Executive's base
salary shall be subject to annual review and may be increased, depending upon
the performance of the Company and Executive, upon the recommendation of the
Chairman or the Board of Directors of the Company (hereafter "BOARD OF
DIRECTORS"). Executive shall be entitled to participate in the bonus "pool" or
other structure established for the Company's top level of management which
currently provides for a bonus up to fifty-percent of base salary if the goals
set by the Board of Directors are satisfied. Nothing contained herein shall
preclude the payment of a bonus, supplemental or incentive compensation to
Executive provided that the Board of Directors authorizes any such compensation
payment. As additional compensation to Executive for the services previously
rendered by him, the services to be rendered by him pursuant to, and Executive's
other duties and obligations arising under this Agreement, including, without
limitation, his obligations under Sections 12 and 14 hereof, the Company has
granted to Executive options to purchase 320,000 shares of common stock of the
Company, par value $.002 per share, at a strike price equal to $2.50.
3. DUTIES AND RESPONSIBILITIES OF EXECUTIVE. During the Employment
Period, Executive shall devote his services full time to the business of the
Company and perform the duties and responsibilities assigned to him by the Chief
Executive Officer, ▇▇▇▇ ▇. ▇▇▇▇▇▇, or the Board of Directors to the best of his
ability and with reasonable diligence. In determining Executive's duties and
responsibilities, ▇▇▇▇ ▇. ▇▇▇▇▇▇ and the Board of Directors shall act in good
faith and shall not assign duties and responsibilities to Executive that are not
appropriate or customary with respect to the position of Executive hereunder.
This Section 3 shall not be construed as preventing Executive from engaging in
reasonable volunteer services for charitable, educational or civic
organizations, or from investing his assets in such form or manner as will not
require a material amount of his services in the operations of the companies or
businesses in which such investments are made.
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4. TERM OF EMPLOYMENT. Executive's term of employment with the Company
under this Agreement shall be for 24 consecutive months beginning on the
Effective Date and continuing thereafter so that the remaining term of
employment hereunder is always 24 months, unless Notice of Termination pursuant
to Section 7 is given by either the Company or Executive to the other party. The
Company and Executive shall each have the right to give Notice of Termination at
will, with or without cause, at any time, subject to the terms of this Agreement
regarding rights and duties of the parties upon termination of employment. This
"evergreen" 24-month employment period hereunder shall be referred to herein as
the "TERM OF EMPLOYMENT." The period from the Effective Date through the date of
Executive's termination of employment for whatever reason shall be referred to
herein as the "EMPLOYMENT PERIOD."
5. BENEFITS. Subject to the terms and conditions of this Agreement,
during the Employment Period, Executive shall be entitled to the following:
(a) REIMBURSEMENT OF EXPENSES. The Company shall pay or reimburse
Executive for all reasonable travel, entertainment and other reasonable
expenses paid or incurred by Executive in performing his business
obligations hereunder. The Company shall also provide Executive with
suitable office space and secretarial help. Executive shall provide
substantiating documentation for expense reimbursement requests as
reasonably required by the Company for its tax and other business records.
In addition to standard business expenses, Company also agrees to
reimburse Executive for his annual dues and other ordinary expenses
associated with his membership and participation in YPO. It is anticipated
that the expenses attributable to YPO will not exceed $15,000.00 annually.
Executive is also authorized to seek reimbursement for charges
attributable to the business use of his personal aircraft up to a maximum
of $150.00 per hour of business use. This authorization is subject to the
restrictions, if any, that may be placed upon the use of personal aircraft
for Company business by a Company insurance policy.
(b) EXPENSE ALLOWANCES. Executive shall be entitled to: (i) a car
allowance of $500 per month, or reimbursement of miles driven in
accordance with Company policy, whichever is greater, and (ii) as of
January 1, 2001 Executive's salary has been increased to provide 100% paid
premiums for family medical and dental insurance coverage under the
Company's plans and Executive is allowed to choose among all options for
medical and dental insurance provided to other Company employees in the
same area.
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(c) OTHER BENEFITS. Executive shall be entitled to participate in
any pension, profit-sharing, stock option, deferred compensation, or
similar plan or program of the Company established by the Company, to the
extent that he is eligible under the provisions thereof. Executive shall
also be entitled to participate in any group insurance, hospitalization,
medical, health and accident, disability or similar plan or program
established by the Company, to the extent that he is eligible under the
provisions thereof.
(d) PAID VACATION. Executive shall initially be entitled to three
(3) weeks of paid vacation during each calendar 12-month period of
employment with the Company (which shall accrue monthly on a pro rata
basis). Executive shall thereafter be entitled to the number of days of
paid vacation each year that is accorded under the Company's vacation
policy as in effect from time to time or three (3) weeks, whichever is
greater. Unused vacation days up to a maximum of five (5) days in one year
shall be carried forward for a period not to exceed 12 months in
accordance with Company's vacation policy as in effect from time to time.
6. RIGHTS AND PAYMENTS UPON TERMINATION. The Executive's right to
compensation and benefits for periods after the date on which his employment
with the Company terminates for whatever reason (the "TERMINATION DATE") shall
be determined in accordance with this Section 6,
(a) MINIMUM PAYMENTS. Executive shall be entitled to the following
payments, in addition to any payments or benefits to which the Executive
is entitled under the terms of any employee benefit plan or the following
provisions of this Section 6:
(1) his unpaid salary for the full month in which his
Termination Date occurred; provided, however, if Executive is
terminated for Cause pursuant to Section 6(b) below, he shall only
be entitled to receive his accrued but unpaid salary through his
Termination Date; and
(2) his accrued but unpaid vacation pay for the period
ending on his Termination Date in accordance with the Company's
vacation pay policy as in effect at such time.
(b) SEVERANCE PAYMENT. Notwithstanding any other provision of this
Agreement to the contrary, in the event that: (i) Executive's employment
hereunder is terminated by the Company at any time for any reason except
(A) for Cause (as defined below) or (B) Executive's death or Disability
(as defined below) or (ii) Executive terminates his own employment
hereunder at any time for Good Reason (as defined below), then, in either
such event, Executive shall be entitled to receive, and the Company shall
be obligated to pay, a lump sum cash payment equal to one hundred percent
(100%) the present value of Executive's annual salary pursuant to Section
2 or the annual salary then being paid to him, whichever is greater. For
purposes of the immediately preceding sentence, the "present
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value" of such annual salary shall be determined in accordance with the
regulations under Section 280G of the Code (as defined below). Also,
except as otherwise specifically provided in this Section 6(b), such
severance payment shall be in addition to, and shall not reduce or offset,
any other payments that are due to Executive from the Company or any other
source or under any other agreements, except any severance pay plan or
program maintained by the Company that covers employees generally. The
provisions of this Section 6(b) shall supersede any conflicting provisions
of this Agreement but shall not be construed to curtail, offset or limit
Executive's rights to any other payments, whether contingent upon a Change
in Control (as defined below) or otherwise, under the Agreement or any
other agreement, contract, plan or other source of payment except as
specifically provided herein. In addition, in the event of a Change in
Control, Executive shall be entitled to receive the bonus payment
described in Section 9 hereof, if applicable.
Notwithstanding any provision of this Section 6(b) to the contrary,
the Executive must first execute an appropriate release and waiver
agreement whereby Executive agrees to release and waive, in return for the
severance payment described in this Section 6(b), any claims that he may
have against the Company for (1) unlawful discrimination (including,
without limitation, age discrimination) and (2) severance pay under any
other severance pay plan or program maintained by the Company that covers
Executive; provided, however, such agreement shall not release or waive
any claims that may be brought by Executive for payments that may be due
under this Agreement, without Executive's express written consent. Any
severance payment required under this Section 6(b) shall be paid to
Executive within twenty (20) days after Executive executes such release
and waiver agreement, unless the parties agree in writing before then to
another payment date or method of payment, e.g., installment payments.
Executive shall not be required to mitigate any damages under this Section
6(b) or any other provision of this Agreement.
A `Change of Control' of the Company shall be deemed to have
occurred if any of the following shall have taken place: (a) Any Person or
group of Persons (within the meaning of Section 13 or 14 of the Securities
and Exchange Act of 1934 (the "Exchange Act"), but excluding (i) the
executive managers of the Company as of January 1, 2001, and (ii) GTCR
Capital Partners, L.P., GTCR Fund VII, L.P. and their respective
Affiliates) shall acquire beneficial ownership (within the meaning of Rule
13d-3 promulgated under the Exchange Act) of the outstanding voting stock
of the Company equal to the greater of (x) 25% of the then outstanding
shares of voting stock of the Company and (y) the proportion of the then
outstanding shares of voting stock of the Company held by GTCR Fund VII,
L.P. and its Affiliates; or (b) during any 12-month period, individuals
who at the beginning of such period constituted the Board (together with
any directors designated by the holders of the Convertible Preferred Stock
or the Lender and new directors whose election by the Board or whose
nomination for election by the Company's shareholders was approved by a
vote of at least majority of the directors who either were directors at
beginning of such period or whose election or nomination was previously so
approved) cease for any reason to constitute a
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majority of the Board. For purposes of this provision, "Person",
"Affiliates", "Board", "Convertible Preferred Stock" and "Lender" shall
have the meanings ascribed to such terms in the Loan Agreement."
"DISABILITY" means a "permanent and total disability" as defined in
Section 22(e)(3) of the Code and the Treasury regulations thereunder.
Evidence of such Disability shall be certified by a physician acceptable
to both the Company and Executive. In the event that the parties are not
able to agree on the choice of a physician, each shall select a physician
who, in turn, shall select a third physician to render such certification.
All costs relating to the determination of whether Executive has incurred
a Disability shall be paid by the Company.
"CODE" means the Internal Revenue Code of 1986, as amended.
References in this Agreement to any Section of the Code shall include any
"Successor Provisions" as defined in Section 9(e).
"CAUSE" means a termination of employment directly resulting from:
(1) the Executive having engaged in intentional misconduct that caused or
would have caused, if the Company did not intervene, a serious violation
by the Company of any state or federal laws, (2) the Executive having
engaged in a theft of corporate funds or corporate assets or in a material
act of fraud upon the Company, (3) an intentional act of personal
dishonesty taken by the Executive that was intended to result in personal
enrichment of the Executive at the expense of the Company, (4) repeated
violations by the Executive of Executive's primary or regular obligations
under this Agreement or under written policies of the Company which are
demonstrably willful on the Executive's part, and for which Executive has
received more than two written warnings that specify each area of
Executive's violations, (5) Executive's use of illegal drugs as evidenced
by a drug test authorized by Company, (6) Executive's final conviction (or
the entry of a plea of nolo contendere or equivalent plea) in a court of
competent jurisdiction of a felony or other crime involving dishonesty,
and (7) a breach by the Executive during the Employment Period of the
provisions of Sections 11, 12, 13 or 14 below, if such breach results in a
material injury to the Company.
"GOOD REASON" means the occurrence of any of the following events
without Executive's express written consent:
(1) A ten percent (10%) or greater reduction in
Executive's annual base salary; or
(2) Any breach by the Company or its successors of any
material provision of this Agreement; or
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(3) A substantial and adverse change in the Executive's
duties, control, authority, status or position, or the assignment to
the Executive of any duties or responsibilities which are materially
inconsistent with such status or position, or a material reduction
in the duties and responsibilities previously exercised by the
Executive, or a loss of title, loss of office, loss of significant
authority, power or control, or any removal of Executive from, or
any failure to reappoint or reelect him to, such positions, except
in connection with the termination of his employment for Cause,
Disability or death; or
(4) Following a Change in Control (as defined in Section
6(b)) any of the following events:
(A) the failure by the Company or its successor to
expressly assume and agree to continue and perform this
Agreement in the same manner and to the same extent that the
Company would be required to perform if such Change in Control
had not occurred;
(B) a relocation of more than twenty-five (25) miles
of Executive's principal office from the location of such
office immediately prior to the Change in Control date;
(C) a substantial increase in the business travel
required of Executive by the Company or its successor; or
(D) the Company or its successor fails to continue in
effect any pension plan, health-and-accident plan, or
disability income plan in which Executive was participating at
the time of the Change in Control (or plans providing
Executive with substantially equal and similar benefits), or
the taking of any action by the Company or its successor which
would adversely affect Executive's participation in or
materially reduce his benefits under any such plan that was
enjoyed by him immediately prior to the Change in Control.
(c) STOCK OPTIONS. In the event of a Change in Control,
Executive's resignation for Good Reason or Executive's termination without
Cause, all unvested stock options previously granted to Executive shall
immediately vest and be exercisable as set forth below. In the event that
there is a termination of Executive's employment hereunder for any reason,
Executive shall be entitled to exercise any and all stock options that
were previously granted to him by the Company, and are outstanding, vested
and unexercised as of his Termination Date, during the exercise period
ending on the greater of (i) two (2) years from his
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Termination Date or (ii) the expiration date of the stock option as
specified in the stock option plan or stock option agreement, as
applicable, notwithstanding any provision in such plan or agreement that
provides for a more limited time period to exercise stock options
following termination of employment; provided however, if said stock
option plan or stock option agreement provides therein for a longer period
of time to exercise such outstanding, vested and unexercised stock options
following his Termination Date, then such stock option plan or agreement
shall control and the remaining provisions of this Section 6(c) shall be
inapplicable and without further force or effect. In the event that there
is a termination of Executive's employment hereunder for Cause or
Executive voluntarily resigns without Good Reason within one year from the
date of this Agreement, Executive shall forfeit any and all stock options
that were previously granted to him by the Company, and are unvested and
unexercised as of his Termination Date.
During the extension period specified in the previous paragraph, if
applicable, the Executive shall be considered an employee of the Company
who shall make himself available to provide consulting services to the
Company in consideration for such extension of the option exercise period
and any post-termination payments provided to Executive under Section 6(a)
or (b) of this Agreement. In this regard, Executive agrees to be
classified as an employee of the Company solely for the limited purpose of
making himself available to provide consulting services on an as-needed
basis; provided, however, Executive hereby specifically waives any right,
entitlement, claim or demand to (i) any additional compensation for such
consulting services and (ii) coverage or benefits under any of the
Company's employee benefit plans or programs, or other perquisites, terms
and conditions of employment, except as expressly specified in other
provisions of this Agreement. Except as expressly provided in this Section
6(c), the provision of consulting services by Executive shall not expand
his rights or duties under this Agreement. Executive hereby agrees to
provide, upon request of the Company, consulting services to the Company
on the following terms and conditions:
(1) Executive will make himself available, on an as-needed basis,
to provide consulting services to the Company for up to three
(3) days per month during the period beginning on the day
after his Termination Date and ending on the last day of the
extension period for exercising stock options as provided in
the first paragraph of Section 6(c) above, subject to the
following conditions:
(A) At least five (5) days written advance notice to
Executive is provided by the Company;
(B) There is no concurrent illness of Executive, his
spouse, or children;
(C) There is no prior commitment of Executive including,
without limitation, vacation or attention to personal
affairs; and
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(D) No travel is required of Executive in excess of 200
miles round-trip.
Executive, in any particular instance, may waive any or all of
the conditions set forth in clauses (A), (B), (C) or (D) above
in his complete discretion. Any such waiver shall not be a
continuing waiver and shall not release Executive of any of
his rights hereunder.
(2) Executive agrees to provide such information, services, advice
and recollection of events as may from time to time be
reasonably requested by, or on behalf of, the Company
regarding corporate, regulatory or business matters of which
Executive may have knowledge, information or understanding,
including testifying truthfully in any litigation or other
proceedings involving the Employer, provided that (i)
Executive first determines that his interests are not adverse,
or potentially adverse, to those of the Company, and (ii) the
Company has indemnified Executive to his satisfaction
including, without limitation, for reasonable attorney's fees
and costs. The parties hereto agree that it is the quality,
and not the quantity, of the consulting services to be
provided by Executive that is important to the Company.
(3) The Company will reimburse Executive for all reasonable
out-of-pocket expenses incurred by Executive in the course of
his performance of consulting services, including, without
limitation, supplies, mileage and travel expenses. Executive
agrees not to incur any expense, obligation, or liability on
behalf of the Company without its prior written consent.
(4) The provision of consulting services by Executive for the
Company is non-exclusive and shall not, in any way, limit the
rights of Executive to seek and maintain other employment or
to perform compensatory services on behalf of any other person
or entity.
(5) The consulting services contemplated under this Section 6(c)
shall not be considered part of Executive's Employment Period
pursuant to Section 4, nor affect his Termination Date.
7. NOTICE OF TERMINATION. Any termination by the Company or the
Executive shall be communicated by Notice of Termination to the other party
hereto. For purposes of this Agreement, the term "NOTICE OF TERMINATION" means a
written notice which indicates the specific termination provision of this
Agreement relied upon and sets forth in reasonable detail the facts and
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circumstances claimed to provide a basis for termination of the Executive's
employment under the provision so indicated.
8. NO MITIGATION REQUIRED. Executive shall not be required to mitigate
the amount of any payment provided for under this Agreement by seeking other
employment or in any other manner.
9. CHANGE IN CONTROL: REQUIREMENT OF BONUS PAYMENT IN CERTAIN
CIRCUMSTANCES.
(a) In the event that Executive is deemed to have received an
"excess parachute payment" (as such term is defined in Section 280G(b) of
the Code) which is subject to the excise taxes (the "EXCISE TAXES")
imposed by Section 4999 of the Code in respect of any payment pursuant to
this Agreement, or any other agreement, plan, instrument or obligation, in
whatever form, the Company shall make the Bonus Payment (defined below) to
Executive promptly after the date on which Executive received or is deemed
to have received any excess parachute payment notwithstanding any contrary
provision herein.
(b) The term "BONUS PAYMENT" means a cash payment in an amount
equal to the sum of (i) all Excise Taxes payable by Executive, plus (ii)
all additional Excise Taxes and federal or state income taxes to the
extent such taxes are imposed in respect of the Bonus Payment, such that
Executive shall be in the same after-tax position and shall have received
the same benefits that he would have received if the Excise Taxes had not
been imposed. For purposes of calculating any income taxes attributable to
the Bonus Payment, Executive shall be deemed for all purposes to be paying
income taxes at the highest marginal federal income tax rate, taking into
account any applicable surtaxes and other generally applicable taxes which
have the effect of increasing the marginal federal income tax rate and, if
applicable, at the highest marginal state income tax rate, to which the
Bonus Payment and Executive are subject. An example of the calculation of
the Bonus Payment is set forth below: Assume that the Excise Tax rate is
20%, the highest federal marginal income tax rate is 40% and Executive is
not subject to state income taxes. Further assume that Executive has
received an excess parachute payment in the amount of $200,000, on which
$40,000 in Excise Taxes are payable. The amount of the required Bonus
Payment is thus $100,000. The Bonus Payment of $100,000, less additional
Excise Taxes on the Bonus Payment of $20,000 (i.e., 20% x $100,000) and
income taxes of $40,000 (i.e., 40% x $100,000), yields $40,000, the amount
of the Excise Taxes payable in respect of the original excess parachute
payment.
(c) Executive agrees to reasonably cooperate with the Company to
minimize the amount of the excess parachute payments, including, without
limitation, assisting the Company in establishing that some or all of the
payments received by Executive that are "contingent on a change", as
described in Section 280G(b)(2)(A)(i) of the Code, are reasonable
compensation for personal services actually rendered by Executive before
the date
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of such change or to be rendered by Executive on or after the date of such
change. In the event that the Company is able to establish that the amount
of the excess parachute payments is less than originally anticipated by
Executive, Executive shall refund to the Company any excess Bonus Payment
to the extent not required to pay Excise Taxes or income taxes (including
those incurred in respect of receipt of the Bonus Payment).
Notwithstanding the foregoing, Executive shall not be required to take any
action which his attorney or tax advisor advises him in writing (i) is
improper or (ii) exposes Executive to material personal liability.
Executive may require the Company to deliver to Executive an
indemnification agreement in form and substance satisfactory to Executive
as a condition to taking any action required by this subsection (c).
(d) The Company shall make any payment required to be made under
this Section 9 in cash and on demand. Any payment required to be paid by
the Company under this Section 9 which is not paid within 30 days of
receipt by the Company of Executive's written demand therefor shall
thereafter be deemed delinquent, and the Company shall pay to Executive
immediately upon demand interest at the highest nonusurious rate per annum
allowed by applicable law from the date such payment becomes delinquent to
the date of payment of such delinquent sum with interest.
(e) In the event that there is any change to the Code which
results in the recodification of Section 280G or Section 4999 of the Code,
or in the event that either such section of the Code is amended, replaced
or supplemented by other provisions of the Code of similar import
("SUCCESSOR PROVISIONS"), then this Agreement shall be applied and
enforced with respect to such new Code provisions in a manner consistent
with the intent of the parties as expressed herein, which is to assure
that Employee is in the same after-tax position and has received the same
benefits that he would have been in and received if any taxes imposed by
Section 4999 or any Successor Provisions had not been imposed.
10. POST-TERMINATION MEDICAL COVERAGE. If the employment of Executive is
terminated for any reason except for Cause (as defined in Section 6(b)), death
or voluntary resignation without Good Reason, then the Company shall provide
post-employment medical coverage in accordance with the terms and conditions of
this Section 10. The Company shall continue to cover Executive and his spouse
(hereinafter referred to as "SPOUSE") and his eligible dependent children, if
any, from the Termination Date until two (2) years following the Termination
Date, under the group health care plan maintained by the Company to provide
major medical insurance coverage for employees and their dependents (such group
medical plan or its successor shall be hereinafter referred to as the "HEALTH
CARE PLAN").
Executive, on behalf of himself and his Spouse and other dependents, if
any, shall be required to pay premiums for their coverage under the Health Care
Plan at the rates, if any, charged by the Company to active employees who are
senior officers of the Company at the time the premium is charged. Any
post-employment coverage under the Health Care Plan provided under
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this Section 10 shall run concurrently with COBRA continuation coverage under
the Health Care Plan and, therefore, Executive and the other qualifying
beneficiaries shall elect any COBRA continuation coverage offered to them under
the Health Care Plan following the Termination Date. The Company shall not be
responsible for the payment of any income or other taxes which may be imposed on
Executive, or on his Spouse or dependents, as the result of receiving coverage
under the Health Care Plan pursuant to this Section 10.
Executive, on behalf of himself and his Spouse and dependents, hereby
agrees and consents to acquire and maintain any coverage that any of them are
entitled to at any time during the two year period (as specified above in this
Section 10) under the Medicare program or any similar or succeeding plan or
program that is sponsored or maintained by the United States Government or any
agency thereof (hereinafter referred to as "MEDICARE"). The coverage described
in the immediately preceding sentence includes, without limitation, parts A and
B of Medicare and any additional or successor parts of Medicare. Executive, on
behalf of himself and his Spouse, further agrees and consents to pay all
required premiums and other costs for Medicare coverage from their personal
funds. Medicare coverage shall be primary payor to the coverage provided under
the Health Care Plan to the extent permitted by applicable federal law.
11. CONFLICTS OF INTEREST. In keeping with his fiduciary duties to
Company, Executive hereby agrees that he shall not become involved in a conflict
of interest, or upon discovery thereof, allow such a conflict to continue at any
time during the Employment Period. Moreover, Executive agrees that he shall
immediately disclose to the Board of Directors any facts that might involve a
conflict of interest that has not been approved by the Board of Directors.
Executive and Company recognize and acknowledge that it is not possible to
provide an exhaustive list of actions or interests that may constitute a
"conflict of interest." Moreover, Company and Executive recognize there are many
borderline situations. In some instances, full disclosure of facts by the
Executive to the Board of Directors may be all that is necessary to enable
Company to protect its interests. In others, if no improper motivation appears
to exist and Company's interests have not demonstrably suffered, prompt
elimination of the outside interest may suffice. In other egregious instances,
it may be necessary for Company to terminate Executive's employment for Cause
pursuant to Section 6(b) hereof. The Board of Directors reserves the right to
take such action as, in its good faith judgment, will resolve the conflict of
interest.
Executive hereby agrees that any direct or indirect interest in,
connection with, or benefit from any outside activities, particularly commercial
activities, which interest might adversely affect the Company or any of its
affiliated entities, involves a possible conflict of interest. Circumstances in
which a conflict of interest on the part of Executive would or might arise, and
which should be reported immediately to the Board of Directors, include, but are
not limited to, any of the following:
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(a) Ownership of more than a de minimis interest in any lender,
supplier, contractor, customer or other entity with which Company or any
of its affiliated entities does business;
(b) Misuse of information, property or facilities to which
Executive has access in a manner which is demonstrably injurious to the
interests of Company or any of its affiliated entities, including its
business, reputation or goodwill; or
(c) Materially trading in products or services connected with
products or services designed or marketed by or for the Company or any of
its affiliated entities.
For purposes of this Agreement, "AFFILIATED ENTITY" means any entity which
owns or controls, is owned or controlled by, or is under common ownership or
control with, the Company.
12. CONFIDENTIAL INFORMATION.
(a) CONFIDENTIAL INFORMATION DEFINED. Executive hereby
acknowledges that in his senior management position, he will create,
acquire and have access to confidential information and trade secrets
pertaining to the business of Company (hereafter "Confidential
Information" as defined below). Executive hereby acknowledges that such
Confidential Information is unique and valuable to Company's business and
that Company would suffer irreparable injury if Confidential Information
was divulged to the public or to persons or entities in competition with
Company. Therefore, Executive hereby covenants and agrees to keep in
strict secrecy and confidence, both during and after the Employment
Period, any Confidential Information. Executive specifically agrees that
he will not at any time disclose to others, use, copy or permit to be
copied, except in pursuance of his duties on behalf of Company or with the
prior consent of Company, Confidential Information relating to the Company
or any of its affiliated entities. For purposes of this Agreement,
"CONFIDENTIAL INFORMATION" shall mean and include, without limitation,
information related to the business affairs, property, methods of
operation, future plans, financial information, customer or client
information, or other data which relates to the business or operations of
Company or any of its affiliated entities, and all other information
obtained by Executive from and during the Employment Period which concerns
the affairs of Company or any of its affiliated entities and which Company
has requested be held in confidence or could reasonably be expected to
desire be held in confidence, or the disclosure of which would likely be
embarrassing, detrimental or disadvantageous to the Company or any of its
affiliated entities, or its and their directors, officers, employees or
shareholders. Confidential Information, however, shall not include
information that is at the time of receipt by Executive in the public
domain or is otherwise generally known in the industry or subsequently
enters the public domain or becomes generally known in the industry
through no fault of Executive or breach of his duty under this Section 12.
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(b) REQUIRED DISCLOSURE. In the event that Executive is required
by law which cannot be waived to disclose any Confidential Information,
Executive agrees that he will provide prompt notice of such potential
disclosure to Company so that an appropriate protective order may be
sought and/or a waiver of compliance with the provisions of this Agreement
may be granted. In the event that (i) such protection or other remedy is
not obtained or (ii) Company waives in writing the compliance by Executive
with this provision, Executive agrees that he may furnish only that
portion of the Confidential Information which Executive is advised by
written opinion of counsel is legally required to be disclosed, and
Executive shall exercise his best efforts to obtain assurances that
confidential treatment will be accorded such Confidential Information.
(c) DELIVERY OF DOCUMENTS. Executive further agrees to deliver to
Company at the termination of his employment, all correspondence,
memoranda, notes, records, drawings, plans, customer lists or other
documents, and all copies thereof made, composed or received by Executive,
solely or jointly with others, and which are in Executive's possession,
custody or control at such date and which relate in any manner to the
past, present or anticipated business of Company or any of its affiliated
entities.
(d) REMEDIES. In the event of a breach or threatened breach of any
of the provisions of this Section 12, Company shall be entitled to an
injunction ordering the return of all such documents, and any and all
copies thereof, and restraining Executive from using or disclosing, for
his benefit or the benefit of others, in whole or in part, any
Confidential Information, including, but not limited to, the Confidential
Information which such documents contain, constitute or embody. Executive
further agrees that any breach or threatened breach of any of the
provisions of this Section 12 would cause irreparable injury to Company,
for which it would have no adequate remedy at law. Nothing herein shall be
construed as prohibiting Company from pursuing any other remedies
available to it for any such breach or threatened breach, including the
recovery of damages.
13. PROPERTY RIGHTS. In keeping with his fiduciary duties to Company,
Executive hereby covenants and agrees that during his Employment Period, and for
a period of one (1) year following his Termination Date,Executive shall promptly
disclose in writing to Company any and all information, ideas, concepts,
improvements, discoveries, inventions and other intellectual properties, whether
patentable or not, and whether or not reduced to practice, which are conceived,
developed, made or acquired by Executive, either individually or jointly with
others, and which relate to the business, products or services of Company or any
of its affiliated entities. In consideration for his employment hereunder,
Executive hereby specifically sells, assigns and transfers to Company all of his
worldwide right, title and interest in and to all such information, ideas,
concepts, improvements, discoveries, inventions and other intellectual
properties.
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If during the Employment Period, Executive creates any original work of
authorship or other property fixed in any tangible medium of expression which
(a) is the subject matter of copyright (including computer programs) and (b)
relates to Company's present or planned business, products, or services, whether
such property is created solely by Executive or jointly with others, such
property shall be deemed a work for hire, with the copyright automatically
vesting in Company. To the extent that any such writing or other property is
determined not to be a work for hire for whatever reason, Executive hereby
consents and agrees to the unconditional waiver of "moral rights" in such
writing or other property, and to assign to Company all of his right, title and
interest, including copyright, in such writing or other property.
Executive hereby agrees to (a) assist Company or its nominee at all times
in the protection of any and all property subject to this Section 13, (b) not to
disclose any such property to others without the written consent of Company or
its nominee, except as required by his employment hereunder, and (c) at the
request of Company, to execute such assignments, certificates or other interests
as Company or its nominee may from time to time deem desirable to evidence,
establish, maintain, perfect, protect or enforce its rights, title or interests
in or to any such property.
14. AGREEMENT NOT TO COMPETE. Executive hereby recognizes and
acknowledges that: (a) in his executive capacity with Company he will be given
knowledge of, and access to, the Confidential Information (as described in
Section 12); (b) in the event that Executive was to enter into competition with
Company, Executive's knowledge of such Confidential Information would be of
invaluable benefit to a competitor of Company, and could cause irreparable harm
to Company's business interests; and (c) Executive's consent and agreement to
enter into the noncompetition provisions and covenants set forth herein is an
integral condition of this Agreement, without which Company would not have
agreed to provide Confidential Information to Executive, nor to his
compensation, benefits, and other terms of this Agreement. Accordingly, in
consideration for his employment, compensation, benefits, access to and
entrustment of Confidential Information, the goodwill, training and experience
provided to Executive during his Employment Period, Executive hereby covenants,
consents and agrees (regardless of whether or not there has been a Change of
Control) that during the Employment Period, and for a period two (2) years after
his employment is terminated for any reason, Executive shall not, directly or
indirectly, acting alone or in conjunction with others, for his own account or
for the account of others, including, without limitation, as an officer,
director, stockholder, owner, partner, member, manager, joint venturer,
employee, promoter, consultant, agent, lender, guarantor, representative, or
otherwise:
(a) Solicit, canvass, or accept any fees or business from any
customer of Company for himself or any other person or entity engaged in a
"Similar Business to Company" (as defined below);
(b) Engage or participate in any Similar Business to Company
within any states of the United States in which the Company transacts
business on Executive's termination of
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employment date, or in which, as of such termination date, the Company has
made any plans or proposals to transact business within one year from such
termination date (referred to herein as the "RESTRICTED AREA");
(c) Request or advise any service provider, supplier, or customer
to reduce or cancel any business that it may transact with Company or any
of its affiliated entities;
(d) Solicit, induce, or otherwise attempt to influence any
employee of the Company or any of its affiliated entities, to terminate
his or her relationship with the Company or any of its affiliated
entities; or
(e) Make any statement or perform any act intended to advance an
interest of an existing or prospective competitor of the Company or any of
its affiliated entities in any way that demonstrably injures the
reputation, goodwill or any other business interest of Company or any of
its affiliated entities.
For purposes of this Agreement, "SIMILAR BUSINESS TO COMPANY" means any
business or other enterprise that is competitive with the current or planned
businesses, products, services or operations of the Company or any of its
affiliated entities at the time of termination of Executive's employment
including, without limitation, handling, processing or transporting municipal
biosolids, industrial organic residuals and manure.
Executive hereby agrees that the limitations set forth above on his rights
to compete with Company after his termination of employment are reasonable and
necessary for the protection of Company. In this regard, Executive specifically
agrees that such limitations as to the period of time, geographic area and types
and scopes of restriction on his activities, as specified above, are reasonable
and necessary to protect the goodwill and other business interests of Company.
However, should the time period, the geographic area or any other
non-competition provision set forth herein be deemed invalid or unenforceable in
any respect, then Executive acknowledges and agrees that, as set forth in
Section 15 hereof, reformation may be made with respect to such time period,
geographic area or other non-competition provision in order to protect Company's
reasonable business interests to the maximum permissible extent.
15. REMEDIES. In the event of any pending, threatened or actual breach
of any of the covenants or provisions of Section 11, 12, 13 or 14, it is
understood and agreed by Executive that the remedy at law for a breach of any of
the covenants or provisions of these Sections may be inadequate, and, therefore,
Company shall be entitled to a restraining order or injunctive relief from any
court of competent jurisdiction, in addition to any other remedies at law and in
equity. In the event that Company seeks to obtain a restraining order or
injunctive relief, Executive hereby agrees that Company shall not be required to
post any bond in connection therewith. Should a court of competent jurisdiction
or an arbitrator (pursuant to Section 25) declare any provision of Section 11,
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12, 13 or 14 to be unenforceable due to an unreasonable restriction of duration
or geographical area, or for any other reason, such court or arbitrator is
hereby granted the consent of each of Executive and the Company to reform such
provision and/or to grant the Company any relief, at law or in equity,
reasonably necessary to protect the reasonable business interests of Company or
any of its affiliated entities. Executive hereby acknowledges and agrees that
all of the covenants and other provisions of Sections 11, 12, 13 and 14 are
reasonable and necessary for the protection of the Company's reasonable business
interests. Executive hereby agrees that if the Company prevails in any action,
suit or proceeding with respect to any matter arising out of or in connection
with Section 11, 12, 13 or 14, Company shall be entitled to all equitable and
legal remedies, including, but not limited to, injunctive relief and
compensatory damages.
16. DEFENSE OF CLAIMS. Executive agrees that, during the Employment
Period and for a period of two (2) years after his Termination Date, upon
reasonable request from the Company, he will cooperate with the Company and its
affiliated entities in the defense of any claims or actions that may be made by
or against the Company or any of its affiliated entities that affect his prior
areas of responsibility, except if Executive's reasonable interests are adverse
to the Company (or affiliated entity) in such claim or action. To the extent
travel is required to comply with the requirements of this Section 16, the
Company shall, to the extent possible, provide Executive with notice at least 10
days prior to the date on which such travel would be required. The Company
agrees to promptly pay or reimburse Executive upon demand for all of his
reasonable travel and other direct expenses incurred, or to be reasonably
incurred, to comply with his obligations under this Section 17.
17. DETERMINATIONS BY THE BOARD OF DIRECTORS.
(a) TERMINATION OF EMPLOYMENT. Prior to a Change in Control (as
defined in Section 6(b)), any question as to whether and when there has
been a termination of Executive's employment, and the cause of such
termination, shall be determined by the Board of Directors in its
discretion.
(b) COMPENSATION. Prior to a Change in Control (as defined in
Section 6(b)), any question regarding salary, bonus and other compensation
payable to Executive pursuant to this Agreement shall be determined by the
Board of Directors in its discretion.
18. WITHHOLDINGS: RIGHT OF OFFSET. Company may withhold and deduct from
any benefits and payments made or to be made pursuant to this Agreement (a) all
federal, state, local and other taxes as may be required pursuant to any law or
governmental regulation or ruling, (b) all other normal employee deductions made
with respect to Company's employees generally, and (c) any advances made to
Executive and owed to Company.
19. NONALIENATION. The right to receive payments under this Agreement
shall not be subject in any manner to anticipation, alienation, sale, transfer,
assignment, pledge or encumbrance
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by Executive, his dependents or beneficiaries, or to any other person who is or
may become entitled to receive such payments hereunder. The right to receive
payments hereunder shall not be subject to or liable for the debts, contracts,
liabilities, engagements or torts of any person who is or may become entitled to
receive such payments, nor may the same be subject to attachment or seizure by
any creditor of such person under any circumstances, and any such attempted
attachment or seizure shall be void and of no force and effect.
20. INCOMPETENT OR MINOR PAYEES. Should the Board of Directors determine
that any person to whom any payment is payable under this Agreement has been
determined to be legally incompetent or is a minor, any payment due hereunder
may, notwithstanding any other provision of this Agreement to the contrary, be
made in any one or more of the following ways: (a) directly to such minor or
person; (b) to the legal guardian or other duly appointed personal
representative of the person or estate of such minor or person; or (c) to such
adult or adults as have, in the good faith knowledge of the Board of Directors,
assumed custody and support of such minor or person; and any payment so made
shall constitute full and complete discharge of any liability under this
Agreement in respect to the amount paid.
21. SEVERABILITY. It is the desire of the parties hereto that this
Agreement be enforced to the maximum extent permitted by law, and should any
provision contained herein be held unenforceable by a court of competent
jurisdiction or arbitrator (pursuant to Section 24), the parties hereby agree
and consent that such provision shall be reformed to create a valid and
enforceable provision to the maximum extent permitted by law; provided, however,
if such provision cannot be reformed, it shall be deemed ineffective and deleted
here from without affecting any other provision of this Agreement.
22. TITLE AND HEADINGS; CONSTRUCTION. Titles and headings to Sections
hereof are for the purpose of reference only and shall in no way limit, define
or otherwise affect the provisions hereof. Any and all Exhibits referred to in
this Agreement are, by such reference, incorporated herein and made a part
hereof for all purposes. The words "herein", "hereof", "hereunder" and other
compounds of the word "here" shall refer to the entire Agreement and not to any
particular provision hereof.
23. CHOICE OF LAW. THIS AGREEMENT SHALL BE GOVERNED BY AND CONSTRUED IN
ACCORDANCE WITH THE LAWS OF THE STATE OF TEXAS, WITHOUT REGARD TO THE PRINCIPLES
OF CONFLICTS OF LAW. VENUE SHALL BE LIMITED TO THE STATE AND FEDERAL COURTS
LOCATED IN ▇▇▇▇▇▇ COUNTY, TEXAS.
24. ARBITRATION.
(a) ARBITRABLE MATTERS. If any dispute or controversy arises
between Executive and the Company as to their respective rights or
obligations under this Agreement, then
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either party may submit the dispute or controversy to arbitration under
the then-current National Employment Dispute Resolution Rules of the
American Arbitration Association (AAA) (the "RULES"); provided, however,
the Company shall retain its rights to seek a restraining order or
injunctive relief pursuant to Section 16. Any arbitration hereunder shall
be conducted before a single arbitrator unless the parties mutually agree
to a panel of three arbitrators. The site for any arbitration hereunder
shall be in ▇▇▇▇▇▇▇▇▇▇ County or ▇▇▇▇▇▇ County, Texas, unless otherwise
mutually agreed by the parties.
(b) SUBMISSION TO ARBITRATION. The party submitting any matter to
arbitration shall do so in accordance with the Rules. Notice to the other
party shall state the question or questions to be submitted for decision
or award by arbitration. Notwithstanding any provision in this Section 25,
Executive shall be entitled to seek specific performance of the
Executive's right to be paid during the pendency of any dispute or
controversy arising under this Agreement. In order to prevent irreparable
harm, the arbitrator may grant temporary or permanent injunctive or other
equitable relief for the protection of property rights.
(c) ARBITRATION PROCEDURES. The arbitrator shall set the date,
time and place for each hearing, and shall give the parties advance
written notice in accordance with the Rules. Any party may be represented
by counsel or other authorized representative at any hearing. The
arbitration shall be governed by the Federal Arbitration Act, 9
U.S.C. Sections 1 et. seq. (or its successor). The arbitrator shall
apply the substantive law (and the law of remedies, if applicable) of the
State of Texas to the claims asserted to the extent that the arbitrator
determines that federal law is not controlling.
(d) COMPLIANCE WITH AWARD.
(1) Any award of an arbitrator shall be final and binding
upon the parties to such arbitration, and each party shall
immediately make such changes in its conduct or provide such
monetary payment or other relief as such award requires. The parties
agree that the award of the arbitrator shall be final and binding
and shall be subject only to the judicial review permitted by the
Federal Arbitration Act.
(2) The parties hereto agree that the arbitration award may
be entered with any court having jurisdiction and the award may then
be enforced as between the parties, without further evidentiary
proceedings, the same as if entered by the court at the conclusion
of a judicial proceeding in which no appeal was taken. The Company
and the Executive hereby agree that a judgment upon any award
rendered by an arbitrator may be enforced in other jurisdictions by
suit on the judgment or in any other manner provided by law.
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(e) COSTS AND EXPENSES. Each party shall pay any monetary amount
required by the arbitrator's award, and the fees, costs and expenses for
its own counsel, witnesses and exhibits, unless otherwise determined by
the arbitrator in the award. The compensation and costs and expenses
assessed by the arbitrator and AAA shall be paid by the losing party
unless otherwise determined by the arbitrator in the award. If court
proceedings to stay litigation or compel arbitration are necessary, the
party who unsuccessfully opposes such proceedings shall pay all associated
costs, expenses, and attorney's fees which are reasonably incurred by the
other party as determined by the arbitrator.
25. BINDING EFFECT: THIRD PARTY BENEFICIARIES. This Agreement shall be
binding upon and inure to the benefit of the parties hereto, and to their
respective heirs, executors, personal representatives, successors and permitted
assigns hereunder, but otherwise this Agreement shall not be for the benefit of
any third parties.
26. ENTIRE AGREEMENT AND AMENDMENT. This Agreement contains the entire
agreement of the parties with respect to Executive's employment and the other
matters covered herein; moreover, this Agreement supersedes all prior and
contemporaneous agreements and understandings, oral or written, including the
Prior Employment Contract, between the parties hereto concerning the subject
matter hereof. This Agreement may be amended, waived or terminated only by a
written instrument executed by both parties hereto.
27. SURVIVAL OF CERTAIN PROVISIONS. Wherever appropriate to the
intention of the parties hereto, the respective rights and obligations of said
parties, including, but not limited to, the rights and obligations set forth in
Sections 6 through 18 and 25 hereof, shall survive any termination or expiration
of this Agreement.
28. WAIVER OF BREACH. No waiver by either party hereto of a breach of
any provision of this Agreement by any other party, or of compliance with any
condition or provision of this Agreement to be performed by such other party,
will operate or be construed as a waiver of any subsequent breach by such other
party or any similar or dissimilar provision or condition at the same or any
subsequent time. The failure of either party hereto to take any action by reason
of any breach will not deprive such party of the right to take action at any
time while such breach continues.
29. SUCCESSORS AND ASSIGNS. This Agreement shall be binding upon and
inure to the benefit of Company and its affiliated entities, and its and their
successors, and upon any person or entity acquiring, whether by merger,
consolidation, purchase of assets or otherwise, all or substantially all of the
assets and business of Company. Any reference herein to "Company" shall mean the
Company as first written above, as well as any successor or successors thereto.
This Agreement is personal to Executive, and Executive may not assign,
delegate or otherwise transfer all or any of his rights, duties or obligations
hereunder without the consent of the
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Board of Directors. Any attempt by the Executive to assign, delegate or
otherwise transfer this Agreement, any portion hereof, or his rights, duties or
obligations hereunder without the prior written consent of the Board of
Directors shall be deemed void and of no force and effect. Subject to the
preceding provisions of this paragraph, this Agreement shall be binding upon and
inure to the benefit of Executive and his heirs and assigns.
30. NOTICES. Notices provided for in this Agreement shall be in writing
and shall be deemed to have been duly received (a) when delivered in person or
sent by facsimile transmission, (b) on the first business day after it is sent
by air express overnight courier service, or (c) on the third business day
following deposit in the United States mail, registered or certified mail,
return receipt requested, postage prepaid and addressed, to the following
address, as applicable:
(1) If to Company, addressed to:
Synagro Technologies, Inc.
▇▇▇▇ ▇▇▇▇▇▇, ▇▇▇▇▇ ▇▇▇▇
▇▇▇▇▇▇▇, ▇▇▇▇▇ ▇▇▇▇▇
Attention: CEO
(2) If to Executive, addressed to the address set forth below
his name on the execution page hereof;
or to such other address as either party may have furnished to the other party
in writing in accordance with this Section 31.
31. COUNTERPARTS. This Agreement may be executed in any number of
counterparts,each of which when so executed and delivered shall be an
original,but all such counterparts shall together constitute one and the same
instrument. Each counterpart may consist of a copy hereof containing multiple
signature pages, each signed by one party hereto, but together signed by both of
the parties hereto.
32. EXECUTIVE ACKNOWLEDGMENT/NO STRICT CONSTRUCTION. The Executive
represents to Company that he is knowledgeable and sophisticated as to business
matters, including the subject matter of this Agreement, that he has read the
Agreement and that he understands its terms and conditions. The parties hereto
agree that the language used in this Agreement shall be deemed to be the
language chosen by them to express their mutual intent, and no rule of strict
construction shall be applied against either party hereto. Executive also
represents that he is free to enter into this Agreement including, without
limitation, that he is not subject to any other contract of employment or
covenant not to compete that would conflict in any way with his duties under
this Agreement. Executive acknowledges that he has had the opportunity to
consult with counsel of his choice,
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independent of Employer's counsel, regarding the terms and conditions of this
Agreement and has done so to the extent that he, in his unfettered discretion,
deemed to be appropriate.
33. SUPERSEDING AGREEMENT. This Employment Agreement shall supersede any
prior employment agreement entered into between the Company, or any of its
subsidiaries and Executive.
IN WITNESS WHEREOF, the Executive has hereunto set his hand, and Company
has caused these presents to be executed in its name and on its behalf, to be
effective as of the Effective Date first above written.
WITNESS: EXECUTIVE:
Signature: Signature:
--------------------------- -----------------------------
Printed Name: Printed Name: ▇▇▇▇▇▇▇ ▇. ▇▇▇▇▇▇
------------------------ --------------------------
Date: Date:
-------------------------------- ----------------------------------
Address for Notices:
▇▇▇▇ ▇▇▇▇▇▇ ▇▇.
▇▇▇▇ #▇▇▇
▇▇▇▇▇▇▇, ▇▇ ▇▇▇▇▇
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ATTEST: SYNAGRO TECHNOLOGIES, INC.:
By: By:
---------------------------------- ------------------------------------
Title: Its: CHAIRMAN & CEO
------------------------------- -----------------------------------
Printed Name: Printed Name: ▇▇▇▇ ▇. ▇▇▇▇▇▇
------------------------ --------------------------
Date: Date:
-------------------------------- ----------------------------------
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