Document:

EX-10.3

 Exhibit 10.3 

FIRST AMENDMENT TO AMENDED AND RESTATED CREDIT, SECURITY AND GUARANTY AGREEMENT 

THIS FIRST AMENDMENT TO AMENDED AND RESTATED CREDIT, SECURITY AND GUARANTY AGREEMENT (this “Agreement”) is made as of this 17
day of March, 2014, by and among ALPHATEC HOLDINGS, INC., a Delaware corporation (“Alphatec Holdings”), ALPHATEC SPINE, INC., a California corporation (“Alphatec Spine”), ALPHATEC INTERNATIONAL LLC, a Delaware
limited liability company (“Alphatec International”), and ALPHATEC PACIFIC, INC. (also known as Kabushiki-Kaisha Alphatec Pacific), a Japanese company (“Alphatec Pacific” and together with Alphatec Holdings,
Alphatec Spine, and Alphatec International, each being referred to herein individually as a “Borrower”, and collectively as “Borrowers”), and MIDCAP FUNDING IV, LLC, a Delaware limited liability company, (as Agent
for Lenders, “Agent”, and individually, as a Lender), and the other financial institutions or other entities from time to time parties to the Credit Agreement referenced below, each as a Lender. 

RECITALS 
 A. Agent,
Lenders, and Borrowers have entered into that certain Amended and Restated Credit, Security and Guaranty Agreement, dated as of August 30, 2013 (the “Original Credit Agreement” and as the same is amended hereby and as it may be
further amended, modified, supplemented and restated from time to time, the “Credit Agreement”), pursuant to which the Lenders have agreed to make certain advances of money and to extend certain financial accommodations to Borrowers
and certain of its Affiliates in the amounts and manner set forth in the Credit Agreement. 
 B. Borrowers have requested that Agent and
Lenders agree to amend the Original Credit Agreement in order to, among other things (i) permit Borrowers to enter into the Deerfield Facility Agreement (as defined below) and to incur certain Debt and grant certain Liens pursuant to the terms
thereof, (ii) expressly permit the merger, consolidation, wind up or liquidation of Surgiview S.A.S., (iii) permit Borrowers and their Subsidiaries to make certain payments related to the Orthotec Litigation (as defined below),
(iv) amend certain conditions with respect to the drawing of second tranche of the Term Loan, (v) add certain financial covenants and (vi) amend certain provisions thereof in order to accommodate the foregoing. 

C. Agent and Lenders are willing to agree to Borrowers’ request for such amendments subject to and in accordance with the terms and
conditions set forth in this Agreement. 
 AGREEMENT 

NOW, THEREFORE, in consideration of the foregoing, the terms and conditions set forth in this Agreement, and other good and valuable
consideration, the receipt and sufficiency of which are hereby acknowledged, Agent, Lenders and Borrowers hereby agree as follows: 
 1.
Recitals. This Agreement shall constitute a Financing Document and the Recitals and each reference to the Credit Agreement, unless otherwise expressly noted, will be deemed to reference the Credit Agreement as amended hereby. The
Recitals set forth above shall be construed as part of this Agreement as if set forth fully in the body of this Agreement and capitalized terms used but not otherwise defined herein shall have the meanings ascribed to them in the Credit Agreement
(including those capitalize terms used in the Recitals hereto). 
 2. Amendment to Original Credit Agreement. Subject to the
terms and conditions of this Amendment, including, without limitation, the conditions to effectiveness set forth in Section 5 below, the Original Credit Agreement is hereby amended as follows: 

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

 (a) Section 1.1 of the Original Credit Agreement is hereby amended by adding the following
definitions in their respective alphabetic order: 
 “Deerfield” means, collectively, Deerfield Private Design Fund II,
L.P., Deerfield Private Design International II, L.P., Deerfield Special Situations Fund, L.P., and Deerfield Special Situations International Master Fund, L.P., and their permitted successors and assigns as “Lenders” under the Deerfield
Facility Agreement. 
 “Deerfield Debt” means Debt incurred pursuant to and in accordance with the terms of the Deerfield
Facility Agreement in a principal amount not to exceed $50,000,000; provided that no more than $15,000,000 of such Debt may be used for purposes other than for making payments related to the Orthotec Matter (including the Orthotec
Litigation). 
 “Deerfield Facility Agreement” means: (a) that certain Facility Agreement, dated as of March 17,
2014, among Alphatec Holdings and Deerfield, without giving effect to any amendment, supplement, restatement or other modification thereto other than those made in accordance with the terms of this Agreement; and (b) the ancillary agreements
and documents, other than any warrants issued in connection therewith, entered into by Borrowers and Deerfield in connection therewith, in each case, true and complete copies of which have been provided to Agent. 

“Deerfield Intercreditor Agreement” means that certain Intercreditor Agreement between Agent and Deerfield, as the same may
be amended, supplemented, restated or otherwise modified from time to time in accordance with the terms thereof, pursuant to which the Deerfield Debt and the Liens securing the Deerfield Debt granted by any Borrower to Deerfield are subordinated to
the Obligations and the Liens created under the Security Documents. 
 “First Amendment Effective Date” means the effective
date of that certain First Amendment to Amended and Restated Credit, Security and Guaranty Agreement, dated as of March 17, 2104, among Borrowers, Agent and Lenders. 

“First Amendment Fee Letter” means that certain fee letter, dated as of the First Amendment Effective Date, from Agent to
Alphatec Holdings and agreed and accepted by Borrowers. 
 Orthotec Litigation” means litigation matters in connection with,
arising from, or related to Orthotec, LLC for which the Borrowers or their Subsidiaries face potential exposure (monetary or otherwise). 

“Orthotec Litigation Settlement” has the meaning set forth in Section 5.16(b). 

“Orthotec Resolution” means such time as the Agent determines, based on information reasonably satisfactory to it, that the
Credit Parties are not directly subject to liability associated with, related to or arising from the 

  
 2 

 
Orthotec Matter or the Orthotec Litigation (including, potential direct liability arising by virtue of liability to which a Subsidiary is subject) that would reasonably be expected to exceed the
sum of (i) $[***] (less any previously made Litigation Payments) plus (ii) cash contributions from one or more shareholders of Alphatec Holdings to the Credit Parties solely for payment
of the Orthotec Settlement Payments plus (iii) insurance proceeds actually received in respect of the Orthotec Litigation. Any such determination shall be made in the Agent’s reasonable discretion in consultation with and upon the
reasonable advice of its outside counsel as it deems necessary or advisable. 
 “Orthotec Settlement Payments” means,
collectively, all amounts paid or transferred (including cash, cash equivalents, assets and/or services) on or after the First Amendment Effective Date by or on behalf of Credit Parties and/or their respective Subsidiaries in connection with any
Orthotec Matter (including the Orthotec Litigation). 
 “Settlement Deposit Account” that certain deposit account
established by and in the sole name of Alpha Holdings and subject to the first priority Lien in favor of Deerfield to hold funds from a draw by Alphatec Holdings of all or any portion of the undrawn amount available under the Facility Agreement
pending the need and requisite authority to use any such funds in accordance with the Facility Agreement to make a settlement payment(s) (or satisfy a judgment(s)) relating to the Orthotec Matter (including the Orthotec Litigation) for which
Alphatec Holdings or its subsidiaries currently or may hereafter face potential liability (“Settlement Funds”); provided, that (i) there shall be no funds other than Settlement Funds on deposit in such account and
(ii) once withdrawn by Alphatec Holdings, no funds may be re-deposited therein. 
 “Surgiview” means Surgiview S.A.S.

 (b) The defined term “Fee Letter” in Section 1.1 of the Original Credit Agreement is hereby amended by replacing
the clause “including the Amended and Restated Fee Letter, dated as of the date hereof, each between Agent and Borrowers” with the clause “including the Amended and Restated Fee Letter, dated as of August 30, 2013, and the First
Amendment Fee Letter, each between Agent and Borrowers.” 
 (c) The defined term “Material Adverse Effect” in
Section 1.1 of the Original Credit Agreement is hereby amended by adding the following sentence to the end of such definition: 

“Notwithstanding the foregoing, so long as the total aggregate exposure (including cash, cash equivalents, assets and/or services) of the
Credit Parties under the Orthotec Matter (including the Orthotec Litigation and whether by settlement, judgment or otherwise) does not exceed the amount of the Deerfield Debt available to pay such settlement or judgment amounts, neither the Orthotec
Matter (including the Orthotec Litigation) nor the resolution of all or any portion thereof shall be deemed to constitute a Material Adverse Effect.” 

(d) The defined term “Permitted Liens” in Section 1.1 of the Original Credit 

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

 
 3 

 
Agreement is hereby amended by deleting the word “and” immediately preceding the clause (k) thereof and the period at the end of clause (k) and adding a new clause (l) as
follows: 
 “and (l) Liens and encumbrances securing the Deerfield Debt that, in each case, are subordinated to the Liens created
under the Security Documents pursuant to the Deerfield Intercreditor Agreement.” 
 (e) The defined term “Subordination
Agreement” in Section 1.1 of the Original Credit Agreement is hereby amended by adding the following parenthetical statement after the word “agreement” in the first line thereof: “(including, without limitation, the
Deerfield Intercreditor Agreement)”. 
 (f) The defined term “Subordinated Debt” in Section 1.1 of the Original
Credit Agreement is hereby amended by adding the following parenthetical statement after the word “Debt” in the first line thereof: “(including, without limitation, the Deerfield Debt)”. 

(g) Section 2.11(i) of the Original Credit Agreement is hereby amended and restated in its entirety to read as follows: 

“(i) Borrowers shall maintain in one or more Deposit Accounts, each of which shall be held in the name of a Borrower in a
bank or financial institution located in the United States and subject to Deposit Account Control Agreement (i) at all times prior to December 31, 2013, at least [***] percent ([***]%)
of the cash held by Holdings and its Subsidiaries, (ii) at all times during the period commencing on December 31, 2013 and ending on the First Amendment Effective Date, at least [***] percent ([***]%) of the cash held by Holdings and its
Subsidiaries, (iii) at all times during the period commencing on the first day following the First Amendment Effective Date and ending on June 30, 2014, at least [***] percent ([***]%) of the cash held by Holdings and its Subsidiaries,
(iv) at all times during the period commencing on July 1, 2014 and ending on December 31, 2014, at least [***] percent ([***]%) of the cash held by Holdings and its Subsidiaries, and (v) at all times thereafter, at least [***]
percent ([***]%) of the cash held by Holdings and its Subsidiaries.” 
 (h) The second sentence of Section 3.4 of the Original
Credit Agreement is hereby amended and restated in its entirety to read as follows: 
 “All issued and outstanding equity securities of
each of the Credit Parties are duly authorized and validly issued, fully paid, nonassessable, free and clear of all Liens other than (a) those in favor of Agent for the benefit of Agent and Lenders and (b) Liens permitted pursuant to
clause (l) of the definition of Permitted Liens, and such equity securities were issued in compliance with all applicable Laws.” 

(i) Clause (iii) of Section 3.6 of the Original Credit Agreement is hereby amended and restated in its entirety to read as follows:

 “(iii) the Orthotec Matter (which, for avoidance of doubt, includes the Orthotec Litigation),” 

(j) Section 3.19 of the Original Credit Agreement is hereby amended by adding the 

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

 
 4 

 
parenthetical statement “(except for Liens granted pursuant to the Deerfield Facility Agreement)” after the word “Liens” in the fourth sentence thereof. 

(k) Section 5.4 of the Original Credit Agreement is hereby amended and restated in its entirety to read as follows: 

“Section 5.4 Restrictive Agreements. No Borrower will, or will permit any Subsidiary to, directly or indirectly
(a) enter into or assume any agreement prohibiting the creation or assumption of any Lien upon its properties or assets, whether now owned or hereafter acquired (except as provided by the Financing Documents and the Deerfield Facility
Agreement), or (b) create or otherwise cause or suffer to exist or become effective any consensual encumbrance or restriction of any kind (except as provided by the Financing Documents and the Deerfield Facility Agreement) on the ability of any
Subsidiary to: (i) pay or make Restricted Distributions to any Borrower or any Subsidiary; (ii) pay any Debt owed to any Borrower or any Subsidiary; (iii) make loans or advances to any Borrower or any Subsidiary; or (iv) transfer
any of its property or assets to any Borrower or any Subsidiary. 
 (l) The Original Credit Agreement is hereby amended by adding the
following Section 5.16 at the end of Article 5: 
 “Section 5.16 Surgiview Dissolution; Orthotec Litigation. 

(a) Surgiview Dissolution. Notwithstanding anything to the contrary in this Article 5 or otherwise in this Agreement or
the other Financing Documents, Borrowers shall be permitted to (i) dissolve, liquidate or wind up Surgiview (including through any voluntary or involuntary insolvency proceeding that would otherwise give rise to an Event of Default pursuant
only to Section 10.1(e) or 10.1(f)) or to consolidate Surgiview with or merge Surgiview into a Credit Party and (ii) terminate the Secured Permitted Intercompany Loan to Surgiview in connection with any action taken pursuant to clause (i),
in each case, solely to the extent permitted by applicable Law. 
 (b) Orthotec Litigation. Notwithstanding anything
to the contrary in this Article 5 or otherwise in this Agreement or the other Financing Documents, but subject to Section 5.16(c) below, Agent and Lenders agree that Credit Parties may make (or may contribute cash to Surgiview in order for it
to make) one or more Orthotec Settlement Payments in an aggregate amount not to exceed the aggregate amount drawn by Alphatec Holdings under the Deerfield Facility Agreement for purposes of making Orthotec Settlement Payments and, so long as the
total aggregate exposure (including cash, cash equivalents, assets and/or services) of the Credit Parties under the Orthotec Matter (including the Orthotec Litigation and whether by settlement, judgment or otherwise) does not exceed the amount of
the Deerfield Debt available to pay such settlement or judgment amounts, any such settlement, judgment or order otherwise entered or rendered in connection therewith shall not constitute a Default or Event of Default; provided that: 

(i) prior to entering into any settlement agreement or other settlement arrangement with respect to the Orthotec Matter
(including the Orthotec Litigation, an “Orthotec Litigation Settlement”), Borrowers shall have delivered to Agent (x) the execution versions of the settlement agreement and all agreements, certificates, instruments and other documents
related thereto, (y) projections demonstrating pro forma compliance with the financial covenants in Article 6 for the 12 month period immediately following such Orthotec Litigation Settlement and after giving effect thereto, and (z) such
other information as Agent may reasonably request regarding the Orthotec Litigation Settlement; 

  
 5 

 (ii) no Event of Default shall have occurred and be continuing at the time such
Orthotec Settlement Payment is made; and 
 (iii) the Orthotec Resolution shall have occurred. 

(c) Initial Orthotec Settlement Payment. Notwithstanding anything to the contrary in this Article 5 or otherwise in this
Agreement or the other Financing Documents, Borrowers shall be permitted to make initial Orthotec Settlement Payments in an aggregate amount not to exceed [***] dollars ($[***]) prior to the satisfaction of the conditions set forth in
Section 5.16(b) (including the initial advance under the Deerfield Facility Agreement); provided, however, at the time of each such initial payment, no Event of Default shall have occurred and be continuing or would result therefrom, excluding
for the purposes of this proviso, any Event of Default that would otherwise not occur had the conditions of Section 5.16(b) been satisfied. 

(m) Section 6.1 of the Original Credit Agreement is hereby amended by 

(i) replacing, in its entirety the defined term “Defined Period” with the following definition: 

“Defined Period” means, for purposes of calculating the Fixed Charge Coverage Ratio, the Senior Leverage Ratio and the Total
Leverage Ratio for any given calendar month, the twelve (12) month period immediately preceding any such calendar month. 

(ii) adding the following definitions in their respective alphabetic order: 

“Total Debt” means an amount equal to the sum of (a) Senior Debt plus (b) the total outstanding balance of
Deerfield Debt. 
 “Total Leverage Ratio” means, for any Defined Period, the ratio of (a) Total Debt to
(b) EBITDA. 
 (n) Article 6 of the Original Credit Agreement is hereby amended by adding a new section 6.5 at the end thereof as
follows: 
 Section 6.5 Total Leverage Ratio. Borrowers will not permit the Total Leverage Ratio for any Defined Period,
as tested monthly, to be greater than [***] to [***]. 
 (o) Schedule 2.1 of the
Original Credit Agreement is hereby deleted in its entirety and replaced with the new Schedule 2.1 attached hereto as Exhibit A. 

(p) Schedule 5.14 of the Original Credit Agreement is hereby deleted in its entirety and replaced with the new Schedule 5.14 attached hereto
as Exhibit B. 
 (q) Schedule 9.1 of the Original Credit Agreement is hereby deleted in its entirety and replaced with the new
Schedule 9.1 attached hereto as Exhibit C. 
 (r) Exhibit B of the Original Credit Agreement is hereby deleted in its entirety and
replaced with the new Compliance Certificate attached hereto as Exhibit D. 

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

 
 6 

 3. Representations and Warranties; Reaffirmation of Security Interest; Updated
Schedules. Each Borrower hereby (a) confirms that all of the representations and warranties set forth in the Credit Agreement are true and correct in all material respects with respect to such Borrower as of the date hereof except to
the extent that any such representation or warranty relates to a specific date in which case such representation or warranty shall be true and correct as of such earlier date, and (b) covenants to perform its respective obligations under the
Credit Agreement. Each Borrower further represents and warrants that the organizational documents of such Borrower delivered to Agent on or prior to August 30, 2013 in connection with the Credit Agreement remain true, accurate and complete and
have not been amended, supplemented or restated and are, and continue to be, in full force and effect. Each Borrower confirms and agrees that all security interests and Liens granted to Agent continue in full force and effect, and all Collateral
remains free and clear of any Liens, other than those granted to Agent and Permitted Liens. Nothing herein is intended to impair or limit the validity, priority or extent of Agent’s security interests in and Liens on the Collateral. Each
Borrower acknowledges and agrees that the Credit Agreement, the other Financing Documents and this Agreement constitute the legal, valid and binding obligation of each Borrower, and are enforceable against each Borrower in accordance with its terms,
except as the enforceability thereof may be limited by bankruptcy, insolvency or other similar laws relating to the enforcement of creditors’ rights generally and by general equitable principles. 

4. Costs and Fees. Borrowers shall be responsible for the payment of all reasonable and documented out-of-pocket costs and fees
of Agent’s counsel incurred in connection with the preparation of this Agreement and any related documents. If Agent or any Lender uses in-house counsel for any of these purposes, Borrowers further agree that the Obligations include reasonable
charges for such work commensurate with the fees that would otherwise be charged by outside legal counsel selected by Agent or such Lender for the work performed. In no event shall the amounts payable by Borrowers under this Section 4 for the
fees of Agent’s outside counsel (and expressly excluding reasonable and documented out-of-pocket costs), for the period commencing on March 1, 2014 through the date of this Agreement, exceed $[***] in the aggregate without the consent of Alphatec Holdings. 
 5. Conditions to
Effectiveness. This Agreement shall become effective as of the date on which each of the following conditions has been satisfied: 

(a) Borrowers shall have delivered to Agent this Agreement, the First Amendment Fee Letter, and the Deerfield Intercreditor Agreement, each
duly executed by an authorized officer of each Borrower; 
 (b) all representations and warranties of Borrowers contained herein shall be
true and correct in all material respects as of the date hereof (and such parties’ delivery of their respective signatures hereto shall be deemed to be its certification thereof); 

(c) after giving effect to the agreements set forth herein, no Default or Event of Default shall exist under any of the Financing Documents;

 (d) Borrower shall have delivered such other documents, information, certificates, records, permits, and filings as the Agent may
reasonably request; and 
 (e) Agent shall have received from Borrowers all of the fees owing pursuant to this Agreement and other documents
and agreements executed in connection herewith, including without limitation, Agent’s reasonable out-of-pocket legal fees and expenses pursuant to Section 4 (Costs and Fees) of this Agreement. 

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

 
 7 

 6. Release. In consideration of the agreements of Agent and Required Lenders
contained herein and for other good and valuable consideration, the receipt and sufficiency of which is hereby acknowledged, each Borrower, voluntarily, knowingly, unconditionally and irrevocably, with specific and express intent, for and on behalf
of itself and all of its respective parents, subsidiaries, affiliates, members, managers, predecessors, successors, and assigns, and each of their respective current and former directors, officers, shareholders, agents, and employees, and each of
their respective predecessors, successors, heirs, and assigns (individually and collectively, the “Releasing Parties”) does hereby fully and completely release, acquit and forever discharge each of Agent, Lenders, and each their
respective parents, subsidiaries, affiliates, members, managers, shareholders, directors, officers and employees, and each of their respective predecessors, successors, heirs, and assigns (individually and collectively, the “Released
Parties”), of and from any and all actions, causes of action, suits, debts, disputes, damages, claims, obligations, liabilities, costs, expenses and demands of any kind whatsoever, at law or in equity, whether matured or unmatured,
liquidated or unliquidated, vested or contingent, choate or inchoate, known or unknown that the Releasing Parties (or any of them) has against the Released Parties or any of them (whether directly or indirectly). Each Borrower acknowledges that the
foregoing release is a material inducement to Agent’s and Required Lender’s decision to enter into this Agreement and agree to the modifications contemplated hereunder, and has been relied upon by Agent and Required Lenders in connection
therewith. 
 7. No Waiver or Novation. The execution, delivery and effectiveness of this Agreement shall not, except as
expressly provided in this Agreement, operate as a waiver of any right, power or remedy of Agent, nor constitute a waiver of any provision of the Credit Agreement, the Financing Documents or any other documents, instruments and agreements executed
or delivered in connection with any of the foregoing. Nothing herein is intended or shall be construed as a waiver of any existing Defaults or Events of Default under the Credit Agreement or other Financing Documents or any of Agent’s rights
and remedies in respect of such Defaults or Events of Default. This Agreement (together with any other document executed in connection herewith) is not intended to be, nor shall it be construed as, a novation of the Credit Agreement. 

8. Affirmation. Except as specifically amended pursuant to the terms hereof, each Borrower hereby acknowledges and agrees that
the Credit Agreement and all other Financing Documents (and all covenants, terms, conditions and agreements therein) shall remain in full force and effect, and are hereby ratified and confirmed in all respects by Borrowers. Each Borrower covenants
and agrees to comply with all of the terms, covenants and conditions of the Credit Agreement and the Financing Documents, notwithstanding any prior course of conduct, waivers, releases or other actions or inactions on Agent’s or any
Lender’s part which might otherwise constitute or be construed as a waiver of or amendment to such terms, covenants and conditions. 

9. Confidentiality. No Borrower will disclose the contents of this Agreement, the Credit Agreement or any of the other Financing
Documents to any third party (including, without limitation, any financial institution or intermediary) without Agent’s prior written consent, other than to Borrowers’ officers and advisors on a need-to-know basis or as otherwise may be
required by Law, including to any court or regulatory agency having jurisdiction over such Borrower. Each Borrower agrees to inform all such persons who receive information concerning this Agreement, the Credit Agreement and the other Financing
Documents that such information is confidential and may not be disclosed to any other person except as may be required by Law, including to any court or regulatory agency having jurisdiction over such Borrower. 

10. Miscellaneous. 

(a) Reference to the Effect on the Credit Agreement. Upon the effectiveness of this Agreement, each reference in the Credit Agreement
to “this Agreement,” “hereunder,” “hereof,” “herein,” 

  
 8 

 
or words of similar import shall mean and be a reference to the Credit Agreement, as amended by this Agreement. Except as specifically amended above, the Credit Agreement, and all other Financing
Documents (and all covenants, terms, conditions and agreements therein), shall remain in full force and effect, and are hereby ratified and confirmed in all respects by Borrowers. 

(b) Incorporation of Credit Agreement Provisions. The provisions contained in Section 11.6 (Indemnification),
Section 12.8 (Governing Law; Submission to Jurisdiction) and Section 12.9 (Waiver of Jury Trial) of the Credit Agreement are incorporated herein by reference to the same extent as if reproduced herein in their entirety. 

(c) Headings. Section headings in this Agreement are included for convenience of reference only and shall not constitute a part of this
Agreement for any other purpose. 
 (d) Counterparts. This Agreement may be signed in any number of counterparts, each of which shall
be deemed an original and all of which when taken together shall constitute one and the same instrument. Delivery of an executed counterpart of this Agreement by facsimile or by electronic mail delivery of an electronic version (e.g., .pdf or .tif
file) of an executed signature page shall be effective as delivery of an original executed counterpart hereof and shall bind the parties hereto. 

(e) Entire Agreement. This Agreement constitutes the entire agreement and understanding among the parties hereto and supersedes any and
all prior agreements and understandings, oral or written, relating to the subject matter hereof. 
 (f) Severability. In case any
provision of or obligation under this Agreement shall be invalid, illegal or unenforceable in any applicable jurisdiction, the validity, legality and enforceability of the remaining provisions or obligations, or of such provision or obligation in
any other jurisdiction, shall not in any way be affected or impaired thereby. 
 (g) Successors/Assigns. This Agreement shall bind,
and the rights hereunder shall inure to, the respective successors and assigns of the parties hereto, subject to the provisions of the Credit Agreement and the other Financing Documents. 

[SIGNATURES APPEAR ON FOLLOWING PAGES] 

  
 9 

 IN WITNESS WHEREOF, intending to be legally bound, and intending that this document constitute an
agreement executed under seal, the undersigned have executed this Agreement under seal as of the day and year first hereinabove set forth. 
  

									
	 AGENT:
	 		 	 MIDCAP FUNDING IV, LLC,
 as
Agent

					
		 		 	By:	 	 /s/ Brett Robinson
	 	(SEAL)
		 		 	Name:	 	Brett Robinson	 	
		 		 	Title:	 	Managing Director	 	
			
	LENDER:	 		 	 MIDCAP FUNDING IV, LLC,
 as a
Lender

					
		 		 	 By:
	 	 /s/ Brett Robinson
	 	(SEAL)
		 		 	 Name:
	 	Brett Robinson	 	
		 		 	Title:	 	Managing Director	 	

 [Signatures Continue on Following Page] 

									
	BORROWERS:	 		 	ALPHATEC HOLDINGS, INC.,
		 		 	a Delaware corporation
					
		 		 	By:	  	 /s/ Michael O’Neill
	 	(SEAL)
		 		 	Name: Michael O’Neill	 	
		 		 	Title: VP and CFO	 	
				
		 		 	ALPHATEC SPINE, INC.,	 	
		 		 	a California corporation	 	
					
		 		 	By:	  	 /s/ Michael O’Neill
	 	(SEAL)
		 		 	Name: Michael O’Neill	 	
		 		 	Title: VP and CFO	 	
			
		 		 	ALPHATEC INTERNATIONAL LLC,
		 		 	a Delaware limited liability company	 	
					
		 		 	By:	  	 /s/ Michael O’Neill
	 	(SEAL)
		 		 	Name: Michael O’Neill	 	
		 		 	 Title: CFO Alphatec Holdings,General Partner of Alphatec Holdings International CV, Sole Manager of Alphatec
International LLC

				
		 		 	ALPHATEC PACIFIC, INC.	 	
		 		 	a Japanese company	 	
					
		 		 	By:	  	 /s/ Ebun Garner
	 	(SEAL)
		 		 	Name: Ebun Garner	 	
		 		 	Title: Director	 	

 EXHIBIT A 

SCHEDULE 2.1 - AMORTIZATION 

Commencing on (i) the first day of the first calendar month following the advance of the initial tranche of the Term Loan made on the
Closing Date and continuing on the first day of each calendar month (each, a “Payment Date”) thereafter, Borrowers shall pay to Agent as a principal payment under the first tranche of the Term Loan, an amount equal to the Tranche 1
Amortization Payment (defined below) as an amortization payment in respect of such advance under the Term Loan, plus (ii) the first day of the calendar month following the sixth
(6th) month anniversary of the advance of the second tranche of the Term Loan made pursuant to Section 2.1(a)(i) and continuing on each Payment Date thereafter, Borrowers shall pay to
Agent as a principal payment under the second tranche of the Term Loan, an amount equal to the Tranche 2 Amortization Payment (defined below) as an amortization payment in respect of such advance under the Term Loan. 

The term “Tranche 1 Amortization Payment” means, (i) for each Payment Date prior to the Termination Date, an amount
equal to $[***] and (ii) for the Termination Date an amount equal to the entire remaining outstanding principal balance under the Term Loans. 

The term “Tranche 2 Amortization Payment” means, (i) for each Payment Date following the sixth (6th) month anniversary of the advance of the second tranche of the Term Loan made pursuant to Section 2.1(a)(i), but prior to the Termination Date, a straight-line amortization payment equal
to $[***] divided by the number of Payment Dates between such sixth (6th) month anniversary and the Commitment Expiry Date and (ii) for the Termination Date an amount equal to the entire
remaining outstanding principal balance under the Term Loans (without duplication of amounts paid pursuant to clause (ii) of the definition of Tranche 1 Amortization Payment). 

Notwithstanding anything to the contrary contained in the foregoing, the entire remaining outstanding principal balance under the Term Loan
shall mature and be due and payable upon the Termination Date. 

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

 EXHIBIT B 

SCHEDULE 5.14 – DEPOSIT AND SECURITIES ACCOUNTS 
  

													
	 Owner
	 	Bank	 	Branch	 	Bank address	 	Account Number	 	Type of Account	 	Currency
	[***]	 	[***]	 	[***]	 	[***]	 	[***]	 	[***]	 	[***]

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

 EXHIBIT C 

Schedule 9.1 – Collateral 

The Collateral consists of all of Borrowers’ assets, including without limitation, all of Borrowers’ right, title and interest in
and to the following, whether now owned or hereafter created, acquired or arising: 
  

	 	(a)	all goods, Accounts (including health-care insurance receivables), Equipment, Inventory, contract rights or rights to payment of money, leases, license agreements, franchise agreements, General Intangibles, commercial
tort claims, documents, instruments (including any promissory notes), chattel paper (whether tangible or electronic), cash, deposit accounts (other than the Settlement Deposit Account), intellectual property, securities accounts, fixtures, letter of
credit rights (whether or not the letter of credit is evidenced by a writing), securities, and all other investment property, supporting obligations, and financial assets, whether now owned or hereafter acquired, wherever located; 

 

	 	(b)	all of Borrowers’ books and records relating to any of the foregoing; 

  

	 	(c)	all of Borrowers’ Promissory Notes; and 

  

	 	(d)	any and all claims, rights and interests in any of the above and all substitutions for, additions, attachments, accessories, accessions and improvements to and replacements, products, proceeds and insurance proceeds of
any or all of the foregoing; 

 Notwithstanding the foregoing, the Collateral: (x) expressly excludes the Settlement
Deposit Account; and (y) with respect to Equity Interests (as defined in the Pledge Agreement), expressly includes only those Equity Interests pledged pursuant to the Pledge Agreement. 

  

 EXHIBIT D 

COMPLIANCE CERTIFICATE 

This Compliance Certificate is given by
                                    , a Responsible Officer of
Alphatec Holdings, Inc., a Delaware corporation (the “Borrower Representative”), pursuant to that certain Amended and Restated Credit, Security and Guaranty Agreement, dated as of August 30, 2013, by and among the Borrower
Representative and each of its Subsidiaries party thereto as “Borrowers”, and any additional Borrower that may hereafter be added thereto (collectively, “Borrowers”), MidCap Financial, LLC, individually as a Lender and as
Agent, and the financial institutions or other entities from time to time parties hereto, each as a Lender (as such agreement may have been amended, restated, supplemented or otherwise modified from time to time, the “Credit
Agreement”). Capitalized terms used herein without definition shall have the meanings set forth in the Credit Agreement. 
 The
undersigned Responsible Officer hereby certifies to Agent and Lenders that: 
 (a) the financial statements delivered with this certificate
in accordance with Section 4.1 of the Credit Agreement fairly present in all material respects the results of operations and financial condition of Borrowers and their Consolidated Subsidiaries as of the dates and the accounting period covered
by such financial statements; 
 (b) I have reviewed the terms of the Credit Agreement and have made, or caused to be made under my
supervision, a review in reasonable detail of the transactions and conditions of Borrowers and their Consolidated Subsidiaries during the accounting period covered by such financial statements, and such review has not disclosed the existence during
or at the end of such accounting period, and I have no knowledge of the existence as of the date hereof, of any condition or event that constitutes a Default or an Event of Default, except as set forth in Schedule 1 hereto, which
includes a description of the nature and period of existence of such Default or an Event of Default and what action Borrowers have taken, are undertaking and propose to take with respect thereto; 

(c) except as noted on Schedule 2 attached hereto, Schedule 9.2 to the Credit Agreement contains a complete and
accurate list of all business locations of Borrowers and Guarantors and all names under which Borrowers or Guarantors currently conduct business, and Schedule 2 specifically notes any changes in the names under which Borrowers or
Guarantors conduct business; 
 (d) except as noted on Schedule 3 attached hereto, the undersigned has no knowledge of
(i) any federal or state tax liens having been filed against the Borrowers, Guarantors or any Collateral, or (ii) any failure of the Borrowers or Guarantors to make required payments of withholding or other tax obligations of the Borrowers
or Guarantors during the accounting period to which the attached statements pertain or any subsequent period; 
 (e) except as noted on
Schedule 4 attached hereto, Schedule 5.14 to the Credit Agreement contains a complete and accurate statement of all Deposit Accounts and Security Accounts maintained by Borrowers or Guarantors; 

(f) except as noted on Schedule 5 attached hereto or Schedule 3.6 to the Credit Agreement, the undersigned has no
knowledge of any current, pending or threatened: (i) litigation against the Borrowers or Guarantors, (ii) inquiries, investigations or proceedings concerning the business affairs, practices, licensing or reimbursement entitlements of
Borrowers or Guarantors, or (iii) default by Borrowers or Guarantors under any Material Contract to which either of them is a party, provided, 

 
however, that the information required pursuant to this clause (f) shall be deemed to have been delivered if the Credit Parties deliver to the Agent that certain litigation letter or
disclosure statement delivered to Holdings’ independent public accountants on a quarterly basis at substantially the same time such letter or disclosure statement is delivered to Holdings’ independent public accountants; 

(g) [except as noted on Schedule 6 attached hereto, no Borrower or Guarantor has acquired, by purchase, by the approval or
granting of any application for registration (whether or not such application was previously disclosed to Agent by Borrowers) or otherwise, any Intellectual Property that is registered with any United States or foreign Governmental Authority, or has
filed with any such United States or foreign Governmental Authority, any new application for the registration of any Intellectual Property, or acquired rights under a license as a licensee with respect to any such registered Intellectual Property
(or any such application for the registration of Intellectual Property) owned by another Person, that has not previously been reported to Agent on Schedule 3.19 to the Credit Agreement or any Schedule 6 to any previous
Compliance Certificate delivered by the Company to Agent;] [To be included in the Compliance Certificate provided at the end of each Fiscal Quarter only] 

(h) except as noted on Schedule 7 attached hereto and except in the ordinary course of business, no Borrower or Guarantor
has acquired, by purchase or otherwise, any Chattel Paper, Letter of Credit Rights, Instruments, Documents or Investment Property that has not previously been reported to Agent on any Schedule 7 to any previous Compliance
Certificate delivered by Borrower Representative to Agent; 
 (i) [except as noted on Schedule 8 attached hereto, no
Borrower or Guarantor is aware of any commercial tort claim that has not previously been reported to Agent on any Schedule 8 to any previous Compliance Certificate delivered by Borrower Representative to Agent; and] [To be
included in the Compliance Certificate provided at the end of each Fiscal Quarter only] 
 (j) Borrowers and Guarantors are in
compliance with the covenants contained in Article 6 of the Credit Agreement, and in any Guarantee constituting a part of the Financing Documents, as demonstrated by the calculation of such covenants as set forth in the attached Worksheets [See
attached worksheets], and such calculations and the certifications contained therein are true, correct and complete; 
 (k) Borrowers are in
compliance with Section 2.11(i) of the Credit Agreement; and 
 (l) [pursuant to the documents and information attached hereto as
Schedule 9, ]the Orthotec Resolution [has / has not] occurred. [To be included in the Compliance Certificate provided at the time of the advance of the second tranche of the Term Loan only] 

The foregoing certifications and computations are made as of             ,
201     (end of month) and as of             , 201    . 
  

			
	 Sincerely,
  

ALPHATEC HOLDINGS, INC.,
 as Borrower Representative

 

	By:	 	  

	Name:	 	
	Title:	 	

  

 Worksheet for Calculation of EBITDA 

 

			
	EBITDA for the applicable Defined Period is calculated as follows:	  	
		
	Net income (or loss) for the Defined Period of Borrowers and their Consolidated Subsidiaries, but excluding: (a) the income (or loss) of any Person (other than Subsidiaries of Borrowers) in which Borrowers or any of their
Subsidiaries has an ownership interest unless received by Borrower or their Subsidiary in a cash distribution; and (b) the income (or loss) of any Person accrued prior to the date it became a Subsidiary of Borrowers or is merged into or
consolidated with Borrowers	  	$            
		  	  

		
	 Plus:    Any provision for (or minus any benefit from) income and franchise taxes deducted in the
determination of net income for the Defined Period
	  	$            
		  	  

		
	 Plus:    Interest expense, net of interest income, deducted in the determination of net income for the
Defined Period
	  	$            
		  	  

		
	 Plus:    Stock-based compensation expense
	  	$            
		  	  

		
	 Plus:    Amortization and depreciation deducted in the determination of net income for the Defined Period
(including impairment charges to goodwill and write downs of intangible assets)
	  	$            
		  	  

		
	 Plus:    Non-recurring expenses approved by Agent (including transaction expenses and restructuring charges
related to acquisitions)
	  	$            
		  	  

		
	EBITDA for the Defined Period:	  	$            
		  	  

 Worksheet for Calculation of Fixed Charges 

 

			
		
	Fixed Charges for the applicable Defined Period is calculated as follows:	  	$            
		  	  

		
	Interest expense ($        ), net of interest income ($        ), interest paid in kind ($        ) and
amortization of capitalized fees and expenses incurred to consummate the transactions contemplated by the Financing Documents and included in interest expense ($        ), included in the determination of net
income of Borrowers and their Consolidated Subsidiaries for the Defined Period (“Total Interest Expense”)	  	$            
		  	  

		
	 Plus:    Any provision for (or minus any benefit from) income or franchise taxes included in the
determination of net income for the Defined Period *
	  	$            
		  	  

		
	 Plus:    Payments of principal and interest for the Defined Period with respect to all Debt (including the
portion of scheduled payments under capital leases allocable to principal and excluding scheduled repayments of Revolving Loans and other Debt subject to reborrowing to the extent not accompanied by a concurrent and permanent reduction of the
Revolving Loan Commitment (or equivalent loan commitment))
	  	$            
		  	  

			
	 Plus:         Permitted Distributions
	  	$            
		  	  

		
	Fixed Charges for the applicable Defined Period:	  	$            
		  	  

	
	Worksheet for Calculation of Operating Cash Flow
		
	Operating Cash Flow for the applicable Defined Period is calculated as follows:	  	
		
	EBITDA for the Defined Period (calculated pursuant to the EBITDA Worksheet)	  	$            
		  	  

		
	 Minus:      Unfinanced capital expenditures for the Defined Period
	  	$            
		  	  

		
	 Minus:      To the extent not already reflected in the calculation of EBITDA, other capitalized
costs, defined as the gross amount paid in cash and capitalized during the Defined Period, as long term assets, other than amounts capitalized during the Defined Period as capital expenditures for property, plant and equipment or similar fixed asset
accounts
	  	$            
		  	  

		
	Operating Cash Flow for the Defined Period:	  	$            
		  	  

	
	Covenant Compliance:
		
	Fixed Charge Coverage Ratio for the Defined Period	  	[***]
		
	Minimum Fixed Charge Coverage Ratio for the Defined Period	  	 [***] 
 [***]

		
	In Compliance	  	Yes / No
		
	Senior Leverage Ratio for the Defined Period	  	[***]
		
	Maximum Senior Leverage Ratio for the Defined Period	  	 [***] 
 [***]

	In Compliance	  	Yes / No
		
	 Total Leverage Ratio for the Defined Period
	  	[***]
		
	 Maximum Total Leverage Ratio for the Defined Period
	  	[***]
		
	 In Compliance
	  	Yes / No

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

 EXHIBIT 4.1 

ALDER BIOPHARMACEUTICALS, INC. 

AMENDED AND RESTATED INVESTORS’ RIGHTS AGREEMENT 

April 16, 2012 

 TABLE OF CONTENTS 
  

					
	 	  	Page	 
	 A. Amendments of Prior Rights Agreement; Waiver of Right of First Offer
	  	 	2	  
		
	 1. Registration Rights
	  	 	3	  
	 1.1 Definitions
	  	 	3	  
	 1.2 Request for Registration
	  	 	4	  
	 1.3 Company Registration
	  	 	6	  
	 1.4 Form S-3 Registration
	  	 	7	  
	 1.5 Obligations of the Company
	  	 	8	  
	 1.6 Information from Holder
	  	 	10	  
	 1.7 Expenses of Registration
	  	 	10	  
	 1.8 Delay of Registration
	  	 	11	  
	 1.9 Indemnification
	  	 	11	  
	 1.10 Reports Under the 1934 Act
	  	 	13	  
	 1.11 Assignment of Registration Rights
	  	 	14	  
	 1.12 Limitations on Subsequent Registration Rights
	  	 	14	  
	 1.13 ‘Market Stand-Off’ Agreement
	  	 	14	  
	 1.14 Termination of Registration Rights
	  	 	16	  
		
	 2. Covenants of the Company
	  	 	16	  
	 2.1 Delivery of Financial Statements
	  	 	16	  
	 2.2 Inspection
	  	 	17	  
	 2.3 Assignment/Termination of Information and Inspection Covenants
	  	 	17	  
	 2.4 Right of First Offer
	  	 	17	  
	 2.5 Proprietary Information and Inventions Agreements
	  	 	20	  
	 2.6 Employee Agreements
	  	 	20	  
	 2.7 Drag Along Agreements
	  	 	20	  
	 2.8 Director’s Liability and Indemnification
	  	 	20	  
	 2.9 Reimbursement of Certain Expenses
	  	 	20	  
	 2.10 Termination
	  	 	20	  
		
	 3. Miscellaneous
	  	 	23	  
	 3.1 Successors and Assigns
	  	 	23	  
	 3.2 Governing Law
	  	 	23	  
	 3.3 Counterparts
	  	 	23	  
	 3.4 Titles and Subtitles
	  	 	23	  
	 3.5 Notices
	  	 	23	  
	 3.6 Expenses
	  	 	24	  
	 3.7 Entire Agreement; Amendments and Waivers
	  	 	24	  
	 3.8 Severability
	  	 	24	  
	 3.9 Aggregation of Stock
	  	 	24	  
	 3.10 Additional Investors
	  	 	24	  
	 3.11 Severability
	  	 	24	  

 AMENDED AND RESTATED INVESTORS’ RIGHTS AGREEMENT 

This AMENDED AND RESTATED INVESTORS’ RIGHTS AGREEMENT (the “Agreement”) is made as of the 16th day of April,
2012, by and among Alder BioPharmaceuticals, Inc., a Delaware corporation (the “Company”), the holders of the Company’s Series A Preferred Stock listed on Schedule A attached hereto (the “Series A Holders”),
the holders of the Company’s Series B Preferred Stock listed on Schedule A attached hereto (the “Series B Holders”), the holders of the Company’s Series C Preferred Stock listed on Schedule A attached hereto (the
“Series C Holders”), the holders of Series D Preferred Stock listed on Schedule A attached hereto (the “Series D Holders,” and together with the Series A Holders, the Series B Holders and the Series C Holders, the
“Investors” and each individually, an “Investor”), and Randall Schatzman, Mark Litton and John Latham, each of whom is herein referred to as a “Founder.” 

RECITALS 

WHEREAS, the Company, the Founders, the Series A Holders, the Series B Holders and the Series C Holders have previously entered into an
Amended and Restated Investors’ Rights Agreement dated as of December 28, 2007 (the “Prior Rights Agreement”), pursuant to which the Company granted the Founders, the Series A Holders, the Series B Holders and the Series C
Holders certain rights; 
 WHEREAS, the Company and certain of the Investors are parties to the Series D Preferred Stock Purchase
Agreement of even date herewith (the “Series D Agreement”); 
 WHEREAS, in order to induce such Investors to
purchase Series D Preferred Stock (the “Series D Preferred Stock” or together, with the Company’s Series A Preferred Stock, Company’s Series B Preferred Stock and the Company’s Series C Preferred Stock, the
“Preferred Stock”) and invest funds in the Company pursuant to the Series D Agreement, the Investors and the Company hereby agree that this Agreement shall govern the rights of the Investors to cause the Company to register shares
of Common Stock issued or issuable to them and certain other matters as set forth herein; and 
 WHEREAS, the Company, the Founders,
the Series A Holders, the Series B Holders and the Series C Holders each desire to amend and restate the Prior Rights Agreement to add the Series D Holders as parties to this Agreement and make certain other changes. 

NOW, THEREFORE, THE PARTIES HEREBY AGREE AS FOLLOWS: 

A. Amendments of Prior Rights Agreement; Waiver of Right of First Offer. Effective and contingent upon execution of this Agreement by
the Company and the holders of at least sixty percent (60%) of Common Stock issuable or issued upon conversion of the Series A 

  
 2 

 
Preferred Stock, Series B Preferred Stock and Series C Preferred Stock, taken together as a single class, and upon closing of the transactions contemplated by the Series D Agreement, the Prior
Rights Agreement is hereby amended and restated in its entirety to read as set forth in this Agreement, and the Company, the Founders, and the Investors hereby agree to be bound by the provisions hereof as the sole agreement of the Company, the
Founders and the Investors with respect to registration rights of the Company’s securities and certain other rights, as set forth herein. The Series A Holders, the Series B Holders and Series C Holders that are Major Investors (as that term is
defined in the Prior Rights Agreement) hereby waive the Right of First Offer, including the notice requirements, set forth in the Prior Rights Agreement with respect to the issuance of Series D Preferred Stock. 

1. Registration Rights. The Company covenants and agrees as follows: 

1.1 Definitions. For purposes of this Section 1: 

(a) The term “Act” means the Securities Act of 1933, as amended. 

(b) The term “Form S-3” means such form under the Act as in effect on the date
hereof or any registration form under the Act subsequently adopted by the SEC that permits inclusion or incorporation of substantial information by reference to other documents filed by the Company with the SEC. 

(c) The term “Founders’ Stock” means the shares of Common Stock issued to the Founders. 

(d) The term “Holder” means any Investor or Founder owning or having the right to acquire Registrable Securities or any
assignee thereof in accordance with Section 1.11 hereof. 
 (e) The term “Initial Offering” means the
Company’s first firm commitment underwritten public offering of its Common Stock under the Act. 
 (f) The term “1934
Act” means the Securities Exchange Act of 1934, as amended. 
 (g) The term “Qualified Public Offering” means a
sale of the Company’s Common Stock in a firm commitment underwritten public offering on the New York Stock Exchange or NASDAQ National Market pursuant to a registration statement on Form S-1 or Form SB-2 under the Securities Act of 1933, as amended, that results in aggregate proceeds to the Company, net of underwriting expenses, in excess of $40,000,000. 

(h) The terms “register,” “registered,” and “registration” refer to a registration effected
by preparing and filing a registration statement or similar document in compliance with the Act, and the declaration or ordering of effectiveness of such registration statement or document. 

  
 3 

 (i) The term “Registrable Securities” means (i) the Common Stock issuable
or issued upon conversion of the Preferred Stock, (ii) the Founders’ Stock, provided, however, that for the purposes of Section 1.2, 1.4 or 1.12 the Founders’ Stock shall not be deemed Registrable Securities and the
Founders shall not be deemed Holders, and (iii) any Common Stock of the Company issued as (or issuable upon the conversion or exercise of any warrant, right or other security that is issued as) a dividend or other distribution with respect to,
or in exchange for, or in replacement of, the shares referenced in (i) and (ii) above, excluding in all cases, however, any Registrable Securities sold by a person in a transaction in which his, her or its rights under this Section 1
are not assigned and any shares of Common Stock (“Special Mandatory Conversion Shares”) issued upon conversion of Preferred Stock pursuant to Section 3 hereof. 

(j) The number of shares of “Registrable Securities” outstanding shall be determined by the number of shares of Common Stock
outstanding that are, and the number of shares of Common Stock issuable pursuant to then exercisable or convertible securities that are, Registrable Securities. 

(k) The term “Rule 144” shall mean Rule 144 under the Act. 

(l) The term “SEC” shall mean the Securities and Exchange Commission. 

1.2 Request for Registration. 

(a) Subject to the conditions of this Section 1.2, if the Company shall receive at any time after the earlier of
(i) December 28, 2015 or (ii) twelve (12) months after the effective date of the Initial Offering, a written request from (A) in the case of the first registration to be effected pursuant to this Section 1.2, the
Holders of at least fifty-one percent (51%) or more of the Registrable Securities then outstanding, or (B) in the case of any permitted subsequent request following the first registration effected pursuant to this Section 1.2, the
holders of at least twenty-five percent (25%) of the Registrable Securities then outstanding (in any such case, for purposes of this Section 1.2, the “Initiating Holders”) that the Company file a registration statement
under the Act covering the registration of at least twenty percent (20%) of the Registrable Securities and with an anticipated aggregate offering price of at least $7,500,000, then the Company shall, within twenty (20) days of the receipt
thereof, give written notice of such request to all Holders, and subject to the limitations of this Section 1.2, use all commercially reasonable efforts to effect, as soon as practicable, the registration under the Act of all Registrable
Securities that the Holders request to be registered in a written request received by the Company within twenty (20) days of the mailing of the Company’s notice pursuant to this Section 1.2(a). 

  
 4 

 (b) If the Initiating Holders intend to distribute the Registrable Securities covered by their
request by means of an underwriting, they shall so advise the Company as a part of their request made pursuant to this Section 1.2 and the Company shall include such information in the written notice referred to in Section 1.2(a). In such
event the right of any Holder to include its Registrable Securities in such registration shall be conditioned upon such Holder’s participation in such underwriting and the inclusion of such Holder’s Registrable Securities in the
underwriting (unless otherwise mutually agreed by a majority in interest of the Initiating Holders and such Holder) to the extent provided herein. All Holders proposing to distribute their securities through such underwriting shall enter into an
underwriting agreement in customary form with the underwriter or underwriters selected for such underwriting by a majority in interest of the Initiating Holders (which underwriter or underwriters shall be reasonably acceptable to the Company).
Notwithstanding any other provision of this Section 1.2, if the underwriter advises the Company that marketing factors require a limitation on the number of securities underwritten (including Registrable Securities), then the Company shall so
advise all Holders of Registrable Securities that would otherwise be underwritten pursuant hereto, and the number of shares that may be included in the underwriting shall be allocated to the Holders of such Registrable Securities pro rata based on
the number of Registrable Securities held by all such Holders (including the Initiating Holders). In no event shall any Registrable Securities be excluded from such underwriting unless all other securities are first excluded. Any Registrable
Securities excluded or withdrawn from such underwriting shall be withdrawn from the registration. 
 (c) Notwithstanding the foregoing, the
Company shall not be required to effect a registration pursuant to this Section 1.2: 
 (i) in any particular jurisdiction in which the
Company would be required to execute a general consent to service of process in effecting such registration, unless the Company is already subject to service in such jurisdiction and except as may be required under the Act; or 

(ii) after the Company has effected two (2) registrations pursuant to this Section 1.2, and such registrations have been declared or
ordered effective; or 
 (iii) during the period starting with the date sixty (60) days prior to the Company’s good faith estimate
of the date of the filing of and ending on a date one hundred twenty (120) days following the effective date of a Company-initiated registration subject to Section 1.3 below, provided that the
Company is actively employing in good faith all commercially reasonable efforts to cause such registration statement to become effective; or 

(iv) if the Initiating Holders propose to dispose of Registrable Securities that may be registered on
Form S-3 pursuant to Section 1.4 hereof; or 

  
 5 

 (v) if the Company shall furnish to Holders requesting a registration statement pursuant to this
Section 1.2 a certificate signed by the Company’s Chief Executive Officer or Chairman of the Board stating that in the good faith judgment of the Board of Directors of the Company, it would be seriously detrimental to the Company and its
stockholders for such registration statement to be effected at such time, in which event the Company shall have the right to defer such filing for a period of not more than one hundred twenty (120) days after receipt of the request of the
Initiating Holders, provided that such right shall be exercised by the Company not more than once and provided further that the Company shall not register any securities for the account of itself or any other stockholder during such one hundred
twenty (120) day period (other than a registration relating solely to the sale of securities of participants in a Company stock plan, a registration relating to a corporate reorganization or transaction under Rule 145 of the Act, a
registration on any form that does not include substantially the same information as would be required to be included in a registration statement covering the sale of the Registrable Securities, or a registration in which the only Common Stock being
registered is Common Stock issuable upon conversion of debt securities that are also being registered). 
 1.3 Company Registration.

 (a) If (but without any obligation to do so) the Company proposes to register (including for this purpose a registration effected by the
Company for stockholders other than the Holders) any of its stock or other securities under the Act in connection with the public offering of such securities (other than a registration relating solely to the sale of securities of participants in a
Company stock plan, a registration relating to a corporate reorganization or transaction under Rule 145 of the Act, a registration on any form that does not include substantially the same information as would be required to be included in a
registration statement covering the sale of the Registrable Securities, or a registration in which the only Common Stock being registered is Common Stock issuable upon conversion of debt securities that are also being registered), the Company shall,
at such time, promptly give each Holder written notice of such registration. Upon the written request of each Holder given within twenty (20) days after mailing of such notice by the Company in accordance with Section 4.5, the Company
shall, subject to the provisions of Section 1.3(c), use all commercially reasonable efforts to cause to be registered under the Act all of the Registrable Securities that each such Holder requests to be registered. 

(b) Right to Terminate Registration. The Company shall have the right to terminate or withdraw any registration initiated by it under
this Section 1.3 prior to the effectiveness of such registration whether or not any Holder has elected to include securities in such registration, and shall promptly notify any Holder that has elected to include shares in such registration of
such termination or withdrawal. The expenses of such withdrawn registration shall be borne by the Company in accordance with Section 1.7 hereof. 

(c) Underwriting Requirements. In connection with any offering involving an underwriting of shares of the Company’s capital stock,
the Company shall not be required under this Section 1.3 to include any of the Holders’ securities in such underwriting unless they accept the terms of the underwriting as agreed upon between the Company and the underwriters selected by
the Company (or by other persons entitled to select the underwriters) and enter into an underwriting agreement in customary form with such 

  
 6 

 
underwriters, and then only in such quantity as the underwriters determine in their sole discretion will not jeopardize the success of the offering by the Company. If the total amount of
securities, including Registrable Securities, requested by stockholders to be included in such offering exceeds the amount of securities sold other than by the Company that the underwriters determine in their sole discretion is compatible with the
success of the offering, then the Company shall be required to include in the offering only that number of such securities, including Registrable Securities, that the underwriters determine in their sole discretion will not jeopardize the success of
the offering. In no event shall any Registrable Securities be excluded from such offering unless all other stockholders’ securities have been first excluded. In the event that the underwriters determine that less than all of the Registrable
Securities requested to be registered can be included in such offering, then the Registrable Securities that are included in such offering shall be apportioned pro rata among the selling Holders based on the number of Registrable Securities held by
all selling Holders or in such other proportions as shall mutually be agreed to by all such selling Holders. For purposes of the preceding sentence concerning apportionment, for any selling stockholder that is a Holder of Registrable Securities and
that is a venture capital fund, partnership or corporation, the affiliated venture capital funds, partners, retired partners and stockholders of such Holder, or the estates and family members of any such partners and retired partners and any trusts
for the benefit of any of the foregoing persons shall be deemed to be a single “selling Holder,” and any pro rata reduction with respect to such “selling Holder” shall be based upon the aggregate amount of Registrable Securities
owned by all such related entities and individuals. 
 1.4 Form S-3 Registration. In case the
Company shall receive from any Holders of Registrable Securities (for purposes of this Section 1.4, the “Initiating Holders”) a written request or requests that the Company effect a registration on Form S-3 and any related qualification or compliance with respect to all or a part of the Registrable Securities owned by such Holder or Holders, the Company shall: 

(a) promptly give written notice of the proposed registration, and any related qualification or compliance, to all other Holders; and 

(b) use all commercially reasonable efforts to effect, as soon as practicable, such registration and all such qualifications and compliances
as may be so requested and as would permit or facilitate the sale and distribution of all or such portion of such Holders’ Registrable Securities as are specified in such request, together with all or such portion of the Registrable Securities
of any other Holders joining in such request as are specified in a written request given within fifteen (15) days after receipt of such written notice from the Company, provided, however, that the Company shall not be obligated to effect any
such registration, qualification or compliance, pursuant to this Section 1.4: 
 (i) if
Form S-3 is not available for such offering by the Holders; or 
 (ii) if the Holders, together
with the holders of any other securities of the Company entitled to inclusion in such registration, propose to sell Registrable Securities and such other securities (if any) at an aggregate price to the public (net of any underwriting discounts) of
less than $500,000; or 

  
 7 

 (iii) if the Company shall furnish to Holders requesting a registration statement pursuant to
this Section 1.4 a certificate signed by the Company’s Chief Executive Officer or Chairman of the Board stating that in the good faith judgment of the Board of Directors of the Company, it would be seriously detrimental to the Company and
its stockholders for such registration statement to be effected at such time, in which event the Company shall have the right to defer such filing for a period of not more than ninety (90) days after receipt of the request of the Initiating
Holders, provided that such right shall be exercised by the Company not more than once and provided further that the Company shall not register any securities for the account of itself or any other stockholder during such ninety (90) day period
(other than a registration relating solely to the sale of securities of participants in a Company stock plan, a registration relating to a corporate reorganization or transaction under Rule 145 of the Act, a registration on any form that does
not include substantially the same information as would be required to be included in a registration statement covering the sale of the Registrable Securities, or a registration in which the only Common Stock being registered is Common Stock
issuable upon conversion of debt securities that are also being registered); or 
 (iv) if the Company has, within the six (6) month
period preceding the date of such request, already effected one registration on Form S-3 for the Holders pursuant to this Section 1.4 or has already effected an aggregate of six
(6) registrations on Form S-3 for the Holders pursuant to this Section 1.4; or 
 (v) in any particular jurisdiction in which the
Company would be required to qualify to do business or to execute a general consent to service of process in effecting such registration, qualification or compliance. 

(c) If the Initiating Holders intend to distribute the Registrable Securities covered by their request by means of an underwriting, they shall
so advise the Company as a part of their request made pursuant to this Section 1.4 and the Company shall include such information in the written notice referred to in Section 1.4(a). The provisions of Section 1.2(b) shall be
applicable to such request (with the substitution of Section 1.4 for references to Section 1.2). 
 (d) Subject to the foregoing,
the Company shall file a registration statement covering the Registrable Securities and other securities so requested to be registered as soon as practicable after receipt of the request or requests of the Initiating Holders. Registrations effected
pursuant to this Section 1.4 shall not be counted as requests for registration effected pursuant to Sections 1.2. 
 1.5
Obligations of the Company. Whenever required under this Section 1 to effect the registration of any Registrable Securities, the Company shall, as expeditiously as reasonably possible: 

  
 8 

 (a) prepare and file with the SEC a registration statement with respect to such Registrable
Securities and use all commercially reasonable efforts to cause such registration statement to become effective, and, upon the request of the Holders of a majority of the Registrable Securities registered thereunder, keep such registration statement
effective for a period of at least one hundred twenty (120) days or, if earlier, until the distribution contemplated in the Registration Statement has been completed; 

(b) prepare and file with the SEC such amendments and supplements to such registration statement and the prospectus used in connection with
such registration statement as may be necessary to comply with the provisions of the Act with respect to the disposition of all securities covered by such registration statement; 

(c) furnish to the Holders such number of copies of a prospectus, including a preliminary prospectus, in conformity with the requirements of
the Act, and such other documents as they may reasonably request in order to facilitate the disposition of Registrable Securities owned by them; 

(d) use all commercially reasonable efforts to register and qualify the securities covered by such registration statement under such other
securities or Blue Sky laws of such jurisdictions as shall be reasonably requested by the Holders, provided that the Company shall not be required in connection therewith or as a condition thereto to qualify to do business or to file a general
consent to service of process in any such states or jurisdictions; 
 (e) in the event of any underwritten public offering, enter into and
perform its obligations under an underwriting agreement, in usual and customary form, with the managing underwriter of such offering; 
 (f)
notify each Holder of Registrable Securities covered by such registration statement at any time when a prospectus relating thereto is required to be delivered under the Act of the happening of any event as a result of which the prospectus included
in such registration statement, as then in effect, includes an untrue statement of a material fact or omits to state a material fact required to be stated therein or necessary to make the statements therein not misleading in the light of the
circumstances then existing; 
 (g) cause all such Registrable Securities registered pursuant to this Section 1 to be listed on a
national exchange or trading system and on each securities exchange and trading system on which similar securities issued by the Company are then listed; and 

(h) provide a transfer agent and registrar for all Registrable Securities registered pursuant hereunder and a CUSIP number for all such
Registrable Securities, in each case not later than the effective date of such registration. 

  
 9 

 Notwithstanding the provisions of this Section 1, the Company shall be entitled to postpone
or suspend, for a period not to exceed sixty (60) days, the filing, effectiveness or use of, or trading under, any registration statement if the Company shall determine that any such filing or the sale of any securities pursuant to such
registration statement would in the good faith judgment of the Board of Directors of the Company: 
 (i) materially impede, delay or
interfere with any material pending or proposed financing, acquisition, corporate reorganization or other similar transaction involving the Company for which the Board of Directors of the Company has authorized negotiations; 

(ii) materially adversely impair the consummation of any pending or proposed material offering or sale of any class of securities by the
Company; or 
 (iii) require disclosure of material nonpublic information that, if disclosed at such time, would be materially harmful to
the interests of the Company and its stockholders; 
 provided, however, that during any such period all executive officers and directors of
the Company are also prohibited from selling securities of the Company (or any security of any of the Company’s subsidiaries or affiliates). 

The Company may extend the suspension period for an additional consecutive sixty (60) days with the consent of the holders of a majority
of the Registrable Securities registered under the applicable registration statement, which consent shall not be unreasonably withheld. No more than two (2) such suspension periods shall occur in any twelve (12) month period. In the event
of the suspension of effectiveness of any registration statement pursuant to this Section 1.5, the applicable time period during which such registration statement is to remain effective shall be extended by that number of days equal to the
number of days the effectiveness of such registration statement was suspended. 
 1.6 Information from Holder. It shall be a
condition precedent to the obligations of the Company to take any action pursuant to this Section 1 with respect to the Registrable Securities of any selling Holder that such Holder shall furnish to the Company such information regarding
itself, the Registrable Securities held by it, and the intended method of disposition of such securities as shall be reasonably required to effect the registration of such Holder’s Registrable Securities. 

1.7 Expenses of Registration. All expenses other than underwriting discounts and commissions incurred in connection with registrations,
filings or qualifications under Sections 1.2, 1.3 and 1.4, including (without limitation) all registration, filing and qualification fees, printers’ and accounting fees, fees and disbursements of counsel for the Company and the reasonable
fees and disbursements of one counsel for the selling Holders shall be borne by the Company. All selling expenses incurred in connection with any registrations hereunder shall be borne by the holders of the securities so registered pro rata
on the basis of the number of shares so registered. Notwithstanding the foregoing, the Company shall not be required to pay for any expenses of any registration proceeding begun pursuant to Section 1.2 or

  
 10 

 
Section 1.4 if the registration request is subsequently withdrawn at the request of the Holders of a majority of the Registrable Securities to be registered (in which case all participating
Holders shall bear such expenses pro rata based upon the number of Registrable Securities that were to be included in the withdrawn registration), unless, in the case of a registration requested under Section 1.2, the Holders of a majority of
the Registrable Securities agree to forfeit their right to one demand registration pursuant to Section 1.2 and provided, however, that if at the time of such withdrawal, the Holders have learned of a material adverse change in the condition,
business or prospects of the Company from that known to the Holders at the time of their request and have withdrawn the request with reasonable promptness following disclosure by the Company of such material adverse change, then the Holders shall
not be required to pay any of such expenses and shall retain all of their rights pursuant to Section 1.2 and 1.4. 
 1.8 Delay of
Registration. No Holder shall have any right to obtain or seek an injunction restraining or otherwise delaying any such registration as the result of any controversy that might arise with respect to the interpretation or implementation of this
Section 1. 
 1.9 Indemnification. In the event any Registrable Securities are included in a registration statement under this
Section 1: 
 (a) To the extent permitted by law, the Company will indemnify and hold harmless each Holder, the partners, members,
officers, directors and stockholders of each Holder, legal counsel and accountants for each Holder, any underwriter (as defined in the Act) for such Holder and each person, if any, who controls such Holder or underwriter within the meaning of the
Act or the 1934 Act, against any losses, claims, damages or liabilities (joint or several) to which they may become subject under the Act, the 1934 Act, any other federal or state laws or any rule or regulation promulgated under the Act, insofar as
such losses, claims, damages, or liabilities (or actions in respect thereof) arise out of or are based upon any of the following statements, omissions or violations (collectively a “Violation”): (i) any untrue statement or
alleged untrue statement of a material fact contained in such registration statement, including any preliminary prospectus or final prospectus contained therein or any amendments or supplements thereto, (ii) the omission or alleged omission to
state in such registration statement a material fact required to be stated therein, or necessary to make the statements therein not misleading or (iii) any violation or alleged violation by the Company of the Act, the 1934 Act, any state
securities laws or any rule or regulation promulgated under the Act, the 1934 Act or any state securities laws, and the Company will reimburse each such Holder, underwriter, controlling person or other aforementioned person for any legal or other
expenses reasonably incurred by them in connection with investigating or defending any such loss, claim, damage, liability or action as such expenses are incurred; provided, however, that the indemnity agreement contained in this
subsection l.9(a) shall not apply to amounts paid in settlement of any such loss, claim, damage, liability or action if such settlement is effected without the consent of the Company (which consent shall not be unreasonably withheld), nor shall
the Company be liable in any such case for any such loss, claim, damage, liability or action to the extent that it arises out of or is based upon a Violation that occurs in reliance upon and in 

  
 11 

 
conformity with written information furnished expressly for use in connection with such registration by any such Holder, underwriter, controlling person or other aforementioned person; provided
further, however, that the foregoing indemnity agreement with respect to any preliminary prospectus shall not inure to the benefit of any Holder or underwriter or other aforementioned person, or any person controlling such Holder or underwriter,
from whom the person asserting any such losses, claims, damages or liabilities purchased shares in the offering, if a copy of the most current prospectus was not sent or given by or on behalf of such Holder or underwriter or other aforementioned
person to such person, if required by law to have been so delivered, at or prior to the written confirmation of the sale of the shares to such person, and if the prospectus (as so amended or supplemented) would have cured the defect giving rise to
such loss, claim, damage or liability. 
 (b) To the extent permitted by law, each Holder will, if Registrable Securities held by such
Holder are included in the securities as to which such registration qualifications or compliance is being effected, indemnify and hold harmless the Company, each of its directors, each of its officers who has signed the registration statement, each
person, if any, who controls the Company within the meaning of the Act, legal counsel and accountants for the Company, any underwriter, any other Holder selling securities in such registration statement and any controlling person of any such
underwriter or other Holder, against any losses, claims, damages or liabilities (joint or several) to which any of the foregoing persons may become subject, under the Act, the 1934 Act, any other federal or state laws or any rule or regulation
promulgated under the Act, the 1934 Act or any state securities laws, insofar as such losses, claims, damages or liabilities (or actions in respect thereto) arise out of or are based upon any Violation, in each case to the extent (and only to the
extent) that such Violation occurs in reliance upon and in conformity with written information furnished by such Holder expressly for use in connection with such registration; and each such Holder will reimburse any person intended to be indemnified
pursuant to this subsection l.9(b) for any legal or other expenses reasonably incurred by such person in connection with investigating or defending any such loss, claim, damage, liability or action as such expenses are incurred; provided, however,
that the indemnity agreement contained in this subsection l.9(b) shall not apply to amounts paid in settlement of any such loss, claim, damage, liability or action if such settlement is effected without the consent of the Holder (which consent
shall not be unreasonably withheld), and provided that in no event shall any indemnity under this subsection l.9(b) exceed the net proceeds from the offering received by such Holder. 

(c) Promptly after receipt by an indemnified party under this Section 1.9 of notice of the commencement of any action (including any
governmental action), such indemnified party will, if a claim in respect thereof is to be made against any indemnifying party under this Section 1.9, deliver to the indemnifying party a written notice of the commencement thereof and the
indemnifying party shall have the right to participate in and, to the extent the indemnifying party so desires, jointly with any other indemnifying party similarly noticed, to assume the defense thereof with counsel mutually satisfactory to the
parties; provided, however, that an indemnified party (together with all other indemnified parties that may be represented without conflict by one counsel) shall have the right to retain one separate

  
 12 

 
counsel, with the fees and expenses to be paid by the indemnifying party, if representation of such indemnified party by the counsel retained by the indemnifying party would be inappropriate due
to actual or potential differing interests between such indemnified party and any other party represented by such counsel in such proceeding. The failure to deliver written notice to the indemnifying party within a reasonable time of the
commencement of any such action, if prejudicial to its ability to defend such action, shall relieve such indemnifying party of any liability to the indemnified party under this Section 1.9 to the extent of such prejudice, but the omission to so
deliver written notice to the indemnifying party will not relieve it of any liability that it may have to any indemnified party otherwise than under this Section 1.9. 

(d) If the indemnification provided for in this Section 1.9 is held by a court of competent jurisdiction to be unavailable to an
indemnified party with respect to any loss, liability, claim, damage or expense referred to herein, then the indemnifying party, in lieu of indemnifying such indemnified party hereunder, shall contribute to the amount paid or payable by such
indemnified party as a result of such loss, liability, claim, damage or expense in such proportion as is appropriate to reflect the relative fault of the indemnifying party on the one hand and the indemnified party on the other hand in connection
with the statements or omissions that resulted in such loss, liability, claim, damage or expense, as well as any other relevant equitable considerations; provided, however, that no contribution by any Holder, when combined with any amounts paid by
such Holder pursuant to Section 1.9(b), shall exceed the net proceeds from the offering received by such Holder. The relative fault of the indemnifying party and the indemnified party shall be determined by reference to, among other things,
whether the untrue or alleged untrue statement of a material fact or the omission or alleged omission to state a material fact relates to information supplied by the indemnifying party or by the indemnified party and the parties’ relative
intent, knowledge, access to information and opportunity to correct or prevent such statement or omission. 
 (e) Notwithstanding the
foregoing, to the extent that the provisions on indemnification and contribution contained in the underwriting agreement entered into in connection with the underwritten public offering are in conflict with the foregoing provisions, the provisions
in the underwriting agreement shall control. 
 (f) The obligations of the Company and Holders under this Section 1.9 shall survive the
completion of any offering of Registrable Securities in a registration statement under this Section 1 and otherwise. 
 1.10 Reports
Under the 1934 Act . With a view to making available to the Holders the benefits of Rule 144 and any other rule or regulation of the SEC that may at any time permit a Holder to sell securities of the Company to the public without
registration or pursuant to a registration on Form S-3, the Company agrees to: 
 (a) make and keep
public information available, as those terms are understood and defined in Rule 144, at all times after the effective date of the Initial Offering; 

  
 13 

 (b) file with the SEC in a timely manner all reports and other documents required of the Company
under the Act and the 1934 Act; and 
 (c) furnish to any Holder, so long as the Holder owns any Registrable Securities, forthwith upon
request (i) a written statement by the Company that it has complied with the reporting requirements of Rule 144 (at any time after ninety (90) days after the effective date of the first registration statement filed by the Company),
the Act and the 1934 Act (at any time after it has become subject to such reporting requirements), or that it qualifies as a registrant whose securities may be resold pursuant to Form S-3 (at any time
after it so qualifies), (ii) a copy of the most recent annual or quarterly report of the Company and such other reports and documents so filed by the Company, and (iii) such other information as may be reasonably requested to avail any
Holder of any rule or regulation of the SEC that permits the selling of any such securities without registration or pursuant to such form. 

1.11 Assignment of Registration Rights. The rights to cause the Company to register Registrable Securities pursuant to this
Section 1 may be assigned (but only with all related obligations) by a Holder to a transferee or assignee of such securities that (i) is a subsidiary, parent, partner, member, limited partner, retired partner or stockholder of a Holder,
(ii) is a Holder’s family member or trust for the benefit of an individual Holder, or (iii) after such assignment or transfer, holds at least 1,500,000 shares of Registrable Securities (subject to appropriate adjustment for stock
splits, stock dividends, combinations or the like), provided: (a) the Company is, within a reasonable time after such transfer, furnished with written notice of the name and address of such transferee or assignee and the securities with respect
to which such registration rights are being assigned; (b) such transferee or assignee agrees in writing to be bound by and subject to the terms and conditions of this Agreement, including, without limitation, the provisions of Section 1.13
below; and (c) such assignment shall be effective only if immediately following such transfer the further disposition of such securities by the transferee or assignee is restricted under the Act. 

1.12 Limitations on Subsequent Registration Rights. From and after the date of this Agreement, the Company shall not, without the prior
written consent of the Holders of a majority of the Registrable Securities, enter into any agreement with any holder or prospective holder of any securities of the Company that would allow such holder or prospective holder (a) to include any of
such securities in any registration filed under Section 1.2, Section 1.3 or Section 1.4 hereof, unless under the terms of such agreement, such holder or prospective holder may include such securities in any such registration only to
the extent that the inclusion of such securities will not reduce the amount of the Registrable Securities of the Holders that are included or (b) to demand registration of their securities. 

1.13 “Market Stand-Off” Agreement. 

(a) Each Holder hereby agrees that it will not, without the prior written consent of the managing underwriter, during the period commencing on
the date of the final prospectus relating to the Company’s Initial Offering and ending on the date specified by the Company and the managing underwriter (such period not to exceed one hundred eighty (l80)

  
 14 

 
days but subject to such extension or extensions, not to exceed 18 days after expiration of the initial 180-day period, as may be required by the underwriters in order to publish research reports
while complying with NASD Rule 2711 or NYSE Member Rule 472 or any successor rule or regulation) (i) lend, offer, pledge, sell, contract to sell, sell any option or contract to purchase, purchase any option or contract to sell, grant any
option, right or warrant to purchase, or otherwise transfer or dispose of, directly or indirectly, any shares of Common Stock or any securities convertible into or exercisable or exchangeable for Common Stock held immediately prior to the
effectiveness of the Registration Statement for such offering, or (ii) enter into any swap or other arrangement that transfers to another, in whole or in part, any of the economic consequences of ownership of the Common Stock, whether any such
transaction described in clause (i) or (ii) above is to be settled by delivery of Common Stock or other securities, in cash or otherwise. The foregoing provisions of this Section 1.13 shall apply only to the Company’s initial
offering of equity securities, shall not apply to the sale of any shares to an underwriter pursuant to an underwriting agreement, and shall only be applicable to the Holders if all officers, directors, Key Common Holders (as defined in the
Company’s First Refusal and Co-Sale Agreement dated of even date herewith) and greater than one percent (1%) stockholders of the Company enter into similar agreements. The underwriters in connection with the Company’s Initial Offering
are intended third-party beneficiaries of this Section 1.13 and shall have the right, power and authority to enforce the provisions hereof as though they were a party hereto. Each Holder further agrees to
execute such agreements as may be reasonably requested by the underwriters in the Company’s Initial Offering that are consistent with this Section 1.13 or that are necessary to give further effect thereto. Any discretionary waiver or
termination of the restrictions of any or all of such agreements by the Company or the underwriters shall apply to all Holders subject to such agreements pro rata based on the number of shares subject to such agreements. In order to enforce the
foregoing covenant, the Company may impose stop-transfer instructions with respect to the Registrable Securities of each Holder (and the shares or securities of every other person subject to the foregoing
restriction) until the end of such period. 
 (b) Each Holder agrees that a legend reading substantially as follows shall be placed on all
certificates representing all Registrable Securities of each Holder (and the shares or securities of every other person subject to the restriction contained in this Section 1.13): 

THE SECURITIES REPRESENTED BY THIS CERTIFICATE ARE SUBJECT TO A LOCK-UP PERIOD OF UP TO 180 DAYS AFTER THE EFFECTIVE DATE OF THE ISSUER’S
REGISTRATION STATEMENT FILED UNDER THE ACT, AS AMENDED, AS SET FORTH IN AN AGREEMENT BETWEEN THE COMPANY AND THE ORIGINAL HOLDER OF THESE SECURITIES, A COPY OF WHICH MAY BE OBTAINED AT THE ISSUER’S PRINCIPAL OFFICE. SUCH LOCK-UP PERIOD IS
BINDING ON TRANSFEREES OF THESE SHARES. 

  
 15 

 1.14 Termination of Registration Rights. No Holder shall be entitled to exercise any
right provided for in this Section 1 (i) after five (5) years following the consummation of the Initial Offering, or (ii) as to any Holder, such earlier time after the Initial Offering at which such Holder (A) can sell all
shares held by it in compliance with Rule 144 or (B) holds one percent (1%) or less of the Company’s outstanding Common Stock and all Registrable Securities held by such Holder (together with any affiliate of the Holder with whom
such Holder must aggregate its sales under Rule 144) can be sold in any three (3)-month period without registration in compliance with Rule 144. Notwithstanding the foregoing, no Holder shall be
entitled to exercise any right provided for in this Section 1 with respect to any Special Mandatory Conversion Shares. 
 2.
Covenants of the Company. 
 2.1 Delivery of Financial Statements. The Company shall, upon request, deliver to each Investor
(or transferee of an Investor) that holds at least 2,000,000 shares of Common Stock issuable or issued upon conversion of the Preferred Stock (subject to appropriate adjustment for stock splits, stock dividends, combinations or the like, but
excluding any Special Mandatory Conversion Shares and including any shares held by any affiliate of a fund Investor) (a “Major Investor”): 

(a) as soon as practicable, but in any event within one hundred twenty (120) days after the end of each fiscal year of the Company, an
income statement for such fiscal year, a balance sheet of the Company and statement of stockholders’ equity as of the end of such year, and a statement of cash flows for such year, such year-end financial
reports to be in reasonable detail, prepared in accordance with generally accepted accounting principles (“GAAP”), and audited and certified by independent public accountants of nationally recognized standing selected by the
Company; 
 (b) as soon as practicable, but in any event within forty-five (45) days after the end of each of the first three
(3) quarters of each fiscal year of the Company, an unaudited income statement, statement of cash flows for such fiscal quarter and an unaudited balance sheet as of the end of such fiscal quarter; 

(c) within thirty (30) days of the end of each month, an unaudited income statement and statement of cash flows and balance sheet for and
as of the end of such month, in reasonable detail; 
 (d) as soon as practicable, but in any event at least thirty (30) days prior to
the end of each fiscal year, a budget and business plan for the next fiscal year and, prepared on a monthly basis, including balance sheets, income statements and statements of cash flows for such months and, as soon as prepared, any other budgets
or revised budgets prepared by the Company; 
 (e) with respect to the financial statements called for in subsections (b) and
(c) of this Section 2.1, an instrument executed by the Chief Financial Officer or President of the Company certifying that such financials were prepared in accordance with GAAP consistently applied with prior practice for earlier periods
(with the exception of footnotes that may be required by GAAP) and fairly present the financial condition of the Company and its results of operation for the period specified, subject to year-end audit
adjustment; and 

  
 16 

 (f) such other information relating to the financial condition, business or corporate affairs of
the Company as the Major Investor may from time to time request, provided, however, that the Company shall not be obligated under this subsection (f) or any other subsection of Section 2.1 to provide information that it deems in good faith
to be a trade secret or similar confidential information. 
 2.2 Inspection. The Company shall permit each Major Investor, at such
Major Investor’s expense, to visit and inspect the Company’s properties, to examine its books of account and records and to discuss the Company’s affairs, finances and accounts with its officers, all at such reasonable times as may be
requested by the Major Investor; provided, however, that the Company shall not be obligated pursuant to this Section 2.2 to provide access to any information that it reasonably considers, after consultation with legal counsel, to be a trade
secret or similar confidential information. 
 2.3 Assignment/Termination of Information and Inspection Covenants. The rights to
cause the Company to provide information pursuant to Sections 2.1 and 2.2 may be assigned (but only with all related obligations) by an Investor to a transferee or assignee of such securities that (i) is a subsidiary, parent, partner, limited
partner, retired partner or stockholder of an Investor, (ii) is an Investor’s family member or trust for the benefit of an individual Investor, or (iii) after such assignment or transfer, holds at least 2,000,000 shares of Registrable
Securities (subject to appropriate adjustment for stock splits, stock dividends, combinations or the like and including any shares held by any affiliate of a fund Investor). The covenants set forth in Sections 2.1 and 2.2 shall terminate and be
of no further force or effect upon the earlier to occur of (x) the consummation of the Qualified Public Offering, (y) when the Company first becomes subject to the periodic reporting requirements of Sections 12(g) or 15(d) of the 1934
Act, whichever event shall first occur, or (z) the consummation of a Liquidation Event, as that term is defined in the Company’s Certificate of Incorporation (as amended from time to time). 

2.4 Right of First Offer. Subject to the terms and conditions specified in this Section 2.4, the Company hereby grants to each
Major Investor a right of first offer with respect to future sales by the Company of its Shares (as hereinafter defined). For purposes of this Section 2.4, the term “Major Investor” includes (i) if the Major Investor is a
partnership, corporation or other entity, any general partners and affiliates, including affiliated venture capital funds, of such Major Investor, or (ii) if the Major Investor is an individual, trusts for the benefit of such Major Investor or
his or her immediate family members. A Major Investor shall be entitled to apportion the right of first offer hereby granted it among itself and its partners and affiliates, immediate family members or trusts in such proportions as it deems
appropriate. 

  
 17 

 Each time the Company proposes to offer any shares of, or securities convertible into or
exchangeable or exercisable for any shares of, its capital stock (“Shares”), the Company shall first make an offering of such Shares to each Major Investor in accordance with the following provisions: 

(a) The Company shall deliver a notice in accordance with Section 4.5 (“Notice”) to the Major Investors, and, in the
case of a Down-Round Financing (as defined below), the former Major Investors stating (i) its bona fide intention to offer such Shares, (ii) the number of such Shares to be offered and (iii) the price and terms upon which it proposes
to offer such Shares. 
 (b) By written notification received by the Company within fifteen (15) calendar days after the giving of
Notice, each Major Investor may elect to purchase, at the price and on the terms specified in the Notice, up to that portion of such Shares that equals the proportion that the number of shares of Common Stock issuable or issued upon conversion of
the Preferred Stock and held by such Major Investor (but excluding any Special Mandatory Conversion Shares) bears to the total number of shares of Common Stock of the Company then outstanding (assuming full conversion and exercise of all convertible
and exercisable securities then outstanding and including any Special Mandatory Conversion Shares). The Company shall promptly, in writing, inform each Major Investor that elects to purchase all the shares available to it (a “Fully-Exercising Investor”) of any other Major Investor’s failure to do likewise. During the five (5) day period commencing after such information is given, each
Fully-Exercising Investor may elect to purchase that portion of the Shares for which Major Investors were entitled to subscribe, but which were not subscribed for by the Major Investors, that is equal to the
proportion that the number of shares of Common Stock issuable or issued upon conversion of the Preferred Stock and held by such Fully-Exercising Investor (but excluding any Special Mandatory Conversion Shares) bears to the total number of shares
Common Stock issuable or issued upon conversion of the Preferred Stock and held by all Fully-Exercising Investors who wish to purchase some of the unsubscribed shares (but excluding any Special Mandatory
Conversion Shares). 
 (c) If all Shares that Major Investors are entitled to obtain pursuant to subsection 2.4(b) are not elected to
be obtained as provided in subsection 2.4(b) hereof, the Company may, during the ninety (90) day period following the expiration of the period provided in subsection 2.4(b) hereof, offer the remaining unsubscribed portion of such
Shares to any person or persons at a price not less than that, and upon terms no more favorable to the Major Investor than those, specified in the Notice. If the Company does not enter into an agreement for the sale of the Shares within such period,
or if such agreement is not consummated within sixty (60) days of the execution thereof, the right provided hereunder shall be deemed to be revived and such Shares shall not be offered unless first reoffered to the Major Investors in accordance
herewith. 
 (d) The right of first offer in this Section 2.4 shall not be applicable to (i) the issuance or sale of Common Stock
(or options or warrants therefor) to employees, directors, consultants and other service providers for the primary purpose of soliciting or retaining their services pursuant to written plans or agreements approved by the Company’s Board of
Directors, (ii) securities issued pursuant to a stock dividend or distribution 

  
 18 

 
on Preferred Stock, stock split or similar reorganization, (iii) the issuance of securities in a Qualified Public Offering, (iv) the issuance of securities pursuant to the conversion or
exercise of convertible or exercisable securities, (v) the issuance of securities in connection with a bona fide business acquisition of or by the Company, whether by merger, consolidation, sale of assets, sale or exchange of stock or otherwise
that is approved by the Company’s Board of Directors, (vi) the issuance and sale of Series D Preferred Stock pursuant to the Series D Agreement, (vii) the issuance of stock, warrants or other securities or rights to persons or
entities pursuant to corporate partnering agreements, provided such issuances are primarily for other than equity financing purposes and are approved by the Board of Directors of the Company, or (viii) securities issued or issuable pursuant to
equipment lease financings or bank credit arrangements, provided such issuances are primarily for other than equity financing purposes and are approved by the Board of Directors of the Company. In addition to the foregoing, the right of first offer
in this Section 2.4 shall not be applicable with respect to any Major Investor in any subsequent offering of Shares if (i) at the time of such offering, the Major Investor is not an “accredited investor,” as that term is
then defined in Rule 501(a) of the Act and (ii) such offering of Shares is otherwise being offered only to accredited investors. 
 (e)
The rights provided in this Section 2.4 may not be assigned or transferred by any Major Investor; provided, however, that a Major Investor that is a venture capital fund may assign or transfer such rights to an affiliated venture capital fund
or partners of such funds. 
 (f) Notwithstanding any of the foregoing in this Section 2.4, if the Company proposes to offer any Shares
(excluding shares described in Section 2.4(d)) in an equity financing with a primary purpose of raising capital for the Company and at a price per share less than that received by the Company in any previous equity financing (as adjusted for
stock splits, stock dividends, recapitalizations or the like) (such financing, a “Down-Round Financing”), then a right of first offer to participate in such Down-Round Financing shall apply with respect to any Special Mandatory
Conversion Shares held by any Major Investor or former Major Investor. In such event, each such Major Investor or former Major Investor may elect to purchase, in addition to any other right of first offer with respect to the issuance of the Shares
held by such Major Investor pursuant to Section 2.4(b), at the price and on the terms specified in the Notice, up to that portion of such Shares that equals the proportion that one-half (1/2) of the number of Special Mandatory Conversion
Shares held by such Major Investor or former Major Investor bears to the total number of shares of Common Stock of the Company then outstanding (assuming full conversion and exercise of all convertible and exercisable securities then outstanding and
including any Special Mandatory Conversion Shares). The limited right of first offer set forth in this Section 2.4(f) shall be exercised by any such Major Investor or former Major Investor that this subsection applies to by providing the
Company with written notification within fifteen (15) calendar days after the Company has delivered the Notice. 
 (g) The covenants
set forth in this Section 2.4 shall terminate and be of no further force or effect upon the earlier of the consummation of (i) the Qualified Public Offering or (ii) a Liquidation Event, as that term is defined in the Company’s
Certificate of Incorporation (as amended from time to time). 

  
 19 

 2.5 Proprietary Information and Inventions Agreements. The Company shall require all
employees and consultants with access to confidential information to execute and deliver a Proprietary Information and Inventions Agreement or Consulting Agreement in substantially the form approved by the Company’s Board of Directors. 

2.6 Employee Agreements. Unless approved by the Board of Directors of the Company, all future employees of the Company who shall
purchase, or receive options to purchase, shares of the Company’s Common Stock following the date hereof shall be required to execute stock purchase or option agreements providing for (i) vesting of shares over a four-year period with the
first twenty-five percent (25%) of such shares vesting following twelve (12) months of continued employment or services, and the remaining shares vesting in equal monthly installments over the following thirty-six (36) months
thereafter, (ii) a 180-day lockup period in connection with the Company’s initial public offering and (iii) restrictions against transfer of non-vested stock (other than to a family trust). The Company shall retain a right of first
refusal on transfers until the Company’s initial public offering and the right to repurchase unvested shares at cost. If the Company does not exercise such right of first refusal, the Company shall assign such right to the Investors on a
pro-rata basis. 
 2.7 Drag Along Agreements. Any drag-along or equivalent agreement to which the Holders (and/or the Company) may
become a party in the future shall provide that the liability for indemnification, if any, of such Holder in such sale is several, not joint, is pro rata in accordance with such Holder’s relative stock ownership of the Company, and will not
exceed the consideration payable to such Holder, if any, in such sale of shares of capital stock of the Company (except in the case of potential liability for fraud or willful misconduct by such Holder). 

2.8 Director’s Liability and Indemnification. Unless the Board of Directors of the Company approves otherwise, the Company shall
maintain adequate directors and officers liability insurance with coverage limits customary for similarly situated companies, but in any event with coverage equal to at least $5,000,000. 

2.9 Reimbursement of Certain Expenses. The Company will reimburse the members of the Board of Directors nominated by H.I.G. Venture
Partners II, L.P., Delphi Ventures, TPG Biotechnology Partners II, L.P., Ventures West (or their affiliates) and Novo A/S pursuant to the Amended and Restated Voting Agreement for such member’s reasonable out-of-pocket expenses incurred in
connection with his or her respective attendance at meetings of the Board of Directors of the Company. 
 2.10 Termination. The
covenants set forth in Section 2.5 and Section 2.6 shall terminate and be of no further force or effect upon the consummation of (i) the Initial Offering or (ii) a Liquidation Event, as that term is defined in the Company’s
Certificate of Incorporation (as amended from time to time). 

  
 20 

 3. Special Mandatory Conversion. 

3.1 In the event: 
 (a) the
Company consummates a financing that results in the sale of any shares of, or securities convertible into or exchangeable or exercisable for any shares of, its capital stock at a price per share that is less than the Original Issue Price (as defined
in the Company’s Certificate of Incorporation (as amended from time to time)) of the Series D Preferred Stock, as adjusted for any stock splits, stock dividends, combinations, subdivisions, recapitalizations, or the like (an “Applicable
Down Round Financing”); 
 (b) the Board of Directors of the Company (including at least one of the directors elected
exclusively by the holders of each of the Series A Preferred Stock, Series B Preferred Stock, Series C Preferred Stock and Series D Preferred Stock) determines (with interested directors able to vote for purposes of this provision) in good faith
that it is in the best interests of the Company for the holders of Preferred Stock of the Company to participate in such Applicable Down Round Financing (in which case such financing will be deemed a “Mandatory Offering”) and
determines the aggregate dollar amount to be invested by all holders of Preferred Stock (the “Aggregate Investment Amount”), which amount may be more than or less than any particular holder’s right to participate in the
financing pursuant to any contractual right of first offer or similar right; 
 (c) the Company delivers a notice
(“Notice”) to the holders of Preferred Stock (1) stating the Company’s bona fide intention to consummate such financing, (2) indicating the number of securities to be offered, (3) indicating the price and terms
upon which it proposes to offer such securities, (4) identifying the Pro Rata Share (as defined below) of each holder of Preferred Stock of the Aggregate Investment Amount, and (5) offering each holder of Preferred Stock the right to
purchase such holder’s Pro Rata Share of the Aggregate Investment Amount within the time periods set forth in the Notice; and 
 (d) a
holder and/or an affiliate of such holder (a “Non-Participating Holder”) does not acquire at least its Pro Rata Share of the Aggregate Investment Amount (whether or not such Aggregate
Investment Amount is more than or less than the aggregate dollar amount actually received by the Company from the holders in connection with the Mandatory Offering, as may be the case, for example, if certain holders do not participate in the
Mandatory Offering) within the time periods set forth in the Notice (provided that the time periods set forth in the Notice provide for the closing of such purchase and sale on a date that is no less than fifteen (15) business days from the
delivery date of the Notice); 
 then that percentage of each Non-Participating Holder’s shares of Preferred
Stock equal to the percentage of such Non-Participating Holder’s Pro Rata Share of the Aggregate Investment Amount not acquired by such Non-Participating Holder
shall automatically and without further action on the part of such holder be converted, effective upon, subject to and concurrently with the consummation of the Mandatory Offering (the “Mandatory Offering Date”), into shares of

  
 21 

 
Common Stock of the Company at a Conversion Price equal to the Original Issue Price for such series (as adjusted for stock splits, stock dividends, recapitalizations or the like but without any
adjustment by reason of consummation of the Mandatory Offering). For purposes of this Section 3, each holder’s Pro Rata Share of the Aggregate Investment Amount shall be an amount determined by multiplying the Aggregate Investment Amount
by a fraction, the numerator of which shall be the number of shares of Common Stock issuable upon conversion of each share of Preferred Stock then held by such holder and the denominator of which shall be the total number of shares of Common Stock
issuable upon conversion of the Preferred Stock then outstanding. For purposes of calculating a holder’s Pro Rata Share, the applicable number of shares of Common Stock issuable upon conversion of the shares of Preferred Stock shall be
calculated based on the number of shares of Preferred Stock outstanding immediately following the closing of the Mandatory Offering, assuming full participation of all such holders of Preferred Stock in such Mandatory Offering; provided, however, a
holder’s Pro Rata Share shall in no event exceed an amount equal to fifty percent (50%) of the aggregate amount that such holder has previously invested in the Company. For purposes of determining whether a holder has purchased its Pro
Rata Share of the Aggregate Investment Amount, all shares held by affiliated holders shall be aggregated. 
 3.2 The holder of any shares of
Preferred Stock converted pursuant to this Section 3 shall deliver to the Company during regular business hours at the office of any transfer agent of the Company for the Preferred Stock, or at such other place as may be designated by the
Company, the certificate or certificates for the shares so converted, duly endorsed or assigned in blank or to the Company. As promptly as practicable thereafter, the Company shall issue and deliver to such holder, at the place designated by such
holder, a certificate or certificates for the number of full shares of the Common Stock to be issued and such holder shall be deemed to have become a stockholder of record of Common Stock on the Mandatory Offering Date, unless the transfer books of
the Company are closed on that date, in which event such holder shall be deemed to have become a stockholder of record of Common Stock on the next succeeding date on which the transfer books are open. From and after the Mandatory Offering Date, the
certificate or certificates representing shares of Preferred Stock converted pursuant to this Section 3 shall represent the shares of Common Stock into which such shares of Preferred Stock were converted. 

3.3 In the event that a holder of Preferred Stock converts any Preferred Stock into Common Stock pursuant to subsection 4(a) of the
Company’s Certificate of Incorporation (as amended from time to time) within ninety (90) days prior to the date of closing of a Mandatory Offering, such holder shall be deemed to have converted such shares pursuant to this Section 3.

 3.4 Notwithstanding any of the foregoing, this Section 3 shall not apply to a holder that, together with its affiliates, holds less
than 500,000 shares of Preferred Stock (as adjusted for any stock splits, stock dividends, combinations, subdivisions, recapitalizations or the like with respect to the Preferred Stock). 

  
 22 

 3.5 POWER OF ATTORNEY. SOLELY IN CONNECTION WITH THE EFFECTUATION OF THE SPECIAL
MANDATORY CONVERSION CONTEMPLATED BY THIS SECTION 3 IN CONNECTION WITH WHICH AN INVESTOR HAS NOT PURCHASED ITS PRO RATA SHARE OF THE AGGREGATE INVESTMENT AMOUNT IN A MANDATORY OFFERING, EACH INVESTOR HEREBY EXPRESSLY AND IRREVOCABLY APPOINTS THE
COMPANY’S PRESIDENT AS SUCH INVESTOR’S ATTORNEY-IN-FACT TO TAKE ANY AND ALL SUCH OTHER ACTION IN CONNECTION WITH A SPECIAL MANDATORY CONVERSION EFFECTED IN ACCORDANCE WITH THIS SECTION 3. SUCH APPOINTMENT OF THE COMPANY’S PRESIDENT AS
PROXY AND ATTORNEY-IN-FACT IS COUPLED WITH AN INTEREST AND MAY NOT BE REVOKED DURING THE TERM OF THIS AGREEMENT. 
 4. Miscellaneous.

 4.1 Successors and Assigns. Except as otherwise provided herein, the terms and conditions of this Agreement shall inure to the
benefit of and be binding upon the respective successors and assigns of the parties (including transferees of any shares of Registrable Securities). Nothing in this Agreement, express or implied, is intended to confer upon any party other than the
parties hereto or their respective successors and assigns any rights, remedies, obligations or liabilities under or by reason of this Agreement, except as expressly provided in this Agreement. 

4.2 Governing Law. This Agreement shall be governed by and construed under the laws of the State of Delaware as applied to agreements
among Delaware residents entered into and to be performed entirely within Delaware. 
 4.3 Counterparts. This Agreement may be
executed in two or more counterparts, each of which shall be deemed an original, but all of which together shall constitute one and the same instrument. 

4.4 Titles and Subtitles. The titles and subtitles used in this Agreement are used for convenience only and are not to be considered in
construing or interpreting this Agreement. 
 4.5 Notices. All notices and other communications given or made pursuant hereto shall
be in writing and shall be deemed effectively given: (i) upon personal delivery to the party to be notified, (ii) when sent by confirmed electronic mail or facsimile if sent during normal business hours of the recipient; if not, then on
the next business day, (iii) five (5) days after having been sent by registered or certified mail, return receipt requested, postage prepaid, or (iv) one (1) business day after deposit with a nationally recognized overnight
courier, specifying next day delivery, with written verification of receipt. All communications shall be sent to the respective parties at the addresses set forth on the signature pages attached hereto (or at such other addresses as shall be
specified by notice given in accordance with this Section 4.5). 

  
 23 

 4.6 Expenses. If any action at law or in equity is necessary to enforce or interpret the
terms of this Agreement, the prevailing party shall be entitled to reasonable attorneys’ fees, costs and necessary disbursements in addition to any other relief to which such party may be entitled. 

4.7 Entire Agreement; Amendments and Waivers. This Agreement (including the Exhibits hereto, if any) constitutes the full and entire
understanding and agreement among the parties with regard to the subjects hereof and thereof. Any term of this Agreement may be amended and the observance of any term of this Agreement may be waived (either generally or in a particular instance and
either retroactively or prospectively) only with the written consent of the Company and the holders of at least sixty percent (60%) of Common Stock issuable or issued upon conversion of the Preferred Stock; provided, however, that
if such amendment or waiver affects the Founders’ Stock (i) in a manner different than securities issued to the Investors and (ii) in a manner adverse to the interests of the holders of the Founders’ Stock, then such amendment
shall require the consent of the holder or holders of a majority of the Founders’ Stock, provided further, that any amendment or waiver of Section 2.7 and Section 2.8 hereof shall require the written consent of Novo A/S
and, provided further, that any amendment which is not generally applicable to all Investors that would adversely affect the rights of any Investor as compared to all other Investors shall only be effective with the written consent of
such Investor. Any amendment or waiver effected in accordance with this paragraph shall be binding upon each holder of any Registrable Securities, each future holder of all such Registrable Securities, and the Company. 

4.8 Severability. If one or more provisions of this Agreement are held to be unenforceable under applicable law, such provision(s)
shall be excluded from this Agreement and the balance of the Agreement shall be interpreted as if such provision(s) were so excluded and shall be enforceable in accordance with its terms. 

4.9 Aggregation of Stock. All shares of Registrable Securities held or acquired by affiliated entities (including affiliated venture
capital funds) or persons shall be aggregated together for the purpose of determining the availability of any rights under this Agreement. 

4.10 Additional Investors. Notwithstanding Section 4.7, no consent shall be necessary to add additional Investors as signatories
to this Agreement, provided that such Investors have purchased Series D Preferred Stock pursuant to the subsequent closing provisions of Section 1.3 of the Series D Agreement, as the same may hereafter be modified or amended. 

4.11 Clarification. For purposes of clarification and the avoidance of doubt, the phrases “Common Stock issuable or issued upon
conversion of the Preferred Stock” shall not include Common Stock that did not or will not derive from the Preferred Stock. 

  
 24 

 IN WITNESS WHEREOF, the parties have executed this Amended and Restated Investors’ Rights
Agreement as of the date first above written. 
  

			
	ALDER BIOPHARMACEUTICALS, INC.
	
	  

		
	By:	 	 /s/ Randall C. Schatzman

	Name: Randall C. Schatzman, Ph.D.
	Title: President and CEO
	
	Address: 11804 North Creek Parkway South
	Bothell, WA 98011

  
 SIGNATURE PAGE TO
ALDER BIOPHARMACEUTICALS, INC. 
 AMENDED AND RESTATED INVESTORS’ RIGHTS AGREEMENT 

 
	
	FOUNDERS
	
	 /s/ Randall Schatzman            

	Randall Schatzman
	
	Address: 11804 North Creek Parkway South
	                Bothell, WA 98011
	
	 /s/ Mark Litton            

	Mark Litton
	
	Address: 11804 North Creek Parkway South
	                Bothell, WA 98011
	
	 /s/ John Latham            

	John Latham
	
	Address: 11804 North Creek Parkway South
	                Bothell, WA 98011

  
 SIGNATURE PAGE TO
ALDER BIOPHARMACEUTICALS, INC. 
 AMENDED AND RESTATED INVESTORS’ RIGHTS AGREEMENT 

 
			
	INVESTORS:
	
	DELPHI VENTURES VII, L.P.
		
	By:	 	Delphi Management Partners VII, LLC
		 	General Partner
		
	By:	 	 /s/ Deepika R. Pakianatham

	Name: Deepika R. Pakianathan
	Title: Managing Member
	
	Address: 3000 Sand Hill Road
	                Bldg 1, Suite 135
	                Menlo Park, CA 94025
	
	DELPHI BIOINVESTMENTS VII, L.P.
		
	By:	 	Delphi Management Partners VII, LLC
		 	General Partner
		
	By:	 	 /s/ Deepika R. Pakianathan

	Name: Deepika R. Pakianathan
	Title: Managing Member
	
	Address: 3000 Sand Hill Road
	                Bldg 1, Suite 135
	                Menlo Park, CA 94025

  
 SIGNATURE PAGE TO
ALDER BIOPHARMACEUTICALS, INC. 
 AMENDED AND RESTATED INVESTORS’ RIGHTS AGREEMENT 

 
			
	INVESTORS:
	
	TPG BIOTECHNOLOGY PARTNERS II, L.P.
		
	By:	 	TPG Biotechnology Genpar II, L.P.
		
	By:	 	TPG Biotechnology Genpar Advisors
		 	II, LLC , Its Manager
		
	By:	 	 /s/ Ronald Cami

	Name: Ronald Cami
	Title: Vice President
	
	Address: 301 Commerce Street, Suite 3300
	                Fort Worth, Texas 76102

  
 SIGNATURE PAGE TO
ALDER BIOPHARMACEUTICALS, INC. 
 AMENDED AND RESTATED INVESTORS’ RIGHTS AGREEMENT 

 
			
	INVESTOR:
	
	H.I.G. VENTURE PARTNERS II, L.P.
		
	By:	 	H.I.G. Venture Advisors II, L.L.C.
		
	By:	 	H.I.G. – GPII, Inc.
Its Manager
		
	By:	 	 /s/ Richard Siegel

		 	Richard Siegel
	Name:	 	Authorized Signatory
	Title:	 	  

	
	Address: 1450 Brickell Avenue, 31st Floor
	                Miami, FL 33131
	
	H.I.G. VENTURES - ALDER, LLC
		
	By:	 	 /s/ Richard Siegel

		 	Richard Siegel
	Name:	 	Authorized Signatory
	Title:	 	  

	
	Address: 1450 Brickell Avenue, 31st Floor
	                Miami, FL 33131

  
 SIGNATURE PAGE TO
ALDER BIOPHARMACEUTICALS, INC. 
 AMENDED AND RESTATED INVESTORS’ RIGHTS AGREEMENT 

 
			
	INVESTOR:
	
	SEVIN ROSEN FUND IX L.P.
		
	By:	 	SRB Associates IX L.P.
		 	Its General Partner
	By:	 	SRB Associates IX L.L.C.
		 	Its General Partner
		
	By:	 	 /s/ John V. Jaggers

		 	Member
		
		 	 John V. Jaggers

		 	Print Name
	
	SEVIN ROSEN IX AFFILIATES FUND L.P.
		
	By:	 	SRB Associates IX L.P.
		 	Its General Partner
	By:	 	SRB Associates IX L.L.C.
		 	Its General Partner
		
	By:	 	 /s/ John V. Jaggers

		 	Member
		
		 	 John V. Jaggers

		 	Print Name
	
	Address: c/o The Sevin Rosen Funds
	13455 Noel Road, Suite 1670
	Dallas, Texas 75240

  
 SIGNATURE PAGE TO
ALDER BIOPHARMACEUTICALS, INC. 
 AMENDED AND RESTATED INVESTORS’ RIGHTS AGREEMENT 

 
			
	INVESTORS:
	
	The Dow Family Trust
		
	By:	 	 /s/ Stephen Dow

	Name:	 	Stephen Dow
	Title:	 	Trustee
		
		 	Address: 
		 	

  
 SIGNATURE PAGE TO
ALDER BIOPHARMACEUTICALS, INC. 
 AMENDED AND RESTATED INVESTORS’ RIGHTS AGREEMENT 

 
					
	INVESTOR:
	
	VENTURES WEST 8 LIMITED PARTNERSHIP
		
	By:	 	its general partner,
		 	Ventures West 8 Management Ltd.
			
	By:	 	/s/ Kenneth Galbraith	 	/s/ David Berkowitz
	Name:	 	Kenneth Galbraith	 	David Berkowitz
	Title:	 	Senior VP	 	Senior VP
	
	Address: 999 West Hastings Street, Suite 400
	                Vancouver, British Columbia
	                Canada V6C 2W2

  
 SIGNATURE PAGE TO
ALDER BIOPHARMACEUTICALS, INC. 
 AMENDED AND RESTATED INVESTORS’ RIGHTS AGREEMENT 

 
	
	INVESTOR:
	
	WASHINGTON RESEARCH FOUNDATION
	
	 /s/ Jeff Eby            

	Jeff Eby, CFO
	
	Address: 2815 Eastlake Avenue East
	Suite 300
	Seattle, WA 98102-3086

  
 SIGNATURE PAGE TO
ALDER BIOPHARMACEUTICALS, INC. 
 AMENDED AND RESTATED INVESTORS’ RIGHTS AGREEMENT 

 
			
	INVESTOR:
	
	NOVO A/S
		
	By:	 	 /s/ Peter Moldt

		 	Name: Peter Moldt
		 	Title: Partner
	
	Address: Tuborg Havnevej 19
	                DK 2900 Hellerup
	                Denmark

  
 SIGNATURE PAGE TO
ALDER BIOPHARMACEUTICALS, INC. 
 AMENDED AND RESTATED INVESTORS’ RIGHTS AGREEMENT 

 
			
	INVESTOR:
	
	 /s/ Paul
Abrams            

	Paul Abrams, MD, JD
	
	Address: 
	

  
 SIGNATURE PAGE TO
ALDER BIOPHARMACEUTICALS, INC. 
 AMENDED AND RESTATED INVESTORS’ RIGHTS AGREEMENT 

 
	
	INVESTOR:
	
	 /s/ Alan Bruce Montgomery

	Alan Bruce Montgomery
	
	Address: 
	

  
 SIGNATURE PAGE TO
ALDER BIOPHARMACEUTICALS, INC. 
 AMENDED AND RESTATED INVESTORS’ RIGHTS AGREEMENT 

 
	
	INVESTOR:
	
	 /s/ Clay B. Siegall

	Clay B. Siegall
	
	Address: 
	

  
 SIGNATURE PAGE TO
ALDER BIOPHARMACEUTICALS, INC. 
 AMENDED AND RESTATED INVESTORS’ RIGHTS AGREEMENT 

 SCHEDULE A 

Series A Holders 
 Sevin Rosen
Bayless Management Company 
 Sevin Rosen IX Affiliates Fund L.P. 

Sevin Rosen Fund IX L.P. 
 Ventures West 8 Limited Partnership

 Washington Research Foundation 
 Paul Abrams, MD, JD 

Karl Erik and Ingegerd Hellstrom, husband and wife 
 Jeffrey
Howbert, Ph.D. 
 HEWM/VLG Investments LLC 
 Sonya Erickson 

John Morrow 
 Chesterton Partners, LP 

WS Investment Company, LLC (2005A) 
 WS Investment Company, LLC
(2005C) 
 Series B Holders 

H.I.G. Venture Partners II, L.P. 
 H.I.G. Ventures—Alder,
LLC 
 Sevin Rosen Bayless Management Company 
 Sevin Rosen IX
Affiliates Fund L.P. 
 Sevin Rosen Fund IX L.P. 
 Ventures West
8 Limited Partnership 
 Washington Research Foundation 
 Clay
B. Siegall 
 VLG Investments 2006 LLC 
 John Robertson 

Sonya F. Erickson 
 Series C Holders

 Delphi Ventures VII, L.P. 
 Delphi BioInvestments
VII, L.P. 
 TPG Biotechnology Partners II, L.P. 
 H.I.G.
Venture Partners II, L.P. 
 H.I.G. Ventures—Alder, LLC 

Sevin Rosen IX Affiliates Fund L.P. 
 Sevin Rosen Fund IX L.P.

 Ventures West 8 Limited Partnership 
 Washington Research
Foundation 
 Karl Erik and Ingegerd Hellstrom, husband and wife 

 Series D Holders 

Delphi Ventures VII, L.P. 
 Delphi BioInvestments VII, L.P. 

TPG Biotechnology Partners II, L.P. 
 H.I.G. Venture Partners II,
L.P. 
 H.I.G. Ventures—Alder, LLC 
 Sevin Rosen IX
Affiliates Fund L.P. 
 Sevin Rosen Fund IX L.P. 
 The Dow
Family Trust 
 Ventures West 8 Limited Partnership 
 Washington
Research Foundation 
 Clay B. Siegall 
 Alan Bruce Montgomery

 Paul Abrams, MD, JD 
 Novo A/S 

Schering Corporation and/or its affiliates or assignees

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