EX-10.4




 EXHIBIT 10.4 

FIRST AMENDMENT 
 TO 

REGISTRATION AGREEMENT 
 This
First Amendment to Registration Agreement (this “Amendment”), is made and entered into effective as of October 30, 2014 (the “Effective Date”), and amends that certain Registration Agreement, dated as of
January 4, 2013, by and among ECPM Holdings, LLC, a Delaware limited liability company (the “Company”), and the other parties thereto (the “Registration Agreement”). All capitalized terms used in this Amendment
and not defined herein shall have the meanings set forth in the Registration Agreement. 
 RECITALS 

A. The Company desires to amend the Registration Agreement in order to amend the definition of “Investor Registrable Securities”, as
more specifically described herein. 
 B. The Board of Managers of the Company has approved this Amendment by unanimous written consent
effective as of October 29, 2014. 
 C. The undersigned holders of units of membership interests of the Company collectively constitute
holders of a majority of each of the Investor Registrable Securities and the Other Registrable Securities. 
 D. For purposes of approving
the Amendment in accordance with Section 9(d) of the Registration Agreement, the undersigned hereby consent to the adoption of this Amendment and the terms and conditions contained herein. 

AMENDMENTS 
 NOW,
THEREFORE, in consideration of the mutual agreements, terms, conditions, and covenants set forth in this Amendment, the parties agree as follows: 

1. Effective Date. This Amendment shall be effective as of the Effective Date. 

2. Amendments. 
 a. The
first “WHEREAS” clause following the introductory paragraph of the Registration Agreement is hereby amended by deleting the phrase “of even date herewith” (which is referenced two (2) times) and replacing it in both
instances with the phrase “dated as of October 6, 2012”. 
 b. The definition of “Other Registrable Securities” in
Section 8(d) of the Registration Agreement is hereby amended by deleting the first sentence in its entirety and replacing it with the following: 

““Other Registrable Securities” means (i) any Common Stock issued or issuable upon the conversion of any Class B
Unit or Class C Unit issued pursuant to the Contribution Agreement, (ii) any Common Stock issued or issuable upon the conversion of any Class A Units issued to any Other Holder pursuant to the Purchase Agreement, (iii) any Common
Stock issued or issuable with respect to the securities referred to in clause (i) or 








 
clause (ii) above by way of a dividend or split of equity securities or in connection with a combination of equity securities, recapitalization, merger, consolidation or other
reorganization, and (iv) any other shares of Common Stock held by Persons holding securities described in clauses (i), (ii) and (iii) above (in each case, other than Investor Registrable Securities).” 

3. Registration Agreement to Remain in Full Force and Effect. Except as specifically provided herein, the Registration Agreement, as
amended by this Amendment, shall remain in full force and effect, and the provisions thereof are hereby ratified and confirmed. 
 4.
Sufficiency of Consent. The undersigned hereby acknowledge and agree that the consent of the undersigned provided herein, together with the approval by the Board of Managers of the Company (which has been separately obtained), constitutes all
the consents and approvals required to adopt this Amendment. 
 5. Further Actions. The undersigned hereby agree to take such actions
and to execute such documents and other instruments as may be necessary or desirable to give effect to the purposes of this Amendment. Furthermore, the undersigned hereby consent to the taking of any actions and the execution of any documents or
other instruments by any officer of the Company deemed by such officer necessary or desirable to give effect to the purposes of this Amendment. 

6. Governing Law. This Amendment shall be governed by the laws of the State of Delaware, without giving effect to principles of
conflict of laws of that State. 
 7. Counterparts. This Amendment may be executed in one or more counterparts, each of which shall
be deemed an original, and all of which shall constitute one instrument. 
 { Signature page to follow } 

  
 2 









 IN WITNESS WHEREOF, the undersigned has executed this Amendment as of the date first set forth
above. 
  

			
	 THE COMPANY:

	
	 ECPM HOLDINGS, LLC

		
	 By:
		 /s/ Mark Gilreath

			 Mark Gilreath

			 President



 Signature Page to First Amendment to Registration Rights Agreement 








 
			
	REQUISITE HOLDERS INVESTOR REGISTRABLE SECURITIES:
	
	SC US GF V HOLDINGS, LTD.,
	a Cayman Islands exempted company
		
	By:		SEQUOIA CAPITAL U.S. GROWTH FUND V, L.P.,
			a Cayman Islands exempted limited partnership, its member
		
	By:		SCGF V MANAGEMENT, L.P.,
			a Cayman Islands exempted limited partnership, its General Partner
		
	By:		SC US (TTGP), LTD.,
			a Cayman Islands exempted company, its General Partner
		
	By:		 /s/ Scott Carter

	Name:		 Scott Carter

	Title:		Director


 Signature Page to First Amendment to Registration Rights Agreement 








 
			
	REQUISITE HOLDERS OTHER REGISTRABLE SECURITIES:
	
	RIVER CITIES CAPITAL FUND IV L.P.
		
	By:		River Cities Management IV LLC
	Its:		General Partner
		
	By:		 /s/ Edwin T. Robinson

	Name:		 Edwin T. Robinson

	Title:		 Manager

	
	RIVER CITIES CAPITAL FUND IV (N.Q.P.) L.P.
		
	By:		River Cities Management IV LLC
	Its:		General Partner
		
	By:		 /s/ Edwin T. Robinson

	Name:		 Edwin T. Robinson

	Title:		 Manager

	
	COUNCIL CAPITAL II, L.P.
		
	By:		Council Capital Partners II, LLC
	Its:		General Partner
		
	By:		 /s/ Katie H. Gambill

	Name:		 Katie H. Gambill

	Title:		 Managing Member

	
	ENVEST III, LLC
		
	By:		Envest Management III, LLC
	Its:		Managing Member
		
	By:		 /s/ David Kaufman

	Name:		 David Kaufman

	Title:		 Manager



 Signature Page to First Amendment to Registration Rights Agreement 








 
			
	U.M. ACCELMED L.P.
		
	By:		U.M. Accelmed Management (2009) Ltd.
	Its:		General Partner
		
	By:		 /s/ Uri Geiger

	Name:		 Uri Geiger

	Title:		 Managing Partner



 Signature Page to First Amendment to Registration Rights Agreement