Safeway 2013 Annual Report Download - page 142

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SAFEWAY INC.
2011 EQUITY AND INCENTIVE AWARD PLAN
PERFORMANCE SHARE AWARD GRANT NOTICE
Safeway Inc., a Delaware corporation, (the “ Company”), pursuant to its 2011 Equity and Incentive Award Plan, as amended from time
to time (the “Plan”), hereby grants to the holder listed below (“ Participant”) an award of performance shares (“ Performance Shares”). Each
Performance Share represents the right to receive one share of common stock of Safeway Inc. (a “ Share”) upon the achievement of certain
performance goals. This award of Performance Shares is subject to all of the terms and conditions set forth herein and in the Performance Share
Award Agreement attached hereto as Exhibit A (the “Performance Share Award Agreement”) and the Plan, each of which are incorporated
herein by reference. Unless otherwise defined herein, the terms defined in the Plan shall have the same defined meanings in this Grant Notice and the
Performance Share Award Agreement.
Participant: [__________________________]
Grant Date: [______________ __], 20__
Target Number of Performance Shares: [_____________]
Performance Commencement Date: [_____________]
Performance Goals: See Section 2.2 of the Performance Share Award Agreement
Termination: Pursuant and subject to Section 2.5 of the Performance Share Award Agreement, if
Participant ceases to be an Employee, Consultant or Director prior to the applicable Payment
Date, all Performance Shares that have not been paid on or prior to the date of such
termination of services will thereupon be forfeited automatically by Participant without
payment of any consideration therefor.
By his or her signature and the Company’s signature below, Participant agrees to be bound by the terms and conditions of the Plan, the
Performance Share Award Agreement and this Grant Notice. Participant has reviewed the Performance Share Award Agreement, the Plan and this
Grant Notice in their entirety, has had an opportunity to obtain the advice of counsel prior to executing this Grant Notice and fully understands all
provisions of this Grant Notice, the Performance Share Award Agreement and the Plan. Participant hereby agrees to accept as binding, conclusive and
final all decisions or interpretations of the Administrator upon any questions arising under the Plan, this Grant Notice or the Performance Share Award
Agreement. If Participant is married, his or her spouse has signed the Consent of Spouse attached to this Grant Notice as Exhibit B.
SAFEWAY INC.: PARTICIPANT:
By:
Robert L. Edwards,
President and CEO Print Name:
Address: