Document:

Exhibit 4.2

 

THIS WARRANT AND THE UNDERLYING SECURITIES
HAVE NOT BEEN REGISTERED UNDER THE SECURITIES ACT OF 1933, AS AMENDED (THE “SECURITIES
ACT”), OR ANY OTHER SECURITIES LAWS, HAVE BEEN TAKEN FOR INVESTMENT, AND MAY
NOT BE SOLD OR TRANSFERRED OR OFFERED FOR SALE OR TRANSFER UNLESS A
REGISTRATION STATEMENT UNDER THE SECURITIES ACT AND OTHER APPLICABLE SECURITIES
LAWS WITH RESPECT TO SUCH SECURITIES IS THEN IN EFFECT, OR IN THE OPINION OF
COUNSEL (WHICH OPINION IS REASONABLY SATISFACTORY TO THE ISSUER OF THESE
SECURITIES), SUCH REGISTRATION UNDER THE SECURITIES ACT AND OTHER APPLICABLE
SECURITIES LAWS IS NOT REQUIRED.

 

	
  Date: December 22, 2004

  	
   

  	
  Warrant to Purchase 

  
	
   

  	
   

  	
   

  	
  ***            ***

  
	
   

  	
   

  	
   

  	
  Shares

  
					

 

 

CARDIOTECH
INTERNATIONAL, INC.

 

(Incorporated
under the laws of the State of Delaware)

 

REPRESENTATIVE’S
WARRANT FOR THE PURCHASE OF SHARES OF

 

COMMON STOCK
[the Warrant will be for the same Securities sold in the Placement]

 

Warrant Price:
$      [the same price that the Securities were
sold in the Placement] per share, subject to adjustment as provided below.

 

THIS IS TO CERTIFY that,
for value received, Stonegate Securities, Inc. (“Stonegate”) and its assigns
(collectively, the “Holder”), is entitled to purchase, subject to the terms and
conditions hereinafter set forth, up to ***      ***
shares of the common stock, no par value (“Common Stock”), of Cardiotech
International, Inc., a Delaware corporation (the “Company”), and to receive
certificate(s) for the Common Stock so purchased.

 

1.             Exercise Period and Vesting.  The exercise period is the period beginning
on the date of this Warrant (the “Issuance Date”) and ending at 5:00 p.m.,
Dallas, Texas time, December 22, 2009 (the “Exercise Period”).  This Warrant is vested in full as of the
Issuance Date and is immediately exercisable by Holder.  This Warrant will terminate automatically and
immediately upon the expiration of the Exercise Period.

 

2.             Exercise of Warrant;
Cashless Exercise.  This
Warrant may be exercised, in whole or in part, at any time and from time to
time during the Exercise Period.  Such
exercise shall be accomplished by tender to the Company of the purchase price
set forth above as the warrant price (the “Warrant Price”), either (a) in cash,
by wire transfer or by certified check or bank cashier’s check, payable to the
order of the Company, or (b) if such exercise is after December 22, 2005 and in
the event that the shares issuable upon exercise of the warrant cannot be
resold pursuant to a currently effective registration statement filed by the
Company with the SEC,  by surrendering
such

 

A-1

 

number of shares of
Common Stock received upon exercise of this Warrant with a current market price
equal to the Warrant Price (a “Cashless Exercise”), together with presentation
and surrender to the Company of this Warrant with an executed subscription in
substantially the form attached hereto as Exhibit A (the “Subscription”).
Upon receipt of the foregoing, the Company will deliver to the Holder, as promptly
as possible, a certificate or certificates representing the shares of Common
Stock so purchased, registered in the name of the Holder or its transferee (as
permitted under Section 3 below).  With
respect to any exercise of this Warrant, the Holder will for all purposes be
deemed to have become the holder of record of the number of shares of Common
Stock purchased hereunder on the date this Warrant, a properly executed
Subscription and payment of the Warrant Price is received by the Company (the “Exercise
Date”), irrespective of the date of delivery of the certificate evidencing such
shares, except that, if the date of such receipt is a date on which the stock
transfer books of the Company are closed, such person will be deemed to have
become the holder of such shares at the close of business on the next
succeeding date on which the stock transfer books are open.  Fractional shares of Common Stock will not be
issued upon the exercise of this Warrant. 
In lieu of any fractional shares that would have been issued but for the
immediately preceding sentence, the Holder will be entitled to receive cash
equal to the current market price of such fraction of a share of Common Stock
on the trading day immediately preceding the Exercise Date.  In the event this Warrant is exercised in
part, the Company shall issue a new Warrant to the Holder covering the
aggregate number of shares of Common Stock as to which this Warrant remains
exercisable for.

 

If the Holder elects to
conduct a Cashless Exercise, the Company shall cause to be delivered to the
Holder a certificate or certificates representing the number of shares of
Common Stock computed using the following formula:

 

	
  X = Y (A-B) 

  
	
   

  	
  A

  
	
   

  
	
  Where:

  
	
   

  	
  X  =

  	
  the number of shares of Common Stock to be issued to Holder;

  
	
   

  	
   

  
	
   

  	
  Y  =

  	
  the portion of the Warrant (in number of shares of Common Stock)
  being exercised by Holder (at the date of such calculation);

  
	
   

  	
   

  
	
   

  	
  A  =

  	
  the fair market value of one share of Common Stock on the Exercise
  Date (as calculated below); and

  
	
   

  	
   

  
	
   

  	
  B  =

  	
  Warrant Price (as adjusted to the date of such calculation).

  
				

 

For purposes of the
foregoing calculation, “fair market value of one share of Common Stock on the
Exercise Date” shall mean:  (i) if the
principal trading market for such securities is a national or regional
securities exchange, the average closing price on such exchange for the ten
(10) trading days immediately prior to such Exercise Date; (ii) if sales prices
for shares of Common Stock are reported by the Nasdaq National Market System or
Nasdaq Small Cap Market (or a similar system then in use), the average last
reported sales price for the ten (10) trading days immediately prior to such
Exercise Date; (iii) if neither (i) nor (ii) above are applicable, and if bid
and ask prices for shares of Common Stock are reported in the over-the-counter
market by Nasdaq (or, if not so 

 

A-2

 

reported, by the
National Quotation Bureau), the average of the high bid and low ask prices so
reported for the ten (10) trading days immediately prior to such Exercise Date;
or (iv) if (i), (ii), or (iii) above is not applicable, and if sales prices for
shares of Common Stock are reported by the London Stock Exchange, the average
closing price on such exchange for the ten (10) trading days immediately prior
to such Exercise Date.  Notwithstanding
the foregoing, if there is no reported closing price, last reported sales
price, or bid and ask prices, as the case may be, for the period in question,
then the current market price shall be determined as of the latest ten (10) day
period prior to such day for which such closing price, last reported sales
price, or bid and ask prices, as the case may be, are available, unless such
securities have not been traded on an exchange or in the over-the-counter
market for 30 or more days immediately prior to the day in question, in which
case the current market price shall be determined in good faith by, and
reflected in a formal resolution of, the Board of Directors of the Company.  The Company acknowledges and agrees that this
Warrant was issued on the Issuance Date.

 

Notwithstanding
the foregoing, the Holder may conduct a cashless exercise pursuant to this
Section 2 only after the first anniversary of the initial issuance date of this
Warrant, and then only in the event that a registration statement covering the
resale of the Warrant Shares is not then effective at the time that the Holder
wishes to conduct such cashless exercise.

 

3.                                       Transferability
and Exchange.

 

(a)           This Warrant, and the Common Stock
issuable upon the exercise hereof, may not be sold, transferred, pledged or
hypothecated unless the Company shall have been provided with an opinion of
counsel, or other evidence reasonably satisfactory to it, that such transfer is
not in violation of the Securities Act, and any applicable state securities
laws.  Subject to the satisfaction of the
aforesaid condition, this Warrant and the underlying shares of Common Stock
shall be transferable from time to time by the Holder upon written notice to
the Company.  If this Warrant is
transferred, in whole or in part, the Company shall, upon surrender of this
Warrant to the Company, deliver to each transferee a Warrant evidencing the
rights of such transferee to purchase the number of shares of Common Stock that
such transferee is entitled to purchase pursuant to such transfer.  The Company may place a legend similar to the
legend at the top of this Warrant on any replacement Warrant and on each
certificate representing shares issuable upon exercise of this Warrant or any
replacement Warrants.  Only a registered
Holder may enforce the provisions of this Warrant against the Company.  A transferee of the original registered
Holder becomes a registered Holder only upon delivery to the Company of the
original Warrant and an original Assignment, substantially in the form set
forth in Exhibit B attached hereto.

 

(b)           This Warrant is exchangeable upon its
surrender by the Holder to the Company for new Warrants of like tenor and date
representing in the aggregate the right to purchase the number of shares
purchasable hereunder, each of such new Warrants to represent the right to
purchase such number of shares as may be designated by the Holder at the time
of such surrender.

 

4.                                       Adjustments to Warrant Price and Number of Shares Subject to Warrant.  The Warrant Price and the number of shares of
Common Stock purchasable upon the exercise of this Warrant are subject to
adjustment from time to time upon the occurrence of any of the events 

 

A-3

 

specified in this Section 4.  For the purpose of this Section 4, “Common
Stock” means shares now or hereafter authorized of any class of common stock of
the Company and any other stock of the Company, however designated, that has
the right to participate in any distribution of the assets or earnings of the
Company without limit as to per share amount (excluding, and subject to any
prior rights of, any class or series of preferred stock).

 

(a)           In case the Company shall (i) pay a
dividend or make a distribution in shares of Common Stock or other securities,
(ii) subdivide its outstanding shares of Common Stock into a greater number of
shares, (iii) combine its outstanding shares of Common Stock into a smaller
number of shares, or (iv) issue by reclassification of its shares of Common
Stock other securities of the Company, then the Warrant Price in effect at the
time of the record date for such dividend or on the effective date of such
subdivision, combination or reclassification, and/or the number and kind of
securities issuable on such date, shall be proportionately adjusted so that the
Holder of any Warrant thereafter exercised shall be entitled to receive the
aggregate number and kind of shares of Common Stock (or such other securities
other than Common Stock) of the Company, at the same aggregate Warrant Price,
that, if such Warrant had been exercised immediately prior to such date, the
Holder would have owned upon such exercise and been entitled to receive by
virtue of such dividend, distribution, subdivision, combination or
reclassification.  Such adjustment shall
be made successively whenever any event listed above shall occur.

 

(b)           In case the Company shall fix a
record date for the making of a distribution to all holders of Common Stock (including
any such distribution made in connection with a consolidation or merger in
which the Company is the surviving corporation) of cash, evidences of
indebtedness or assets, or subscription rights or warrants, the Warrant Price
to be in effect after such record date shall be determined by multiplying the
Warrant Price in effect immediately prior to such record date by a fraction,
the numerator of which shall be the current market price per share of Common
Stock on such record date, less the amount of cash so to be distributed (or the
fair market value (as determined in good faith by, and reflected in a formal
resolution of, the Board of Directors of the Company) of the portion of the
assets or evidences of indebtedness so to be distributed, or of such subscription
rights or warrants, applicable to one share of Common Stock, and the
denominator of which shall be such current market price per share of Common
Stock.  Such adjustment shall be made
successively whenever such a record date is fixed; and in the event that such
distribution is not so made, the Warrant Price shall again be adjusted to be
the Warrant Price which would then be in effect if such record date had not
been fixed.

 

(c)           For the purpose of any computation
under any subsection of this Section 4, the “current market price” per share of
Common Stock on any date shall be the per share price of the Common Stock on
the trading day immediately prior to the event requiring an adjustment
hereunder and shall be:  (i) if the
principal trading market for such securities is a national or regional
securities exchange, the closing price on such exchange on such day; or (ii) if
sales prices for shares of Common Stock are reported by the Nasdaq National
Market System or Small Cap Market System (or a similar system then in use), the
last reported sales price so reported on such day; (iii) if neither (i) nor
(ii) above are applicable, and if bid and ask prices for shares of Common Stock
are reported in the over-the-counter market by Nasdaq (or, if not so reported,
by the National Quotation Bureau), the average of the high bid and low ask
prices so reported on such day; or (iv) if (i), (ii) or (iii) above is not
applicable, and if sales price for shares of Common Stock are reported by the
London Stock Exchange, the closing price on such exchange on such day.  Notwithstanding the foregoing, if there 

 

A-4

 

is no reported closing price, last reported sales
price, or bid and ask prices, as the case may be, for the day in question, then
the current market price shall be determined as of the latest date prior to
such day for which such closing price, last reported sales price, or bid and
ask prices, as the case may be, are available, unless such securities have not
been traded on an exchange or in the over-the-counter market for 30 or more
days immediately prior to the day in question, in which case the current market
price shall be determined in good faith by, and reflected in a formal
resolution of, the Board of Directors of the Company.

 

(d)           Notwithstanding any provision herein
to the contrary, no adjustment in the Warrant Price shall be required unless
such adjustment would require an increase or decrease of at least 1% in the
Warrant Price; provided, however, that any adjustments which by reason of this
subsection (d) are not required to be made shall be carried forward and taken
into account in any subsequent adjustment. 
All calculations under this Section 4 shall be made to the nearest cent
or the nearest one-hundredth of a share, as the case may be.

 

(e)           In the event that at any time, as a
result of an adjustment made pursuant to subsection (a) above, the Holder of
any Warrant thereafter exercised shall become entitled to receive any shares of
capital stock of the Company other than shares of Common Stock, thereafter the
number of such other shares so receivable upon exercise of any Warrant shall be
subject to adjustment from time to time in a manner and on terms as nearly
equivalent as practicable to the provisions with respect to the shares of
Common Stock contained in this Section 4, and the other provisions of this
Warrant shall apply on like terms to any such other shares.

 

(f)            If the Company merges or
consolidates into or with another corporation or entity, or if another
corporation or entity merges into or with the Company (excluding such a merger
in which the Company is the surviving or continuing corporation and which does
not result in any reclassification, conversion, exchange, or cancellation of
the outstanding shares of Common Stock), or if all or substantially all of the
assets or business of the Company are sold or transferred to another
corporation, entity, or person, then, as a condition to such consolidation,
merger, or sale (a “Transaction”), lawful and adequate provision shall be made
whereby the Holder shall have the right from and after the Transaction to
receive, upon exercise of this Warrant and upon the terms and conditions
specified herein and in lieu of the shares of the Common Stock that would have
been issuable if this Warrant had been exercised immediately before the
Transaction, such shares of stock, securities, or assets as the Holder would
have owned immediately after the Transaction if the Holder had exercised this
Warrant immediately before the effective date of the Transaction.

 

5.             Registration Rights.  The Company hereby grants to Holder, with
respect to the shares of Common Stock underlying this Warrant, registration
rights identical to those that are granted to Purchasers in the Placement (as
such terms are defined in that certain Placement Agency Agreement, dated as of July
14, 2004 by and between the Company and Stonegate); it being specifically
agreed and understood that the shares of Common Stock underlying this Warrant
will be included in any registration statement filed by the Company which
includes shares of Common Stock, or shares of Common Stock underlying any
securities, issued to Purchasers in the Placement.

 

6.             Reservation of Shares.  The Company agrees at all times to reserve
and hold available out of its authorized but unissued shares of Common Stock
the number of shares of Common Stock issuable upon the full exercise of this
Warrant.  The Company further covenants
and 

 

A-5

 

agrees that all shares of Common Stock that may be
delivered upon the exercise of this Warrant will, upon delivery, be fully paid
and nonassessable and free from all taxes, liens and charges with respect to
the purchase thereof hereunder.

 

7.             Notices to Holder.  Upon any adjustment of the Warrant Price (or
number of shares of Common Stock purchasable upon the exercise of this Warrant)
pursuant to Section 4, the Company shall promptly thereafter cause to be given
to the Holder written notice of such adjustment.  Such notice shall include the Warrant Price
(and/or the number of shares of Common Stock purchasable upon the exercise of
this Warrant) after such adjustment, and shall set forth in reasonable detail
the Company’s method of calculation and the facts upon which such calculations
were based.  Where appropriate, such
notice shall be given in advance and included as a part of any notice required
to be given under the other provisions of this Section 7.

 

In the event of (a) any
fixing by the Company of a record date with respect to the holders of any class
of securities of the Company for the purpose of determining which of such
holders are entitled to dividends or other distributions, or any rights to
subscribe for, purchase or otherwise acquire any shares of capital stock of any
class or any other securities or property, or to receive any other right, (b)
any capital reorganization of the Company, or reclassification or
recapitalization of the capital stock of the Company or any transfer of all or
substantially all of the assets or business of the Company to, or consolidation
or merger of the Company with or into, any other entity or person, or (c) any
voluntary or involuntary dissolution or winding up of the Company, then and in
each such event the Company will give the Holder a written notice specifying,
as the case may be (i) the record date for the purpose of such dividend,
distribution, or right, and stating the amount and character of such dividend,
distribution, or right; or (ii) the date on which any such reorganization,
reclassification, recapitalization, transfer, consolidation, merger,
conveyance, dissolution, liquidation, or winding up is to take place and the
time, if any is to be fixed, as of which the holders of record of Common Stock
(or such capital stock or securities receivable upon the exercise of this
Warrant) shall be entitled to exchange their shares of Common Stock (or such
other stock securities) for securities or other property deliverable upon such
event.  Any such notice shall be given at
least 10 days prior to the earliest date therein specified.

 

8.             No Rights as a Stockholder.  This Warrant does not entitle the Holder to
any voting rights or other rights as a stockholder of the Company, nor to any
other rights whatsoever except the rights herein set forth.

 

9.             Additional Covenants of
the Company.  For so long as
the Common Stock is listed for trading on any regional or national securities
exchange or Nasdaq (National Market or Small Cap System) or the London Stock
Exchange, the Company shall, upon issuance of any shares for which this Warrant
is exercisable, at its expense, promptly obtain and maintain the listing of
such shares.  The Company shall also
comply with the reporting requirements of Sections 13 and 15(d) of the Exchange
Act or any other applicable securities laws of any other applicable
jurisdictions for so long as and to the extent that such requirements apply to
the Company.

 

The Company shall not, by
amendment of its Articles of Incorporation or through any reorganization,
transfer of assets, consolidation, merger, dissolution, issue or sale of
securities, or any other voluntary action, avoid or seek to avoid the
observance or performance of any of the terms of this Warrant.  Without limiting the generality of the
foregoing, the Company (a) will at all times 

 

A-6

 

reserve and keep
available, solely for issuance and delivery upon exercise of this Warrant,
shares of Common Stock issuable from time to time upon exercise of this Warrant,
(b) will not increase the par value of any shares of capital stock receivable
upon exercise of this Warrant above the amount payable therefor upon such
exercise, and (c) will take all such actions as may be necessary or appropriate
in order that the Company may validly and legally issue fully paid and
nonassessable stock.

 

10.           Successors and Assigns.  This Agreement shall be binding upon and
inure to the benefit of the Company, the Holder and their respective successors
and permitted assigns.

 

11.           Notices.  The Company agrees to maintain a ledger of
the ownership of this Warrant (the “Ledger”). 
Any notice hereunder shall be given by registered or certified mail if
to the Company, at its principal executive office and, if to the Holder, to its
address shown in the Ledger of the Company; provided, however, that the Holder
may at any time on three (3) days written notice to the Company designate or
substitute another address where notice is to be given.  Notice shall be deemed given and received
after a certified or registered letter, properly addressed with postage
prepaid, is deposited in the U.S. mail.

 

12.           Severability.  Every provision of this Warrant is intended
to be severable. If any term or provision hereof is illegal or invalid for any
reason whatsoever, such illegality or invalidity shall not affect the remainder
of this Warrant.

 

13.           Governing Law.  This Warrant shall be governed by and
construed in accordance with the laws of the State of Massachusetts without
giving effect to the principles of choice of laws thereof.

 

14.           Attorneys’ Fees.  In any action or proceeding brought to
enforce any provision of this Warrant, the prevailing party shall be entitled
to recover reasonable attorneys’ fees in addition to its costs and expenses and
any other available remedy.

 

15.           Entire Agreement.  This Warrant (including the Exhibits attached
hereto) constitutes the entire understanding between the Company and the Holder
with respect to the subject matter hereof, and supersedes all prior
negotiations, discussions, agreements and understandings relating to such
subject matter.

 

IN WITNESS WHEREOF, the
Company has caused this Warrant to be executed by its duly authorized officer
as of the date first set forth above.

 

	
   

  	
  CARDIOTECH
  INTERNATIONAL, INC.

  
	
   

  	
   

  
	
   

  	
   

  
	
   

  	
  By:

  	
   

  	
   

  
	
   

  	
   

  
	
   

  	
  2.

  	
  Michael Szycher, Ph.D.,

  
	
   

  	
   

  
	
   

  	
  3.

  	
  Chairman
  & Chief Executive Officer

  
	
   

  	
   

  
	
   

  	
   

  
					

 

A-7

 

Exhibit A

 

SUBSCRIPTION
FORM

 

(To be Executed by the Holder to Exercise the Rights To Purchase Common
Stock Evidenced by the Within Warrant)

 

The undersigned hereby
irrevocably subscribes for        shares
(the “Stock”) of the Common Stock of Cardiotech International, Inc. (the “Company”)
pursuant to and in accordance with the terms and conditions of the attached Warrant
(the “Warrant”), and hereby makes payment of $       
therefor by [tendering cash, wire transferring or delivering a certified check
or bank cashier’s check, payable to the order of the Company] [surrendering        shares
of Common Stock received upon exercise of the Warrant, which shares have a
current market price equal to such payment as required in Section 2 of the
Warrant].  The undersigned requests that
a certificate for the Stock be issued in the name of the undersigned and be
delivered to the undersigned at the address stated below.  If the Stock is not all of the shares
purchasable pursuant to the Warrant, the undersigned requests that a new
Warrant of like tenor for the balance of the remaining shares purchasable
thereunder be delivered to the undersigned at the address stated below.

 

In connection with the
issuance of the Stock, I hereby represent to the Company that I am acquiring
the Stock for my own account for investment and not with a view to, or for
resale in connection with, a distribution of the shares within the meaning of
the Securities Act of 1933, as amended (the “Securities Act”).

 

I understand that because
the Stock has not been registered under the Securities Act, I must hold such
Stock indefinitely unless the Stock is subsequently registered and qualified
under the Securities Act or is exempt from such registration and qualification.
I shall make no transfer or disposition of the Stock unless (a) such transfer
or disposition can be made without registration under the Securities Act by
reason of a specific exemption from such registration and such qualification,
or (b) a registration statement has been filed pursuant to the Securities Act
and has been declared effective with respect to such disposition.  I agree that each certificate representing
the Stock delivered to me shall bear substantially the same as set forth on the
front page of the Warrant.

 

I agree that each
certificate representing the Stock delivered to me shall bear substantially the
same legend as set forth on the front page of the Warrant.

 

I further agree that the
Company may place stop orders on the certificates evidencing the Stock with the
transfer agent, if any, to the same effect as the above legend.  The legend and stop transfer notice referred
to above shall be removed only upon my furnishing to the Company of an opinion
of counsel (reasonably satisfactory to the Company) to the effect that such
legend may be removed.

 

	
   

  	
  Date:

  	
   

  	
   

  	
  Signed: 

  	
   

  
	
   

  	
   

  
	
   

  	
  Address:

  	
   

  
	
   

  	
   

  	
   

  
								

 

A-8

 

Exhibit B

 

ASSIGNMENT

 

(To be
Executed by the Holder to Effect Transfer of the Attached Warrant)

 

For Value Received                                    
hereby sells, assigns and transfers to                          
the Warrant attached hereto and the rights represented thereby to purchase             
shares of Common Stock in accordance with the terms and conditions hereof, and
does hereby irrevocably constitute and appoint                                       
as attorney to transfer such Warrant on the books of the Company with full
power of substitution.

 

	
   

  	
  Dated:

  	
   

  	
   

  	
  Signed:

  	
   

  
	
   

  	
   

  
	
  Please print or
  typewrite 

  name and address of 

  assignee:

  	
  Please insert Social
  Security 

  or other Tax Identification 

  Number of Assignee:

  
	
   

  	
   

  
	
   

  	
   

  	
   

  	
   

  
	
   

  	
   

  	
   

  
	
   

  	
   

  	
   

  
	
   

  	
   

  	
   

  
	
   

  	
   

  	
   

  
								

 

A-9Exhibit
4.3

 

NEITHER THIS SECURITY NOR THE SECURITIES INTO WHICH THIS SECURITY IS
EXERCISABLE HAVE BEEN REGISTERED WITH THE SECURITIES AND EXCHANGE COMMISSION OR
THE SECURITIES COMMISSION OF ANY STATE IN RELIANCE UPON AN EXEMPTION FROM
REGISTRATION UNDER THE SECURITIES ACT OF 1933, AS AMENDED (THE “SECURITIES
ACT”), AND, ACCORDINGLY, MAY NOT BE OFFERED OR SOLD EXCEPT PURSUANT TO AN
EFFECTIVE REGISTRATION STATEMENT UNDER THE SECURITIES ACT OR PURSUANT TO AN
AVAILABLE EXEMPTION FROM, OR IN A TRANSACTION NOT SUBJECT TO, THE REGISTRATION
REQUIREMENTS OF THE SECURITIES ACT AND IN ACCORDANCE WITH APPLICABLE STATE
SECURITIES LAWS AS EVIDENCED BY A LEGAL OPINION OF COUNSEL TO THE TRANSFEROR
REASONABLY ACCEPTABLE TO THE COMPANY TO SUCH EFFECT, THE SUBSTANCE OF WHICH SHALL
BE REASONABLY ACCEPTABLE TO THE COMPANY. THIS SECURITY MAY BE PLEDGED IN
CONNECTION WITH A BONA FIDE MARGIN ACCOUNT WITH A REGISTERED BROKER-DEALER OR
OTHER LOAN WITH A FINANCIAL INSTITUTION THAT IS AN “ACCREDITED INVESTOR” AS
DEFINED IN RULE 501(a) UNDER THE SECURITIES ACT.

 

ADDITIONAL INVESTMENT RIGHT

 

To Purchase shares of Common Stock of

 

CARDIOTECH INTERNATIONAL,
INC.

 

THIS ADDITIONAL INVESTMENT RIGHT (this “Additional
Investment Right”) CERTIFIES that, for value received,                  
(the “Holder”) is entitled, upon the terms and subject to the
limitations on exercise and the conditions hereinafter set forth, at any time
on or after the date of issuance of this Additional Investment Right (the “Initial
Exercise Date”) and on or prior to the earlier to occur of (i) the 90th
Business Day following the date that the Registration Statement is
declared effective by the Commission, and (ii) the one year anniversary of the
Closing Date (either (i) or (ii) above, the “Termination Date”), but not
thereafter, to subscribe for and purchase from CardioTech International, Inc.,
a Massachusetts corporation (the “Company”), up to                       
shares of Common Stock, par value $0.01 per share, of the Company (each such
share, an “Additional Investment Right Share” and all such shares, the “Additional
Investment Right Shares”), at a price of $2.40 per share (the “Exercise
Price”). Capitalized terms used and
not otherwise defined herein shall have the meanings set forth in that certain
Securities Purchase Agreement (the “Securities Purchase Agreement”),
dated December 22, 2004, among the Company and the Purchasers signatory
thereto.

 

1.   Title to the Additional Investment Right.  Prior to the Termination Date and subject to
compliance with applicable laws and Section 7 of this Additional Investment
Right, this Additional Investment Right and all rights hereunder are
transferable, in whole or in part, at the office or agency of the Company by
the Holder in person or by duly authorized attorney, upon surrender of this
Additional Investment Right together with the Assignment Form annexed

 

1

 

hereto properly endorsed.  The transferee shall sign an investment
letter in form and substance reasonably satisfactory to the Company.

 

2.   Authorization of Shares. The Company
covenants that all Additional Investment Right Shares which may be issued upon
the exercise of the purchase rights represented by this Additional Investment
Right will, upon exercise of the purchase rights represented by this Additional
Investment Right, be duly authorized, validly issued, fully paid and
nonassessable and free from all taxes, liens and charges in respect of the
issue thereof (other than taxes in respect of any transfer occurring contemporaneously
with such issue).

 

3.   Exercise of Additional Investment Right.

 

(a)  Exercise of
the purchase rights represented by this Additional Investment Right may be made
at any time or times on or after the Initial Exercise Date and on or before the
Termination Date by delivery to the Company of a duly executed facsimile copy
of the Notice of Exercise Form annexed hereto (or such other office or agency
of the Company as it may designate by notice in writing to the registered
Holder at the address of such Holder appearing on the books of the Company); provided,
however, within 5 Business Days of the date said Notice of Exercise is
delivered to the Company, the Holder shall have surrendered this Additional
Investment Right to the Company and the Company shall have received payment of
the aggregate Exercise Price of the shares thereby purchased by wire transfer
or cashier’s check drawn on a United States bank.  Certificates for shares purchased hereunder
shall be delivered to the Holder within 5 Business Days from the delivery to
the Company of the Notice of Exercise Form, surrender of this Additional
Investment Right and payment of the aggregate Exercise Price as set forth
above.  This Additional Investment Right
shall be deemed to have been exercised on the later of the date the Notice of
Exercise is delivered to the Company by facsimile copy and the date the
Exercise Price is received by the Company. The Additional Investment Right
Shares shall be deemed to have been issued, and the Holder or any other person
so designated to be named therein shall be deemed to have become a holder of
record of such shares for all purposes, as of the date the Additional
Investment Right has been exercised by payment to the Company of the Exercise
Price and all taxes required to be paid by the Holder, if any, pursuant to
Section 4 prior to the issuance of such shares, have been paid.

 

(b)  If this
Additional Investment Right shall have been exercised in part, the Company
shall, at the time of delivery of the certificate or certificates representing
Additional Investment Right Shares, deliver to Holder a new Additional
Investment Right evidencing the rights of Holder to purchase the unpurchased
Additional Investment Right Shares called for by this Additional Investment
Right, which new Additional Investment Right shall in all other respects be
identical to this Additional Investment Right.

 

4.   Charges, Taxes and Expenses. Issuance
of certificates for Additional Investment Right Shares shall be made without
charge to the Holder for any issue or transfer tax or other incidental expense
in respect of the issuance of such certificate, all of which taxes and expenses
shall be paid by the Company, and such certificates shall be issued in the name
of the Holder or in such name or names as may be directed by the Holder; provided,
however, that in 

 

2

 

the event certificates
for Additional Investment Right Shares are to be issued in a name other than
the name of the Holder, this Additional Investment Right when surrendered for
exercise shall be accompanied by the Assignment Form attached hereto duly
executed by the Holder; and the Company may require, as a condition thereto,
the payment of a sum sufficient to reimburse it for any transfer tax incidental
thereto.

 

5.    Transfer, Division and Combination.

 

(a)  Subject to
compliance with any applicable securities laws and the conditions set forth
herein and in the Securities Purchase Agreement, this Additional Investment
Right and all rights hereunder are transferable (i) to one of its nominees,
affiliates or a nominee thereof, (ii) to a pension or profit-sharing fund
established and maintained for its employees or for the employees of any
affiliate, or (iii) from a nominee to any of the aforementioned persons as
beneficial owner of this AIR or such AIR Shares, in whole or in part, upon
surrender of this Additional Investment Right at the principal office of the
Company, together with a written assignment of this Additional Investment Right
substantially in the form attached hereto duly executed by the Holder or its
agent or attorney and funds sufficient to pay any transfer taxes payable upon
the making of such transfer.  Upon such
surrender and, if required, such payment, the Company shall execute and deliver
a new Additional Investment Right or Additional Investment Rights in the name
of the assignee or assignees and in the denomination or denominations specified
in such instrument of assignment, and shall issue to the assignor a new
Additional Investment Right evidencing the portion of this Additional
Investment Right not so assigned, and this Additional Investment Right shall
promptly be cancelled. An Additional Investment Right, if properly assigned,
may be exercised by a new holder for the purchase of Additional Investment
Right Shares without having a new Additional Investment Right issued.

 

(b)  This
Additional Investment Right may be divided or combined with other Additional
Investment Rights upon presentation hereof at the aforesaid office of the
Company, together with a written notice specifying the names and denominations
in which new Additional Investment Rights are to be issued, signed by the
Holder or its agent or attorney.  Subject
to compliance with Section 5(a), as to any transfer which may be involved in
such division or combination, the Company shall execute and deliver a new
Additional Investment Right or Additional Investment Rights in exchange for the
Additional Investment Right or Additional Investment Rights to be divided or
combined in accordance with such notice.

 

(c)  The Company
shall prepare, issue and deliver at its own expense (other than transfer taxes)
the new Additional Investment Right or Additional Investment Rights under this
Section 5.

 

(d)  The Company
agrees to maintain, at its aforesaid office, books for the registration and the
registration of transfer of the Additional Investment Rights.

 

(e)  If,
at the time
of the surrender of this Additional Investment Right in connection with any
transfer of this Additional Investment Right, the transfer of this

 

3

 

Additional Investment Right shall not be registered
pursuant to an effective registration statement under the Securities Act and
under applicable state securities or blue sky laws, the Company may require, as
a condition of allowing such transfer (i) that the Holder or transferee of this
Additional Investment Right, as the case may be, furnish to the Company a
written opinion of counsel (which opinion shall be in form, substance and scope
customary for opinions of counsel in comparable transactions) to the effect
that such transfer may be made without registration under the Securities Act
and under applicable state securities or blue sky laws, (ii) that the holder or
transferee execute and deliver to the Company an investment letter in form and
substance acceptable to the Company and (iii) that the transferee be an “accredited
investor” as defined in Rule 501(a)(1), (a)(2), (a)(3), (a)(7), or (a)(8)
promulgated under the Securities Act or a qualified institutional buyer as
defined in Rule 144A(a) under the Securities Act.

 

6.   No Rights as Shareholder until Exercise.
This Additional Investment Right does not entitle the Holder to any voting
rights or other rights as a shareholder of the Company prior to the exercise
hereof. Upon the surrender of this Additional Investment Right and the payment
of the aggregate Exercise Price, the Additional Investment Right Shares so
purchased shall be and be deemed to be issued to such Holder as the record
owner of such shares and warrants, as the case may be, as of the close of
business on the later of the date of such surrender or payment.

 

7.   Loss, Theft, Destruction or Mutilation of
Additional Investment Right. The Company covenants that upon receipt by the
Company of evidence reasonably satisfactory to it of the loss, theft,
destruction or mutilation of this Additional Investment Right or any
certificate relating to the Additional Investment Right Shares, and in case of
loss, theft or destruction, of indemnity or security reasonably satisfactory to
it (which, in the case of the Additional Investment Right, shall not include
the posting of any bond), and upon surrender and cancellation of such
Additional Investment Right or certificate, if mutilated, the Company will make
and deliver a new Additional Investment Right or certificate of like tenor and
dated as of such cancellation, in lieu of such Additional Investment Right or
certificate.

 

8.   Saturdays, Sundays, Holidays, etc.  If the last or appointed day for the taking
of any action or the expiration of any right required or granted herein shall
be a Saturday, Sunday or a legal holiday, then such action may be taken or such
right may be exercised on the next succeeding day not a Saturday, Sunday or
legal holiday.

 

9.   Adjustments of Exercise Price and
Number of Additional Investment Right Shares; Stock Splits, etc. The number
Additional Investment Right Shares purchasable upon the exercise of this
Additional Investment Right shall be subject to adjustment from time to time
upon the happening of any of the following. 
In case the Company shall (i) pay a dividend in shares of Common Stock
or make a distribution in shares of Common Stock to holders of all of its
outstanding Common Stock, (ii) subdivide its outstanding shares of Common Stock
into a greater number of shares, (iii) combine its outstanding shares of Common
Stock into a smaller number of shares of Common Stock, or (iv) issue any shares
of its capital stock in a reclassification of the Common Stock, then the number
of Additional Investment Right Shares purchasable upon exercise of this
Additional Investment Right immediately prior thereto shall be adjusted so that
the Holder shall be entitled to receive the number of Additional Investment

 

4

 

Right Shares or other
securities of the Company which it would have owned or have been entitled to
receive had this Additional Investment Right been exercised in advance
thereof.  Upon each such adjustment of
the number of Additional Investment Right Shares or other securities of the
Company which are purchasable hereunder, the Holder shall thereafter be
entitled to purchase the number of Additional Investment Right Shares or other
securities resulting from such adjustment at an Exercise Price obtained by
multiplying such Exercise Price in effect immediately prior to such adjustment
by the number of Additional Investment Right Shares purchasable pursuant hereto
immediately prior to such adjustment and dividing by the number of Additional
Investment Right Shares or other securities of the Company that are purchasable
pursuant hereto immediately after such adjustment. An adjustment made pursuant
to this Section 9 shall become effective immediately after the effective date
of such event retroactive to the record date, if any, for such event.

 

10.     Reorganization, Reclassification,
Merger, Consolidation or Disposition of Assets.  In case the Company shall reorganize its
capital, reclassify its capital stock, consolidate or merge with or into
another corporation (where the Company is not the surviving corporation or
where there is a change in or distribution with respect to the Common Stock of
the Company), or sell, transfer or otherwise dispose of its property, assets or
business to another corporation and, pursuant to the terms of such
reorganization, reclassification, merger, consolidation or disposition of
assets, shares of common stock of the successor or acquiring corporation, or
any cash, shares of stock or other securities or property of any nature
whatsoever (including Additional Investment Rights or other subscription or
purchase rights) in addition to or in lieu of common stock of the successor or
acquiring corporation (“Other Property”),
are to be received by or distributed to the holders of Common Stock of the
Company, then the Holder shall have the right thereafter to receive, upon
exercise of this Additional Investment Right, the number of shares of Common
Stock of the successor or acquiring corporation or of the Company, if it is the
surviving corporation, and Other Property receivable upon or as a result of
such reorganization, reclassification, merger, consolidation or disposition of
assets by a Holder of the number of shares of Common Stock for which this
Additional Investment Right is exercisable into immediately prior to such
event. In case of any such reorganization, reclassification, merger,
consolidation or disposition of assets, the successor or acquiring corporation
(if other than the Company) shall expressly assume the due and punctual
observance and performance of each and every covenant and condition of this
Additional Investment Right to be performed and observed by the Company and all
the obligations and liabilities hereunder, subject to such modifications as may
be deemed appropriate (as determined in good faith by resolution of the Board
of Directors of the Company) in order to provide for adjustments of Additional
Investment Right Shares for which this Additional Investment Right is exercisable
which shall be as nearly equivalent as practicable to the adjustments provided
for in this Section 10.  For purposes of
this Section 10, “common stock of the successor or acquiring corporation” shall
include stock of such corporation of any class which is not preferred as to
dividends or assets over any other class of stock of such corporation and which
is not subject to redemption and shall also include any evidences of
indebtedness, shares of stock or other securities which are convertible into or
exchangeable for any such stock, either immediately or upon the arrival of a
specified date or the happening of a specified event and any Additional
Investment Rights or other rights to subscribe for or purchase any such stock.  The foregoing provisions of this Section 10
shall similarly apply to successive reorganizations, reclassifications,
mergers, consolidations or disposition of assets.

 

5

 

11.     Voluntary Adjustment by the Company.
The Company may at any time during the term of this Additional Investment Right
reduce the then current Exercise Price to any amount and for any period of time
deemed appropriate by the Board of Directors of the Company.

 

12.     Notice of Adjustment.  Whenever the number of Additional Investment
Right Shares or number or kind of securities or other property purchasable upon
the exercise of this Additional Investment Right or the Exercise Price is
adjusted, as herein provided, the Company shall give notice thereof to the
Holder, which notice shall state the number of Additional Investment Right
Shares and other securities issuable upon exercise of this Additional
Investment Right (and other securities or property) purchasable upon the
exercise of this Additional Investment Right and the Exercise Price of such
Additional Investment Right Shares or other securities issuable upon exercise
of this Additional Investment Right (as applicable) after such adjustment,
setting forth a brief statement of the facts requiring such adjustment and setting
forth the computation by which such adjustment was made.

 

13.     Notice of Corporate Action.  If at any time:

 

(a)  the Company
shall take a record of the holders of its Common Stock for the purpose of
entitling them to receive a dividend or other distribution, or any right to
subscribe for or purchase any evidences of its indebtedness, any shares of
stock of any class or any other securities or property, or to receive any other
right, or

 

(b)  there shall
be any capital reorganization of the Company, any reclassification or
recapitalization of the capital stock of the Company or any consolidation or
merger of the Company with, or any sale, transfer or other disposition of all
or substantially all the property, assets or business of the Company to, another
corporation or,

 

(c)  there shall
be a voluntary or involuntary dissolution, liquidation or winding up of the
Company;

 

then, in any one
or more of such cases, the Company shall give to Holder (i) at least 20 days’
prior written notice of the date on which a record date shall be selected for
such dividend, distribution or right or for determining rights to vote in
respect of any such reorganization, reclassification, merger, consolidation,
sale, transfer, disposition, liquidation or winding up, and (ii) in the case of
any such reorganization, reclassification, merger, consolidation, sale,
transfer, disposition, dissolution, liquidation or winding up, at least 20 days’
prior written notice of the date when the same shall take place.  Such notice in accordance with the foregoing
clause also shall specify (i) the date on which any such record is to be taken
for the purpose of such dividend, distribution or right, the date on which the
holders of Common Stock shall be entitled to any such dividend, distribution or
right, and the amount and character thereof, and (ii) the date on which any
such reorganization, reclassification, merger, consolidation, sale, transfer,
disposition, dissolution, liquidation or winding up is to take place and the
time, if any such time is to be fixed, as of which the holders of Common Stock
shall be entitled to exchange their shares of Common Stock for securities or
other property deliverable upon such disposition, dissolution, liquidation or
winding up.  Each such written notice
shall be sufficiently given if

 

6

 

addressed to
Holder at the last address of Holder appearing on the books of the Company and
delivered in accordance with Section 15(d).

 

14.     Authorized Shares. The Company
covenants that during the period the Additional Investment Right is
outstanding, it will reserve from its authorized and unissued Common Stock a
sufficient number of shares to provide for the issuance of Additional
Investment Right Shares upon the exercise of any purchase rights under this
Additional Investment Right. The Company further covenants that its issuance of
this Additional Investment Right shall constitute full authority to its
officers who are charged with the duty of executing certificates to execute and
issue the necessary certificates for the Additional Investment Right Shares
upon the exercise of the purchase rights under this Additional Investment
Right. The Company will take all such reasonable action as may be necessary to
assure that such Additional Investment Right Shares may be issued as provided
herein without violation of any applicable law or regulation, or of any
requirements of the principal trading market upon which the Common Stock may be
listed.

 

Except and to the extent as waived or consented to by
the Holder, the Company shall not by any action, including, without limitation,
amending its articles of incorporation or through any reorganization, transfer
of assets, consolidation, merger, dissolution, issue or sale of securities or
any other voluntary action, avoid or seek to avoid the observance or
performance of any of the terms of this Additional Investment Right, but will
at all times in good faith assist in the carrying out of all such terms and in
the taking of all such actions as may be necessary or appropriate to protect
the rights of Holder as set forth in this Additional Investment Right against
impairment.  Without limiting the
generality of the foregoing, the Company will (a) not increase the par value of
any Additional Investment Right Shares above the amount payable therefor upon
such exercise immediately prior to such increase in par value, (b) take all
such action as may be necessary or appropriate in order that the Company may
validly and legally issue fully paid and nonassessable Additional Investment
Right Shares upon the exercise of this Additional Investment Right, and (c) use
commercially reasonable efforts to obtain all such authorizations, exemptions
or consents from any public regulatory body having jurisdiction thereof as may
be necessary to enable the Company to perform its obligations under this
Additional Investment Right.

 

Before taking any action which would result in an
adjustment in the number of Additional Investment Right Shares for which this
Additional Investment Right is exercisable or in the Exercise Price, the
Company shall obtain all such authorizations or exemptions thereof, or consents
thereto, as may be necessary from any public regulatory body or bodies having
jurisdiction thereof.

 

15.     Miscellaneous.

 

(a)  Jurisdiction.
All questions concerning the construction, validity, enforcement and
interpretation of this Additional Investment Right shall be determined in
accordance with the provisions of the Securities Purchase Agreement.

 

7

 

(b)  Restrictions.  The Holder acknowledges that the Additional
Investment Right Shares acquired upon the exercise of this Additional
Investment Right, if not registered, will have restrictions upon resale imposed
by state and federal securities laws.

 

(c)  Nonwaiver
and Expenses.  No course of dealing
or any delay or failure to exercise any right hereunder on the part of Holder
shall operate as a waiver of such right or otherwise prejudice Holder’s rights,
powers or remedies, notwithstanding all rights hereunder terminate on the
Termination Date. If the Company willfully and knowingly fails to comply with
any provision of this Additional Investment Right, which results in any
material damages to the Holder, the Company shall pay to Holder such amounts as
shall be sufficient to cover any costs and expenses including, but not limited
to, reasonable attorneys’ fees, including those of appellate proceedings,
incurred by Holder in collecting any amounts due pursuant hereto or in otherwise
enforcing any of its rights, powers or remedies hereunder.

 

(d)  Notices.  Any notice, request or other document
required or permitted to be given or delivered to the Holder by the Company
shall be delivered in accordance with the notice provisions of the Securities
Purchase Agreement.

 

(e)  Limitation
of Liability.  No provision hereof,
in the absence of any affirmative action by Holder to exercise this Additional
Investment Right or purchase Additional Investment Right Shares, and no
enumeration herein of the rights or privileges of Holder, shall give rise to
any liability of Holder for the purchase price of any Common Stock or as a
stockholder of the Company, whether such liability is asserted by the Company
or by creditors of the Company.

 

(f)  Remedies.  Holder, in addition to being entitled to
exercise all rights granted by law, including recovery of damages, will be
entitled to specific performance of its rights under this Additional Investment
Right.  The Company agrees that monetary
damages would not be adequate compensation for any loss incurred by reason of a
breach by it of the provisions of this Additional Investment Right and hereby
agrees to waive the defense in any action for specific performance that a
remedy at law would be adequate.

 

(g)  Successors
and Assigns.  Subject to applicable
securities laws, this Additional Investment Right and the rights and
obligations evidenced hereby shall inure to the benefit of and be binding upon
the successors of the Company and the successors and permitted assigns of
Holder.  The provisions of this
Additional Investment Right are intended to be for the benefit of all Holders
from time to time of this Additional Investment Right and shall be enforceable
by any such Holder or holder of Additional Investment Right Shares.

 

(h)  Amendment.
This Additional Investment Right may be modified or amended or the provisions
hereof waived only with the written consent of the Company and the Holder.

 

(i)  Severability.
Wherever possible, each provision of this Additional Investment Right shall be
interpreted in such manner as to be effective and valid under

 

8

 

applicable law,
but if any provision of this Additional Investment Right shall be prohibited by
or invalid under applicable law, such provision shall be ineffective to the
extent of such prohibition or invalidity, without invalidating the remainder of
such provisions or the remaining provisions of this Additional Investment
Right.

 

(j)  Headings.
The headings used in this Additional Investment Right are for the convenience
of reference only and shall not, for any purpose, be deemed a part of this
Additional Investment Right.

 

 

********************

 

9

 

IN WITNESS WHEREOF, the
Company has caused this Additional Investment Right to be executed by its
officer thereunto duly authorized.

 

 

	
  Dated:  December 22, 2004

  	
   

  
	
   

  	
   

  
	
   

  	
  CARDIOTECH INTERNATIONAL, INC.

  
	
   

  	
   

  
	
   

  	
   

  
	
   

  	
  By:

  	
   

  	
   

  
	
   

  	
   

  	
  Name:

  	
  Michael Szycher, Ph.D.

  
	
   

  	
   

  	
  Title: 

  	
  Chairman & Chief Executive Officer

  
					

 

10

 

NOTICE OF EXERCISE

 

To:          CardioTech
International, Inc.

 

(1)     The undersigned hereby elects to purchase           
Additional Investment Right Shares of the Company pursuant to the terms of the
attached Additional Investment Right (only if exercised in full), and tenders
herewith payment of the exercise price in full, together with all applicable
transfer taxes, if any.

 

(2)     Please issue a certificate or certificates
representing said Additional Investment Right Shares in the name of the
undersigned or in such other name as is specified below:

 

	
   

  

 

The Additional Investment Right Shares shall be delivered to the
following:

 

	
   

  
	
   

  
	
   

  
	
   

  
	
   

  

 

(4)     Accredited Investor. The undersigned
is an “accredited investor” as defined in Regulation D under the Securities Act
of 1933, as amended.

 

	
   

  	
  [BUYER]

  
	
   

  	
   

  
	
   

  	
  By:

  	
   

  	
   

  
	
   

  	
  Name:

  
	
   

  	
  Title:

  
	
   

  	
   

  
	
   

  	
  Dated: 

  	
   

  	
   

  
						

 

 

ASSIGNMENT FORM

 

(To assign the foregoing Additional Investment Right, execute

this form and supply required information. 

Do not use this form to exercise the Additional Investment Right.)

 

FOR VALUE RECEIVED, the
foregoing Additional Investment Right and all rights evidenced thereby are
hereby assigned to

 

	
   

  	
  whose address is

  
	
   

  	
   

  
	
   

  	
  .

  
	
   

  
	
   

  
	
   

  	
   

  
	
   

  
	
   

  	
  Dated: 

  	
   

  	
  , 

  	
   

  	
   

  
	
   

  
	
   

  	
  Holder’s Signature:

  	
   

  	
   

  
	
   

  	
   

  	
   

  	
   

  
	
   

  	
  Holder’s Address:

  	
   

  	
   

  
	
   

  	
   

  	
   

  	
   

  
	
   

  	
   

  	
   

  	
   

  
	
   

  
	
   

  
	
  Signature Guaranteed:

  	
   

  	
   

  
														

 

NOTE:  The signature to this
Assignment Form must correspond with the name as it appears on the face of the
Additional Investment Right, without alteration or enlargement or any change
whatsoever, and must be guaranteed by a bank or trust company. Officers of
corporations and those acting in a fiduciary or other representative capacity
should file proper evidence of authority to assign the foregoing Additional
Investment Right.

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