0001193125-11-072105 Sample Contracts

AFFIRMATIVE INSURANCE HOLDINGS, INC. RESTRICTED STOCK AWARD AGREEMENT
Restricted Stock Award Agreement • March 21st, 2011 • Affirmative Insurance Holdings Inc • Fire, marine & casualty insurance • Delaware

This Restricted Stock Award Agreement (this “Agreement”), made as of the day of March, 2011 (the “Grant Date”) by and between Affirmative Insurance Holdings, Inc. (the “Company”), and (the “Grantee”), evidences the grant by the Company of a stock award (the “Award”) of restricted Common Stock, par value $0.01 per share (the “Common Stock”) to the Grantee on such date and the Grantee’s acceptance of the Award in accordance with the provisions of the Company’s 2004 Stock Incentive Plan (the “Plan”), a copy of which is attached hereto as Exhibit A.

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