Exhibit 10.3
PALOMAR HOLDINGS, INC.
NOTICE OF GRANT OF RESTRICTED STOCK UNITS
(For U.S. Participants)
Palomar Holdings, Inc. (the “Company”) has granted to the Participant an award (the “Award”) of certain units pursuant to the Palomar Holdings, Inc. 2019 Equity Incentive Plan (the “Plan”), each of which represents the right to receive on the applicable Settlement Date one (1) share of Stock, as follows:
Participant:
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Employee ID:
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Date of Grant:
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Total Number of Units: | TOTAL_SHARES_GRANTED,
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Settlement Date: | Except as provided by the Restricted Stock Units Agreement, the date on which a Unit becomes a Vested Unit.
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Vesting Start Date:
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Vested Shares: | Subject to the provisions in the Agreement, provided that the Participant’s Service has not terminated, the number of Vested Units (disregarding any resulting fractional Unit) as of any date is determined by multiplying the Total Number of Units by the “Vested Ratio” determined as of such date, as follows:
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| Vested Ratio |
| Prior to first year anniversary of the Date of Grant | 0 |
| On first year anniversary of the Date of Grant | 1/3 |
| On second year anniversary of the Date of Grant | 1/3 |
| On third year anniversary of the Date of Grant | 1/3 |
Superseding Agreement:
| None | |
Mandatory Sale To Cover Withholding Taxes | As a condition to acceptance of this Award, to the fullest extent permitted under the Plan, Article 7 of the Restricted Stock Units Agreement and applicable law, withholding taxes and other tax related items will be satisfied through the sale of a number of the shares of Stock issued on the settlement of Vested Units and the remittance of the cash proceeds to the Company. The Company is authorized and directed by the Participant to make payment from the cash proceeds of this sale directly to the appropriate taxing authorities in an amount equal to the taxes required to be withheld. The mandatory sale of shares of Stock to cover withholding taxes and tax related items is imposed by the Company on the Participant in connection with the receipt of this Award, and it is intended to comply with the requirements of Rule 10b5-1(c)(1)(i)(B) under the Exchange Act and be interpreted to meet the requirements of Rule 10b5-1(c). | |
By their signatures below or by electronic acceptance or authentication in a form authorized by the Company, the Company and the Participant agree that the Award is governed by this Grant Notice and by the provisions of the Restricted Stock Units Agreement and the Plan, both of which are made a part of this document, and by the Superseding Agreement, if any. The Participant acknowledges that copies of the Plan, the Restricted Stock Units Agreement and the prospectus for the Plan are available on the Company’s internal web site and may be viewed and printed by the Participant for attachment to the Participant’s copy of this Grant Notice. The Participant represents that
the Participant has read and is familiar with the provisions of the Restricted Stock Units Agreement and the Plan, and hereby accepts the Award subject to all of their terms and conditions.
PALOMAR HOLDINGS, INC.
| PARTICIPANT
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By: /s/ Mac Armstrong Mac Armstrong Chief Executive Officer
| Signature: |
Address: 7979 Ivanhoe Avenue, Suite 500 | Address:
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ATTACHMENTS: 2019 Equity Incentive Plan, as amended to the Date of Grant; Restricted Stock Units Agreement and Plan Prospectus | |
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