Statement of ERISA Rights Clause Example with 18 Variations from Business Contracts

This page contains Statement of ERISA Rights clauses in business contracts and legal agreements. An example clause is provided at the top of the page, followed by clauses with minor variations. You can view the text differences by selecting the "Show Differences" option.
Statement of ERISA Rights. As a Participant under the Plan, you have certain rights and protections under ERISA: (a) You may examine (without charge) all Plan documents, including any amendments and copies of all documents filed with the U.S. Department of Labor. These documents are available for your review upon written request to the Administrator. (b) You may obtain copies of all Plan documents and other Plan information upon written request to the Administrator. A reasonable charge may be made for such copies. In addi...tion to creating rights for Participants, ERISA imposes duties upon the people who are responsible for the operation of the Plan. The people who operate the Plan (called "fiduciaries") have a duty to do so prudently and in the interests of you and the other Participants. No one, including the Company or any other person, may fire you or otherwise discriminate against you in any way to prevent you from obtaining a benefit under the Plan or exercising your rights under ERISA. If your claim for a severance benefit is denied, in whole or in part, you must receive a written explanation of the reason for the denial. You have the right to have the denial of your claim reviewed. (The claim review procedure is explained in Section 14 above.) Under ERISA, there are steps you can take to enforce the above rights. For example, if you request materials and do not receive them within 30 days, you may file suit in a federal court. In such a case, the court may require the Administrator to provide -14- the materials and to pay you up to $110 a day until you receive the materials, unless the materials were not sent due to reasons beyond the control of the Administrator. If you have a claim which is denied or ignored, in whole or in part, you may file suit in a federal court. If it should happen that you are discriminated against for asserting your rights, you may seek assistance from the U.S. Department of Labor, or you may file suit in a federal court. In any case, the court will decide who will pay court costs and legal fees. If you are successful, the court may order the person you have sued to pay these costs and fees. If you lose, the court may order you to pay these costs and fees, for example, if it finds that your claim is frivolous. If you have any questions regarding the Plan, please contact the Administrator. If you have any questions about this statement or about your rights under ERISA, you may contact the nearest area office of the Employee Benefits Security Administration (formerly the Pension and Welfare Benefits Administration), U.S. Department of Labor, listed in your telephone directory, or the Division of Technical Assistance and Inquiries, Employee Benefits Security Administration, U.S. Department of Labor, 200 Constitution Avenue, N.W. Washington, D.C. 20210. You also may obtain certain publications about your rights and responsibilities under ERISA by calling the publications hotline of the Employee Benefits Security Administration. o 0 o -15- Appendix A Lyft, Inc. Executive Change in Control and Severance Plan Participation Agreement Lyft, Inc. (the "Company") is pleased to inform you, , that you have been selected to participate in the Company's Executive Change in Control and Severance Plan (the "Plan") as a Participant. A copy of the Plan was delivered to you with this Participation Agreement. Your participation in the Plan is subject to all of the terms and conditions of the Plan. The capitalized terms used but not defined herein will have the meanings ascribed to them in the Plan. In order to actually become a participant in the Plan, you must complete and sign this Participation Agreement and return it to [NAME] no later than [DATE]. The Plan describes in detail certain circumstances under which you may become eligible for Severance Benefits. As described more fully in the Plan, you may become eligible for certain Severance Benefits if you experience an Involuntary Termination. View More Arrow
Found in Lyft, Inc. contract

Variations of a "Statement of ERISA Rights" Clause from Business Contracts

Statement of ERISA Rights. As Participants in this Plan (which is a Participant under the Plan, you have welfare benefit plan sponsored by Vor Biopharma Inc.) are entitled to certain rights and protections under ERISA: ERISA. If you are an Eligible Employee, you are considered a participant in the Plan and, under ERISA, you are entitled to: (a) You may examine (without charge) all Receive Information About Your Plan documents, including any amendments and copies of Benefits (i) Examine, without charge, at the Plan Adminis...trator's office and at other specified locations, such as worksites, all documents governing the Plan and a copy of the latest annual report (Form 5500 Series), if applicable, filed by the Plan with the U.S. Department of Labor. These documents are Labor and available for your review at the Public Disclosure Room of the Employee Benefits Security Administration; (ii) Obtain, upon written request to the Administrator. (b) You may obtain Plan Administrator, copies of all documents governing the operation of the Plan documents and other copies of the latest annual report (Form 5500 Series), if applicable, and an updated (as necessary) Summary Plan information upon written request to the Administrator. A Description. The Administrator may make a reasonable charge may be made for such copies. the copies; and (iii) Receive a summary of the Plan's annual financial report, if applicable. The Plan Administrator is required by law to furnish each Eligible Employee with a copy of this summary annual report. 12 (b) Prudent Actions by Plan Fiduciaries. In addition to creating rights for Participants, Plan Eligible Employees, ERISA imposes duties upon the people who are responsible for the operation of the Plan. employee benefit plan. The people who operate the Plan (called "fiduciaries") Plan, called "fiduciaries" of the Plan, have a duty to do so prudently and in the interests interest of you and the other Participants. Eligible Employees and beneficiaries. No one, including the Company your employer, your union or any other person, may fire you or otherwise discriminate against you in any way to prevent you from obtaining a Plan benefit under the Plan or exercising your rights under ERISA. (c) Enforce Your Rights. If your claim for a severance Plan benefit is denied, denied or ignored, in whole or in part, you must receive have a written explanation of the reason for the denial. You have the right to have know why this was done, to obtain copies of documents relating to the denial of your claim reviewed. (The claim review procedure is explained in Section 14 above.) decision without charge, and to appeal any denial, all within certain time schedules. Under ERISA, there are steps you can take to enforce the above rights. For example, instance, if you request materials a copy of Plan documents or the latest annual report from the Plan, if applicable, and do not receive them within 30 days, you may file suit in a federal Federal court. In such a case, the court may require the Plan Administrator to provide -14- the materials and to pay you up to $110 a day until you receive the materials, unless the materials were not sent due to because of reasons beyond the control of the Plan Administrator. If you have a claim for benefits which is denied or ignored, in whole or in part, you may file suit in a federal state or Federal court. If it should happen that you are discriminated against for asserting your rights, you may seek assistance from the U.S. Department of Labor, or you may file suit in a federal Federal court. In any case, the The court will decide who will should pay court costs and legal fees. If you are successful, the court may order the person you have sued to pay these costs and fees. If you lose, the court may order you to pay these costs and fees, for example, if it finds that your claim is frivolous. (d) Assistance with Your Questions. If you have any questions regarding about the Plan, please you should contact the Plan Administrator. If you have any questions about this statement or about your rights under ERISA, or if you may need assistance in obtaining documents from the Plan Administrator, you should contact the nearest area office of the Employee Benefits Security Administration (formerly the Pension and Welfare Benefits Administration), Administration, U.S. Department of Labor, listed in your telephone directory, directory or the Division of Technical Assistance and Inquiries, Employee Benefits Security Administration, U.S. Department of Labor, 200 Constitution Avenue, N.W. Avenue N.W., Washington, D.C. 20210. You may also may obtain certain publications about your rights and responsibilities under ERISA by calling the publications hotline of the Employee Benefits Security Administration. o 0 o -15- Appendix A Lyft, Inc. Adopted by the Board: January 19, 2021 13 EX-10.15 12 d942530dex1015.htm EX-10.15 EX-10.15 Exhibit 10.15 VOR BIOPHARMA INC. Executive Severance and Change in Control Benefits Plan 1. Establishment of Plan. Vor Biopharma Inc., a Delaware corporation, hereby establishes an unfunded severance benefits plan (the "Plan") that is intended to be a welfare benefit plan within the meaning of Section 3(1) of ERISA. The Plan is in effect for Covered Employees who experience a Covered Termination occurring after the Effective Date and Severance before the termination of this Plan. This Plan Participation Agreement Lyft, Inc. (the "Company") is pleased supersedes any and all (i) severance plans and separation policies applying to inform you, , Covered Employees that you may have been selected in effect before the Effective Date with respect to participate in the Company's Executive Change in Control and Severance Plan (the "Plan") as a Participant. A copy of the Plan was delivered to you with this Participation Agreement. Your participation in the Plan is subject to all of any termination that would, under the terms of this Plan, constitute a Covered Termination and conditions (ii) the provisions of any agreements between any Covered Employee and the Plan. The capitalized terms used but not defined herein will have the meanings ascribed to them in the Plan. In order to actually become a participant in the Plan, you must complete and sign this Participation Agreement and return it to [NAME] no later than [DATE]. The Plan describes in detail certain circumstances under which you may become eligible Company that provide for Severance Benefits. As described more fully in the Plan, you may become eligible for certain Severance Benefits if you experience an Involuntary Termination. severance benefits. View More Arrow
Found in Vor Biopharma Inc. contract
Statement of ERISA Rights. As a Participant Covered Employee under the Plan, you have certain rights and protections under ERISA: (a) You (a)You may examine (without charge) all Plan documents, including any amendments and copies of all documents filed with the U.S. Department of Labor. These documents are available for your review upon written request to in the Administrator. (b) You Company's Human Resources Department. (b)You may obtain copies of all Plan documents and other Plan information upon written request to the... Administrator. A reasonable charge may be made for such copies. In addition to creating rights for Participants, Covered Employees, ERISA imposes duties upon the people who are responsible for the operation of the Plan. The people who operate the Plan (called "fiduciaries") have a duty to do so prudently and in the interests of you and the other Participants. Covered Employees. No one, including the Company or any other person, may fire you or otherwise discriminate against you in any way to prevent you from obtaining a benefit under the Plan or exercising your rights under ERISA. If your claim for a severance benefit is denied, in whole or in part, you must receive a written explanation of the reason for the denial. You have the right to have the denial of your claim reviewed. (The claim review procedure is explained in Section Sections 14 and 15 above.) Under ERISA, there are steps you can take to enforce the above rights. For example, instance, if you request materials and do not receive them within 30 thirty (30) days, you may file suit in a federal court. In such a case, the court may require the Administrator to provide -14- the materials and to pay you up to $110 a day until you receive the materials, unless the materials were not sent due to because of reasons beyond the control of the Administrator. If you have a claim which is denied 12 4883-2460-1861.2 sf-4645817 or ignored, in whole or in part, you may file suit in a federal court. If it should happen that you are discriminated against for asserting your rights, you may seek assistance from the U.S. Department of Labor, or you may file suit in a federal court. In any case, the court will decide who will pay court costs and legal fees. If you are successful, the court may order the person you have sued to pay these costs and fees. If you lose, the court may order you to pay these costs and fees, for example, if it finds that your claim is frivolous. If you have any questions regarding the Plan, please contact the Administrator. If you have any questions about this statement or about your rights under ERISA, you may contact the nearest area office of the Employee Benefits Security Administration (formerly the Pension and Welfare Benefits Administration), U.S. Department of Labor, listed in your telephone directory, or the Division of Technical Assistance and Inquiries, Employee Benefits Security Administration, U.S. Department of Labor, 200 Constitution Avenue, N.W. Washington, D.C. 20210. You may also may obtain certain publications about your rights and responsibilities under ERISA by calling the publications hotline of the Employee Benefits Security Administration. o 0 o -15- 13 4883-2460-1861.2 sf-4645817 Appendix A Lyft, Inc. Executive Aplan participants CEO, CFO and COO 4883-2460-1861.2 sf-4645817 APPENDIX B mcgrath rentcorp CHANGE in CONTROL SEVERANCE PLAN PARTICIPATION AGREEMENT This Participation Agreement (the "Agreement") with respect to participation in the McGrath RentCorp Change in Control and Severance Plan Participation Agreement Lyft, Inc. (the "Plan") is made as of __________, 20__ by and between McGrath RentCorp (the "Company") and [Click and Type Name] ("Employee"). Capitalized terms not otherwise defined herein shall have the meanings given to them in the Plan. WHEREAS, the Company has adopted and sponsors the Plan, a copy of which is pleased to inform you, , that you have attached hereto; and WHEREAS, Employee has been selected to participate in the Company's Executive Change Plan in Control accordance with and Severance Plan (the "Plan") as a Participant. A copy subject to the terms of the Plan was delivered and this Agreement. NOW, THEREFORE, in consideration of the mutual promises made herein, the parties hereby agree as follows: 1. Participation. Employee has been designated as a Covered Employee in the Plan, subject to you Employee executing this Agreement pursuant to which Employee has agreed to, among other things, (i) waive his or her rights to any severance benefits provided under any other agreement with this Participation Agreement. Your the Company or arrangement or plan sponsored by the Company and (ii) amend any existing employment or other agreement by and between Employee and the Company pursuant to which Employee is entitled to receive severance benefits to remove the severance provisions from such agreement. The terms and conditions of Covered Employee's participation in the Plan is subject to all of the terms and conditions of the Plan. The capitalized terms used but not defined herein will have the meanings ascribed to them are as set forth in the Plan. In order to actually become a participant in the Plan, you must complete Plan and sign this Participation Agreement and return it to [NAME] no later than [DATE]. The Plan describes in detail certain circumstances under which you may become eligible for Severance Benefits. As described more fully in the Plan, you may become eligible for certain Severance Benefits if you experience an Involuntary Termination. herein. View More Arrow
Found in MCGRATH RENTCORP contract
Statement of ERISA Rights. As a Participant Covered Employee under the Plan, you have certain rights and protections under ERISA: (a) You may examine (without charge) all Plan documents, including any amendments and copies of all documents filed with the U.S. Department of Labor. These documents are available for your review upon written request to in the Administrator. Company's Human Resources Department. (b) You may obtain copies of all Plan documents and other Plan information upon written request to the Administrator.... A reasonable charge may be made for such copies. In addition to creating rights for Participants, Covered Employees, ERISA imposes duties upon the people who are responsible for the operation of the Plan. The people who operate the Plan (called "fiduciaries") have a duty to do so prudently and in the interests of you and the other Participants. Covered Employees. No one, including the Company or any other person, may fire you or otherwise discriminate against you in any way to prevent you from obtaining a benefit under the Plan or exercising your rights under ERISA. If your claim for a severance benefit Severance Benefit is denied, in whole or in part, you must receive have a written explanation of the reason for the denial. You have the right to have know why, to obtain copies of documents relating to the denial of your claim reviewed. (The claim review procedure is explained decision without charge, and to appeal any denial, all within certain time schedules, in accordance with Section 14 above.) 12 and Section 13. Under ERISA, there are steps you can take to enforce the above rights. For example, instance, if you request materials a copy of Plan documents and do not receive them within 30 thirty (30) days, you may file suit in a federal court. In such a case, the court may require the Administrator to provide -14- the materials and to pay you up to $110 a day until you receive the materials, unless the materials were not sent due to because of reasons beyond the control of the Administrator. If you have a claim which is denied or ignored, in whole or in part, you may file suit in a federal court. If it should happen that you are discriminated against for asserting your rights, you may seek assistance from the U.S. Department of Labor, or you may file suit in a federal court. In any case, the The court will decide who will should pay court costs and legal fees. If you are successful, the court may order the person you have sued to pay these costs and fees. If you lose, the court may order you to pay these costs and fees, for example, if it finds that your claim is frivolous. If you have any questions regarding the Plan, please contact the Administrator. If you have any questions about this statement or about your rights under ERISA, you may contact the nearest area office of the Employee Benefits Security Administration (formerly the Pension and Welfare Benefits Administration), Administration, U.S. Department of Labor, listed in your telephone directory, or the Division of Technical Assistance and Inquiries, Employee Benefits Security Administration, U.S. Department of Labor, 200 Constitution Avenue, N.W. Washington, D.C. 20210. You may also may obtain certain publications about your rights and responsibilities under ERISA by calling the publications hotline of the Employee Benefits Security Administration. o 0 o -15- Appendix A Lyft, Administration at 1-866-444-3272. * * * * * EX-10.27 26 d833938dex1027.htm EX-10.27 EX-10.27 Exhibit 10.27 CARDIVA MEDICAL, INC. SEVERANCE PLAN AND SUMMARY PLAN DESCRIPTION (Adopted by the Board of Directors on March 2, 2020) 1. Introduction. The purpose of this Cardiva Medical, Inc. Executive Change in Control and Severance Plan Participation Agreement Lyft, Inc. (the "Company") (as may be amended from time to time, the "Plan") is pleased to inform you, , that you have been selected provide specified severance benefits to participate eligible employees of the Company or a Subsidiary whose employment is involuntarily terminated by the Company or a Subsidiary other than for Cause or who resign for Good Reason under the circumstances described in the Company's Executive Change Plan. The Plan is an "employee welfare benefit plan," as defined in Control and Severance Plan (the "Plan") as a Participant. A copy Section 3(1) of the Plan was delivered to you with this Participation Agreement. Your participation in Employee Retirement Income Security Act of 1974, as amended. This document constitutes both the written instrument under which the Plan is subject to all of maintained and the terms and conditions of required summary plan description for the Plan. The capitalized terms used but not defined herein will have the meanings ascribed to them in the Plan. In order to actually become a participant in the Plan, you must complete and sign this Participation Agreement and return it to [NAME] no later than [DATE]. The Plan describes in detail certain circumstances under which you may become eligible for Severance Benefits. As described more fully in the Plan, you may become eligible for certain Severance Benefits if you experience an Involuntary Termination. View More Arrow
Found in Cardiva Medical, Inc. contract
Statement of ERISA Rights. As a Participant under an employee eligible to participate in the Plan, you have are entitled to certain rights and protections under ERISA: (a) You may examine (without charge) the Employee Retirement Income Security Act of 1974 (ERISA). 14.1Receive Information About Your Plan and Benefit. ERISA provides that all Plan documents, including any amendments plan participants shall be entitled to: (i)Examine, without charge, at the Administrator's office and copies of at other specified locations, s...uch as worksites, all documents governing the plan, and (if applicable) a copy of the latest annual report (Form 5500 Series) filed by the plan with the U.S. U. S. Department of Labor. These documents are Labor and available for your review at the Public Disclosure Room of the Employee Benefits Security Administration. 14 (ii)Obtain, upon written request to the Administrator. (b) You may obtain Administrator, copies of all Plan documents and other Plan information upon written request to the Administrator. A reasonable charge may be made for such copies. In addition to creating rights for Participants, ERISA imposes duties upon the people who are responsible for governing the operation of the Plan. plan, and (if applicable) copies of the latest annual report (Form 5500 Series) and updated summary plan description. The people who operate Administrator may make a reasonable charge for the copies. (iii)Receive a summary of the plan's annual financial report (if applicable). 14.2Actions by Plan (called "fiduciaries") have a duty to do so prudently and in the interests of you and the other Participants. Fiduciaries. No one, including the Company your employer, or any other person, may fire you or otherwise discriminate against you in any way to prevent you from obtaining a benefit under the Plan or exercising your rights under ERISA. 14.3Enforce Your Rights. If your claim for a severance benefit is denied, denied or ignored, in whole or in part, you must receive have a written explanation of the reason for the denial. You have the right to have know why this was done, to obtain copies of documents relating to the denial of your claim reviewed. (The claim review procedure is explained in Section 14 above.) decision without charge, and to appeal any denial, all within certain time schedules. Under ERISA, there are steps you can take to enforce the above rights. For example, instance, if you request materials a copy of plan documents or the latest annual report from the plan and do not receive them within 30 days, you may file suit in a federal Federal court. In such a case, the court may require the Administrator to provide -14- the materials and to pay you up to $110 a day until you receive the materials, unless the materials were not sent due to because of reasons beyond the control of the Administrator. If you have a claim which for benefits that is denied or ignored, in whole or in part, you may file suit in a federal state of Federal court. If it should happen that you are discriminated against for asserting your rights, you may seek assistance from the U.S. U. S. Department of Labor, or you may file suit in a federal Federal court. In any case, the The court will decide who will should pay court costs and legal fees. If you are successful, successful the court may order the person you have sued to pay these costs and fees. If you lose, the court may order you to pay these costs and fees, for example, if it finds that your claim is frivolous. 14.4Assistance with Your Questions. If you have any questions regarding the Plan, please about your plan, you should contact the Administrator. If you have any questions about this statement or about your rights under ERISA, or if you may need assistance in obtaining documents form the Administrator, you should contact the nearest area office of the Employee Benefits Security Administration (formerly the Pension and Welfare Benefits Administration), U.S. Administration. U. S. Department of Labor, listed in your telephone directory, directory or the Division of Technical Assistance and Inquiries, Employee Benefits Security Administration, U.S. Department of Labor, 200 Constitution Avenue, N.W. N.W., Washington, D.C. D. C. 20210. You may also may obtain certain publications about your rights and responsibilities under ERISA by calling the publications hotline of the Employee Benefits Security Administration. o 0 o -15- Appendix A Lyft, Inc. Executive Change in Control and Severance Plan Participation Agreement Lyft, Inc. (the "Company") is pleased to inform you, , that you have been selected to participate in the Company's Executive Change in Control and Severance Plan (the "Plan") as a Participant. A copy of the Plan was delivered to you with this Participation Agreement. Your participation in the Plan is subject to all of the terms and conditions of the Plan. The capitalized terms used but not defined herein will have the meanings ascribed to them in the Plan. In order to actually become a participant in the Plan, you must complete and sign this Participation Agreement and return it to [NAME] no later than [DATE]. The Plan describes in detail certain circumstances under which you may become eligible for Severance Benefits. As described more fully in the Plan, you may become eligible for certain Severance Benefits if you experience an Involuntary Termination. Administration at 800.998.7542. View More Arrow
Found in TripAdvisor, Inc. contract
Statement of ERISA Rights. As a Participant Covered Employee under the Plan, you have certain rights and protections under ERISA: (a) You may examine (without charge) all Plan documents, including any amendments and copies of all documents filed with the U.S. Department of Labor. These documents are available for your review upon written request to in the Administrator. Company's Human Resources Department. (b) You may obtain copies of all Plan documents and other Plan information upon written request to the Administrator.... A reasonable charge may be made for such copies. In addition to creating rights for Participants, Covered Employees, ERISA imposes duties upon the people who are responsible for the operation of the Plan. The people who operate the Plan (called "fiduciaries") have a duty to do so prudently and in the interests of you and the other Participants. Covered Employees. No one, including the Company or any other person, may fire you or otherwise discriminate against you in any way to prevent you from obtaining a benefit under the Plan or exercising your rights under ERISA. If your claim for a severance benefit is denied, in whole or in part, you must receive a written explanation of the reason for the denial. You have the right to have the denial of your claim reviewed. (The claim review procedure is explained in Section Sections 14 and 15 above.) 13 Under ERISA, there are steps you can take to enforce the above rights. For example, instance, if you request materials and do not receive them within 30 thirty (30) days, you may file suit in a federal court. In such a case, the court may require the Administrator to provide -14- the materials and to pay you up to $110 a day until you receive the materials, unless the materials were not sent due to because of reasons beyond the control of the Administrator. If you have a claim which is denied or ignored, in whole or in part, you may file suit in a federal court. If it should happen that you are discriminated against for asserting your rights, you may seek assistance from the U.S. Department of Labor, or you may file suit in a federal court. In any case, the court will decide who will pay court costs and legal fees. If you are successful, the court may order the person you have sued to pay these costs and fees. If you lose, the court may order you to pay these costs and fees, for example, if it finds that your claim is frivolous. If you have any questions regarding the Plan, please contact the Administrator. If you have any questions about this statement or about your rights under ERISA, you may contact the nearest area office of the Employee Benefits Security Administration (formerly the Pension and Welfare Benefits Administration), U.S. Department of Labor, listed in your telephone directory, or the Division of Technical Assistance and Inquiries, Employee Benefits Security Administration, U.S. Department of Labor, 200 Constitution Avenue, N.W. Washington, D.C. 20210. You may also may obtain certain publications about your rights and responsibilities under ERISA by calling the publications hotline of the Employee Benefits Security Administration. o 0 o -15- 14 Appendix A Lyft, Participants in Polycom, Inc. Executive Change in Control and Severance Plan Participation Agreement Lyft, Inc. (the "Company") is pleased as of January 31, 2013 Employee Name1 Section 16 Officers: Non-Section 16 Officers: 1 In accordance with Section 2.7, each U.S. employee of the Company who becomes a Section 16 Officer on or after the Effective Date shall be deemed to inform you, , that you have been selected designated by the Administrator to participate in the Company's Plan as of the date he or she becomes a Section 16 Officer and shall become a Covered Employee on such date, unless otherwise expressly determined by the Administrator. Appendix A shall be deemed to include each employee described in the preceding sentence, notwithstanding that Appendix A has not been updated to include such employee's name in the table above. A-1 EX-10.1 2 d480599dex101.htm EX-10.1 EX-10.1 Exhibit 10.1 POLYCOM, INC. EXECUTIVE SEVERANCE PLAN AND SUMMARY PLAN DESCRIPTION (January 31, 2013 Amendment and Restatement) 1. Introduction. The purpose of this Polycom, Inc. Executive Change in Control and Severance Plan (the "Plan") as a Participant. A copy is to provide assurances of specified severance benefits to eligible employees of the Company whose employment is subject to being involuntarily terminated other than for death, Disability, or Cause or voluntarily terminated for Good Reason under the circumstances described in the Plan. This Plan was delivered to you with this Participation Agreement. Your participation is an "employee welfare benefit plan," as defined in Section 3(1) of the Employee Retirement Income Security Act of 1974, as amended. This document constitutes both the written instrument under which the Plan is subject to all of maintained and the terms and conditions of summary plan description for the Plan. The capitalized terms used but not defined herein will have the meanings ascribed to them in the Plan. In order to actually become a participant in the Plan, you must complete and sign this Participation Agreement and return it to [NAME] no later than [DATE]. The Plan describes in detail certain circumstances under which you may become eligible for Severance Benefits. As described more fully in the Plan, you may become eligible for certain Severance Benefits if you experience an Involuntary Termination. View More Arrow
Found in POLYCOM INC contract
Statement of ERISA Rights. As a Participant under the Plan, participant in this Semtech Corporation Executive Change in Control Retention Plan you have are entitled to certain rights and protections under ERISA: (a) You may examine (without charge) the Employee Retirement Income Security Act of 1974 (as noted above, ERISA). ERISA provides that all Plan documents, including any amendments participants shall be entitled to: (a) Receive Information About Your Plan and copies of Benefits Examine, without charge, all documents... governing the Plan, and a copy of insurance contracts and the latest annual report (Form 5500 Series), if any, filed by the Plan with the U.S. Department of Labor. These documents are Labor and available for your review at the Public Disclosure Room of the Employee Benefits Security Administration and at Semtech's corporate office and other specified locations without charge. Obtain, upon written request to the Administrator. (b) You may obtain Administrative Committee, copies of all Plan documents governing the operation of the plan, including insurance contracts and other Plan information upon written request to copies of the Administrator. A latest annual report (Form 5500 Series), if any, and an updated summary plan description. The Administrative Committee may make a reasonable charge may be made for such the copies. Receive a summary of the Plan's annual financial report, if any. The Plan administrator is required by law to furnish each participant with a copy of this summary annual report, if any. (b) Prudent Actions by Plan Fiduciaries 16 In addition to creating rights for Participants, Plan participants ERISA imposes duties upon the people who are responsible for the operation of the Plan. The people who operate your Plan, called "fiduciaries" of the Plan (called "fiduciaries") Plan, have a duty to do so prudently and in the interests interest of you and the other Participants. Plan participants and beneficiaries. No one, including the Company your employer or any other person, may fire you or otherwise discriminate against you in any way to prevent you from obtaining a welfare benefit under the Plan or exercising your rights under ERISA. (c) Enforce Your Rights If your claim for a severance welfare benefit is denied, denied or ignored, in whole or in part, you must receive have a written explanation of the reason for the denial. You have the right to have know why this was done, to obtain copies of documents relating to the denial of your claim reviewed. (The claim review procedure is explained in Section 14 above.) decision without charge, and to appeal any denial, all within certain time schedules. Under ERISA, there are steps you can take to enforce the above rights. For example, instance, if you request materials a copy of Plan documents or the latest annual report, if any, from the Plan and do not receive them within 30 days, you may file suit in a federal Federal court. In such a case, the court may require the Administrator Plan administrator to provide -14- the materials and to pay you up to $110 a day until you receive the materials, unless the materials were not sent due to because of reasons beyond the control of the Administrator. administrator. If you have a claim for benefits which is denied or ignored, in whole or in part, you may file suit in a federal state or Federal court. In addition, if you disagree with the Plan's decision or lack thereof concerning the qualified status of a domestic relations order or a medical child support order, you may file suit in Federal court. If it should happen that Plan fiduciaries misuse the Plan's money, or if you are discriminated against for asserting your rights, you may seek assistance from the U.S. Department of Labor, or you may file suit in a federal Federal court. In any case, the The court will decide who will should pay court costs and legal fees. If you are successful, successful the court may order the person you have sued to pay these costs and fees. If you lose, the court may order you to pay these costs and fees, for example, if it finds that your claim is frivolous. (d) Assistance with Your Questions If you have any questions regarding the about your Plan, please you should contact the Administrator. Plan administrator. If you have any questions about this statement or about your rights under ERISA, or if you may need assistance in obtaining documents from the Plan administrator, you should contact the nearest area office of the Employee Benefits Security Administration (formerly the Pension and Welfare Benefits Administration), Administration, U.S. Department of Labor, listed in your telephone directory, directory or the Division of Technical Assistance and Inquiries, Employee Benefits Security Administration, U.S. Department of Labor, 200 Constitution Avenue, N.W. Avenue N.W., Washington, D.C. 20210. You may also may obtain certain publications about your rights and responsibilities under ERISA by calling the publications hotline of the Employee Benefits Security Administration. o 0 o -15- Appendix A Lyft, Inc. Executive Change in Control and Severance Plan Participation Agreement Lyft, Inc. (the "Company") is pleased to inform you, , that you have been selected to participate in the Company's Executive Change in Control and Severance Plan (the "Plan") as a Participant. A copy of the Plan was delivered to you with this Participation Agreement. Your participation in the Plan is subject to all of the terms and conditions of the Plan. The capitalized terms used but not defined herein will have the meanings ascribed to them in the Plan. In order to actually become a participant in the Plan, you must complete and sign this Participation Agreement and return it to [NAME] no later than [DATE]. The Plan describes in detail certain circumstances under which you may become eligible for Severance Benefits. As described more fully in the Plan, you may become eligible for certain Severance Benefits if you experience an Involuntary Termination. Administration or by visiting its website (http://www.dol.gov/ebsa/). View More Arrow
Found in Semtech Corporation contract
Statement of ERISA Rights. As a Participant Covered Employee under the Plan, you have certain rights and protections under ERISA: (a) You (a)You may examine (without charge) all Plan documents, including any amendments and copies of all documents filed with the U.S. Department of Labor. These documents are available for your review upon written request to in the Administrator. (b) You Company's Human Resources Department. (b)You may obtain copies of all Plan documents and other Plan information upon written request to the... Administrator. A reasonable charge may be made for such copies. In addition to creating rights for Participants, Covered Employees, ERISA imposes duties upon the people who are responsible for the operation of the Plan. The people who operate the Plan (called "fiduciaries") have a duty to do so prudently and in the interests of you and the other Participants. Covered Employees. No one, including the Company or any other person, may fire you or 12 pa-1562188 otherwise discriminate against you in any way to prevent you from obtaining a benefit under the Plan or exercising your rights under ERISA. If your claim for a severance benefit is denied, in whole or in part, you must receive a written explanation of the reason for the denial. You have the right to have the denial of your claim reviewed. (The claim review procedure is explained in Section Sections 14 and 15 above.) Under ERISA, there are steps you can take to enforce the above rights. For example, instance, if you request materials and do not receive them within 30 thirty (30) days, you may file suit in a federal court. In such a case, the court may require the Administrator to provide -14- the materials and to pay you up to $110 a day until you receive the materials, unless the materials were not sent due to because of reasons beyond the control of the Administrator. If you have a claim which is denied or ignored, in whole or in part, you may file suit in a federal court. If it should happen that you are discriminated against for asserting your rights, you may seek assistance from the U.S. Department of Labor, or you may file suit in a federal court. In any case, the court will decide who will pay court costs and legal fees. If you are successful, the court may order the person you have sued to pay these costs and fees. If you lose, the court may order you to pay these costs and fees, for example, if it finds that your claim is frivolous. If you have any questions regarding the Plan, please contact the Administrator. If you have any questions about this statement or about your rights under ERISA, you may contact the nearest area office of the Employee Benefits Security Administration (formerly the Pension and Welfare Benefits Administration), U.S. Department of Labor, listed in your telephone directory, or the Division of Technical Assistance and Inquiries, Employee Benefits Security Administration, U.S. Department of Labor, 200 Constitution Avenue, N.W. Washington, D.C. 20210. You may also may obtain certain publications about your rights and responsibilities under ERISA by calling the publications hotline of the Employee Benefits Security Administration. o 0 o -15- 13 pa-1562188 Appendix A Lyft, Inc. Executive Aplan participants pa-1562188 APPENDIX B mcgrath rentcorp CHANGE in CONTROL SEVERANCE PLAN PARTICIPATION AGREEMENT This Participation Agreement (the "Agreement") with respect to participation in the McGrath RentCorp Change in Control and Severance Plan Participation Agreement Lyft, Inc. (the "Plan") is made as of January 1, 2017 by and between McGrath RentCorp (the "Company") and [Click and Type Name] ("Employee"). Capitalized terms not otherwise defined herein shall have the meanings given to them in the Plan. WHEREAS, the Company has adopted and sponsors the Plan, a copy of which is pleased to inform you, , that you have attached hereto; and WHEREAS, Employee has been selected to participate in the Company's Executive Change Plan in Control accordance with and Severance Plan (the "Plan") as a Participant. A copy subject to the terms of the Plan was delivered and this Agreement. NOW, THEREFORE, in consideration of the mutual promises made herein, the parties hereby agree as follows: 1. Participation. Employee has been designated as a Covered Employee in the Plan, subject to you Employee executing this Agreement pursuant to which Employee has agreed to, among other things, (i) waive his or her rights to any severance benefits provided under any other agreement with this Participation Agreement. Your the Company or arrangement or plan sponsored by the Company and (ii) amend any existing employment or other agreement by and between Employee and the Company pursuant to which Employee is entitled to receive severance benefits to remove the severance provisions from such agreement. The terms and conditions of Covered Employee's participation in the Plan is subject to all of the terms and conditions of the Plan. The capitalized terms used but not defined herein will have the meanings ascribed to them are as set forth in the Plan. In order to actually become a participant in the Plan, you must complete Plan and sign this Participation Agreement and return it to [NAME] no later than [DATE]. The Plan describes in detail certain circumstances under which you may become eligible for Severance Benefits. As described more fully in the Plan, you may become eligible for certain Severance Benefits if you experience an Involuntary Termination. herein. View More Arrow
Found in MCGRATH RENTCORP contract
Statement of ERISA Rights. As a Participant under the Plan, you have Participants in this Plan are entitled to certain rights and protections under ERISA: (a) You may examine (without charge) all ERISA. If you are an Eligible Employee, you are considered a participant in the Plan documents, including any amendments and, under ERISA, you are entitled to: (a)Receive Information About Your Plan and copies of Benefits (1)Examine, without charge, at the Plan Administrator's office and at other specified locations, such as work...sites, all documents governing the Plan and a copy of the latest annual report (Form 5500 Series), if applicable, filed by the Plan with the U.S. Department of Labor. These documents are Labor and available for your review at the Public Disclosure Room of the Employee Benefits Security Administration; (2)Obtain, upon written request to the Administrator. (b) You may obtain Plan Administrator, copies of all documents governing the operation of the Plan documents and other copies of the latest annual report (Form 5500 Series), if applicable, and an updated (as necessary) Summary Plan information upon written request to the Administrator. A Description. The Administrator may make a reasonable charge may be made for such copies. the copies; and (3)Receive a summary of the Plan's annual financial report, if applicable. The Plan Administrator is required by law to furnish each participant with a copy of this summary annual report. (b)Prudent Actions by Plan Fiduciaries. In addition to creating rights for Participants, Plan participants, ERISA imposes duties upon the people who are responsible for the operation of the Plan. employee benefit plan. The people who operate the Plan (called "fiduciaries") Plan, called "fiduciaries" of the Plan, have a duty to do so prudently and in the interests interest of you and the other Participants. Plan participants and beneficiaries. No one, including the Company your employer, your union or any other person, may fire you or otherwise discriminate against you in any way to prevent you from obtaining a Plan benefit under the Plan or exercising your rights under ERISA. (c)Enforce Your Rights. If your claim for a severance Plan benefit is denied, denied or ignored, in whole or in part, you must receive have a written explanation of the reason for the denial. You have the right to have know why this was done, to obtain copies of documents 11. 151739967 vl relating to the denial of your claim reviewed. (The claim review procedure is explained decision without charge, and to appeal any denial, all within certain time schedules as set forth in detail in Section 14 above.) 12 herein. Under ERISA, there are steps you can take to enforce the above rights. For example, instance, if you request materials a copy of Plan documents or the latest annual report from the Plan, if applicable, and do not receive them within 30 thirty (30) days, you may file suit in a federal court. Federal court and you are not required to follow the claims procedure set forth in Section 12 herein. In such a case, the court may require the Plan Administrator to provide -14- the materials and to pay you up to $110 a day until you receive the materials, unless the materials were not sent due to because of reasons beyond the control of the Plan Administrator. If you have completed the claims and appeals procedure described in Section 12 and have a claim for benefits which is denied or ignored, in whole or in part, you may file suit in a federal state or Federal court. If it should happen that you are discriminated against for asserting your rights, you may seek assistance from the U.S. Department of Labor, or you may file suit in a federal Federal court. In any case, the The court will decide who will should pay court costs and legal fees. If you are successful, the court may order the person you have sued to pay these costs and fees. If you Ifyou lose, the court may order you to pay these costs and fees, for example, if it finds that your claim is frivolous. (d)Assistance with Your Questions. If you have any questions regarding about the Plan, please you should contact the Plan Administrator. If you have any questions about this statement or about your rights under ERISA, or if you may need assistance in obtaining documents from the Plan Administrator, you should contact the nearest area office of the Employee Benefits Security Administration (formerly the Pension and Welfare Benefits Administration), Administration, U.S. Department of Labor, listed in your telephone directory, directory or the Division of Technical Assistance and Inquiries, Employee Benefits Security Administration, U.S. Department of Labor, 200 Constitution Avenue, N.W. Avenue N.W., Washington, D.C. 20210. You may also may obtain certain publications about your rights and responsibilities under ERISA by calling the publications hotline of the Employee Benefits Security Administration. o 0 o -15- Appendix A Lyft, Inc. Executive Change in Control and Severance Plan Participation Agreement Lyft, Inc. (the "Company") is pleased to inform you, , that you have been selected to participate in the Company's Executive Change in Control and Severance Plan (the "Plan") as a Participant. A copy of the Plan was delivered to you with this Participation Agreement. Your participation in the Plan is subject to all of the terms and conditions of the Plan. The capitalized terms used but not defined herein will have the meanings ascribed to them in the Plan. In order to actually become a participant in the Plan, you must complete and sign this Participation Agreement and return it to [NAME] no later than [DATE]. The Plan describes in detail certain circumstances under which you may become eligible for Severance Benefits. As described more fully in the Plan, you may become eligible for certain Severance Benefits if you experience an Involuntary Termination. Administration or accessing its website at http://www.dol.gov/ebsa/. View More Arrow
Found in Aravive, Inc. contract
Statement of ERISA Rights. As a Participant Covered Employee under the Plan, you have certain rights and protections under ERISA: (a) You may examine (without charge) all Plan documents, including any amendments and copies of all documents filed with the U.S. Department of Labor. These documents are available for your review upon written request to in the Administrator. Company's Human Resources Department. (b) You may obtain copies of all Plan documents and other Plan information upon written request to the Administrator.... A reasonable charge may be made for such copies. In addition to creating rights for Participants, Covered Employees, ERISA imposes duties upon the people who are responsible for the operation of the Plan. The people who operate the Plan (called "fiduciaries") have a duty to do so prudently and in the interests of you and the other Participants. Covered Employees. No one, including the Company or any other person, may fire you or otherwise discriminate against you in any way to prevent you from obtaining a benefit under the Plan or exercising your rights under ERISA. If your claim for a severance benefit is denied, in whole or in part, you must receive a written explanation of the reason for the denial. You have the right to have the denial of your claim reviewed. (The claim review procedure is explained in Section 14 Sections 15 and 16 above.) Under ERISA, there are steps you can take to enforce the above rights. For example, instance, if you request materials and do not receive them within 30 thirty (30) days, you may file suit in a federal court. In such a case, the court may require the Administrator to provide -14- the materials and to pay you up to $110 a day until you receive the materials, unless the materials were not sent due to because of reasons beyond the control of the Administrator. If you have a claim which is denied or ignored, in whole or in part, you may file suit in a federal court. If it should happen that you are discriminated against for asserting your rights, you may seek assistance from the U.S. Department of Labor, or you may file suit in a federal court. In any case, the court will decide who will pay court costs and legal fees. If you are successful, the court may order the person you have sued to pay these costs and fees. If you lose, the court may order you to pay these costs and fees, for example, if it finds that your claim is frivolous. If you have any questions regarding the Plan, please contact the Administrator. If you have any questions about this statement or about your rights under ERISA, you may contact the nearest area office of the Employee Benefits Security Administration (formerly the Pension and Welfare Benefits Administration), U.S. Department of Labor, listed in your telephone directory, or the Division of Technical Assistance and Inquiries, Employee Benefits Security Administration, U.S. Department of Labor, 200 Constitution Avenue, N.W. Washington, D.C. 20210. You may also may obtain certain publications about your rights and responsibilities under ERISA by calling the publications hotline of the Employee Benefits Security Administration. o 0 o -15- Appendix A Lyft, Inc. ATMEL CORPORATIONAMENDED AND RESTATED SENIOR EXECUTIVE CHANGE OF CONTROL AND SEVERANCE PLANPARTICIPATION AGREEMENTThis Participation Agreement (the "Agreement") with respect to participation in the Atmel Corporation Amended and Restated Senior Executive Change in of Control and Severance Plan Participation Agreement Lyft, Inc. (the "Plan") is made as of [INSERT DATE] by and between Atmel Corporation (the "Company") and [INSERT NAME] ("Employee"). Capitalized terms not otherwise defined herein shall have the meanings given to them in the Plan.WHEREAS, the Company had previously adopted the Atmel Corporation Senior Executive Change of Control and Severance Plan as of August 5, 2013 (the "2013 Plan"); WHEREAS, the Company amended and restated the 2013 Plan and has adopted and sponsors the Plan, a copy of which is pleased to inform you, , that you have attached hereto; and WHEREAS, Employee has been selected to participate in the Company's Executive Change Plan in Control accordance with and Severance Plan (the "Plan") as a Participant. A copy subject to the terms of the Plan was delivered and this Agreement. NOW, THEREFORE, in consideration of the mutual promises made herein, the parties hereby agree as follows: 1.Participation. Employee has been designated as a Covered Employee in the Plan, subject to you Employee executing this Agreement pursuant to which Employee has agreed to, among other things, (i) waive his or her rights to any severance benefits provided under any other agreement with this Participation Agreement. Your the Company or arrangement or plan sponsored by the Company and (ii) amend any existing employment or other agreement by and between Employee and the Company pursuant to which Employee is entitled to receive severance benefits to remove the severance provisions from such agreement. The terms and conditions of Covered Employee's participation in the Plan is subject to all of the terms and conditions of the Plan. The capitalized terms used but not defined herein will have the meanings ascribed to them are as set forth in the Plan. In order to actually become a participant in the Plan, you must complete Plan and sign this Participation Agreement and return it to [NAME] no later than [DATE]. The Plan describes in detail certain circumstances under which you may become eligible for Severance Benefits. As described more fully in the Plan, you may become eligible for certain Severance Benefits if you experience an Involuntary Termination. herein. View More Arrow
Found in ATMEL CORP contract
Statement of ERISA Rights. As a Participant Covered Employee under the Plan, you have certain rights and protections under ERISA: (a) You may examine (without charge) all Plan documents, including any amendments and copies of all documents filed with the U.S. Department of Labor. These documents are available for your review upon written request to in the Administrator. Company's Human Resources Department. (b) You may obtain copies of all Plan documents and other Plan information upon written request to the Administrator.... A reasonable charge may be made for such copies. In addition to creating rights for Participants, Covered Employees, ERISA imposes duties upon the people who are responsible for the operation of the Plan. The people who operate the Plan (called "fiduciaries") have a duty to do so prudently and in the interests of you and the other Participants. Covered Employees. No one, including the Company or any other person, may fire you or otherwise discriminate against you in any way to prevent you from obtaining a benefit under the Plan or exercising your rights under ERISA. If your claim for a severance benefit is denied, in whole or in part, you must receive have a written explanation of the reason for the denial. You have the right to have know why this was done, to obtain copies of documents relating to the denial of your claim reviewed. decision without charge, and to appeal any denial, all within certain time schedules. (The claim review procedure is explained in Section 13 and Section 14 above.) 11 Under ERISA, there are steps you can take to enforce the above rights. For example, instance, if you request materials a copy of Plan documents and do not receive them within 30 thirty (30) days, you may file suit in a federal court. In such a case, the court may require the Administrator to provide -14- the materials and to pay you up to $110 a day until you receive the materials, unless the materials were not sent due to because of reasons beyond the control of the Administrator. If you have a claim which is denied or ignored, in whole or in part, you may file suit in a federal court. If it should happen that you are discriminated against for asserting your rights, you may seek assistance from the U.S. Department of Labor, or you may file suit in a federal court. In any case, the The court will decide who will should pay court costs and legal fees. If you are successful, the court may order the person you have sued to pay these costs and fees. If you lose, the court may order you to pay these costs and fees, for example, if it finds that your claim is frivolous. If you have any questions regarding the Plan, please contact the Administrator. If you have any questions about this statement or about your rights under ERISA, you may contact the nearest area office of the Employee Benefits Security Administration (formerly the Pension and Welfare Benefits Administration), Administration, U.S. Department of Labor, listed in your telephone directory, or the Division of Technical Assistance and Inquiries, Employee Benefits Security Administration, U.S. Department of Labor, 200 Constitution Avenue, N.W. Washington, D.C. 20210. You may also may obtain certain publications about your rights and responsibilities under ERISA by calling the publications hotline of the Employee Benefits Security Administration. o 0 o -15- Appendix A Lyft, Administration at 1-866-444-3272. 12 EX-10.1 2 evbg-ex10_1.htm EX-10.1 EX-10.1 Exhibit 10.1 EVERBRIDGE, INC. SEVERANCE PLAN AND SUMMARY PLAN DESCRIPTION (Adopted by the Board of Directors on August 5, 2022) 1. Introduction. The purpose of this Everbridge, Inc. Executive Change in Control and Severance Plan Participation Agreement Lyft, Inc. (the "Company") is pleased to inform you, , that you have been selected to participate in the Company's Executive Change in Control and Severance Plan (the "Plan") as a Participant. A copy is to provide assurances of specified severance benefits to eligible employees of the Company whose employment is subject to being involuntarily terminated by the Company other than for Cause or who resign for Good Reason under the circumstances described in the Plan. The Plan was delivered to you with this Participation Agreement. Your participation is an "employee welfare benefit plan," as defined in Section 3(1) of the Employee Retirement Income Security Act of 1974, as amended. This document constitutes both the written instrument under which the Plan is subject to all of maintained and the terms and conditions of required summary plan description for the Plan. The capitalized terms used but not defined herein will have the meanings ascribed to them in the Plan. In order to actually become a participant in the Plan, you must complete and sign this Participation Agreement and return it to [NAME] no later than [DATE]. The Plan describes in detail certain circumstances under which you may become eligible for Severance Benefits. As described more fully in the Plan, you may become eligible for certain Severance Benefits if you experience an Involuntary Termination. View More Arrow
Found in EVERBRIDGE, INC. contract