FIRST NATIONAL BANK OF NORTHERN CALIFORNIA AMENDED AND RESTATED SPLIT DOLLAR LIFE INSURANCE AGREEMENT
Exhibit 10.6
FIRST NATIONAL BANK OF NORTHERN CALIFORNIA
AMENDED AND RESTATED
SPLIT DOLLAR LIFE INSURANCE AGREEMENT
FIRST NATIONAL BANK OF NORTHERN CALIFORNIA
AMENDED AND RESTATED
SPLIT DOLLAR LIFE INSURANCE AGREEMENT
THIS SPLIT DOLLAR LIFE INSURANCE AGREEMENT (the “Agreement”), entered into this 27th day of May, 2016, AMENDS AND RESTATES the agreement originally entered into on February 15, 2012, by and between FIRST NATIONAL BANK OF NORTHERN CALIFORNIA, a national bank organized under the laws of the United States, located in South San Francisco, California (the “Bank”), and XXX XXXXXX (the “Executive”).
The purpose of this Agreement is to retain and reward the Executive, by dividing the death proceeds of certain life insurance policies which are owned by the Bank on the life of the Executive with the designated beneficiary of the Executive. The Bank will pay the life insurance premiums from its general assets.
Death proceeds payable under this Agreement shall be paid solely by the Insurer from the proceeds of any Policy(ies) on the life of the Insured. In no event shall the Bank be obligated to pay a death benefit under this Agreement from its general funds. Should an Insurer refuse or be unable to pay death proceeds endorsed to Insured under the express terms of this Agreement, Executive’s Beneficiary(ies) shall not be entitled to a death benefit.
Article 1
Whenever used in this Agreement, the following terms shall have the meanings specified:
1.1 | “Bank’s Interest” means the benefit set forth in Section 2.1. |
1.2 | “Beneficiary” means each designated person, or the estate of the deceased Executive, entitled to benefits, if any, upon the death of the Executive. |
1.3 | “Beneficiary Designation Form” means the form established from time to time by the Plan Administrator that the Executive completes, signs and returns to the Plan Administrator to designate one or more Beneficiaries. |
1.4 | “Board” means the Board of Directors of the Bank as from time to time constituted. |
1.5 | “Executive’s Interest” means the benefit set forth in Section 2.2. |
1.6 | “Insurer” means the insurance company issuing the Policy on the life of the Executive. |
1.7 | “Net Death Proceeds” means the total death proceeds of the Policy minus the greater of (i) the cash surrender value or (ii) the aggregate premiums paid by the Bank. |
1.8 | “Policy” or “Policies” means the individual insurance policy or policies adopted by the Bank for purposes of insuring the Executive’s life under this Agreement. |
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FIRST NATIONAL BANK OF NORTHERN CALIFORNIA
AMENDED AND RESTATED
SPLIT DOLLAR LIFE INSURANCE AGREEMENT
Article 2
Policy Ownership/Interests/Insurer/Assignment
2.1 | Bank’s Interest. The Bank shall be the sole owner of the Policies and shall have the right to exercise all incidents of ownership. The Bank shall be the beneficiary of the remaining death proceeds of the Policies after the Executive’s Interest is determined according to Section 2.2 below. |
2.2.1 | Death During Active Service. If the Executive dies while in the active service of the Bank, the Bank shall pay to the Executive’s beneficiary the present value of the stream of payments the Executive would have received under the First National Bank of Northern California Amended and Restated Executive Supplemental Compensation Agreement (the “ESCA”), dated ________________________, between the Executive and the Bank, as if the Executive had reached full retirement benefit status under the ESCA while in the active service of the Bank. This amount is payable in a lump sum upon the death of the Executive. |
2.2.4. | Limitation on Amounts. Notwithstanding anything to the contrary in this Agreement, any benefit payable under this Agreement shall not exceed the Net Death Proceeds of the Policy. |
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FIRST NATIONAL BANK OF NORTHERN CALIFORNIA
AMENDED AND RESTATED
SPLIT DOLLAR LIFE INSURANCE AGREEMENT
Article 3
3.1 | Premium Payment. The Bank shall pay all premiums due on all Policies. |
3.3 | Imputed Income. The Bank shall impute the economic benefit to the Executive on an annual basis, by adding the economic benefit to the Executive’s W-2, or if applicable, Form 1099. |
Article 4
4.1 | Termination for Cause. In the event that Executive’s employment is terminated for Cause, Executive shall forfeit all rights and benefits under this Agreement. |
“Cause” shall mean (i) the Executive’s willful misconduct, usurpation of business opportunity or gross negligence related to the Bank; provided that Executive shall first be given ten (10) days following written notice from the Board to cure any such breach (to the extent such breach is capable of being cured); (ii) the Executive’s willful failure to adhere to the reasonable policies of the Bank or any State of California or federal banking laws (including the laws, rules, or regulations of the Federal Deposit Insurance Corporation, the Board of Governors of the Federal Reserve System or the Office of the Comptroller of the Currency); provided that Executive shall first be given ten (10) days following written notice from the Board to commence compliance with such policies or laws to the extent such failure is able to be complied with subsequently; (iii) the Executive’s unauthorized disclosure to third parties of any confidential information (including trade secrets) of the Bank; or (iv) the Executive’s conviction of or entering of a guilty pleas or a plea of no contest with respect to (A) a felony, (B) any crime involving fraud, larceny, or embezzlement, or (C) any other crime involving moral turpitude which is injurious to the reputation of the Bank. No act, or failure to act, by Executive shall be “willful” unless committed without good faith and without a reasonable belief that the act or omission was in the best interest of the Bank. |
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FIRST NATIONAL BANK OF NORTHERN CALIFORNIA
AMENDED AND RESTATED
SPLIT DOLLAR LIFE INSURANCE AGREEMENT
Article 5
5.3 | Acknowledgment. No designation or change in designation of a Beneficiary shall be effective until received, accepted and acknowledged in writing by the Bank or its designated agent. |
Article 6
6.1.1 | Initiation – Written Claim. The claimant initiates a claim by submitting to the Bank a written claim for the benefits. |
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XXXXX XXXXXXXX XXXX XX XXXXXXXX XXXXXXXXXX
AMENDED AND RESTATED
SPLIT DOLLAR LIFE INSURANCE AGREEMENT
(a) | The specific reasons for the denial; | ||
(b) | A reference to the specific provisions of the Agreement on which the denial is based; | ||
(c) | A description of any additional information or material necessary for the claimant to perfect the claim and an explanation of why it is needed; | ||
(d) | An explanation of the Agreement’s review procedures and the time limits applicable to such procedures; and | ||
(e) | A statement of the claimant’s right to bring a civil action under ERISA Section 502(a) following an adverse benefit determination on review. |
6.2 | Review Procedure. If the Bank denies part or all of the claim, the claimant shall have the opportunity for a full and fair review by the Bank of the denial, as follows: |
6.2.1 | Initiation – Written Request. To initiate the review, the claimant, within 60 days after receiving the Bank’s notice of denial, must file with the Bank a written request for review. |
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FIRST NATIONAL BANK OF NORTHERN CALIFORNIA
AMENDED AND RESTATED
SPLIT DOLLAR LIFE INSURANCE AGREEMENT
(a) | The specific reasons for the denial; | ||
(b) | A reference to the specific provisions of the Agreement on which the denial is based; | ||
(c) | A statement that the claimant is entitled to receive, upon request and free of charge, reasonable access to, and copies of, all documents, records and other information relevant (as defined in applicable ERISA regulations) to the claimant’s claim for benefits; and | ||
(d) | A statement of the claimant’s right to bring a civil action under ERISA Section 502(a). |
Article 7
Article 8
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FIRST NATIONAL BANK OF NORTHERN CALIFORNIA
AMENDED AND RESTATED
SPLIT DOLLAR LIFE INSURANCE AGREEMENT
Article 9
9.1 | Binding Effect. This Agreement shall bind the Executive and the Bank, their beneficiaries, survivors, executors, administrators and transferees and any Beneficiary. |
9.3 | Applicable Law. The Agreement and all rights hereunder shall be governed by and construed according to the laws of the State of California, except to the extent preempted by the laws of the United States of America. |
9.5 | Notice. Any notice or filing required or permitted to be given to the Bank under this Agreement shall be sufficient if in writing and hand-delivered, or sent by registered or certified mail, to the address below: |
First National Bank of Northern California
000 Xx Xxxxxx Xxxx
Xxxxx Xxx Xxxxxxxxx, XX 00000
Such notice shall be deemed given as of the date of delivery or, if delivery is made by mail, as of the date shown on the postmark or the receipt for registration or certification. |
Any notice or filing required pr permitted to be given to the Executive under this Agreement shall be sufficient if in writing and hand-delivered, or sent by mail, to the last known address of the Executive. |
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FIRST NATIONAL BANK OF NORTHERN CALIFORNIA
AMENDED AND RESTATED
SPLIT DOLLAR LIFE INSURANCE AGREEMENT
9.6 | Entire Agreement. This Agreement, along with the Executive’s Beneficiary Designation Form, constitutes the entire agreement between the Bank and the Executive as to the subject matter hereof. No rights are granted to the Executive under this Agreement other than those specifically set forth herein. |
IN WITNESS WHEREOF, the parties executed this Agreement as of the date indicated above.
(NAME OF THE EXECUTIVE) | |||
Executive | |||
FIRST NATIONAL BANK OF NORTHERN CALIFORNIA | |||
By | |||
Title: |
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XXXXX XXXXXXXX XXXX XX XXXXXXXX XXXXXXXXXX
AMENDED AND RESTATED
SPLIT DOLLAR LIFE INSURANCE AGREEMENT
Beneficiary Designation
{ } New Designation
{ } Change in Designation
I, ________________________________. Designate the following as Beneficiary under the Agreement:
Primary: _______________________________________________________________ _______________________________________________________________ |
_________ % _________ % |
Contingent: | |
______________________________________________________________ | _________ % |
______________________________________________________________ | _________ % |
Notes:
· | Please PRINT CLEARLY or TYPE the names of the beneficiaries. | |
· | To name a trust as Beneficiary, please provide the name of the trustee(s) and the exact name and date of the trust agreement. | |
· | To name your estate as Beneficiary, please write “Estate of [your name]”. | |
· | Be aware that none of the contingent beneficiaries will receive anything unless ALL of the primary beneficiaries predecease you. |
I understand that I may change these beneficiary designations by delivering a new written designation to the Plan Administrator, which shall be effective only upon receipt and acknowledgment by the Plan Administrator prior to death. I further understand that the designations will be automatically revoked if the Beneficiary predeceases me, or, if I have named my spouse as Beneficiary and our marriage is subsequently dissolved.
Name: _____________________________________
Signature:__________________________________ Date: ___________________
SPOUSAL CONSENT (Required if Spouse not named beneficiary): | |
I consent to the beneficiary designation above, and acknowledge that if I am named Beneficiary and our marriage is subsequently dissolved, the designation will be automatically revoked.
Spouse Name: _________________________________________
Signature:_____________________________________________ Date: ___________________
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Received by the Plan Administrator this ____________ day of ____________, 2____
By: _____________________________________
Title: ____________________________________
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