Boston Scientific Corporation
Exhibit 10.41
Boston Scientific Corporation
2003 Long-Term Incentive Plan
[ ] 2010
Employee’s Name
EMPLOYEE COPY
PLEASE RETAIN FOR YOUR RECORDS
BOSTON SCIENTIFIC CORPORATION
INTENT TO GRANT
This
Agreement, dated as of the [ ] day of February, 2010 (the “Grant Date”), is between
Boston Scientific Corporation, a Delaware corporation (the “Company”), and the “Participant”, an
employee of the Company or any of its affiliates or subsidiaries. All capitalized terms not
otherwise defined herein shall have the meaning ascribed thereto in either the Company’s 2003
Long-Term Incentive Plan (the “Plan”) or in the Performance Share Program (the “Program”) for the
period beginning January 1, 2010 and ending on December 31, 2012 (the “Performance Period”).
1. Grant and Acceptance of Award. The Company hereby indicates its award to the
Participant that number of Performance Share Units (the “Units”) set forth on Appendix A to
this Agreement (the “Award”). Each Unit represents the Company’s commitment to issue to the
Participant shares of the Company’s common stock, par value $.01 per share (the “Stock”), subject
to certain eligibility, performance and other conditions set forth herein. The Award is intended
to be granted pursuant to and is subject to the terms and conditions of this Agreement and the
provisions of the Plan and the Program.
2. Eligibility Conditions upon Award of Units. The Participant hereby acknowledges
the intent of the Company to award Units subject to certain eligibility, performance and other
conditions set forth herein.
3. Satisfaction of Performance-Based Conditions. Subject to the eligibility
conditions described in Section 7 of this Agreement, except as otherwise provided in Sections 5, 6
and 8 of this Agreement and Appendix B, and the satisfaction of the performance conditions
set forth on Appendix A to this Agreement during the Performance Period, the Company
intends to award shares of Stock hereunder to the Participant at the end of the Performance
Period. Except as set forth in Sections 5, 6 and 8 of this Agreement, no shares of Stock in
settlement of the Units shall be issued to the Participant prior to the end of the Performance
Period.
4. Participant’s Rights in Stock. The shares of Stock, if and when issued hereunder,
shall be registered in the name of the Participant and evidenced in the manner as the Company may
determine. During the period prior to the issuance of Stock, the Participant will have no rights
of a stockholder of the Company with respect to the Stock, including no right to receive dividends
or vote the shares of Stock underlying each Award.
5. Death. In the event that the Participant’s employment with the Company or its
subsidiaries or affiliates is terminated due to death on or after January 1, 2011, but prior to the
end of the Performance Period, shares of Stock shall be issued on a prorated basis based on actual
performance as determined at the first Committee meeting following the Participant’s death. The
number of shares of Stock to be issued under the prorated Award shall be determined by calculating
(a)(i) the number of Units set forth on Appendix A multiplied by (ii) the quotient of the
number of months that the Participant worked during the Performance Period (rounded to the nearest
whole month) divided by 36, and then multiplying the product of (a)(i) and (a)(ii) by (b) either
(i) the Performance Cycle 1 percentile funding amount (if the Participant’s employment is
terminated due to death on or after January 1, 2011, but prior to January 1, 2012) or (ii) the
average of the Performance Cycle 1 and the Performance Cycle 2 percentile performance amount (if
the Participant’s employment is terminated due to death on or after January 1, 2012 but prior to
the end of the Performance Period), as each are calculated in accordance with the terms of the
Program. In the event of the Participant’s death prior to January 1, 2011, the Award shall be
forfeited in its entirety.
6. Retirement or Disability. In the event that the Participant’s employment with the
Company or its subsidiaries or affiliates is terminated due to Retirement or Disability on or after
January 1, 2011, but prior to the end of the Performance Period, shares of Stock shall be issued on
a prorated basis based on actual performance as determined at the first Committee meeting following
the Participant’s termination of employment due to Retirement or Disability. The number of shares
of Stock to be issued under the prorated Award shall be determined by calculating (a)(i) the number
of Units set forth on Appendix A multiplied by (ii) the quotient of the number of months
that the Participant worked during the Performance Period (rounded to the nearest whole month)
divided by 36, and then multiplying the product of (a)(i) and (a)(ii) by (b) either (i) the
Performance Cycle 1 percentile funding amount (if the Participant’s employment is terminated due to
Retirement or Disability on or after January 1, 2011, but prior to January 1, 2012) or (ii) the
average of the Performance Cycle 1 and the Performance Cycle 2 percentile performance amount (if
the Participant’s employment is terminated due to Retirement or Disability on or after January 1,
2012 but prior to the end of the Performance Period), as each are calculated in accordance with the
terms of the Program. In the event that the Participant terminates his employment due to
Retirement or Disability prior to January 1, 2011, the Award shall be forfeited in its entirety.
7. Other Termination of Employment — Eligibility Conditions. If the employment of
the Participant with the Company and its affiliates or subsidiaries is terminated or the
Participant separates from the Company and its affiliates or subsidiaries for any reason other than
death, Retirement or Disability, any Units that remain subject to eligibility conditions shall be
void and no Stock shall be issued. Except as set forth in Sections 5, 6 and 8, eligibility to be
issued shares of Stock is conditioned on the Participant’s continuous employment with the Company
through and on the last day of the Performance Period as set forth in Section 3 above.
8. Change in Control of the Company. Subject to the terms of any separate Change in
Control or similar agreement to which the Participant is bound, in the event of a Change in Control
of the Company on or after January 1, 2011, but prior to the end of the Performance Period, shares
of Stock shall be issued on a prorated basis based on actual performance as determined by the
Committee immediately prior to the consummation of the Change in Control. The number of shares of
Stock to be issued under the prorated Award shall be determined by calculating (a)(i) the number of
Units set forth on Appendix A multiplied by (ii) the quotient of the number of months
during the Performance Period (rounded to the nearest whole month) prior to the consummation of the
Change in Control divided by 36, and then multiplying the product of (a)(i) and (a)(ii) by (b)
either (i) the Performance Cycle 1 percentile funding amount (if the Change in Control is
consummated on or after January 1, 2011, but prior to January 1, 2012) or (ii) the average of the
Performance Cycle 1 and the Performance Cycle 2 percentile performance amount (if the Change in
Control is consummated on or after January 1, 2012 but prior to the end of the Performance Period),
as each are calculated in accordance with terms of the Program. In the event that Change in
Control occurs prior to January 1, 2011, the Award shall be forfeited in its entirety
9. Consideration for Stock. The shares of Stock are intended to be issued for no cash
consideration.
10. Delivery of Stock. The Company shall not be obligated to deliver any shares of
Stock to be awarded hereunder until (i) all federal and state laws and regulations as the Company
may deem applicable have been complied with; (ii) the shares have been listed or authorized for
listing upon official notice to the New York Stock Exchange, Inc. or have otherwise been accorded
trading privileges; and (iii) all other legal matters in connection with the issuance and delivery
of the shares have been approved by the Company’s legal department.
11. Tax Withholding. The Participant shall be responsible for the payment of any
taxes of any kind required by any national, state or local law to be paid with respect to the Units
or the shares of Stock to be awarded hereunder, including, without limitation, the payment of any
applicable withholding, income, social and similar taxes or obligations. Except as otherwise
provided in this Section 11, upon the issuance of Stock or the satisfaction of any eligibility
condition with respect to the Stock to be issued hereunder, or upon any other event
giving rise to any tax liability, the Company shall hold back from the total number of shares of
Stock to be delivered to the Participant, and shall cause to be transferred to the Company, whole
shares of Stock having a Fair Market Value on the date the Stock is subject to issuance or taxation
an amount as nearly as possible equal to (rounded to the next whole share) the Company’s
withholding, income, social and similar tax obligations with respect to the Stock at such
time. To the extent of the Fair Market Value of the withheld shares, the Participant shall be
deemed to have satisfied the Participant’s responsibility under this Section 11 to pay these
obligations. The Participant shall satisfy the Participant’s responsibility to pay any other
withholding, income, social or similar tax obligations with respect to the Stock, and (subject to
such rules as the Committee may prescribe) may satisfy the Participant’s responsibility to pay
the tax obligations described in the immediately preceding sentence, by so indicating to the
Company or its designee in writing at least one (1) business day prior to the date the shares of
stock are subject to issuance and by paying the amount of these tax obligations in cash to the
Company or its designee within fifteen (15) business days following the date the Units vest or by
making other arrangements satisfactory to the Committee for payment of these obligations. In no
event shall whole shares be withheld by or delivered to the Company in satisfaction of tax
withholding requirements in excess of the maximum statutory tax withholding required by law. The
Participant agrees to indemnify the Company against any and all liabilities, damages, costs and
expenses that the Company may hereafter incur, suffer or be required to pay with respect to the
payment or withholding of any taxes. The obligations of the Company under this Agreement, the Plan
and the Program shall be conditional upon such payment or arrangements, and the Company shall, to
the extent permitted by law, have the right to deduct any such taxes from any payment of any kind
otherwise due to the Participant.
12. Investment Intent. The Participant acknowledges that the acquisition of the Stock
to be issued hereunder is for investment purposes without a view to distribution thereof.
13. Limits on Transferability. Until the eligibility conditions of this Award have
been satisfied and shares of Stock have been issued in accordance with the terms of this Agreement
or by action of the Committee, the Units awarded hereunder are not transferable and shall not be
sold, transferred, assigned, pledged, gifted, hypothecated or otherwise disposed of or encumbered
by the Participant. Transfers of shares of Stock by the Participant are subject to the Company’s
Stock Trading Policy.
14. Award Subject to the Plan and the Program. The Award to be made pursuant to this
Agreement is made subject to the Plan and the Program. The terms and provisions of the Plan and
the Program, as each may be amended from time to time are hereby incorporated herein by reference.
In the event of a conflict between any term or provision contained in this Agreement and a term or
provision of the Plan or the Program, the applicable terms and conditions of the Plan or Program
will govern and prevail. However, no amendment of the Plan or the Program after the date hereof
may adversely alter or impair the issuance of the Stock to be made pursuant to this Agreement.
15. No Rights to Continued Employment. The Company’s intent to issue the shares of
Stock hereunder shall not confer upon the Participant any right to continued employment or other
association with the Company or any of its affiliates or subsidiaries; and this Agreement shall not
be construed in any way to limit the right of the Company or any of its subsidiaries or affiliates
to terminate the employment or other association of the Participant with the Company or to change
the terms of such employment or association at any time.
16. Legal Notices. Any legal notice necessary under this Agreement shall be addressed
to the Company in care of its General Counsel at the principle executive
offices of the Company and to the Participant at the address appearing in the personnel records of
the Company for such Participant or to either party at such other address as either party may
designate in writing to the other. Any such notice shall be deemed effective upon receipt thereof
by the addressee.
17. Governing Law. The interpretation, performance and enforcement of this Agreement
shall be governed by the laws of The Commonwealth of Massachusetts (without regard to the conflict
of laws principles thereof) and applicable federal laws.
18. Headings. The headings contained in this Agreement are for convenience only and
shall not affect the meaning or interpretation of this Agreement.
19. Counterparts. This Agreement may be executed in any number of counterparts, each
of which shall be deemed to be an original and all of which together shall be deemed to the one and
the same instrument.
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SIGNATURE PAGE
IN WITNESS WHEREOF, the Company, by its duly authorized officer, and the Participant have
executed and delivered this Agreement as a sealed instrument as of the date and year first above
written.
| PARTICIPANT: | ||||||
| Signature | ||||||
| Signature | ||||||
| BOSTON SCIENTIFIC CORPORATION | ||||||
| J. Xxxxxxx Xxxxxxx President and Chief Executive Officer |
||||||
APPENDIX A
PLAN: 2003 LONG-TERM INCENTIVE PLAN
Number of Performance Share Units:
The Performance Share Units will pay out in shares of Stock in a range of 0% to 260% of the number
of Performance Share Units as follows:
| TSR Performance | ||
| Percentile Rank | Units Vesting | |
| 100th Percentile | 260% | |
| 95th Percentile | 240% | |
| 80th Percentile | 150% | |
| 55th Percentile | 100% | |
| 30th Percentile | 50% | |
| Below 30th Percentile | 0% |
APPENDIX B
Nature of Grant. In accepting the grant, I acknowledge that:
(1) the Plan is established voluntarily by the Company, is discretionary in nature and may be
modified, amended, suspended or terminated by the Company at any time;
(2) this Award is does not create any contractual or other right to receive future awards, or other
benefits in lieu of an award, even if awards have been given repeatedly in the past, and all
decisions with respect to future awards, if any, will be at the sole discretion of the Company;
(3) this Award is not part of normal or expected compensation or salary for any purposes,
including, but not limited to, calculating any severance, termination, bonuses, retirement benefits
or similar payments;
(4) the future value of the Stock is unknown and cannot be predicted with certainty; and
(5) in consideration of the Award, no claim or entitlement to compensation or damages shall arise
from termination of the Award resulting from termination of my employment by the Company (for any
reason whatsoever and whether or not in breach of local labor laws) and I irrevocably release the
Company from any such claim that may arise; if, notwithstanding the foregoing, any such claim is
found by a court of competent jurisdiction to have arisen, then, by accepting this Award, I shall
be deemed irrevocably to have waived my entitlement to pursue such claim.
Data Privacy. I hereby explicitly and unambiguously consent to the collection, use and
transfer, in electronic or other form, of my personal data as described herein by and among, as
applicable, the Company and its subsidiaries and affiliates for the exclusive purpose of
implementing, administering and managing my participation in the Plan.
I understand that the Company holds certain personal information about me, including, but not
limited to, my name, home address and telephone number, date of birth, social insurance number or
other identification number, salary, nationality, job title, any shares of stock or directorships
held in the Company, details of all options or any other entitlement to shares of stock awarded,
canceled, exercised, vested, unvested or outstanding in my favor, for the purpose of implementing,
administering and managing the Plan (“Data”). I understand that Data may be transferred to any
third parties assisting in the implementation, administration and management of the Plan, that
these recipients may be located in my country or elsewhere, and that the recipient’s country may
have different data privacy laws and protections than my country. I understand that I may request
a list with the names and addresses of any potential recipients of the Data by contacting my local
human resources representative. I authorize the recipients to receive, possess, use, retain and
transfer the Data, in electronic or other form, for the purposes of implementing, administering and
managing my participation in the Plan, including any requisite transfer of such Data as may be
required to a broker or other third party with whom I may elect to deposit any shares of stock
acquired upon exercise of the option. I understand that Data will be held only as long as is
necessary to implement, administer and manage my participation in the Plan. I understand that I
may, at any time, view Data, request additional information about the storage and processing of
Data, require any necessary amendments to Data or refuse or withdraw the consents herein, in any
case without cost, by contacting in writing my local human resources representative. I understand,
however, that refusing or withdrawing my consent may affect my ability to participate in the Plan.
For more information on the consequences of my refusal to consent or withdrawal of consent, I
understand that I may contact my local human resources representative.
Electronic Delivery of Documents. The Company may, in its sole discretion, decide to
deliver any documents related to the option granted under and participation in the Plan or future
options that may be granted under the Plan by electronic means or to request my consent to
participate in the Plan by electronic means. I hereby consent to receive such documents by
electronic delivery and, if requested, to agree to participate in the Plan through an on-line or
electronic system established and maintained by the Company or another third party designated by
the Company.
