0001145197-17-000017 Sample Contracts

PERFORMANCE VESTING RESTRICTED STOCK UNIT AGREEMENT
Performance Vesting Restricted Stock Unit Agreement • November 3rd, 2017 • Insulet Corp • Surgical & medical instruments & apparatus

Pursuant to the Insulet Corporation 2017 Stock Option and Incentive Plan (the “Plan”), Insulet Corporation (the “Company”) hereby grants an award under the Plan of the target number of Restricted Stock Units listed above (an “Award”) to the Grantee named above. Each Restricted Stock Unit shall relate to one share of Common Stock, par value $0.001 per share (the “Stock”) of the Company, subject to the restrictions and conditions set forth herein and in the Plan. The actual number of Restricted Stock Units to be earned by the Grantee may be equal to or less than the target number. The Award, and the Restricted Stock Units included therein, are governed by this Performance Vesting Restricted Stock Unit Agreement (this “Agreement”) and the Plan, as further described in Section 6 below.

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