Document:

Securities Purchase Agreement

  
 Exhibit 10.20

  
 SECURITIES PURCHASE AGREEMENT 
  
 THIS SECURITIES PURCHASE AGREEMENT (this
“Agreement”), dated as of November 17, 2004, is made and entered into between Symmetry Medical Inc., a Delaware corporation (the “Company”), and each of the Persons (as defined below) set forth on the Schedule of
Sellers attached hereto (as such schedule may be amended, the “Schedule of Sellers”) that execute this Agreement (each a “Seller” and, collectively, the “Sellers”). 
  
 WHEREAS, each Seller owns the number of shares of the Company’s Class A
Preferred Stock, par value $0.01 per share (the “Class A Preferred Shares”), set forth opposite such Seller’s name in Column A on the Schedule of Sellers and/or Class A Preferred Warrants (as defined below) set forth
opposite such Seller’s name in Column B on the Schedule of Sellers. 
  
 WHEREAS, the Company desires to purchase from each Seller, and such Seller desires to sell to the Company, the number of (i) shares of Class A Preferred Stock (together with any Repurchased Warrant Shares (as defined
below), “Repurchased Shares of Class A Preferred”) and/or (ii) Class A Preferred Warrants (“Repurchased Warrants”), in each case set forth opposite such Seller’s name in columns D and E, respectively, on the
Schedule of Sellers (as such numbers may be adjusted through one or more amendments to such Schedule of Sellers), and any Repurchased Warrant Shares (collectively, the “Repurchased Securities”), in accordance with the terms
and conditions set forth herein. 
  
 WHEREAS, the Company and the
Sellers have previously entered into an agreement with respect to the transactions contemplated hereby, which agreement terminated in accordance with its terms on September 30, 2004 (the “July Securities Purchase Agreement”).

  
 WHEREAS, the Company has prepared and filed with the
Securities and Exchange Commission (the “Commission”) a Registration Statement on Form S-1 (file number 333-116038) under the Securities Act of 1933, as amended (the “Securities Act”) (as amended from time to time,
the “Form S-1 Registration Statement”), with respect to a potential initial public offering (the “IPO”) of the Company’s common stock. 
  
 WHEREAS, in connection with an IPO, the Company would enter into an underwriting agreement with representatives of the
underwriters under which the Company would agree to sell and the underwriters would agree to purchase the shares of the Company’s common stock to be offered in the IPO (the “Underwriting Agreement”). 
  
 WHEREAS, the Company expects that (subject to approval by the board of
directors and the stockholders of the Company) in anticipation of an IPO, the Company’s certificate of incorporation would be amended (and may be amended and restated) on one or more occasions and the terms of the such amended (or amended and
restated) certificate of incorporation are currently expected to provide that, among other things, (i) Repurchased Shares of Class A Preferred shall not be reclassified as shares of the Company’s common stock, (ii) as of the Repurchase
Effective Time (as defined below), Repurchased Shares of Class A Preferred shall no longer be outstanding and shall automatically be cancelled and retired and shall cease to 

  

 
exist and each holder of any formerly outstanding Repurchased Share of Class A Preferred shall cease to have any rights with respect thereto, other than the
right to receive the payment payable pursuant to Section 2 (of this Agreement), and (iii) immediately following the Repurchase Effective Time (the “Reclassification Effective Time”), each outstanding Class A Preferred Share
(which will not include Repurchased Shares of Class A Preferred) will automatically be reclassified as a number of shares of the Company’s common stock (“Reclassification Stock”) computed by dividing the liquidation value of
such outstanding Class A Preferred Share (plus all accrued and unpaid dividends thereon and, with respect to any outstanding Class A Preferred Share originally issued upon the exercise or conversion of a Class A Preferred Warrant, all dividends that
would have accrued on such share from the date of the original Warrant Certificates through the date of such exercise or conversion had such share been issued on the date of the original Warrant Certificates) by an amount equal to 85% of the per
share price at which the common stock of the Company is proposed to be offered to the public in the IPO, as set forth in the Underwriting Agreement, with cash being paid in lieu of any fractional shares (the “Class A Preferred
Reclassification”). 
  
 WHEREAS, pursuant to the
provisions of Section 18 of the Stockholders Agreement (as defined below), the parties hereto desire to amend the terms thereof. 
  
 WHEREAS, each holder of Class A Preferred Warrants desires to reaffirm its waiver of certain specified advance notice provisions under each of the
original Warrant Certificates and the Common Stock Warrants (as defined below) and the holders of Senior Subordinated Notes (as defined below) desire to reaffirm their waiver of certain specified covenants under the Subordinated Loan Agreement (as
defined below). 
  
 NOW, THEREFORE, the parties hereto agree as
follows: 
  
 1. Purchase and Sale of Repurchased Securities
at the Repurchase Effective Time. 
  
 (a) Purchase of
Class A Preferred Stock and Warrants. Upon the terms and conditions set forth in this Agreement, effective as of the Repurchase Effective Time (and without any action on the part of any Seller or any other Person) each Seller hereby sells,
transfers and assigns to the Company free from all Encumbrances all of such Seller’s right, title and interest in and to the Repurchased Securities set forth opposite such Seller’s name in columns D and E, respectively, on the Schedule
of Sellers (and any Repurchased Warrant Shares issued to such Seller). The purchase price for each Repurchased Share of Class A Preferred shall be (i) the Liquidation Value (as defined in the Company’s Certificate of Incorporation) of such
share, plus (ii) an amount equal to all accrued and unpaid dividends with respect thereto, plus (iii) with respect to any Repurchased Share of Class A Preferred that was originally issued upon the exercise or conversion of a Class A Preferred
Warrant, all dividends that would have accrued on such Repurchased Share of Class A Preferred from the date of the original Warrant Certificates through the date of such exercise or conversion had such share been issued on the date of the original
Warrant Certificates. The purchase price for each Repurchased Warrant shall be (i) the Liquidation Value of a Class A Preferred Share, plus (ii) an amount equal to all dividends that 

  

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would have accrued on a Class A Preferred from the date of the original Warrant Certificates through and including the date of the Repurchase Effective Time
had such share been issued on the date of the original Warrant Certificates, minus (iii) $0.01. The purchase price for any fractional Repurchased Share of Class A Preferred or fractional Repurchased Warrant shall be such fraction multiplied by the
purchase price payable in respect of a whole Repurchased Share of Class A Preferred or whole Repurchased Warrant, respectively. 
  
 (b) Effect on Repurchased Securities. 
  
 (i) Repurchased Shares of Class A Preferred shall not be subject to reclassification as Reclassification Stock and, accordingly, shall not
be reclassified as Reclassification Stock in connection with an IPO. As of the Repurchase Effective Time, Repurchased Shares of Class A Preferred shall no longer be outstanding and shall automatically be cancelled and retired and shall cease to
exist, and each holder of any formerly outstanding Repurchased Share of Class A Preferred shall cease to have any rights with respect thereto, other than the right to receive the payment payable pursuant to Section 2. Any certificate to the
extent formerly representing any Repurchased Shares of Class A Preferred shall, from and after the Repurchase Effective Time, solely represent the right to receive the payment payable pursuant to Section 2. 
  
 (ii) As of the Repurchase Effective Time, Repurchased
Warrants shall no longer be outstanding and shall automatically be cancelled and terminated and shall cease to exist, and each holder of any formerly outstanding Repurchased Warrant shall cease to have any rights with respect thereto, other than the
right to receive the payment payable pursuant to Section 2. Any Warrant Certificate, to the extent formerly representing any Repurchased Warrant shall, from and after the Repurchase Effective Time, solely represent the right to receive the
payment payable pursuant to Section 2. 
  
 2. Payment
of Purchase Price; Certificates and Warrants. 
  
 (a)
Purchase Price. Subject to Section 2(b), on the closing date of the transactions contemplated by the Underwriting Agreement (without regard to any transactions related to the grant of any over-allotment option) (the “IPO
Closing”), the Company shall deliver to each Seller the aggregate purchase price, determined in accordance with Section 1(a) (the “Purchase Price”), for the Repurchased Securities purchased by the Company from such
Seller, together with interest on the unpaid Purchase Price accrued at a rate of 8% per annum from (but not including) the date of the Repurchase Effective Time through and including such date as the Purchase Price is paid in full (the
“Accrued Interest Amount”), by wire transfer of immediately available funds to an account designated by such seller (a “Cash Payment”). If the IPO Closing does not occur on or before the date which is 15 days after
the date of the Repurchase Effective Time, then, subject to Section 2(b), the Company shall use commercially reasonable efforts (including by seeking to obtain any necessary consents, and subject to the receipt of any such consents) to
deliver, in lieu of a Cash Payment, to each Seller as promptly as practicable payment in the form of subordinated notes and/or equity securities of the Company (“Replacement Securities”) having an aggregate value (as determined by
the board of directors of the Company 

  

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in good faith, and provided that the terms of such Replacement Securities must have been approved by Sellers entitled to receive at least 50% of the
aggregate Purchase Price to be received by all Sellers) equal to the aggregate Purchase Price and Accrued Interest Amount to be paid to such Seller for the Repurchased Securities purchased by the Company from such Seller. 
  
 (b) Delivery of Certificates Representing Repurchased Securities.
Promptly after the execution of this Agreement, each Seller shall deliver to the offices of the Company’s attorneys, Kirkland & Ellis, Attn: Robert Kiburz, 200 East Randolph Drive, Chicago, Illinois 60601, the stock certificates and/or
Warrant Certificates representing the Repurchased Securities to be sold by such Seller accompanied by duly executed assignments in the form of Exhibit A attached hereto (provided that such endorsements shall not be deemed effective until the
Repurchase Effective Time). The Company shall not be obligated to deliver the Cash Payment or Replacement Securities to a Seller until such Seller shall have so delivered the stock certificates and/or Warrants Certificates representing, immediately
prior to the Repurchase Effective Time, the Repurchased Securities purchased from such Seller accompanied by such duly executed assignments; provided that if any stock certificates and/or Warrant Certificates representing, immediately prior
to the Repurchase Effective Time, the Repurchased Securities to be sold by a Seller shall have been lost, stolen or destroyed, upon (i) the making of an affidavit of that fact by the Person claiming such stock certificate and/or Warrant Certificate
to be lost, stolen or destroyed, and (ii) if such Person is not an institutional investor or, with respect to a Warrant Certificate, a Purchaser (as defined in the original Warrant Certificates), the posting by such Person of a bond, if required by
the Company, in such reasonable form and amount as the Company shall require as indemnity against any claim that may be made against the Company with respect to such stock certificate and/or Warrant Certificate, then, for purposes of this Section
2(b), such stock certificate and/or Warrant Certificate shall be deemed to have been delivered to the Company. In the event that this Agreement is terminated pursuant to Section 8, the Company shall return, or cause to be returned,
to each Seller any stock certificates or Warrant Certificates that have been delivered by such Seller to the Company pursuant to this Section 2(b). 
  
 (c) Warrants and/or Shares Not Purchased. In the event that less than all of the outstanding Class A Preferred Warrants provided for by a Warrant
Certificate are sold pursuant to this Agreement, then promptly after the Repurchase Effective Time (and after delivery of such Warrant Certificate in accordance with Section 2(b)) the Company shall issue to the holder of such Warrant
Certificate a new warrant of like tenor, dated the date of the original Warrant Certificate and entitling the holder thereof to receive, upon due exercise, the number of shares of Reclassification Stock equal to the number of such shares of
Reclassification Stock (subject to adjustments subsequent to the Reclassification Effective Time as nearly equivalent as possible to the adjustments provided for in Sections 2, 3 and 4 of the original Warrant Certificates) that would have been
received by such holder if the remaining outstanding Class A Preferred Warrants had been duly exercised as of the Reclassification Effective Time and the resulting Class A Preferred Shares issued upon such exercise had been reclassified as
Reclassification Stock as of the Reclassification Effective Time. In the event that a stock certificate delivered pursuant to Section 2(b) represents any Class A Preferred Shares that are not Repurchased Securities (“Outstanding
Shares of Class A Preferred”), then the Company shall, as soon as is practicable after the Reclassification Effective Time, issue to the holder thereof a stock 

  

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certificate or certificates representing the number of shares of Reclassification Stock issuable by reason of the reclassification of such Outstanding Shares
of Class A Preferred. 
  
 3. Conditions of Obligation to
Purchase and Sell. The obligation of each Seller to sell the Repurchased Securities to the Company, and the obligation of the Company to purchase the Repurchased Securities, at the Repurchase Effective Time is subject to the satisfaction of
the following conditions: 
  
 (a) Consent Under Bank Credit
Agreement. The Company shall have obtained a consent under the Credit Agreement, dated as of June 11, 2003, by and among Symmetry Medical Inc., Olympus/Symmetry Holdings LLC, Wachovia Bank, National Association as administrative agent and
several financial institutions named therein as lenders, as amended from time to time, with respect to the repurchase of the Repurchased Securities pursuant to Section 1; provided that such consent shall not be required to include any
consent to any payment of the Purchase Price or Accrued Interest pursuant to Section 2. 
  
 (b) S-1 Registration Statement Effective. The Form S-1 Registration Statement shall have become effective in accordance with the provisions of the Securities Act. 
  
 (c) Waiver. Any condition specified in this Section 3 may be
waived by any Seller, solely as to such Seller. No such waiver will be effective against any Seller or the Company unless it is set forth in a writing executed by such Seller or the Company, as applicable. 
  
 4. Representations and Warranties of the Sellers. Each Seller
hereby, severally and not jointly, represents and warrants to the Company as follows: 
  
 (a) Ownership. All of the Repurchased Securities set forth opposite such Seller’s name on the Schedule of Sellers are owned of record and beneficially by such Seller, and such Seller has good and
marketable title to such securities, free and clear of all security interests, claims, liens, pledges, options, encumbrances, charges, agreements, voting trusts, proxies and other arrangements or restrictions whatsoever
(“Encumbrances”), except the Stockholders Agreement, dated as of October 18, 2000, among the Company and certain of its stockholders and warrantholders, as amended from time to time (the “Stockholders Agreement”).
At the Repurchase Effective Time, such Seller shall transfer to the Company good and marketable title to the Repurchased Securities, free and clear of all Encumbrances. 
  
 (b) Authorization. This Agreement has been duly authorized, executed and delivered by such Seller and constitutes a
valid and legally binding obligation of such Seller, enforceable in accordance with its terms, subject to the availability of equitable remedies and to the laws of bankruptcy and other similar laws affecting creditors’ rights generally.

  
 (c) Conflicts. The execution, delivery and performance
of this Agreement by such Seller does not conflict with, violate or result in the breach of, or create any lien or encumbrance on such Seller’s Repurchased Securities pursuant to, any agreement, instrument, 

  

 5 

 
order, judgment, decree, law or governmental regulation to which such Seller is a party or is subject or by which such Seller’s Repurchased Securities
are bound. 
  
 5. Representations and Warranties of the
Company. The Company represents and warrants to the Sellers as follows: 
  
 (a) Authorization. The execution and performance of this Agreement have been authorized by all necessary corporate action on the part of the Company, and this Agreement when executed and delivered shall
constitute a valid and legally binding obligation of the Company, enforceable in accordance with its terms, subject to the availability of equitable remedies and to the laws of bankruptcy and other similar laws affecting creditors’ rights
generally. 
  
 6. Stockholders Agreement Amendment.
In accordance with Section 18 of the Stockholders Agreement, the parties to this Agreement hereby approve the following amendment and waiver with respect to the Stockholders Agreement: 
  
 Section 10(a) of the Stockholders Agreement, as amended pursuant to the July
Securities Purchase Agreement, is hereby amended by replacing the proviso at the end of the section with the following: 
  
 “; provided, however, that the term “Piggyback Registration” shall not include any registration filed on or before January
31, 2005 (or any amendments filed with respect to such a registration) with respect to an initial public offering of securities of the Company (a “2004-5 IPO”).” 
  
 The Stockholders Agreement, as amended pursuant to the terms of this Section 6, shall continue in full force and effect after the
date of this Agreement, provided that any registration rights relating to a 2004-5 IPO (as defined in the above amendment to the Stockholders Agreement), including any rights to receive notice thereof, are hereby waived. 
  
 7. Waivers under Warrant Certificates and Subordinated Loan
Agreement. 
  
 (a) Each party hereto that holds Class A
Preferred Warrants hereby reaffirms its waiver, as made pursuant to the July Securities Purchase Agreement, of any right to receive prior notice pursuant to Section 7 of the original Warrant Certificates with respect to the Class A Preferred
Reclassification or the Common Stock Split. Each holder of Common Stock Purchase Warrants (the “Common Stock Warrants”) originally issued in connection with the execution and delivery of the Senior Subordinated Loan Agreement (the
“Subordinated Loan Agreement”) dated June 11, 2003 among the Company and the lenders named therein, hereby reaffirms its waiver, as made pursuant to the July Securities Purchase Agreement, of any right to receive prior notice
pursuant to Section 7 of the original certificates providing for the Common Stock Warrants with respect to the Class A Preferred Reclassification or the Common Stock Split. 
  

 6 

 (b) Each party hereto that holds 12% Senior Subordinated Notes due 2011 (“Senior Subordinated
Notes”), issued under the Subordinated Loan Agreement, hereby reaffirms its consent, as made pursuant to the July Securities Purchase Agreement, to the Class A Preferred Reclassification, the Common Stock Split and/or the repurchase of the
Repurchased Securities pursuant to Section 1; provided that such consent shall not be apply to any payment of the Purchase Price or Accrued Interest pursuant to Section 2. Each party hereto that was an original Lender (as
defined in the preamble to the Subordinated Loan Agreement) represents and warrants to the Company that such party continues to own the Senior Subordinated Notes originally issued to such party (or has caused the current owner of any Senior
Subordinated Note that such party has sold, assigned, transferred or negotiated to deliver a written consent to the Company in the form of the immediately preceding sentence). 
  
 8. Termination. In the event that the Repurchase Effective Time has not occurred prior to 11:59 PM Eastern
Time on January 31, 2005 (the “Termination Date”), then this Agreement shall terminate automatically. Upon termination, this Agreement will forthwith become void and there will be no liability on the part of any party hereto to any
other party hereto or its stockholders or directors or officers in respect thereof, except that the provisions of this Section 8, the last sentence of Section 2(b) and Sections 6 and 7 shall continue in full force and
effect. 
  
 9. Survival of Representations and
Warranties. All representations, warranties and covenants contained herein or made in writing by any party in connection herewith shall survive the execution and delivery of this Agreement (and shall survive the Repurchase Effective Time and
the performance of obligations hereunder). 
  
 10. Tax
Withholding for Non-U.S. Persons. The Seller acknowledges that the Company, in order to comply with U.S. withholding tax requirements that may arise as a result of the transactions contemplated by this Agreement, is authorized to withhold a
portion of the proceeds from the repurchase and, to the extent necessary, shares of common stock to be received in the Class A Preferred Reclassification from non-U.S. persons to the extent necessary to satisfy such withholding obligations. To the
extent any such amounts are deducted and withheld, such amounts shall be treated for all purposes under this Agreement as having been paid to the Seller to whom such amounts would otherwise have been paid. 
  
 11. Indemnification. Each Seller shall indemnify, severally and
not jointly, the Company and hold the Company harmless against and in respect of any and all losses, liabilities, damages, obligations, claims, encumbrances, costs and expenses (including, without limitation, costs of suit and attorneys’ fees
and expenses) incurred by the Company resulting from any breach of any representation, warranty, covenant or agreement made by such Seller herein. 
  
 12. Complete Agreement; Amendments. This Agreement constitutes the entire agreement between the parties hereto regarding the subject matter
of this Agreement and supersedes and preempts any prior understandings, agreements or representations, written or oral, which may have related to the subject matter hereof. Any provision of this Agreement may be amended by the Company and any
Seller, solely as to such Seller. Other than amendments to 

  

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the Schedule of Sellers in accordance with the terms described thereon, no amendment of this Agreement will be effective against a Seller or the
Company unless it is set forth in a writing executed by such Seller and the Company. 
  
 13. Counterparts. This Agreement may be executed in two or more counterparts, each of which shall be deemed to be an original, but all of which taken together shall constitute one and the same agreement.
This Agreement may be executed by, without limitation, facsimile signature (signature pages hereto may be delivered, without limitation, by facsimile, e-mail or other electronic means). The effectiveness of this Agreement is not conditioned on any
specified Person or Persons, or Persons holding any specified number of Class A Preferred Shares or Class A Preferred Warrants, executing this Agreement. Accordingly, the effectiveness of this Agreement as between the Company and each of those
Persons listed on the Schedule of Sellers who do execute this Agreement (i.e., Sellers) shall not be limited or otherwise affected by a failure of any Person or Persons listed on the Schedule of Sellers (or listed following the caption “The
Sellers:” on the signature pages hereto) to execute this Agreement. 
  
 14. Further Assurances. After the Repurchase Effective Time, as and when requested by the Company, each Seller shall, without further consideration, execute and deliver all such instruments of conveyance
and transfer and shall take such further actions as the Company may deem necessary or desirable in order to transfer the Repurchased Securities to the Company and to carry out fully the provisions and purposes of this Agreement. 
  
 15. Successors and Assigns. This Agreement is intended to bind
and inure to the benefit of and be enforceable by the Company and the Sellers and their respective successors and assigns. 
  
 16. Choice of Law. The construction, validity, interpretation and enforcement of this Agreement shall be governed by the internal law, and
not the law of conflicts, of the State of Delaware. 
  
 17.
Certain Defined Terms. For purposes of this Agreement: 
  
 “Class A Preferred Warrant” means the right to purchase a Class A Preferred Share from the Company, at the initial purchase price per share of $0.01, pursuant to a Class A Preferred Stock Purchase
Warrant (including any such warrant certificates issued in substitution therefor, a “Warrant Certificate”) originally issued in connection with the execution and delivery of the Senior Subordinated Loan Agreement dated June 11, 2003
among the Company and the lenders named therein; and “Class A Preferred Warrants” refers to multiple Class A Preferred Warrants, which may be evidenced by one or more Warrant Certificates. 
  
 “Common Stock Split” means the conversion,
as of the Repurchase Effective Time, of each then outstanding share of the Company’s common stock (which will not include the Reclassification Stock) into a specified number of shares of the Company’s common stock, with cash being paid in
lieu of any fractional shares, 
  

 8 

 “Person” means an individual, a partnership, a corporation, a limited
liability company, a limited liability partnership, an association, a joint stock company, a trust, a joint venture, an unincorporated organization and a governmental entity or any department, agency or political subdivision thereof. 
  
 “Repurchase Effective Time” means the date
and time that an Underwriting Agreement has been executed by each of the parties thereto (which execution may, without limitation, be by facsimile signature) and executed signature pages of the representatives of the underwriters that are parties to
the Underwriting Agreement have been delivered to the Company (which delivery may, without limitation, be by facsimile, e-mail or other electronic means). 
  
 “Repurchased Warrant Shares” means any Class A Preferred Shares issued, after the date hereof, pursuant to the exercise
or conversion of a Class A Preferred Warrant to the extent that the Person exercising or converting such Class A Preferred Warrant would, after such exercise or conversion, hold less than the number of Class A Preferred Warrants that the Company has
agreed to purchase from such Person pursuant to this Agreement. 
  
 *     *     *     * 
  

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 IN WITNESS WHEREOF, the parties have executed this Securities Purchase Agreement as of the day and year
first above written. 
  

			
	The Company:
	
	 SYMMETRY MEDICAL INC.

		
	 By:
	 	 
	 Name:
	 	 Fred Hite

	 Its:
	 	Senior Vice President and Chief Financial Officer
	
	The Sellers:
	
	 OLYMPUS/SYMMETRY HOLDINGS LLC

		
	 By:
	 	 
	 Name:
	 	 
	 Its:
	 	 
	
	 OLYMPUS GROWTH FUND III, L.P.

		
	 By:
	 	 OGP III, L.L.C.

	 Its:
	 	 General Partner

		
	 By:
	 	 Conroy, L.L.C.

	 Its:
	 	 Member

		
	 By:
	 	 
	 Name:
	 	 
	 Its:
	 	 
	
	 OLYMPUS GROWTH CO-INVESTMENT FUND III, L.P.

		
	 By:
	 	 OGP III, L.L.C.

	 Its:
	 	 General Partner

		
	 By:
	 	 Conroy, L.L.C.

	 Its:
	 	 Member

		
	 By:
	 	 
	 Name:
	 	 
	 Its:
	 	 

  

 (Continuation of Signature Pages to Securities Purchase Agreement) 
  

			
	 OLYMPUS EXECUTIVE FUND, L.P.

		
	 By:
	 	 OEF, L.P.

	 Its:
	 	 General Partner

		
	 By:
	 	 Conroy, L.L.C.

	 Its:
	 	 General Partner

		
	 By:
	 	 
	 Name:
	 	 
	 Its:
	 	 
	
	WINDJAMMER MEZZANINE & EQUITY FUND II, L.P., a Delaware limited partnership
		
	 By:
	 	 Windjammer Capital Investors, LLC

	 Its:
	 	 General Partner

		
	 By:
	 	 
	 Name:
	 	 
	 Its:
	 	 
	
	 ANTARES CAPITAL CORPORATION

		
	 By:
	 	 
	 Name:
	 	 
	 Its:
	 	 
	
	 RBS EQUITY CORPORATION

		
	 By:
	 	 
	 Name:
	 	 
	 Its:
	 	 

  

 (Continuation of Signature Pages to Securities Purchase Agreement) 
  

			
	CIT LENDING SERVICES CORPORATION
		
	 By:
	 	 
	 Name:
	 	 
	 Its:
	 	 
	
	 KNOWLEDGE VENTURES LLC

		
	 By:
	 	 
	 Name:
	 	 
	 Its:
	 	 
	
	 METTIS GROUP LIMITED

		
	 By:
	 	 
	 Name:
	 	 
	 Its:
	 	 

  

	
	
	 
	 Roger Hand

	
	 
	 Brian Salyer

	
	 
	 Paul Salyer

	
	 
	 William Hough, Jr.

	
	 
	 D. Darin Martin

	
	 
	 Andrew Miclot

  

 (Continuation of Signature Pages to Securities Purchase Agreement) 
  

	
	
	 
	 Scott Amstutz (individually and as custodian for
 Isaac Amstutz under the Indiana Transfers to
 Minors Act)

	
	 
	 Lee Crowe

	
	 
	 Timothy Wood

	
	 
	 Steffan Burns

	
	 
	 Donald McPherson, Jr.

	
	 
	 Sibyl Nelson

	
	 
	 Frank Milne

	
	 
	 Max Elder

	
	 
	 William Flanagan

	
	 
	 Harry Rockwell

	
	 
	 Daniel Sands

	
	 
	 Linda Scalet

	
	 
	 Todd Wolford

	
	 
	 Randy Woodcock

  

 (Continuation of Signature Pages to Securities Purchase Agreement) 
  

	
	
	 
	 Richard Senior

	
	 
	 Matthew Bell

	
	 
	 Steve Womack

	
	 
	 Tony Huison

	
	 
	 Mark Corry

	
	 
	 Alan Wall

	
	 
	 Dave Glossop

	
	 
	 Lynne Norman

	
	 
	 Chris Carney

	
	 
	 Matt Rudd

	
	 
	 Brian Leyrer

	
	 
	 Pat Hefron

	
	 
	 Kim Campbell

	
	 
	 Tom Sherer

	
	 
	 Brian Moore

  

 (Continuation of Signature Pages to Securities Purchase Agreement) 
  

			
	 POTENZA ENTERPRISES LIMITED

		
	 By:
	 	 
	Name:	 	 
	Its:	 	 

  

  
 EXHIBIT A 
  
 ASSIGNMENT SEPARATE FROM CERTIFICATE 
 [For transfers of Class A Preferred Stock 
 (and appointment of attorney in fact)] 
  
 FOR VALUE RECEIVED, the undersigned, subject to the terms and conditions of the Securities Purchase Agreement dated as of November 17, 2004, does hereby sell, assign and transfer unto Symmetry Medical Inc., a Delaware
corporation (the “Corporation”), the number of shares of Class A Preferred Stock, par value $.01 per share, of the Corporation, standing in his or her or its name on the books of said Corporation represented by the Certificate Number(s)
set forth on Annex A attached hereto, and does hereby irrevocably constitute and appoint the secretary of the Corporation attorney to transfer the said stock on the books of the Corporation with full power of substitution in the premises.

  
 The undersigned does hereby irrevocably constitute and appoint
Robert A. Kiburz and Gregory C. Vogelsperger each as attorney in fact to make additional changes and corrections to Annex A, in accordance with the Securities Purchase Agreement, on behalf of, and as representative of the undersigned. 
  

					
			
	 Dated:                     
    , 2004
	 	 	 	  
	 	 	 	 	 [Seller]

  

  
 Annex A 
  

			
	 Certificate Number

	  	 Shares of
 Class A Preferred Stock

  

  
 ASSIGNMENT 

[For transfers of Warrants] 
  
 FOR VALUE RECEIVED, the undersigned registered holder of the within Warrant, subject to the terms and conditions of the Securities Purchase
Agreement dated as of November             , 2004, hereby sells, assigns and transfers unto Symmetry Medical Inc., a Delaware corporation (the “Corporation”), the right
represented by such Warrant to purchase the number of shares set forth on Annex A attached hereto of Class A Preferred Stock, par value $.01 per share, of the Corporation, to which such Warrant relates, and hereby irrevocably constitutes and
appoints the secretary of the Corporation attorney to make such transfer on the books of the Corporation maintained for such purpose, with full power of substitution in the premises. 
  
 The undersigned does hereby irrevocably constitute and appoint Robert A. Kiburz and Gregory C. Vogelsperger each as attorney
in fact to make additional changes and corrections to Annex A, in accordance with the Securities Purchase Agreement, on behalf of, and as representative of the undersigned. 
  

					
			
	 Dated:                     
    , 2004
	 	 	 	  
	 	 	 	 	 [Seller]

  

  
 Annex A 
  

			
	 Warrant
 Certificate Number

	  	 Shares of Class A Preferred Stock Represented by CertificateAmendment to Securities Purchase Agreement

  
 Exhibit 10.21

  
 Amendment to Securities Purchase Agreement

  
 This amendment (this “Amendment”), dated
as of December 1, 2004, by and between Symmetry Medical Inc. (the “Company”) and each of the Persons set forth on the Schedule of Sellers that execute this Amendment (each, a “Seller” and, collectively, the
“Sellers”), confirms, clarifies and amends (pursuant to Section 11 of the Purchase Agreement (defined below)), as between the Company and each of such Persons, the Securities Purchase Agreement, dated as of November 17, 2004, as
amended from time to time, between the Company and the other parties thereto (the “Purchase Agreement”). Capitalized terms used but not defined herein have the meaning given to them in the Purchase Agreement. 
  
 Notwithstanding anything to the contrary contained in the Purchase Agreement,
the Company hereby agrees with each of the Sellers as follows: 
  
 1. The introduction to the Schedule of Sellers is deemed to be replaced in its entirety by the introduction attached hereto as Exhibit A. 
  
 2. Each Seller acknowledges that the Company may, pursuant to Clause (I) of the Schedule of Sellers, reduce or increase pro rata among the Sellers (or, in
the case of an increase, pro rata among the Sellers subject to such increase)the amount of Repurchased Securities to be purchased by the Company pursuant to the Purchase Agreement and that such reduction or increase may be determined by, among other
things in case of a reduction, a formula based on the expected net proceeds of the planned IPO. 
  
 3. Other than a expressly modified as between the Company and the Sellers pursuant to foregoing provisions, the remaining terms of the Purchase Agreement
remain in full force and effect. 
  
 * * * 
  

 If you agree with the foregoing, please sign and return a copy of this Amendment, which will constitute
our agreement with respect to the subject matter hereof. This Amendment will be deemed dated as of the date of the Purchase Agreement. 
  

			
	The Company:
	
	SYMMETRY MEDICAL INC.
		
	 By:
	 	 
	 Name:
	 	 Fred Hite

	 Its:
	 	Senior Vice President and Chief Financial Officer
	
	The Sellers:
	
	 OLYMPUS/SYMMETRY HOLDINGS LLC

		
	 By:
	 	 
	 Name:
	 	 
	 Its:
	 	 
	
	 OLYMPUS GROWTH FUND III, L.P.

		
	 By:
	 	 OGP III, L.L.C.

	 Its:
	 	 General Partner

		
	 By:
	 	 Conroy, L.L.C.

	 Its:
	 	 Member

		
	 By:
	 	 
	 Name:
	 	 
	 Its:
	 	 
	
	OLYMPUS GROWTH CO-INVESTMENT FUND III, L.P.
		
	 By:
	 	 OGP III, L.L.C.

	 Its:
	 	 General Partner

		
	 By:
	 	 Conroy, L.L.C.

	 Its:
	 	 Member

		
	 By:
	 	 
	 Name:
	 	 
	 Its:
	 	 

  

 (Continuation of Signature Pages to Amendment to Securities Purchase Agreement) 
  

			
	 OLYMPUS EXECUTIVE FUND, L.P.

		
	 By:
	 	 OEF, L.P.

	 Its:
	 	 General Partner

		
	 By:
	 	 Conroy, L.L.C.

	 Its:
	 	 General Partner

		
	 By:
	 	 
	 Name:
	 	 
	 Its:
	 	 
	
	 ANTARES CAPITAL CORPORATION

		
	 By:
	 	 
	 Name:
	 	 
	 Its:
	 	 
	
	 RBS EQUITY CORPORATION

		
	 By:
	 	 
	 Name:
	 	 
	 Its:
	 	 

  

 3 

 (Continuation of Signature Pages to Amendment to Securities Purchase Agreement) 
  

			
	 CIT LENDING SERVICES CORPORATION

		
	 By:
	 	 
	 Name:
	 	 
	 Its:
	 	 
	
	 KNOWLEDGE VENTURES LLC

		
	 By:
	 	 
	 Name:
	 	 
	 Its:
	 	 
	
	 
	 Roger Hand

	
	 
	 Brian Salyer

	
	 
	 Paul Salyer

	
	 
	 William Hough, Jr.

	
	 
	 D. Darin Martin

	
	 
	 Andrew Miclot

  

 4 

 (Continuation of Signature Pages to Amendment to Securities Purchase Agreement) 
  

	
	
	 
	Scott Amstutz (individually and as custodian for Isaac Amstutz under the Indiana Transfers to Minors Act)
	
	 
	 Lee Crowe

	
	 
	 Timothy Wood

	
	 
	 Steffan Burns

	
	 
	 Donald McPherson, Jr.

	
	 
	 Sibyl Nelson

	
	 
	 Frank Milne

	
	 
	 Max Elder

	
	 
	 William Flanagan

	
	 
	 Harry Rockwell

	
	 
	 Daniel Sands

	
	 
	 Linda Scalet

	
	 
	 Todd Wolford

	
	 
	 Randy Woodcock

  

 5 

 (Continuation of Signature Pages to Amendment to Securities Purchase Agreement) 
  

	
	
	 
	 Richard Senior

	
	 
	 Matthew Bell

	
	 
	 Steve Womack

	
	 
	 Tony Huison

	
	 
	 Mark Corry

	
	 
	 Alan Wall

	
	 
	 Dave Glossop

	
	 
	 Lynne Norman

	
	 
	 Chris Carney

	
	 
	 Matt Rudd

	
	 
	 Brian Leyrer

	
	 
	 Pat Heffron

	
	 
	 Kim Campbell

	
	 
	 Tom Sherer

	
	 
	 Brian Moore

  

 6 

 (Continuation of Signature Pages to Amendment to Securities Purchase Agreement) 
  

			
	POTENZA ENTERPRISES LIMITED
		
	 By:
	 	 
	 Name:
	 	 
	 Its:
	 	 

  

 7

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