AMERISAFE, INC. 2005 EQUITY INCENTIVE PLAN NONQUALIFIED STOCK OPTION AWARD AGREEMENT
Exhibit 10.20
THIS OPTION AWARD AGREEMENT (this “Agreement”), dated as of ____________ ____, 2005 is entered
into between AMERISAFE, Inc., a Texas corporation (the “Company”), and ▇▇▇▇ ▇. ▇▇▇▇▇▇▇▇
(“Optionee”). Capitalized terms used herein but not defined shall have the meanings assigned to
those terms in the AMERISAFE, Inc. 2005 Equity Incentive Plan (the “Plan”). Optionee is currently
an executive officer of the Company. Optionee will resign as an officer of the Company and its
Subsidiaries as of December 31, 2005 but shall remain a consultant to the Company pursuant to an
agreement dated October 27, 2005 (the “Consulting Agreement”).
1. Grant of Option Right. Pursuant to the Plan, the Company hereby grants to
Optionee, as a Participant in the Plan and effective as of the Date of Grant (as defined in Section
3), an option right (“Option Right”) to purchase 95,000 shares (“Option Shares”) of the Company’s
common stock, par value $0.01 per share (“Common Shares”), at the price of $_______ per share
(the “Option Price”).
2. Type of Option Right. The Option Right is intended to be a nonqualified stock
option and shall not be treated as an “incentive stock option” within the meaning of Section 422 of
the Code.
3. Date of Grant. The effective date of the grant of this Option Right is ________ (“Date of Grant”).
4. Date of Expiration. This Option Right shall expire on the tenth anniversary of the
Date of Grant (the “Date of Expiration”), unless earlier terminated under Section 7(a).
5. Vesting of Option Right.
(a) Except as otherwise provided in this Agreement, the Option Right shall become
vested and exercisable to the extent of 20% of the Option Shares on each of the first five
anniversaries of the Date of Grant.
(b) Notwithstanding the provisions of Section 5(a) above, the Option Right shall become
immediately vested and exercisable in full upon the occurrence of a Change in Control, as
defined in the Plan.
(c) Notwithstanding Section 5(a) above, the Board, in its sole discretion, may
determine within 60 days following one of the events described in clauses (i) through (iii)
below that the Option Right shall become immediately exercisable in full (i) if Optionee
becomes permanently disabled (as determined by the Board), (ii) if Optionee dies while
an employee of, or consultant to, the Company or a Subsidiary, or (iii) under other
special circumstances.
6. Manner of Exercise.
(a) To the extent that the Option Right is exercisable in accordance with Section 5,
the Option Right may be exercised by Optionee at any time, or from time to time, in whole or
in part on or prior to the Termination Date; provided, however, that
Optionee must exercise the Option Right in multiples of 100 Option Shares unless fewer than
100 Option Shares are available for purchase by Optionee under this Agreement at the time of
exercise.
(b) Optionee shall exercise the Option Right by delivering a signed written notice to
the Company, which notice shall specify the number of Option Shares to be purchased and be
accompanied by payment in full of the Option Price and any required taxes (as provided in
the Plan) for the number of Option Shares specified for purchase; provided,
however, that, with the prior approval of the Board, payment of the Option Price may
be deferred and paid from the proceeds of sale through a bank or broker of some or all of
the shares to which such exercise relates.
(c) The Option Price shall be payable (i) in cash or by check acceptable to the Company
or by wire transfer of immediately available funds, (ii) by the actual or constructive
transfer to the Company of Common Shares owned by Optionee for at least six months having a
Market Value per Share at the time of exercise equal to the total Option Price, or (iii) by
a combination of such methods of payment.
(d) The Company’s obligation to deliver Option Shares to Optionee is subject to and
conditioned upon Optionee satisfying all tax obligations associated with Optionee’s exercise
of the Option Right. Unless otherwise approved by the Board, all such tax obligations shall
be payable in cash or by check acceptable to the Company or by wire transfer of immediately
available funds. The Company and its Subsidiaries, as applicable, shall be entitled to
deduct from any payment otherwise due to Optionee the amount necessary to satisfy all such
taxes.
(e) Upon full payment of the Option Price and satisfaction of all applicable tax
obligations, and subject to the applicable terms and conditions of the Plan and the terms
and conditions of this Agreement, the Company will cause certificates for the Option Shares
purchased hereunder to be delivered to Optionee.
7. Termination.
(a) The Option Right shall terminate on the earliest of the following dates (such date,
the “Termination Date”):
(i) 90 days after the later of (A) Optionee’s employment with the Company or a
Subsidiary is terminated for any reason other than for cause or (B) the expiration
or termination (other than for cause) of the Consulting Agreement, as currently in
effect or as hereafter amended. Notwithstanding the
foregoing, the Option Right shall terminate immediately if Optionee is
terminated for cause. For purposes of the foregoing, termination for cause shall be
as defined in the Consulting Agreement, as currently in effect or as hereafter
amended; or
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(ii) The Date of Expiration.
(b) During the 90-day period referred to in Section 7(a)(i) above, the Option Right may
be exercised only to the extent that, at the time that Optionee ceases to be an employee of,
or consultant to, the Company or a Subsidiary, it is exercisable pursuant to Section 5
hereof.
8. Share Certificates. All certificates evidencing Option Shares purchased pursuant
hereto, and any certificates for Common Shares issued as dividends on, in exchange of, or as
replacements for, certificates evidencing Option Shares which, in the opinion of counsel for the
Company, are subject to similar legal requirements, shall have endorsed thereon before issuance
such restrictive or other legends as the Company (upon advice of counsel) may deem necessary or
advisable. The Company and any transfer agent shall not be required to register or record the
transfer of any such shares unless and until the Company or its transfer agent shall have received
from Optionee’s counsel an opinion, in a form satisfactory to the Company, that any such transfer
will not be in violation of any applicable law, rule or regulation. Optionee agrees not to sell,
assign, pledge or otherwise dispose of any Option Shares or any Common Shares that are subject to
restrictions on transfer described in this Section 8 without the Company first receiving such an
opinion.
9. Transfer. The Option Right may not be transferred by Optionee except by will or
the laws of descent and distribution and may not be exercised during the lifetime of Optionee
except by Optionee or Optionee’s guardian or legal representative acting on behalf of Optionee in a
fiduciary capacity under state law and court supervision.
10. Compliance with Law. The Company shall make reasonable efforts to comply with all
applicable federal or state securities laws; provided, however, that
notwithstanding any other provision of this Agreement, the Option Right shall not be exercisable if
the exercise and issuance of the Option Shares would result in a violation of any such laws.
11. Employment/Consulting Rights. This Agreement shall not confer on Optionee any
right with respect to the continuance of employment, consulting or other service with the Company
or any Subsidiary. No provision of this Agreement shall limit in any way whatsoever any right that
the Company or a Subsidiary may otherwise have to terminate the employment of Optionee, or the
Consulting Agreement.
12. Communications. All notices, demands and other communications required or
permitted hereunder or designated to be given with respect to the rights or interests covered by
this Agreement shall be deemed to have been properly given or delivered when delivered personally
or sent by certified or registered mail, return receipt requested, U.S. mail or reputable overnight
carrier, with full postage prepaid and addressed to the parties as follows:
If to the Company, at: the Company’s principal executive office, addressed to the attention
of the Secretary
If to Optionee, at: Optionee’s address provided by Optionee on the last page hereof
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Either the Company or Optionee may change the above designated address by written notice to the
other specifying such new address.
13. Interpretation. The interpretation and construction of this Agreement by the
Board shall be final and conclusive. No member of the Board shall be liable for any such action or
determination made in good faith.
14. Amendments. The Plan may be amended, suspended or terminated and this Agreement
may be amended by the Board for purposes of satisfying changes in the law or for any other lawful
purposes, provided that (i) no such action shall adversely affect Optionee’s rights under this
Agreement without Optionee’s consent, and (ii) all such amendments shall be in writing.
15. Integration. The Option Right is granted pursuant to the Plan. Notwithstanding
anything in this Agreement to the contrary, this Agreement is subject to all of the terms and
conditions of the Plan, a copy of which has been made available to the Optionee and is available
upon request to the Secretary at the address specified in Section 12 and which is incorporated
herein by reference. As such, this Agreement and the Plan embody the entire agreement and
understanding of the Company and Optionee and supersede any prior understandings or agreements,
whether written or oral, with respect to the Option Right.
16. Severance. In the event that one or more of the provisions of this Agreement
shall be invalidated for any reason by a court of competent jurisdiction, any provision so
invalidated shall be deemed to be separable from the other provisions hereof and the remaining
provisions hereof shall continue to be valid and fully enforceable.
17. Governing Law. This Agreement is made under, and shall be construed in accordance
with, the laws of the State of Texas, without regard to the conflict of laws principles thereof.
18. Counterparts. This Agreement may be executed in one or more counterparts, each of
which shall be deemed an original and all of which together shall constitute one and the same
instrument.
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IN WITNESS WHEREOF, this Agreement is executed by a duly authorized representative of the
Company on the day and year first above written.
| AMERISAFE, INC. |
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| By: | ||||
| Name: | C. ▇▇▇▇▇ ▇▇▇▇▇▇▇, ▇▇. | |||
| Title: | President and Chief Executive Officer | |||
The undersigned Optionee hereby acknowledges receipt of an executed original of this Agreement and
accepts the Option Right subject to the applicable terms and conditions of the Plan and the terms
and conditions hereinabove set forth.
Date: |
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| Optionee |
OPTIONEE: Please complete/update the following information, as applicable.
Name: |
▇▇▇▇ ▇. ▇▇▇▇▇▇▇▇ | |
Home Address: |
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Social Security Number: |
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