Fill and Sign the 09 Employment Agreement Workform

11.09 Employment Agreement Workform Reviewer:______ Client/Matter Number:______Date:__________ EMPLOYMENT AGREEMENT WORKFORM Name of Employee and Current Title: ____________________________ Name of Company: (and relationship to target company if other than target):__________________________________________ Title of Agreement: ____________________________________ Effective Dates (e.g., term-initial and subsequent): ____________ Renewal Provision Description (evergreen? at whose option? when?):______________________________________________ Summary of Agreement: ________________________________ ¥ Title/Position Now, and indication of any changes therein during term of agreement:_____________________________ ¥ Salary:_______________________________________ ¥ Bonus:_______________________________________ ¥ Timing of Payments:____________________________ ¥ Options:______________________________________ ¥ Other Compensation:____________________________ ¥ Noncompetition, Confidentiality, Non-Circumvention Payments:____________________________________ Summarize Separation/Termination Provision (if any): _______ Does Agreement Survive a Change of Control of the Company? ____ Yes ____ No ____ Unclear Explain: __________________________________________________ Describe Any Noncompetition, Non-Solicitation, or Non-Circumvention Provisions: Describe Any Contingencies Affecting the Offer:____________ Describe Any Confidentiality Provision: ____________________ Describe Whether Any Benefits, Payments, etc. Survive Termination or Death (e.g., does salary, bonus,SAR, option or other economic component pass to employee's estate?): _____________________ Additional Comments or Issues: ________________________