Document:

Exhibit

Exhibit 4.1

HC INCORPORATED UNDER THE CUSIP 42225T 10 7 LAWS OF THE STATE SEE REVERSE FOR CERTAIN OF DELAWARE DEFINITIONS AND LEGENDS This certifies that BY: REGISTERED: COUNTERSIGNED AND AMERICAN STOCK TRANSFER & TRUST COMPANY, LLC (BROOKLYN, NY) TRANSFER AGENT is the record holder of FULLY PAID AND NONASSESSABLE SHARES OF COMMON STOCK, $0.001 PAR VALUE PER SHARE, OF Health Catalyst, Inc. transferable on the books of the corporation in person or by duly authorized attorney upon surrender of this Certificate properly endorsed. This Certificate is not valid until countersigned by the Transfer Agent and registered by the Registrar. AUTHORIZED SIGNATURE WITNESS the facsimile seal of the Corporation and the facsimile signatures of its duly authorized officers. AND REGISTRAR Dated: CATALY H ST T OR , L RP AT IN O E A C E C . CHIEF EXECUTIVE OFFICER H SEAL SECRETARY SEPTEMBER 20, # 2011 # D E E L A W A R

The Corporation shall furnish without charge to each stockholder who so requests a statement of the powers, designations, preferences and relative, participating, optional or other special rights of each class of stock of the Corporation or series thereof and the qualifications, limitations or restrictions of such preferences and/or rights. Such requests shall be made to the Corporation’s Secretary at the principal office of the Corporation. KEEP THIS CERTIFICATE IN A SAFE PLACE. IF IT IS LOST, STOLEN,OR DESTROYED THE CORPORATION WILL REQUIRE A BOND INDEMNITY AS A CONDITION TO THE ISSUANCE OF A REPLACEMENT CERTIFICATE. The following abbreviations, when used in the inscription on the face of this certificate, shall be construed as though they were written out in full according to applicable laws or regulations: TEN COM - as tenants in common UNIF GIFT MIN ACT - ......................... Custodian ......................... TEN ENT - as tenants by the entireties (Cust) (Minor) JT TEN - as joint tenants with right of under Uniform Gifts to Minors survivorship and not as tenants Act.............................................................................. in common (State) COM PROP - as community property UNIF TRF MIN ACT - ................. Custodian (until age ..................) (Cust) ..................................... under Uniform Transfers (Minor) to Minors Act............................................................ (State) Additional abbreviations may also be used though not in the above list. FOR VALUE RECEIVED, _____________________________________________________ hereby sell(s), assign(s) and transfer(s) unto PLEASE INSERT SOCIAL SECURITY OR OTHER IDENTIFYING NUMBER OF ASSIGNEE (PLEASE PRINT OR TYPEWRITE NAME AND ADDRESS, INCLUDING ZIP CODE, OF ASSIGNEE) shares of the capital stock represented by within Certificate, and do hereby irrevocably constitute and appoint attorney-in-fact to transfer the said stock on the books of the within named Corporation with full power of the substitution in the premises. Dated X X Signature(s) Guaranteed: NOTICE: THE SIGNATURE TO THIS ASSIGNMENT MUST CORRESPOND WITH THE NAME AS WRITTEN UPON THE FACE OF THE CERTIFICATE IN EVERY PARTICULAR, WITHOUT ALTERATION OR ENLARGEMENT OR ANY CHANGE WHATSOEVER. By THE SIGNATURE(S) SHOULD BE GUARANTEED BY AN ELIGIBLE GUARANTOR INSTITUTION, (BANKS, STOCKBROKERS, SAVINGS AND LOAN ASSOCIATIONS AND CREDIT UNIONS WITH MEMBERSHIP IN AN APPROVED SIGNATURE GUARANTEE MEDALLION PROGRAM), PURSUANT TO S.E.C. RULE 17Ad-15. GUARANTEES BY A NOTARY PUBLIC ARE NOT ACCEPTABLE. SIGNATURE GUARANTEES MUST NOT BE DATED.Exhibit

Exhibit 4.5

AMENDMENT NO. 1 TO FINANCING DOCUMENTS
This Amendment No.1 to the Financing Documents (this “Amendment”) is made as of July 10, 2019, by and among Health Catalyst, Inc., a Delaware corporation (the “Company”) and the parties listed on the signature pages hereto (the “Stockholders”). 
WHEREAS, pursuant to Section 3F of that certain Health Catalyst, Inc. Fifth Amended and Restated Investors’ Rights Agreement, dated as of February 6, 2019, by and among the Company and the investors listed on Schedule I thereto (the “Rights Agreement”), and subject to the qualifications set forth therein, the Rights Agreement may be amended with the written consent of holders of a majority of the Preferred Stock (as defined in the Rights Agreement);
WHEREAS, pursuant to Section 11 of that certain Fifth Amended and Restated Stockholders Agreement, dated as of February 6, 2019, by and among the Company and the Stockholders (as defined therein) (the “Stockholders Agreement”), and subject to the qualifications set forth therein, the Stockholders Agreement may be amended with the written consent of (a) the Company, (b) the Investors (as defined in the Stockholders Agreement) that hold a majority of the Stockholder Shares (as defined in the Stockholders Agreement) then held by the Investors and (c) the Key Holders (as defined in the Stockholders Agreement) that hold a majority of the Stockholder Shares then held by the Key Holders;
WHEREAS, pursuant to Section 9(d) of that certain Fifth Amended and Restated Registration Agreement, dated as of February 6, 2019, by and among the Company, the Investors listed on Schedule of Investors thereto (the “Registration Agreement” and together with the Rights Agreement and the Stockholders Agreement, the “Financing Documents”), and subject to the qualifications set forth therein, the Registration Agreement may be amended with the written consent of the Company and the holders of a majority of the Investor Registrable Securities (as defined in the Registration Agreement); and
WHEREAS, the Company and the Stockholders wish to amend the Financing Documents in order to allow for termination upon certain events. 
NOW, THEREFORE, for good and valuable consideration, the receipt and sufficiency of which are hereby acknowledged, the parties hereto agree as follows:
		
	1.
	The following language is added as a new Section 3S of the Rights Agreement:

“Term. This Agreement shall be effective as of the date hereof and shall continue in effect until and shall terminate upon the consummation of an IPO.”
		
	2.
	The following language is added as a new Section 26 of the Stockholders Agreement:

“Term. This Agreement shall be effective as of the date hereof and shall continue in effect until and shall terminate upon the consummation of an IPO; provided that the provisions of Section 24 hereof will survive any such termination under this Section 26.”

1

		
	3.
	The following language is added as a new Section 9(n) of the Registration Agreement:

“Termination of Registration Rights. The right of any holder to request registration or inclusion of Investor Registrable Securities in any registration pursuant to Sections 1 or 2 shall terminate upon the earliest to occur of:
(i)    such time after consummation of the IPO as Rule 144 or another similar exemption under the Securities Act is available for the sale of all of such holder’s shares without limitation during a three-month period without registration; 
(ii)    the fifth anniversary of the IPO.”
		
	4.
	Except as expressly amended herein, the Financing Documents shall remain in full force and effect.

		
	5.
	This Amendment and any controversy arising out of or relating to this Amendment shall be governed by the internal laws of the State of Delaware, without regard to its principles of conflicts of laws.

		
	6.
	This Amendment 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. This Amendment may also be executed and delivered by facsimile signature and 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.

[Remainder of Page Intentionally Left Blank]

2

IN WITNESS WHEREOF, the parties have executed this Amendment as of the date first above written.

	
		
	COMPANY:

	 
	 

	HEALTH CATALYST, INC.

	 
	 

	 
	 

	By:
	/s/ Daniel Burton

	Name: Daniel Burton

	Title: Chief Executive Officer

	 
	 

	Address: 
Health Catalyst, Inc. 
3165 East Millrock Drive
Suite 400 
Salt Lake City, UT 84121

[Signature Page to Amendment No. 1 to the Financing Documents]

IN WITNESS WHEREOF, the parties have executed this Amendment as of the date first above written.

	
		
	STOCKHOLDERS:

	 
	 

	SEQUOIA CAPITAL U.S. GROWTH FUND IV, L.P. SEQUOIA CAPITAL USGF PRINCIPALS FUND IV, L.P.

	 
	 

	By:
	SCGF IV Management, L.P., a Cayman Islands exempted limited partnership, General Partner of Each

	 
	 

	By:
	SC US (TTG P), LTD., a Cayman Islands limited liability company

	 
	 

	Its:
	General Partner

	 
	 

	 
	 

	By:
	/s/ Mike Dixon

	Name:
	Mike Dixon

	Title:
	Authorized Signatory

	 
	 

	 
	 

	SC US GF V HOLDINGS, LTD.

	a Cayman Islands exempted company

	 
	 

	By:
	Sequoia Capital U.S. Growth Fund V, L.P. and Sequoia Capital USGF Principals Fund V, L.P., both Cayman Islands Exempted Limited Partnerships, its Members

	 
	 

	By:
	SCGF V Management, L.P., a Cayman Islands Exempted Limited Partnership, its General Partner

	 
	 

	By:
	SC US (TTGP), LTD., a Cayman Islands Exempted company, its General Partner

	 
	 

	 
	 

	By:
	/s/ Mike Dixon

	Name:
	Mike Dixon

	Title:
	Authorized Signatory

[Signature Page to Amendment No. 1 to the Financing Documents]

IN WITNESS WHEREOF, the parties have executed this Amendment as of the date first above written.

	
		
	STOCKHOLDERS:

	 
	 

	SEQUOIA CAPITAL U.S. GROWTH FUND V, L.P.

	a Cayman Islands exempted limited partnership

	 
	 

	By:
	SCGF V MANAGEMENT, L.P., a Cayman Islands exempted limited partnership, its General Partner

	 
	 

	By:
	SC US (TTGP), LTD.,
a Cayman Islands exempted company, its General Partner

	 
	 

	 
	 

	By:
	/s/ Mike Dixon

	Name:
	Mike Dixon

	Title:
	Authorized Signatory

[Signature Page to Amendment No. 1 to the Financing Documents]

IN WITNESS WHEREOF, the parties have executed this Amendment as of the date first above written.

	
		
	STOCKHOLDERS:

	 
	 

	NORWEST VENTURE PARTNERS XI, LP

	 
	 

	By:
	Genesis VC Partners XI, LLC 

	Its:
	General Partner

	 
	 

	By:
	NVP Associates, LLC

	Its:
	Managing Member

	 
	 

	 
	 

	By:
	/s/ Promod Haque

	Name:
	Promod Haque

	Title:
	Senior Managing Partner

	 
	 

	 
	 

	NORWEST VENTURE PARTNERS XII, LP

	 
	 

	By:
	Genesis VC Partners XII, LLC 

	Its:
	General Partner

	 
	 

	By:
	NVP Associates, LLC

	Its:
	Managing Member

	 
	 

	 
	 

	By:
	/s/ Promod Haque

	Name:
	Promod Haque

	Title:
	Senior Managing Partner

[Signature Page to Amendment No. 1 to the Financing Documents]

IN WITNESS WHEREOF, the parties have executed this Amendment as of the date first above written.

	
		
	STOCKHOLDERS:

	 
	 

	UPMC

	 
	 

	By:
	/s/ Talbot Heppenstall

	Name:
	Talbot Heppenstall

	Its:
	Treasurer

[Signature Page to Amendment No. 1 to the Financing Documents]

IN WITNESS WHEREOF, the parties have executed this Amendment as of the date first above written.

	
		
	STOCKHOLDERS:

	 
	 

	HQC ACQUISITION, LLC

	 
	 

	By:
	/s/ Fraser Bullock

	Name:
	Fraser Bullock

	Title:
	President

[Signature Page to Amendment No. 1 to the Financing Documents]

IN WITNESS WHEREOF, the parties have executed this Amendment as of the date first above written.

	
		
	STOCKHOLDERS:

	 
	 

	Leerink Transformation Fund I L.P.

	 
	 

	By:
	/s/ Todd Cozzens

	Name:
	Todd Cozzens

	Title:
	Managing Partner

[Signature Page to Amendment No. 1 to the Financing Documents]

IN WITNESS WHEREOF, the parties have executed this Amendment as of the date first above written.

	
		
	STOCKHOLDERS:

	 
	 

	TENAYA CAPITAL VI, LP

	 
	 

	By: Tenaya Capital VI GP, LLC, its General Partner

	 
	 

	 
	 

	By:
	/s/ Stewart Gollmer

	Name:
	Stewart Gollmer

	Its:
	Managing Director

[Signature Page to Amendment No. 1 to the Financing Documents]

IN WITNESS WHEREOF, the parties have executed this Amendment as of the date first above written.

	
		
	STOCKHOLDERS:

	 
	 

	ORBIMED ROYALTY OPPORTUNITIES II, LP

	 
	 

	By OrbiMed Advisors LLC, 
its investment manager

	 
	 

	 
	 

	By:
	/s/ W. Carter Neild

	Name:
	W. Carter Neild

	Its:
	Member

[Signature Page to Amendment No. 1 to the Financing Documents]

IN WITNESS WHEREOF, the parties have executed this Amendment as of the date first above written.

	
		
	STOCKHOLDERS:

	 
	 

	SANDS CAPITAL PRIVATE GROWTH FUND, L.P.

	 
	 

	By: Sands Capital Private Growth Fund-GP, L.P.

	Its:
	General Partner

	 
	 

	By: Sands Capital Private Growth Fund-GP, LLC

	Its:
	General Partner

	 
	 

	 
	 

	By:
	/s/ Jonathan Goodman

	Name:
	Jonathan Goodman

	Title:
	General Counsel

	 
	 

	 
	 

	SANDS CAPITAL PRIVATE GROWTH FUND-HC, L.P.

	 
	 

	SANDS CAPITAL PRIVATE GROWTH FUND-HC2, L.P.

	 
	 

	SANDS CAPITAL PRIVATE GROWTH FUND-HC3, L.P.

	 
	 

	SANDS CAPITAL PRIVATE GROWTH FUND-HC4, L.P.

	 
	 

	By: Sands Capital Private Growth Fund-GP, L.P., its general partner

	 
	 

	By: Sands Capital Private Growth Fund-GP, LLC, its general partner

	 
	 

	 
	 

	By:
	/s/ Jonathan Goodman

	Name:
	Jonathan Goodman

	Title:
	General Counsel

[Signature Page to Amendment No. 1 to the Financing Documents]

IN WITNESS WHEREOF, the parties have executed this Amendment as of the date first above written.

	
	
	STOCKHOLDERS:

	 

	 

	/s/ Steven C. Barlow

	Steven C. Barlow

[Signature Page to Amendment No. 1 to the Financing Documents]

IN WITNESS WHEREOF, the parties have executed this Amendment as of the date first above written.

	
		
	STOCKHOLDERS:

	 
	 

	Patricia Cardon Burton, Trustee of the Burton 2013 Descendants Trust

	 
	 

	By:
	/s/ Patricia Burton

	Name:
	Patricia Burton

	Title:
	Trustee

[Signature Page to Amendment No. 1 to the Financing Documents]

IN WITNESS WHEREOF, the parties have executed this Amendment as of the date first above written.

	
		
	STOCKHOLDERS:

	 
	 

	THOMAS DAVID BURTON AND PATRICIA CARDON 
BURTON MULTI-GENERATIONAL TRUST II

	 
	 

	By:
	/s/ Thomas D. Burton

	Name:
	Thomas D. Burton

	Title:
	Trustee

[Signature Page to Amendment No. 1 to the Financing Documents]

IN WITNESS WHEREOF, the parties have executed this Amendment as of the date first above written.

	
		
	STOCKHOLDERS:

	 
	 

	CATALYST INVESTMENTS, LLC

	 
	 

	By:
	/s/ Patricia Cardon Burton

	Name: Patricia Cardon Burton, acting under Authority of the General Partner of Burton Family Pavilions, L.P.

[Signature Page to Amendment No. 1 to the Financing Documents]

Source: [{"source": "alea-institute/alea-institute/kl3m-data-edgar-agreements/train-00297-of-00352.parquet"}, [{"source": "alea-institute/alea-institute/kl3m-data-edgar-agreements/train-00297-of-00352.parquet"}]]