0001193125-10-133990 Sample Contracts

INFUSYSTEM HOLDINGS, INC. Restricted Stock Award Agreement

Restricted Stock Award Agreement • June 7th, 2010 • InfuSystem Holdings, Inc • Surgical & medical instruments & apparatus • Delaware

• Contract Type
  Restricted Stock Award Agreement
• Filed
  June 7th, 2010
• Company
  InfuSystem Holdings, Inc
• Industry
  Surgical & medical instruments & apparatus
• Jurisdiction
  Delaware

This Award Agreement by and between (the “Participant”) and InfuSystem Holdings, Inc. (the “Company”) evidences the grant to the Participant of shares of the Company, par value $0.0001 per share (“Shares”).