CLASS B COMMON
Exhibit 4.2
CLASS B |
| CLASS B COMMON |
| |
|
|
|
|
|
|
| [CHIPOTLE LOGO] |
|
|
| PAR VALUE $.01 |
| THIS CERTIFICATE |
|
|
|
|
|
|
Certificate |
|
|
| Shares |
|
|
|
| ***** |
[Number] |
| CHIPOTLE MEXICAN GRILL, INC. |
| ***[Number] |
|
| INCORPORATED UNDER THE LAWS OF THE STATE OF DELAWARE |
| **** |
| THIS CERTIFIES |
| CUSIP 169656 20 4 |
|
|
| [Name] | CERTAIN DEFINITIONS |
|
| is the owner of | **[NUMBER]** |
|
|
FULLY-PAID AND NON-ASSESSABLE SHARES OF THE CLASS B COMMON STOCK OF
Chipotle Mexican Grill, Inc. (hereinafter called the Company), transferable on the books of the Company in person or by duly authorized attorney, upon surrender of this Certificate properly endorsed. This Certificate and the shares represented hereby, are issued and shall be held subject to all of the provisions of the Certificate of Incorporation, as amended, and the By-Laws, as amended, of the Company (copies of which are on file with the Company and with the Transfer Agent), to all of which each holder, by acceptance hereof, assents. This Certificate is not valid unless countersigned and registered by the Transfer Agent and Registrar.
Witness the facsimile seal of the Company and the facsimile signatures of its duly authorized officers.
|
|
|
|
|
| DATED [Date] | ||
|
|
|
|
|
|
|
| |
| /s/ Montgomery F. Moran |
|
|
|
| COUNTERSIGNED AND REGISTERED | ||
|
| President and Chief |
|
|
|
| COMPUTERSHARE INVESTOR TRANSFER AGENT AND REGISTRAR | |
|
|
|
|
|
|
|
|
|
|
| /s/ Steve Ells |
|
|
|
| By | [Name] |
|
| Chairman and Chief |
|
|
|
|
| AUTHORIZED SIGNATURE |
CHIPOTLE MEXICAN GRILL, INC.
The following abbreviations, when used in inscription on the face of this certificate, shall be construed as though they were written out in full according to applicable laws of regulations:
| TEN COM |
| - as tenants in common |
| UNIF GIFT IN ACT- |
|
|
| Custodian |
|
| |
|
|
|
|
|
|
|
| (Cust) |
|
|
| (Minor) |
|
| TEN ENT |
| as tenants by the entireties |
|
|
| under Uniform Gifts to Minors Act |
|
| ||
|
|
|
|
|
|
|
|
|
|
|
| (State) |
|
| JT TEN |
| as joint tenants with right of survivorship and not as tenants in common |
| UNIF TRF MIN ACT |
|
|
| Custodian (until age) |
|
|
|
|
|
|
|
|
|
| (Cust) |
|
|
| (Minor) |
|
|
|
|
|
|
|
| under Uniform Transfers to Minors Act |
|
| ||
|
|
|
|
|
|
|
|
|
|
|
| (State) |
|
|
|
|
|
|
|
|
|
|
|
|
|
Additional abbreviations may also be used though not in the above list. |
THE COMPANY WILL FURNISH WITHOUT CHARGE TO EACH SHAREHOLDER WHO SO REQUESTS, A SUMMARY OF THE POWERS, DESIGNATIONS, PREFERENCES AND RELATIVE, PARTICIPATING OPTIONAL OR OTHER SPECIAL RIGHTS OF EACH CLASS OF STOCK OF THE COMPANY AND THE QUALIFICATIONS, LIMITATIONS OR RESTRICTIONS OF SUCH PREFERENCES AND RIGHTS, AND THE VARIATIONS IN RIGHTS, PREFERENCES AND LIMITATIONS DETERMINED FOR EACH SERIES, WHICH ARE FIXED BY THE CERTIFICATE OF INCORPORATION OF THE COMPANY, AS AMENDED, AND THE RESOLUTIONS OF THE BOARD OF DIRECTORS OF THE COMPANY, AND THE AUTHORITY OF THE BOARD OF DIRECTORS TO DETERMINE VARIATIONS FOR FURTURE SERIES. SUCH REQUEST MAY BE MADE TO THE OFFICE OF THE SECRETARY OF THE COMPANY OR TO THE TRANSFER AGENT. THE BOARD OF DIRECTORS MAY REQUIRE THE OWNER OF A LOST OR DESTROYED STOCK CERTIFICATE, OR HIS LEGAL REPRESENTATIVES, TO GIVE THE COMPANY A BOND TO INDEMNIFY IT AND ITS TRANSFER AGENTS
AND REGISTRARS AGAINST ANY CLAIM THAT MAY BE MADE AGAINST THEM ON ACCOUNT OF THE ALLEGED LOSS OR DESTRUCTION OF ANY SUCH CERTIFICATE.
|
| PLEASE INSERT SOCIAL SECURITY OR OTHER IDENTIFYING NUMBER OF ASSIGNEE | ||||
For value |
| hereby sell assign and |
| |||
(PLEASE PRINT OR TYPEWRITE NAME AND ADDRESS, INCLUDING POSTAL ZIP CODE, OF ASSIGNEE) | ||||||
| ||||||
| ||||||
|
|
|
| |||
|
|
|
| |||
|
|
|
| |||
| Shares | |||||
of the Class A common stock represented by the within Certificate, and do hereby irrevocably constitute and appoint |
| |||||
| Attorney | |||||
to transfer the said stock on the books of the within-named Corporation with full power of substitution in the premises. |
| |||||
|
|
|
|
|
| ||||
Dated: |
|
| 20 |
|
| Signature(s) Guaranteed: Medallion | |||
|
|
|
|
|
| THE SIGNATURE(S) SHOULD BE GUARANTEED BY AN ELIGIBLE GUARANTOR INSTITUTION (Banks, Stockbrokers, Savings and Loan Associations and Credit Unions) WITH MEMBERSHIP IN AN APPROVED SIGNATURE GUARANTEE MEDALLION PROGRAM, PURSUANT TO S.E.C. RULE 17Ad-15 | |||
Signature: |
|
|
|
|
|
| |||
|
|
|
|
|
|
| |||
|
|
|
|
|
|
| |||
|
|
|
|
|
|
| |||
Signature: |
|
|
|
|
|
| |||
|
|
|
|
|
|
| |||
|
| Notice: | The signature to this assignment must correspond with the name as written upon the face of the certificate, in every particular, without alteration or enlargement, or any change whatever. |
|
|
| |||