ANNEX A
SEPARATION, WAIVER AND RELEASE AGREEMENT
This Separation, Waiver and Release Agreement (this Agreement) by and between Piedmont Office Realty Trust, Inc. (the
Company) and [NAME](You or Your and, collectively with the Company, the Parties) is entered into and effective as of [DATE] (the Effective Date). The
Company executes this Agreement for itself and on behalf of its subsidiaries, affiliates, and all related companies, as well as each of their respective current and former officers, directors, shareholders, noteholders, lenders, members, managers,
employees, agents, other representatives and any employee benefits plans and any fiduciary of those plans (the Company Group) and for purposes of Sections 3, 4, 5, 6, 7 and 8 of this
Agreement, Company will mean the Company and the Company Group. Capitalized terms used and not otherwise defined herein shall have the meanings given to such terms in the Companys Executive Severance Plan (the
Severance Plan).
1. Termination Date. The Parties agree that Your employment with the Company terminated, effective as of
[DATE] (the Termination Date).
2. Compliance Terms. Your compliance with the terms of this Agreement and that certain
Executive Severance Plan Participation Agreement with the Company, dated as of [DATE] (the Participation Agreement), which is fully incorporated herein by this reference, is a condition precedent to Your rights to the compensation
and benefits set forth in the Severance Plan (together with the Participation Agreement, the Severance Arrangements).
3. Release. In exchange for the consideration set forth in this Agreement and the Severance Arrangements, except as otherwise set forth below,
You release, waive and discharge the Company from any and all claims or liability, whether known or unknown, arising out of any event, act, or omission occurring on or before the day You sign this Agreement, including, but not limited to, claims
arising out of Your employment or the termination of Your employment, claims arising out of any separation or severance pay or benefits agreement with the Company, claims arising out of the Employee Retirement Income Security Act of 1974
(ERISA), 29 U.S.C. §§ 1001-1461, claims arising under the Age Discrimination in Employment Act (ADEA), Title VII of the Civil Rights Act of 1964, the Equal Pay Act, the Civil Rights Act of 1866, the
Americans with Disabilities Act, the Family and Medical Leave Act, the Worker Adjustment and Retraining Notification Act, the Genetic Information Nondiscrimination Act, the Georgia Fair Employment Practices Act, the Georgia Equal Pay Act
(GEPA), the Georgia Prohibition of Age Discrimination in Employment Act, the Georgia Equal Employment for Persons with Disabilities Code (GEEPDC), and the Georgia Discriminatory Wage Practices Based on Sex Act,
all including any amendments and their respective implementing regulations, claims for breach of contract, tort, negligent hiring, negligent retention, negligent supervision, negligent training, employment discrimination, retaliation, or harassment,
as well as any other statutory or common law claims, at law or in equity, recognized under any federal, state, or local law.
You acknowledge and agree
that You will execute any additional documentation or instruments as may be reasonably requested by the Company to confirm or effectuate this Agreement.