Exhibit 10.1








 


EXECUTION VERSION


 


DISTRIBUTION
AGREEMENT


 


This Distribution Agreement
(this “Agreement”) is made and entered into as of January 23, 2014 (the “Effective Date”),
by and between Zimmer Spine, Inc., a Delaware corporation (“Zimmer”), and X-spine Systems, Inc., an Ohio corporation
(“X-spine”).


 


Recitals


 


A.           X-spine
designs, develops, manufactures and markets spine surgery implants and instruments, including the Products (as defined below).


 


B.           Zimmer
designs, develops, manufactures and markets implants, instruments, devices and related products for use in orthopedic surgery,
including spinal applications.


 


C.           X-spine
desires to appoint Zimmer as an exclusive worldwide distributor of the Products (as defined below) for all uses and applications
in the Field (as defined below), and Zimmer desires to accept such appointment, all in accordance with the terms and conditions
of this Agreement.


 


Agreement


 


In consideration of the mutual
covenants contained in this Agreement, Zimmer and X-spine agree as follows:


 


ARTICLE
I

DEFINITIONS AND RULES OF CONSTRUCTION


 


1.1           Definitions.


 


(a)          Terms
Defined in this Article. For purposes of this Agreement, the following terms shall have the following meanings:


 


“Affiliate”
means, with respect to an entity, a Person that directly, or indirectly through one or more intermediaries, controls, is controlled
by, or is under common control with, the entity. For this purpose, “control” of an entity means the possession, direct
or indirect, of the power to direct or cause the direction of the management or policies of the entity, whether through the ownership
of voting securities, by contract or otherwise.


 


“Applicable Laws”
means all applicable common law, statutes, ordinances, rules, regulations or orders of any Governmental Authority, including the
federal Anti-Kickback Statute (42 U.S.C. § 1302a-7b) (the “Anti-Kickback Statute”), the Physician Self-Referral
Law (42 U.S.C. § 1395nn), the Foreign Corrupt Practices Act (15 U.S.C. § 78dd-1) (the “FCPA”), and
all laws, ordinances, rules and regulations promulgated by the Department of Health and Human Services Office of Inspector General,
the Centers for Medicare and Medicaid Services, and the FDA, or their counterparts in foreign jurisdictions, and any other Regulatory
Laws.


 




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“Average Gross Margin”
means, with respect to any Product for the applicable Pricing Measurement Period, (i) the aggregate gross profit for such Product
during such period, divided by (ii) the aggregate gross sales of such Product during such period, in each case as determined in
accordance with United States generally accepted accounting principles.


 


“Axle Products”
means all of the Products described in Exhibit A as part of the Axle product family.


 


“Business Day”
means any day other than a Saturday, a Sunday or a day on which banks in New York are authorized or obligated by Applicable Law
to remain closed.


 


“Change of Control”
means, with respect to X-spine, a transaction or series of related transactions as a result of which a Person or group of Persons
acting in concert directly or indirectly acquires (i) control of X-spine or (ii) ownership of all or substantially all of X-spine’s
assets related to the Products. The transaction(s) may be in any form or combination of forms, including an issuance or transfer
of voting securities, a grant of one or more proxies, a merger (whether or not X-spine survives), a consolidation, a share exchange,
a reorganization, or an asset sale. For this purpose, “control” of X-spine means the possession, direct or indirect,
of the power to direct or cause the direction of the management or policies of the entity, whether through the ownership of voting
securities, by contract or otherwise.


 


“Copyrights”
means all copyrights and copyrightable works, and all applications, registrations and renewals in connection therewith.


 


“Distribution Term”
means the period from the Effective Date until the earlier to occur of the following: (i) the IP License Effective Date or (ii)
the expiration or termination of this Agreement pursuant to Article XI.


 


“FDA”
means the United States Food and Drug Administration.


 


“Field”
means any and all spine applications.


 


“Field Action”
means any recall, correction or removal action by Zimmer or X- spine with respect to any Products due to safety, efficacy, quality
or regulatory compliance concerns, including actions to recover title to or possession of, or to halt distribution of, Products
that previously have been shipped to customers.


 


“Final Regulatory
Clearance Date” means, with respect to any Product, the date on which Zimmer (or its designee) has received Regulatory
Clearance for such Product in all jurisdictions for which Regulatory Clearances were in effect for such Product as of the IP License
Effective Date.


 


“Governmental Authority”
means the governmental authority in any country in which the Products are manufactured, sterilized, marketed, sold, tested, investigated
or otherwise regulated, and all states or other political subdivisions thereof and supranational bodies applicable thereto, and
all agencies, commissions, officials, courts or other instrumentalities of the foregoing.


 




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“Improvement”
means, with respect to any Product, any improvement, modification, addition, new feature or refinement to such Product (and for
the purposes of this definition, including any substantially similar product) created or developed by or on behalf of X-spine.


 


“Industrial Designs”
means all features of shape, configuration, pattern, ornament and the like that are or can be registered as designs or industrial
designs under Applicable Laws and all applications, registrations and renewals in connection therewith.


 


“Insolvency Event”
means that a Party (i) has commenced a voluntary proceeding under any insolvency law, (ii) had an involuntary proceeding commenced
against it under any insolvency law which has continued undismissed or unstayed for sixty (60) consecutive days, (iii) had a receiver,
trustee or similar official appointed for it or for any substantial part of its property which appointment has not been stayed
or revoked within sixty (60) days of such appointment, (iv) made an assignment for the benefit of creditors or (v) had an order
for relief entered with respect to it by a court of competent jurisdiction under any insolvency law which has not been stayed within
sixty (60) days of entry. For purposes hereof, the term “insolvency law” means any applicable bankruptcy, insolvency
or other similar law now or hereafter in effect.


 


“Intellectual Property”
means all registered and unregistered Patents, Copyrights, Industrial Designs, Proprietary Information and Trademarks, including
all modifications, enhancements and Improvements thereto and all Intellectual Property Rights therein.


 


“Intellectual Property
Rights” means all forms of legal rights and protections that may pertain to or be obtained for any type of Intellectual
Property under the laws of any Governmental Authority of any country or jurisdiction.


 


“Irix-A Products”
means all of the Products described in Exhibit A as part of the Irix-A product family.


 


“License Trigger
Event” means the occurrence of any of the following: (i) X- spine is the subject of a Change of Control by a Zimmer Competitor
or (ii) the expiration or termination of this Agreement.


 


“Marketing Partners”
means distributors, sales entities, sales representatives, sales agents, and sales and distribution partners authorized by Zimmer
or X-spine, as applicable, to promote, market, sell and distribute the Products.


 




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“Net Sales”
means the cumulative gross invoice price at which the Products are sold to end users during any measurement period by or for Zimmer
or any of its Affiliates or sublicensees, less (i) commissions allowed to distributors or direct sales force expense associated
with the sale of the Products, (ii) warehouse expenses directly related to inventoried Products, (iii) royalties paid to Third
Parties for the manufacture, sale or use of the Products, (iv) discounts allowed for sale of the Products, (v) refunds, replacements,
rebates, or credits allowed to purchasers for return of the Products or as reimbursement for damaged Products, (vi) freight, postage,
insurance and other shipping charges, and (vii) sales, use and excise taxes, customs, duties and any other governmental charges
imposed on the production, approval, importation, use or sale of the Products.


 


“Party”
means Zimmer or X-spine, as the context requires.


 


“Patent No. 8,439,953”
means United States patent number 8,439,953, including (i) all reissues, substitutions, confirmations, registrations, validations,
re-examinations, additions, continuations, continued prosecution applications, continuations-in-part, and divisions to, of or for
it, and (ii) supplementary protection certificates and other governmental actions that extend exclusive rights to an invention
or technology beyond the original patent expiration date.


 


“Patents”
means (i) all United States or foreign patents, United States and foreign patent applications and PCT applications, (including
provisional applications and applications for a certificate of invention); (ii) all reissues, substitutions, confirmations, registrations,
validations, re-examinations, additions, continuations, continued prosecution applications, continuations-in-part, and divisions
of, to or for any patent or patent application; and (iii) all term extensions, supplementary protection certificates and other
governmental actions that extend exclusive rights to an invention or technology beyond the original patent expiration date.


 


“Person”
means any individual, group or entity, including Governmental Authorities.


 


“Pricing Approval”
means, with respect to any country or jurisdiction in which Governmental Authorities determine the pricing at which products will
be reimbursed, the approval, agreement, determination or decision by the applicable authorities establishing that pricing.


 


“Pricing Measurement
Period” means, for each full calendar year during the Distribution Term, the period from January 1 through August 30.


 


“Product Complaint”
means any expression by a Third Party of dissatisfaction relating to the identity, durability, reliability, safety, efficacy or
performance of any Product, including actual or suspected product tampering, contamination, mislabeling or misformulation.


 


“Products”
means X-spine’s products set forth in Exhibit A, including all Improvements thereto.


 


“Proprietary Information”
means a Party’s trade secrets, know-how, business plans, manufacturing processes, clinical strategies, product specifications,
scientific data, market analyses, formulae, designs, training manuals and other non-public information (whether business, financial,
commercial, scientific, clinical, regulatory or otherwise).


 


“Regulatory Authority”
means, with respect to any country or jurisdiction, any Governmental Authority involved in granting Regulatory Clearance or Pricing
Approval or in administering Regulatory Laws in that country or jurisdiction.


 




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“Regulatory Clearance”
means, with respect to any country or jurisdiction, all acts of the applicable Regulatory Authority that are necessary under applicable
Regulatory Laws for the manufacture, marketing, distribution and sale of the Product in that country or jurisdiction, and satisfaction
of all applicable regulatory and notification requirements and, to the extent applicable, the grant of Pricing Approval.


 


“Regulatory Laws”
means all Applicable Laws governing (i) the import, export, testing, sterilization, investigation, manufacture, marketing or sale
of the Product; (ii) establishing recordkeeping or reporting obligations; (iii) Field Actions; or (iv) similar regulatory matters.


 


“Restricted Customers”
means, collectively, the X-spine Restricted Customers and the Zimmer Restricted Customers, such customers to be defined at the
individual health care professional level, rather than at the hospital or other institutional customer level.


 


“Specifications”
means, with respect to each Product, (i) X-spine’s design and functionality specifications relating to the Product, (ii)
any design and functionality specifications provided by X-spine in its sales literature or other product documentation with respect
to the Product and (iii) any specifications for manufacturing, testing, sterilization, storing, packaging, shipping or labeling
the Product set forth in any approved application for Regulatory Clearance and any supplements and amendments thereto.


 


“Term”
means the period from the Effective Date through the expiration or termination of this Agreement pursuant to Article XI.


 


“Territory”
means the entire world.


 


“Third Party”
means any Person other than the Parties and their Affiliates.


 


“Trademarks”
means all trademarks, service marks, trade dress, logos and trade names, together with all translations, adaptations, derivations
and combinations thereof (including all goodwill associated therewith), and all applications, registrations and renewals in connection
therewith.


 


“Transition Period”
for any Product means the period from the IP License Effective Date until the later to occur of (i) the Final Regulatory Clearance
Date, or (ii) the date on which X-spine has fulfilled and delivered on all Firm Orders for such Product that were submitted by
Zimmer prior to the Final Regulatory Clearance Date.


 


“United States”
or “U.S.” means the United States of America, including its territories, commonwealths and possessions.


 


“X-spine IP”
means all Intellectual Property that is subject as of the Effective Date, or becomes subject during the Term, to X-spine’s
ownership or control and that is necessary or useful for the manufacture, testing, use, promotion, marketing, sale or distribution
(including import/export) of the Products. For purposes of this Agreement, X-spine shall be considered to control Intellectual
Property or an Intellectual Property Right if X-spine or any of its Affiliates has a license, sublicense or other right to it,
including any rights to future licenses, sublicenses or other rights, and also has the right to assign, license, sublicense or
otherwise grant rights under it to Zimmer.


 




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“X-spine Restricted
Customers” means the United States-based customers of X-spine set forth on Exhibit B, such customers to be defined
at the individual health care professional level, rather than at the hospital or other institutional customer level, as updated
from time to time pursuant to this Agreement.


 


“Zimmer Competitors”
means the Third Parties set forth in Exhibit C, their Affiliates and Marketing Partners.


 


“Zimmer Restricted
Customers” means the United States-based customers of Zimmer set forth on Exhibit D, such customers to be defined
at the individual health care professional level, rather than at the hospital or other institutional customer level, as updated
from time to time pursuant to this Agreement.


 


(b)          Terms
Defined Elsewhere. Capitalized terms not defined in Section 1.1(a) shall have the meanings specified elsewhere in the text
of this Agreement. Those terms include the following: 





	Term	Section
	Agreement	Introductory Paragraph
	Claim	8.1(c)
	Clinical Data	2.4
	Code of Conduct	6.1(c)
	Confidential Information	7.1(a)
	Covered Transaction	13.1
	Debarred Entity	6.10(a)
	Debarred Individual	6.10(a)
	Distribute	2.1
	Effective Date	Introductory Paragraph
	Election	13.2
	Excess Products	3.5(d)
	Excused Material Shipping Delay	3.5(c)
	Firm Orders	3.2
	Forecast	3.1
	Impeding Event	3.8(c)
	Indemnifiable Loss	10.1(a)
	Initial Term	11.1
	IP License	12.1
	IP License Effective Date	12.3
	ISO	5.2
	Material Shipping Delays	3.5(c)
	Minimum Thresholds	3.8
	Negotiation Period	13.2
	Option to License	12.1
	Product Liability Claim	10.1(a)
	Renewal Term	11.1
	Review Period	13.2
	Shortfall Products	3.5(d)
	Third-Party Offer	13.1
	Transaction Notice	13.1
	Transfer Price	4.1
	X-spine	Introductory Paragraph
	X-spine Parties	6.10(a)
	Zimmer	Introductory Paragraph
	Zimmer Indemnified Parties	10.1(a)









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1.2           Rules
of Construction.


 


(a)          When
a reference is made in this Agreement to a Recital, an Article, a Section or an Exhibit, such reference is to a Recital, Article
or Section of, or an Exhibit to, this Agreement, unless otherwise indicated.


 


(b)          Whenever
the words “include,” “includes” or “including” are used in this Agreement, they shall be understood
to be followed by the words “without limitation.”


 


(c)          Pronouns,
including “he,” “she” and “it,” when used in reference to any Person, shall be deemed applicable
to entities or individuals, male or female, as appropriate in any given case.


 


(d)          Article,
Section and other headings contained in this Agreement are for reference purposes only and are not intended to describe, interpret,
define or limit the scope, extent or intent of any provision of this Agreement.


 


(e)          Standard
variations on defined terms (such as the plural form of a term defined in the singular form and the past tense of a term defined
in the present tense) shall be deemed to have meanings that correlate to the meanings of the defined terms.


 


ARTICLE
II

DISTRIBUTION


 


2.1           Distribution
Rights. X-spine hereby grants to Zimmer, and Zimmer hereby accepts, the co-exclusive right to promote, market, sell and distribute
(“Distribute”) the Products throughout the Territory during the Distribution Term and any applicable Transition
Period for all uses and applications in the Field; provided, however, that Zimmer shall not Distribute or permit Distribution of
the Products, directly or indirectly, to any X-Spine Restricted Customer. Notwithstanding the foregoing, X-spine shall retain the
right to Distribute the Products; provided, however, that X-spine shall not Distribute or permit Distribution of the Products,
directly or indirectly, to any Zimmer Restricted Customer or with any Zimmer Competitor.


 




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2.2           Restricted
Customers.


 


(a)          Each
Party agrees and acknowledges that Exhibit B and Exhibit D set forth the respective X-Spine Restricted Customers
and Zimmer Restricted Customers, as of the Effective Date.


 


(b)          Beginning
on December 31, 2014, each Party shall update and deliver its respective list of Restricted Customers within thirty (30) days of
June 30th and December 31st of each year after the Effective Date as follows:


 


(i)          During
2014 and 2015, each Party shall remove from its list of Restricted Customers any customer who has not purchased, acquired, ordered
or utilized in surgery at least (A) fifty thousand dollars ($50,000) of products (including the Products and any other products
sold by such Party) or (B) twenty- five thousand dollars ($25,000) of Products from such Party or its Marketing Partners during
the twelve (12) month period immediately preceding the applicable June 30th or December 31st date.


 


(ii)         During
2016 and for the remainder of the Distribution Term (and any applicable Transition Period), each Party shall remove from its list
of Restricted Customers any customer who has not purchased, acquired, ordered or utilized in surgery at least twenty-five thousand
dollars ($25,000) of Products from such Party or its Marketing Partners during the twelve (12) month period immediately preceding
the applicable June 30th or December 31st date.


 


(iii)        Subject
to clause (iv) below, a Party may add to its list of Restricted Customers any customer who has purchased, acquired, ordered or
utilized in surgery at least twenty-five thousand dollars ($25,000) of Products from such Party or its Marketing Partners during
the twelve (12) month period immediately preceding the applicable June 30th or December 31st date. In the
event that both Parties add the same customer to their respective lists of Restricted Customers, the Parties agree to take commercially
reasonable efforts to equitably resolve the status of such customer.


 


(iv)        Neither
Party may add a customer to its list of Restricted Customers if such customer is already included (and maintained according to
this Section 2.2(b)) on the Restricted Customer list of the other Party.


 


All dollar amounts referred to in this Section
2.2(b) are to be defined by end user pricing.


 


(c)          X-spine
represents and warrants that none of the customers listed in Exhibit B are currently purchasing, acquiring or ordering products
from Zimmer Marketing Partners.


 


(d)          Only
customers located in the United States are eligible to be considered Restricted Customers.


 




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(e)          The
Parties acknowledge the confidential nature of each list of Restricted Customers and agree that such lists shall be subject to
the confidentiality provisions set forth in Article VII. In addition, each Party shall comply with the following provisions:


 


(i)          The
Zimmer Restricted Customer list shall not be furnished or disclosed to any Person without prior written consent from Zimmer, with
the exception of the following recipients: David Kirschman (President and CEO), Mike Schmitz (Chief Financial Officer) and Daniel
Abromowitz (Sales and Marketing Director), or any equivalent successors.


 


(ii)         The
X-spine Restricted Customer list shall not be furnished or disclosed to any Person without prior written consent from X-spine,
with the exception of the following recipients: Steve Healy (President), Chris Ryan (Vice President of Sales), Jamey Rottman (Vice
President of Marketing) and Jonathan Toronto (Division General Counsel), or any equivalent successors.


 


(iii)        The
Restricted Customer lists shall be stored and maintained by the Parties and all recipients in a manner so as to fully protect its
strictly confidential nature.


 


(iv)        Any
recipient of the Restricted Customers list (or any portion thereof) shall be informed by X-spine or Zimmer, as applicable, of the
confidential nature of such information and shall be directed to treat the information strictly confidentially.


 


2.3           Marketing
and Sales Support. Except as otherwise expressly provided herein, Zimmer shall have sole control and authority over its marketing
and sales activities relating to the Products, including design and production of marketing materials. X-spine shall use commercially
reasonable efforts to support Zimmer’s marketing and sale of the Products, including providing Zimmer with reasonable quantities
of its existing marketing and promotional materials for distribution to Zimmer’s customers and cooperating with Zimmer in
making reasonable modifications to existing marketing and promotional materials as may be requested by Zimmer. Any marketing materials
designed or produced by Zimmer (including any modifications requested by Zimmer under the previous sentence) are subject to approval
from X- spine, which shall not be unreasonably withheld, conditioned or delayed. If X-spine does not respond to such a modification
request within five (5) Business Days, such request shall be deemed approved.


 


2.4           Clinical
Data. Zimmer shall have reasonable access to all clinical data supporting the commercialization and use of the Products created
by or in coordination with X- spine, whether collected prior to or after the Effective Date (“Clinical Data”).
Zimmer will have continuing rights to access and use Clinical Data in the event it exercises either its Option to License under
Article XII or its Right of First Refusal under Article XIII.


 


2.5           Marketing
Partners.


 


(a)          Each
Party shall have the right to appoint Marketing Partners to participate in the Distribution of the Products in accordance with
Sections 2.1, except as follows:


 




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(i)          X-spine
shall not appoint any Zimmer Competitors as a Marketing Partner for the Products.


 


(ii)         Neither
Party shall distribute or permit Distribution of the Products, directly or indirectly, to or through any Marketing Partner of the
other Party; provided, however, to the extent any Marketing Partner of X-Spine is as of the Effective Date also engaged by Zimmer
to sell Zimmer products other than the Products, Zimmer shall have exclusive rights to market the Products through that Marketing
Partner.


 


(iii)        Notwithstanding
the foregoing, X-spine acknowledges that Matt McCoy, Mark Howat and Steve Schrader and their respective organizations may execute
sales representative agreements (or other distribution agreements) with Zimmer and upon such execution, each shall be considered
a Zimmer Marketing Partner.


 


(b)          Each
Party shall ensure compliance by its Marketing Partners with the terms of this Agreement.


 


2.6           Training
Support. Zimmer shall be responsible for training health care provider customers, Zimmer’s Marketing Partners and Zimmer
employees. X-spine shall support Zimmer’s training efforts by participating in twelve (12) training sessions at no cost to
Zimmer. Zimmer shall reimburse X-spine’s reasonable, documented, out of pocket travel and meeting expenses, not to exceed
ten thousand dollars ($10,000) per training session. Such training and support is not intended to include services of licensed
physicians. If additional training sessions are requested by Zimmer, the Parties will negotiate the terms, including costs, of
such sessions.


 


ARTICLE
III

PURCHASING


 


3.1           Forecasts.
On a monthly basis Zimmer shall provide to X-spine a rolling twelve (12) month forecast of the anticipated quantities of the Products
that Zimmer expects to order (each, a “Forecast”). Each Forecast shall be non-binding and for planning purposes
only.


 


3.2           Firm
Orders. Zimmer will place firm orders for the Products (“Firm Orders”) in Zimmer’s standard form,
as modified from time to time. Each Firm Order will state the quantity and type of Product purchased, delivery date(s) and applicable
Transfer Price (as defined below). Firm Orders may be submitted via e-mail. Each Firm Order made in accordance with this Agreement
shall be accepted by X-spine. If any term in any Firm Order or confirmation conflicts with any term in this Agreement, the conflicting
term in this Agreement shall govern and control.


 


3.3           Initial
Inventory Purchase. Within thirty (30) days of such time that X-spine completes and Zimmer gives final approval in writing
for all engineering specifications and, as applicable, branding and/or private labeling activities to be performed under Section
5.7, Zimmer shall place a binding Firm Order to purchase the following type and number of Products in configurations substantially
similar to those set forth in Exhibit A:


 




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		·	Axle Kit Assembly X060-0000: 25 kits



		·	X063-1000FIXCET II Kit Assembly and/or X076-1000 Zygafix Kit Assembly: 10 kits



		·	X070-0000 Silex Kit Assembly: 10 kits



		·	Irix C Implant Kit Assembly: 10 kits



		·	Irix C Instrument Kit Assembly: 10 kits



 


Zimmer may at its discretion opt to modify
the configuration of the kits, for example including a lower quantity of a specific implant size in the kits. The Parties agree
and acknowledge that multiple Firm Orders may be placed by separate product lines in order to fulfill Zimmer’s obligations
under this Section 3.3.


 


3.4           Irix-A
Purchase. X-spine shall notify Zimmer immediately upon receipt of Regulatory Clearance from the FDA for the Irix-A Products.
Within thirty (30) days of such notice from X-spine, Zimmer shall place a binding Firm Order to purchase twenty-five (25) Irix-A
kits in configurations to be mutually agreed upon by the Parties.


 


3.5           Shipping.


 


(a)          X-spine
shall ship the Products FOB shipping point (X-spine’s facility in Dayton, Ohio or other facility designated by X-spine) to
the Zimmer facilities designated by Zimmer. All shipments shall be made by a carrier designated by Zimmer, and shipping costs be
borne by Zimmer.


 


(b)          X-spine
shall use commercially reasonable efforts to deliver the Products no later than the delivery date(s) specified in the applicable
Firm Order, as long as such Firm Order is accepted by X-spine. X-spine’s acceptance of any such Firm Order shall not be unreasonably
withheld or delayed. X-spine shall be deemed to have accepted a Firm Order unless X-spine delivers a written rejection to Zimmer
within ten (10) Business Days of X-spine’s receipt of the Firm Order.


 


(c)          In
the event that X-spine is not able to timely make available an entire Firm Order, X-spine shall (i) make available for delivery
as much of the Firm Order as possible, and (ii) provide prompt notice to Zimmer of the anticipated shortfall, which notice shall
specify the cause for the delay and the estimated delivery date for the remaining Products. Any delays of greater than thirty (30)
days beyond the lead times specified in Exhibit E (excluding delays caused by force majeure as provided in Section
14.2) (“Material Shipping Delays”) shall constitute a material breach of this Agreement by X-spine, except that
one Material Shipping Delay per rolling twelve (12) month period shall be permitted without constituting a material breach of this
Agreement by X-Spine (“Excused Material Shipping Delay”). If any Excused Material Shipping Delay is greater
than ninety (90) days beyond the lead times specified in Exhibit E (excluding delays caused by force majeure as provided
in Section 14.2), such delay shall no longer be excused and it shall constitute a material breach of this Agreement by X-spine.
Notwithstanding the foregoing, a shipping delay impacting less than ten percent (10%) of any individual SKU within an applicable
Firm Order shall not constitute a Material Shipping Delay.


 




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(d)          Notwithstanding
the foregoing, to the extent a Firm Order of Products exceeds one hundred and twenty-five percent (125%) of the amount specified
in the Forecast (such amount to be calculated in terms of SKU’s) provided at least sixty (60) but no more than ninety (90)
days prior to the Firm Order (measured by units of Product) (the amount above such one hundred and twenty-five percent (125%) threshold
is referred to herein as the “Excess Products”), the Parties shall negotiate and mutually agree upon revised
lead times for the Excess Products, and a failure of X-spine to deliver such Excess Products within the time periods set forth
in the previous sentence shall not constitute a material breach of this Agreement. To the extent a Firm Order of Products falls
below fifty percent (50%) of the amount specified in the Forecast provided at least thirty (30) days, but no more than sixty (60)
days, prior to such Firm Order (measured by total dollar amount) (the shortfall below such fifty percent (50%) threshold is referred
to herein as the “Shortfall Products”), Zimmer shall be obligated to purchase the Shortfall Products within
ninety (90) days of manufacture. For the initial inventory purchase described in Section 3.3, the delivery lead times shall not
be initiated until the applicable Firm Orders are accepted by X-spine.


 


(e)          X-spine
shall package, label, store and make available for shipment all Products in compliance with Applicable Laws, the Specifications
and any reasonable requests by Zimmer and in accordance with good commercial and industry practice. The shipping container used
by X-spine shall be validated per ISTA standard 3A (as published by International Safe Transit Association), to ensure that the
safety and integrity of the Product is maintained during transit. The Products shall be ready for resale. X-spine shall package
the Products suitably for export and appropriately to prevent damage during shipment. The packing slip/delivery note for each shipment
of Products shall have the part number, purchase order number and delivery quantity.


 


3.6           Quality
Testing. Prior to shipping Products to Zimmer, X-spine will inspect and perform quality testing on each Product to confirm
finished device acceptance to ensure that each production run, lot or batch of finished devices meets acceptance criteria. X-spine
shall document the results of said inspection and quality testing for each Product. Such documentation shall be made available
to Zimmer upon request. X-spine will ship to Zimmer only those Products that have passed such inspection and quality testing and
are defect free and conform to the Specifications.


 


3.7           Acceptance
of Products. Zimmer, its Marketing Partners and/or the end users of the Products shall have a reasonable right of inspection
to verify that the Products conform to the applicable Firm Order and the terms of this Agreement. Any defective or non-conforming
Product shall be returned to X-spine. X-spine shall bear all costs of return (including freight and insurance) and shall either
replace the defective or non-conforming Product without charge (including payment of freight and insurance for delivery of the
replacement product) or, at Zimmer’s request, refund to Zimmer the entire amount paid in connection with the rejected Product.
Nothing in this Section 3.7, including the exercise of rights hereunder, shall be construed as a waiver of Zimmer’s indemnification
rights, its warranty rights or any other common law or statutory remedies.


 




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3.8           Minimum
Payments.


 


(a)          Minimum
Thresholds.


 


(i)          Loss
of Co-Exclusivity and the Right of First Refusal. In the event that the aggregate transfer price for the Firm Orders submitted
in any given measurement period (comprised of a calendar year unless otherwise indicated) by Zimmer is less than the dollar amounts
set forth below (the “Minimum Thresholds”), then, at the option of X-spine (A) the co-exclusive Distribution
rights granted to Zimmer under Section 2.1 shall become nonexclusive and (B) the Right of First Refusal granted to Zimmer under
Article XIII shall become void and without effect. The Minimum Thresholds for this Section 3.8(a)(i) shall be as follows:


 





	Loss
    of Co-Exclusivity and the Right of First Refusal
	Measurement
    Period	Minimum
    Requirement
	July
    through December of 2015	$1,500,000




	Each
    calendar year from 2016 through 2019	$3,000,000




	Each
    calendar year from 2020 and thereafter	$2,000,000











  


For the sake of clarity, if X-spine
properly exercises its rights under clause (A) above, Section 2.5(a)(i) will also be rendered void and without effect.


 


(ii)         Loss
of Option to License. In addition to Section 3.8(a)(i) above, in the event that the aggregate transfer price for the Firm Orders
submitted in any given measurement period (comprised of a calendar year unless otherwise indicated) by Zimmer is less than the
Minimum Thresholds set forth below, then, at the option of X-spine, the Option to License granted to Zimmer under Article XII shall
become void and without effect. The Minimum Thresholds for this Section 3.8(a)(ii) shall be as follows:


 





	Loss
    of Option to License
	Measurement
    Period	Minimum
    Requirement
	July
    through December of 2015	$1,000,000




	Each
    calendar year from 2016 through 2019	$2,000,000




	Each
    calendar year from 2020 and thereafter	$1,250,000











  




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(iii)        As
used below, unless otherwise noted, the term “Minimum Thresholds” shall apply to both of the Minimum Thresholds set
forth above.


 


(b)          To
the extent that the aggregate transfer price for the Firm Orders for any calendar year exceeds one or both of the Minimum Thresholds
for such period, Zimmer shall have the right to carry forward the excess and apply it toward such Minimum Threshold(s) for any
subsequent calendar year.


 


(c)          Notwithstanding
the foregoing, and without limiting the indemnification or termination provisions herein, Zimmer shall have no obligations and
X-spine shall have no rights under Section 3.8(a) for any given calendar year if Zimmer’s Distribution of any particular
Product is materially and adversely affected for a continuous period of at least sixty (60) days or for a total period of at least
seventy-five (75) days (on a non-continuous basis) during such calendar year by any of the following (each, an “Impeding
Event”): (i) any claim, action or litigation (including claims, actions or litigation related to intellectual property
or product liability) relating to such Product or this Agreement which prevents or impedes Zimmer from selling such Products (e.g.,
patent infringement injunction); (ii) any occurrence or development that reasonably calls into question the safety or efficacy
of such Product or reasonably poses a substantial legal liability on Zimmer; (iii) the FDA or other Regulatory Authority withdraws
or otherwise materially limits Regulatory Clearance for such Product; (iv) X-spine is in breach of this Agreement and such breach
adversely affects, in any material way, Zimmer’s ability to Distribute such Product; or (v) any other circumstance beyond
Zimmer’s control legally prevents Zimmer from Distributing such Product.


 


(d)          In
order to exercise its rights under either Section 3.8(a)(i) or Section 3.8(a)(ii), X-spine must notify Zimmer in writing thereof
within thirty (30) days of the end of the measurement period for which Zimmer failed to meet the applicable Minimum Threshold(s).
Zimmer shall be entitled to retain its co-exclusive Distribution, Right of First Refusal rights and/or Option to License by submitting,
within thirty (30) days after its receipt of such notice, one or more Firm Orders for the Products required to make up the shortfall
in meeting the applicable Minimum Threshold(s) for such measurement period. For clarification, orders made pursuant to this subsection
(d) do not count toward the applicable Minimum Threshold(s) for the following calendar year (in other words, such orders do not
count twice).


 


(e)          For
clarification purposes, X-spine’s sole remedy for Zimmer’s failure to meet the Minimum Thresholds under Section 3.8(a)(ii)
is to render the Option to License under Article XII void and without effect, and X-spine’s sole remedies for Zimmer’s
failure to meet the Minimum Thresholds under both Section 3.8(a)(i) and Section 3.8(a)(ii) are (i) to render nonexclusive the Distribution
rights under Section 2.1, (ii) to render the Right of First Refusal under Article XIII void and without effect and (iii) to render
the Option to License under Article XII void and without effect.


 


3.9           Preliminary
Test Kits. The Parties agree that Zimmer may, in advance of the Initial Inventory Purchase and subject to availability and
shipping terms as determined by X- spine in its reasonable judgment, order X-spine-branded kits from each of the Axle, Irix-C and
Irix-A product families. Upon accepting any such orders, X-spine shall fill the orders using commercially reasonable efforts.


 




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ARTICLE
IV

PRICING AND PAYMENTS


 


4.1           Transfer
Pricing. With the exception of Irix-A Products, the initial Transfer Price (“Transfer Price”) for each Product
offered for sale, by X-spine to Zimmer, is set forth in Exhibit A. The initial Transfer Price for Irix-A Products shall
be agreed upon by the Parties using a pricing approach substantially similar to that set forth in Sections 4.1(a) and 4.1(b) (i.e.
a 75% Average Gross Margin for Zimmer on Irix-A Implant Products and a 20% Average Gross Margin for X-spine on Instrument Products).
These Transfer Prices shall be firm through December 31, 2015. Thereafter, the Transfer Prices shall be adjusted as follows during
the Distribution Term:


 


(a)          Effective
on January 1 of each calendar year beginning on January 1, 2016, the Transfer Price for each Implant Product shall be adjusted
to equal the Transfer Price that if paid by Zimmer to X-spine would ultimately have resulted in a seventy-five percent (75%) Average
Gross Margin for Zimmer, based upon Zimmer’s sales to end users, during the Pricing Measurement Period of the previous calendar
year; provided that such annual adjustment shall not increase or decrease the Transfer Price for any Implant Product by more than
five percent (5%) of the total Transfer Price for that Implant Product. Zimmer shall calculate the new Transfer Prices for the
Implant Products on an annual basis and Zimmer shall notify X-spine of the new Transfer Prices no later than September 30 of the
calendar year immediately preceding the calendar year in which such new Transfer Prices are to take effect.


 


(b)          Effective
on January 1 of each calendar year beginning on January 1, 2016, the Transfer Price for each Instrument Product shall be adjusted
to equal the Transfer Price that if paid by Zimmer to X-spine would ultimately have resulted in a twenty percent (20%) Average
Gross Margin for X-spine, based upon X-spine’s sales to Zimmer, during the Pricing Measurement Period of the previous calendar
year; provided that such annual adjustment shall not increase or decrease the Transfer Price for any Instrument Product by more
than five percent (5%) of the total Transfer Price for that Instrument Product. X-spine shall calculate the new Transfer Prices
for the Instrument Products on an annual basis and X-spine shall notify Zimmer of the new Transfer Prices no later than September
30 of the calendar year immediately preceding the calendar year in which such new Transfer Prices are to take effect.


 


(c)          Notwithstanding
the foregoing, in the event that then-cumulative Transfer Price adjustments described in Sections 4.1(a) and (b) above result in
an aggregate increase or reduction to the Transfer Price for any Product of twenty percent (20%) or more relative to the Transfer
Price set forth in Exhibit A (or in the case of Irix-A Products, the initial Transfer Price as agreed to by the Parties),
the Parties shall review and negotiate the Transfer Price using commercially reasonable judgment based upon then-current market
circumstances. If the Parties are unable to reach agreement on a new Transfer Price for any particular Product, the Transfer Price
for such Product shall be adjusted such that the aggregate increase or reduction beyond twenty percent (20%) shall be borne equally
by the Parties (each Party’s Average Gross Margin would be reduced by the same absolute percentage). For clarification by
example, if the current Transfer Price resulted in an Average Gross Margin of seventy-five percent (75%) for Zimmer and fifty-five
percent (55%) for X-spine, a reduction in Transfer Price to result in an Average Gross Margin of seventy percent (70%) for Zimmer
and fifty percent (50%) for X-spine would be acceptable. In no case, however, shall Transfer Prices fall below seventy percent
(70%) of those set forth in Exhibit A (or in the case of Irix-A Products, the initial Transfer Price as agreed to by the Parties).


 




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(d)          Each
Party shall have reasonable access to the books and records of the other Party as may be necessary in order to verify the Average
Gross Margin calculation for any pricing adjustment made under this Section 4.1.


 


4.2           Royalty
Payments. Zimmer shall make royalty payments to X-spine in an amount equal to four percent (4%) of Net Sales of all Products
except for Axle Products and two percent (2%) of Net Sales of Axle Products, in each case to the extent received by Zimmer during
the Distribution Term and with the following limitations:


 


(a)          In
the event Zimmer reasonably determines that it needs a license or other access to Intellectual Property Rights of a Third Party
in order to Distribute the Products, any consideration paid to such Third Party by Zimmer in order to obtain such license or access
(including upfront fees, royalties and other forms of consideration) shall be credited against any royalty payments due to X-spine
under this Agreement. Nothing herein shall be construed to limit Zimmer’s indemnification rights under Section 10.1.


 


(b)          Multiple
royalties shall not be payable in the case of multiple resales of the Products through a distribution chain. Royalties shall be
payable in arrears on a quarterly basis in immediately available funds. So long as royalties are due hereunder, Zimmer shall provide
to X-spine reports (in written or electronic form) on Net Sales for each calendar quarter and the amount of royalties due thereon.
Each report shall be due on the sixtieth (60th) day following the last day of the applicable calendar quarter. Royalty
payments shall be due and payable on the date each report is due.


 


(c)          The
obligation to pay royalties under this Section 4.2 shall terminate with respect to each Product in each jurisdiction upon the expiration
of the last to expire valid Patent claim covering such Product in such jurisdiction.


 


4.3           Payment
Terms. Zimmer shall pay X-spine for purchased Products within sixty (60) days from the date Zimmer receives the purchased Products
and the applicable invoice from X-spine. Zimmer shall receive a three percent (3%) discount on any invoice if Zimmer makes a full
payment within ten (10) days of receipt of the purchased Products and the invoice.


 


4.4           Taxes.
X-spine shall be responsible for any and all federal, state or local excise or gross receipts taxes, personal property taxes, customs
duties or levies and any foreign taxes which may be imposed on manufacturing or production activities related to the Products,
or on articles, supplies or services ordered hereunder by reason of their sale, delivery to or subsequent payment by Zimmer. X-spine
represents that any federal, state or local sales/use taxes which are charged on the Products ordered hereunder will be promptly
remitted to the designated jurisdiction and that X-spine is authorized and properly registered with the jurisdiction taxing authorities
to collect and remit said taxes. In the event that X-spine has an obligation to collect said sales/use taxes, fails to do so and
is subsequently assessed by a taxing authority or agency, X-spine waives all rights to seek contribution from Zimmer, its Marketing
Partners or end users for any interest or penalty charged. Further, X-spine shall not have the right to seek contribution for any
sales/use taxes assessed on Products sold to Zimmer to the extent that Zimmer has either previously self-assessed and paid said
taxes itself or the statute of limitations with respect to the jurisdiction has expired. Zimmer shall be responsible for any federal,
state or local sales or gross receipts taxes, personal property taxes, customs duties or levies and any foreign taxes which may
be imposed on the sale of the Products by Zimmer.


 




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ARTICLE
V

MANUFACTURING


 


5.1           Inventory.
X-spine shall use commercially reasonable efforts to maintain sufficient manufacturing capacity (including appropriate manufacturing,
storage and distribution facilities and qualified personnel) to meet Zimmer’s Forecasts for the Products. Without limiting
the foregoing, X-spine shall keep a safety stock of no less than two (2) months’ supply of the Products (based upon the Forecasts)
at all times during the Distribution Term.


 


5.2           Manufacturing.
X-spine shall be responsible in all respects for manufacturing and supplying the Products. The Products shall be manufactured and
sterilized in accordance with the Specifications and all Applicable Laws, including Good Manufacturing Practices (as defined by
the FDA) and standard 13485 specifications (as defined by the International Organization for Standards (“ISO”).
X-spine shall maintain accurate and complete records relating to its manufacture, sterilization and testing of the Products, including
all records required under Applicable Laws, throughout the Distribution Term and any applicable Transition Period (or for such
longer period as may be required by Applicable Laws).


 


5.3           Process
and Product Modifications. X-spine shall notify Zimmer at least thirty (30) days in advance of any proposed material changes
to the manufacturing processes for the Products. X-spine shall not materially alter or modify the Products or their packaging or
labeling without the prior written consent of Zimmer. X-spine will use reasonable efforts to make product Improvements and modifications
as may be reasonably requested by Zimmer, and Zimmer shall pay commercially reasonable expenses for such product Improvements and
modifications.


 


5.4           Product
Warranty. X-spine warrants to Zimmer, its Marketing Partners and the end users of each Product, that such Product, when delivered
in accordance with the applicable Firm Order, will (i) conform to the Specifications, (ii) have been manufactured, tested, stored,
packaged, labeled, sterilized and shipped in compliance with Applicable Laws and the Specifications and (iii) be free of defects
in design, material, engineering, fabrication and workmanship. X-spine further warrants to Zimmer that the Products, when delivered,
shall be free and clear of any liens, security interests or encumbrances of any nature whatsoever. X- SPINE DISCLAIMS ALL IMPLIED
WARRANTIES, INCLUDING ANY WARRANTY OF MERCHANTABILITY OR FITNESS FOR A PARTICULAR PURPOSE.


 


5.5           Specifications.
X-spine shall provide to Zimmer information concerning the Specifications as reasonably requested by Zimmer from time to time.


 




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5.6           Subcontracting.
X-spine shall be permitted to subcontract its obligations under this Agreement only to subcontractors currently engaged by X-spine
(and disclosed to Zimmer) as of the Effective Date and approved through X-spine’s supplier assessment process. X-spine shall
cause such permitted subcontractors to comply with all terms under this Agreement and all Applicable Laws in connection with their
performance hereunder. X-spine shall remain primarily responsible for performance of its obligations hereunder, including obligations
relating to product quality assurance, compliance with Applicable Laws and Confidential Information, regardless of whether any
of X-spine’s obligations are undertaken by a subcontractor. Except as set forth in the first sentence of this Section 5.6,
X-spine shall not subcontract its obligations under this Agreement to any Person without providing Zimmer with prior written notice
of X- Spine’s selection and qualification of the proposed subcontractor consistent with the requirements of X-Spine’s
quality system.


 


5.7           Product
Branding. All Products will be branded as private label for Zimmer, which shall include use of the following: (a) new product
names determined by Zimmer, (b) part numbers specific to Zimmer and (c) packaging and labeling consistent with Zimmer’s current
branding. Zimmer shall provide X-spine with detailed direction on the branding of the Products. X-spine shall be responsible for
the development, quality and regulatory efforts required in conjunction with the branding activities described in this Section
5.7. Without limiting Zimmer’s rights under Section 5.7(c), the Parties agree that Zimmer-specific marking or labeling shall
be included on Product packaging and labeling but not on actual physical Products (unless otherwise agreed to by the Parties).
Zimmer shall compensate X-spine for reasonable, pre- approved costs incurred for this work.


 


ARTICLE
VI

REGULATORY MATTERS


 


6.1           Compliance.


 


(a)          Each
Party shall comply in all material respects with all Applicable Laws that pertain to its activities under this Agreement and, except
as otherwise provided for herein, shall bear the entire cost and expense of such compliance.


 


(b)          Without
limiting the generality of the foregoing, both Parties will abide by the FCPA, the Anti-Kickback Statute, and all other anti-corruption
and anti-bribery laws of the United States, as well as the local anti-corruption and anti-bribery laws of each country within the
Territory. Neither Party shall offer, give, promise to give or authorize giving, directly or indirectly, any money or anything
else of value to any government official (including any employee of a state-owned or controlled entity or public international
organization), political party, political official, candidate for public office or any other Person or entity, with the knowledge
that such payment, offer or promise to pay will be made to any governmental official in an effort to win or retain business, secure
any advantage over competitors, or for the purpose of influencing such governmental official to make one or more business decisions
favorable to Zimmer, X-spine or both. The Parties understand that, for these purposes, in some cases, doctors, nurses, hospital
administrators, and other healthcare providers may be considered government officials. Zimmer represents that it does not desire
and covenants that it will not request any service or action by X-spine which may constitute a violation of applicable anti-corruption
laws.


 




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(c)          X-spine
shall comply with Zimmer’s Code of Business Conduct and compliance policies and procedures related to the engagement and
retention of health care professionals (“Code of Conduct”).


 


6.2           Regulatory
Clearances.


 


(a)          X-spine
represents and warrants to Zimmer that it has applied for and received Regulatory Clearance for the Products (except the Irix-A
Products) in the United States and that such Regulatory Clearance is in good standing.


 


(b)          X-spine
shall use commercially reasonable efforts to obtain Regulatory Clearance for the Irix-A Products in the United States.


 


(c)          X-spine
shall use commercially reasonable efforts to apply for and obtain Regulatory Clearance for the Products in jurisdictions outside
of the United States as requested by Zimmer.


 


(d)          During
the Distribution Term and any applicable Transition Period, X- spine shall be responsible as the manufacturer of record of the
Products for all costs and expenses relating to the application for and maintenance of Regulatory Clearances in the Territory.
X-spine shall have primary responsibility for all communications, submissions and interactions with the Regulatory Authorities
for the purpose of obtaining and maintaining Regulatory Clearances. X-spine shall notify Zimmer any time that it applies for, obtains
or loses any Regulatory Clearance. To the extent permitted under Applicable Laws, X-spine hereby grants to Zimmer the fully paid
up right to use during the Term any and all Regulatory Clearances and regulatory approvals related to the Products owned by or
licensed to X-spine and existing as of the Effective Date or obtained during the Term necessary or useful for Zimmer to exercise
its rights and perform its obligations under this Agreement.


 


6.3           Actions
by Regulatory Authorities.


 


(a)          X-spine
shall be primarily responsible to Regulatory Authorities throughout the Territory as the manufacturer of record of the Products.


 


(b)          If
either Party receives notice of an audit, inspection, investigation, inquiry, import or export ban, product seizure, enforcement
proceeding or similar action by a Regulatory Authority with respect to any Product or a Party’s activities in connection
with any Product, it will notify the other Party as soon as reasonably practicable, but in any event within seventy-two (72) hours
after its receipt of notice of the action and will promptly deliver to the other Party copies of all relevant documents received
from the Regulatory Authority. The Parties shall cooperate in response to the action, including providing information and documentation
as requested by the Regulatory Authority. If the action primarily concerns the activities of Zimmer or its Marketing Partners or
Affiliates, then Zimmer shall have primary responsibility to respond to the Regulatory Authority and will bear all costs in connection
therewith; otherwise, X-spine shall have primary responsibility to respond and will bear all costs in connection therewith. In
either case, upon request of the responding Party, the other Party shall provide consulting advice and assistance with the response.


 




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6.4           Inspections.
Zimmer shall have the right, upon reasonable prior notice to X- spine and not more frequently than once per year and during regular
business hours, to inspect and audit X-spine’s, and to the extent possible, X-spine’s subcontractor’s, facilities
and operations for the purpose of verifying their compliance with their obligations under Regulatory Laws, this Agreement and applicable
quality system requirements, including the right to (a) inspect and take samples of the Products, (b) observe manufacturing and
related operations, processes and methods, (c) review documentation and (d) conduct quality assurance, quality system and regulatory
compliance audits. Zimmer will be responsible for the cost and expense of such audit.


 


6.5           Product
Labels. During the Distribution Term and any applicable Transition Period, X-spine shall have sole responsibility for obtaining
all necessary Product labels and for negotiating the language of the Product labels with the applicable Regulatory Authorities
in the Territory. All labels (and any changes to labels) shall, without limitation, include both Zimmer- specific and X-spine-specific
part numbers and be subject to approval of Zimmer prior to implementation, except as required by Applicable Law. X-spine shall
establish and maintain procedures to control label integrity, inspection and storage and to control operations of labeling used
for each production unit, lot or batch to prevent labeling mix-ups. X-spine shall control the packaging and labeling of the Products
to ensure conformance to their respective Specifications and Applicable Laws.


 


6.6           Product
Complaints and Reports. The Parties each shall collect and record Product Complaints (and any other events required to be recorded
under Applicable Laws) in accordance with Applicable Laws and their standard procedures and policies in effect from time to time.
Each Party shall provide to the other Party reports of such complaints or events within seventy-two (72) hours after receipt. X-spine
shall be responsible for investigating all Product Complaints. X-spine shall be responsible for submitting to the Regulatory Authorities
all required reports and other materials, including annual reports, distribution reports and safety reports. Each Party shall immediately
notify the other Party of any material information it learns concerning the safety or efficacy of the Product, regardless of whether
formal reporting to any Regulatory Authority is required.


 


6.7           Field
Actions. If either Party in good faith determines that a removal, correction, recall or other Field Action involving a Product
or its labeling is warranted (whether or not required by a Regulatory Authority), such Party shall immediately notify the other
Party in writing and shall advise such other Party of the reasons underlying its determination that a removal, correction, recall
or other Field Action is warranted. The Parties shall consult with each other as to any action to be taken in regard to such removal,
correction, recall or other Field Action. If, after consultations, either Party in good faith believes that such a removal, correction,
recall or Field Action should be undertaken with respect to the Product or its labeling, the Parties shall cooperate in carrying
out the same, and Zimmer shall follow any reasonable direction for X-spine with respect thereto. X-spine shall be responsible for
all of Zimmer’s reasonable out-of-pocket costs and expenses, including the replacement cost of the Products, in the event
of removals, corrections, recalls or other Field Actions with respect to any Product except to the extent such removal, correction,
recall or other Field Action was due to an act or omission of Zimmer in which case Zimmer shall be responsible for X-spine’s
reasonable out-of-pocket costs and expenses in connection therewith. X-spine shall be responsible for any required reporting to
Regulatory Authorities with respect to any removal, correction, recall or other Field Action involving the Product or its labeling.


 




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6.8           Additional
Quality and Regulatory Provisions.


 


(a)          During
the Distribution Term and any applicable Transition Period, X- spine shall be responsible for all design control, manufacturing,
process, validation and process control activities relative to the Products, including design assurance and product and process
validations, as required by the FDA’s Quality System Regulations (“QSRs”), ISO standards, and applicable
regulations, and Applicable Laws.


 


(i)          X-spine
shall develop, conduct, control, and monitor production processes to ensure that the Products conform to the Specifications. This
includes the establishment and maintenance of procedures for acceptance activities, to include inspections, tests, or other verification
activities, to ensure that specified requirements are met for incoming Products, in-process Products and finished goods.


 


(ii)         X-spine
shall establish and maintain procedures for changes to a manufacturing specification, method, or process. X-spine shall notify
Zimmer of any material change(s) to a manufacturing specification, method or process pursuant to Section 5.3.


 


(iii)        X-spine
shall establish and maintain schedules for the adjustment, cleaning, and other maintenance of equipment to ensure that manufacturing
Specifications are met.


 


(iv)        X-spine
shall ensure that all inspection, measuring, and test equipment is suitable for its intended purposes and is capable of producing
valid results.


 


(v)         X-spine
shall establish and maintain procedures to ensure that equipment is routinely calibrated, inspected, checked and maintained.


 


(vi)        X-spine
shall establish and maintain documented process validations to support all cleaning and sterilization instructions included in
any Product labeling.


 


(b)          X-spine
shall be responsible for managing an effective document change control system relative to the design, manufacture, and labeling
of the Products at the location of X-spine and its permitted Third-Party vendors.


 




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(c)          X-spine
shall be responsible for managing an effective product and process validation system relative to the design and manufacture of
the Products at the location of X-spine and its permitted Third-Party manufacturers. X-spine shall develop and implement validation
or qualification protocols for significant processes, equipment and computer systems.


 


(d)          X-spine
shall establish and maintain procedures for acceptance activities, including inspections, tests or other verification activities
to ensure that specified requirements are met for incoming Product, in-process Product and finished Product, as required by the
QSRs. X-spine shall identify by suitable means the acceptance of Product and, if applicable, shall indicate the conformance or
non-conformance of Product with established acceptance criteria throughout manufacturing, packaging, labeling and servicing of
Product, as required by the QSRs. X-spine shall establish and maintain procedures to control Product that does not conform, by
addressing identification, documentation, evaluation, segregation and reevaluation of non-conforming Product as required by the
QSRs.


 


(e)          X-spine
shall maintain appropriate documented procedures designed to prevent mix-ups. X-spine shall provide evidence to the effect that
packaging containers maintain the integrity, quality, and function of the Product for the entire shelf life, and not produce toxic
residues during storage, all consistent with industry practice. Packaging must be designed to prevent or indicate the occurrence
of tampering.


 


(f)          X-spine
shall establish and maintain procedures for implementing and documenting corrective and preventive actions, including analyzing
processes, work operations, concessions, quality audit reports, quality records, service records, complaints and returned Product,
as required by the QSRs. Appropriate statistical methodology shall be employed where necessary to detect recurring quality problems.


 


(g)          X-spine
shall deliver Products to Zimmer using documented procedures for the handling, storage, packaging, preservation and delivery of
the Products. The shipping container shall be validated to ensure that the safety and integrity of each Product is maintained during
transit. Zimmer shall deliver Products to its customers using documented procedures for handling, storage, packing, preservation
and delivery of the Products.


 


(h)          Zimmer
reserves the right to request lot specific compliance to specification information in the form of a certificate of compliance.


 


(i)          X-spine
shall establish and maintain a quality system in compliance with QSR, ISO, and various international requirements for the manufacture
of the Products. X-spine shall also ensure that its permitted subcontractors and vendors of Products maintain a quality system
in compliance with QSR requirements.


 


(j)          X-spine
shall establish procedures for identifying training needs and ensure that all personnel are trained adequately to perform their
assigned responsibilities. Training shall be documented.


 


(k)          X-spine
and Zimmer shall enter into a supplier quality agreement in order to fulfill Zimmer supplier control requirements. The Parties
agree to work together in good faith to finalize and execute such agreement within thirty (30) days after the Effective Date.


 




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6.9           Quality
Records. Both X-spine and Zimmer shall retain all applicable quality records (e.g., Device Master Records, Device History Records,
distribution records, complaint records, etc., as applicable) for a period of five (5) years after the expiration of the expected
life of the Products. Where the expected life of the Products is undetermined, the records shall be retained permanently.


 


6.10         Regulatory
Representations and Warranties. X-spine hereby represents and warrants to Zimmer that:


 


(a)          This
Agreement is not intended to violate the Anti-Kickback Statute, 42 U.S.C. 1320-7b(b). Zimmer has referenced and made available
to X-spine a copy of its Code of Conduct and a summary of Zimmer’s Anti-Kickback Statute policies and procedures on Zimmer’s
website (www.zimmer.com). None of X-spine, its Affiliates or any of their respective officers, directors, subcontractors, agents
or employees (collectively, “X-spine Parties”) have ever been debarred, excluded or suspended by the Office
of Inspector General of the Department of Health and Human Services, or from federal or state procurement programs, or convicted
of a criminal offense with respect to health care reimbursement. Without limiting the generality of the foregoing, X-spine further
represents and warrants that none of the X-spine Parties has been, is currently, or, during the Term, will become: (a) an individual
who has been debarred by the FDA pursuant to 21 U.S.C. §335a(a) or §335a(b) (a “Debarred Individual”)
from providing services in any capacity to a Person that has an approved or pending drug product application, or an employer, employee
or partner of a Debarred Individual, or (b) an entity that has been by the FDA pursuant to 21 U.S.C. §335a(a) or §335a
(b) (a “Debarred Entity”) from submitting or assisting in the submission of any abbreviated drug application,
or an employee, partner, shareholder, member, subsidiary or Affiliate of a Debarred Entity. No Debarred Individual or Debarred
Entity will perform on X-spine’s behalf any services or render any assistance relating thereto in connection with this Agreement.
X-spine further represents and warrants that X-spine has no knowledge of any circumstances which may affect the accuracy of the
foregoing representations and warranties, including FDA investigations of, or debarment proceedings against the X-spine Parties,
and X-spine will immediately notify Zimmer if X-spine becomes aware of any such circumstances during the term of this Agreement.


 


(b)          No
X-spine Party has ever been in violation of the FCPA.


 


(c)          No
government official is a principal, owner, officer, employee or agent of any entity in which X-spine has an interest, and no government
official has any material financial interest in the business of the X-spine.


 


(d)          There
are no circumstances that may affect the accuracy of the foregoing representatives and warranties, including FDA investigations
of, or debarment proceedings against, X-spine or any Person performing services or rendering assistance relating thereto, and X-spine
will immediately notify Zimmer if it becomes aware of any such circumstances during the Term.


 


(e)          X-spine
represents and warrants that the terms of this Agreement are not inconsistent with any other contractual or legal obligations X-spine
may have or with the policies of any institution with which X-spine is associated.


 




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(f)          X-spine
warrants that it does not undertake the direct or indirect sales and marketing promotion of Zimmer products to sources of federal
health care program business, including individuals and entities in a position to recommend or refer federal health care program
business. X-spine warrants that it does not employ or contract with any health care professional in a position to recommend or
refer Zimmer’s products for purchase by any source of federal health care program business and further warrants no owner,
investor or manager of X-spine is authorized to undertake any such activities. In the event of any subsequent ownership, investment,
management or employment structure of X-spine changes these representations, X- spine with notify Zimmer within five (5) Business
Days and such changes in representation may be a basis for Zimmer to terminate this agreement immediately upon written notice to
X-spine.


 


ARTICLE
VII

CONFIDENTIALITY


 


7.1           Confidentiality.
In the course of their activities pursuant to this Agreement, the Parties anticipate that they may disclose Confidential Information
to one another and that either Party may, from time to time, be either the disclosing Party or the recipient of Confidential Information.
The Parties wish to protect such Confidential Information in accordance with this Section 7.1. The provisions of this Section shall
apply to disclosures furnished to or received by a Party and its agents and representatives (which may include agents and representatives
of its Affiliates and Marketing Partners). Each Party shall advise its agents and representatives of the requirements of this Section
and shall be responsible to ensure their compliance with such provisions.


 


(a)          For
purposes hereof, “Confidential Information” with respect to a disclosing Party means all information, in any
form or media that the disclosing Party furnishes to the recipient, whether furnished before or after the Effective Date, and all
notes, analyses, compilations, studies and other materials, whether prepared by the recipient or others, that contain or reflect
such information; provided, however, that Confidential Information does not include information that (i) is or hereafter becomes
generally available to the public other than as a result of a disclosure by the recipient, (ii) was already known to the recipient
prior to receipt from the disclosing Party as evidenced by prior written documents in its possession not subject to an existing
confidentiality obligation to the disclosing Party, (iii) is disclosed to the recipient on a non-confidential basis by a Person
who is not in breach of any confidentiality obligation to the disclosing Party or (iv) is developed by or on behalf of the recipient
without reliance on Confidential Information received hereunder. The contents of this Agreement shall be deemed to be Confidential
Information of each Party.


 


(b)          The
recipient of Confidential Information shall (i) maintain its confidentiality using efforts and precautions at least as great as
those it uses and takes to protect its own confidential information and trade secrets; (ii) use such Confidential Information solely
in connection with the discharge of its obligations under this Agreement and (iii) not disclose such Confidential Information to
any Person other than those of its agents and representatives who need to know such Confidential Information in order to accomplish
the objectives for which it was disclosed. Notwithstanding the foregoing, the recipient of Confidential Information may disclose
it to the extent necessary to comply with Applicable Laws or regulations or with an order issued by a court or regulatory body
with competent jurisdiction; provided that, in connection with such disclosure, the recipient uses commercially reasonable efforts
to obtain confidential treatment or an appropriate protective order, to the extent available, with respect to such Confidential
Information.


 




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(c)          Within
thirty (30) days of the disclosing Party’s request, the recipient of Confidential Information shall redeliver to the disclosing
Party all Confidential Information provided to the recipient in tangible form, and the recipient shall not retain any copies, extracts
or other reproductions, in whole or in part, of such Confidential Information. All notes or other work product prepared by the
recipient based upon or incorporating Confidential Information of the disclosing Party shall be destroyed, and such destruction
shall be certified in writing to the disclosing Party by an authorized representative of the recipient who supervised such destruction.
Notwithstanding the foregoing, in-house legal counsel to the recipient shall be permitted to retain in its files one copy of all
Confidential Information to evidence the scope of the Party’s obligation of confidentiality.


 


(d)          The
obligations under this Section shall remain in effect from the Effective Date through the fifth (5th) anniversary of
the expiration or termination of the Term of this Agreement.


 


(e)          In
addition to any other remedies available in law or equity, the disclosing Party shall be entitled to temporary and permanent injunctive
relief in the event of a breach (or threatened breach) under this Section.


 


(f)          The
provisions of this Section shall supersede and replace any prior agreements between the Parties relating to Confidential Information
covered hereby, including the Mutual Confidential Information Disclosure Agreement, dated as of August 12, 2011.


 


7.2           Publicity.
Neither X-spine nor Zimmer shall issue any press release or otherwise publicize the subject matter of this Agreement without the
prior written approval of the other Party, except to the extent that such press release or other public announcement is required
by law in the opinion of legal counsel to the releasing Party or that the substance thereof has been previously reviewed and released
by the other Party or is in the public domain through no fault of the releasing Party. In the event of a required press release
or other public announcement, the releasing Party shall provide the other Party with a copy of the proposed text prior to such
announcement. The Parties agree that if either Party is required to file this Agreement with any Governmental Authority, the releasing
Party shall redact the financial terms of this Agreement to the extent possible in order to keep the financial terms of this Agreement
confidential.


 


ARTICLE
VIII

INTELLECTUAL PROPERTY RIGHTS


 


8.1           Intellectual
Property Representations. X-spine hereby represents and warrants to, and covenants with, Zimmer as follows:


 




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(a)          X-spine
owns or holds valid and enforceable rights to use and license (to the extent a license is required), without, to the best of its
knowledge, infringing, misappropriating or violating the rights of any Person, any Intellectual Property that is necessary for
(i) X-spine to manufacture and sell the Products, (ii) Zimmer to Distribute the Products as contemplated by this Agreement, (iii)
Zimmer to make, have made, use, sell, offer to sell, have sold, import/export and otherwise commercialize the Products as contemplated
by this Agreement, and (iv) X-spine to grant to Zimmer and its Marketing Partners the Distribution rights and Intellectual Property
Rights under this Agreement.


 


(b)          X-spine
has not previously granted any license, covenant not to sue or other right that would be inconsistent with or conflict with the
grant of the Distribution rights and license rights under this Agreement.


 


(c)          No
Person has asserted and there is no threatened or pending claim, suit, proceeding, action or demand (a “Claim”)
with respect to any of the Products or X-spine IP, which Claim (i) challenges the validity of X-spine’s interest in the X-spine
IP, (ii) alleges that the manufacture, use, sale or import/export of the Products or X-spine’s use or practice of the X-
spine IP infringes, misappropriates or violates the rights of any Person or (iii) seeks to enjoin or restrain the manufacture,
use, sale or import/export of the Products or X-spine’s use or practice of the X-spine IP in any manner that would interfere
with the transactions contemplated by this Agreement. X-spine has no knowledge that any Person intends to assert such a Claim.


 


8.2           Trademarks.
Zimmer and its Marketing Partners shall have the right to use X- spine’s Trademarks associated with the Products as may be
necessary in order to comply with applicable Regulatory Laws. Zimmer and its Marketing Partners shall comply with the reasonable
instructions of X-spine as to the form and manner in which such Trademarks shall be used. Other than as expressly provided herein,
no Party shall acquire or have any right to use the name or Trademarks of the other Party without its prior written consent. All
uses by Zimmer or its Marketing Partners or Affiliates of X-spine’s Trademarks shall inure to the exclusive benefit of X-spine.


 


8.3           Axle
Products License.


 


(a)          Zimmer
hereby grants to X-spine a non-exclusive, perpetual, worldwide license under Patent No. 8,439,953, and U.S. Patent Publication
Nos. 13/0204301, 08/0140125 and 03/0040746 to Distribute the Axle Products pursuant to and subject to the limitations set forth
in Section 2.1.


 


(b)          The
license granted under this Section 8.3 shall be transferable under a Change of Control. For the sake of clarity, whether the license
is transferred or not, the license is granted solely for the Distribution of Axle Products and may not be applied to any other
activities (whether by X-spine or a transferee).


 


(c)          The
license granted under this Section 8.3 shall include the following royalty payments based on Net Sales (the definition of Net Sales
shall apply to X-spine and the Axle Products, mutatis mutandis) of Axle Products received by X-spine:


 


(i)          Except
as further provided below, during the Term of this Agreement, the license granted under this Section 8.4 shall be royalty-free.


 




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(ii)         Upon
X-spine’s exercising of its right in Section 3.8(a) to render nonexclusive Zimmer’s Distribution rights, X-spine shall
make royalty payments to Zimmer in an amount equal to one percent (1%) of Net Sales.


 


(iii)        After
the expiration or termination of this Agreement, X-spine shall make royalty payments to Zimmer in an amount equal to two percent
(2%) of Net Sales.


 


(iv)        Upon
a Change of Control, X-spine or its successor shall make royalty payments to Zimmer in an amount equal to four percent (4%).


 


In the event that more than one of the previous
royalty rates applies, X-spine shall make royalty payments at whichever rate is highest. The obligation to pay royalties under
this Section 8.4 shall terminate with respect to any jurisdiction upon the expiration of the last to expire, valid Patent claim
under Patent No. 8,439,953 in such jurisdiction. Zimmer shall not directly or indirectly challenge or induce any Third Party to
challenge X-spine’s activities relating to this license during the Distribution Term.


 


(d)          Multiple
royalties shall not be payable in the case of multiple resales of the Products through a distribution chain. Royalties shall be
payable in arrears on a quarterly basis in immediately available funds. So long as royalties are due hereunder, X-spine shall provide
to Zimmer reports (in written or electronic form) on Net Sales for each calendar quarter and the amount of royalties due thereon.
Each report shall be due on the sixtieth (60th) day following the last day of the applicable calendar quarter. Royalty
payments shall be due and payable on the date each report is due.


 


(e)          X-spine
may not grant sublicenses under this Section 8.3. Notwithstanding the foregoing, X-spine may engage Third Parties to manufacture
the Axle Products, in whole or in part, for X-spine that are to be sold by X-spine. Zimmer shall have the sole and exclusive right,
in its discretion, to institute and prosecute lawsuits against Third Persons for infringement of the rights licensed in this Section
8.3. All sums recovered in any such lawsuits, whether by judgment, settlement, or otherwise, in excess of the amount of reasonable
attorneys’ fees and other out of pocket expenses of such suit, shall be retained solely by Zimmer. X-spine agrees to reasonably
cooperate with Zimmer in the prosecution of any such suit against a Third party and shall execute all papers, testify on all matters,
and otherwise cooperate as reasonably necessary for the prosecution of any such lawsuit. For avoidance of doubt, reasonable cooperation
shall not include joining as a party to any such lawsuit. Zimmer shall reimburse X-spine for reasonable expenses incurred as a
result of such cooperation.


 


8.4           Reverse
Engineering. During the Distribution Term, neither Zimmer nor its Affiliates shall “reverse engineer” the Products
in order to design or develop any products that are substantially similar to and competitive with the Products.


 




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8.5           X-spine
Intellectual Property. During the Distribution Term, Zimmer shall not directly or indirectly challenge or induce any Third
Party to challenge the validity or enforceability of any present or future Patent controlled by X-spine related to the Products
or any patent claim(s) therein, or initiate or participate in any re-examination or other proceeding related to the validity, enforceability
or patentability of any claim of any such X-spine Patent before any tribunal or patent office. This Section shall not prohibit
Zimmer from responding to a subpoena, process, or discovery requests in any litigation or administrative proceeding provided that
the Zimmer give prompt notice to X-spine of the receipt of said subpoena, process or discovery requests.


 


8.6           Zimmer
Intellectual Property. Zimmer agrees not to make any infringement claims against X-spine related to (a) the Products during
the Distribution Term, and (b) any Products licensed under Article XII, during the term of the IP License for such Product.


 


ARTICLE
IX

REPRESENTATIONS AND WARRANTIES


 


Each Party hereby represents
and warrants to, and covenants with, the other Party that:


 


(a)          It
is a corporation duly organized, validly existing and, if relevant in its jurisdiction of organization, in good standing under
the laws of its jurisdiction of organization and has the power and authority to own, lease and operate its assets and to conduct
the business now being conducted by it. It has all requisite power and authority to enter into this Agreement and to perform its
obligations hereunder.


 


(b)          The
execution, delivery and performance by it of this Agreement and the consummation by it of the transactions contemplated hereby
have been duly authorized and approved by all necessary corporate or equivalent action on its part. This Agreement has been duly
executed and delivered by it and constitutes its legal, valid and binding obligation, enforceable against it in accordance with
its terms, except as the same may be limited by applicable bankruptcy, insolvency, reorganization, moratorium or other laws relating
to or affecting creditors’ rights generally and by general equity principles.


 


(c)          The
execution, delivery and performance by it of this Agreement and the consummation by it of the transactions contemplated hereby
do not and will not: (i) violate any Applicable Laws; (ii) conflict with, or result in the breach of any provision of, its certificate
of incorporation, bylaws or equivalent organizational documents; (iii) result in the creation of any lien or encumbrance of any
nature upon any property being transferred or licensed by it pursuant to this Agreement; or (iv) violate, conflict with, result
in the breach or termination of, or constitute a breach under (or event which, with notice, lapse of time or both, would constitute
a breach under), any permit, contract or agreement to which it is a party or by which any of its properties or businesses are bound.


 


(d)          No
authorization, consent or approval of, or notice to or filing with, any Governmental Authority is required for the execution, delivery
and performance by it of this Agreement, other than Regulatory Clearances that have not been obtained prior to the Effective Date.


 




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ARTICLE
X

INDEMNIFICATION AND INSURANCE


 


10.1         Indemnification
by X-spine.


 


(a)          X-spine
shall indemnify, defend and hold harmless Zimmer and its Affiliates and Marketing Partners and their respective shareholders, directors,
officers, employees and agents (the “Zimmer Indemnified Parties”) from and against any and all liabilities,
damages, losses, penalties, fines, costs and expenses, including reasonable attorneys’ fees (each, an “Indemnifiable
Loss”), paid or incurred by them in connection with any Claim based upon or arising from: (i) any facts or circumstances
that would constitute a breach by X- spine of any of its representations, warranties or obligations under this Agreement; (ii)
any bodily injury, death or property damage resulting from any defect in the design, engineering, fabrication, manufacture or label
(including the label warnings) of any Product manufactured by or on behalf of X-spine or from the failure of any such Product to
conform to the applicable Specifications therefor, unless the Claim arises from Products modified by Zimmer without X- spine consent
(a “Product Liability Claim”); (iii) any infringement or violation of a Third-Party’s Intellectual Property
Rights as a result of the use, manufacture, sale or distribution of any Product; (iv) any violation by X-spine of Applicable Laws;
or (v) any negligent or more culpable act or omission of X-spine or its Affiliates or subcontractors or any of their respective
employees or agents relating to the activities subject to this Agreement.


 


(b)          Zimmer
shall give X-spine prompt written notice of any Claim with respect to which X-spine’s indemnification obligations may apply,
but any delay or failure of such notice shall not excuse X-spine’s indemnification obligations except to the extent that
X- spine’s legal position is prejudiced thereby. X-spine shall have the right to assume and control the defense and settlement
of any such Claim; except that Zimmer shall have the right to assume and control, at X-spine’s expense, the defense and settlement
of any such Claim if: (i) such Claim relates to Indemnifiable Losses under Section 10.1(a)(iii), (ii) Zimmer reasonably determines
that there is a conflict of interest between Zimmer and X-spine with respect to such Claim; (iii) X-spine fails to employ counsel
reasonably satisfactory to Zimmer to represent Zimmer within a reasonable time after X-spine’s receipt of notice of the Claim
or (iv) in the reasonable opinion of counsel to Zimmer, the Claim could result in Zimmer becoming subject to injunctive or other
non-monetary relief that could have a material adverse effect on Zimmer’s ongoing business. The Party not controlling the
defense shall have the right to participate in the Claim at its own expense, but in any event shall cooperate with the controlling
Party in the investigation and defense of the Claim.


 


(c)          If
X-spine is entitled to, and does, assume and control the defense and settlement of any Claim with respect to which its indemnification
obligations apply, then X-spine shall not settle such Claim without Zimmer’s prior written consent (which consent shall not
be unreasonably withheld or delayed), unless (i) the sole relief provided in such settlement is monetary in nature and shall be
paid in full by X-spine and (ii) such settlement does not include any finding or admission of a violation by Zimmer of any Applicable
Laws or Third Party’s rights. Whenever Zimmer assumes and controls the defense and settlement of a Claim with respect to
which X-spine’s indemnification obligations apply, X-spine shall not be liable for any settlement thereof effected by Zimmer
unless Zimmer shall have obtained X-spine’s prior written consent to the proposed settlement (which consent shall not be
unreasonably withheld or delayed).


 




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(d)          X-spine
shall maintain, from the Effective Date through the first anniversary of the expiration date of the Term, a policy of insurance
for Product Liability Claims. Such policy shall (i) have a per occurrence limit of at least $1,000,000 and an annual aggregate
limit of at least $5,000,000, and (ii) provide for at least thirty (30) days’ advance written notice to Zimmer of cancellation
or material change in coverage. Promptly following execution of this Agreement and annually thereafter, X-spine shall provide to
Zimmer evidence of such coverage and a certificate of insurance indicating that Zimmer is an additional insured. If X-spine breaches
its obligation to maintain insurance, (x) Zimmer shall have the right to obtain coverage as required on X-spine’s behalf
and at X-spine’s expense, (y) Zimmer shall have the right to set off the cost of such coverage against any payment owed to
X-spine and (z) X-spine shall indemnify Zimmer from and against all costs and expenses associated with obtaining such coverage.


 


10.2         Indemnification
by Zimmer.


 


(a)          Zimmer
shall indemnify, defend and hold harmless X-spine and its Affiliates and their respective shareholders, directors, officers, employees
and agents from and against any and all Indemnifiable Losses paid or incurred by them in connection with any Claim based upon or
arising from: (i) any facts or circumstances that would constitute a breach by Zimmer of any of its representations, warranties
or obligations under this Agreement; (ii) any violation by Zimmer of Applicable Laws; (iii) any negligent or more culpable act
or omission of Zimmer or its Affiliates or Marketing Partners or any of their respective employees or agents relating to the activities
subject to this Agreement; (iv) any claims arising from Zimmer private label branding, including claims of trademark infringement;
or (v) claims arising from modifications to Products performed by Zimmer without written consent from X-spine.


 


(b)          X-spine
shall give Zimmer prompt written notice of any Claim with respect to which Zimmer’s indemnification obligations may apply,
but any delay or failure of such notice shall not excuse Zimmer’s indemnification obligations except to the extent that Zimmer’s
legal position is prejudiced thereby. Zimmer shall have the right to assume and control the defense and settlement of any such
Claim; except that X-spine shall have the right to assume and control, at Zimmer’s expense, the defense and settlement of
any such Claim if: (i) X-spine reasonably determines that there is a conflict of interest between Zimmer and X-spine with respect
to such Claim; (ii) Zimmer fails to employ counsel reasonably satisfactory to X-spine to represent X-spine within a reasonable
time after Zimmer’s receipt of notice of the Claim or (iii) in the reasonable opinion of counsel to X-spine, the Claim could
result in X-spine becoming subject to injunctive or other non-monetary relief that could have a material adverse effect on X- spine’s
ongoing business. The Party not controlling the defense shall have the right to participate in the Claim at its own expense, but
in any event shall cooperate with the controlling Party in the investigation and defense of the Claim.


 




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(c)          If
Zimmer is entitled to, and does, assume and control the defense and settlement of any Claim with respect to which its indemnification
obligations apply, then Zimmer shall not settle such Claim without X-spine’s prior written consent (which consent shall not
be unreasonably withheld or delayed), unless (i) the sole relief provided in such settlement is monetary in nature and shall be
paid in full by Zimmer and (ii) such settlement does not include any finding or admission of a violation by X-spine of any Applicable
Laws or Third Party’s rights. Whenever X-spine assumes and controls the defense and settlement of a Claim with respect to
which Zimmer’s indemnification obligations apply, Zimmer shall not be liable for any settlement thereof effected by X-spine
unless X-spine shall have obtained Zimmer’s prior written consent to the proposed settlement (which consent shall not be
unreasonably withheld or delayed).


 


10.3         Combined
Obligations. To the extent that Zimmer and X-spine have indemnification obligations to one another in connection with a single
Claim, Zimmer and X- spine shall contribute to the aggregate damages arising from such Claim in such proportion as is appropriate
to reflect their relative responsibilities for such damages, as well as any other relevant equitable considerations. The amount
paid or payable by Zimmer or X-spine for purposes of apportioning the aggregate damages shall be deemed to include all reasonable
legal fees and expenses incurred by such Party in connection with investigating, preparing for or defending against such Claim.


 


ARTICLE
XI

TERM AND TERMINATION


 


11.1         Term.
Unless earlier terminated in accordance with Section 11.2, the initial term of this Agreement (the “Initial Term”)
shall begin on the Effective Date and shall continue for ten (10) years. The Initial Term shall be automatically extended for renewal
terms of two (2) years (each, a “Renewal Term”) unless either Party notifies the other Party in writing that
it desires not to renew the Initial Term or Renewal Term at least six (6) months prior to the expiration of such Initial Term or
Renewal Term, as applicable.


 


11.2         Termination.
This Agreement may be terminated as follows:


 


(a)          If
a Party is dissolved under applicable corporate law or becomes subject to an Insolvency Event, the other Party may terminate this
Agreement by delivering written notice thereof.


 


(b)          If
either Party believes the other is in material breach of this Agreement, it may give notice of such breach to the other Party,
and the breaching Party shall have thirty (30) days in which to remedy the breach. If the breach is not remedied within such thirty
(30) day period, the non-breaching Party may terminate this Agreement immediately upon delivery to the breaching Party of a written
notice of termination. The non-breaching Party’s right to terminate this Agreement shall not be construed as an exclusive
remedy.


 


(c)          Either
Party may terminate this Agreement in accordance with the terms of Section 14.2.


 


(d)          Zimmer
may terminate this Agreement at its sole discretion immediately upon notice to X-spine under the following circumstances: (i) if
X-spine is subject to a Change of Control involving a Zimmer Competitor; or (ii) in accordance with the terms of Section 6.10(f).


 




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11.3         Order
Fulfillment; Depletion of Inventory. Upon the expiration or termination of this Agreement for any reason other than pursuant
to Section 11.2(b) as a result of a material breach by Zimmer, (i) at Zimmer’s written request, X-spine shall continue to
manufacture and deliver all Products that are the subject of Firm Orders submitted by Zimmer prior to the expiration or termination
of this Agreement, and (ii) Zimmer shall be permitted to sell to depletion any remaining inventory of the Products, including any
Products delivered pursuant to clause (i) above.


 


11.4         Survival.
Termination or expiration of this Agreement for any reason shall be without prejudice to any rights that shall have accrued to
the benefit of any Party prior to such termination or expiration. The following Articles and Sections shall survive the expiration
or termination of this Agreement: Articles VII, IX, X, and XI and Sections 4.4, 5.4, 6.3, 6.6, 6.7, 6.8, 6.10, 8.1, 8.4, 14.4 and
14.9. For the avoidance of doubt, in the event Zimmer exercises its Option to License, the IP License shall be perpetual and Article
XII shall survive indefinitely.


 


ARTICLE
XII

OPTION TO LICENSE


 


12.1         Option.
Upon the occurrence of a License Trigger Event, Zimmer shall have the option (the “Option to License”) to acquire
from X-spine a non-exclusive, perpetual, irrevocable, worldwide, royalty-bearing license under the X-spine IP to make, have made,
use, sell, offer to sell, have sold, import/export and otherwise commercialize any of the Products throughout the Territory for
all uses and applications in the Field (the “IP License”). The IP License shall be sublicenseable to Zimmer’s
Marketing Partners, Affiliates, and Third Party manufacturers as is necessary or useful to commercialize the Products.


 


12.2         Royalties.
In the event Zimmer exercises its Option to License, Zimmer shall make royalty payments to X-spine beginning on the IP License
Effective Date (as defined below) in an amount equal to two percent (2%) of Net Sales of all Products included in the IP License
except for Axle Products and one percent (1%) of Net Sales of Axle Products, in each case to the extent received by Zimmer and
with the following limitations:


 


(a)          In
the event Zimmer reasonably determines that it needs a license or other access to Intellectual Property Rights of a Third Party
in order to make, have made, use, sell, offer to sell, have sold, import/export and otherwise commercialize any Product, any consideration
paid to such Third Party by Zimmer in order to obtain such license or access (including upfront fees, royalties and other forms
of consideration) shall be credited against any royalty payments due hereunder. Nothing herein shall be construed to limit Zimmer’s
indemnification rights under Section 10.1.


 


(b)          Multiple
royalties shall not be payable in the case of multiple resales of a Product through a distribution chain. Royalties shall be payable
in arrears on a quarterly basis in immediately available funds. So long as royalties are due hereunder, Zimmer shall provide to
X- spine reports (in written or electronic form) on Net Sales for each calendar quarter and the amount of royalties due thereon.
Each report shall be due on the sixtieth (60th) day following the last day of the applicable calendar quarter. Royalty
payments shall be due and payable on the date each report is due.


 




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(c)          The
obligation to pay royalties under this Section 12.2 shall terminate with respect to each Product in each jurisdiction upon the
expiration of the last to expire valid Patent claim covering such Product in such jurisdiction.


 


12.3         IP
License Effective Date. In order to exercise its Option to License pursuant to Section 12.1 above, Zimmer shall provide ten
(10) days prior written notice thereof to X-spine. The effective date of the IP License (the “IP License Effective Date”)
shall be the tenth (10th day after such notice is delivered to X-spine or a later effective date if so specified by
Zimmer in such notice. Upon the valid exercise of such Option to License, effective as of the IP License Effective Date, X-spine
hereby grants to Zimmer the IP License subject to the terms and conditions of this Agreement.


 


12.4         Information
Transfer. As soon as practicable after the IP License Effective Date, and in no event more than thirty (30) days thereafter,
X-spine shall disclose in writing to Zimmer, without charge, all Proprietary Information and other information known to X-spine
that is necessary or useful in connection with the manufacture and sale of the Products, including design, engineering and manufacturing
drawings; supplier and vendor records; Specifications; testing data; protocols; operating procedures; work instructions; regulatory
filings; Regulatory Clearances; risk analyses; design history files; project history files; and device master records.


 


12.5         Transition
Period. As soon as practicable after the IP License Effective Date, Zimmer shall begin the process of applying for Regulatory
Clearances for the licensed Products with Zimmer (or its designee) as the manufacturer of record. X-spine shall provide reasonable
assistance as requested by Zimmer in connection with such Regulatory Clearances. At Zimmer’s request, X-spine shall continue
to manufacture and deliver each Product to Zimmer in accordance with the terms of this Agreement until the expiration of the Transition
Period for such Product.


 


12.6         Effect
on the Agreement. Upon Zimmer’s receipt of Regulatory Clearance for any Product in any jurisdiction, the Parties shall
have no further rights or obligations under the following provisions with respect to such Product in such jurisdiction: Sections
3.8, 6.2 and 6.3(a). Upon the expiration of the Transition Period for any Product, the following provisions shall terminate with
respect to such Product and thereafter the Parties shall have no further rights or obligations under such provisions with respect
to such Product: Articles II, III, IV, V and XII, and Sections 6.4-6.8 and 8.2-8.3. Notwithstanding the foregoing, nothing herein
shall affect any rights, obligations, claims, liabilities or remedies of any Party accruing or arising under any provision of this
Agreement prior to the termination of such provision under this Section 12.6.


 


ARTICLE
XIII

RIGHT OF FIRST REFUSAL


 


13.1         Offer.
In the event that X-spine receives a bona fide offer from one or more Third Parties (a “Third-Party Offer”)
during the Term of the Agreement, that would result in (a) a Change of Control of X-spine or (b) the sale, license or other divestment
of its rights in and to the Products or any of the X-spine IP (a “Covered Transaction”), and X-spine desires
to accept such Third-Party Offer, X-spine shall provide prompt written notice of such Third-Party Offer (a “Transaction
Notice”) to Zimmer and shall offer to consummate the Covered Transaction with Zimmer on substantially equivalent terms
and conditions. The Transaction Notice shall describe in detail the terms of the Covered Transaction and shall be accompanied by
a copy of the Third-Party Offer. If the consideration to be provided by the Third Party includes any non-cash component, Zimmer
shall have the right to provide cash in lieu thereof in an amount equal to the fair value of such non-cash component.


 




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13.2         Review
and Negotiation Periods. Within twelve (12) Business Days after receipt by Zimmer of a Transaction Notice (the “Review
Period”), Zimmer may elect by written notice to X-spine to consummate the Covered Transaction on substantially equivalent
terms and conditions (an “Election”). The Parties shall have one hundred twenty (120) days from the Review Period
to negotiate and sign a definitive agreement (the “Negotiation Period”). During the Negotiation Period, X-spine
shall provide Zimmer with any relevant information that Zimmer reasonably requests and Zimmer shall notify X-spine if it is no
longer interested in pursuing the transaction.


 


13.3         Forfeiture
of Right.


 


(a)          No
Election. If Zimmer does not make an Election within the Review Period, then the right of first refusal shall be forfeited,
solely with respect to the Covered Transaction that triggered the Review Period, for one (1) year and X-spine shall be free to
consummate the Covered Transaction with the Third Party at a price and on terms that are no more favorable to the Third Party than
the price and terms set forth in the Third-Party Offer. If X-spine does not consummate the Covered Transaction with the Third Party
within one year after the end of the Review Period (or, if earlier, within one (1) year of the date Zimmer notifies X-spine in
writing of its decision not to negotiate a Covered Transaction), then Zimmer’s rights under this Article XIII shall apply
again with respect to such transaction and to any subsequent Covered Transaction.


 


(b)          Failed
Negotiation Period. If Zimmer does make an Election but the Parties are unable to sign a definitive agreement within the Negotiation
Period (and X-spine shall have negotiated and responded to information requests in good faith throughout the Negotiation Period),
then the right of first refusal shall be forfeited for one (1) year and X-spine shall be free to consummate any Covered Transaction
with any Third Party. If X-spine does not consummate a Covered Transaction within one year after the end of the Negotiation Period,
then Zimmer’s rights under this Article XIII shall apply again with respect to any subsequent Covered Transaction.


 


ARTICLE
XIV

MISCELLANEOUS


 


14.1         Agency.
The Parties are independent contractors. Neither Party is, nor shall be deemed to be, an employee, agent, partner or legal representative
of the other Party for any purpose. Neither Party shall have the right, power or authority to enter into any contracts in the name
of, or on behalf of, the other Party, nor shall either Party have the right, power or authority to pledge the credit of the other
Party in any way or hold itself out as having the authority to do so.


 




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14.2         Force
Majeure. If the performance of any obligation under this Agreement is prevented, restricted or interfered with by reason of
war, revolution, civil commotion, acts of terrorism, blockade, embargo, labor unrest or strikes, government acts, natural disasters,
acts of God or similar events which are beyond the reasonable control of the Party affected, then the Party so affected shall,
upon giving prior written notice to the other Party, be excused from such performance to the extent of such prevention, restriction,
or interference, provided that the Party so affected shall use commercially reasonable efforts to avoid or remove such causes of
nonperformance, and shall continue performance hereunder with reasonable dispatch whenever such causes are removed. If such conditions
inhibiting complete performance shall continue in excess of ninety (90) days, then the Party that is not affected by the force
majeure event shall have the option, by delivery of written notice of termination to the affected Party, to terminate this Agreement.


 


14.3         Entire
Agreement; Amendments. This Agreement (together with all Exhibits and other attachments referred to herein) constitutes the
entire agreement between the Parties hereto concerning its subject matter and supersedes all previous negotiations, agreements
and commitments with respect thereto. This Agreement shall not be released, discharged, amended or modified in any manner except
by a written instrument signed by duly authorized officers or representatives of each of the Parties hereto.


 


14.4         Governing
Law; Jurisdiction.


 


(a)          This
Agreement shall be governed by and interpreted in accordance with the substantive laws of the State of Ohio, without regard to
its choice of law rules.


 


(b)          The
Parties hereto agree that any suit, action or proceeding seeking to enforce any provision of, or based upon any matter arising
out of or in connection with, this Agreement or the transactions contemplated hereby shall be brought (i) if by X-spine, in the
federal courts of the Southern District of Ohio or the state courts of Montgomery County, Ohio, as applicable, and (ii) if by Zimmer,
in the federal courts of the District of Minnesota or the state courts of Hennepin County, Minnesota, as applicable. Each of the
Parties hereby irrevocably consents to the jurisdiction of such courts (and of the appropriate appellate courts therefrom) in any
such suit, action or proceeding and irrevocably waives, to the fullest extent permitted by law, any objection that it may now or
hereafter have to the laying of the venue of any such suit, action or proceeding in any such court or that any such suit, action
or proceeding brought in any such court has been brought in an inconvenient forum. Process in any such suit, action or proceeding
may be served on any Party anywhere in the world, whether within or without the jurisdiction of any such court.


 


14.5         Partial
Illegality. If any provision of this Agreement, or the application thereof to any Party or circumstances, shall be declared
void, illegal or unenforceable, the remainder of this Agreement shall be valid and enforceable to the extent permitted by Applicable
Laws. In such event, the Parties shall use their best efforts to replace the invalid or unenforceable provision by a provision
that, to the extent permitted by Applicable Laws, achieves the purposes intended under the invalid or unenforceable provision.
Any deviation by either Party from the terms and provisions of this Agreement in order to comply with Applicable Laws shall not
be considered a breach of this Agreement.


 




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14.6         Waiver
of Compliance. No provision of this Agreement shall be waived by any act, omission or knowledge of a Party or its agents or
employees, except by an instrument in writing expressly waiving such provision and signed by a duly authorized officer of the waiving
Party, which waiver shall be effective only with respect to the specific obligation and instance described therein.


 


14.7         Notices.
Except as otherwise provided herein, all notices and other communications in connection with this Agreement shall be in writing
and shall be sent to the respective Parties at the following addresses, or to such other addresses as may be designated by the
Parties in writing from time to time in accordance with this Section, by registered or certified mail, postage prepaid, or by express
courier service, service fee prepaid, or by facsimile in accordance with this Section.


 


	To X-spine:	X-spine Systems, Inc.
	 	452 Alexandersville Rd
	 	Miamisburg, OH 45342
	 	Attn:  President
	 	Fax No.: 937-847-8410
	 	 
	To Zimmer:	Zimmer Spine, Inc.
	 	7375 Bush Lake Road
	 	Edina, MN 55439
	 	Attn:  President
	 	 
	With a copy to:	Zimmer Spine, Inc.
	 	7375 Bush Lake Road
	 	Edina, MN 55439
	 	Attn:  Legal Department


 


All notices shall be deemed given and received
(i) if delivered by hand, immediately, (ii) if sent by mail, three (3) Business Days after posting, (iii) if delivered by express
courier service, the next Business Day in the jurisdiction of the recipient or (iv) if sent by fax, at the time shown in the confirmed
electronic receipt, or on the first Business Day thereafter if the notice is not sent on a Business Day.


 


14.8         Counterparts
and Facsimile/Electronic. This Agreement may be executed in counterparts, each of which shall be deemed to be an original and
all of which together shall be deemed to be one and the same instrument. A manual signature on this Agreement or any document executed
in connection with this Agreement, the image of which is transmitted electronically (including facsimile or e-mail), shall constitute
an original signature for purposes of this Agreement.


 


14.9         Limitation
on Liability. Except with respect to the indemnification and confidentiality obligations, neither Party shall be liable to
the other for indirect, incidental, consequential, punitive or special damages, including lost profits, arising from or relating
to any breach of this Agreement, regardless of any notice of the possibility of such damages.


 




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14.10         Offset
Rights. To the extent that X-spine owes any payment obligations to Zimmer under this Agreement, Zimmer shall be entitled to
withhold and offset such obligations against payments otherwise due to X-spine by Zimmer under this Agreement.


 


14.11         Further
Actions. Each Party agrees, subsequent to the execution and delivery of this Agreement and without any additional consideration,
to execute, acknowledge and deliver such further documents and instruments, and to do all such other acts, as may be necessary
or appropriate in order to carry out the purposes and intent of this Agreement.


 


14.12         Assignment.
Neither Party shall have the right to assign any of its rights or obligations under this Agreement without the prior written consent
of the non-assigning Party, except that (a) Zimmer may assign its rights and obligations under this Agreement to an Affiliate without
X-spine’s approval and (b) X-spine may assign its rights and obligations under this Agreement upon a Change of Control to
an acquiring party that is not a Zimmer Competitor, so long as such acquiring party is reasonably qualified to undertake all of
X-spine’s obligations and agrees in writing to be bound by the terms of this Agreement. If and to the extent that a Party
assigns any of its rights and/or obligations hereunder in accordance with this Section 14.12, then this Agreement shall be binding
upon the assignee to the same extent as if it were a Party hereto, and each reference herein to the name of the assigning Party
shall be deemed to include the assignee. Any assignment not in accordance with this Section 14.12 shall be void.


 


14.13         Jointly
Prepared. This Agreement has been prepared jointly and shall not be strictly construed against either Party.


 


14.14         Third-Party
Rights. Except as otherwise expressly provided herein, this Agreement is not intended to confer any benefits upon, or create
any rights in favor of any Person other than the Parties.


 


14.15         Expenses.
Except as otherwise expressly provided in this Agreement, each Party shall be responsible for its own expenses incurred in connection
with this Agreement and the transactions contemplated hereby.


 


[SIGNATURES ON FOLLOWING PAGE]


 




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IN WITNESS WHEREOF, each
Patty has caused this Agreement to be executed by its respective duly authorized representative as of the Effective Date.


 


	 	X-SPINE SYSTEMS, INC.
	 	 	 
	 	By:	/s/ David Kirschman
	 	 	 
	 	Name:	David Kirschman
	 	 	 
	 	Title:	CEO
	 	 	 
	 	ZIMMER SPINE, INC.
	 	 	 
	 	By:	/s/ Steven J. Healy
	 	 	 
	 	Name:	Steven J. Healy
	 	 	 
	 	Title:	President


 


[Signature page to Zimmer/X-spine Distribution
Agreement]