0001193125-14-077734 Sample Contracts

AMERISAFE, INC.
Restricted Stock Award Agreement • February 28th, 2014 • Amerisafe Inc • Fire, marine & casualty insurance • Texas

THIS RESTRICTED STOCK AWARD AGREEMENT (this “Agreement”), dated as of , is entered into between AMERISAFE, INC., a Texas corporation (the “Company”), and (“Grantee”). Capitalized terms used herein but not defined shall have the meanings assigned to those terms in the AMERISAFE, Inc. 2010 Restated Non-Employee Director Restricted Stock Plan (the “Plan”).

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RESTRICTED STOCK AWARD AGREEMENT AMERISAFE, INC. RESTRICTED STOCK AWARD AGREEMENT
Restricted Stock Award Agreement • February 28th, 2014 • Amerisafe Inc • Fire, marine & casualty insurance • Texas

THIS RESTRICTED STOCK AWARD AGREEMENT (this “Agreement”), dated as of , 20 (the “Grant Date”), is entered into by and between AMERISAFE, Inc., a Texas corporation (the “Company”), and (the “Grantee”). Where the context permits, references to the Company shall include any successor to the Company. Any capitalized term that is used, but not defined, in this Agreement shall have the meaning assigned to such term in the AMERISAFE, Inc. 2012 Equity and Incentive Compensation Plan (as amended from time to time, the “Plan”).

AMERISAFE, INC. ANNUAL CASH INCENTIVE AWARD AGREEMENT
Annual Cash Incentive Award Agreement • February 28th, 2014 • Amerisafe Inc • Fire, marine & casualty insurance • Louisiana

THIS ANNUAL CASH INCENTIVE AWARD AGREEMENT (this “Agreement”), dated as of , 201 is entered into by and between AMERISAFE, Inc., a Texas corporation (the “Company”), and (the “Participant”). Any capitalized term that is used, but not defined, in this Agreement shall have the meaning assigned to such term in the AMERISAFE, Inc. 2012 Equity and Incentive Compensation Plan (as amended from time to time, the “Plan”).

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