Document:

EXHIBIT
10.1

 

AMENDMENT

 

to

 

12%
SUBORDINATED CONVERTIBLE NOTE

DUE
DECEMBER 31, 2018

 

This
Amendment (“Amendment”) to the 12% Subordinated Convertible Notes due December 31, 2018, dated December 30, 2016,
January 6, 2017, and January 31, 2017 (the “Notes”) is entered into and effective as of the last date indicated below,
by and between Intellinetics, Inc., a Nevada corporation (the “Company”) and the holders of the Notes (the “Holders”).

 

WHEREAS,
Company and the Holders entered into the Notes, effective December 30, 2016, January 6, 2017, and January 31, 2017; and

 

WHEREAS,
the Notes may be amended in accordance with Section 9.e of the Notes by a written instrument signed by the Company and the holders
of at least 60% in principal amount of the then outstanding Notes (the “Required Holders”).

 

WHEREAS,
the Company and the Required Holders desire to amend the Notes to permit the Company to extend the Maturity Date and specify the
interest rate applicable as of the date hereof until the Maturity Date, as modified herein.

 

NOW
THEREFORE, the parties agree as follows:

 

1.
The second paragraph of the recitals to the Notes is hereby amended and modified to change the Maturity Date to December 31,
2020.

 

2.
Section 2(a) is hereby deleted and replaced in its entirety by the following, with such change to be effective as of the date
of this Amendment:

 

Payment
of Interest in Cash. The Company shall pay interest to the Holder on the aggregate unconverted and then outstanding principal
amount of this Note at the rate of 10.0% per annum in the aggregate, subject to adjustment as set forth herein, of which (i) 5.0%
shall be payable quarterly in cash in arrears on the first Trading Day of each fiscal quarter, and on the Maturity Date (each
such date, an “Interest Payment Date”) (if any Interest Payment Date is not a Business Day, then the applicable
payment shall be due on the next succeeding Business Day), and (ii) 5.0% per annum (the “Deferred Interest Amount”),
subject to adjustment as set forth herein, which shall accrue and become due on the Maturity Date. If any quarterly interest payment
is not made by its Interest Payment Date, then the Deferred Interest Amount for such quarterly interest payment shall increase
from 5.0% to 7.0%.

 

3.
Section 4(b) is hereby amended and modified to change the Conversion Price to $0.40.

 

4.
Except as set forth herein, the terms of the Notes shall remain in full force and effect.

 

5.
Capitalized terms not otherwise defined herein shall have the meanings set forth in the Notes.

 

6.
This Amendment may be signed in multiple counterparts, each of which shall be deemed an original, but all of which together
shall constitute one and the same instrument.

 

    	 	 	 

    	 

    

 

IN
WITNESS WHEREOF, the parties have executed this Amendment as of the date of the last signature of a Required Holder hereto.

 

	REQUIRED HOLDER	 	REQUIRED
    HOLDER (IF JOINT)
	 	 	 	 
	Print
    Entity Name:	 	 	 
	(if
    applicable)	 	 	 
	 	 	 	 
	/s/
    Required Holders	 	 
	Print Name: Required Holders	 	Print
    Name:
	Date:	 	 	Date:

 

Signature
Page to Amendment to 12% Secured Convertible Note

 

    	 	 	 

    	 

    

 

	INTELLINETICS, INC.	 
	 	 	 
	By:	/s/
    James F. DeSocio	 
	Name:	James
F. DeSocio	 
	Title:	President
    and Chief Executive Officer	 

 

Signature
Page to Amendment to 12% Secured Convertible NoteEXHIBIT
10.2

 

AMENDMENT

 

to

 

8%
SECURED CONVERTIBLE NOTE

DUE
NOVEMBER 30, 2019

 

This
Amendment (“Amendment”) to the 8% Secured Convertible Notes due November 30, 2019, dated November 17, 2017 and November
29, 2017 (the “Notes”) is entered into and effective as of the last date indicated below, by and between Intellinetics,
Inc., a Nevada corporation (the “Company”) and the holders of the Notes (the “Holders”).

 

WHEREAS,
Company and the Holders entered into the Notes, effective November 17, 2017, and November 29, 2017; and

 

WHEREAS,
the Notes may be amended in accordance with Section 9.e of the Notes by a written instrument signed by the Company and the holders
of at least 51% in principal amount of the then outstanding Notes (the “Required Holders”).

 

WHEREAS,
the Company and the Required Holders desire to amend the Notes to permit the Company to extend the Maturity Date and specify the
interest rate applicable as of the date hereof until the Maturity Date, as modified herein.

 

NOW
THEREFORE, the parties agree as follows:

 

1.
The second paragraph of the recitals to the Notes is hereby amended and modified to change the Maturity Date to December 31,
2020.

 

2.
Except as set forth herein, the terms of the Notes shall remain in full force and effect.

 

3.
Capitalized terms not otherwise defined herein shall have the meanings set forth in the Notes.

 

4.
This Amendment may be signed in multiple counterparts, each of which shall be deemed an original, but all of which together
shall constitute one and the same instrument.

 

    	 	 	 

    	 

    

 

IN
WITNESS WHEREOF, the parties have executed this Amendment as of the date of the last signature of a Required Holder hereto.

 

	REQUIRED HOLDER	 	REQUIRED
    HOLDER (IF JOINT)
	 	 	 	 
	Print
    Entity Name: 	 	 	 
	(if
    applicable)	 	 	 
	 	 	 	 
	/s/
    Required Holders	 	 
	Print Name: Required Holders	 	Print
    Name:
	Date:	 	 	Date:

 

Signature
Page to Amendment to 8% Secured Convertible Note

 

    	 	 	 

    	 

    

 

	INTELLINETICS, INC.	 
	 	 	 
	By:	/s/
    James F. DeSocio	 
	Name:	James
F. DeSocio	 
	Title:	President
    and Chief Executive Officer	 

 

Signature
Page to Amendment to 8% Secured Convertible NoteEX-4.3

 Exhibit 4.3 

THIS WARRANT AND THE SHARES ISSUABLE HEREUNDER HAVE NOT BEEN REGISTERED UNDER THE SECURITIES ACT OF 1933, AS AMENDED (THE “ACT”), OR
THE SECURITIES LAWS OF ANY STATE AND, EXCEPT AS SET FORTH IN SECTIONS 5.3 AND 5.4 BELOW, MAY NOT BE OFFERED, SOLD, PLEDGED OR OTHERWISE TRANSFERRED UNLESS AND UNTIL REGISTERED UNDER SAID ACT AND LAWS OR IN FORM AND SUBSTANCE SATISFACTORY TO THE
COMPANY, SUCH OFFER, SALE, PLEDGE OR OTHER TRANSFER IS EXEMPT FROM SUCH REGISTRATION. 
 WARRANT TO PURCHASE COMMON STOCK 

 

			
	Company: SI-BONE INC.
	Number of Shares of Common Stock: 909,091 (Subject to Section 1.7)
	Warrant Price: $0.22 per share
	Issue Date: July 17, 2013
	Expiration Date:	  	July 17, 2023        See also Section 5.1(b).
	Credit Facility:	  	This Warrant to Purchase Common Stock (“Warrant”) is issued in connection with that certain Loan and Security Agreement of even date herewith between Silicon Valley Bank and the Company (the “Loan
Agreement”).

 THIS WARRANT CERTIFIES THAT, for good and valuable consideration,
                                        (together
with any successor or permitted assignee or transferee of this Warrant or of any shares issued upon exercise hereof, “Holder”) is entitled to purchase the number of fully paid and non-assessable shares (the
“Shares”) of the above-stated common stock (the “Common Stock”) of the above-named company (the “Company”) at the above-stated Warrant Price, all as set forth above and as
adjusted pursuant to Section 2 of this Warrant, subject to the provisions and upon the terms and conditions set forth in this Warrant. 

SECTION 1. EXERCISE. 

1.1 Method of Exercise. Holder may at any time and from time to time exercise this Warrant, in whole or in part, by delivering to the
Company the original of this Warrant together with a duly executed Notice of Exercise in substantially the form attached hereto as Appendix 1 and, unless Holder is exercising this Warrant pursuant to a cashless exercise set forth in
Section 1.2, a check, wire transfer of same-day funds (to an account designated by the Company), or other form of payment acceptable to the Company for the aggregate Warrant Price for the Shares being purchased. 

1.2 Cashless Exercise. On any exercise of this Warrant, in lieu of payment of the aggregate Warrant Price in the manner as specified in
Section 1.1 above, but otherwise in accordance with the requirements of Section 1.1, Holder may elect to receive Shares equal to the value of this Warrant, or portion hereof as to which this Warrant is being exercised. Thereupon, the
Company shall issue to the Holder such number of fully paid and non-assessable Shares as are computed using the following formula: 
 X =
Y(A-B)/A 
 where: 
  

			
	X =	  	the number of Shares to be issued to the Holder;

  
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	Y =	  	the number of Shares with respect to which this Warrant is being exercised (inclusive of the Shares surrendered to the Company in payment of the aggregate Warrant Price);
		
	A =	  	the Fair Market Value (as determined pursuant to Section 1.3 below) of one Share; and
		
	B =	  	the Warrant Price.

 1.3 Fair Market Value. If the Company’s Common Stock is then traded or quoted on a nationally
recognized securities exchange, inter-dealer quotation system or over-the-counter market (a “Trading Market”), the fair market value of a Share shall be the closing price or last sale price of a share of Common Stock reported
for the Business Day immediately before the date on which Holder delivers this Warrant together with its Notice of Exercise to the Company. If the Company’s Common Stock is not traded in a Trading Market, the Board of Directors of the Company
shall determine the fair market value of a Share in its reasonable good faith judgment. 
 1.4 Delivery of Certificate and New
Warrant. Within a reasonable time after Holder exercises this Warrant in the manner set forth in Section 1.1 or 1.2 above, the Company shall deliver to Holder a certificate representing the Shares issued to Holder upon such exercise and, if
this Warrant has not been fully exercised and has not expired, a new warrant of like tenor representing the Shares not so acquired. 
 1.5
Replacement of Warrant. On receipt of evidence reasonably satisfactory to the Company of the loss, theft, destruction or mutilation of this Warrant and, in the case of loss, theft or destruction, on delivery of an indemnity agreement
reasonably satisfactory in form, substance and amount to the Company or, in the case of mutilation, on surrender of this Warrant to the Company for cancellation, the Company shall, within a reasonable time, execute and deliver to Holder, in lieu of
this Warrant, a new warrant of like tenor and amount. 
 1.6 Treatment of Warrant Upon Acquisition of Company. 

(a) Acquisition. For the purpose of this Warrant, “Acquisition” means any transaction or series of related
transactions involving: (i) the sale, lease, exclusive license, or other disposition of all or substantially all of the assets of the Company (ii) any merger or consolidation of the Company into or with another person or entity (other than
a merger or consolidation effected exclusively to change the Company’s domicile), or any other corporate reorganization, in which the stockholders of the Company in their capacity as such immediately prior to such merger, consolidation or
reorganization, own less than a majority of the Company’s (or the surviving or successor entity’s) outstanding voting power immediately after such merger, consolidation or reorganization; or (iii) any sale or other transfer by the
stockholders of the Company of shares representing at least a majority of the Company’s then-total outstanding combined voting power. 

  
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 (b) Treatment of Warrant at Acquisition. In the event of an Acquisition in which the
consideration to be received by the Company’s stockholders consists solely of cash, solely of Marketable Securities or a combination of cash and Marketable Securities (a “Cash/Public Acquisition”), either (i) Holder
shall exercise this Warrant pursuant to Section 1.1 and/or 1.2 and such exercise will be deemed effective immediately prior to and contingent upon the consummation of such Acquisition or (ii) if Holder elects not to exercise the Warrant,
this Warrant will expire immediately prior to the consummation of such Acquisition. 
 (c) The Company shall provide Holder with written
notice of its request relating to the Cash/Public Acquisition (together with such reasonable information as Holder may reasonably require regarding the treatment of this Warrant in connection with such contemplated Cash/Public Acquisition giving
rise to such notice), which is to be delivered to Holder not less than seven (7) Business Days prior to the closing of the proposed Cash/Public Acquisition. In the event the Company does not provide such notice, then if, immediately prior to
the Cash/Public Acquisition, the fair market value of one Share (or other security issuable upon the exercise hereof) as determined in accordance with Section 1.3 above would be greater than the Warrant Price in effect on such date, then this
Warrant shall automatically be deemed on and as of such date to be exercised pursuant to Section 1.2 above as to all Shares (or such other securities) for which it shall not previously have been exercised, and the Company shall promptly notify
the Holder of the number of Shares (or such other securities) issued upon such exercise to the Holder and Holder shall be deemed to have restated each of the representations and warranties in Section 4 of the Warrant as the date thereof. 

(d) Upon the closing of any Acquisition other than a Cash/Public Acquisition defined above, the acquiring, surviving or successor entity shall
assume the obligations of this Warrant, and this Warrant shall thereafter be exercisable for the same securities and/or other property as would have been paid for the Shares issuable upon exercise of the unexercised portion of this Warrant as if
such Shares were outstanding on and as of the closing of such Acquisition, subject to further adjustment from time to time in accordance with the provisions of this Warrant. 

(e) As used in this Warrant, “Marketable Securities” means securities meeting all of the following requirements:
(i) the issuer thereof is then subject to the reporting requirements of Section 13 or Section 15(d) of the Securities Exchange Act of 1934, as amended (the “Exchange Act”), and is then current in its filing of
all required reports and other information under the Act and the Exchange Act; (ii) the class and series of shares or other security of the issuer that would be received by Holder in connection with the Acquisition were Holder to exercise this
Warrant on or prior to the closing thereof is then traded in Trading Market, and (iii) following the closing of such Acquisition, Holder would not be restricted from publicly re-selling all of the issuer’s shares and/or other securities
that would be received by Holder in such Acquisition were Holder to exercise or convert this Warrant in full on or prior to the closing of such Acquisition, except to the extent that any such restriction (x) arises solely under federal or state
securities laws, rules or regulations, and (y) does not extend beyond six (6) months from the closing of such Acquisition. 
 1.7
Adjustment to Underlying Number of Shares. The Number of Shares for which this Warrant is exercisable shall, upon funding of the Mezzanine Term Loan B under and as defined in the Loan Agreement, be automatically increased by an additional
545,455 Shares for a total of 1,454,546 Shares exercisable pursuant to this Warrant. Any adjustments made to the Warrant pursuant to this Article 1.7 shall be in addition to any adjustments made pursuant to Article 2 hereof. 

  
 3 

 SECTION 2. ADJUSTMENTS TO THE SHARES AND WARRANT PRICE. 

2.1 Stock Dividends, Splits, Etc. If the Company declares or pays a dividend or distribution on the outstanding shares of the Common
Stock payable in securities or property (other than cash), then upon exercise of this Warrant, for each Share acquired, Holder shall receive, without additional cost to Holder, the total number and kind of securities and property which Holder would
have received had Holder owned the Shares of record as of the date the dividend or distribution occurred. If the Company subdivides the outstanding shares of the Common Stock by reclassification or otherwise into a greater number of shares, the
number of Shares purchasable hereunder shall be proportionately increased and the Warrant Price shall be proportionately decreased. If the outstanding shares of the Common Stock are combined or consolidated, by reclassification or otherwise, into a
lesser number of shares, the Warrant Price shall be proportionately increased and the number of Shares shall be proportionately decreased. 

2.2 Reclassification, Exchange, Combinations or Substitution. Upon any event whereby all of the outstanding shares of the Common Stock
are reclassified, exchanged, combined, substituted, or replaced for, into, with or by Company securities of a different class and/or series, then from and after the consummation of such event, this Warrant will be exercisable for the number, class
and series of Company securities that Holder would have received had the Shares been outstanding on and as of the consummation of such event, and subject to further adjustment thereafter from time to time in accordance with the provisions of this
Warrant. The provisions of this Section 2.2 shall similarly apply to successive reclassifications, exchanges, combinations substitutions, replacements or other similar events. 

2.3 Intentionally Omitted. 

2.4 Intentionally Omitted. 

2.5 No Fractional Share. No fractional Share shall be issuable upon exercise of this Warrant and the number of Shares to be issued
shall be rounded down to the nearest whole Share. If a fractional Share interest arises upon any exercise of the Warrant, the Company shall eliminate such fractional Share interest by paying Holder in cash the amount computed by multiplying the
fractional interest by (i) the fair market value (as determined in accordance with Section 1.3 above) of a full Share, less (ii) the then-effective Warrant Price. 

2.6 Notice/Certificate as to Adjustments. Upon each adjustment of the Warrant Price, Common Stock and/or number of Shares, the Company,
at the Company’s expense, shall notify Holder in writing within a reasonable time setting forth the adjustments to the Warrant Price, class and/or number of Shares and facts upon which such adjustment is based. The Company shall, upon written
request from Holder, furnish Holder with a certificate of its Chief Financial Officer, including computations of such adjustment and the Warrant Price, class and number of Shares in effect upon the date of such adjustment. 

SECTION 3. REPRESENTATIONS AND COVENANTS OF THE COMPANY. 

3.1 Representations and Warranties. The Company represents and warrants to, and agrees with, the Holder as follows: 

(a) The initial Warrant Price referenced on the first page of this Warrant is not greater than the price per share at which shares of Company
Common Stock or options to purchase shares of Company Common Stock were issued immediately prior to the Issue Date hereof. 

  
 4 

 (b) All Shares which may be issued upon the exercise of this Warrant, shall, upon issuance, be
duly authorized, validly issued, fully paid and non-assessable, and free of any liens and encumbrances except for restrictions on transfer provided for herein or under applicable federal and state securities laws. The Company covenants that it shall
at all times cause to be reserved and kept available out of its authorized and unissued capital stock such number of securities as will be sufficient to permit the exercise in full of this Warrant. 

(c) The Company’s capitalization table attached hereto as Schedule 1 is true and complete, in all material respects, as of the Issue
Date. 
 3.2 Notice of Certain Events. If the Company proposes at any time to: 

(a) declare any dividend or distribution upon the outstanding shares of the Company’s stock, whether in cash, property, stock, or
other securities and whether or not a regular cash dividend; 
 (b) offer for subscription or sale pro rata to the holders of the
outstanding shares any additional shares of any class or series of the Company’s stock (other than pursuant to contractual pre-emptive rights); 

(c) effect any reclassification, exchange, combination, substitution, reorganization or recapitalization of the outstanding shares of
the Common Stock; 
 (d) effect an Acquisition or to liquidate, dissolve or wind up; or 

(e) effect its initial, underwritten offering and sale of its securities to the public pursuant to an effective registration statement
under the Act (the “IPO”); 
 then, in connection with each such event, the Company shall give Holder: 

(1) in the case of the matters referred to in (a) and (b) above, at least seven (7) Business Days prior
written notice of the earlier to occur of the effective date thereof or the date on which a record will be taken for such dividend, distribution, or subscription rights (and specifying the date on which the holders of outstanding shares of the
Common Stock will be entitled thereto) or for determining rights to vote, if any, 
 (2) in the case of the matters
referred to in (c) and (d) above at least seven (7) Business Days prior written notice of the date when the same will take place (and specifying the date on which the holders of outstanding shares of Common Stock will be entitled to
exchange their shares for the securities or other property deliverable upon the occurrence of such event); and 

(3) with respect to the IPO, at least seven (7) Business Days prior written notice of the date on which the Company
proposes to file its registration statement in connection therewith. 
 Reference is made to Section 1.6(c) whereby this Warrant will be deemed to be
exercised pursuant to Section 1.2 hereof if the Company does not give written notice to Holder of a Cash/Public Acquisition as required by the terms hereof. Company will also provide information requested by Holder that is reasonably necessary
to enable Holder to comply with Holder’s accounting or reporting requirements. 

  
 5 

 SECTION 4. REPRESENTATIONS, WARRANTIES OF THE HOLDER. 

The Holder represents and warrants to the Company as follows: 

4.1 Purchase for Own Account. This Warrant and the Shares to be acquired upon exercise of this Warrant by Holder are being acquired for
investment for Holder’s account, not as a nominee or agent, and not with a view to the public resale or distribution within the meaning of the Act. Holder also represents that it has not been formed for the specific purpose of acquiring this
Warrant or the Shares. 
 4.2 Disclosure of Information. Holder is aware of the Company’s business affairs and financial
condition and has received or has had full access to all the information it considers necessary or appropriate to make an informed investment decision with respect to the acquisition of this Warrant and its underlying securities. Holder further has
had an opportunity to ask questions and receive answers from the Company regarding the terms and conditions of the offering of this Warrant and its underlying securities and to obtain additional information (to the extent the Company possessed such
information or could acquire it without unreasonable effort or expense) necessary to verify any information furnished to Holder or to which Holder has access. 

4.3 Investment Experience. Holder understands that the purchase of this Warrant and its underlying securities involves substantial
risk. Holder has experience as an investor in securities of companies in the development stage and acknowledges that Holder can bear the economic risk of such Holder’s investment in this Warrant and its underlying securities and has such
knowledge and experience in financial or business matters that Holder is capable of evaluating the merits and risks of its investment in this Warrant and its underlying securities and/or has a preexisting personal or business relationship with the
Company and certain of its officers, directors or controlling persons of a nature and duration that enables Holder to be aware of the character, business acumen and financial circumstances of such persons. 

4.4 Accredited Investor Status. Holder is an “accredited investor” within the meaning of Regulation D promulgated under the
Act. 
 4.5 The Act. Holder understands that this Warrant and the Shares issuable upon exercise hereof have not been registered under
the Act in reliance upon a specific exemption therefrom, which exemption depends upon, among other things, the bona fide nature of the Holder’s investment intent as expressed herein. Holder understands that this Warrant and the Shares issued
upon any exercise hereof must be held indefinitely unless subsequently registered under the Act and qualified under applicable state securities laws, or unless exemption from such registration and qualification are otherwise available. Holder is
aware of the provisions of Rule 144 promulgated under the Act. 
 4.6 Market Stand-off Agreement. The Holder agrees that the Shares
shall be subject to the Market Standoff provisions in Section 1.13 of that certain Amended and Restated Investor Rights Agreement dated September 21, 2011 by and among the Company and the investors listed on Schedule A thereto or similar
agreement. 
 4.7 No Voting Rights. Holder, as a Holder of this Warrant, will not have any voting rights until the exercise of this
Warrant. 

  
 6 

 SECTION 5. MISCELLANEOUS. 

5.1 Term and Automatic Conversion Upon Expiration. 

(a) Term. Subject to the provisions of Section 1.6 above, this Warrant is exercisable in whole or in part at any time and from
time to time on or before 6:00 PM, Pacific time, on the Expiration Date and shall be void thereafter. 
 (b) Automatic Cashless Exercise
upon Expiration. In the event that, upon the Expiration Date, the fair market value of one Share (or other security issuable upon the exercise hereof) as determined in accordance with Section 1.3 above is greater than the Warrant Price in
effect on such date, then this Warrant shall automatically be deemed on and as of such date to be exercised pursuant to Section 1.2 above as to all Shares (or such other securities) for which it shall not previously have been exercised, and the
Company shall, within a reasonable time, deliver a certificate representing the Shares (or such other securities) issued upon such exercise to Holder. 

5.2 Legends. The Shares (and the securities issuable, directly or indirectly, upon conversion of the Shares, if any) shall be imprinted
with a legend in substantially the following form: 
 THE SHARES EVIDENCED BY THIS CERTIFICATE HAVE NOT BEEN REGISTERED UNDER THE SECURITIES
ACT OF 1933, AS AMENDED (THE “ACT”), OR THE SECURITIES LAWS OF ANY STATE AND, EXCEPT AS SET FORTH IN THAT CERTAIN WARRANT TO PURCHASE COMMON STOCK ISSUED BY THE ISSUER TO
                                        DATED
JULY 1, 2013, MAY NOT BE OFFERED, SOLD, PLEDGED OR OTHERWISE TRANSFERRED UNLESS AND UNTIL REGISTERED UNDER SAID ACT AND LAWS OR IN FORM AND SUBSTANCE SATISFACTORY TO THE ISSUER, SUCH OFFER, SALE, PLEDGE OR OTHER TRANSFER IS EXEMPT FROM SUCH
REGISTRATION. 
 5.3 Compliance with Securities Laws on Transfer. This Warrant and the Shares issuable upon exercise of this Warrant
(and the securities issuable, directly or indirectly, upon conversion of the Shares, if any) may not be transferred or assigned in whole or in part except in compliance with applicable federal and state securities laws by the transferor and the
transferee (including, without limitation, the delivery of investment representation letters and legal opinions reasonably satisfactory to the Company, as reasonably requested by the Company). The Company shall not require Holder to provide an
opinion of counsel if the transfer is to any other affiliate of Holder, provided that any such transferee is an “accredited investor” as defined in Regulation D promulgated under the Act. Additionally, the Company shall also not require an
opinion of counsel if there is no material question as to the availability of Rule 144 promulgated under the Act. 
 5.4 Transfer
Procedure. Subject to the provisions of Section 5.3 and upon providing the Company with written notice, Holder may transfer all or part of this Warrant or the Shares issuable upon exercise of this Warrant (or the securities issuable
directly or indirectly, upon conversion of the Shares, if any) to any transferee, provided, however, in connection with any such transfer, Holder will give the Company notice of the portion of the Warrant being transferred with the name, address and
taxpayer identification number of the transferee and Holder will surrender this Warrant to the Company for reissuance to the transferee(s) (and Holder if applicable); and provided further, that any subsequent transferee shall agree in writing with
the Company to be bound by all of the terms and conditions of this Warrant. Notwithstanding any contrary provision herein, at all times prior to the IPO, Holder may not, without the Company’s prior written consent, transfer this Warrant or any
portion hereof, or any Shares 

  
 7 

 
issued upon any exercise hereof, or any shares or other securities issued upon any conversion of any Shares issued upon any exercise hereof, to any person or entity who directly competes with the
Company, except in connection with an Acquisition of the Company by such a direct competitor. 
 5.5 Notices. All notices and other
communications hereunder from the Company to the Holder, or vice versa, shall be deemed delivered and effective (i) when given personally, (ii) on the third (3rd) Business Day after being mailed by first-class registered or certified
mail, postage prepaid, (iii) upon actual receipt if given by facsimile or electronic mail and such receipt is confirmed in writing by the recipient, or (iv) on the first Business Day following delivery to a reliable overnight courier
service, courier fee prepaid, in any case at such address as may have been furnished to the Company or Holder, as the case may be, in writing by the Company or such Holder from time to time in accordance with the provisions of this Section 5.5.
All notices to Holder shall be addressed as follows until the Company receives notice of a change of address in connection with a transfer or otherwise: 
  

							
	  
	  		  		  	
	  
	  		  		  	
	  
	  		  		  	
	  
	  		  		  	
	  
	  		  		  	
	  
	  		  		  	
	  
	  		  		  	
				
	  
	  		  		  	
	  
	  		  		  	
	  
	  		  		  	
	  
	  		  		  	
	  
	  		  		  	
	  
	  		  		  	
	  
	  		  		  	

 Notice to the Company shall be addressed as follows until Holder receives notice of a change in address: 

SI BONE Inc. 
 3055 Olin Avenue,
Suite 2200 
 San Jose, CA 95128 

Attn: President 
 Fax: 

Email: 
 5.6 Waiver. This
Warrant and any term hereof may be changed, waived, discharged or terminated (either generally or in a particular instance and either retroactively or prospectively) only by an instrument in writing signed by the party against which enforcement of
such change, waiver, discharge or termination is sought. 
 5.7 Attorneys’ Fees. In the event of any dispute between the parties
concerning the terms and provisions of this Warrant, the party prevailing in such dispute shall be entitled to collect from the other party all costs incurred in such dispute, including reasonable attorneys’ fees. 

  
 8 

 5.8 Counterparts; Facsimile/Electronic Signatures. This Warrant may be executed in
counterparts, all of which together shall constitute one and the same agreement. Any signature page delivered electronically or by facsimile shall be binding to the same extent as an original signature page with regards to any agreement subject to
the terms hereof or any amendment thereto. 
 5.9 Governing Law. This Warrant shall be governed by and construed in accordance with
the laws of the State of California, without giving effect to its principles regarding conflicts of law. 
 5.10 Headings. The
headings in this Warrant are for purposes of reference only and shall not limit or otherwise affect the meaning of any provision of this Warrant. 

5.11 Business Days. “Business Day” is any day that is not a Saturday, Sunday or a day on which
                                         is
closed. 
 [Remainder of page left blank intentionally] 

[Signature page follows] 

  
 9 

 IN WITNESS WHEREOF, the parties have caused this Warrant to Purchase Common Stock to be executed
by their duly authorized representatives effective as of the Issue Date written above. 
  

			
	“COMPANY”
	
	  

		
	By:	 	  

		
	Name:	 	  

		 	(Print)
	Title:	 	
	
	“HOLDER”
		
	By:	 	  

		
	Name:	 	  

		 	(Print)
	Title:	 	

  
 [Signature
Page to Warrant to Purchase Stock] 

 APPENDIX 1 

NOTICE OF EXERCISE 
 1.
The undersigned Holder hereby exercises its right purchase                 shares of the Common Stock of SI-BONE INC. (the “Company”) in
accordance with the attached Warrant To Purchase Common Stock, and tenders payment of the aggregate Warrant Price for such shares as follows: 
  

	 	 ̈	check in the amount of $         payable to order of the Company enclosed herewith 

  

	 	 ̈	Wire transfer of immediately available funds to the Company’s account 

  

	 	 ̈	Cashless Exercise pursuant to Section 1.2 of the Warrant 

  

	 	 ̈	Other [Describe]
                                        

 2. Please issue a certificate or certificates representing the Shares in the name specified below: 

 

			
	  
	  	
	 Holder’s Name
	  	
		
	  
	  	
		
	  
	  	
	 (Address)
	  	

 3. By its execution below and for the benefit of the Company, Holder hereby restates each of the
representations and warranties in Section 4 of the Warrant to Purchase Common Stock as of the date hereof. 
  

			
	HOLDER:
	
	  

		
	By:	 	  

		
	Name:	 	  

		
	Title:	 	  

		
	(Date):	 	  

  
 Schedule 1

Source: [{"source": "alea-institute/alea-institute/kl3m-data-edgar-agreements/train-00287-of-00352.parquet"}, [{"source": "alea-institute/alea-institute/kl3m-data-edgar-agreements/train-00287-of-00352.parquet"}], [{"source": "alea-institute/alea-institute/kl3m-data-edgar-agreements/train-00287-of-00352.parquet"}]]