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NAME LAST FIRST MIDDLE
TITLE 1
TITLE 2/ DEPT NAME
TITLE 3/ DEPT NAME
BUSINESS CARD ORDER FORMYou may order standard Aquo business cards using this form. Please allow 7 to 10 days for delivery. Deadline for order placement is each Wednesday at 12pm Pacific Time.
PERSONAL 1INFO
LOCATION 2
QUANTITY 3
SUBMIT
ADDRESS 1
ADDRESS 2
cITY STATE zIP
TELEPHONE AREA cODE NUMBER
MAIN LINE EXT
PHONE LABEL PHONE #
PHONE LABEL PHONE #
EMAIL ADDRESS
250 500 1,000
John DoeSales Manager
Aquo Energy Drinks, Ltd.345 Park AvenueSan Jose, CA 95110-2704555.555.5555 (phone)555.555.5555 (fax)
john@aquo-drinks.com
Aquo Energy Drinks, Ltd. 345 Park Avenue, San Jose, California 95110-2704 phone 555.555.6000 fax 555.555.6001 www.aquo-drinks.com
401(K) RETIREMENT SAVINGS PLAN To become a Participant in the Aquo Energy Drinks, Ltd. 401(k) Retirement Savings Plan, you must meet the applicable eligibility requirements. Once you become a Participant, Aquo will maintain an individual account for you. Your account will be valued to reflect contributions, gains, losses, etc. on each business day the New York Stock Exchange is open for trading. The percentage of your account to which you will be entitled when your employment with Aquo ends depends on the Plan's vesting schedule. These features are explained further in the following pages. SECTION 1: ELIGIBILITY Eligible Classes of Employees You will generally be allowed to enter the Plan, make Elective Deferrals, and receive a Matching Contribution after satisfying the age and service requirements described in the sections below. You will not be eligible to make Elective Deferrals and receive a Matching Contribution if you:
• are covered by a collective bargaining agreement (e.g., union agreement) unless the agreement requires you to be eligible,
• are a nonresident alien and receive no earned income from Aquo within the U.S., • are an employee not on U.S. payroll (including Employees not on the main Aquo U.S.
payroll system for up to 3 months following a corporate transaction, unless the Committee determines otherwise),
• are a leased employee, or • are incorrectly determined to be an independent contractor.
Age and Service Requirements You are eligible to enter the Plan and begin making Elective Deferrals and receive Matching Contributions when you attain the age of 18. You need not perform a minimum amount of service to be eligible to participate. SECTION 2: ENROLLMENT Enrollment in the Plan If you meet the Plan eligibility requirements, you may enroll in the Plan at any time after your first day of employment with Aquo. To enroll and begin making Elective Deferrals, you should complete the form at the end of this document and submit to Aquo Financial Participant Services. You will need the Aquo 401(k) Plan number 555-55. Your participation in the Plan continues until all amounts credited to your Individual Account are paid out to you or your Beneficiary.
Automatic Enrollment Program All new hires, rehires, non-U.S. transfers to U.S. payroll, acquired employees, and interns, who do not affirmatively elect to participate in the Plan or not participate in the Plan, will be automatically enrolled in the Plan within approximately 60 days from the applicable hire or eligibility date. If you are automatically enrolled in the Plan, 6% of your Eligible Compensation will be automatically withheld and contributed to the Plan as a Pre-Tax Elective Deferral. Your failure to affirmatively elect a different deferral percentage or opt out of the Plan entirely will represent your acceptance of this automatic contribution provision. If you later wish to contribute at a different deferral percentage or stop your contributions, you may change your deferral percentage. SECTION THREE: PLAN FUNDING AND ADMINISTRATION Plan Contribution Sources, Allocations and Limitations Your Individual Account All contributions made to the Plan on your behalf will be placed in a trust fund established to hold dollars for the benefit of all Participants. Aquo will establish and maintain an Individual Account for you. Your Individual Account will be used to track your share in the total trust fund. Elective Deferrals You may make before-tax and/or Roth after-tax contributions to the Plan through payroll deduction. Such contributions are called Elective Deferrals. For example, assume your Eligible Compensation is $50,000. You wish to make a pre-tax contribution to the Plan authorizing a deferral amount of 5% of your Eligible Compensation. As a result, Aquo will pay you $47,500 as gross taxable income and will deposit your 5% contribution (i.e., $2,500) into the plan for you. For an example of a Roth after-tax deferral, assume again that your Eligible Compensation is $50,000. You wish to make an after-tax Roth deferral to the Plan of 5% of your Eligible Contribution. As a result, Aquo will pay you $47,500 in net taxable income and deposit $2,500 into the Plan as a Roth after-tax deferral. Your gross taxable income continues to be $50,000. The Roth deferral, plus earnings, may be eligible for a tax-free withdrawal if certain requirements are met (see Section Four).
Managing Your Individual Account Information About Investment Options When you are eligible to participate in the Plan, you will be provided with comprehensive information about the investment options available in the Plan, including an explanation of investment objectives and policies, risk and return characteristics, past and current investment performance (net of expenses), operating expenses, and the type and diversification of assets comprising the portfolio of each fund. As a Participant, you will receive ongoing updates of this information in the form of prospectuses and shareholder reports for each of the investment options that you have selected for the investment of your Plan contributions. SECTION FOUR: BENEFITS Benefit Eligibility Certain events must occur before you may withdraw money from the Plan. Benefits may be withdrawn upon: • termination of employment, • attaining Early Retirement Age (age 55 with 10 years of service), • attaining Normal Retirement Age (age 65), • attaining in-service distribution eligibility (age 59 1/2), • attaining required minimum distribution eligibility (age 70 1/2), • incurring a financial hardship, or • termination of the Plan. SECTION FIVE: CLAIMS PROCEDURE What to Do to Receive Benefits You or your beneficiary must file a written request with Aquo to start receiving benefits when you become eligible. If you do not receive a benefit to which you believe you are entitled, you should file a claim with Aquo using the process described below. How to File a Claim You may claim a benefit to which you think you are entitled by filing a written request to: Aquo 401(k) Retirement Savings Plan Committee c/o Aquo Energy Drinks, Ltd. 345 Park Avenue San Jose, CA 95110-2704 The claim must set forth the reasons you believe you are eligible to receive benefits and authorize Aquo to conduct such examinations and take such steps as may be necessary to evaluate the claim.
NAME OF PAYEE LAST FIRST MIDDLE
ADDRESS NO. STREET APT. NO.
cITY STATE zIP
TELEPHONE AREA cODE NUMBER
NAME OF PERSON(S) ENTITLED TO PAYMENT
cLAIM OR PAYROLL ID NUMBER PREFIX SUFFIX
TYPE OF DEPOSITOR AccOUNT checking Savings
DEPOSITOR AccOUNT NUMBER
TYPE OF PAYMENT (cHEcK ONLY ONE):
Salary Unemployment Benefit
Pension Plan Other (specify)
PAYEE/JOINT PAYEE cERTIFIcATIONI certify that I am entitled to the payment identified above, and that I have read and understood this form. In signing this form, I authorize my payment to be sent to the financial institution named below to be deposited to the designated account.
SIGNATURE DATE
DIRECT DEPOSIT SIGN-UP FORMTo sign up for Direct Deposit, read this form and fill in the information requested. Then take or mail to your financial institution. The financial institution will verify the information in Sections 1 and 2, and will complete Section 3. Then the completed form will be returned to Aquo Energy Drinks, Ltd.
A separate form must be completed for each type of payment to be sent by Direct Deposit.
Payees must keep Aquo Energy Drinks, Ltd. informed of any address changes in order to receive information about benefits and to remain qualified for payments.
SECTION 1TO BE cOMPLETED BY PAYEE
AQUO DEPARTMENT NAME
AQUO DEPARTMENT ADDRESS NO. STREET
cITY STATE zIP
SECTION 2TO BE cOMPLETED BY PAYEE
OR TEAM LEADER
NAME OF FINANcIAL INSTITUTION
FINANcIAL INSTITUTION NO. STREET
ADDRESS cITY STATE zIP
ROUTING NUMBER
DEPOSITOR AccOUNT TITLE
FINANcIAL INSTITUTION cERTIFIcATIONI confirm the identity of the above-named payee(s) and the account number. As representative of the above-named financial institution, I certify that the financial institution agrees to receive and deposit the payment identified above.
PRINT REPRESENTATIVE’S NAME
SIGNATURE OF REPRESENTATIVE
TELEPHONE NUMBER DATE
THE FINANCIAL INSTITUTION SHOULD MAIL THE COMPLETED FORM TO:
AQUO ENERGY DRINKS, LTD., 345 PARK AVENUE, SAN JOSE, CALIFORNIA 95110-2704.
SECTION 3TO BE cOMPLETE BY
FINANcIAL INSTITUTION
SUBMIT
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Create a PDF Portfolio Choose File > Create PDF Portfolio.
Add files to a PDF Portfolio From an open PDF Portfolio, do one of the following: •ChooseFile>ModifyPDFPortfolio>AddFiles,andselectoneormorefiles. •ChooseFile>ModifyPDFPortfolio>AddExistingFolder,andselectafolder. •Onthedesktoporfromafolder,draganyfilesorfoldersintothePDFPortfolio
workarea.
Create a folder in a PDF Portfolio ChooseFile>ModifyPDFPortfolio>CreateNewFolder.
Remove files and folders from a PDF Portfolio SelectoneormorefilesorfoldersinthePDFPortfolioandpressDelete. Ifyoudeleteafolder,allofthefileswithinitaredeletedfromthePDFPortfolio.
Choose a layout 1FromanopenPDFPortfolio,chooseFile>ModifyPDFPortfolio>EditPortfolio. 2IntheEditPortfoliopane,selectChooseALayout. 3Ifnecessary,chooseacategoryfromthepop-upmenu. 4Clickthelayoutyouwant.
Add a welcome page and header 1ChooseFile>ModifyPDFPortfolio>EditPortfolio. 2IntheEditPortfoliopane,chooseAddWelcome&Header. 3SelecteitherWelcomePageorHeader,andthenselectatemplatefromthelist. 4Clickintheboxestoaddcontent. 5Asneeded,selectatextorimageboxandspecifysize,backgroundcolor,
and other properties.
Select a color scheme 1ChooseFile>ModifyPDFPortfolio>EditPortfolio. 2IntheEditPortfoliopane,chooseSelectAColorScheme. 3Clickthecolorbuttonstopreviewcolorschemes,orclickCustomizeColorScheme andspecifythecolors.
1
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Create your Portfolio and add files
Customize your Portfolio
Specify file details TheFileDetailsviewlistsPDFPortfoliocomponentfilesintableformat,withcolumnssuchasfiledescriptions,size,andmodificationdates.YoucancustomizethecolumnsthatappearintheFileDetailsview.
1ChooseFile>ModifyPDFPortfolio>EditPortfolio. 2IntheEditPortfoliopane,chooseSpecifyFileDetails. 3DoanyofthefollowingunderSpecifyFileDetails: •Toshoworhideacolumninthelist,selectordeselectit. •Toaddacolumn,typethenameintheAddAColumnbox,selectadatatype
fromthemenu,andclicktheAddbutton. •Todeleteacolumn,selectitandclicktheDeletebutton.Youcannotdelete
presetcolumns. •Tochangetheorderofacolumn,selectitandclicktheupordownarrow. •TospecifytheorderinwhichfilesappearwhenthePDFPortfolioisinitially
opened,selectacolumnnamefromtheInitialSortmenu.Thenclickthebutton forascendingordescendingorder.InitialSortaffectsHomeviewaswellas FileDetailsview.Tocreateacustomsortorder,addanewcolumn,specify adatatype,andenteravalueforeachdocument.(Forexample,createacolumnnamedMySortandspecifyNumberasthedatatype.Thenenter1forthefirstdocument,2forthesecond,andsoon.)Youcanthenspecifythisasthe Initial Sort order.
3 Add details about your files
1
HEAltH bEnEfitsAt a Glance
As an Aquo employee you are eligible to enroll yourself and your eligible family members in a medical, dental and vision plan, choosing from a wide range of options. On the pages that follow, you’ll find details of the following plans:
• Medical Plans • Dental Plans • Vision Plans
This document provides an overview of certain health care plan provisions under the Benefits Program for U.S. employees of Aquo Energy Drinks, Ltd. This document is not intended to be a complete description of these benefits. If there is any conflict between the information presented here and the official plan documents, the plan documents will govern. Aquo reserves the right to modify or terminate any of the benefits described in this document at any time. The descriptions of these benefits are not guarantees of current or future employment or benefits. References to Aquo or the Company apply to Aquo Energy Drinks, Ltd.
2
Medical PlansPercentages shown represent the amount the plan pays after you meet the deductible (unless otherwise noted) —you pay the remaining percentage (your coinsurance); flat dollar amounts represent the amount you pay (your co-payment), while the plan pays the remainder. All out-of-network benefits are paid up to the UCR maximum. The Out-of-Area Plan is offered to those employees who do not live within the Plan network.
PlanProvisions
Plan A Plan b Plan COut of Area
Planin network
Out of network
in networkOut of
networkin network
Out of network
General Provisions
Provider Choice
You may use any licensed provider; however, you’ll receive
a higher level of benefits by using providers in the network
You may use any licensed provider; however, you’ll receive
a higher level of benefits by using providers in the network
You may use any licensed provider; however, you’ll receive
a higher level of benefits by using providers in the network
You may use any licensed
provider
fund Amount
Aquo provides the following funding:
$1,000/employee$1,500/employee + 1$2,000/employee + 2or more dependents
Not applicable Not applicableNot
applicable
Annual Deductible(applies to all expenses except as noted)
$1,500/employee$2,250/employee + 1$3,000/employee + 2
$1,000/ individual$2,000/family
$2,000/ individual$4,000/family
$250/ individual
$500/family
$500/ individual$1,000/family
$250/ individual
$500/family
Out-of-PocketMaximum(includes deductible except as noted)
$1,000/ employee$1,500/
employee + 1$2,000/
employee + 2 or more(excludes
deductible)
$3,000/ employee$4,500/
employee + 1$6,000/
employee + 2 or more(excludes
deductible)
$5,000/ individual$10,000/
family
$10,000/ individual$20,000/
family
$1,000/ individual$2,000/family
$2,750/ individual$5,500/family
$1,750/ individual$3,300/family
lifetime Maximum
Unlimited(excluding certain services)
Unlimited(excluding certain services)
Unlimited(excluding certain services)
Unlimited(excluding certain
services)
Routine Care: Doctor’s office visits includes specialist visits and second surgical opinions, though certain limitations may apply; well child care includes immunizations; routine physical exam includes OB/GYN exams, mammograms and prostate exams—well care services all provided in accordance with age frequency guidelines
Doctor’sOfficeVisit
Plan pays 90%
Plan pays 70%
Plan pays 80%
Plan pays 60%
Plan pays 100% after $10 (PCP)
or $25 (specialist)
co-pay
Plan pays 70%
Plan pays 80%
Well baby/Child Care
Plan pays 100%
Not covered
Plan pays 100% after $10 (PCP)
or $25 (specialist)
co-pay
Plan pays 70%
Plan pays 80%Deductible is waived
if in-network
RoutinePhysicalExam
Plan pays 100%
Not covered
Plan pays 100% after $10 (PCP)
or $25 (specialist)
co-pay
Plan pays 70%
Plan pays 80%Deductible is waived
if in-network
3
PlanProvisions
Plan A Plan b Plan COut of Area
Planin network
Out of network
in networkOut of
networkin network
Out of network
Hospital Care & surgery
Pre-certification
Handled automatically by network providers
inpatient stays and certain surgical
procedures: a $400
(inpatient) or $200
(outpatient) penalty/
occurrence applies if not
obtained
Handled automatically by network providers
inpatient stays and certain surgical
procedures: a $400
(inpatient) or $200
(outpatient) penalty/
occurrence applies if not
obtained
Handled automatically by network providers
inpatient stays and certain surgical
procedures: a $400
(inpatient) or $200
(outpatient) penalty/
occurrence applies if not
obtained
inpatient stays and certain surgical
procedures: a $400
(inpatient) or $200
(outpatient) penalty/
occurrence applies if not
obtained
semi-Private Room & board
Plan pays 90%
Plan pays 70%
Plan pays 80%
Plan pays 60%
Plan pays 90%
Plan pays 70%
Plan pays 80%
Different benefit payment provisions apply for care provided in a skilled nursing facility
Emergency Room and Ambulance
Plan pays 90% Plan pays 80%Plan pays 100% after
$50 co-pay (ER) or 90% (ambulance)
Plan pays 80%
Under all of the plans, non-emergency use of an emergency room or ambulance service is covered at 50%—usage determined by Aetna
surgery (Outpatient/Inpatient)
Plan pays 90%
Plan pays 70%
Plan pays 80%
Plan pays 60%
Office visit: You pay $10
(PCP) or $25 (specialist)
co-paySurgical
facility: Plan pays 90%
Plan pays 70%
Plan pays 80%
Maternity and family Planning services
Maternity (Office visits and hospital care/birthing center)
Plan pays 90%
Plan pays 70%
Plan pays 80%
Plan pays 60%
First Visit: You pay $10
(PCP) or $25 (specialist);
Plan pays 90% thereafter
Plan pays 70%
Plan pays 80%
infertility services (Separate calendar year max. may apply)
Plan pays 90%
Plan pays 70%
Plan pays 80%*
Plan pays 60%*
Office visit: You pay $10
(PCP) or $25 (specialist)
co-payOther facility:
Plan pays 90%
Plan pays 70%
Plan pays 80%
IVF and GIFT limited to $25,000/lifetime; for both Artificial Insemination services and Ovulation Induction procedures, benefits limited to six attempts/lifetime—the amount the Plan pays for AI and OI services does not count toward the $25,000 maximum *Under the 80/60 Plan, limited to diagnosis and treatment for underlying cause only—IVF, AI and GIFT not covered
fertility treatment Drugs
Plan pays up to $15,000/lifetime; a $25 co-payment/prescription applies
Medical Plans (continued)
4
Dental PlansPercentages shown represent the amount the plan pays after you meet the deductible (unless otherwise noted) —you pay the remaining percentage (your coinsurance); under the Dental PPO Plan, PPO and Preferred Dentists cannot charge you amounts above the allowed fee. Benefits to Non-Plan Dentists are paid up to the UCR maximum. The Dental PPO Plan is available to all employees.
Plan Provisions
Dental PPO Plan
PPO Dentists Preferred Dentists non-Plan Dentists
General Provisions
Provider Choice
You may use any licensed dentist; however, your out-of-pocket costs will be lower when you use Preferred Dentists and the lowest when you use PPO Dentists; if you use Non-Plan Dentists,
you are responsible for your percentage share plus any amounts the dentist charges above the allowed amount
Annual Deductible
$50/individual, $150/family
Annual benefit Maximum
$2,000/calendar year
Covered services
Diagnostic & Preventive Care
Plan pays 100%, no deductible Plan pays 100%, no deductible
basic Care Plan pays 90% Plan pays 80% Plan pays 80%
Major Care Plan pays 60% Plan pays 50% Plan pays 50%
Orthodontic treatment(Adults and children)
Plan pays 50%; benefits limited to $2,000/lifetime per individual
Plan pays 50%; benefits limited to $2,000/lifetime per individual
Plan pays 50%; benefits limited to $2,000/llifetime per individual
5
Vision PlansBoth Standard Vision and the Premium Vision Plan are offered. You may use any provider; however, benefits are higher when you use preferred providers. The Premium Vision Plan allows for glasses and contacts or two pair of glasses or two sets of contacts on an annual basis.
Plan Provisions
Vision basic Plan Vision Plus Plan non-Preferred Provider frequency Allowance
General ProvisionsStandard Vision
PlanPremium Vision
Plan
Co-payment $10 $10 $10
Exam You pay $10* $10 Plan pays up to $45Every 12 months
Every 12 months
lenses (pair)
Single visionLined bifocalLined trifocalLenticular
Subject to Plan limits; you pay $10*, then Plan
pays:100%100%100%100%
Subject to Plan limits; you pay $10*, then Plan
pays:100%100%100%100%
Plan pays up to:$45$65$85
$125
Every 12 months
Every 12 months
frames Plan pays up to $130 $200 Plan pays up to $50Every 24 months
Every 12 months
Contact lensesContact Lenses in lieu of lenses and frames for the Vision Basic Plan
Plan pays up to $150 $200 Plan pays up to $150Every 12 months
Every 12 months
Additional benefits
When you use Preferred providers: Additional prescription glasses, including sun glasses available at a 20% discount; contact lens fitting and evaluation is subject to 15% discount (either in addition to plan allowance or for purchase of contact lenses in addition to eyeglasses); 20% discount provided on cosmetic lens options; laser eye surgery available at a discount through contracted Laser Centers
* The $10 copayment applies to exam and materials, combined
Aquo Energy Drinks, Ltd. 345 Park Avenue, San Jose, California 95110-2704 phone 555.555.6000 fax 555.555.6001 www.aquo-drinks.com
NONDISCLOSURE AGREEMENT This agreement is made as of ________________,____ between Aquo Energy Drinks, Ltd. and __________________________, the (Recipient).
1. The Purpose. Aquo Energy Drinks, Ltd. and The Recipient plan to explore a potential business relationship in the course of which Aquo Energy Drinks, Ltd. may disclose its Confidential Information (as defined below) to the Recipient, (The Relationship).
2. Definition of Confidential Information. Confidential Information means any information, technical data, or learnings, including but not limited to, that which relates to research, product plans, products, services, customers, markets, formulas, developments, inventions, processes, designs, drawings, engineering, hardware configuration information, marketing or finances of Aquo Energy Drinks, Ltd., which all shall be deemed as Confidential Information. Confidential Information does not include information, technical data or know how which (I) is in the possession of the receiving party at the time of disclosure as shown by the receiving party’s files and records immediately prior to the time of disclosure, or (ii) prior to or after the time of disclosure becomes part of the public knowledge or literature other than as a result of any improper inaction or action of the Recipient or, (iii) is approved by Aquo Energy Drinks, Ltd., in writing, for release.
3. Nondisclosure of Confidential Information. The Recipient agrees not to use any Confidential Information disclosed to it by Aquo Energy Drinks, Ltd. for its own use of for any purpose other then to carry out discussions concerning, and the undertaking of the Relationship. The Recipient will not disclose any Confidential Information of Aquo Energy Drinks, Ltd. to parties outside the Relationship or to employees of the Recipient other than employees or agents under appropriate burden of confidentiality and who are required to have the information in order to carry our the discussions regarding the Relationship. The Recipient agrees to notify Aquo Energy Drinks, Ltd. in writing of any misuse or misappropriation of Confidential Information of the disclosing party, which may come to the receiving party’s attention.
4. Return of Materials. Any materials or documents that have been furnished by Aquo Energy Drinks, Ltd. to the Recipient in connection with the Relationship will be promptly returned by the Recipient, accompanied by all copies of such documentation or certification of destruction, within (10) days after (I) the Relationship has been terminated or (ii) the written request of Aquo Energy Drinks, Ltd.
5. Patent or Copyright Infringement. Nothing in this agreement is intended to grant any rights to the Recipient with regard to any and all rights of Aquo Energy Drinks, Ltd.’s rights to patents or copyrights.
6. Successors and Assigns. This agreement shall be binding upon and for the benefits of the undersigned parties, their successors and assigns, provided that Confidential Information of Aquo Energy Drinks, Ltd. may not be assigned without the prior written consent of Aquo Energy Drinks, Ltd. Failure to enforce any provision of this Agreement shall not constitute a waiver of any term hereof.
7. Governing Law. This agreement shall be governed by and enforced in accordance with the laws of the State of California and shall be binding upon the Recipient in the United States and worldwide.
8. Remedies. The Recipient agrees that any violation or threatened violation will cause irreparable injury, both financial and strategic, to Aquo Energy Drinks, Ltd. and in addition to any and all remedies that may be available, in law, in equity or otherwise, Aquo Energy Drinks, Ltd. shall be entitled to injunctive relief against the threatened breach of this Agreement by the Recipient without the necessity of proving actual damages.
In Witness whereof, this Nondisclosure Agreement is effective as of the date first above written: __________________________________ Recipient By: _____________________________ Title: _____________________________
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