0001145197-22-000018 Sample Contracts

INSULET CORPORATION PERFORMANCE SHARES AGREEMENT
Performance Shares Agreement • March 1st, 2022 • Insulet Corp • Surgical & medical instruments & apparatus • Delaware

Pursuant to the Insulet Corporation 2017 Stock Option and Incentive Plan (the “Plan”), Insulet Corporation (the “Company”) hereby grants an award under Section 10 of the Plan of the target number of Restricted Stock Units listed above (an “Award”) to the Grantee. Each Restricted Stock Unit shall relate to one share of Company common stock, par value $0.001 per share (the “Stock”), 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, if any, may be more or less than the target number. This Award is governed by this Performance Shares Agreement, including Appendix A and Appendix B attached hereto (this “Agreement”) and the Plan.

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