EX-4.3



 Exhibit 4.3 
  

 
  

AMENDED AND RESTATED 

REGISTRATION AND PARTICIPATION RIGHTS AGREEMENT 

by and among 
 inVentiv Group
Holdings, Inc., 
 inVentiv Midco Holdings, Inc., 

inVentiv Holdings, Inc., 

inVentiv Health, Inc. 
 and 

Certain Stockholders of inVentiv Group Holdings, Inc. 

Dated as of [•], 2016 
  

 
  

  
 1 








 TABLE OF CONTENTS 

 

							
	 	 	 	  	Page	 
		
	 SECTION 1. DEFINITIONS
	  	 	2	  
			
	 1.1
	 	Definitions	  	 	2	  
		
	 SECTION 2. [RESERVED.]
	  	 	2	  
		
	 SECTION 3. REGISTRATION RIGHTS
	  	 	2	  
			
	 3.1
	 	Demand Registration Rights	  	 	2	  
			
	 3.2
	 	Piggyback Registration Rights	  	 	5	  
			
	 3.3
	 	Certain Other Provisions	  	 	7	  
			
	 3.4
	 	Indemnification and Contribution	  	 	13	  
		
	 SECTION 4. REMEDIES
	  	 	16	  
			
	 4.1
	 	Generally	  	 	16	  
		
	 SECTION 5. PERMITTED TRANSFEREES
	  	 	16	  
		
	 SECTION 6. AMENDMENT, TERMINATION, ETC
	  	 	16	  
			
	 6.1
	 	Oral Modifications	  	 	16	  
			
	 6.2
	 	Written Modifications	  	 	16	  
			
	 6.3
	 	Effect of Termination	  	 	17	  
		
	 SECTION 7. DEFINITIONS
	  	 	17	  
			
	 7.1
	 	Certain Matters of Construction	  	 	17	  
			
	 7.2
	 	Definitions	  	 	17	  
		
	 SECTION 8. MISCELLANEOUS
	  	 	23	  
			
	 8.1
	 	Authority; Effect	  	 	23	  
			
	 8.2
	 	Notices	  	 	23	  
			
	 8.3
	 	Entire Agreement; Binding Effect, Etc	  	 	24	  
			
	 8.4
	 	Descriptive Headings	  	 	24	  
			
	 8.5
	 	Counterparts	  	 	24	  
			
	 8.6
	 	Severability	  	 	24	  
			
	 8.7
	 	No Recourse	  	 	25	  
			
	 8.8
	 	Aggregation of Shares	  	 	25	  


  
 i 









 TABLE OF CONTENTS 

(continued) 
  


							
	 	 	 	  	Page	 
		
	 SECTION 9. GOVERNING LAW
	  	 	25	  
			
	 9.1
	 	Governing Law	  	 	25	  
			
	 9.2
	 	Consent to Jurisdiction	  	 	25	  
			
	 9.3
	 	WAIVER OF JURY TRIAL	  	 	26	  
			
	 9.4
	 	Exercise of Rights and Remedies	  	 	26	  


  
 ii 








 AMENDED AND RESTATED 

REGISTRATION AND PARTICIPATION RIGHTS AGREEMENT 

This Amended and Restated Registration and Participation Rights Agreement (this “Agreement”) is made as of [•], 2016 by
and among: 
  

	 	(i)	inVentiv Group Holdings, Inc. (formerly Papillon Holdings, Inc.) (together with its successors and permitted assigns) (the “Company”); 


 

	 	(ii)	inVentiv Midco Holdings, Inc. (together with its successors and permitted assigns) (“Midco Holdings”); 

  

	 	(iii)	inVentiv Holdings, Inc. (together with its successors and permitted assigns) (“Holdings”); 

  

	 	(iv)	inVentiv Health, Inc. (together with its successors and permitted assigns) (“inVentiv”); 

  

	 	(v)	each of Thomas H. Lee Equity Fund VI, L.P., Thomas H. Lee Parallel Fund VI, L.P., Thomas H. Lee Parallel (DT) Fund VI, L.P., Great-West Investors, L.P., Putnam Investments Employees’ Securities Company III, LLC,
THL Coinvestment Partners, L.P., and THL Operating Partners, L.P., THL Equity Fund VI Investors (inVentiv), LLC (collectively, the “THL Funds”), and such other Affiliated Funds that from time to time become party hereto by executing
a counterpart signature page hereof in the form of Exhibit A hereto or such other form as may be designated by the Board and are designated by the Board as “Investors” (together with their Permitted Transferees, the
“Investors”); 

  

	 	(vi)	each of R. Blane Walter (“Walter”) (solely in his capacity as a holder of Walter Rollover Shares), Liberty Lane IH, LLC (“Liberty Lane”) (solely in its capacity as a holder of LL Other
Investor Shares), RGIP, LLC, and such other Persons who from time to time become party hereto by executing a counterpart signature page hereof in the form of Exhibit A hereto or such other form as may be designated by the Board and are
designated by the Board as “Other Investors” (together with their Permitted Transferees, the “Other Investors”); 

  

	 	(vii)	each of Walter (solely in his capacity as a holder of Shares other than the Walter Rollover Shares), Liberty Lane (solely in its capacity as a holder of Shares other than LL Other Investor Shares), and such other
Persons who were party to the Prior Agreement or who from time to time become party hereto by executing a counterpart signature page hereof in the form of Exhibit A hereto or such other form as may be designated by the Board and are
designated by the Board as “Managers” (together with their Permitted Transferees, the “Managers”), it being understood for purposes of clarity that (a) Walter shall not be deemed a Manager in respect of the Walter
Rollover Shares and (b) neither Liberty Lane nor any of its employees or members shall be deemed a Manager in respect of the LL Other Investor Shares; and 


  
 1 









	 	(viii)	each Person executing this Agreement and listed as a Manager Designee on the signature pages hereto and such other Persons, if any, that from time to time become party hereto by executing a counterpart signature page
hereof and are designated by the Board as “Manager Designees” (collectively, the “Manager Designees”). 


RECITALS 
 1. On
August 4, 2010, the parties entered into a Registration and Participation Rights Agreement (the “Prior Agreement”). 
 2. The
parties desire to amend and restate the Prior Agreement, and this Agreement has been approved and executed by (i) Stockholders holding a majority of the Shares held by all Stockholders and (ii) all Stockholders who would be
disproportionately and adversely affected by this amendment and restatement, and the Stockholders that were a party to the Prior Agreement remain bound by the obligations herein. 

AGREEMENT 

Therefore, the parties hereto hereby agree to amend and restate the Prior Agreement in its entirety with effect from the date hereof as
follows: 
 SECTION 1. 

DEFINITIONS. 
 1.1
Definitions. Certain terms are used in this Agreement as specifically defined herein. These definitions are set forth or referred to in Section 7 hereof. 

SECTION 2. 
 [RESERVED.]

 SECTION 3. 

REGISTRATION RIGHTS. 
 The
Company will perform and comply, and cause each of its subsidiaries to perform and comply, with such of the following provisions as are applicable to it. Each Holder will perform and comply with such of the following provisions as are applicable to
such Holder. 
 3.1 Demand Registration Rights. 

3.1.1 IPO Demand Registration Rights. 

(a) At any time following the Closing, if the Company has not yet completed the Initial Public Offering, any THL Fund, by
notice to the Company specifying the intended method or methods of disposition, may request (each such requesting THL Fund, an “IPO Initiating Holder”) that the Company effect the registration under the Securities Act for the
Initial Public Offering of all or a specified part of the Registrable Securities held by such IPO Initiating Holder. 

  
 2 








 (b) The Company will use its best efforts to (i) effect the registration
under the Securities Act (including by means of a shelf registration pursuant to Rule 415 under the Securities Act if so requested by a majority of the IPO Initiating Holders and if the Company is then eligible to use such registration) of the
Registrable Securities that the Company has been requested to register by an IPO Initiating Holder pursuant to this Section 3.1.1 together with all other Registrable Securities that the Company has been requested to register pursuant to
Section 3.2 by other Holders, all to the extent required to permit the disposition of the Registrable Securities that the Company has been so requested to register, and (ii) if requested by an IPO Initiating Holder, obtain acceleration of
the effective date of the registration statement relating to such registration. 
 3.1.2 Post-IPO Demand Registration Rights. At any
such time as any THL Fund which, together with its Affiliates and Affiliated Funds, beneficially holds, in the aggregate, more than five percent (5%) of the outstanding Shares (the “Initiating Holders”), by notice to the
Company specifying the intended method or methods of disposition, may request that the Company effect the registration under the Securities Act for a Public Offering of all or a specified part of the Registrable Securities held by such Initiating
Holders; provided, however, that the value of Registrable Securities that the Initiating Holders propose to sell in such Public Offering is at least Ten Million Dollars ($10,000,000) or such lower amount as agreed by the Board. The
Company will then use its best efforts to (i) effect the registration under the Securities Act (including by means of a shelf registration pursuant to Rule 415 under the Securities Act if so requested by a majority of the Initiating Holders and
if the Company is then eligible to use such registration) of the Registrable Securities that the Company has been requested to register by such Initiating Holders together with all other Registrable Securities that the Company has been requested to
register pursuant to Section 3.2 by other Holders, all to the extent required to permit the disposition of the Registrable Securities that the Company has been so requested to register, and (ii) if requested by an Initiating Holder, obtain
acceleration of the effective date of the registration statement relating to such registration; provided, however, that the Company shall not be obligated to take any action to effect any such registration pursuant to this
Section 3.1.2: 
 (a) during the effectiveness of any lock-up agreement entered into in connection with any registration
statement pertaining to an underwritten Public Offering of securities of the Company for its own account (other than a Rule 145 Transaction, or a registration relating solely to employee benefit plans); or 

(b) if a registration statement requested under this Section 3.1.2 became effective within the preceding 90 days (unless
otherwise consented to by the Board). 

  
 3 








 3.1.3 Shelf Takedowns. At any time during which the Company has effective a shelf
registration pursuant to Rule 415 under the Securities Act with respect to such Holder’s Shares, any THL Fund (the “Shelf Takedown Holder”), by notice to the Company specifying the intended method or methods of disposition, may
request that the Company effect an underwritten offering of the Shelf Takedown Holder’s Shares that are subject to such registration statement (an “Underwritten Shelf Takedown”) of all or a specified part of the Registrable
Securities held by such Shelf Takedown Holder; provided, however, that the value of Registrable Securities that the Shelf Takedown Holder together with Shares owned by its Affiliated Funds proposes to sell in an Underwritten Shelf
Takedown is at least Twenty Million Dollars ($20,000,000) or such lower amount as agreed by the Board. The Company shall not be obligated to take any action to effect any such Underwritten Shelf Takedown pursuant to this Section 3.1.3 if an
Underwritten Shelf Takedown requested under this Section 3.1.3 was consummated within the preceding 90 days (unless otherwise consented to by the Board). 

3.1.4 Form. Except as otherwise provided above or required by law, so long as the Company is eligible and qualified to register
Registrable Securities on Form S-3 (or any successor or similar short-form registration statement), each registration requested pursuant to Section 3.1.2 shall be effected by the filing of a registration statement on Form S-3 (or any other form
which includes substantially the same information as would be required to be included in a registration statement on such form as currently constituted); provided that if any registration requested pursuant to this Section 3.1 is
proposed to be effected on Form S-3 (or any successor or similar short-form registration statement) and is in connection with an underwritten offering, and if the managing underwriter shall advise the Company in writing that, in its opinion, it is
of material importance to the success of such proposed offering to file a registration statement on Form S-1 (or any successor or similar registration statement) or to include in such registration statement information not required to be included
pursuant to Form S-3 (or any successor or similar short-form registration statement), then the Company will file a registration statement on Form S-1 or supplement Form S-3 (or any successor or similar short-form registration statement) as
reasonably requested by such managing underwriter. 
 3.1.5 Payment of Expenses. The Company shall pay all Registration Expenses in
connection with registrations of Registrable Securities pursuant to this Section 3.1, including all reasonable expenses (other than fees and disbursements of counsel that do not constitute Registration Expenses) that any Holder incurs in
connection with each registration of Registrable Securities requested pursuant to this Section 3.1. 
 3.1.6 Additional
Procedures. In the case of a registration pursuant to Section 3.1 hereof, whenever an IPO Initiating Holder or an Initiating Holder is entitled to request and so requests that such registration shall be effected pursuant to an underwritten
offering, the Company shall include such information in any written notice to Holders required by Section 3.2. In such event, the right of any Holder to have securities owned by such Holder included in such registration shall be conditioned
upon the inclusion of such Holder’s Registrable Securities in the underwriting (unless otherwise mutually agreed upon by the IPO Initiating Holder or Initiating Holder and such Holder). If requested by the IPO Initiating Holder, Initiating
Holder or Shelf Takedown Holder the Company together with the Holders proposing to distribute their securities through the underwriting will enter into an underwriting agreement with the underwriters for such offering containing such representations
and warranties by the Company and such Holders and such other terms and provisions as are customarily contained in underwriting agreements with respect to secondary distributions, including customary indemnity and contribution provisions (subject,
in each case, to the limitations on such liabilities set forth in this Agreement). 

  
 4 








 3.1.7 Suspension of Registration. If the filing, initial effectiveness or continued use of
a registration statement, including a shelf registration statement pursuant to Rule 415 under the Securities Act, in respect of a registration pursuant to this Section 3.1 at any time would require the Company to make a public disclosure of
material non-public information, which disclosure in the good faith judgment of the Board (after consultation with external legal counsel) (i) would be required to be made in any registration statement so that such registration statement would
not be materially misleading, (ii) would not be required to be made at such time but for the filing, effectiveness or continued use of such registration statement and (iii) would have a material adverse effect on the Company or its
business or on the Company’s ability to effect a material proposed acquisition, disposition, financing, reorganization, recapitalization or similar transaction, then the Company may, upon giving prompt written notice of such action to the
Holders participating in such registration, delay the filing or initial effectiveness of, or suspend use of, such registration statement; provided, that the Company shall not be permitted to do so (i) for a period exceeding 30 days on
any one occasion or (ii) for an aggregate period exceeding 60 days in any 12 month period. In the event the Company exercises its rights under the preceding sentence, such Holders agree to suspend, promptly upon their receipt of the notice
referred to above, their use of any prospectus relating to such registration in connection with any sale or offer to sell Registrable Securities. The Company shall promptly notify such Holders of the expiration of any period during which it
exercised its rights under this Section 3.1.7. The Company agrees that, in the event it exercises its rights under this Section 3.1.7, it shall, within 30 days following such Holders’ receipt of the notice of suspension, update the
suspended registration statement as may be necessary to permit the Holders to resume use thereof in connection with the offer and sale of their Registrable Securities in accordance with applicable law. 

3.2 Piggyback Registration Rights. 

3.2.1 Piggyback Registration. 

(a) General. Each time the Company proposes to register any shares of its capital stock or any securities convertible
into or exchangeable for any shares of its capital stock under the Securities Act on a form which would permit registration of Registrable Securities for sale to the public, for its own account and/or for the account of any other Person (pursuant to
Section 3.1 or otherwise) for sale in a Public Offering, including pursuant to a shelf registration statement, the Company will give notice to all Holders of its intention to do so (other than in the case of a registration statement being filed
in connection with a THL Block Trade). Any Holder may, by written response delivered to the Company within 5 business days after the date of delivery of such notice, request that all or a specified part of such Holder’s Registrable Securities
be included in such registration. A Holder may request in any such response that varying numbers of such Holder’s Registrable Securities be included in the registration based on varying prices at which such Registrable Securities are to be sold
in the registered offering. The Company thereupon will use its best efforts to cause to be included 

  
 5 








 
in such registration under the Securities Act all Registrable Securities that the Company has been so requested to register by such Holders, to the extent required to permit the disposition (in
accordance with the methods to be used by the Company or, pursuant to Section 3.1, other Holders in such Public Offering) of the Registrable Securities to be so registered; provided that (i) if, at any time after giving written
notice of its intention to register any securities, the Company shall determine for any reason not to proceed with the proposed registration of the securities to be sold by it, the Company may, at its election, give written notice of such
determination to each Holder and, thereupon, shall be relieved of its obligation to register any Registrable Securities in connection with such registration (but not from its obligation to pay the Registration Expenses in connection therewith), and
(ii) if such registration involves an underwritten offering, all Holders requesting to be included in the Company’s registration must sell their Registrable Securities to the underwriters selected by the Company on the same terms and
conditions as apply to the Company (with such differences as may be customary or appropriate in combined primary and secondary offerings and, in any event, without providing for indemnification or contribution obligations in excess of what is
required by Section 3.4) or, in the case of a registration initiated pursuant to Section 3.1.1 or 3.1.2, the THL Funds. No registration of Registrable Securities effected under this Section 3.2 shall relieve the Company of any of its
obligations to effect registrations of Registrable Securities pursuant to Section 3.1 hereof. 
 (b) Excluded
Transactions. The Company shall not be obligated to effect any registration of Registrable Securities under this Section 3.2 or give any notice to any Holder of the Company’s intent to register Registrable Securities, in each case
incidental to the registration of any of its securities in connection with: 
 (i) Any Public Offering relating to employee
benefit plans or dividend reinvestment plans; 
 (ii) Any Public Offering relating to the acquisition or merger after the
date hereof by the Company or any of its subsidiaries of or with any other businesses except to the extent such Public Offering is for the sale of securities for cash; or 

(iii) The Initial Public Offering, unless such offering shall have been initiated pursuant to Section 3.1.1 or the Board
determines otherwise, provided, that even if such offering is the Initial Public Offering and has been initiated pursuant to Section 3.1.1, the Company shall not be obligated to effect any registration of Registrable Securities or give
any notice to Holders under this Section 3.2 to the extent the lead underwriters determine that inclusion of such Registrable Securities would materially adversely affect the marketability or pricing of the offering. 

3.2.2 Payment of Expenses. The Company will pay all Registration Expenses in connection with registrations of Registrable Securities
pursuant to this Section 3.2. 

  
 6 








 3.2.3 Additional Procedures. Holders participating in any Public Offering pursuant to this
Section 3.2 shall take all such actions and execute all such documents and instruments that are reasonably requested by the Company to effect the sale of their Registrable Securities in such Public Offering, including being parties to the
underwriting agreement entered into by the Company and any other selling shareholders in connection therewith and being liable in respect of customary selling stockholder representations, warranties, indemnifications, “lock-up” agreements
and other agreements for the benefit of the underwriters contained therein; provided, however, that (i) with respect to individual representations, warranties, indemnities and agreements of sellers of Registrable Securities in
such Public Offering, the aggregate amount of such liability shall not exceed such holder’s gross proceeds from such offering, and (ii) to the extent selling stockholders give further representations, warranties and indemnities, then with
respect to all other representations, warranties and indemnities of sellers of Registrable Securities in such Public Offering, the aggregate amount of such liability shall not exceed the lesser of (i) such holder’s pro rata portion of any
such liability, in accordance with such holder’s portion of the total number of Registrable Securities included in the offering, and (ii) such holder’s gross proceeds from such offering. 

3.2.4 THL Block Trades. Notwithstanding anything to the contrary in this Agreement, if one or more of the THL Funds propose to execute a
THL Block Trade, only the THL Funds and the Other Investors shall be deemed Holders for purposes of Section 3 with respect to such THL Block Trade or the filing of any related registration statement or prospectus, and for the avoidance of
doubt, no other Holder shall be entitled to receive notice of, or elect to participate in, such THL Block Trade or the filing of any registration statement and prospectus to be used in connection with such THL Block Trade. 

3.3 Certain Other Provisions. 

3.3.1 Underwriter’s Cutback. In connection with any registration of shares, the underwriter may determine that marketing factors
(including an adverse effect on the per share offering price) require a limitation of the number of shares to be underwritten. Notwithstanding any contrary provision of this Section 3 and subject to the terms of this Section 3.3.1, the
underwriter may limit the number of shares that would otherwise be included in such registration by excluding any or all Registrable Securities from such registration, it being understood that, if the registration in question involves a registration
for sale of securities for the Company’s own account, then the number of shares which the Company seeks to have registered in such registration shall not be subject to exclusion, in whole or in part, under this Section 3.3.1. Upon receipt
of notice from the underwriter of the need to reduce the number of shares to be included in the registration, the Company shall advise all holders of the Company’s securities that would otherwise be registered and underwritten pursuant hereto,
and the number of shares of such securities, including Registrable Securities, that may be included in the registration shall be allocated in the following manner, unless the underwriter shall reasonably determine that marketing factors require a
different allocation: shares, other than Registrable Securities, requested to be included in such registration by other shareholders shall be excluded unless the Company, with the consent of the parties required to approve any amendment or waiver of
this Agreement pursuant to Section 6.2 hereof, has granted registration rights which are to be treated on an equal basis with Registrable Securities for the purpose of the exercise of the underwriter cutback (such shares afforded such equal
treatment being “Parity Shares”); and, if a limitation on the number of shares is still required, the number of Registrable Securities, Parity Shares and other shares of Common Stock that may be included in such registration shall
be allocated among the holders thereof in proportion, as nearly as practicable, as follows: 

  
 7 








 (a) there shall be first allocated to each such holder requesting that its
Registrable Securities or Parity Shares be registered in such registration a number of such shares to be included in such registration equal to the lesser of (i) the number of such shares requested to be registered by such holder, and
(ii) a number of such shares equal to such holder’s Pro Rata Portion; 
 (b) the balance, if any, not allocated
pursuant to clause (a) above shall be allocated to those holders requesting that their Registrable Securities or Parity Shares be registered in such registration that requested to register a number of such shares in excess of such holder’s
Pro Rata Portion pro rata to each such holder based upon the number of Registrable Securities and Parity Shares held by such holder, or in such other manner as the holders requesting that their Registrable Securities or Parity Shares be registered
in such registration may otherwise agree; and 
 (c) the balance, if any, not allocated pursuant to clause (b) above
shall be allocated to shares, other than Registrable Securities and Parity Shares, requested to be included in such registration by other stockholders. 

For purposes of any underwriter cutback, all Registrable Securities held by any Holder shall also include any Registrable Securities held by
the partners, retired partners, shareholders or Affiliates of such Holder, or the estates and family members of any such Holder or such partners and retired partners, any trusts for the benefit of any of the foregoing Persons, and such Holder and
other Persons shall be deemed to be a single selling Holder, and any pro rata reduction with respect to such selling Holder shall be based upon the aggregate amount of Common Stock owned by all entities and individuals included with such selling
Holder, as defined in this sentence. No securities excluded from the underwriting by reason of the underwriter’s marketing limitation shall be included in such registration. Upon delivery of a written request pursuant to Section 3.1.1,
3.1.2 or 3.2.1(a) that Registrable Securities be sold in an underwritten offering, the Holders thereof may not thereafter elect to withdraw therefrom without the written consent of the THL Funds. 

3.3.2 Registration Procedures. If, and in each case when, the Company is required to effect a registration of any Registrable Securities
as provided in this Section 3, the Company shall promptly: 
 (a) prepare and, in any event within 45 days (30 days in
the case of a Form S-3 registration) after the end of the period under Section 3.2.1(a) within which a piggyback request for registration may be given to the Company, file with the Commission a registration statement with respect to such
Registrable Securities and use its best efforts to cause such registration statement to become effective within 90 days of the initial filing; 

  
 8 








 (b) prepare and file with the Commission such amendments and supplements to such
registration statement and the prospectus used in connection therewith as may be necessary to keep such registration statement effective for a period not in excess of 270 days (or such shorter period which will terminate when all Registrable
Securities covered by such registration statement have been sold) and to comply with the provisions of the Securities Act and the Exchange Act with respect to the disposition of all securities covered by such registration statement during such
period in accordance with the intended methods of disposition by the seller or sellers thereof set forth in such registration statement; provided that before filing a registration statement or prospectus, or any amendments or supplements
thereto in accordance with Sections 3.1 or 3.2, the Company will furnish to counsel selected pursuant to Section 3.3.3 hereof copies of all documents proposed to be filed, which documents will be subject to the review of such counsel; 

(c) furnish to each seller of such Registrable Securities such number of copies of such registration statement and of each
amendment and supplement thereto (in each case including all exhibits filed therewith), such number of copies of the prospectus included in such registration statement (including each preliminary prospectus and summary prospectus), in conformity
with the requirements of the Securities Act, and such other documents as such seller may reasonably request in order to facilitate the disposition of the Registrable Securities by such seller; 

(d) use its best efforts to register or qualify such Registrable Securities covered by such registration in such jurisdictions
as each seller shall reasonably request, and do any and all other acts and things which may be reasonably necessary or advisable to enable such seller to consummate the disposition in such jurisdictions of the Registrable Securities owned by such
seller, except that the Company shall not for any such purpose be required to qualify generally to do business as a foreign corporation in any jurisdiction where, but for the requirements of this clause (d), it would not be obligated to be so
qualified or to consent to general service of process in any such jurisdiction; 
 (e) notify each seller of any such
Registrable Securities covered by such registration statement, at any time when a prospectus relating thereto is required to be delivered under the Securities Act, of the Company’s becoming aware that the prospectus included in such
registration statement, as then in effect, includes an untrue statement of a material fact or omits to state a material fact required to be stated therein or necessary to make the statements therein not misleading in the light of the circumstances
then existing, and at the request of any such seller, prepare and furnish to such seller a reasonable number of copies of an amended or supplemental prospectus as may be necessary so that, as thereafter delivered to the purchasers of such
Registrable Securities, such prospectus shall not include an untrue statement of a material fact or omit to state a material fact required to be stated therein or necessary to make the statements therein not misleading in the light of the
circumstances then existing; 

  
 9 








 (f) otherwise use its best efforts to comply with all applicable rules and
regulations of the Commission, and make available to its security holders, as soon as reasonably practicable (but not more than 18 months) after the effective date of the registration statement, an earnings statement which shall satisfy the
provisions of Section 11(a) of the Securities Act; 
 (g) (i) if such Registrable Securities are Common Stock (including
Common Stock issuable upon conversion, exchange or exercise of another security), use its best efforts to list such Registrable Securities on any securities exchange on which the Common Stock is then listed if such Registrable Securities are not
already so listed; and (ii) use its best efforts to provide a transfer agent and registrar for such Registrable Securities covered by such registration statement not later than the effective date of such registration statement; 

(h) enter into such customary agreements (including an underwriting agreement in customary form), which may include
indemnification provisions in favor of underwriters and other Persons in addition to the provisions of Section 3.4 hereof, and take such other actions as the THL Funds or the underwriters, if any, reasonably requested in order to expedite or
facilitate the disposition of such Registrable Securities; 
 (i) obtain a “cold comfort” letter or letters from
the Company’s independent public accountants in customary form and covering matters of the type customarily covered by “cold comfort” letters as the THL Funds shall reasonably request; 

(j) make available for inspection by any seller of such Registrable Securities covered by such registration statement, by any
managing underwriter or underwriters participating in any disposition to be effected pursuant to such registration statement and by any attorney, accountant or other agent retained by any such seller or any such managing underwriter(s), all
pertinent financial and other records, pertinent corporate documents and properties of the Company, and cause all of the Company’s officers, directors and employees to supply all information reasonably requested by any such seller, underwriter,
attorney, accountant or agent in connection with such registration statement (subject to each party referred to in this clause (j) entering into customary confidentiality agreements in a form reasonably acceptable to the Company); 

(k) notify counsel (selected pursuant to Section 3.3.3 hereof) for the Holders of Registrable Securities included in such
registration statement and the managing underwriter or agent, immediately, and confirm the notice in writing (i) when the registration statement, or any post-effective amendment to the registration statement, shall have become effective, or any
supplement to the prospectus or any amendment to the prospectus shall have been filed, (ii) of the receipt of any comments from the Commission, (iii) of any request of the Commission to amend the registration statement or amend or
supplement the prospectus or for additional information, and (iv) of the issuance by the 

  
 10 








 
Commission of any stop order suspending the effectiveness of the registration statement or of any order preventing or suspending the use of any preliminary prospectus, or of the suspension of the
qualification of the registration statement for offering or sale in any jurisdiction, or of the institution or threatening of any proceedings for any of such purposes; 

(l) use its best efforts to prevent the issuance of any stop order suspending the effectiveness of the registration statement
or of any order preventing or suspending the use of any preliminary prospectus and, if any such order is issued, to obtain the withdrawal of any such order as soon as practicable; 

(m) if requested by the managing underwriter or agent or any Holder of Registrable Securities covered by the registration
statement, incorporate in a prospectus supplement or post-effective amendment such information as the managing underwriter or agent or such Holder reasonably requests to be included therein, including, with respect to the number of Registrable
Securities being sold by such Holder to such underwriter or agent, the purchase price being paid therefor by such underwriter or agent and with respect to any other terms of the underwritten offering of the Registrable Securities to be sold in such
offering; and make all required filings of such prospectus supplement or post-effective amendment as soon as practicable after being notified of the matters incorporated in such prospectus supplement or post-effective amendment; 

(n) cooperate with the Holders of Registrable Securities covered by the registration statement and the managing underwriter or
agent, if any, to facilitate the timely preparation and delivery of certificates (not bearing any restrictive legends) representing securities to be sold under the registration statement, and enable such securities to be in such denominations and
registered in such names as the managing underwriter or agent, if any, or such Holders may request; 
 (o) obtain for
delivery to the underwriter or agent an opinion or opinions from counsel for the Company in customary form, substance and scope reasonably satisfactory to the THL Funds and their counsel; 

(p) cooperate with each seller of Registrable Securities and each underwriter or agent participating in the disposition of such
Registrable Securities and their respective counsel in connection with any filings required to be made with the FINRA; and 

(q) use its best efforts to make available the executive officers of the Company to participate with the Holders of Registrable
Securities and any underwriters in any “road shows” that may be reasonably requested by the Holders in connection with distribution of the Registrable Securities. 

  
 11 








 To the extent the Company is a WKSI at the time any demand registration request is submitted to
the Company, and such demand registration request requests that the Company file an automatic shelf registration statement (as defined in Rule 405 under the Securities Act) (an “automatic shelf registration statement”) on Form S-3, the
Company shall reasonably promptly file an automatic shelf registration statement which covers those Registrable Securities which are requested to be registered. The Company shall use its commercially reasonable best efforts to remain a WKSI (and not
become an ineligible issuer (as defined in Rule 405 under the Securities Act)) during the period during which such automatic shelf registration statement is required to remain effective. 

If the Company does not pay the filing fee covering the Registrable Securities at the time the automatic shelf registration statement is filed,
the Company agrees to pay such fee at such time or times as the Registrable Securities are to be sold. If the automatic shelf registration statement has been outstanding for at least three years, at the end of the third year the Company shall refile
a new automatic shelf registration statement covering the Registrable Securities. If at any time when the Company is required to re-evaluate its WKSI status the Company determines that it is not a WKSI, the Company shall use its commercially
reasonable best efforts to refile the shelf registration statement on Form S-3 and, if such form is not available, Form S-l and keep such registration statement continuously effective during the period during which such registration statement is
required to be kept effective. 
 3.3.3 Selection of Underwriters and Counsel. The underwriters and legal counsel to be retained by
the Company in connection with any Public Offering shall be selected by the Board; provided that, in the case of an offering following a request therefor under Section 3.1.1 or 3.1.2, such underwriters and counsel shall be reasonably
acceptable to the THL Funds. In connection with any registration of Registrable Securities pursuant to Sections 3.1 and 3.2 hereof, the THL Funds may select one counsel to represent all Holders of Registrable Securities covered by such registration;
provided, however, that in the event that the counsel selected as provided above is also acting as counsel to the Company in connection with such registration, the remaining Holders shall be entitled to select one additional counsel to
represent, at the Company’s expense, all such remaining Holders. 
 3.3.4 Company Lock-Up. If any registration pursuant to
Section 3.1 of this Agreement shall be in connection with an underwritten Public Offering, the Company agrees not to effect any public sale or distribution of any Common Stock of the Company (or securities convertible into or exchangeable or
exercisable for Common Stock) (in each case, other than as part of such underwritten Public Offering and other than pursuant to a registration on Form S-4 or S-8) for its own account, within 90 days (or such shorter period as the managing
underwriters may require) after, the effective date of such registration (except as part of such registration). 
 3.3.5 Holder
Lock-Up. Each Holder shall comply with the provisions of Section 3.7 of the Stockholders Agreement applicable to a “Stockholder” as though such Section were set forth herein. No Stockholder will Transfer Common Stock or any
securities convertible into or exercisable or exchangeable for Common Stock pursuant to a waiver from a lock-up agreement described in Section 3.7 of the Stockholders Agreement unless the benefit of such waiver is extended in a pro rata manner
to all Stockholders. Notwithstanding the requirements of 

  
 12 








 
this Section 3.3.5 or Section 3.6 of the Stockholders Agreement, no Holder other than the THL Funds (and the Other Investors) shall be required to sign a lock-up agreement in the case
of a THL Block Trade, unless such other Holder has the option to participate in such THL Block Trade. 
 3.3.6 Other Agreements. The
Company covenants and agrees that, so long as any Person holds any Registrable Securities in respect of which any registration rights provided for in Section 3.1 of this Agreement remain in effect, the Company will not, directly or indirectly,
grant to any Person or agree to or otherwise become obligated in respect of rights of registration in the nature or substantially in the nature of those set forth in Section 3.1 or 3.2 of this Agreement without the consent of Stockholders
holding a majority of the Registrable Securities (plus the consent of any Stockholder who would be disproportionately and adversely affected thereby compared to other Stockholders) other than registration rights set forth in Section 3.1 or 3.2
that are provided to Managers, Manager Designees, Other Investors or Investors that join this Agreement from time to time. 
 3.4
Indemnification and Contribution. 
 3.4.1 Indemnities of the Company. In the event of any registration of any Registrable
Securities or other debt or equity securities of the Company or any of its subsidiaries under the Securities Act pursuant to this Section 3 or otherwise, and in connection with any registration statement or any other disclosure document
produced by or on behalf of the Company or any of its subsidiaries including reports required and other documents filed under the Exchange Act, and other documents pursuant to which any debt or equity securities of the Company or any of its
subsidiaries are sold (whether or not for the account of the Company or its subsidiaries), the Company will, and hereby does, and will cause each of its subsidiaries, jointly and severally, to indemnify and hold harmless each holder of Registrable
Securities, any Person who is or might be deemed to be a controlling Person of the Company or any of its subsidiaries within the meaning of Section 15 of the Securities Act or Section 20 of the Exchange Act, their respective direct and
indirect partners, advisory board members, advisors, directors, officers, employees, trustees, members and shareholders, and each other Person, if any, who controls any such holder or any such controlling Person within the meaning of Section 15
of the Securities Act or Section 20 of the Exchange Act (each such Person being referred to herein as a “Covered Person”), against any losses, claims, damages or liabilities (or actions or proceedings in respect thereof), joint
or several, to which such Covered Person may be or become subject under the Securities Act, the Exchange Act, any other securities or other law of any jurisdiction, the common law or otherwise, insofar as such losses, claims, damages or liabilities
(or actions or proceedings in respect thereof) arise out of or are based upon (i) any untrue statement or alleged untrue statement of any material fact contained or incorporated by reference in any registration statement under the Securities
Act, any preliminary prospectus or final prospectus included therein, or any related summary prospectus, or any amendment or supplement thereto, or any document incorporated by reference therein, or any other such disclosure document (including
reports and other documents filed under the Exchange Act and any document incorporated by reference therein) or other document or report, (ii) any omission or alleged omission to state therein a material fact required to be stated therein or
necessary to make the statements therein not misleading or (iii) any violation or alleged violation by the Company or any of its subsidiaries of any federal, state, foreign or common law rule or regulation applicable to the


  
 13 








 
Company or any of its subsidiaries and relating to action or inaction in connection with any such registration, disclosure document or other document or report, and will reimburse such Covered
Person for any legal or any other expenses incurred by it in connection with investigating or defending any such loss, claim, damage, liability, action or proceeding; provided, however, that neither the Company nor any of its
subsidiaries shall be liable to any Covered Person in any such case to the extent that any such loss, claim, damage, liability, action or proceeding arises out of or is based upon an untrue statement or alleged untrue statement or omission or
alleged omission made in such registration statement, any such preliminary prospectus, final prospectus, summary prospectus, amendment or supplement, incorporated document or other such disclosure document or other document or report, in reliance
upon and in conformity with written information furnished to the Company or to any of its subsidiaries through an instrument duly executed by such Covered Person specifically stating that it is for use in the preparation thereof. The indemnities of
the Company and of its subsidiaries contained in this Section 3.4.1 shall remain in full force and effect regardless of any investigation made by or on behalf of such Covered Person and shall survive any transfer of securities or any
termination of this Agreement. 
 3.4.2 Indemnities to the Company. Subject to Section 3.4.4, the Company and any of its
subsidiaries may require, as a condition to including any securities in any registration statement filed pursuant to this Section 3, that the Company and any of its subsidiaries shall have received an undertaking satisfactory to it from the
prospective seller of such securities, severally and not jointly, to indemnify and hold harmless the Company and any of its subsidiaries, each director of the Company or any of its subsidiaries, each officer of the Company or any of its subsidiaries
who shall sign such registration statement and each other Person (other than such seller), if any, who controls the Company and any of its subsidiaries within the meaning of Section 15 of the Securities Act or Section 20 of the Exchange
Act and each other prospective seller of such securities with respect to any statement in or omission from such registration statement, any preliminary prospectus, final prospectus or summary prospectus included therein, or any amendment or
supplement thereto, or any other disclosure document (including reports and other documents filed under the Exchange Act or any document incorporated therein) or other document or report, if such statement or omission was made in reliance upon and
in conformity with written information furnished to the Company or any of its subsidiaries through an instrument executed by such seller specifically stating that it is for use in the preparation of such registration statement, preliminary
prospectus, final prospectus, summary prospectus, amendment or supplement, incorporated document or other document or report. Such indemnity shall remain in full force and effect regardless of any investigation made by or on behalf of the Company,
any of its subsidiaries or any such director, officer or controlling Person and shall survive any transfer of securities or any termination of this Agreement. 

3.4.3 Contribution. If the indemnification provided for in Sections 3.4.1 or 3.4.2 hereof is unavailable to a party that would have been
entitled to indemnification pursuant to the foregoing provisions of this Section 3.4 (an “Indemnitee”) in respect of any losses, claims, damages or liabilities (or actions or proceedings in respect thereof) referred to therein,
then each party that would have been an indemnifying party thereunder shall, subject to Section 3.4.4 and in lieu of indemnifying such Indemnitee, contribute to the amount paid or payable by such Indemnitee as a result of such losses, claims,
damages or liabilities (or actions or proceedings in respect thereof) in such proportion as is appropriate to reflect the relative fault of such indemnifying party on the one hand and such Indemnitee on the other in connection with the


  
 14 








 
statements or omissions which resulted in such losses, claims, damages or liabilities (or actions or proceedings in respect thereof). The relative fault shall be determined by reference to, among
other things, whether the untrue or alleged untrue statement of a material fact or the omission or alleged omission to state a material fact relates to information supplied by such indemnifying party or such Indemnitee and the parties’ relative
intent, knowledge, access to information and opportunity to correct or prevent such statement or omission. The parties agree that it would not be just or equitable if contribution pursuant to this Section 3.4.3 were determined by pro rata
allocation or by any other method of allocation which does not take account of the equitable considerations referred to in the preceding sentence. The amount paid or payable by a contributing party as a result of the losses, claims, damages or
liabilities (or actions or proceedings in respect thereof) referred to above in this Section 3.4.3 shall include any legal or other expenses reasonably incurred by such Indemnitee in connection with investigating or defending any such action or
claim. No Person guilty of fraudulent misrepresentation (within the meaning of Section 11(f) of the Securities Act) shall be entitled to contribution from any Person who was not guilty of such fraudulent misrepresentation. 

3.4.4 Limitation on Liability of Holders of Registrable Securities. The liability of each holder of Registrable Securities in respect of
any indemnification or contribution obligation of such holder arising under this Section 3.4 shall not in any event exceed an amount equal to the gross proceeds to such holder from the disposition of the Registrable Securities disposed of by
such holder pursuant to such registration. 
 3.4.5 Indemnification Procedures. Promptly after receipt by an Indemnitee of written
notice of the commencement of any action or proceeding with respect to which a claim for indemnification may be made pursuant to this Section 3.4, such Indemnitee will, if a claim in respect thereof is to be made against an indemnifying party,
give written notice to the latter of the commencement of such action or proceeding; provided that the failure of the Indemnitee to give notice as provided herein shall not relieve the indemnifying party of its obligations under this
Section 3.4, except to the extent that the indemnifying party is materially prejudiced by such failure to give notice. In case any such action or proceeding is brought against an Indemnitee, the indemnifying party will be entitled to
participate in and to assume the defense thereof (at its expense), jointly with any other indemnifying party similarly notified to the extent that it may wish, with counsel reasonably satisfactory to such Indemnitee, and after notice from the
indemnifying party to such Indemnitee of its election so to assume the defense thereof, the indemnifying party will not be liable to such Indemnitee for any legal or other expenses subsequently incurred by the latter in connection with the defense
thereof other than reasonable costs of investigation and shall have no liability for any settlement made by the Indemnitee without the consent of the indemnifying party, such consent not to be unreasonably withheld. Notwithstanding the foregoing, if
in such Indemnitee’s reasonable judgment a conflict of interest between such Indemnitee and the indemnifying parties may exist in respect of such action or proceeding or the indemnifying party does not assume the defense of any such action or
proceeding within a reasonable time after notice of commencement, the Indemnitee shall have the right to assume or continue its own defense and the indemnifying party shall be liable for any reasonable expenses therefor, but in no event will bear
the expenses for more than one firm of counsel for all Indemnitees in each jurisdiction who shall be approved by the THL Funds included in the registration in respect of which such indemnification is sought (or, if none, the Company). No
indemnifying party will settle any action or proceeding or consent to the entry of 

  
 15 








 
any judgment without the prior written consent of the Indemnitee, unless such settlement or judgment (i) includes as an unconditional term thereof the giving by the claimant or plaintiff of
a release to such Indemnitee from all liability in respect of such action or proceeding and (ii) does not involve the imposition of equitable remedies or the imposition of any obligations on such Indemnitee and does not otherwise adversely
affect such Indemnitee, other than as a result of the imposition of financial obligations for which such Indemnitee will be indemnified hereunder. 

SECTION 4. 
 REMEDIES.

 4.1 Generally. The parties shall have all remedies available at law, in equity or otherwise in the event of any breach or
violation of this Agreement or any default hereunder. The parties acknowledge and agree that in the event of any breach of this Agreement, in addition to any other remedies which may be available, each of the parties hereto shall be entitled to
specific performance of the obligations of the other parties hereto and, in addition, to such other equitable remedies (including preliminary or temporary relief) as may be appropriate in the circumstances. 

SECTION 5. 
 PERMITTED
TRANSFEREES. 
 The rights of a Holder hereunder may be assigned (but only with all related obligations as set forth below) in
connection with a Transfer of Shares effected in accordance with the terms of the Stockholders Agreement and this Agreement to a Permitted Transferee of such Holder. Without prejudice to any other or similar conditions imposed hereunder with respect
to any such Transfer, no assignment permitted under the terms of this Section 5 shall be effective unless the Permitted Transferee to which such assignment is being made, if not a Stockholder, has delivered to the Company a written
acknowledgment and agreement in form and substance reasonably satisfactory to the Company that the Shares in respect of which such assignment is made shall continue to be deemed Shares and shall be subject to all of the provisions of this Agreement
relating to Shares and that such Permitted Transferee shall be bound by, and shall be a party to, this Agreement. A Permitted Transferee to whom rights are transferred pursuant to this Section 5 may not again transfer such rights to any other
Permitted Transferee, other than as provided in this Section 5. 
 SECTION 6. 

AMENDMENT, TERMINATION, ETC. 

6.1 Oral Modifications. This Agreement may not be orally amended, modified, extended or terminated, nor shall any oral waiver of any of
its terms be effective. 
 6.2 Written Modifications. This Agreement may be amended, modified, extended or terminated, and the
provisions hereof may be waived, only by an agreement in writing signed by the Company and the Stockholders that hold a majority of the Shares held by all Stockholders; 

  
 16 








 
provided, however, that any amendment, modification, extension, termination or waiver (an “Amendment”) shall also require the consent of any Stockholder who would
be disproportionately and adversely affected thereby. Each such Amendment shall be binding upon each party hereto and each holder of Shares subject hereto. In addition, each party hereto and each holder of Shares subject hereto may waive any right
hereunder by an instrument in writing signed by such party or holder. 
 6.3 Effect of Termination. No termination under this
Agreement shall relieve any Person of liability for breach prior to termination. In the event this Agreement is terminated, each Covered Person shall retain the indemnification rights pursuant to Section 3.4 hereof with respect to any matter
that (i) may be an indemnified liability thereunder and (ii) occurred prior to such termination. 
 SECTION 7. 

DEFINITIONS. 
 For
purposes of this Agreement: 
 7.1 Certain Matters of Construction. In addition to the definitions referred to or set forth below in
this Section 7: 
 (i) The words “hereof’, “herein”, “hereunder” and words of similar
import shall refer to this Agreement as a whole and not to any particular Section or provision of this Agreement, and reference to a particular Section of this Agreement shall include all subsections thereof; 

(ii) The word “including” shall mean including, without limitation; 

(iii) Definitions shall be equally applicable to both nouns and verbs and the singular and plural forms of the terms defined;
and 
 (iv) The masculine, feminine and neuter genders shall each include the other. 

7.2 Definitions. The following terms shall have the following meanings: 

“Affiliate” shall mean, with respect to any specified Person, (a) any other Person which directly or indirectly through
one or more intermediaries controls, or is controlled by, or is under common control with, such specified Person (for the purposes of this definition, “control” (including, with correlative meanings, the terms “controlling,”
“controlled by” and “under common control with”), as used with respect to any Person, means the possession, directly or indirectly, of the power to direct or cause the direction of the management or policies of such Person,
whether through the ownership of voting securities, by agreement or otherwise) and (b) with respect to any natural Person, any Member of the Immediate Family of such natural Person. 

  
 17 








 “Affiliated Fund” shall mean each corporation, trust, limited liability company,
general or limited partnership or other entity under common control with any Investor or that receives investment advice from the investment adviser to any Investor or an investment adviser Affiliated with such investment adviser. 

“Agreement” shall have the meaning set forth in the Preamble. 

“Amendment” shall have the meaning set forth in Section 6.2. 

“Board” shall mean the board of directors of the Company. 

“business day” shall mean any day that is not a Saturday, a Sunday or other day on which banks are required or authorized by
law to be closed in the City of New York. 
 “Change of Control” shall mean (a) any change in the ownership of the
capital stock of the Company if, immediately after giving effect thereto, any Person (or group of Persons acting in concert) other than the Investors and their Affiliates will have the direct or indirect power to elect a majority of the members of
the board of directors of the Company or (b) any change in the ownership of the capital stock of the Company if, immediately after giving effect thereto, the THL Funds and their Affiliates shall own less than 25% of the Equivalent Shares. 

“Closing” shall mean the closing of the merger on August 4, 2010 pursuant to the Agreement and Plan of Merger dated as
of May 6, 2010, as amended, among inVentiv, the Company and inVentiv Acquisition, Inc. 
 “Commission” shall mean the
Securities and Exchange Commission. 
 “Common Stock” shall mean the common stock, par value $0.01 per share, of the
Company. 
 “Company” shall have the meaning set forth in the Preamble. 

“Covered Person” shall have the meaning set forth in Section 3.4.1. 

“Convertible Securities” shall mean any evidence of indebtedness, shares of stock (other than Common Stock) or other
securities (other than Options and Warrants) which are directly or indirectly convertible into or exchangeable or exercisable for shares of Common Stock. 

“Equivalent Shares” shall mean, at any date of determination, (a) as to any outstanding shares of Common Stock, such
number of shares of Common Stock and (b) as to any outstanding Options, Warrants or Convertible Securities which constitute Shares, the maximum number of shares of Common Stock for which or into which such Options, Warrants or Convertible
Securities may at the time be exercised, converted or exchanged (or which will become exercisable, convertible or exchangeable on or prior to, or by reason of, the transaction or circumstance in connection with which the number of Equivalent Shares
is to be determined); provided, however, that with respect to any Manager or Manager Designee only Vested Shares shall be counted in determining the Equivalent Shares held by such Manager or Manager Designee. 

  
 18 








 “Exchange Act” shall mean the Securities Exchange Act of 1934, as in effect from
time to time. 
 “FINRA” shall mean the Financial Industry Regulatory Authority. 

“Holders” shall mean the holders of Registrable Securities under this Agreement. 

“Holdings” shall have the meaning set forth in the Preamble. 

“Indemnitee” shall have the meaning set forth in Section 3.4.3. 

“Initial Public Offering” shall mean the initial Public Offering registered on Form S-1 (or any successor form under the
Securities Act) after the date of the Prior Agreement following which the Company’s Common Stock is listed on the New York Stock Exchange, the NASDAQ Global Select Market or any successor to the foregoing. 

“Initiating Holders” shall have the meaning set forth in Section 3.1.2. 

“inVentiv” shall mean inVentiv Health, Inc. 

“Investors” shall have the meaning set forth in the Preamble. 

“Investor Shares” shall mean (a) all shares of Common Stock originally issued to, or issued with respect to shares
originally issued to, or held by, an Investor, whenever issued, including all shares of Common Stock issued upon the exercise, conversion or exchange of any Options, Warrants or Convertible Securities and (b) all Options, Warrants and
Convertible Securities originally granted or issued to an Investor (treating such Options, Warrants and Convertible Securities as a number of Shares equal to the number of Equivalent Shares represented by such Options, Warrants and Convertible
Securities for all purposes of this Agreement except as otherwise specifically set forth herein). 
 “IPO Initiating
Holders” shall have the meaning set forth in Section 3.1.1. 
 “Liberty Lane” shall have the meaning set
forth in the Preamble. 
 “LL Other Investor Shares” shall mean those Shares issued to Liberty Lane in connection with the
Closing in exchange for a cash investment by Liberty Lane in the Company on or prior to the Closing or issued to Liberty Lane after the Closing in exchange for a cash investment (other than in connection with the exercise of any Option) to the
extent so designated by the Investors. 
 “Management Shares” shall mean all Shares held by a Manager or Manager Designee.
Any Management Shares that are Transferred by the holder thereof to such holder’s Permitted Transferees shall remain Management Shares in the hands of such Permitted Transferee. 

“Manager Designees” shall have the meaning set forth in the Recitals. 

  
 19 








 “Managers” shall have the meaning set forth in the Recitals. For the avoidance
of doubt, (a) Walter shall be deemed to be a Manager under this Agreement solely in his capacity as a holder of Shares other than the Walter Rollover Shares and (b) Liberty Lane shall be deemed to be a Manager under this Agreement solely
in its capacity as a holder of Shares other than the LL Other Investor Shares. 
 “Member of the Immediate Family” shall
mean, with respect to any individual, each spouse or child or other descendant of such individual, each trust, partnership or other entity controlled by one or more of the aforementioned Persons and created solely for the benefit of one or more of
the aforementioned Persons and their spouses and each custodian or guardian of any property of one or more of the aforementioned Persons in his or her capacity as such custodian or guardian. 

“Midco Holdings” shall have the meaning set forth in the Preamble. 

“No Recourse Person” shall have the meaning set forth in Section 8.7. 

“Options” shall mean any options to subscribe for, purchase or otherwise directly acquire Common Stock, other than any such
option held by the Company or any right to purchase shares pursuant to this Agreement. 
 “Other Investors” shall have the
meaning set forth in the Preamble. For the avoidance of doubt, (a) Walter shall be deemed to be an Other Investor under this Agreement solely in his capacity as a holder of the Walter Rollover Shares and (b) Liberty Lane shall be deemed to
be an Other Investor under this Agreement solely in its capacity as a holder of the LL Other Investor Shares. 
 “Parity
Shares” shall have the meaning set forth in Section 3.3.1. 
 “Participation Shares” shall mean all Shares
held by an Investor or Other Investor and all Vested Shares held by a Manager or Manager Designee. 
 “Permitted
Transferee” shall have the meaning set forth in the Stockholders Agreement. 
 “Person” shall mean any individual,
partnership, corporation, company, association, trust, joint venture, limited liability company, unincorporated organization, entity or division, or any government, governmental department or agency or political subdivision thereof. 

“Prior Agreement” shall have the meaning set forth in the Recitals. 

“Pro Rata Portion” shall mean for purposes of Section 3.3, with respect to each holder of Registrable Securities or
Parity Shares requesting that such shares be registered in such registration statement, a number of such shares equal to the aggregate number of shares of Common Stock to be registered in such registration (excluding any shares to be registered for
the account of the Company) multiplied by a fraction, the numerator of which is the aggregate number of Registrable Securities and Parity Shares held by such holder, and the denominator of which is the aggregate number of Registrable Securities and
Parity Shares held by all holders requesting that their Registrable Securities or Parity Shares be registered in such registration. 

  
 20 








 “Public Offering” shall mean a public offering and sale of Common Stock for cash
pursuant to an effective registration statement under the Securities Act. 
 “Registrable Securities” shall mean
(a) all shares of Common Stock, (b) all shares of Common Stock issuable upon exercise, conversion or exchange of any Option, Warrant or Convertible Security and (d) all shares of Common Stock directly or indirectly issued or issuable
with respect to the securities referred to in clauses (a) or (b) above by way of stock dividend or stock split or in connection with a combination of shares, recapitalization, merger, consolidation or other reorganization, in each case
constituting Shares and, in the case of any Manager or Manager Designee, Vested Shares. As to any particular Registrable Securities, such shares shall cease to be Registrable Securities when (v) a registration statement with respect to the sale
of such securities shall have become effective under the Securities Act and such securities shall have been disposed of in accordance with such registration statement, (w) such securities shall have been Transferred pursuant to Rule 144,
(x) subject to the provisions of Section 5 hereof, such securities shall have been otherwise Transferred, new certificates for them not bearing a legend restricting further transfer shall have been delivered by the Company and subsequent
disposition of them shall not require registration of them under the Securities Act, (y) such securities may be distributed without volume limitation or other restrictions on transfer under Rule 144 or (z) such securities shall have ceased
to be outstanding. 
 “Registration Expenses” means any and all expenses incident to performance of or compliance with
Section 3 of this Agreement (other than underwriting discounts and commissions paid to underwriters and transfer taxes, if any), including (a) all Commission and securities exchange or FINRA registration and filing fees, (b) all fees
and expenses of complying with securities or blue sky laws (including reasonable fees and disbursements of counsel for the underwriters in connection with blue sky qualifications of the Registrable Securities), (c) all printing, messenger and
delivery expenses, (d) all fees and expenses incurred in connection with the listing of the Registrable Securities on any securities exchange pursuant to Section 3.3.2(g), all fees and expenses incurred in connection with any applicable
FINRA filings pursuant to Section 3.3.2(p), and all rating agency fees, (e) the fees and charges of counsel for the Company and of its independent public accountants, including the expenses of any special audits and/or “cold
comfort” letters required by or incident to such performance and compliance, (f) the reasonable fees and charges of one counsel for the Holders selected pursuant to the terms of Section 3 and one counsel for certain Holders selected
pursuant to the second proviso of Section 3.3.3, if applicable, (g) any fees and disbursements customarily paid by the issuers of securities, (h) expenses incurred in connection with any road show (including the reasonable
out-of-pocket expenses of the Holders) and (i) fees and expenses incurred in connection with the distribution or Transfer of Registrable Securities to or by a Holder or its permitted transferees in connection with a Public Offering. 

“Rule 144” shall mean Rule 144 under the Securities Act (or any successor Rule). 

“Securities Act” shall mean the Securities Act of 1933, as in effect from time to time. 

“Shares” shall mean (a) all shares of Common Stock held by a Stockholder, whenever issued, including all shares of
Common Stock issued upon the exercise, conversion or exchange of any Options, Warrants or Convertible Securities and (b) all Options, Warrants and Convertible 

  
 21 








 
Securities held by a Stockholder (treating such Options, Warrants and Convertible Securities as a number of Shares equal to the number of Equivalent Shares represented by such Options, Warrants
and Convertible Securities for all purposes of this Agreement except as otherwise specifically set forth herein). 
 “Shelf Takedown
Holders” shall have the meaning set forth in Section 3.1.3. 
 “Stockholders” shall mean the Investors, the
Other Investors, the Managers, and the Manager Designees. 
 “Stockholders Agreement” shall mean the Stockholders Agreement
between the Company and its stockholders dated as of August 4, 2010, as amended. 
 “THL Block Trade” means an
offering and/or sale of Registrable Securities by the THL Funds (and any Other Investor that elects to participate) on a block trade or underwritten basis (whether firm commitment or otherwise) without substantial marketing efforts prior to pricing,
including, without limitation, a same day trade, overnight trade or similar transaction. 
 “THL Funds” shall have the
meaning set forth in the Preamble. 
 “Transfer” shall mean any sale, pledge, assignment, encumbrance or other transfer or
disposition of any Shares to any other Person, whether directly, indirectly, voluntarily, involuntarily, by operation of law, pursuant to judicial process or otherwise. 

“Underwritten Shelf Takedown” shall have the meaning set forth in Section 3.1.3. 

“Vested Shares” shall mean, with respect to a Manager or Manager Designee at any time, the Management Shares held by such
Manager or Manager Designee which are not subject to vesting or similar requirements at such time. 
 “Walter” shall have
the meaning set forth in the Preamble. 
 “Walter GRAT” shall mean any grantor retained annuity trust existing as of the
date of this Agreement or created in the future (a) of which Walter is the trustee and (b) whose residual beneficiaries are Members of the Immediate Family of Walter. The term “Walter GRAT” shall also include that certain
intentionally defective grantor retained annuity trust existing as of the date of this Agreement (a) of which Walter’s brother, Peter A. Walter, is the trustee and (b) whose residual beneficiaries are Walter and/or Members of the
Immediate Family of Walter. 
 “Walter Rollover Shares” shall mean those Shares issued to Walter or any Walter GRAT in
connection with the Closing in exchange for (a) shares of common stock of inVentiv issued to Walter prior to the Closing and (b) a cash investment by Walter in the Company on or prior to the Closing. 

“Warrants” shall mean any warrants to subscribe for, purchase or otherwise directly acquire Common Stock. 

  
 22 








 “WKSI” means a well-known seasoned issuer (as defined in Rule 405 under the
Securities Act). 
 SECTION 8. 

MISCELLANEOUS. 
 8.1
Authority; Effect. Each party hereto represents and warrants to and agrees with each other party that the execution and delivery of this Agreement and the consummation of the transactions contemplated hereby have been duly authorized on
behalf of such party and do not violate any agreement or other instrument applicable to such party or by which its assets are bound. This Agreement does not, and shall not be construed to, give rise to the creation of a partnership among any of the
parties hereto, or to constitute any of such parties members of a joint venture or other association. Each of the Company, Midco Holdings, Holdings and inVentiv shall be jointly and severally liable for any payment obligation of the Company, Midco
Holdings, Holdings or inVentiv pursuant to this Agreement. 
 8.2 Notices. Any notices, requests, demands, claims and other
communications required or permitted to be delivered, given or otherwise provided under this Agreement shall be in writing and shall be (a) delivered or given personally, (b) sent by facsimile, or (c) sent by overnight courier, in
each case, to the address (or facsimile number) listed below: 
 If to the Company, Midco Holdings, Holdings or inVentiv: 

inVentiv Group Holdings, Inc. 

c/o Thomas H. Lee Partners, L.P. 

100 Federal Street 

Boston, Massachusetts 02110 

Attention: Todd M. Abbrecht 

Facsimile: (617) 227-3514 

with a copy (which shall not constitute notice) to: 

Weil, Gotshal & Manges LLP 

767 Fifth Avenue 

New York, New York 10153 

Attention: Michael J. Aiello 

                 Sachin Kohli 

Facsimile: (212) 310-8007 

If to the THL Funds: 

c/o Thomas H. Lee Partners, L.P. 

100 Federal Street 

Boston, Massachusetts 02110 

Attention: Todd M. Abbrecht 

Facsimile: (617) 227-3514 

  
 23 








 with a copy (which shall not constitute notice) to: 

Weil, Gotshal & Manges LLP 

767 Fifth Avenue 

New York, New York 10153 

Attention: Michael J. Aiello 

                 Sachin Kohli 

Facsimile: (212) 310-8007 

If to an Investor, Other Investor or a Manager, to the most recent address of such Investor, Other Investor or Manager shown on the records of
the Company. 
 Notice to the holder of record of any shares of capital stock shall be deemed to be notice to the holder of such shares for
all purposes hereof. 
 Unless otherwise specified herein, such notices or other communications shall be deemed effective (a) on the
date received, if personally delivered, (b) on the date received if delivered by facsimile on a business day, or if delivered on other than a business day, on the first business day thereafter and (c) two business days after being sent by
overnight courier. Each of the parties hereto shall be entitled to specify a different address by giving notice as aforesaid to each of the other parties hereto. 

8.3 Entire Agreement; Binding Effect, Etc. This Agreement, together with the Stockholders Agreement, constitute the entire agreement of
the parties with respect to their subject matter, supersede all prior or contemporaneous oral or written agreements or discussions with respect to such subject matter, and shall be binding upon and inure to the benefit of the parties hereto and
thereto and their respective heirs, representatives, successors and permitted assigns. Except as otherwise expressly provided herein, no Stockholder or other party hereto may assign any of its respective rights or delegate any of its respective
obligations under this Agreement without the prior written consent of the other parties hereto, and any attempted assignment or delegation in violation of the foregoing shall be null and void. 

8.4 Descriptive Headings. The descriptive headings of this Agreement are for convenience of reference only, are not to be considered a
part hereof and shall not be construed to define or limit any of the terms or provisions hereof. 
 8.5 Counterparts. This Agreement
may be executed in multiple counterparts, each of which shall be deemed an original, but all of which taken together shall constitute one instrument. 

8.6 Severability. In the event that any provision hereof would, under applicable law, be invalid or unenforceable in any respect, such
provision shall be construed by modifying or limiting it so as to be valid and enforceable to the maximum extent compatible with, and possible under, applicable law. The provisions hereof are severable, and in the event any provision hereof should
be held invalid or unenforceable in any respect, it shall not invalidate, render unenforceable or otherwise affect any other provision hereof. 

  
 24 








 8.7 No Recourse. Notwithstanding anything that may be expressed or implied in this
Agreement, the Company and each Stockholder covenant, agree and acknowledge that no recourse under this Agreement or any documents or instruments delivered in connection with this Agreement shall be had against any former, current or future, direct
or indirect director, officer, employee, agent or affiliate of any Investor, any former, current or future, direct or indirect holder of any equity interests or securities of any Investor (whether such holder is a limited or general partner, member,
stockholder or otherwise), any former, current or future assignee of any Investor or any former, current or future director, officer, employee, agent, general or limited partner, manager, member, stockholder, affiliate, controlling person,
representative or assignee of any of the foregoing (collectively, the “No Recourse Persons”), as such, whether by the enforcement of any assessment or by any legal or equitable proceeding, or by virtue of any statute, regulation or
other applicable law, it being expressly agreed and acknowledged that no personal liability whatsoever shall attach to, be imposed on or otherwise be incurred by any No Recourse Person for any obligation of any Stockholder under this Agreement or
any documents or instruments delivered in connection with this Agreement for any claim based on, in respect of or by reason of such obligations or their creation. 

8.8 Aggregation of Shares. All Shares held by a Stockholder and its Affiliates and Affiliated Funds shall be aggregated together for
purposes of determining the availability of any rights under Sections 2 and 3. Within any group comprised of a Stockholder and its Affiliates and Affiliated Funds, such Stockholders may allocate the ability to exercise any rights under this
Agreement in any manner that such group (by a majority of the Shares held by such group) sees fit. 
 SECTION 9. 

GOVERNING LAW. 
 9.1
Governing Law. This Agreement shall be governed by and construed in accordance with the domestic substantive laws of the State of Delaware without giving effect to any choice or conflict of laws provision or rule that would cause the
application of the domestic substantive laws of any other jurisdiction. 
 9.2 Consent to Jurisdiction. Each party to this Agreement,
by its execution hereof, (a) hereby irrevocably submits to the exclusive jurisdiction of the state and federal courts sitting in State of Delaware for the purpose of any action, claim, cause of action or suit (in contract, tort or otherwise),
inquiry, proceeding or investigation arising out of or based upon this Agreement or relating to the subject matter hereof, (b) hereby waives to the extent not prohibited by applicable law, and agrees not to assert, by way of motion, as a
defense or otherwise, in any such action, any claim that it is not subject personally to the jurisdiction of the above-named courts, that its property is exempt or immune from attachment or execution, that any such proceeding brought in one of the
above-named courts is improper, or that this Agreement or the subject matter hereof or thereof may not be enforced in or by such court and (c) hereby agrees not to commence or maintain any action, claim, cause of action or suit (in contract,
tort or otherwise), inquiry, proceeding or investigation arising out of or based upon this Agreement or relating to the subject matter hereof or thereof other than before one of the above-named courts nor to make any motion or take any other action
seeking or intending to cause the transfer or removal of any such action, 

  
 25 








 
claim, cause of action or suit (in contract, tort or otherwise), inquiry, proceeding or investigation to any court other than one of the above-named courts whether on the grounds of inconvenient
forum or otherwise. Notwithstanding the foregoing, to the extent that any party hereto is or becomes a party in any litigation in connection with which it may assert indemnification rights set forth in this Agreement, the court in which such
litigation is being heard shall be deemed to be included in clause (a) above. Each party hereto hereby consents to service of process in any such proceeding in any manner permitted by Delaware law, and agrees that service of process by
registered or certified mail, return receipt requested, at its address specified pursuant to Section 8.2 hereof is reasonably calculated to give actual notice. Notwithstanding the foregoing in this Section 9.2, a party may commence any
action in a court other than the above-named courts solely for the purpose of enforcing an order or judgment issued by one of the above-named courts. 

9.3 WAIVER OF JURY TRIAL. TO THE EXTENT NOT PROHIBITED BY APPLICABLE LAW WHICH CANNOT BE WAIVED, EACH PARTY HERETO HEREBY WAIVES AND
COVENANTS THAT IT WILL NOT ASSERT (WHETHER AS PLAINTIFF, DEFENDANT OR OTHERWISE) ANY RIGHT TO TRIAL BY JURY IN ANY FORUM IN RESPECT OF ANY ISSUE OR ACTION, CLAIM, CAUSE OF ACTION OR SUIT (IN CONTRACT, TORT OR OTHERWISE), INQUIRY, PROCEEDING OR
INVESTIGATION ARISING OUT OF OR BASED UPON THIS AGREEMENT OR THE SUBJECT MATTER HEREOF OR IN ANY WAY CONNECTED WITH OR RELATED OR INCIDENTAL TO THE TRANSACTIONS CONTEMPLATED HEREBY, IN EACH CASE WHETHER NOW EXISTING OR HEREAFTER ARISING. EACH PARTY
HERETO ACKNOWLEDGES THAT IT HAS BEEN INFORMED BY THE OTHER PARTIES HERETO THAT THIS SECTION 9.3 CONSTITUTES A MATERIAL INDUCEMENT UPON WHICH THEY ARE RELYING AND WILL RELY IN ENTERING INTO THIS AGREEMENT. ANY PARTY HERETO MAY FILE AN ORIGINAL
COUNTERPART OR A COPY OF THIS SECTION 9.3 WITH ANY COURT AS WRITTEN EVIDENCE OF THE CONSENT OF EACH SUCH PARTY TO THE WAIVER OF ITS RIGHT TO TRIAL BY JURY. 

9.4 Exercise of Rights and Remedies. No delay of or omission in the exercise of any right, power or remedy accruing to any party as a
result of any breach or default by any other party under this Agreement shall impair any such right, power or remedy, nor shall it be construed as a waiver of or acquiescence in any such breach or default, or of any similar breach or default
occurring later; nor shall any such delay, omission nor waiver of any single breach or default be deemed a waiver of any other breach or default occurring before or after that waiver. 

  
 26 








 EXHIBIT A 

Counterpart Signature Page 

The undersigned hereby agrees to join, become a party to and be bound by, as a “Stockholder” and a [Investor/Other Investor/Manager]
under that certain Amended and Restated Registration and Participation Rights Agreement of inVentiv Group Holdings, Inc. (the “Company”), entered into as of [•], 2016, by and among: (i) the Company, (ii) inVentiv
Midco Holdings, Inc., (iii) inVentiv Holdings, Inc., (iv) inVentiv Health, Inc. and (v) certain other holders of the Company’s outstanding securities, as the same may be in effect from time to time. 

 

			
	 
	Name of Stockholder
		
	 By:
	 	  

		 	 (if applicable)

		
	 By:
	 	  

		 	 Name:

		 	 Title:

	
	 Dated:
                , 20    

	
	 Address for notices: