Subject: Alsius Corporation Change in Control Severance Plan Participation Notice
Exhibit 10.2
[DATE]
[NAME]
[ADDRESS]
Subject:
Alsius Corporation Change in Control Severance Plan Participation
Notice
Dear
[NAME]:
The
Company has selected you to be a Covered Employee in the Alsius Corporation
Change in Control Severance Plan (the “Plan”). This letter is your
Change in Control Severance Plan Participation Notice (the "Agreement") as
defined in the Plan. A copy of the Plan (and its Summary Plan
Description) is enclosed with this Agreement. Certain terms defined
in the Plan are used in this Agreement.
As a
Covered Employee, if there is a Qualifying Termination and if you timely execute
and do not revoke the Release and you remain in full compliance with the Plan
and this Agreement, then you will receive the severance benefits described in
Section 1 below. Separately, as of
your Termination Date, you shall also be paid for your accrued but unpaid salary
and vacation, unreimbursed valid business expenses that were submitted in
accordance with Company policies and procedures, and you are eligible for other
vested benefits pursuant to the express terms of any employee benefit
plan.
This
Agreement is personal in nature and your right to receive payments hereunder is
not assignable, transferable or delegable, whether by pledge, creation of a
security interest, or otherwise, other than by a transfer by your will or by the
laws of descent and distribution. All provisions of this Agreement
are subject to and governed by the terms of the Plan.
1. Severance
Benefits. The Company shall pay you cash in three monthly
installments with each installment equal to one-twelfth of your annual base
salary with the first such installment payable on the first business day of the
month following the effective date of the Release. In addition, for
the three month period commencing with the month following the month of the
Termination Date, the Company shall continue to provide to you all Employee
Benefits which were received by, or with respect to, you as of the Termination
Date, at the same expense to you as before the Change in Control subject to
immediate cessation if you are offered other employee benefits coverage in
connection with new employment. You shall provide advance written
notice to the Company informing the Company when you are offered or become
eligible for other employee benefits in connection with new
employment. In addition, if periodically requested by the Company,
you will provide the Company with written confirmation that you have not been
offered other employee benefits. All payments and benefits made under
this Agreement shall be subject to reduction to reflect any withholding taxes or
other amounts required by applicable law or regulation. In addition,
to the extent you receive severance or similar payments and/or benefits under
any other Company plan, program, agreement, policy, practice, or the like, or
under the WARN Act or similar state law, the payments and benefits due to you
under this Agreement will be correspondingly reduced on a dollar-for-dollar
basis (or vice-versa) in a manner that complies with Internal Revenue Code
Section 409A.
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2. Defined Terms:
"Cause"
means any of the following, each as determined in the discretion of the
Company's (or its successor's) Board of Directors or Chief Executive Officer:
(i) the Covered Person's dereliction of his or her duties, (ii) the Covered
Person's material violation of Company policy, or (iii) the Covered Person's
conviction of, or guilty plea to, a crime against the Company or one which
reflects negatively on the reputation of the Company.
"Change
in Control" means any of the following transactions, provided, however, that the
Company shall determine under parts (iv) and (v) whether multiple transactions
are related, and its determination shall be final, binding and
conclusive:
(i) a
merger or consolidation in which the Company is not the surviving entity, except
for a transaction the principal purpose of which is to change the state in which
the Company is incorporated;
(ii) the
sale, transfer or other disposition of all or substantially all of the assets of
the Company;
(iii) the
complete liquidation or dissolution of the Company;
(iv) any
reverse merger or series of related transactions culminating in a reverse merger
(including, but not limited to, a tender offer followed by a reverse merger) in
which the Company is the surviving entity but (A) the shares of Common Stock
outstanding immediately prior to such merger are converted or exchanged by
virtue of the merger into other property, whether in the form of securities,
cash or otherwise, or (B) in which securities possessing more than forty percent
(40%) of the total combined voting power of the Company’s outstanding securities
are transferred to a person or persons different from those who held such
securities immediately prior to such merger or the initial transaction
culminating in such merger, but excluding any such transaction or series of
related transactions that the Company determines shall not be a Change in
Control; or
(v)
acquisition in a single or series of related transactions by any person or
related group of persons (other than the Company or by a Company-sponsored
employee benefit plan) of beneficial ownership (within the meaning of Rule 13d-3
of the Exchange Act) of securities possessing more than fifty percent (50%) of
the total combined voting power of the Company’s outstanding securities but
excluding any such transaction or series of related transactions that the
Company determines shall not be a Change in Control.
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"Company"
means Alsius Corporation, a Delaware corporation.
"Disability"
means that you are unable to engage in any substantial gainful activity by
reason of any medically determinable physical or mental impairment which can be
expected to result in death or which has lasted or can be expected to last for a
continuous period of not less than twelve (12) months.
"Employee
Benefits" means any group health and dental benefit plans provided, however,
that Employee Benefits shall not include contributions made by the Company to
any retirement plan, pension plan or profit sharing plan for the benefit of you
in connection with amounts earned by you.
"Exchange
Act" means the Securities Exchange Act of 1934, as amended.
"Qualifying
Termination" means that the Company has terminated your employment for any
reason other than Cause, death or Disability and where your Termination Date
occurred during the twelve month period immediately following a Change in
Control.
"Release"
means a general
release of claims and covenant not to sue substantially in the form attached
hereto as Exhibit A (or as may be reasonably modified by the Company in its
reasonable discretion). Such release must become effective within
sixty days after the Termination Date or else you will be deemed to have waived
all rights to any payments or benefits under this Agreement.
"Termination
Date" means your last day of employment with the Company (and any Company
subsidiary or affiliate) and where such termination of employment constitutes a
"separation from service" within the meaning of Internal Revenue Code Section
409A.
ALSIUS
CORPORATION
By:
_______________________________
Title:
______________________________
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EXHIBIT
A
RELEASE
OF CLAIMS AND COVENANT NOT TO SUE
This
Release of Claims and Covenant Not To Sue (the "Release") is entered into by
____________ ("Executive"). This Release is effective only if (i) it
has been executed by the Executive after his/her termination of employment with
Alsius Corporation (the "Company"), (ii) such executed Release has been provided
to the Company on or before [DATE] and (iii) the revocation period has expired
without revocation as set forth in Section 5(c) below (the “Effective
Date”). The Company and the Executive are collectively referred to
herein as the Parties.
WHEREAS,
Executive was an employee of the Company and served as the Company's [JOB
TITLE];
WHEREAS,
Executive was a participant in and "Covered Employee" under the Alsius
Corporation Change in Control Severance Plan (the "Plan");
WHEREAS,
pursuant to the Plan and the Change in Control Severance Plan Participation
Notice provided to the Executive by the Company (the "Severance Agreement"), the
Executive is eligible for specified severance benefits upon the occurrence of
certain events with such benefits conditioned upon, among other things, the
Executive's execution and non-revocation of this Release;
WHEREAS,
the Company was subject to a Change in Control (as defined in the Severance
Agreement) on [DATE];
WHEREAS,
the Executive's employment was terminated by the Company without Cause (as
defined in the Severance Agreement) on [DATE] (the "Separation Date");
and
WHEREAS,
pursuant to the terms of the Plan and Severance Agreement, the Company has
determined to treat the termination of Executive’s employment as eligible for
payment of certain separation benefits provided in the Severance
Agreement.
NOW,
THEREFORE, the Executive agrees as follows:
1. Termination
of Employment. Executive acknowledges and agrees that Executive’s
employment with the Company terminated as of the close of business on the
Separation Date. As of the Separation Date, Executive agrees that
he/she is no longer an employee of the Company and no longer holds any positions
or offices with the Company.
2. Separation
Benefits. In consideration for the release of claims set forth below
and other obligations under this Release, the Plan and the Severance Agreement
and in satisfaction of all of the Company's obligations to Executive and further
provided that (i) this Release is signed by Executive and not revoked by
Executive under Section 5(c) herein and (ii) the Executive remains in continuing
compliance with all of the terms of this Release, the Plan and the Severance
Agreement, the Executive is eligible to receive the separation benefits
specified in Section 1 of the Severance Agreement.
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3. Integration. This
Release, the Plan, and the Severance Agreement (and any agreements referenced
therein) represents the entire agreement and understanding between the Parties
as to the subject matter hereof and supersedes all prior agreements whether
written or oral.
4. Right
to Advice of Counsel. Executive acknowledges that Executive has had
the opportunity to fully review this Release and, if Executive so chooses, to
consult with counsel, and is fully aware of Executive’s rights and obligations
under this Release.
5. Executive's
Release of Claims. Executive hereby expressly covenants not to sue
and releases and waives any and all claims, liabilities, demands, damages,
penalties, debts, accounts, obligations, actions, grievances, and causes of
action (“Claims”), whether now known or unknown, suspected or unsuspected,
whether in law, in equity or in arbitration, of any kind or nature whatsoever,
which Executive has or claims to have, now or hereafter, against the Company and
its divisions, facilities, subsidiaries and affiliated entities, successors and
assigns, or any of its or their respective past or present officers, directors,
trustees, shareholders, agents, employees, attorneys, insurers, representatives
(collectively, the Releasees), including, but not limited to, any Claims arising
out of or relating in any way to Executive’s employment at the Company and the
termination thereof. Without limiting the foregoing, Executive hereby
acknowledges and agrees that the Claims released by this Release include, but
are not limited to, any and all claims which arise or could arise under Title
VII of the Civil Rights Act of 1964, the Age Discrimination in Employment Act of
1967, the Federal Worker Adjustment and Retraining Notification Act (or any
similar state, local or foreign law), the Employee Retirement Income Security
Act of 1974, as amended, the California Fair Employment and Housing Act,
California statutory or common law, the Orders of the California Industrial
Welfare Commission regulating wages, hours, and working conditions, and federal
statutory law, or any Claim for severance pay, bonus, sick leave, disability,
holiday pay, vacation pay, life insurance, health or medical insurance or any
other fringe benefit. Nothing in this Release shall limit in any way
Executive’s right under California Workers’ Compensation laws to file or pursue
any workers’ compensation claim. Nothing herein shall release any
rights to indemnification Executive may have in connection with Executive's
actions taken in the course of his/her duties with the Company. This
release shall not apply to any claims that may not be waived as a matter of
applicable law.
(a) As
part of this general release, Executive expressly releases, waives and
relinquishes all rights under Section 1542 of the California Civil Code which
states:
“A
GENERAL RELEASE DOES NOT EXTEND TO CLAIMS WHICH THE CREDITOR DOES NOT KNOW OR
SUSPECT TO EXIST IN HIS FAVOR AT THE TIME OF EXECUTING THE RELEASE, WHICH IF
KNOWN BY HIM MUST HAVE MATERIALLY AFFECTED HIS SETTLEMENT WITH THE
DEBTOR.”
Executive
acknowledges that he/she may later discover facts in addition to or different
from those which Executive now knows, or believes to be true, with respect to
any of the subject matters of this Release, but that it is nevertheless
Executive’s intention to settle and release any and all Claims released
herein.
(b)
Executive warrants and represents that there is not now pending any action;
complaint, petition Executive charge, grievance, or any other form of
administrative, legal or arbitral proceeding by Executive against the Company
and further warrants and represents that no such proceeding of any kind shall be
instituted by or on Executive’s behalf based upon any and all Claims released
herein.
(c)
Executive expressly acknowledges, understands and agrees that this Release
includes a waiver and release of all claims which Executive has or may have
under the Age Discrimination in Employment Act of 1967, as amended, 29 U.S.C.
§621, et seq.
(“ADEA”). The following terms and conditions apply to and are part of
the waiver and release of ADEA claims under this Release:
(i)
Executive is advised to consult an attorney before signing this
Release;
(ii)
Executive is granted twenty-one (21) days after he/she is presented with this
Release to decide whether or not to sign this Release;
(iii)
Executive will have the right to revoke the waiver and release of claims under
the ADEA within seven (7) days of signing this Release, and this Release shall
not become effective and enforceable until that revocation period has expired
without such revocation;
(iv)
Executive hereby acknowledges and agrees that he/she is knowingly and
voluntarily waiving and releasing Executive’s rights and claims in exchange for
consideration (something of value) in addition to anything of value to which
he/she is already entitled; and
(v)
Nothing in this Release prevents or precludes Executive from challenging or
seeking a determination in good faith of the validity of this waiver under the
ADEA, nor does it impose any condition precedent, penalties or costs from doing
so, unless specifically authorized by federal law.
6. Labor
Code Section 206.5. Executive agrees that the Company has paid to
Executive his/her salary and vacation accrued as of the Separation Date and that
these payments represent all such monies due to Executive through the Separation
Date. In light of the payment by the Company of all wages due, or to
become due to Executive, California Labor Code Section 206.5 is not
applicable. That section provides in pertinent part as
follows:
No employer shall require the
execution of any release of any claim or right on account of wages due, or to
become due, or made as an advance on wages to be earned, unless payment of such
wages has been made.
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7. Severability. Executive
understands that whenever possible, each provision of this Release will be
interpreted in such a manner as to be effective and valid under applicable law,
but if any provision of this Release is held to be invalid, illegal or
unenforceable in any respect under any applicable law or rule in any
jurisdiction, such invalidity, illegality or unenforceability will not affect
any other provision or any other jurisdiction, but this Release will be
reformed, construed and enforced in such jurisdiction as if such invalid,
illegal or unenforceable provision had never been contained herein.
8. No
Representations. Executive has not relied upon any representations or
statements made by the Company in deciding whether to execute this
Release.
9. Voluntary
Execution of Release. This Release is executed voluntarily by
Executive and without any duress or undue influence and with the full intent of
releasing all claims. The Executive acknowledges that:
(a) He/She
has read this Release;
(b) He/She
has been represented in the preparation, negotiation, and execution of this
Release by legal counsel of his/her own choice or that he/she has voluntarily
declined to seek such counsel;
(c) He/She
understands the terms and consequences of this Release and of the releases it
contains;
(d) He/She
is fully aware of the legal and binding effect of this Release.
IN
WITNESS WHEREOF, the Executive has executed this Release as shown
below.
EXECUTIVE
_______________
Dated:
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