UNIVERSITY OF NEBRASKA MEDICAL CENTER

COLLEGE OF DENTISTRY

SUPPLEMENTAL COMPENSATION PLAN AGREEMENT

I, , hereby accept the terms and conditions of this Agreement as a participating staff member of the University of Nebraska College of Dentistry Supplemental Salary Plan (hereinafter referred to as the “Plan”) and agree that the terms of my employment at the University of Nebraska Medical Center, Department of , shall include the following:

1.  I will participate in the Plan and will comply with the requirements of the Plan in all respects. In doing so, I understand that:

(a)  All supplemental salary and retirement benefits are compensation in addition to the University base salary and benefits paid to me for performance of my teaching, research and administrative duties.

(b)  As an academic-administrative staff member, who holds an appointment of at least one-half full-time equivalent (.50 FTE), I am eligible to participate in the plan.

(c)  That my participation in the Plan is voluntary, and that by giving the Dean of the College of Dentistry 30 days written notice I may withdraw from the Plan and terminate this Agreement. I understand that in the event I elect to withdraw from the Plan and terminate this Agreement prior to the termination date specified in Section 4 hereof, my base University salary and fringe benefits will continue thereafter so long as I am employed by the University, but the supplemental salary and retirement benefits provided by Section 4 of this Agreement shall stop as of the date of my withdrawal from the Plan.

2.  I shall be entitled to receive as supplemental compensation, not to exceed 25% of my University base salary, during the term of this Agreement:

Supplemental salary in the amount of $ per month over the term of this agreement.

Supplemental salary equal to % of that portion of my base University salary funded by extramural grants and contracts as described in Section 5.3. of the Supplemental Compensation Plan.

3. I acknowledge that I have received a copy of the College of Dentistry Supplemental Compensation Plan. Plan can be found at:

http://codis1.codad/codweb/polyproc/COD%20Supplemental%20Compensation%20Policy%201999.pdf

4. The term of this Agreement shall begin on , 20, and shall end at midnight on June 30, 20. This Agreement shall not be amended, extended or renewed, except by written instrument signed by myself and duly approved and signed by the University. Termination of this Agreement shall not affect existing academic tenure that I possess under the Bylaws of the Board of Regents with respect to my academic responsibilities.

In Witness Whereof, this Agreement is signed:

Date Date

Department Chair Faculty Member

APPROVED:

Dean, College of Dentistry Date Vice Chancellor for Date

Academic Affairs, UNMC

COD Supplemental Compensation

Plan Agreement (04/09)