Document:

Amended License Agreement

 Exhibit 10.28 
 AMENDED LICENSE AGREEMENT 
 THIS LICENSE AGREEMENT
(“License Agreement”) is made and entered into as of this 30th day of December, 2011 (the “Effective Date”), by Alphatec Spine, Inc. (“Alphatec” or “Licensee”), on the one hand, and Cross Medical Products, LLC
(“Cross”), on the other hand. Alphatec and Cross are each individually referred to herein as a “Party,” and collectively as the “Parties.” 

RECITALS 
 A. Cross, through its affiliate EBI, LLC, is the owner of all rights, title, and interest in and to United States Patent Nos. 5,466,237 and 5,474,555. 

B. Both Cross and Alphatec are parties to an Original License Agreement, dated April 23, 2003, that licensed the subject matter of
the 5,466,237 Patent and the 5,474, 555 Patent to Alphatec. 
 C. In 2009, a dispute arose between the Parties concerning the
amount of royalties due under the Original License Agreement and the Alphatec products that are considered “Licensed Product” as defined in the Original License Agreement. 

D. On February 12, 2010, Cross filed an action entitled Cross Medical Products, LLC v. Alphatec Spine, Inc., Case No.
SACV10-00176-MRP (MLGx) in the United States District Court for the Central District of California (the “License Action”). 
 E. In the License Action, Cross alleged that Alphatec had breached an April 23, 2003, License Agreement between them by failing to pay royalties on certain “Licensed Product,” as defined in
that License Agreement. Alphatec denied the allegations and asserted affirmative defenses and counterclaims. 
 F. The License
Action, including the Complaint, defenses and counterclaims, and any contemplated appeal, is collectively referred to herein as the “Dispute.” 
 G. In settlement of the Dispute, the Parties have agreed to enter into this Amended License Agreement, which is expressly meant to, and does, modify the Original License Agreement. 

ARTICLE 1. 

DEFINITIONS 
 1.1 “the ‘555 Patent” shall mean U.S. Patent No. 5,474,555; all patents issued from any divisions, reissues, and continuations of U.S. Patent No. 5,474,555 or from any application
on which U.S. Patent No. 5,474,555 is based or from which it claims priority; and all foreign patents or patent applications that correspond to or claim priority from U.S. Patent No. 5,474,555 or any application on which it is based or
from which it claims priority. 

 1.2 “the ‘237 Patent” shall mean U.S. Patent No. 5,466,237; all patents
issued from any divisions, reissues, and continuations of U.S. Patent No. 5,466,237 or from any application on which U.S. Patent No. 5,466,237 is based or from which it claims priority; and all foreign patents or patent applications that
correspond to or claim priority from U.S. Patent No. 5,466,237 or any application on which it is based or from which it claims priority. 
 1.3 “Licensed Product” shall refer to the polyaxial screw component of any spinal implant products, devices or solutions that stabilize the spine during spinal fusions. 

1.4 “Original License Agreement” shall mean the Agreement between Cross and Alphatec dated April 23, 2003, that licensed
the subject matter of the ‘555 Patent and the ‘237 Patent to Alphatec. 
 ARTICLE 2. 

LICENSE GRANT 
 2.1 Cross hereby grants to Licensee and its current subsidiaries and affiliates a non-exclusive, non-transferable (except as set forth in Article 7), right and license, under the ‘237 Patent and
under the ‘555 Patent to make, have made, use, sell, offer for sale, and import the Licensed Products. 
 2.2 Other than as
set forth in Section 2.1, Licensee and its current subsidiaries and affiliates shall not have any right to sublicense any of the rights granted in Article 2.1 to any third party without the prior written consent of Cross. 

ARTICLE 3. 

ROYALTY AND PAYMENTS 
 3.1 Royalties. 
 3.1.1 Up-front payment. Alphatec
shall pay Cross royalties of $5,000,000 no later than January 6, 2012. 
 3.1.2 Future payments.
Alphatec shall pay royalties of $13,000,000 in thirteen equal quarterly installments of $1,000,000. The first payment shall be due no later than August [***], 2012, and further quarterly payments shall be due no later than November [***],
February [***], May [***], and August [***] of each year until a total of $13,000,000 is paid on August [***], 2015. 
 3.1.3 Notwithstanding the timing of the payments set forth above, which timing is for the convenience of Alphatec, no royalty is due, owing, or being collected on Licensed Product made, used, sold,
offered for sale, or imported after the expiration of the latest-expiring of the ‘237 Patent and the ‘555 Patent. 

  
 Portions of
this Exhibit were omitted, as indicated by [***], and have been filed separately with the Secretary of the Commission pursuant to the Registrant’s application requesting confidential treatment under Rule 24b-2 of the Securities Exchange
Act of 1934, as amended. 
 2 

 3.2 Manner of Payment. 

3.2.1 All payments required under this Agreement shall be paid in U.S. dollars, without deduction of taxes or any other
costs of any kind, and shall be wired to the bank account of Cross using the following wiring instructions: 
 [***] 

3.2.2 Cross may, from time to time, change these payment instructions by giving Licensee 10 days’ notice under
Article 8. 
 3.3 Interest. If any payment is not made by Licensee by the date set forth in this Agreement, interest
shall be payable on the past due amounts at the rate equal to the legal rate (under California law), from the date payment was due until the date of the actual payment. 
 3.4 These payments are being made as part of a compromise of a dispute and to settle litigation regarding the Original License Agreement. 

3.5 Regardless of any ruling by a court regarding the scope, validity, or enforceability of the ‘237 Patent or the ‘555 Patent,
including any ruling construing any claims of either Patent; any finding that either Patent does not read on a particular product, device, or apparatus; or any decision that a particular product, device, or apparatus does not infringe either Patent:

 3.5.1 This Agreement shall remain in full force and effect without modification, and the royalties to be paid
under it shall remain fully due and payable, and 
 3.5.2 All payments made under this Agreement, and the
Original License Agreement, shall be nonrefundable. 
 ARTICLE 4. 

REPRESENTATIONS AND WARRANTIES 
 4.1 Cross represents, warrants, and covenants that (a) it has the full right and authority to enter into this Agreement and grant the right and licenses granted in this Agreement, and (b) it has
not previously granted and will not grant any rights or licenses in conflict with the rights and licenses granted in this Agreement. 
 4.2 The undersigned represent and warrant that they have authority to execute this Agreement on behalf of the respective Parties and to carry out all obligations imposed under this Agreement. The
undersigned have read, understand, and agree to the terms of this Agreement and have had the opportunity to consult with counsel regarding this Agreement. 
 ARTICLE 5.  
 TERM AND TERMINATION 

5.1 This Agreement shall remain in effect until the expiration of the last-expiring patent of the ‘237 Patent and the ‘555
Patent, unless terminated earlier under this Article. 

  
 Portions of
this Exhibit were omitted, as indicated by [***], and have been filed separately with the Secretary of the Commission pursuant to the Registrant’s application requesting confidential treatment under Rule 24b-2 of the Securities Exchange
Act of 1934, as amended. 
  
 3 

 5.2 Notice and Opportunity to Cure. 

5.2.1 If Licensee fails to make any payment required under this Agreement, Licensee shall be in default. 

5.2.2 In the event of a default or breach of any term of this License Agreement, the aggrieved Party shall give written
notice of the default or breach by facsimile, personal service, overnight delivery by a nationally recognized courier, or first class registered or certified mail, return receipt requested, to the other Party at the addresses identified below in
Article 7. The other Party shall then have fifteen (15) business days to rectify the alleged default or breach and shall provide written notice to the complaining Party of steps taken to rectify the alleged default or breach (the “Cure
Period”). The complaining Party shall withhold any legal action during the Cure Period, and to the extent that any alleged default or breach shall be cured within the Cure Period, the Parties agree to treat such default or breach as though
it had not occurred. 
 5.3 Failure to Cure. Upon Licensee’s failure to cure any default as set forth in Article
5.2, Cross may, at its sole discretion: 
 5.3.1 Sue for breach of this Amended License Agreement. In the event
of such a suit, Licensee (a) agrees that all unpaid royalties as set forth in Article 3 of this Agreement become immediately due and payable, and (b) waives all defenses to a claim for breach of contract, except defenses based on payments
actually made by Alphatec under this Amended License Agreement. 
 5.3.2 Declare that Licensee has breached this
Amended License Agreement and therefore seek entry of a consent judgment in a form substantially similar to Exhibit 1. In such an event, Licensee is deemed to have consented to the entry of such judgment, and the amount of the judgment shall equal
[***], less any royalty payments made by Alphatec under this Amended License Agreement). 
 5.4 Cross may terminate this Amended
License Agreement without notice if a receiver is appointed for Licensee or proceedings are commenced by, for, or against Licensee under any bankruptcy, insolvency, or debtor’s relief law. 

5.5 Article 6 survives a termination of this Amended License Agreement under Article 5.3.2 above. 

ARTICLE 6.  
 WAIVERS 
 6.1 Licensee expressly waives any right it may have to
seek to invalidate, reexamine, or otherwise challenge the ‘237 Patent or the ‘555 Patent, or to seek a ruling that any of its products do not infringe the ‘237 Patent or the ‘555 Patent. 

  
 Portions of
this Exhibit were omitted, as indicated by [***], and have been filed separately with the Secretary of the Commission pursuant to the Registrant’s application requesting confidential treatment under Rule 24b-2 of the Securities Exchange
Act of 1934, as amended. 
  
 4 

 6.2 Licensee expressly waives its right to challenge the validity or enforceability of this
Agreement, or the Original License Agreement, on any ground already decided against it, or that was raised or could have been raised by Licensee, in the License Action, including without limitation defenses based on patent misuse or public policy.

 6.3 The waivers set forth in this Article 6 shall not apply with respect to any action commenced by Licensor in which it
claims that the Licensee or its current subsidiaries or affiliates have infringed either the ‘237 Patent or the ‘555 Patent. 
 ARTICLE 7.  
 ASSIGNMENT 

7.1 The Parties may assign any or all of their rights or delegate any or all of their duties under this Agreement only upon the prior
written consent of the other party. But such consent shall not be unreasonably withheld in the event that a party wishes to assign this Agreement to a purchaser of all or substantially all of its assets relating to the ‘237 Patent, the
‘555 Patent, or the Licensed Products. 
 ARTICLE 8.  

NOTICES 
 8.1 All notices and other communications among the Parties in connection with this Agreement shall be in writing addressed to the following persons or Parties, and shall be deemed duly served, given and
received (a) on the date of service, if served personally or sent be telex or facsimile transmission (with appropriate confirmation of receipt) to the Party to whom notice is to be given, or (b) on the fourth day after mailing, if mailed
by first class registered or certified mail, return receipt requested, postage pre-paid in the United States mail, or (c) on the next day if sent by a nationally recognized courier for next day service and so addressed as follows: 

  
 Portions of
this Exhibit were omitted, as indicated by [***], and have been filed separately with the Secretary of the Commission pursuant to the Registrant’s application requesting confidential treatment under Rule 24b-2 of the Securities Exchange
Act of 1934, as amended. 
  
 5 

  

			
	If to Alphatec:	 	 President and CEO, Alphatec Spine,
 Inc.

		
		 	 5818 El Camino Real

Carlsbad, CA 92008

		
	and	 	 General Counsel and SVP, Alphatec
 Spine, Inc.

		
		 	 5818 El Camino Real

Carlsbad, CA 92008

		
	If to Cross or EBI:	 	 Vice President Finance, EBI LLC,
 d/b/a Biomet Spine and Bone Healing

		
		 	 100 Interpace Parkway
 Parsippany, New Jersey 07054

		
	and	 	 Vice President and Division

Counsel, EBI LLC d/b/a Biomet
 Spine and Bone
Healing

		
		 	 100 Interpace Parkway
 Parsippany, New Jersey 07054

 8.2 The Parties, by like notice, may designate another or additional address(es), facsimile number(s) or
person(s) to which notices shall be given in connection with this Agreement. 
 ARTICLE 9.  

GENERAL PROVISIONS 
 9.1 The Parties agree that this License Agreement shall inure to the benefit of and be binding on each of their respective agents, representatives, shareholders, officers, directors, attorneys, employees,
permitted assigns, subsidiaries, insurers, and predecessor or successor companies. 
 9.2 Choice of Law and Venue. The
Parties agree that any action to enforce or interpret this License Agreement must be filed exclusively in the Superior Court of Orange County or in the United States District Court for the Central District of California, and that personal
jurisdiction and venue are appropriate in those courts. This License Agreement shall be 

  
 Portions of
this Exhibit were omitted, as indicated by [***], and have been filed separately with the Secretary of the Commission pursuant to the Registrant’s application requesting confidential treatment under Rule 24b-2 of the Securities Exchange
Act of 1934, as amended. 
  
 6 

 
deemed executed and delivered in the State of California and shall be construed and governed by the internal laws of the State of California, without regard to California’s conflict of law
provisions. 
 9.3 Enforcement and Attorney Fees. If litigation is commenced to interpret or enforce the terms of this
License Agreement, the prevailing party shall be entitled to its costs and its reasonable attorney fees, in addition to any other available remedies. 
 9.4 Severability. If any part of this Agreement shall be determined to be illegal, invalid, or unenforceable, that part shall be replaced with an enforceable provision that is closest in intent and
economic effect to the severed provision, so long as the revised License Agreement continues to fulfill the original intent of the Parties. 
 8.5 No Waiver. No breach of any provision of this License Agreement may be waived unless in writing signed by the Party against whom a waiver is asserted. Waiver of any one breach shall not be
deemed to be a waiver of any other breach of the same or any other provision. 
 8.6 Counterparts. 

8.6.1 This License Agreement may be signed in counterparts and that it shall be fully executed when signed by all Parties
whether the signatures of all Parties appear on the original or one or more copies of this License Agreement. 

8.6.2 The Parties agree to sign three (3) originals of this License Agreement so that each Party will have a fully
executed original version of it. 
 8.7 Integration. This License Agreement constitutes the entire agreement between the
Parties and supersedes any and all prior agreements or understandings, written or oral, between them relating to the subject matter of this License Agreement. Except as set forth in the Settlement Agreement to which this License Agreement is an
Exhibit, no other promises or agreements shall be binding upon the Parties with respect to this subject matter unless contained in or attached to this License Agreement, or separately agreed to in writing and signed by an authorized representatives
of each of the Parties. 
 8.8 Modification. The provisions of this License Agreement may be modified or amended only in
a writing that is signed by each of the Parties and expressly states that modification or amendment of this License Agreement is intended. 
 8.7 Construction. The Parties acknowledge that the terms of this License Agreement are contractual and are the result of negotiations between the Parties and their counsel. Each party and its
counsel cooperated in the drafting and preparation of this License Agreement. This License Agreement shall not be construed against any Party as if that Party had drafted it. 

  
 Portions of
this Exhibit were omitted, as indicated by [***], and have been filed separately with the Secretary of the Commission pursuant to the Registrant’s application requesting confidential treatment under Rule 24b-2 of the Securities Exchange
Act of 1934, as amended. 
  
 7 

 8.8 Survival of Representations. All representations, warranties, and other
agreements contained in this License Agreement shall survive the execution and delivery of this License Agreement by all Parties. 
 8.9 Admissibility of Agreement. In any action or proceeding relating to this License Agreement (including, but not limited to, actions or proceedings relating to the releases, conferred rights, or
retained rights contained in this License Agreement), the Parties stipulate that a fully executed copy of this License Agreement may be admissible to the same extent as the fully executed original. 

8.10 Captions. The captions or headings of the Sections of this License Agreement are for convenience of reference only and in no
way define, limit or affect the scope or substance of any Section of this License Agreement. 
 IN WITNESS WHEREOF, the Parties have executed
this Agreement as of the day and year below written. 
  

			
	ALPHATEC SPINE, INC.
		
	By:	 	 /s/ Dirk Kuyper

	Its:	 	President and CEO
	Date:	 	12/30/11
	
	CROSS MEDICAL PRODUCTS, LLC
		
	By:	 	 /s/ Glen Kashuba

	Its:	 	President
	Date:	 	12/31/11

  
 Portions of
this Exhibit were omitted, as indicated by [***], and have been filed separately with the Secretary of the Commission pursuant to the Registrant’s application requesting confidential treatment under Rule 24b-2 of the Securities Exchange
Act of 1934, as amended. 
  
 8First Amendment to the Consulting Agreement

 Exhibit 10.41 
 FIRST AMENDMENT TO THE CONSULTING AGREEMENT 
 This First Amendment to the
Consulting Agreement (this “Amendment”) between Stephen H. Hochschuler, M.D. (the “Consultant”), having an address set forth on the signature page hereof, Alphatec Spine Inc., (“Spine”), a California corporation having
a principal place of business at 5818 El Camino Real, Carlsbad, CA 92008, and Alphatec Holdings, Inc. (“Holdings”), a Delaware corporation having a principal place of business at 5818 El Camino Real, Carlsbad, CA 92008 (collectively, Spine
and Holdings shall be referred to as the “Company”), is made effective as of October 1, 2011 (the “Amendment Effective Date”). 
 RECITALS 
 Reference is made to that certain Consulting Agreement dated
October 13, 2006, between the parties to this Amendment (the “Agreement”). 
 The Parties desire to amend the
Agreement as set forth herein. 
 Now, therefore, in consideration of the mutual promises set forth herein and for other good
and valuable consideration, the receipt and sufficiency of which is acknowledged by the Parties hereto, the Parties hereto agree as follows: 

1. AMENDMENT AND RESTATEMENT OF SECTION 1. Section 1 of the Agreement is hereby amended and restated in its entirety to read as
follows: 
 “1. Service on the Board of Directors. The Consultant agrees to serve or continue to serve as a
member of the board of directors (a “Board”) of Holdings for so long as the Consultant is duly elected or appointed, or until the Consultant resigns in writing, whichever is first. While the Consultant remains on the Board, the Consultant
will perform the usual and customary duties of a member of the Board, which will include attendance at Board meetings and reasonable preparation for such meetings. While the Consultant remains on the Board, the Consultant shall be paid $2,000 for
in-person attendance at a Board meeting, and $1,000 for attendance at a Board meeting via teleconference.” 
 2. AMENDMENT AND
RESTATEMENT OF PORTIONS OF SECTIONS 3, 4, 5 and 7. Sections 3, 4(a), (b), (d) and (e), 5 and 7 of the Agreement are hereby amended and restated in their entirety to read as follows: 

“3. Performance of Services. The Consultant shall devote up to two full days (a “full day” shall mean a
minimum of eight business hours, excluding all travel time as reasonably requested by the Company, over the course of every Period (defined below) during the Term (defined below) and shall use reasonable efforts to provide those Services as may be
reasonably be requested from time to time by the Company during such Period. Services shall be performed at the Company’s principal place of business or at some other location agreed upon by the Company and the Consultant. The Consultant agrees
to devote its reasonable best efforts to the performance of the Services. The Company shall have the right to publicize the Consultant’s affiliation with the Company. For purposes hereof the term “Period” means each calendar month
commencing on the Amendment Effective Date. 

 4. Compensation. 

(a) Consideration. In consideration of the agreements of Consultant set forth herein (other than the compensation and activities
related to serving on the Board, which are not governed by this Section 4), beginning on the Period that begins on the Amendment Effective Date, the Company shall pay to the Consultant $10,000 for each Period in which Services are performed.
After the conclusion of each Period the Consultant shall send Spine an invoice setting forth a brief description of the Services provided during that Period. Following receipt of an invoice delivered in accordance with this Section 4(a), the
Company shall pay to the Consultant the amount due to be paid to the Consultant hereunder for that Period. In addition, promptly following the Amendment Effective Date, Holdings shall grant to the Consultant options to purchase 25,000 shares of the
common stock of Holdings (the “New Options”), which New Options shall have an exercise price equal to the closing price of Holdings’ common stock on the trading day of issuance. Upon the termination of this Agreement or upon the
non-renewal of this Agreement, all outstanding New Options that have not vested shall be forfeited. The New Options shall vest annually over a three-year period beginning on the first anniversary of the date of issuance, and shall vest immediately
upon a Change in Control (as defined in the Plan referenced below). The New Options shall be subject, in all respects, to (i) the Alphatec Holdings, Inc. 2005 Employee, Director and Consultant Stock Plan (the “Plan”), and (ii) a
Nonqualified Stock Option Agreement to be entered into by Holdings and the Consultant. 
 (b) Reimbursement of Expenses.
The Company will promptly reimburse Consultant for all reasonable travel and other expenses incurred by Consultant in rendering the Services, provided that such expenses are consistent with the Company’s Travel and Expense Policy, and are
confirmed by appropriate written expense statements and other supporting documentation. 
 (d) Performance Objectives.
The Consultant shall use reasonable best efforts towards the attainment of performance objectives jointly established by the Company’s President and CEO and the Consultant, each agreeing hereby to act reasonably in setting those objectives.

 (e) Acknowledgement of Consultant. Consultant understands and acknowledges that the payments Consultant will receive
pursuant to Section 4 of this Agreement are intended solely to compensate Consultant for the Services. Such payments shall in no way influence Consultant’s clinical or professional judgment in providing Services hereunder or otherwise.

 5. Term. The term of this Agreement shall commence on the Amendment Effective Date and shall continue until the
date that is the earlier of (i) the date that this Agreement is terminated pursuant to Section 5; (ii) or the anniversary of the Amendment Effective Date. This Agreement shall only renew upon the written agreement of the parties. The
period between the Amendment Effective Date and the date of termination or expiration of this Agreement is referred to as the “Term”. 
 7. Non-competition. During the Term and during the six-month period following the end of the Term, the Consultant shall not serve as an employee, officer, member of the board of directors or
other governing board of a publicly traded entity that directly or indirectly manufactures, distributes or sells products used in the human body to treat spinal disorders. In addition, Consultant may not, without prior written notice to the Company,
alone or as a partner, officer, director, consultant, employee, stockholder or otherwise, engage in any commercial 

 
employment, consulting or business activity, occupation or other activity that is or is intended to be competitive with the business of the Company in the Field of Interest (each a
“Competitive Activity”); provided, however, that (i) the holding by the Consultant of any investment in any security shall not be deemed to be a violation of this Section 7 if such investment does not constitute
over five percent (5%) of the outstanding issue of such security; and (ii) the expenditure of reasonable amounts of time as (a) a member of a third party company’s advisory board, or (b) as a consultant to a third party
company shall not be deemed a breach of this Section 7 if such actions are disclosed to the Company, and such actions do not interfere with the provision of Services under this Agreement. Upon receiving notice that Consultant intends to engage
in any such Competitive Activity, Consultant shall comply with such safeguards as may be reasonably requested by the Company.” 
 3.
MISCELLANEOUS. In the event of any conflict between the provisions of this Amendment and the Agreement, the provisions of this Amendment shall prevail. Other than as set forth in this Amendment, the remainder of the Agreement shall remain
in full force and effect. 
 [Signature Page Follows] 

 IN WITNESS WHEREOF, the parties hereto have duly executed Agreement as of the Effective
Date. 
  

			
	ALPHATEC SPINE INC.
		
	By:	 	 /s/ Dirk Kuyper

	Dirk Kuyper
	President and CEO
	
	ALPHATEC HOLDINGS, INC.
		
	By:	 	 /s/ Dirk Kuyper

	Dirk Kuyper
	President and CEO
	
	 /s/ Stephen h. Hochschuler, M.D.

	Stephen H. Hochschuler, M.D.
	
	Address for Notice Purposes:

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