STOCK OPTION AWARD AGREEMENT INFUSYSTEM HOLDINGS, INC. EQUITY PLANEquity Plan • November 10th, 2014 • InfuSystem Holdings, Inc • Surgical & medical instruments & apparatus
A stock option (the “Option”) for a total of shares (the “Shares”) of common stock, par value $0.0001 per share (“Common Stock”) of InfuSystem Holdings, Inc. (the “Company”), is hereby granted to (the “Optionee”). The Option in all respects is subject to the terms and conditions of the InfuSystem Holdings, Inc. Equity Plan (the “Plan”), which is incorporated by reference herein, and the receipt of which is hereby acknowledged by Optionee. Any capitalized terms that are not defined in this Agreement shall have the same meaning as in the Plan.
