0001193125-16-641575 Sample Contracts

PERFORMANCE STOCK UNIT AWARD AGREEMENT
Performance Stock Unit Award Agreement • July 5th, 2016 • Surgery Partners, Inc. • Services-general medical & surgical hospitals, nec • Tennessee

This agreement (the “Agreement”) evidences a grant of Performance Stock Units (“PSUs”) by Surgery Partners, Inc. (the “Company”) to the undersigned (the “Grantee”) pursuant to and subject to the terms of the Surgery Partners, Inc. 2015 Omnibus Incentive Plan (as amended from time to time, the “Plan”).

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