SETTLEMENT, RELEASE AND ACKNOWLEDGEMENT AGREEMENT
THIS SETTLEMENT, RELEASE AND ACKNOWLEDGEMENT AGREEMENT (the “Agreement”) is made and entered into
as of the 5th day of December, 2003, and shall be effective as of the 27th day of December, 2003 (the “Effective Date”), by and
between COCA-COLA BOTTLING CO. CONSOLIDATED, a Delaware corporation (the “Corporation”), and
(the “Executive” and together with the Corporation, the “Parties”).
Statement of Purpose
Executive participates in the Corporation’s Supplemental Savings Incentive Plan, (the “SSIP”), a non-qualified deferred
compensation plan providing benefits to certain key employees of the Corporation. Executive has been previously designated
as an Insurable Participant by the Committee for purposes of the SSIP. The Corporation has amended and restated the SSIP
effective as of December 28, 2003. The amended and restated SSIP amends Section 4.4 of the SSIP to delete the death benefit
previously provided by the Fixed Benefit Option for Insurable Participants who die before Normal Retirement Age (the
“Amendment”). In exchange for Executive acknowledging and consenting to the Amendment and releasing the Corporation
from any and all liability relating thereto, the Corporation has agreed to pay Executive a single sum amount as provided below.
NOW, THEREFORE, in consideration of the foregoing Statement of Purpose, the mutual covenants and promises
contained herein and other good and valuable consideration, the receipt and sufficiency of which are hereby acknowledged, the
Parties hereto hereby agree as follows:
1. Terminology . Capitalized terms not otherwise defined herein shall have the same meanings ascribed to them in the SSIP.
2. Consent to the Amendment; Settlement Payment . Executive hereby acknowledges that Executive has received and
reviewed a copy of: (i) the SSIP as amended and restated effective as of December 28, 2003 and (ii) the Plan Summary for the