Document:

omnibio10k_ex1262709.htm

     

    

      Exhibit 10.12

      

      IMPORTANT:  PLEASE
READ CAREFULLY BEFORE SIGNING.

      SIGNIFICANT
REPRESENTATIONS ARE CALLED FOR HEREIN.

      

      SUBSCRIPTION
AGREEMENT

      and

      LETTER OF
INVESTMENT INTENT

      

      

      Across
America Financial Services, Inc.

      5350
South Roslyn Street, Suite 400

      Greenwood
Village, CO  80111-2124

      

      Gentlemen:

      

      The undersigned (the "Subscriber")
hereby tenders this subscription for the purchase of units (“Units”) issued by
Across America Financial Services, Inc. (the “Company”).  Each Unit
consists of one share of the common stock of the Company, one warrant to
purchase one-half a share of the common stock of the Company at an exercise
price of twenty-five cents ($0.25) per share—two warrants must be exercised to
purchase one share of common stock (the “Twenty-Five Cent Warrants”), two
warrants to purchase shares of the common stock of the Company at an exercise
price of fifty cents ($0.50) per share (the “Fifty Cent Warrants”) and one
warrant to purchase shares of the common stock of the Company at an exercise
price of one dollar ($1.00) per share (the “Dollar Warrants”) (collectively, the
Units, common stock, Twenty-Five Cent Warrants, Fifty Cent Warrants and Dollar
Warrants are referred to herein as the
“Securities”).      The Units are being offered at
a price of $1.00 per Unit.  By execution below, the Subscriber
acknowledges that the Company is relying upon the accuracy and completeness of
the representations contained herein in complying with their obligations under
applicable securities laws.

      

      1.           Subscription
Commitment.  The Subscriber hereby subscribes for the purchase
of ____ Units at a purchase price of $________  as full payment
therefor.  The purchase price shall be paid to the Company by
cashier’s check made payable to the Company or by wire transfer to the account
of the Company.

      

      The Subscriber understands that this
subscription is not binding on the Company until accepted by the Company, which
acceptance is at the discretion of the Company and is to be evidenced by the
Company's execution of this Subscription Agreement where
indicated.  If the subscription is rejected the Company shall return
to the Subscriber, without interest or deduction, any payment tendered by the
Subscriber, and the Company and the Subscriber shall have no further obligation
to each other hereunder.  Unless and until rejected by the Company
this subscription shall be irrevocable by the Subscriber.

      

      2.           Representations and
Warranties.  In order to induce the Company to accept this
subscription, the Subscriber hereby represents and warrants to, and covenants
with, the Company as follows:

      
        
           

        

        
           

          
            

          

        

        
           

        

      

      

      (a)           Subscriber
has been provided with a copy of the Company’s Form 8-K filed on March __, 2009
with the Securities and Exchange Commission, a copy of which is attached hereto
as Exhibit A, as well as a form of the Twenty-Five Cent Warrant, the Fifty Cent
Warrant and the Dollar Warrant, copies of which are attached hereto as Exhibits
B, C and D.  (the “Exhibits”) (the Exhibits and this Subscription
Agreement are referred to herein as the “Documents”).  The Subscriber
has been given access to full and complete information regarding the Company and
has utilized such access to the Subscriber’s satisfaction for the purpose of
obtaining such information regarding the Company as the Subscriber has
reasonably requested; and, particularly, the Subscriber has been given
reasonable opportunity to ask questions of, and receive answers from,
representatives of the Company concerning the terms and conditions of the
offering of the Securities and to obtain any additional information, to the
extent reasonably available;

      

      (b)           Except
for the Documents, the Subscriber has not been furnished with any other
materials or literature relating to the offer and sale of the Securities; except
as set forth in the Documents, no representations or warranties have been made
to the Subscriber by the Company, any selling agent of the Company, or any
agent, employee, or affiliate of the Company or such selling agent.

      

      (c)           The
Subscriber believes that an investment in the securities is suitable for the
Subscriber based upon the Subscriber investment objectives and financial
needs.  The Subscriber (i) has adequate means for providing for the
Subscriber’s current financial needs and personal contingencies; (ii) has no
need for liquidity in this investment; (iii) at the present time, can afford a
complete loss of such investment; and (iv) does not have an overall commitment
to investments which are not readily marketable that is disproportionate to the
Subscriber's net worth, and the Subscriber's investment in the Securities will
not cause such overall commitment to become excessive.

      

      (d)           The
Subscriber, in reaching a decision to subscribe, has such knowledge and
experience in financial and business matters that the Subscriber is capable of reading
and interpreting financial statements and evaluating the merits and risk of an
investment in the Securities and has the net worth to undertake such
risks.  The investment contemplated hereby is the result of arm’s
length negotiation between the Subscriber and the Company.

      

      (e)           The
Subscriber was not offered or sold the Securities, directly or indirectly, by
means of any form of general advertising or general solicitation, including, but
not limited to, the following:  (1) any advertisement, article, notice
or other communication published in any newspaper, magazine, or similar medium
of or broadcast over television or radio; or (2) to the knowledge of the
undersigned, any seminar or meeting whose attendees had been invited by any
general solicitation or general advertising.

      

      (f)           The
Subscriber has obtained, to the extent the Subscriber deems necessary, the
Subscriber’s own personal professional advice with respect to the risks inherent
in the investment in the securities, and the suitability of an investment in the
Securities in light of the Subscriber's financial condition and investment
needs;

      

      (g)           The
Subscriber recognizes that the Securities as an investment involves a high
degree of risk, including those set forth under the caption "Risk Factors" in
the Form 8-K attached hereto as Exhibit A.

      
        
           

        

        
           

          
            

          

        

        
           

        

      

      

      (h)           The
information contained in this agreement is true, complete and correct in all
material respects as of the date hereof; the Subscriber understands that the
Company's determination that the exemption from the registration provisions of
the Securities Act of 1933, as amended (the "Act"), which is based upon
non-public offerings and applicable to the offer and sale of the Securities, is
based, in part, upon the representations, warranties, and agreements made by the
Subscriber herein; and the Subscriber consents to the disclosure of any such
information, and any other information furnished to the Company, to any
governmental authority, self-regulatory organization, or, to the extent required
by law, to any other person.

      

      (i)           The
Subscriber realizes that (i) the purchase of the Securitiesis a long-term
investment; (ii) the purchaser of the Securities must bear the economic risk of
investment for an indefinite period of time because the Securities have not been
registered under the Securities Act of 1933 or under the securities laws of any
state and, therefore, the Securities cannot be resold unless they are
subsequently registered under said laws or exemptions from such registrations
are available;  (iii) there is presently no public market for the
Securities and the Subscriber may be unable to liquidate the Subscriber’s
investment in the event of an emergency, or pledge the Securities as collateral
for a loan; and (iv) the transferability of the Securities is restricted and (A)
requires conformity with the restrictions contained in paragraph 2 below and (B)
legends will be placed on the certificate(s) representing the Securities
referring to the applicable restrictions on transferability; and

      

      (j)           The
Subscriber certifies, under penalties of perjury, that the Subscriber is NOT
subject to the backup withholding provisions of Section 3406(a)(i)(C) of the
Internal Revenue Code.

      

      (k)           Stop
transfer instructions will be placed with the transfer agent for the Securities,
and a legend may be placed on any certificate representing the Securities
substantially to the following effect:

      

      THIS
SECURITY HAS NOT BEEN REGISTERED WITH THE SECURITIES AND EXCHANGE COMMISSION
UNDER THE SECURITIES ACT OF 1933, AS AMENDED (THE "ACT"), IN RELIANCE UPON THE
EXEMPTIONS FROM REGISTRATION PROVIDED IN THE ACT AND REGULATION D UNDER THE
ACT.  AS SUCH, THE PURCHASE OF THIS SECURITY WAS NECESSARILY WITH THE
INTENT OF INVESTMENT AND NOT WITH A VIEW FOR DISTRIBUTION.  THEREFORE,
ANY SUBSEQUENT TRANSFER OF THIS SECURITY OR ANY INTEREST THEREIN WILL BE
UNLAWFUL UNLESS IT IS REGISTERED UNDER THE ACT OR UNLESS AN EXEMPTION FROM
REGISTRATION IS AVAILABLE. FURTHERMORE, IT IS UNLAWFUL TO CONSUMMATE A SALE OR
TRANSFER OF THIS SECURITY OR ANY INTEREST THEREIN, WITHOUT THE OPINION OF
COUNSEL ACCEPTABLE TO THE COMPANY THAT THE PROPOSED TRANSFER OR SALE DOES NOT
AFFECT THE EXEMPTIONS RELIED UPON BY THE COMPANY IN ORIGINALLY DISTRIBUTING THE
SECURITY AND THAT REGISTRATION IS NOT REQUIRED.

      

      (l)           The
subscriber understands that Bathgate Capital Partners LLC is acting as placement
agent on this transaction and the Company will pay Bathgate Capital Partners LLC
a fee of a cash payment of six percent (6%) of my investment and warrants equal
to six percent (6%) of my investment.  The subscriber further
understands that Bathgate Capital Partners LLC will receive an advisory fee for
the reverse merger of 1,700,000 warrants exercisable at $.001 per
share.

      
        
           

        

        
           

          
            

          

        

        
           

        

      

      

      

      3.           Restricted Nature of the
Securities. The Subscriber has been advised and understands that (a) the
Securities have not been registered under the Securities Act of 1933 or
applicable state securities laws and that the securities are being offered and
sold pursuant to exemptions from such laws; (b) the Documents may not have been
filed with or reviewed by certain state securities administrators because of the
limited nature of the offering; (c) the Company is under no obligation to
register the Securities under the Act or any state securities laws, or to take
any action to make any exemption from any such registration provisions
available. The Subscriber represents and warrants that the Securities are being
purchased for the Subscriber’s own account and for investment purposes only, and
without the intention of reselling or redistributing the same; the Subscriber
has made no agreement with others regarding any of the Securities; and the
Subscriber’s financial condition is such that it is not likely that it will be
necessary to dispose of any of such Securities in the foreseeable
future.  The Subscriber is aware that, in the view of the Securities
and Exchange Commission, a purchase of such securities with an intent to resell
by reason of any foreseeable specific contingency or anticipated change in
market value, or any change in the condition of the Company, or in connection
with a contemplated liquidation settlement of any loan obtained for the
acquisition of such securities and for which such securities were pledged, would
represent an intent inconsistent with the representations set forth
above.  The Subscriber further represents and agrees that if, contrary
to the foregoing intentions, the Subscriber should later desire to dispose of or
transfer any of such securities in any manner, the Subscriber shall not do so
unless and until (i) said Securities shall have first been registered under the
Act and all applicable securities laws; or (ii) the Subscriber shall have first
delivered to the Company a written notice declaring such holder's intention to
effect such transfer and describe in sufficient detail the manner and
circumstances of the proposed transfer, which notice shall be accompanied either
by a written opinion of legal counsel who shall be reasonably satisfactory to
the Company, which opinion shall be addressed to the Company and reasonably
satisfactory in form and substance to the Company's counsel, to the effect that
the proposed sale or transfer is exempt from the registration provisions of the
Act and all applicable state securities laws, or by a "no action" letter from
the Securities and Exchange Commission to the effect that the transfer of the
Securities without registration will not result in recommendation by the staff
of the Commission that action be taken with respect thereto.

      

      4.           Residence.  The
Subscriber represents and warrants that the Subscriber is a bona fide resident
of, is domiciled in and received the offer and made the decision to invest in
the Securities in the state set forth on the signature page hereof, and the
Securities are being purchased by the Subscriber in the Subscriber’s name solely
for the Subscriber’s own beneficial interest and not as nominee for, or on
behalf of, or for the beneficial interest of, or with the intention to transfer
to, any other person, trust or organization, except as specifically set forth in
paragraph 15 of this Subscription Agreement and Letter of Investment
Intent.

      

      5.           Investor
Qualification.  The Subscriber represents and warrants that the
Subscriber or the purchaser of the Securities named in paragraph 15 comes within at least
one category marked below, and that for any category marked the Subscriber has
truthfully set forth the factual basis or reason the Subscriber comes within
that category.  ALL INFORMATION IN RESPONSE TO THIS PARAGRAPH WILL BE
KEPT STRICTLY CONFIDENTIAL.  The Subscriber agrees to furnish any
additional information which the Company deems necessary in order to verify the
answers set forth below.

      

      
        	
                 
      

              	
                Category
      I ______

              	 	
                The
      Subscriber is an individual (not a partnership, corporation, etc.) whose
      individual net worth, or joint net worth with the Subscriber’s spouse,
      presently exceeds $1,000,000.

                 

                Explanation.  In
      calculation of net worth the Subscriber may include equity in personal
      property and real estate, including the Subscriber’s principal residence,
      cash, short term investments, stocks and securities.  Equity in
      personal property and real estate should be based on the fair market value
      of such property less debt secured by such
  property.

              

      

      
        
           

        

        
           

          
            

          

        

        
           

        

      

       

       

      

      
        	
                 
      

              	
                Category
      II _______

              	 	
                The
      Subscriber is an individual (not a partnership, corporation, etc.) who had
      an individual net income in excess of $200,000 in each of the last two
      years, or joint income with his/her spouse in excess of $300,000 in each
      of the last two years, and has a reasonable expectation of reaching the
      same income level in the current
year.

              

      

      
        

        
          	
                   
      

                	
                  Category
      III ______

                	 The Subscriber is an executive officer or director of the
      Company.	
                

        

         

      

      
        	
                 
      

              	
                Category
      IV ______

              	 	
                The
      Subscriber is a bank; savings and loan; insurance company; registered
      broker or dealer; registered investment company; registered business
      development company; licensed small business investment company (“SBIC”);
      or employee benefit plan within the meaning of Title I of ERISA whose plan
      fiduciary is either a bank, savings and loan, insurance company or
      registered investment advisor or whose total assets exceed $5,000,000; or
      a self-directed employee benefit plan with investment decisions made
      solely by persons that are accredited
investors.

              

      

      

      

      

      

                          (describe
entity)

      
        
          

          
            	
                     
      

                  	
                    Category
      V ______

                  	 The Subscriber is a private business development company as
      defined inSection 202(a)(22) of the Investment Advisers Act of 1940.	
                  

          

           

        

        
          
          

        

         

      

      
 

                          (describe
entity)

       

      
        
           

        

        
           

          
            

          

        

        
           

        

      

      
        	
                 
      

              	
                Category
      VI ______

              	 	
                The
      Subscriber is an entity with total assets in excess of $5,000,000 which
      was not
      formed for the purpose of investing in the Securities and which is one of
      the following:

              

      

      

      _______ a
corporation; or

      

      _______ a
partnership; or

      

      _______ a
business trust; or

      
        

        _______ a
tax-exempt organization described in Section 501(c)(3) ofthe Internal Revenue
Code of 1986, as amended.

        

 

      

      

      

      (describe entity)

      

      
        	
                 
      

              	
                Category
      VII ______

              	 	
                The
      Subscriber is a trustee for a trust that is revocable by the grantor at
      any time (including an IRA) and the grantor qualifies under either
      Category I or Category II above.  A copy of the declaration of
      trust or trust agreement and a representation as to the net worth or
      income of the grantor is enclosed.

              

      

       

      
        
          

          
            	
                     
      

                  	
                    Category
      VIII _____

                  	
                    The
      Subscriber is an entity all the equity owners of which are “accredited
      investors” within one or more of the above categories, other than
      Category  IV or Category V.  [If relying upon this category
      alone, each equity owner must complete a separate copy of this
      Agreement.]

                  	
                  

          

           

        

        
          
          

        

        
 

         

                            (describe
entity)

         

      

      

      
        	
                 
      

              	
                Category
      IX ______

              	 	
                The
      Subscriber is a trust with total assets in excess of $5,000,000, not
      formed for the specific purpose of acquiring the Securities, whose
      purchase is directed by a person who has such knowledge and experience in
      financial and business matters that he is capable of evaluating the merits
      and risks of the prospective
investment.

              

      

      

      6.           FINRA
Questionnaire.

      

      (a)           Are
you a member of FINRA,1 a person associated with a member2 of FINRA, or an affiliate of a
member?

      

               
Yes [  ]     
No  [  ]

      

      If "Yes,"
please list any members of FINRA with whom you are associated or
affiliated.

        
         

      

      
        
          
          

        

        
          
          

          
            

          

        

        
          
          

        

      

      

      

      

      (b)           If
you are a corporation, are any of your officers, directors or 5% shareholders a
member of FINRA, a person associated with a member of FINRA, or an affiliate of
a member?

      

      
                 
Yes [  ]     
No  [  ]

      If "Yes,"
please list the name of the respective officer, director, or 5% shareholder and
any members of FINRA with whom they are associated or affiliated.

      

      

      

      

      

      7.           Additional
Representations.  The undersigned, if other than an individual,
makes the following additional representations:

      

      (a)           The
Subscriber was not organized for the specific purpose of acquiring the
Securities; and

      

      (b)           This
Subscription Agreement and Letter of Investment Intent has been duly authorized
by all necessary action on the part of the Subscriber, has been duly executed by
an authorized officer or representative of the Subscriber, and is a legal, valid
and binding obligation of the Subscriber enforceable in accordance with its
terms.

      

      8.           Sophistication.  The
Subscriber further represents and warrants that he has such knowledge and
experience in financial and business matters so as to be capable of evaluating
the merits and risks of an investment in the Securities and protecting the
Subscriber’s own interests in this transaction, and does not desire to utilize
the services of any other person in connection with evaluating such merits and
risks.

      

      9.           Reliance on
Representations.  The Subscriber understands the meaning and
legal consequences of the representations, warranties, agreements, covenants,
and confirmations set out above and agrees that the subscription made hereby may
be accepted in reliance thereon.  The Subscriber agrees to indemnify
and hold harmless the Company and any selling agent (including for this purpose
their employees, and each person who controls either of them within the meaning
of Section 20 of the Securities Exchange Act of 1934, as amended) from and
against any and all loss, damage, liability or expense, including reasonable
costs and attorney's fees and disbursements, which the Company, or such other
persons may incur by reason of, or in connection with, any representation or
warranty made herein not having been true when made, any misrepresentation made
by the Subscriber or any failure by the Subscriber to fulfill any of the
covenants or agreements set forth herein, in the Purchaser Questionnaire or in
any other document provided by the Subscriber to the Company.

      

      10.           Transferability and
Assignability.  Neither this Subscription Agreement nor any of
the rights of the Subscriber hereunder may be transferred or assigned by the
Subscriber.  The Subscriber agrees that the Subscriber may not cancel,
terminate, or revoke this Subscription Agreement or any agreement of the
Subscriber made hereunder (except as otherwise specifically provided herein) and
that this Subscription Agreement shall survive the death or disability of the
Subscriber and shall be binding upon the Subscriber's heirs, executors,
administrators, successors, and assigns.

      
        
           

        

        
           

          
            

          

        

        
           

        

      

      

      11.           
Survival.  The
representations and warranties of the Subscriber set forth herein shall survive
the sale of the Securities pursuant to this Subscription Agreement.

      

      12.           Notices.  All
notices or other communications hereunder shall be in writing and shall be
deemed to have been duly given if delivered personally or mailed by certified or
registered mail, return receipt requested, postage prepaid, as
follows:  if to the Subscriber, to the address set forth below; and if
to the Company to the address at the beginning of this letter, or to such other
address as the Company or the Subscriber shall have designated to the other by
like notice.

      

      13.           Counterparts.  This
Agreement may be executed in one or more counterparts, each of which shall be
deemed an original, but all of which together shall constitute one and the same
document.

      

      INVESTORS
MUST LOOK SOLELY TO, AND RELY ON, THEIR OWN ADVISORS WITH RESPECT TO THE TAX
CONSEQUENCES OF INVESTING IN THE SECURITIES.

      

      

      14.           Title.  Manner
in Which Title is To Be Held.

      

      Place an “X” in one space
below:

      

      (a)   ____    Individual Ownership

      (b)   ____    Community Property

      (c)   ____    Joint Tenant with Right of Survivorship
(both parties must sign)

      (d)   ____    Partnership

      (e)   ____    Tenants in Common

      (f)   ____    Corporation

      (g)   ____    Trust

      (h)   ____    Other (Describe):

       

      ________________________________________________________________________________________________________________

       

      ________________________________________________________________________________________________________________

       

      ________________________________________________________________________________________________________________

      

               Please
print above the exact name(s) in which the Securities are to be
held.

       

      
        
           

        

        
           

          
            

          

        

        
           

        

      

      

      15.           State of
Residence.  My state of residence and the state in which I
received the offer to invest and made the decision to invest in the Securities
is. _________________

      

      16.           Date of
Birth.  My date of birth
is: __________________________ 

      
        
           

        

        
           

          
            

          

        

        
           

        

      

      SIGNATURES

      

      The
Subscriber hereby represents he has read this entire Subscription
Agreement.

      

      Dated:
________________

      

      INDIVIDUAL

       

      
        

        
          
            
              
                
                  
                    
                      
                        
                          
                            
                              
                                
                                  	 
      	 	
                                          Address
      to Which Correspondence Should
      be Directed

                                        
	 
      	 	
                                           

                                        
	 
      	 	 
      
	 
      	 	 
      
	 
      	 	 
      
	
                                          Signature
      (Individual)

                                        	 	 
      
	 
      	 	 
      
	 
      	 	 
      
	 
      	 	 
      
	
                                          Signature
      (All record holders should sign)

                                        	 	
                                          City,
      State and Zip Code

                                        
	 
      	 	 
      
	 
      	 	 
      
	
                                          Name(s)
      Typed or Printed

                                        	 	
                                          Tax
      Identification or Social Security Number

                                        
	 
      	 	 
      
	 
      	 	
                                          (           )                                                      

                                        
	 
      	 	
                                          Telephone
      Number

                                        

                                

                              

                            

                          

                        

                      

                    

                  

                

              

            

          

        

        

      

      

      

      

      COPY OF DRIVER’S LICENSE OR
PASSPORT REQUIRED IF NON-BCP CUSTOMER

      Customer Identification Program
Notice:  To help the government fight the funding of terrorism and
money laundering activities, federal law requires financial institutions to
obtain, verify, and record information that identifies each client.  This
means that we will require you to provide the following information: name, date
of birth, address, identification number, and a piece of documentary
identification. If you are an individual and do not have an account with
Bathgate Capital Partners, please include a copy of your driver’s license or
passport. If you are an entity, please provide a copy of your articles of
incorporation, trust document, or other identifying document. If you are unable
to produce the information required, we may not be able to complete your
investment transaction.

      

      

      

      

      

      

      

      

      

      

      
        
           

        

        
           

          
            

          

        

        
           

        

      

      CORPORATION,
PARTNERSHIP, TRUST, RETIREMENT ACCOUNT OR OTHER ENTITY

      

       

      
         

        
          

          
            
              
                
                  
                    
                      
                        
                          
                            
                              
                                
                                  
                                    
                                      
                                        
                                          
                                            
                                              
                                                
                                                  
                                                    
                                                      
                                                        
                                                          
                                                            
                                                              
                                                                	 	 
      	 	
                                                                        Address
      to Which Correspondence Should
      be Directed

                                                                      
	 Name of Entity  	 	
                                                                         

                                                                      
	 	 
      	 	 
      
	 	 
      	 	 
      
	
                                                                         By:  
      

                                                                      	 
      	 	 
      
	 	
                                                                        Signature*

                                                                      	 	 
      
	 	 
      	 	 
      
	
                                                                        Its:  
      

                                                                      	 
      	 	 
      
	 	 	 	 
	 	 
      	 	 
      
	 	
                                                                        Signature
      (All record holders should sign)

                                                                      	 	
                                                                        City,
      State and Zip Code

                                                                      
	 	 
      	 	 
      
	 	 
      	 	 
      
	
                                                                        NameTyped
      or Printed

                                                                      	 	
                                                                        Tax
      Identification or Social Security Number

                                                                      
	 	 
      	 	 
      
	 	 
      	 	
                                                                        (           )                                                      

                                                                      
	 	 
      	 	
                                                                        Telephone
      Number

                                                                      

                                                              

                                                            

                                                          

                                                        

                                                      

                                                    

                                                  

                                                

                                              

                                            

                                          

                                        

                                      

                                    

                                  

                                

                              

                            

                          

                        

                      

                    

                  

                

              

            

          

           

        

      

      *If
Securities are being subscribed for by an entity, the Certificate of Signatory
must also be completed.

      

      

      

      CERTIFICATE
OF SIGNATORY

      

      To
be completed if Securities are being subscribed for by an entity.

      

      I, ________________________________________ ,
am the _____________________________ of
__________________________________________ (the
“Entity”).

      

      I certify that I am empowered and duly
authorized by the Entity to execute and carry out the terms of the Subscription
Agreement and Letter of Investment Intent and to purchase and hold the
Securities, and certify that the Subscription Agreement and Letter of Investment
Intent has been duly and validly executed on behalf of the Entity and
constitutes a legal and binding obligation of the Entity.

      

      IN WITNESS WHEREOF, I have hereto set
may hand this ______ day of _______, 2009.

      

      

       

      
        	 	 	 ___________________________________________________
	 	 	         Signature

      

       

      
 

      
        
           

        

        
           

          
            

          

        

        
           

        

      

      ACCEPTANCE

      

      

      This
Subscription Agreement is accepted as of __________________________,
2009

      

       

      
         

        
          	 	 Omni Bio Pharmaceutical, Inc.
	 	 
	
                   By:       
    

                	 
	 	 Authorized Officer
	 	 
	 Date:     	   
      
	 	 

        

         

      

      ________________

      
        

        

        
          	
                   
      

                	
                  1  FINRA
      defines a "member" as being either any broker or dealer admitted to
      membership in FINRA or any officer or partner of such a member, or the
      executive representative of such a member or the substitute for such
      representative.

                

        

          
          
            	
                     
      

                  	
                    2  FINRA
      defines a "person associated with a member" as being every sole
      proprietor, general or limited partner, officer, director or branch
      manager or such member, or any natural person occupying a similar status
      or performing similar functions, or any natural person engaged in the
      investment banking or securities business who is directly or indirectly
      controlling or controlled by such member (for example, any employee),
      whether or not any such person is registered or exempt from registration
      without FINRA.  Thus, "person associated with a member" includes
      a sole proprietor, general or limited partner, officer, director or branch
      manager or an organization of any kind (whether a corporation, partnership
      or other business entity) which itself is a "member" or a "person
      associated with a member."  In addition, an organization of any
      kind is a "person associated with a member" if its sole proprietor or
      anyone of its general or limited partners, officers, director or branch
      managers is a "member" or "person associated with a
    member."

                  

          

          

           

        

      

      
        
           

        

        
           

          
            

          

        

        
           

        

      

    
       

      

      

      

      APPENDIX
A

      

      BCP
DISCLOSURES

       

      Bathgate
Capital Partners LLC

       

      Privacy
Policy Concerning Clients' Financial Information Dated January 1,
2009

      This
privacy disclosure statement puts in writing the privacy policies that BCP
follows.   Our policy is based on the recognition that our
clients have an expectation that nonpublic personal information will be kept
confidential.  We have adopted this Privacy Policy concerning
information you have provided to us and information we obtained in providing
services to you.

      Information
about you is collected in the normal course of business for purposes of
providing services to you.  This information is not collected for
resale.  We provide information to unaffiliated third parties that is
necessary for us to provide services to you.  The information that is
collected, the source of the information and the parties to which the
information is provided are explained below.

      Categories
of Nonpublic Information We Collect In the Normal Course of Business:

      1.   Information
you provide in establishing an account.  This is information provided
by you on forms used to open and maintain an account with us and our affiliates
and otherwise provided by you in using our services. Examples of such
information are your name, address, employment, age, assets and investment
objectives and experience.

      2.   Information
about your transactions.  This includes information obtained from you
concerning a transaction that we have done on your behalf.  We also
have information about assets held for you.  If your account was
transferred to us, we may have received information from another financial
institution.  Our Brokerage services are introduced by us to a
clearing firm that effects transactions and maintains assets for
you.  We have access to information about these transactions and
assets.  We anticipate that the clearing firm will separately provide
you with their privacy policies concerning client financial information that is
collected or available to them.

      Categories of Nonpublic
Information That is Disclosed:

      We do not
disclose any nonpublic personal information about our clients or former clients
to anyone, except as required or permitted by law.  Examples of such
disclosures include:

      1.   All
information about your account may be disclosed to any person that you
authorized pursuant to the documentation you have provided us.  For
example, information about accounts held jointly shall be disclosed to all
persons jointly sharing the account.

      2.   Any
information that is compelled to be produced by law, such as pursuant to a
subpoena issued by a court.

      3.   Information
provided with your consent or at your direction, such as disclosure to a
nonaffiliated mortgage lender with whom you are applying for a mortgage
loan.

      4.   Information to a
financial institution where your account is transferred.

      5.  Information
provided by us to non-affiliated third parties that assist us in providing our
services to you such as data processing firms that prepare and print your
account statements.

      Parties to Whom We May
Disclose Nonpublic Information

      We may
disclose both identification and transaction information to affiliated and
non-affiliated parties as permitted by law for the following
reasons:

      
        	
                 
      

              	
                1.Non-financial
      Entities.  Such entities include persons we engage to prepare
      confirmations, account statements and other account records and transfer
      agents to permit the issuance of security certificates to
    you.

              

      

      
        	
                 
      

              	
                2.Financial
      Entities.  Such entities include a clearing firm that is a
      securities broker-dealer that we

              

      

      introduce
transactions or accounts in certain types of security products.

      We do not
disclose nonpublic information about our clients to any party except as required
or permitted by law.

      Our Policies Protecting the
Confidentiality of Information About You

      We
restrict access to nonpublic personal information about you to those employees
and nonaffiliated third parties who need to know that information so as to
enable us to provide products and services to you.

      Such
employees include your account executive, personnel in the trading department
who effect or route your transactions, operations personnel who prepare and
reconcile records of your transactions and your security and money positions,
and management and compliance personnel who oversee our business.

       

      
        
          
          

        

        
          
          

          
            

          

        

        
          
          

        

      

       

      Nonaffiliated
third parties include our clearing firm or others that:

      1.   Prepare
confirmations, account statements and other records of your
account.

      2.   Transmit
trade information to securities regulators and other government agencies as
required by applicable rules.

      3.   Regulate
our business in accordance with applicable law.

      4.   Maintain
accounts.

      5.   Facilitate
the clearing and settlement of transactions.

      6.   Such
other parties as permitted by law.

      We
maintain physical, electronic and procedural safeguards to guard against persons
not authorized by us from having access to your nonpublic personal
information.

      Internally, we maintain all written
records in secured locations that are accessible only to authorized
personnel.  Account executives are provided with transaction records
of accounts that they have responsibility for servicing.  Electronic
records are maintained on secure computers that are password
protected.  Employees undergo background checks as a condition of
employment.

      

      We
appreciate being able to provide our services to you and will continue to do so
while maintaining the confidentiality of the information needed to provide such
services.  If you have any questions concerning this notice, please
call Vicki Barone at (303) 694-0862.

       

      BATHGATE CAPITAL PARTNERS
BUSINESS CONTINUITY PLANNING

       

      Bathgate
Capital Partners LLC has developed a Business Continuity Plan on how we will
respond to events that significantly disrupt our business.  Since the
timing and impact of disasters and disruptions is unpredictable, we will have to
be flexible in responding to actual events as they occur.  With that
in mind, we are providing you with this information on our business continuity
plan.

       

      Contacting Us – If after a
significant business disruption you cannot contact us as you usually do at
303-694-0862, please go to our web site at www.bathgatepartners.com.  

       

      Our Business Continuity Plan –
We plan to quickly recover and resume business operations after a significant
business disruption and respond by safeguarding our employees and property,
making a financial and operational assessment, protecting the firm’s books and
records, and allowing our customers to transact business.  In short,
our business continuity plan is designed to permit our firm to resume operations
as quickly as possible, given the scope and severity of the significant business
disruption.  Our business continuity plan addresses: data back up and
recovery; all mission critical systems; financial and operational assessments;
alternative communications with customers, employees, and regulators; alternate
physical location of employees; critical supplier, contractor, bank and
counter-party impact; regulatory reporting; and assuring our customers prompt
access to their funds and securities if we are unable to continue our business.

      

      Varying Disruptions –
Significant business disruptions can vary in their scope, such as only our firm,
a single building housing our firm, the business district where our firm is
located, the city where we are located, or the whole region.  Within
each of these areas, the severity of the disruption can also vary from minimal
to severe.  In a disruption to only our firm or a building housing our
firm, we will transfer our operations to a local site when needed and expect to
recover and resume business within an hour.  In a disruption affecting
our business district, city, or region, we will transfer our operations to a
site outside of the affected area, and recover and resume business within a few
hours.  In either situation, we plan to continue in business, transfer
operations to our clearing firm if necessary, and notify you through our web
site [www.bathgatepartners.com] or a telephone recording from our main line,
[303-694-0862] how to contact us.  If the significant business
disruption is so severe that it prevents us from remaining in business, we will
assure our customer’s prompt access to their funds and securities.

      

      For more information – If you
have questions about our business continuity planning, you can contact us at
(303) 694-0862 or send inquiries to our main office: 5350 S. Roslyn St. Suite
400 Greenwood Village, CO  80111.omnibio10k_ex1362709.htm

     

    

    Exhibit
10.13

    

    FORM
OF INVESTOR WARRANT

    

    WARRANT
NO.__

    

    

    WARRANT
TO PURCHASE SHARES

    OF
COMMON STOCK

    Across
America Financial Services, Inc

    (pending
name change to Omni Bio Pharmaceutical, Inc.)

    

    

    Two
Warrants Entitle the Holder to Purchase One Share

    (subject
to adjustment as set forth herein)

    

    

    Exercise
Price $0.25 Per Share

    (subject
to adjustment as set forth herein)

    

    VOID
AFTER 5 P.M., MST, TIME, March 31, 2014  

    

    

    THE
SECURITIES REPRESENTED BY THIS WARRANT HAVE NOT BEEN REGISTERED UNDER THE
SECURITIES ACT OF 1933, AS AMENDED (THE "ACT") OR REGISTERED OR QUALIFIED UNDER
ANY OTHER APPLICABLE FEDERAL OR STATE SECURITIES LAWS.  THESE
SECURITIES MAY NOT BE OFFERED FOR SALE, SOLD, OR OTHERWISE TRANSFERRED, IN WHOLE
OR IN PART, EXCEPT PURSUANT TO AN EFFECTIVE REGISTRATION STATEMENT OR
QUALIFICATION FILED IN ACCORDANCE WITH THE ACT OR PURSUANT TO AN EXEMPTION FROM
REGISTRATION UNDER THE ACT.

    

    

    Across
America Financial Services, Inc. (whose name is being changed to Omni Bio
Pharmaceutical, Inc.), 5350 S. Roslyn St., Suite 400, Greenwood Village,
Colorado 80111 (the "Company"), hereby certifies that, for value received,
«Name», «Address», «City_», «State_» «Zip», (who, together with any subsequent
holder of the Warrant, is referred to as the "Holder"), is entitled, subject to
the terms and conditions set forth below, to «Amount_25_word» («Amount_25»)
warrants to purchase from the Company at any time before 5 p.m., MST time,
on March 31, 2014 ("Expiration Date")(five years from date of issue), shares of
the Company's $.001 par value Common Stock (the "Shares") at a purchase price of
$0.25 per Share (the "Exercise Price").  Each Warrant entitles the
Holder to purchase one-half a Share, such that two Warrants must be exercised to
purchase one Share at $0.25 per share.

    

    The term
"Warrant" as used herein shall include this Warrant and any Warrants issued in
substitution for or replacement of this Warrant, or any Warrants into which this
Warrant may be divided or exchanged.  The number and character of the
securities purchasable upon exercise of this Warrant and the Exercise Price are
subject to adjustment as provided below.

    

    This
Warrant may be assigned, transferred, sold, offered for sale, or exercised, in
whole or in part, by the Holder upon compliance with all the pertinent
provisions hereof.

    

    
      
        
           

        

        
          
          

          
            

          

        

        
           

        

      

    

    

    

    
       

      
        
          	
                  
                    1.

                  

                	
                	Exercise of Warrant

        

         

      

    

    
      	
               
      

            	
              (a)

            	
              Subject
      to the other terms and conditions of this Warrant, the purchase rights
      evidenced by this Warrant may be exercised in whole or in part at any
      time, and from time to time before the Expiration Date, by the Holder's
      presentation and surrender of this Warrant to the Company at its principal
      office or at the office of the Company's stock transfer agent, if any,
      accompanied by a duly executed Notice of Exercise, in the form attached to
      and by this reference incorporated in this Warrant as Exhibit A, and
      by payment of the aggregate Exercise Price, in immediately available
      funds, for that number of Warrant Securities specified in the Notice of
      Exercise.  In the event this Warrant is exercised in part only,
      as soon as is practicable after the presentation and surrender of this
      Warrant to the Company for exercise, the Company shall execute and deliver
      to the Holder a new Warrant, containing the same terms and conditions as
      this Warrant, evidencing the right of the Holder to purchase that number
      of Warrant Securities as to which this Warrant has not been
      exercised.

            

    

     

    
      
        	
                 
      

              	
                (b)

              	Upon receipt of this Warrant by the Company as described in
      subsection (a) above, the Holder shall be deemed to be the holder of
      record of the Warrant Securities issuable upon such exercise,
      notwithstanding that the transfer books of the Company may then be closed
      or that certificates representing such Warrant Securities may not have
      been prepared or actually delivered to the
Holder.

      

      
         

        
          
            	
                    
                      2.

                    

                  	
                  	Exchange, Assignment or Loss of
Warrant.

          

        

      

    

    

    
      	
               
      

            	
              (a)

            	
              This
      Warrant may be sold, transferred or assigned at any time, in whole or in
      part, if (i) the transfer is by operation of law as a result of the
      death of any Holder to whom all or a portion of this Warrant may be
      transferred, (ii) the transfer is to any successor of the Holder's
      business and (iii) to such other persons for which transaction an
      exemption from the registration requirements of the Act can be established
      to the satisfaction of the Company.  All sales, transfers,
      assignments or hypothecations of this Warrant must be in compliance with
      Section 8 hereof.  Any assignment or transfer of this
      Warrant shall be made by the presentation and surrender of this Warrant to
      the Company at its principal office or the office of its transfer agent,
      if any, accompanied by a duly executed Assignment Form, in the form
      attached to and by this reference incorporated in this Warrant as
      Exhibit B.  Upon the presentation and surrender of these
      items to the Company, the Company, at its sole expense, shall execute and
      deliver to the new Holder or Holders a new Warrant or Warrants, containing
      the same terms and conditions as this Warrant, in the name of the new
      Holder or Holders as named in the Assignment Form, and this Warrant shall
      at that time be canceled.

            

    

    

    
      
        
           

        

        
          -
2 -

          
            

          

        

        
           

        

      

    

    

    

    
      	
               
      

            	
              (b)

            	
              This
      Warrant, alone or with other Warrants containing the same terms and
      conditions and owned by the same Holder, is exchangeable at the option of
      the Holder but at the Company's sole expense, at any time prior to its
      expiration either by its terms or by its exercise in full upon
      presentation and surrender to the Company at its principal office or at
      the office of its transfer agent, if any, for another Warrant or other
      Warrants, of different denominations but containing the same terms and
      conditions as this Warrant, entitling the Holder to purchase the same
      aggregate number of Warrant Securities that were purchasable pursuant to
      the Warrant or Warrants presented and surrendered.  At the time
      of presentation and surrender by the Holder to the Company, the Holder
      also shall deliver to the Company a written notice, signed by the Holder,
      specifying the denominations in which new Warrants are to be issued to the
      Holder.

            

    

    

    
      	
               
      

            	
              (c)

            	
              The
      Company will execute and deliver to the Holder a new Warrant containing
      the same terms and conditions as this Warrant upon receipt by the Company
      of evidence reasonably satisfactory to it of the loss, theft, destruction,
      or mutilation of this Warrant, provided that (i) in the case of loss,
      theft, or destruction, the Company receives from the Holder a reasonably
      satisfactory indemnification, and (ii) in the case of mutilation, the
      Holder presents and surrenders this Warrant to the Company for
      cancellation.  Any new Warrant executed and delivered shall
      constitute an additional contractual obligation on the part of the Company
      regardless of whether the Warrant that was lost, stolen, destroyed, or
      mutilated shall be enforceable by anyone at any
  time.

            

    

     

    
      
        
          	
                  
                    3.

                  

                	
                	Anti-Dilution Provisions.

        

         

      

    

    
      
        	
                 
      

              	
                3.1

              	Stock Splits, Dividends, Etc.

      

       

    

    
      	
               
      

            	
              (a)

            	
              If
      the Company shall at any time subdivide its outstanding shares of Common
      Stock (or other securities at the time receivable upon the exercise of the
      Warrant) by recapitalization, reclassification or split-up thereof, or if
      the Company shall declare a stock dividend or distribute shares of Common
      Stock to its stockholders, the number of shares of Common Stock subject to
      this Warrant immediately prior to such subdivision shall be
      proportionately increased, and if the Company shall at any time combine
      the outstanding shares of Common Stock by recapitalization,
      reclassification or combination thereof, the number of shares of Common
      Stock subject to this Warrant immediately prior to such combination shall
      be proportionately decreased.  Any such adjustment and
      adjustment to the Exercise Price pursuant to this section shall be
      effective at the close of business on the effective date of such
      subdivision or combination or if any adjustment is the result of a stock
      dividend or distribution then the effective date for such adjustment based
      thereon shall be the record date
therefor.

            

    

    

    
      
        
           

        

        
          -
3 -

          
            

          

        

        
           

        

      

    

    

    

    

    
      	
               
      

            	
              (b)

            	
              Whenever
      the number of shares of Common Stock purchasable upon the exercise of this
      Warrant is adjusted, as provided in this section, the Exercise Price shall
      be adjusted to the nearest cent by multiplying such Exercise Price
      immediately prior to such adjustment by a fraction (x) the numerator of
      which shall be the number of shares of Common Stock purchasable upon the
      exercise immediately prior to such adjustment, and (y) the denominator of
      which shall be the number of shares of Common Stock so purchasable
      immediately thereafter.

            

    

    

    
      	
               
      

            	
              3.2

            	
              Adjustment for
      Reorganization, Consolidation, Merger, Etc.  In case of
      any reorganization of the Company (or any other corporation, the
      securities of which are at the time receivable on the exercise of this
      Warrant) shall consolidate with or merge into another corporation or
      convey all or substantially all of its assets to another corporation,
      then, and in each such case, the Holder of this Warrant upon the exercise
      at any time after the consummation of such reorganization, consolidation,
      merger or conveyance, shall be entitled to receive, in lieu of the
      securities and property receivable upon the exercise of this Warrant prior
      to such consummation, the securities or property to which such Holder
      would have been entitled upon such consummation if such Holder had
      exercised this Warrant immediately prior thereto; in each such case, the
      terms of this Warrant shall be applicable to the securities or property
      received upon the exercise of this Warrant after such
      consummation.

            

    

    

    
      	
               
      

            	
              3.3

            	
              Certificate as to
      Adjustments.  In each case of an adjustment in the number
      of shares of Common Stock receivable on the exercise of this Warrant, the
      Company at its expense shall promptly compute such adjustment in
      accordance with the terms of the Warrant and prepare a certificate
      executed by an officer of the Company setting forth such adjustment and
      showing the facts upon which such adjustment is based.  The
      Company shall forthwith mail a copy of each such certificate to each
      Holder.  The failure to prepare or provide such certificate
      shall not modify the rights of any party
  hereunder.

            

    

     

    
      
        	
                 
      

              	
                3.4

              	Notices of Record Date, Etc.  In
case:

      

       

    

    
      	
               
      

            	
              (a)

            	
              the
      Company shall take a record of the holders of its Common Stock (or other
      securities at the time receivable upon the exercise of the Warrant) for
      the purpose of entitling them to receive any dividend (other than a cash
      dividend at the same rate as the rate of the last cash dividend
      theretofore paid) or other distribution, or any right to subscribe for,
      purchase or otherwise acquire any shares of stock of any class or any
      other securities, or to receive any other right;
  or

            

    

    

    
      
        
           

        

        
          -
4 -

          
            

          

        

        
           

        

      

    

    

    

    
      	
               
      

            	
              (b)

            	
              of
      any voluntary or involuntary dissolution, liquidation or winding-up of the
      Company, then, and in each such case, the Company shall mail or cause to
      be mailed to each Holder a notice specifying, as the case may be,
      (i) the date on which a record is to be taken for the purpose of such
      dividend, distribution or right, and stating the amount and character of
      such dividend, distribution or right, or (ii) the date on which such
      reorganization, reclassification, consolidation, merger, conveyance,
      dissolution, liquidation or winding-up is to take place, and the time, if
      any, to be fixed, as to which the holders of record of Common Stock (or
      such other securities at the time receivable upon the exercise of this
      Warrant) shall be entitled to exchange their shares of Common Stock (or
      such other securities) for securities or other property deliverable upon
      such reorganization, reclassification, consolidation, merger, conveyance,
      dissolution, liquidation or winding-up.  Such notice shall be
      mailed at least twenty (20) days prior to the date therein specified, and
      this Warrant may be exercised prior to said date during the term of the
      Warrant.

            

    

    

    
      	
               
      

            	
              3.5

            	
              Threshold for
      Adjustments.  Anything in this section to the contrary
      notwithstanding, the Company shall not be required to give effect to any
      adjustment until the cumulative resulting adjustment in the Exercise Price
      pursuant to Subsection 6.1.2 shall have required a change of the
      Exercise Price by at least $.01, but when the cumulative net effect of
      more than one adjustment so determined shall be to change the Exercise
      Price by at least $.01, such full change in the Exercise Price shall
      thereupon be given effect.  No adjustment shall be made by
      reason of the issuance of shares upon conversion rights, stock issuance
      rights or similar rights currently outstanding or any change in the number
      of treasury shares held by the
Company.

            

    

    

    
      	
              
                4.

              

            	
            	
              Reservation of Warrant
      Securities.  The Company hereby agrees that at all times
      prior to the Expiration Date, it will have authorized and will reserve and
      keep available for issuance and delivery to the Holder that number of
      Warrant Securities that may be required from time to time for issuance and
      delivery upon the exercise of the then unexercised portion of this Warrant
      and all other similar Warrants then outstanding and unexercised and upon
      the exercise of any Warrant
Securities.

            

    

     

    
      
        	
                
                  5.

                

              	
              	Registration Under
      the Securities Act of 1933.

      

       

    

    
      	
               
      

            	
              (a)

            	
              If
      at any time prior to the Expiration Date, the Company files a registration
      statement with the United States Securities and Exchange Commission
      pursuant to the Securities Act of 1933, as amended (the "Act"), or
      pursuant to any other act passed after the date of this Agreement, which
      filing provides for the sale of securities by the Company to the public,
      or files a Regulation A Offering Statement under the Act, the Company
      shall offer to the Holder or Holders of this Warrant and the holders of
      any Warrant Securities the opportunity to register or qualify the Warrant
      (if prior to its expiration), Warrant Securities and any Warrant
      Securities underlying the unexercised portion of this Warrant, if any, at
      the Company's sole expense; provided, however, that in the case of a
      Regulation A offering, the opportunity to qualify shall be limited to
      the amount of the available exemption after taking into account the
      securities that the  Company wishes to
      qualify.  Notwithstanding anything to the contrary, this
      subsection (a) shall not be applicable to a registration statement on
      Forms S-4,
      S-8 or their successors or any other inappropriate forms filed by the
      Company with the United States Securities and Exchange
      Commission.

            

    

     

     

    
      
        
           

        

        
          -
5 -

          
            

          

        

        
           

        

      

    

    

    
       

      
        
          
             

            
              
                	
                         
      

                      	
                         

                      	
                        The
      Company shall deliver written notice to the Holder or Holders of this
      Warrant and to any holders of the Warrant Securities of its intention to
      file a registration statement or Regulation A Offering Statement
      under the Act at least 60 days prior to the filing of such registration
      statement or offering statement, and the Holder or Holders and holders of
      Warrant Securities shall have 30 days thereafter to request in writing
      that the Company register or qualify the Warrant, Warrant Securities, or
      the Warrant Securities underlying the unexercised portion of this Warrant
      in accordance with this subsection (a).  Upon the delivery
      of such a written request within the specified time, the Company shall be
      obligated to include in its contemplated registration statement or
      offering statement all information necessary or advisable to register or
      qualify the Warrant, Warrant Securities or Warrant Securities underlying
      the unexercised portion of this Warrant for a public offering, if the
      Company does file the contemplated registration statement or offering
      statement; provided, however, that neither the delivery of the notice by
      the Company nor the delivery of a request by a Holder or by a holder of
      Warrant Securities shall in any way obligate the Company to file a
      registration statement or offering statement.  Furthermore,
      notwithstanding the filing of a registration statement or offering
      statement, the Company may, at any time prior to the effective date
      thereof, determine not to offer the securities to which the registration
      statement or offering statement relates, other than the Warrant, Warrant
      Securities and Warrant Securities underlying the unexercised portion of
      this Warrant.

                        

                        The
      Company shall comply with the requirements of this subsection (a) and
      the related requirements of subsection (g) at its own
      expense.  That expense shall include, but not be limited to,
      legal, accounting, consulting, printing, federal and state filing fees,
      NASD fees, out-of-pocket expenses incurred by counsel, accountants and
      consultants retained by the Company, and miscellaneous expenses directly
      related to the registration statement or offering statement and the
      offering.  However, this expense shall not include the portion
      of any underwriting commissions, transfer taxes and the underwriter's
      accountable and nonaccountable expense allowances attributable to the
      offer and sale of the Warrant, Warrant Securities and the Warrant
      Securities underlying the unexercised portion of this Warrant, all of
      which expenses shall be borne by the Holder or Holders of this Warrant and
      the holders of the Warrant Securities registered or
    qualified.

                      

              

               

            

          

        

      

    

    

    
      	
               
      

            	
              (b)

            	
              In
      the event that the Company registers or qualifies the Warrant, Warrant
      Securities or the Warrant Securities underlying the unexercised portion of
      this Warrant pursuant to subsection (a) above, the Company shall
      include in the registration statement or qualification, and the prospectus
      included therein, all information and materials necessary or advisable to
      comply with the applicable statutes and regulations so as to permit the
      public sale of the Warrant, Warrant Securities or the Warrant Securities
      underlying the unexercised portion of this Warrant.  As used in
      subsection (a) of this Section 7, reference to the Company's
      securities shall include, but not be limited to, any class or type of the
      Company's securities or the securities of any of the Company's
      subsidiaries or affiliates.

            

    

    

    
      
        
           

        

        
          -
6 -

          
            

          

        

        
           

        

      

    

    

    

    

    
      	
               
      

            	
              (c)

            	
              In
      addition to the registration rights described in subsection (a)
      above, the Company shall use its best efforts to register or qualify the
      Warrant and Warrant Securities within ninety (90) days of the date of this
      Warrant.  The Company shall deliver written notice to all
      Holders of this Warrant and holders of Warrant Securities, if any,
      advising them that the Company is proceeding with a registration statement
      or offering statement and that their Warrant and Warrant Securities will
      be included therein.  The Company will supply all information
      necessary or advisable for any such registration statements or offering
      statements at its own expense.

            

    

    

    
      	
               
      

            	
              (d)

            	
              As
      to each registration statement or offering statement, the Company's
      obligations contained in this Section 7 shall be conditioned upon a
      timely receipt by the Company in writing of the
  following:

            

    

    

    
      	
               
      

            	
              (i)

            	
              Information
      as to the terms of the contemplated public offering furnished by and on
      behalf of each Holder or holder intending to make a public distribution of
      the Warrant, Warrant Securities or Warrant Securities underlying the
      unexercised portion of the Warrant;
and

            

    

    

    
      	
               
      

            	
              (ii)

            	
              Such
      other information as the Company may reasonably require from such Holders
      or holders, or any underwriter for any of them, for inclusion in the
      registration statement or offering
statement.

            

    

    

    
      	
               
      

            	
              (e)

            	
              In
      each instance in which the Company shall take any action to register or
      qualify the Warrant, Warrant Securities or the Warrant Securities
      underlying the unexercised portion of this Warrant, if any, pursuant to
      this Section 7, the Company shall do the
  following:

            

    

    

    
      	
               
      

            	
              (i)

            	
              supply
      to Holder, or any successor or assign whose Warrant and Warrant Securities
      are being registered or qualified, two (2) manually signed copies of each
      registration statement or offering statement, and all amendments thereto,
      and a reasonable number of copies of the preliminary, final or other
      prospectus or offering circular, all prepared in conformity with the
      requirements of the Act and the rules and regulations promulgated
      thereunder, and such other documents as Holder shall reasonably
      request;

            

    

    

    
      	
               
      

            	
              (ii)

            	
              cooperate
      with respect to (A) all necessary or advisable actions relating to
      the preparation and the filing of any registration statements or offering
      statements, and all amendments thereto, arising from the provisions of
      this Section 7, (B) all reasonable efforts to establish an
      exemption from the provisions of the Act or any other federal or state
      securities statutes, (C) all necessary or advisable actions to
      register or qualify the public offering at issue pursuant to federal
      securities statutes and the state "blue sky" securities statutes of each
      jurisdiction that the Holders of the Warrant or holders of Warrant
      Securities shall reasonably request, and (D) all other necessary or
      advisable actions to enable the Holders of the Warrant and holders of the
      Warrant Securities to complete the contemplated disposition of their
      securities in each reasonably requested
  jurisdiction;

            

    

    

    
      
        
           

        

        
          -
7 -

          
            

          

        

        
           

        

      

    

    

    

    
      	
               
      

            	
              (iii)

            	
              keep
      all registration statements or offering statements to which this
      Section 7 applies, and all amendments thereto, effective under the
      Act for a period of at least nine (9) months after their initial
      effective date and cooperate with respect to all necessary or advisable
      actions to permit the completion of the public sale or other disposition
      of the securities subject to a registration statement or offering
      statement; and

            

    

    

    
      	
               
      

            	
              (iv)

            	
              indemnify
      and hold harmless each Holder of the Warrant, each holder of Warrant
      Securities, and each underwriter within the meaning of the Act for each
      such Holder or holder, from and against all losses, claims, damages, and
      liabilities, including, but not limited to, any and all expenses
      reasonably incurred in investigating, preparing, defending or settling any
      claim, arising from or relating to (A) any untrue or alleged untrue
      statement of a material fact contained in any registration statement or
      offering statement to which this Section 7 applies, or (B) any
      omission or alleged omission to state a material fact necessary to make
      the statements contained in a registration statement or offering statement
      to which this Section 7 applies not misleading; provided, however,
      that the indemnification contained in this provision (iv) shall not
      apply if the untrue statement or omission, or alleged untrue statement or
      omission, was the result of information furnished in writing to the
      Company by the Holder, holder or underwriter seeking indemnification
      expressly for use in the registration statement or offering statement at
      issue.  To the extent that the indemnification contained in this
      provision applies, the Company also shall indemnify and hold harmless each
      officer, director, employee, controlling person or agent of an indemnified
      Holder, holder or underwriter.

            

    

    

    
      	
               
      

            	
              (f)

            	
              In
      each instance in which pursuant to this Section 7 the Company shall
      take any action to register or qualify the Warrant, Warrant Securities or
      the Warrant Securities underlying the unexercised portion of this Warrant,
      prior to the effective date of any registration statement or offering
      statement, the Company and each Holder or holder of Warrants or Warrant
      Securities being registered or qualified shall enter into reciprocal
      indemnification agreements, in the form customarily used by reputable
      investment bankers with respect to public offerings of securities,
      containing substantially the same terms as described in
      subsection (e)(iv) above.  These indemnification agreements
      also shall contain an agreement by the Holder or shareholder at issue to
      indemnify and hold harmless the Company, its officers, directors from and
      against any and all losses, claims, damages and liabilities, including,
      but not limited to, all expenses reasonably incurred in investigating,
      preparing, defending or settling any claim, directly resulting from any
      untrue statements of material facts, or omissions to state a material fact
      necessary to make a statement not misleading, contained in a registration
      statement or offering statement to which this Section 7 applies, if,
      and only if, the untrue statement or omission directly resulted from
      information provided in writing to the Company by the indemnifying Holder
      or shareholder expressly for use in the registration statement or offering
      statement at issue.

            

    

    

    
      
        
           

        

        
          -
8 -

          
            

          

        

        
           

        

      

    

    

    

    
      	
               
      

            	
              (g)

            	
              The
      term "Majority Holder" as used in this Section 7 shall include any
      Holder, any holder of Warrant Securities, or any combination of Holders
      and such holders of Warrant Securities, if they hold, in the aggregate,
      unexercised Warrants plus issued and outstanding Warrant Securities equal
      to more than 50% of the total of (i) all Warrant Securities issued
      and outstanding as a result of the exercise of the Warrant, and
      (ii) all Warrant Securities that may at that time be purchased by
      exercising the unexercised portion of the Warrant.  For purposes
      hereof, a Warrant entitling the Holder to purchase more than one Warrant
      Security shall be deemed to hold Warrants equal to the number of Warrant
      Securities which may be acquired pursuant to any such
    Warrant.

            

    

    

    
      	
               
      

            	
              (h)

            	
              The
      Company's obligations described in this Section 7 shall continue in
      full force and effect regardless of the exercise, surrender, cancellation
      or expiration of this Warrant.

            

    

    

    
      	
               
      

            	
              (i)

            	
              The
      registration rights provided under this Section 7 shall not be applicable
      to an initial public offering of the Company’s Common Stock, nor for a
      period of six (6) months following the initial public offering of the
      Company’s Common Stock.

            

    

    
       

      
        
          	
                  
                    6.

                  

                	
                	
                  Maximum
      Exercise.  The Holder shall not be entitled to exercise
      this Warrant on an exercise date nor may the Company exercise its right to
      give a “Call Notice” (as defined in Section 7) in connection with that
      number of shares of Common Stock which would be in excess of the sum
      of:  (i) the number of shares of Common Stock beneficially
      owned by the Holder and its Affiliates on an exercise date or Call Date;
      and (ii) the number of shares of Common Stock issuable upon the
      exercise of this Warrant with respect to which the determination of this
      limitation is being made on an exercise date or Call Date, which would
      result in beneficial ownership by the Holder and its Affiliates of more
      than 9.99% of the outstanding Common Stock on such date.  For
      the purposes of the immediately preceding sentence, beneficial ownership
      shall be determined in accordance with Section 13(d) of the
      Securities Exchange Act of 1934, as amended, and Regulation 13d-3
      thereunder.  Subject to the foregoing, the Holder shall not be
      limited to aggregate exercises which would result in the issuance of more
      than 9.99%.  The restriction described in this Section may
      be waived, in whole or in part, upon sixty-one (61) days prior notice from
      the Holder to the Company.  The Holder may allocate which of the
      equity of the Company deemed beneficially owned by the Subscriber shall be
      included in the 9.99% amount described above and which shall be allocated
      to the excess above
9.99%.

                

        

      

    

     

    
      	
              
                7.

              

            	
            	
              Call.   The
      Company shall have the option to "call" the exercise of the Warrant from
      time to time, in accordance with and governed by the
      following:

            

    

     

    
      	
               
      

            	
              (a)

            	
              The
      Company shall exercise the Warrant Call by giving to the Holder a notice
      of call upon twenty (20) days written notice (the "Call Notice") during
      the period in which the Warrant Call may be exercised.  The
      effective date of each Call Notice (the “Call Date”) is the date on which
      notice is effective under the notice provision of Section 13 of this
      Warrant.

            

    

     

    
      	
               
      

            	
              (b)

            	
              The
      Company's right to exercise the Warrant Call shall commence twenty (20)
      Trading Days after the actual effective date of a Registration Statement
      and end twenty (20) days prior to the Expiration
  Date.

            

    

     

    

    
      
        
           

        

        
          -
9 -

          
            

          

        

        
           

        

      

    

    

    

     

    
      	
               
      

            	
              (c)

            	
              The
      number of shares of Common Stock to be issued upon exercise of the
      Warrants which are subject to a Call Notice must be registered in a
      Registration Statement effective from thirty (30) Business Days prior to
      the Call Date and through the date such Common Stock is actually delivered
      to the Warrant Holder (the “Delivery
Date”).

            

    

     

    
      	
               
      

            	
              (d)

            	
              A
      Call Notice may be given by the Company only within ten (10) days after
      the Common Stock has had a closing price as reported for the Principal
      Market (as defined below) of not less than $2.50 per share for twenty out
      of thirty consecutive Trading Days (the “Lookback Period”) with trading
      volume in excess of 50,000 shares per
day.

            

    

    

    
      	
               
      

            	
              (e)

            	
              For
      purposes hereof, the Principal Market for the Company shall be as
      follows:  If the Company's Common Stock is traded on an exchange
      or is quoted on Nasdaq Global Select Market, Nasdaq Global Market, Nasdaq
      Capital Market or the American Stock Exchange, LLC, then such exchange
      shall be the Principal Market.  If the Company's Common Stock is
      not traded on an exchange, but is traded in the over-the-counter market,
      then that shall be the Principal
Market.

            

    

    
       

      
        	
                 
      

              	
                (f)

              	
                The
      Common Stock must be listed on the Principal Market for the Lookback
      Period and through the Delivery
Date.

              

      

       

    

    
      	
               
      

            	
              (g)

            	
              The
      Holder shall exercise his Warrant rights and purchase the Called Warrant
      Shares and pay for same within twenty (20) days after the Call
      Date.  If the Holder fails to timely pay the amount required by
      the Warrant Call, the Company’s sole remedy shall be to cancel a
      corresponding amount of the Holder’s
Warrants.

            

    

     

    
      	
               
      

            	
              (h)

            	
              In
      no event shall a Call Notice be given in connection with the exercise of
      an amount of Common Stock which would cause the Holder to exceed the
      limitation amount set forth in Section
6.

            

    

     

    
      
        
          	
                  
                    8.

                  

                	
                	Transfer to Comply
      With the Securities Act of
1933.

        

      

    

     

    
      	
               
      

            	
              (a)

            	
              This
      Warrant, the Warrant Securities, and all other securities issued or
      issuable upon exercise of this Warrant, may not be offered, sold or
      transferred, in whole or in part, except in compliance with the Act, and
      except in compliance with all applicable state securities
      statutes.

            

    

    

    
      	
               
      

            	
              (b)

            	
              The
      Company may cause the following legend, or its equivalent, to be set forth
      on each certificate representing the Warrant Securities, or any other
      security issued or issuable upon exercise of this Warrant, not theretofore
      distributed to the public or sold to underwriters, as defined by the Act,
      for distribution to the public pursuant to Section 7
      above:

               

              
                "The
      securities represented by this Certificate have not been registered under
      the Securities Act of 1933 ("the Act") and are 'restricted securities' as
      that term is defined in Rule 144 under the Act.  The
      securities may not be offered for sale, sold or otherwise transferred
      except pursuant to an effective registration statement under the Act or
      pursuant to an exemption from registration under the Act, the availability
      of which is to be established to the satisfaction of the
      Company."

              

            

    

    

    
      
      

    

    

    
      
        
           

        

        
          -
10 -

          
            

          

        

        
           

        

      

    

    

    

    

    
      	
              
                9.

              

            	
            	
              Fractional
      Shares.  No fractional shares or scrip representing
      fractional shares shall be issued upon the exercise of all or any part of
      this Warrant.  With respect to any fraction of a share of any
      security called for upon any exercise of this Warrant, the Company shall
      pay to the Holder an amount in money equal to that fraction multiplied by
      the current market value of that share.  The current market
      value shall be determined as
follows:

            

    

    

    
      	
               
      

            	
              (i)

            	
              if
      the security at issue is listed on a national securities exchange or
      admitted to unlisted trading privileges on such an exchange or listed on
      the National Association of Securities Dealers National Market System, the
      current value shall be the last reported sale price of that security on
      such exchange or system on the last business day prior to the date of the
      applicable exercise of this Warrant or, if no such sale is made on such
      day, the average of the highest closing bid and lowest asked price for
      such day on such exchange or system;
or

            

    

    

    
      	
               
      

            	
              (ii)

            	
              if
      the security at issue is not so listed or admitted to unlisted trading
      privileges, the current market value shall be the average of the last
      reported highest bid and lowest asked prices quoted on the National
      Association of Securities Dealers Automated Quotations System or, if not
      so quoted, then by the National Quotation Bureau, Inc. on the last
      business day prior to the day of the applicable exercise of this Warrant;
      or

            

    

    

    
      	
               
      

            	
              (iii)

            	
              if
      the security at issue is not so listed or admitted to unlisted trading
      privileges and bid and asked prices are not reported, the current market
      value shall be determined in such reasonable manner as may be prescribed
      from time to time by the Board of Directors of the Company, subject to the
      arbitration procedure as described in Section 15 below if a Holder
      delivers written notice to the Company of an objection within thirty (30)
      days after the Board’s decision.

            

    

    

    
      	
              10.

            	
              Rights of the
      Holder.  The Holder shall not be entitled to any rights
      as a shareholder in the Company by reason of this Warrant, either at law
      or equity, except as specifically provided for herein.  The
      Company covenants, however, that for so long as this Warrant is at least
      partially unexercised, it will furnish any Holder of this Warrant with
      copies of all reports and communications furnished to the shareholders of
      the Company.

            

    

    

    
      	
              11.

            	
              Charges Due Upon
      Exercise.  The Company shall pay any and all issue or
      transfer taxes, including, but not limited to, all federal or state taxes,
      that may be payable with respect to the transfer of this Warrant or the
      issue or delivery of Warrant Securities upon the exercise of this
      Warrant.

            

    

    

    
      	
              12.

            	
              Warrant Securities to
      be Fully Paid.  The Company covenants that all Warrant
      Securities that may be issued and delivered to a Holder of this Warrant
      upon the exercise of this Warrant will be, upon such delivery, validly and
      duly issued, fully paid and
nonassessable.

            

    

    

    
      
        
           

        

        
          -
11 -

          
            

          

        

        
           

        

      

    

    

    

    

    
      	
              13.

            	
              Notices.  All
      notices, certificates, requests, or other similar items provided for in
      this Warrant shall be in writing and shall be personally delivered or
      deposited in the United States mail, postage prepaid, addressed to the
      respective party as indicated in the portions of this Warrant preceding
      Section 1.  All notices shall be deemed to be delivered
      upon personal delivery or upon the expiration of three (3) business days
      following deposit in the United States mail, postage
      prepaid.  The addresses of the parties may be changed, and
      addresses of other Holders and holders of Warrant Securities may be
      specified, by written notice delivered pursuant to this
      Section 13.  The Company's principal office shall be deemed
      to be the address provided pursuant to this Section for the delivery of
      notices to the Company.

            

    

    

    
      	
              14.

            	
              Applicable
      Law.  This Warrant shall be governed by and construed in
      accordance with the laws of the State of Colorado, and courts located in
      Colorado shall have exclusive jurisdiction over all disputes arising
      hereunder except as provided in Section 15
  hereof.

            

    

    

    
      
        	
                15.

              	
                      
                  Dispute
      Resolution.  The parties shall attempt in good faith to
      resolve any controversy or claim arising out of or relating to this
      Warrant, or the breach, termination, or validity thereof (a “Dispute”)
      promptly by negotiation between the parties.  If a Dispute has
      not been resolved within thirty (30) days by negotiation, the parties
      shall attempt to mediate the Dispute through the selection of a mutually
      agreeable mediator who shall conduct such mediation in
      confidence.  If a Dispute is not resolved by mediation, then the
      Dispute shall be settled by arbitration in accordance with the Commercial
      Arbitration Rules of the American Arbitration Association, and governed by
      the United States Arbitration Act, 9 U.S.C. §§ 1-16, except as otherwise
      provided herein.  Judgment upon the award rendered by the
      arbitrator may be entered by any court having jurisdiction
      thereof.  The place of arbitration shall be Denver,
      Colorado.  Each party shall be responsible for his own attorney
      fees incurred during any phase of dispute resolution.  The
      arbitrator shall apply the law to the dispute in the same manner as a
      judge as though the dispute was before a court of law of the State of
      Colorado.  The arbitrator shall have the authority to award any
      remedy or relief that a court of the State of Colorado could order or
      grant, including, without limitation, specific performance of any
      obligation created under the Agreement, the issuance of an injunction, or
      the imposition of sanctions for abuse or frustration of the arbitration
      process.  Notwithstanding the foregoing, the arbitrator shall
      not have authority to award punitive damages.  The parties shall
      take all reasonable steps necessary to conduct a hearing no later than
      forty-five (45) days after submission of the matter to
      arbitration.  The arbitrator shall render his decision within
      fifteen (15) days after the close of the arbitration
      hearing.  The arbitration award shall be in writing and shall
      specify the factual and legal bases for the
  award.

                

              

      

    

     

    
      
        	
                16.

              	Miscellaneous Provisions.

      

    

    

    
      	
               
      

            	
              (a)

            	
              Subject
      to the terms and conditions contained herein, this Warrant shall be
      binding on the Company and its successors and shall inure to the benefit
      of the original Holder, its successors and assigns and all holders of
      Warrant Securities and the exercise of this Warrant in full shall not
      terminate the provisions of this Warrant as it relates to holders of
      Warrant Securities.

            

    

    

    
      
        
           

        

        
          -
12 -

          
            

          

        

        
           

        

      

    

    

    

    

    
      	
               
      

            	
              (b)

            	
              If
      the Company fails to perform any of its obligations hereunder, it shall be
      liable to the Holder for all damages, costs and expenses resulting from
      the failure, including, but not limited to, all reasonable attorney's fees
      and disbursements.

            

    

    

    
      	
               
      

            	
              (c)

            	
              This
      Warrant cannot be changed or terminated or any performance or condition
      waived in whole or in part except by an agreement in writing signed by the
      party against whom enforcement of the change, termination or waiver is
      sought.

            

    

    

    
      	
               
      

            	
              (d)

            	
              If
      any provision of this Warrant shall be held to be invalid, illegal or
      unenforceable, such provision shall be severed, enforced to the extent
      possible, or modified in such a way as to make it enforceable, and the
      invalidity, illegality or unenforceability shall not affect the remainder
      of this Warrant.

            

    

    

    
      	
               
      

            	
              (e)

            	
              The
      Company agrees to execute such further agreements, conveyances,
      certificates and other documents as may be reasonably requested by the
      Holder to effectuate the intent and provisions of this
      Warrant.

            

    

    

    
      	
               
      

            	
              (f)

            	
              Paragraph
      headings used in this Warrant are for convenience only and shall not be
      taken or construed to define or limit any of the terms or provisions of
      this Warrant.  Unless otherwise provided, or unless the context
      shall otherwise require, the use of the singular shall include the plural
      and the use of any gender shall include all
  genders.

            

    

    

    

    
      
        
          
            
              	 	 
      	 	 
      
	 	 
      	 	
                      OMNI
      BIO PHARMACEUTICAL, INC.

                    
	 	
                      ATTEST:

                    	 	 
      
	 	 
      	 	 
      
	 	 
      	 	 
      
	 	 
      	 	 
      
	 By:
       	
                      ____________________________
      

                    	 By:  
      	
                      
                        ___________________________
      

                      

                    
	 	
                      Bob
      Ogden

                    	 	
                      Edward
      Larkin

                    
	 	
                      Secretary

                    	 	
                      Chief
      Operating
Officer

                    

            

          

        

      

    

    

    

    
      
        
           

        

        
          -
13 -

          
            

          

        

        
           

        

      

    

    

    EXHIBIT
A

    

    NOTICE
OF EXERCISE

    

    (To be
executed by a Holder desiring to exercise the right to purchase Shares pursuant
to a Warrant.)

    

    The undersigned Holder of a Warrant
hereby

    

    
      	
              (a)

            	
              irrevocably
      elects to exercise the Warrant to the extent of purchasing _______________
      Shares;

            

    

    

    
      	
              (b)

            	
              makes
      payment in full of the aggregate Exercise Price for those Shares in the
      amount of $_______________ by
      the delivery of immediately available funds in the amount of
      $_______________ ;

            	
               

            	
            

    

    

    
      	
              (c)

            	
              requests
      that certificates evidencing the securities underlying such Shares be
      issued in the name of the undersigned, or, if the name and address of some
      other person is specified below, in the name of such other
      person:

            

    

     

    __________________________________________________

    
__________________________________________________

    
__________________________________________________

    (Name and
address of person other than
the

    undersigned
in whose name Shares are to be registered)

    

    
      	
              (d)

            	
              requests,
      if the number of Shares purchased are not all the Shares purchasable
      pursuant to the unexercised portion of the Warrant, that a new Warrant of
      like tenor for the remaining Shares purchasable pursuant to the Warrant be
      issued and delivered to the undersigned at the address stated
      below.

            

    

     

    
 

    
      
        	
                Dated:
      _______________________

              	 
      	 
      
	 
      	 
      	
                Signature
      ______________________________________

              
	 
      	 
      	
                (This
      signature must conform in all respects

                to
      the name of the Holder as specified on the

                face
      of the Warrant.)

              
	 
      	 
      	 
      
	 ____________________________________	 
      	 
      
	
                Social
      Security Number or Employer ID Number

              	 
      	 _____________________________________
	 
      	 
      	
                Printed
      Name

              
	 
      	 
      	 
      
	 
      	
                 Address:    
      

              	
                _____________________________________

                 

                _____________________________________

              

      

    

    

    
      
        
           

        

        
          -
14 -

          
            

          

        

        
           

        

      

    

    

    

    EXHIBIT
B

    

    ASSIGNMENT
FORM

    

    

    FOR VALUE
RECEIVED, the undersigned,, hereby sells, assigns and transfers
unto:

    

    Name: _______________________________________________________                

    (Please type or print in block
letters)

    

    Address:  _____________________________________________________

    
 

    

    the right
to purchase  ____________ Shares of Omni Bio Pharmaceutical, Inc. (the
"Company") pursuant to the terms and conditions of the Warrant held by the
undersigned.  The undersigned hereby authorizes and directs the
Company (i) to issue and deliver to the above-named assignee at the above
address a new Warrant pursuant to which the rights to purchase being assigned
may be exercised, and (ii) if there are rights to purchase Shares remaining
pursuant to the undersigned's Warrant after the assignment contemplated herein,
to issue and deliver to the undersigned at the address stated below a new
Warrant evidencing the right to purchase the number of Shares remaining after
issuance and delivery of the Warrant to the above-named
assignee.  Except for the number of Shares purchasable, the new
Warrants to be issued and delivered by the Company are to contain the same terms
and conditions as the undersigned's Warrant.  To complete the
assignment contemplated by this Assignment Form, the undersigned hereby
irrevocably constitutes and
appoints ____________________________________ as the undersigned's
attorney-in-fact to transfer the Warrants and the rights thereunder on the books
of the Company with full power of substitution for these
purposes.
 

    
      
        
          	
                  Dated:
      _______________________________

                	 
      	 
      
	 
      	 
      	
                  Signature
      _____________________________________

                
	 
      	 
      	
                  (This
      signature must conform in all respects

                  to
      the name of the Holder as specified on the

                  face
      of the Warrant.)

                
	 
      	 
      	 
      
	 ____________________________________	 
      	 
      
	
                  Social
      Security Number or Employer ID Number

                	 
      	_____________________________________
	 
      	 
      	
                  Printed
      Name

                
	 
      	 
      	 
      
	 
      	
                   Address:    
      

                	
                  _____________________________________

                   

                  _____________________________________

                

        

      

      

    

    - 15 -

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