Document:

Exhibit 10.1

      

       

      

      SECOND AMENDMENT TO NOTE AND WARRANT PURCHASE AND SECURITY AGREEMENT

       

      This Second Amendment to Note and Warrant Purchase and Security Agreement (this “Amendment”) is entered into
        as of February 25, 2022, by and among NH EXPANSION CREDIT FUND HOLDINGS LP (“North Haven Expansion”), as agent (in such capacity, together with its successors or
        permitted assigns, “Agent”), the Holders from time to time signatory to the NPA (as hereinafter defined), including North Haven Expansion (each, a “Holder” and collectively, the “Holders”), and SANUWAVE HEALTH, INC. a Nevada corporation (“Issuer”).

       

      RECITALS

       

      WHEREAS, Issuer, Agent and the Holders are parties to that certain Note and Warrant Purchase and Security Agreement dated as of August 6, 2020 (as
        amended, restated, amended and restated, supplemented or otherwise modified from time to time, the “NPA”).

       

      WHEREAS, Issuer is in default of the NPA as described below;

       

      WHEREAS, Issuer has requested that Agent and the Holders amend the NPA to (i) forbear from exercising remedies under the NPA as a result of the
        Existing Defaults (as hereafter defined) and (ii) advance to Issuer an additional Note (as hereafter described);

       

      WHEREAS, Agent and the Holders have agreed to so amend certain provisions of the NPA, and to so forbear from exercising Agent’s and the Holders’
        rights and remedies during the Forbearance Period (as defined below), but only to the extent in accordance with the terms, subject to the conditions and in reliance upon the representations and warranties set forth below; and

       

      WHEREAS, all terms not otherwise defined herein and defined in the NPA shall have the same meanings herein as in the NPA.

       

      NOW, THEREFORE, in consideration of the foregoing recitals and other good and valuable consideration, the receipt and adequacy of which is hereby
        acknowledged, and intending to be legally bound, the parties hereto hereby agree as follows:

       

      1.           Certain Events of Default have occurred and continue under the NPA, as more particularly described on Annex ED attached
          hereto (collectively, the “Existing Defaults”).  Subject to the terms of this Amendment, Agent and the Holders shall forbear from exercising their remedies arising out of the Existing Defaults from the date
          hereof (including, for the avoidance of doubt, the collection in cash or payment in kind of the Default Rate on the outstanding Obligations under the NPA and the other Note Documents), until the earlier to occur of (x) the occurrence of an Event
          of Default after the date hereof, at which time Agent and the Holders may exercise any and all rights available to them without notice to Issuer; or (y) June 30, 2022.  Agent and the Holders do not forbear from exercising their remedies arising
          out of any other Events of Default that have occurred, are continuing or may occur on or after the Second Amendment Effective Date. Issuer shall comply with all other provisions of the NPA and the other Note Documents.

       

      2.           Section 1.1(a) of the NPA hereby is renumbered as Section 1.1(a)(i), and new Section 1.1(a)(ii) hereby is added to the NPA
          to read as follows:

       

      “(ii)           Second Closing.  On or about the Second Amendment
          Effective Date, or as soon thereafter as practical, subject to satisfaction of the terms and conditions set forth in this Agreement, the Holders shall purchase a Note in an original principal amount of Three Million Dollars ($3,000,000) (the “Second Closing Note”), and an Amended and Restated Warrant to Purchase Stock, on terms, and subject to adjustments as set forth therein (as amended, restated, amended and restated, supplemented or otherwise
          modified from time to time, the “Second Closing Warrant”).

       

      3.          A new Section 5.2(h) hereby is added to the NPA to read as follows:

       

        

      
        
          

      

       “(h)          Notwithstanding any other provision of Section 5.2(a) to the contrary, deliver to Agent, within two (2)
          Business Days’ thereof, evidence of the following: (i) filing of the 10-Q for the period ending September 30, 2021 by February 28, 2022; (ii) filing of the 10-K for the period ending December 31, 2021 by May 15, 2022; (iii) filing of the 10-Q for
          the fiscal quarter ending March 31, 2022 by May 31, 2022 and (iv) filing of all other 10-Q and 10-K reports for fiscal year 2022 prior to SEC filing deadlines.”

       

      4.           Section 5.9 of the NPA hereby is amended and restated in its entirety to read as follows:

       

      “5.9           Use of Proceeds. Issuer shall use the proceeds of the Notes: (i) as working capital and to fund its general corporate and business
          requirements and not for personal, family, household or agricultural purposes, (ii) to repay the Existing Indebtedness in full on the Issue Date, (iii) to finance a portion of the Celularity Acquisition and (iv) in the case of proceeds of the
          Second Closing Note, in accordance with a budget for the projected use of the proceeds from and after the Second Amendment Effective Date, as reviewed and approved in writing by Agent (the “Budgeted Use of
            Proceeds”).”

       

      5.           Section 11.6 of the NPA hereby is renumbered to “11.6.1,” and re-titled “Purchase Price Allocation – First Closing Note;”
          and a new Section 11.6.2 hereby is added to the NPA to read as follows:

       

      “11.6.2      Purchase Price Allocation – Second Closing Note.  Issuer and each Holder acknowledge and agree that the Second Closing Note and the Second
          Closing Warrant are part of an investment unit within the meaning of Section 1273(c)(2) of the IRC.  Issuer and each Holder further agree as between them, that the fair market value of the Second Closing Warrant is Two Million Forty-Three
          Thousand Five Hundred Sixteen Dollars $(2,043,516) and that, pursuant to Treas.  Reg.  § 1.1273-2(h), Two Million Forty-Three Thousand Five Hundred Sixteen Dollars $(2,043,516) of the issue price of the investment unit will be allocable to such
          Second Closing Warrant and the balance shall be allocable to such Second Closing Note.  Issuer and each Holder agree to prepare their federal income tax returns in a manner consistent with the foregoing.  Issuer agrees that it shall not (and
          shall cause its Subsidiaries not to) challenge or support any challenge to the agreed-upon value of such Second Closing Warrant.”

        

      

      6.           The following definitions hereby are added to Section 13.1 of the NPA as follows:

       

      “Advisor Shares” means Twenty Million Six Hundred Sixty-Six Thousand Nine Hundred
        Ninety-Three (20,666,993) shares of Issuer’s common stock, issued without cost to Agent, as a result of Agent’s role as an advisor to Issuer.

       

      “Budgeted Use of Proceeds” has the meaning ascribed in Section 5.9.

       

      “Second Amendment Effective Date” means February 25, 2022.

       

      “Second Closing Note” has the meaning ascribed in Section 1.1(a)(ii).

       

      “Second Closing Warrant” has the meaning ascribed in Section 1.1(a)(ii).

       

      7.           Schedule 1.1 to the NPA hereby is replaced in its entirety with Schedule 1.1 attached hereto.

       

      8.           No course of dealing on the part of Agent or the Holders or their respective officers, nor any failure or delay in the
          exercise of any right by Agent or the Holders, shall operate as a waiver thereof, and any single or partial exercise of any such right shall not preclude any later exercise of any such right except as specially waived herein.  Except as
          specifically waived herein, Agent’s or any Holder’s failure at any time to require strict compliance by Issuer of any provision under the NPA, shall not affect any right of Agent or the Holders under the NPA thereafter to demand strict
          compliance.  Any suspension or waiver of a right must be in writing signed by an officer of Agent or the Holders, as applicable.

       

      9.           The NPA, as amended hereby, shall be and remain in full force and effect in accordance with their respective terms and
          hereby are ratified and confirmed in all respects.  Except as expressly set forth herein, the execution, delivery, and performance of this Amendment shall not operate as a waiver of, or as an amendment of, any right, power, or remedy of Agent or
          the Holders under the NPA, as in effect prior to the date hereof.

       

      
        
          

      

      10.        Issuer hereby represents and warrants that (a) the representations and warranties in the NPA, shall be true, accurate, and
          complete in all material respects immediately after giving effect to this Amendment; provided, that such materiality qualifier shall not be applicable to any representations and warranties that already are qualified or modified by
          materiality in the text thereof, which representations and warranties shall be true, accurate and complete immediately after giving effect to this Amendment in all respects subject to such qualification; and provided, further,
          that those representations and warranties expressly referring to a specific date shall be true, accurate and complete in all material respects as of such date, (b) other than the Existing Defaults, no Default or Event of Default shall have
          occurred and be continuing immediately after giving effect to this Amendment, (c) Issuer has the power and authority to execute and deliver this Amendment and to perform its obligations under the NPA, as amended by this Amendment, (d) the
          execution and delivery by Issuer of this Amendment and the performance by Issuer of its obligations under the NPA, as amended by this Amendment, have been duly authorized by Issuer, (e) the execution and delivery by Issuer of this Amendment and
          the performance by Issuer of its obligations under the NPA, as amended by this Amendment, do not and will not contravene (i) any law or regulation binding on or affecting Issuer, (ii) any contractual restriction with a Person binding on Issuer,
          (iii) any order, judgment or decree of any court or other governmental or public body or authority, or subdivision thereof, binding on Issuer, or (iv) the organizational documents of Issuer, (f) the execution and delivery by Issuer of this
          Amendment and the performance by Issuer of its obligations under the NPA, as amended by this Amendment, do not require any order, consent, approval, license, authorization or validation of, or filing, recording or registration with, or exemption
          by any governmental or public body or authority, or subdivision thereof, binding on Issuer, except as already has been obtained or made, and (g) this Amendment has been duly executed and delivered by Issuer and is the binding obligation of
          Issuer, enforceable against Issuer in accordance with its terms, except as such enforceability may be limited by bankruptcy, insolvency, reorganization, liquidation, moratorium or other similar laws of general application and equitable principles
          relating to or affecting creditors’ rights.

       

      11.         Release by Issuer.

       

      A.           FOR GOOD AND VALUABLE CONSIDERATION, Issuer hereby forever relieves, releases, and discharges Agent,
          the Holders and their respective present or former employees, officers, directors, agents, representatives, attorneys, and each of them, from any and all claims, debts, liabilities, demands, obligations, promises, acts, agreements, costs and
          expenses, actions and causes of action, of every type, kind, nature, description or character whatsoever, whether known or unknown, suspected or unsuspected, absolute or contingent, arising out of or in any manner whatsoever connected with or
          related to facts, circumstances, issues, controversies or claims existing or arising from the beginning of time through and including the date of execution of this Amendment (collectively, the “Released Claims”). 

          Without limiting the foregoing, the Released Claims shall include any and all liabilities or claims arising out of or in any manner whatsoever connected with or related to the Note Documents, the recitals hereto, any instruments, agreements or
          documents executed in connection with any of the foregoing or the origination, negotiation, administration, servicing and/or enforcement of any of the foregoing, in each case existing or arising on or prior to the date of this Amendment.

       

      B.            In furtherance of this release, Issuer expressly acknowledges and waives any and all rights under Section 1542 of
        the California Civil Code (or its equivalent under New York law), which provides as follows:

       

      “A general release does not extend to claims that the creditor or releasing party does not know or suspect to exist in his or her
        favor at the time of executing the release and that, if known by him or her, would have materially affected his or her settlement with the debtor or released party.”

       

      
        
          

      

      C.            By entering into this release, Issuer recognizes that no facts or representations are ever absolutely certain and
        it may hereafter discover facts in addition to or different from those which it presently knows or believes to be true, but that it is the intention of Issuer hereby to fully, finally and forever settle and release all matters, disputes and
        differences, known or unknown, suspected or unsuspected; accordingly, if Issuer should subsequently discover that any fact that it relied upon in entering into this release was untrue, or that any understanding of the facts was incorrect, Issuer
        shall not be entitled to set aside this release by reason thereof, regardless of any claim of mistake of fact or law or any other circumstances whatsoever.  Issuer acknowledges that it is not relying upon and has not relied upon any representation
        or statement made by Agent or the Holders with respect to the facts underlying this release or with regard to any of such party’s rights or asserted rights.

       

      D.            This release may be pleaded as a full and complete defense and/or as a cross-complaint or counterclaim against any
        action, suit, or other proceeding that may be instituted, prosecuted or attempted in breach of this release.  Issuer acknowledges that the release contained herein constitutes a material inducement to Agent and the Holders to enter into this
        Amendment, and that Agent and the Holders would not have done so but for their expectation that such release is valid and enforceable in all events.

       

      E.              Issuer hereby represents and warrants to Agent and the Holders, and Agent and the Holders are
          relying thereon, as follows:

       

      1.     Except as expressly stated in this Amendment, neither Agent or the Holders nor any agent, employee or representative of
        Agent or the Holders has made any statement or representation to Issuer regarding any fact relied upon by Issuer in entering into this Amendment.

       

      2.       Issuer has made such investigation of the facts pertaining to this Amendment and all of the matters appertaining
        thereto, as it deems necessary.

       

      3.      The terms of this Amendment are contractual and not a mere recital.

       

      4.     This Amendment has been carefully read by Issuer, the contents hereof are known and understood by Issuer, and this
        Amendment is signed freely, and without duress, by Issuer.

       

      5.        Issuer hereby represents and warrants that it is the sole and lawful owner of all right, title and interest in and to every claim and
        every other matter which it releases herein, and that it has not heretofore assigned or transferred, or purported to assign or transfer, to any person, firm or entity any claims or other matters herein released.  Issuer shall indemnify, defend and
        hold harmless Agent and Holders from and against all claims based upon or arising in connection with prior assignments or purported assignments or transfers of any claims or matters released herein.

       

      12.         As a condition to the effectiveness of this Amendment, Agent shall have received, in form and substance reasonably
          satisfactory to Agent, the following:

       

      (a)          this Amendment, duly executed by Issuer;

       

      (b)        a completed Issuer Resolutions and Incumbency, with all exhibits, as of the Second Amendment Effective Date, in
          substantially the form attached hereto;

       

      (c)          the Second Closing Note, in substantially the form attached hereto;

       

      (d)          the Second Closing Warrant;

       

      (e)          An Affirmation of Unconditional Guaranty and Third Party Security Agreement, duly executed by the parties thereto;

       

      (f)          an Affirmation Intercreditor Agreement, in substantially the form attached hereto;

       

      (g)          the Budgeted Use of Proceeds;

       

      
        
          

      

      (h)         all Holder Expenses incurred through the date of this Amendment, which shall be wired to Agent’s and Holder’s counsel on
          the date hereof in accordance with the wire instructions attached hereto as Supplement I; and

       

      (i)         such other documents, and completion of such other matters, as Agent or Holder may reasonably deem necessary or
          appropriate.

       

      13.        As conditions subsequent to the effectiveness of this Amendment, Agent shall have received, in form and substance
          reasonably satisfactory to Agent, the following by the respective dates (the failure timely to achieve of any of which shall constitute an immediate and non-curable Event of Default):

       

      13.1           Evidence of Issuer’s receipt, on or before February 28, 2022, of net proceeds of at least Seven Hundred Twenty-Five
          Thousand Dollars ($725,000.00) from an initial closing under the Asset Purchase Agreement (the “Initial APA Closing”);

       

      13.2           Evidence of Issuer’s receipt, on or before April 15, 2022, of net proceeds of at least One Million Dollars ($1,000,000.00)
          from a subsequent closing (including the proceeds received in the Initial APA Closing) under the Asset Purchase Agreement; and

       

      13.3           Evidence of (i) Issuer’s receipt of net proceeds of at least Seven Million Five Hundred Thousand Dollars ($7,500,000.00)
          from the sale and issuance of Issuer’s equity securities, on terms and conditions reasonably acceptable to Agent (the “May 2022 Equity Raise”); and (ii) satisfaction in full of the Indebtedness owing
          Leviston Resources, LLC under the Future Advance Convertible Promissory Note dated April 20, 2021 in the original principal amount of up to $3,402,000, from the proceeds of the May 2022 Equity Raise; in each case, on or before May 1, 2022; and

       

      13.4           The Advisor Shares, by no later than March 4, 2022; provided that Issuer shall cause the Advisor Shares to be registered
          on Form S-1, and thereafter freely tradeable, no later than June 30, 2022, provided that Issuer shall cause to be filed with the Securities and Exchange Commission (“SEC”) no later than June 30, 2022, a Registration Statement on Form S-1 for the
          resale of the Advisor Shares, and shall use its best efforts to have the Form S-1 declared effective by the SEC as soon as possible thereafter.

       

      14.         Section 10 of the NPA hereby is incorporated herein by this reference as though fully set forth herein.

       

      15.         This Amendment may be executed in any number of counterparts and by different parties on separate counterparts, each of
          which, when executed and delivered, are an original, and all taken together, constitute one Amendment.

       

      [Balance of Page Intentionally Left Blank]

       

      
        
          

      

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

       

      

      	 	
              COMPANY:

            
	 	 
	 	SANUWAVE HEALTH, INC.
	 	 
	 	
              By:/s/ Kevin A. Richardson II

            
	 	
              Name: Kevin A. Richardson II

            
	 	
              Title: CEO & Chairman

            

      

      

      [Signature Page to Second Amendment to Note and Warrant Purchase and Security Agreement]

       

      [Signatures Continued, Next Page]

       

      
        
          

      

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

       

      	 	AGENT AND HOLDER:
	 	 
	 	
              NH EXPANSION CREDIT FUND HOLDINGS LP

            
	 	 
	 	By: MS Expansion Credit GP, L.P.
	 	Its: General Partner
	 	 
	 	By: MS Expansion Credit GP Inc.
	 	Its: General Partner
	 	 
	 	By: /s/ William Reiland
	 	Name: William Reiland
	 	
              Title: Managing Director

            

      

      

      [Signature Page to First Amendment to Note and Warrant Purchase and Security Agreement]

       

      
        
          

      

      ANNEX ED

      (Existing Defaults)

       

      	
              NPA Section:

            	
              As a result of:

            
	
              7.2(a)

            	
              Failure timely to deliver financial

               reporting required under Section  5.2 

              of the NPA

            
	 	 
	
              7.2(a)

            	
              Failure to maintain at all times 

              minimum Liquidity of $5,000,000 

              as required under Section 6.5 of the 

              NPA

            
	 	 
	
              7.5

            	
              As a result of Issuer’s failure to pay 

              its debts, including trade debts, when 

              due

            
	 	 
	
              7.6

            	
              As a result of Issuer’s default of 

              other agreements; failure to pay

               Indebtedness at maturity 

              (Cellularity, et al)

            
	 	 

      

      

      
        
          

      

      SCHEDULE 1.1

       

      Holders and Commitments

       

      	
              First Closing Note:

               

            	 	 
	
              Lender

            	
              Commitment Amount

            	
              Commitment Percentage

            
	
              NH EXPANSION CREDIT FUND HOLDINGS LP

            	
              $15,000,000.00

            	
              100.00%

            
	
              TOTAL

            	
              $15,000,000.00

            	
              100.00%

            

      

      

      	
              Second Closing Note:

               

            	 	 
	
              Lender

            	
              Commitment Amount

            	
              Commitment Percentage

            
	
              NH EXPANSION CREDIT FUND HOLDINGS LP

            	
              $3,000,000.00

            	
              100.00%

            
	
              TOTAL

            	
              $3,000,000.00

            	
              100.00%

            

      

      

      Total:

      	 	 	 
	
              Lender

            	
              Commitment Amount

            	
              Commitment Percentage

            
	
              NH EXPANSION CREDIT FUND HOLDINGS LP

            	
              $18,000,000.00

            	
              100.00%

            
	
              TOTAL

            	
              $18,000,000.00

            	
              100.00%

            

      

      

      
        
          

      

      SECURED PROMISSORY NOTE

      [Second Closing Note]

      

      

      
        	
                 $3,000,000.00  

                  

              	
                 February 25, 2022

              

      

                         

        

      FOR VALUE RECEIVED,  SANUWAVE HEALTH, INC., a Nevada  corporation (“Issuer”), hereby unconditionally promises to pay to NH EXPANSION CREDIT
        FUND HOLDINGS LP, a Delaware limited partnership (together with its registered successors and permitted assigns, “Holder”), at the Holder’s lending office, or at such other place as Holder may from time to time designate in writing, in
        lawful money of the United States of America and in immediately available funds, the principal sum of Three Million Dollars ($3,000,000.00), pursuant to the terms of that certain Note and Warrant Purchase and Security Agreement, dated as of August
        6, 2020 (as amended, restated, amended and restated, supplemented or otherwise modified from time to time, the “NWPSA”), by and among Issuer, NH EXPANSION CREDIT FUND HOLDINGS LP, as Agent for the noteholders, Holder and each other
        noteholder from time to time party thereto.  All capitalized terms used herein (which are not otherwise specifically defined herein) shall be used in this Secured Promissory Note (this “Note”) as defined in the NWPSA.

      

      

      This Note is issued in accordance with the provisions of the NWPSA and is entitled to the benefits and security of the NWPSA and the other Note
        Documents, and reference is hereby made to the NWPSA for a statement of the terms and conditions under which this Note was made and is required to be repaid.

      

      

      The outstanding principal balance evidenced by this Note shall be payable in full on the Maturity Date, or on such earlier date as provided for in
        the NWPSA.

      

      

      Issuer promises to pay interest from the date hereof until payment in full hereof on the unpaid principal balance of this Note at the per annum rate
        or rates set forth in the NWPSA.  Interest on the unpaid principal balance of this Note shall be payable on the dates and in the manner set forth in the NWPSA.  Interest as aforesaid shall be calculated in accordance with the terms of the NWPSA.

      

      

      Upon and after the occurrence of an Event of Default, and as provided in the NWPSA, the principal outstanding under this Note may be declared, and
        immediately upon such declaration shall become, due and payable without demand, notice or legal process of any kind; provided, however, that upon the occurrence of an Event of Default pursuant to the provisions of Section 7.5(b) or Section 7.5(c)
        of the NWPSA, the principal outstanding under this Note shall automatically be due and payable, without demand, notice or acceleration of any kind whatsoever.

      

      

      Payments received in respect of this Note shall be applied as provided in the NWPSA.

      

      

      Issuer hereby waives presentment, demand, protest and notice of presentment, demand, nonpayment and protest.

      

      

      No waiver by any Holder of any one or more defaults by Issuer in the performance of any of its obligations under this Note shall operate or be
        construed as a waiver of any future default or defaults, whether of a like or different nature, or as a waiver of any obligation of Issuer to any other Holder under the NWPSA.

      

      

      No provision of this Note may be amended, waived or otherwise modified unless such amendment, waiver or other modification is in writing and is
        signed or otherwise approved by Issuer, Holder and the Required Holders under the NWPSA, to the extent required under Section 11.3 of the NWPSA.

      

      

      THIS NOTE SHALL BE GOVERNED BY, AND SHALL BE CONSTRUED AND
          ENFORCED IN ACCORDANCE WITH THE LAWS OF THE STATE OF NEW YORK WITHOUT REGARD TO CONFLICTS OF LAW PRINCIPLES.

      

      

      
        
          

      

      Whenever possible each provision of this Note shall be interpreted in such manner as to be effective and valid under applicable law, but in case any
        provision of or obligation under this Note shall be invalid, illegal or unenforceable in any jurisdiction, the validity, legality and enforceability of the remaining provisions or obligations, or of such provision or obligation in any other
        jurisdiction, shall not in any way be affected or impaired thereby.

      

      

      Whenever in this Note reference is made to Holder or Issuer, such reference shall be deemed to include, as applicable, a reference to their
        respective successors and permitted assigns.  The provisions of this Note shall be binding upon Issuer and its successors and permitted assigns, and shall inure to the benefit of Holder and its successors and permitted assigns.

      

      

      In addition to, and without limitation, of any of the foregoing, this Note shall be deemed to be a Note Document and shall otherwise be subject to
        all of the general terms and conditions contained in Section 8.4 and Article 11 of the NWPSA, mutatis mutandis.

      

      

      [Signature Page Follows]

       

      

      
        
          

      

      IN WITNESS WHEREOF, Issuer has caused this Secured Promissory Note to be executed as of the date first written above.

       

      	 	
              ISSUER:

            
	 	 
	 	
              SANUWAVE HEALTH, INC.

            

      	 	 
	 	
              By

            	 
	 	
              Name:

            	 
	 	
              Title:

            	 
	 	 

      	 	
              Address for Notice:

            
	 	
              SANUWAVE HEALTH, INC.

            
	 	 
	 	 

      	 	
              Attn:

            	 
	 	
              Email:

            	 

      

      

      [Signature Page to Secured Promissory Note (Second Closing Note)]

       

      

      
        
          

      

      AFFIRMATION OF UNCONDITIONAL GUARANTY AND THird PArty SECURITY AGREEMENT

      February __, 2002

       

      Each of the undersigned hereby ratifies and confirms that certain Unconditional Guaranty (as amended, restated, amended and restated, supplemented or
        otherwise modified from time to time, the “Guaranty”), and that certain Third Party Security Agreement (as amended, restated, amended and restated, supplemented or otherwise modified from time to time, the “Security Agreement”), each
        dated as of August 6, 2020 (collectively, the “Guaranty Documents”), executed and delivered to NH EXPANSION CREDIT FUND HOLDINGS LP as agent (in such capacity, together with its successors and permitted assigns, “Agent”) on behalf of
        the Holders (as defined therein), pursuant to which the undersigned guaranteed certain present and future indebtedness of SANUWAVE HEALTH, INC., a Nevada corporation (“Issuer”), in accordance with the terms contained in said Guaranty
        Documents, and represents and warrants to Agent as follows:

       

      	

            	1.	
              that said Guaranty Documents remain in full force and effect, are valid and binding in accordance with their terms, and that the undersigned have no defenses to the enforceability thereof;

            

       

      	

            	2.	
              that said Guaranty Documents run in favor of Agent; and

            

       

      	

            	3.	
              that pursuant to that certain Second Amendment to Note and Warrant Purchase and Security Agreement dated as of the date hereof, which amends that certain Note and Warrant Purchase and Security Agreement, dated as of August 6, 2020 (as
                may be otherwise amended, restated, amended and restated, supplemented or otherwise modified from time to time, the “NPA”), Holders, amongst other things, have purchased from Issuer that certain Promissory Note in the original
                principal amount of Three Million Dollars ($3,000,000.00).

            

       

      The undersigned has obtained such information as it desires as to the affairs of Issuer and understands that Agent has no duty or obligation, now or in
        the future, to supply the undersigned with any information whatsoever concerning Issuer. The undersigned furthermore understands and agrees that the giving of this affirmation at this time does not create an obligation on Agent to obtain an
        affirmation in the future or effect the terms of the Guaranty Documents as expressed therein, and that the failure of Agent to obtain such an affirmation in the future shall not at any time affect the validity or scope of the Guaranty Documents,
        including but not limited to any future amendment of any of the Loan Documents (as such term is defined in the NPA).

       

      In all other respects, as set forth above, the Guaranty Documents are hereby ratified and affirmed.

       

      

      [Balance of Page Intentionally Left Blank]

       

      
        
          

      

      IN WITNESS WHEREOF, each undersigned Guarantor has executed this Affirmation of Unconditional Guaranty and Third Party Security Agreement, intending to
        be legally bound hereby, as of the date first set forth above.

       
        SANUWAVE, INC.

      

      

      

      	
              By:

            	 	 

      

      

      	
              Name:

            	 	 
	 	 
	
              Title:

            	 	 

      

      

      
        SANUWAVE SERVICES, LLC

         

        

      

      	
              By:

            	 	 

      

      

      	
              Name:

            	 	 
	 	 
	
              Title:

            	 	 

      

      

      
        
          

      

      AFFIRMATION OF INTERCREDITOR AGREEMENT

       

      This Affirmation of Intercreditor Agreement (this “Affirmation”) is executed by and between Goodman Capital Finance, a division of Independent
        Bank (together with its successors and permitted assigns, “Senior Creditor”), and NH Expansion Credit Fund Holdings LP, as Agent for the Holders (under and as defined in the Junior Creditor Documents (as defined below)) (together with its
        successors and permitted assigns, “Junior Creditor”), as of February 25, 2022. Capitalized terms used without definitions herein shall have the definitions ascribed in the Intercreditor Agreement (as hereafter defined).

       

      A.          WHEREAS, Senior Creditor and Junior Creditor are parties to that certain Intercreditor Agreement dated as of June 8, 2021 (as
          amended, restated, amended and restated, supplemented or otherwise modified from time to time, the “Intercreditor Agreement”).

       

      B.          WHEREAS, Junior Creditor and Debtor are entering into that certain Second Amendment to Note and Warrant Purchase and Security
          Agreement (the “Amendment”) as of February 25, 2022, with respect to which, among other things, Junior Creditor is purchasing from Debtor that Second Closing Note (as defined in the Amendment), in the original principal amount of Three
          Million Dollars ($3,000,000.00).

       

      NOW, THEREFORE, in consideration of the foregoing recitals and other good and valuable consideration, the receipt and adequacy of which is hereby
        acknowledged, and intending to be legally bound, the parties hereto agree as follows:

       

      1.          The Intercreditor Agreement is and shall remain in full force and effect.

       

      2.          Senior Creditor hereby consents to the execution, delivery and performance by Junior Creditor and Debtor of the Amendment and
          the documents and instruments executed and/or delivered in connection therewith.

       

      3.          Senior Creditor acknowledges and agrees that the obligations of Issuer to Junior Creditor, as modified by the Amendment,
          constitute Junior Debt, and that the Amendment constitutes a Junior Creditor Document, for all purposes of the Intercreditor Agreement.

       

      4.          This Affirmation may be executed in two or more counterparts, each of which shall be deemed an original and all of which
          together shall constitute one instrument. In the event that any signature is delivered by facsimile transmission or by e-mail delivery of a “.pdf” format data file, such signature shall create a valid and binding obligation of the party executing
          (or on whose behalf such signature is executed) with the same force and effect as if such facsimile or “pdf’ signature page were an original hereof.

       

      [Balance of Page Intentionally Left Blank]

       

      
        
          

      

      IN WITNESS WHEREOF, the parties hereto have caused this Affirmation to Intercreditor Agreement to be duly executed as of the day and year
        first above written.

       

      	 	
              SENIOR CREDITOR

            
	 	 
	 	
              GOODMAN CAPITAL FINANCE,

            
	 	
              A DIVISION OF INDEPENDENT BANK

            
	 	 

      	 	
              By:

            	 	 

      	 	
              Title:

            	 	 
	 	 	 

      	 	
              Address: 3010 LBJ Freeway, Suite 140

            
	 	
                             Dallas, TX 75234

            

      	 	
              Attention:

            	 	 
	 	
              Fax:

            	 	 
	 	 	 

      	 	
              JUNIOR CREDITOR

            
	 	 
	 	
              NH EXPANSION CREDIT FUND HOLDINGS LP

            
	 	 

      	 	
              By: MS Expansion Credit GP, L.P.

            
	 	
              Its: General Partner

            
	 	 

      	 	
              By: MS Expansion Credit GP Inc.

            
	 	
              Its: General Partner

            

      	 	 	 
	 	
              By

            	 	 

      	 	
              Name:William Reiland

            
	 	
              Title:   Managing Director

            
	 	 

      	 	
              Address:

            
	 	
              1585 Broadway, 39th Floor

            
	 	
              New York, NY 10036

            
	 	
              Attn: Debra Abramovitz

            
	 	
              Expansion_credit_reporting@morganstanley.com

            

      

        [Signature Page to Affirmation of Intercreditor Agreement]

         

        

      

      
        
          

      

      ISSUER RESOLUTIONS

       

      CORPORATE CERTIFICATE

       
        	
                Issuer: SANUWAVE HEALTH, INC. 

                  

              	
                  Date: February 25, 2022

              
	
                
                  Holder: NH EXPANSION CREDIT FUND HOLDINGS LP

                

              	 

      

              

          

      I hereby certify as follows, as of the date set forth above:

       

      	

            	1.	
              I am the Secretary, Assistant Secretary or other officer of the Issuer.  My title is as set forth below.

            

       

      	

            	2.	
              Issuer’s exact legal name is set forth above.  Issuer is a corporation existing under the laws of the State of Delaware.

            

       

      	

            	3.	
              Attached hereto as Exhibit 1 is a true, correct and complete copy of Issuer’s Certificate of Incorporation (including amendments), as filed with the Secretary of State of the State of Delaware.  Such Certificate of Incorporation
                has not been amended, annulled, rescinded, revoked or supplemented, and remains in full force and effect as of the date hereof.

            

       

      	

            	4.	
              Attached hereto as Exhibit 2 is a true, correct and complete copy of Issuer’s Bylaws (including amendments), which Bylaws have not been amended, annulled, rescinded, revoked or supplemented, and remain in full force and effect as
                of the date hereof.

            

       

      	

            	5.	
              The following resolutions were duly and validly adopted by Issuer’s Board of Directors at a duly held meeting of such directors (or pursuant to a unanimous written consent or other authorized corporate action).  Such resolutions are in
                full force and effect as of the date hereof and have not been in any way modified, repealed, rescinded, amended or revoked, and Holder may rely on them until Holder receives written notice of revocation from Issuer.

            

       

      
        
          

      

      Resolved, that any one of the following officers or employees of Issuer, whose names, titles and signatures are below, may act on behalf of Issuer:

       

      	
              Name

            	 	
              Title

            	 	
              Signature

            	
              Authorized to

               Add or Remove 

              Signatories

            
	 	 	 	 	 	 
	 	 	 	 	 	
              ☐

            
	 	 	 	 	 	 
	 	 	 	 	 	
              ☐

            
	 	 	 	 	 	 
	 	 	 	 	 	
              ☐

            
	 	 	 	 	 	 
	 	 	 	 	 	
              ☐

            

      

          Resolved Further, that any one of the persons designated above with a checked box beside his or her name may, from time to time, add or remove any individuals to and from the
          above list of persons authorized to act on behalf of Issuer.

       

      Resolved Further, that such individuals may, on behalf of Issuer:

       

      Execute Note Documents.  Execute the Second Amendment to Note and Warrant Purchase and Security Agreement, dated as of February __, 2002, which amends the Note and Warrant Purchase and Security Agreement dated
          as of August 6, 2020, between Holder and Issuer (as amended, restated, amended and restated, supplemented or otherwise modified from time to time, the “NWPSA”), and any other Note Documents (as defined in the NWPSA) that Holder requires.

      Grant Security.  Grant Holder a security interest in any of Issuer’s assets.

      Subsidiary Collateral. Cause certain subsidiaries to provide guaranties of the obligations, which may be secured.

      Issue Warrants.  Issue warrants for Issuer’s capital stock.

      Further Acts.  Designate other individuals to request advances, pay fees and costs and execute other documents or agreements (including documents or agreement that waive Issuers right to a jury trial) they believe to be
          necessary to effectuate such resolutions.

       

        

      [Balance of Page Intentionally Left Blank]

       

      
        
          

      

      Resolved Further, that all acts authorized by the above resolutions and any prior acts relating thereto are ratified.

       

      	

            	6.	
              The persons listed above are Issuer’s officers or employees with their titles and signatures shown next to their names.

            

       

      	 	
              By:

            	 	 
	 	
              Name:

            	 	 
	 	
              Title:

            	 	 

       

      

      *** If the Secretary, Assistant Secretary or other certifying officer executing above is designated by the
        resolutions set forth in paragraph 6 as one of the authorized signing officers, this Certificate must also be signed by a second authorized officer or director of Issuer.

       

      I, the ________________________ of Issuer, hereby certify as to paragraphs 1 through 6 above, as

      [print title]

      of the date set forth above.

       

      	 	
              By:

            	 	 
	 	
              Name:

            	 	 
	 	
              Title:

            	 	 

      

      

       [Signature Page to Issuer Resolutions]

       

      

      
        
          

      

      Exhibit 1

      Certificate of Incorporation (including amendments)

      

      

      
        
          

      

      Exhibit 2

      Bylaws (including amendments)

       

      
        
          

      

      SUPPLEMENT I

      (Wire Instructions)

       

      Agent’s and Holders’ counsel fees in the amount of $28,588.00 shall be wired as follows:

      

      

      	
              Bank Name:

               

              SWIFT CODE:

            	
              Fifth Third Bank

              Indianapolis, IN

              ***

            
	
              Routing Number:

            	
              ***

            
	
              Account Number:

            	
              ***

            
	
              Reference:

            	
              ***Document

Exhibit 4.15

DESCRIPTION OF REGISTERED SECURITIES 

The following description of our capital stock and provisions of our amended and restated certificate of incorporation and amended and restated bylaws are summaries. You should also refer to the amended and restated certificate of incorporation and the amended and restated bylaws, which are included as exhibits to this Annual Report on Form 10-K, and to the provisions of applicable Delaware law.

General

Under our amended and restated certificate of incorporation, we are authorized to issue up to 200,000,000 shares of common stock, $0.001 par value per share, and 5,000,000 shares of preferred stock, $0.001 par value per share, all of which shares of preferred stock are undesignated.  Our board of directors may establish the rights and preferences of the preferred stock from time to time. 

Common Stock

Voting

Each holder of common stock is entitled to one vote for each share held of record on all matters submitted to a vote of the stockholders, including the election of directors, and does not have cumulative voting rights. Accordingly, the holders of a majority of the shares of common stock entitled to vote in any election of directors can elect all of the directors standing for election.

Dividends

Subject to preferences that may be applicable to any then-outstanding preferred stock, the holders of common stock are entitled to receive dividends, if any, as may be declared from time to time by the board of directors out of legally available funds.

Liquidation

In the event of our liquidation, dissolution or winding up, holders of our common stock will be entitled to share ratably in the net assets legally available for distribution to stockholders after the payment of all of our debts and other liabilities, and the satisfaction of any liquidation preference granted to the holders of any then-outstanding shares of preferred stock.

Rights and Preferences

Holders of our common stock have no preemptive, conversion or subscription rights, and there are no redemption or sinking fund provisions applicable to our common stock. The rights, preferences and privileges of the holders of common stock are subject to, and may be adversely affected by, the rights of the holders of shares of any series of preferred stock that we may designate in the future.

Fully Paid and Nonassessable

All of our outstanding shares of common stock are fully paid and nonassessable.

Preferred Stock

Pursuant to our amended and restated certificate of incorporation, our board of directors has the authority, without further action by the stockholders (unless such stockholder action is required by applicable law or stock exchange listing rules), to designate and issue up to 5,000,000 shares of preferred stock in one or more series, to establish from time to time the number of shares to be included in each such series, to fix the designations, powers, preferences, privileges and relative participating, optional or special rights and the qualifications, limitations or restrictions 
1

thereof, including dividend rights, conversion rights, voting rights, terms of redemption and liquidation preferences, any or all of which may be greater than the rights of the common stock, and to increase or decrease the number of shares of any such series, but not below the number of shares of such series then outstanding.

Our board of directors, without stockholder approval, can issue preferred stock with voting, conversion or other rights that could adversely affect the voting power and other rights of the holders of common stock. Preferred stock could be issued quickly with terms designed to delay or prevent a change in control of our company or make removal of management more difficult. Additionally, the issuance of preferred stock may have the effect of decreasing the market price of the common stock and may adversely affect the voting power of holders of common stock and reduce the likelihood that common stockholders will receive dividend payments and payments upon liquidation.

Our board of directors will fix the designations, voting powers, preferences and rights of each series, as well as the qualifications, limitations or restrictions thereof, of the preferred stock of each series that we offer under the prospectus and applicable prospectus supplements in the certificate of designation relating to that series. We will file as an exhibit to the registration statement of which such prospectus forms a part, or will incorporate by reference from reports that we file with the SEC, the form of any certificate of designation that describes the terms of the series of preferred stock we may offer before the issuance of that series of preferred stock. This description will include:

•the title and stated value;
•the number of shares we are offering;
•the liquidation preference per share;
•the purchase price per share;
•the dividend rate per share, dividend period and payment dates and method of calculation for dividends;
•whether dividends will be cumulative or non-cumulative and, if cumulative, the date from which dividends will accumulate;
•our right, if any, to defer payment of dividends and the maximum length of any such deferral period;
•the procedures for any auction and remarketing, if any;
•the provisions for a sinking fund, if any;
•the provisions for redemption or repurchase, if applicable, and any restrictions on our ability to exercise those redemption and repurchase rights;
•any listing of the preferred stock on any securities exchange or market;
•whether the preferred stock will be convertible into our common stock or other securities of ours, including depositary shares and warrants, and, if applicable, the conversion period, the conversion price, or how it will be calculated, and under what circumstances it may be adjusted;
•whether the preferred stock will be exchangeable into debt securities, and, if applicable, the exchange period, the exchange price, or how it will be calculated, and under what circumstances it may be adjusted;
•voting rights, if any, of the preferred stock;
•preemption rights, if any;
•restrictions on transfer, sale or other assignment, if any;
•whether interests in the preferred stock will be represented by depositary shares;
•a discussion of any material or special U.S. federal income tax considerations applicable to the preferred stock;
•the relative ranking and preferences of the preferred stock as to dividend rights and rights if we liquidate, dissolve or wind up our affairs;
•any limitations on issuances of any class or series of preferred stock ranking senior to or on a parity with the series of preferred stock being issued as to dividend rights and rights if we liquidate, dissolve or wind up our affairs; and
•any other specific terms, rights, preferences, privileges, qualifications or restrictions of the preferred stock.

The Delaware General Corporation Law (“DGCL”), the corporate law of our state of our incorporation, provides that the holders of preferred stock will have the right to vote separately as a class (or, in some cases, as a series) on an amendment to our certificate of incorporation if the amendment would change the par value or, unless the 
2

certificate of incorporation provided otherwise, the number of authorized shares of the class or change the powers, preferences or special rights of the class or series so as to adversely affect the class or series, as the case may be. This right is in addition to any voting rights that may be provided for in the applicable certificate of designation.

Anti-Takeover Effects of Delaware Law and Our Charter and Bylaws

Provisions of Delaware law, our amended and restated certificate of incorporation, and our amended and restated bylaws could make it more difficult to acquire us by means of a tender offer, a proxy contest, open market purchases, removal of incumbent directors and otherwise. These provisions, summarized below, are expected to discourage types of coercive takeover practices and inadequate takeover bids and to encourage persons to acquire control of us to first negotiate with us. We believe that the benefits of increase protection of our potential ability to negotiate with the proponent of an unfriendly or unsolicited proposal to acquire or restructure us outweigh the disadvantages of discouraging takeover or acquisition proposals because negotiation of these proposals could result in an improvement of their terms.

Delaware Anti-Takeover Law

We are subject to section 203 of the DGCL, or Section 203. Section 203 generally prohibits a public Delaware corporation from engaging in a “business combination” with an “interested stockholder” for a period of three years after the date of the transaction in which the person became an interested stockholder, unless:

•prior to such time the board of directors of the corporation approved either the business combination or the transaction which resulted in the stockholder becoming an interested stockholder;
•upon consummation of the transaction which resulted in the stockholder becoming an interested stockholder, the interested stockholder owned at least 85% of the voting stock of the corporation outstanding at the time the transaction commenced, excluding for purposes of determining the voting stock outstanding (but not the outstanding voting stock owned by the interested stockholder) those shares owned (i) by persons who are directors and also officers and (ii) employee stock plans in which employee participants do not have the right to determine confidentially whether shares held subject to the plan will be tendered in a tender or exchange offer; or
•at or subsequent to such time the business combination is approved by the board of directors and authorized at an annual or special meeting of stockholders, and not by written consent, by the affirmative vote of at least 66 2/3% of the outstanding voting stock which is not owned by the interested stockholder.

Section 203 defines a business combination to include:

•any merger or consolidation involving the corporation and the interested stockholder;
•any sale, transfer, pledge or other disposition involving the interested stockholder of 10% or more of the assets of the corporation;
•subject to exceptions, any transaction that results in the issuance or transfer by the corporation of any stock of the corporation to the interested stockholder;
•subject to exceptions, any transaction involving the corporation that has the effect of increasing the proportionate share of the stock of any class or series of the corporation beneficially owned by the interested stockholder; or
•the receipt by the interested stockholder of the benefit of any loans, advances, guarantees, pledges or other financial benefits provided by or through the corporation.

Subject to certain exceptions, Section 203 defines an “interested stockholder” as an entity or person (other than the corporation or any direct or indirect majority-owned subsidiary of the corporation) who, together with the entity or person’s affiliates and associates, beneficially owns, or is an affiliate or associate of the corporation and within three years prior to the time of determination of interested stockholder status did own, 15% or more of the outstanding voting stock of the corporation.

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The existence of this provision generally will have an anti-takeover effect for transactions not approved in advance by the board of directors, including discouraging attempts that might result in a premium over the market price for the shares of common stock held by stockholders.

Amended and Restated Certificate of Incorporation and Amended and Restated Bylaws

Provisions of our amended and restated certificate of incorporation and amended and restated bylaws may delay or discourage transactions involving an actual or potential change in our control or change in our management, including transactions in which stockholders might otherwise receive a premium for their shares or transactions that our stockholders might otherwise deem to be in their best interests. Therefore, these provisions could adversely affect the price of our common stock. Among other things, our amended and restated certificate of incorporation and amended and restated bylaws:

•permit our board of directors to issue up to 5,000,000 shares of preferred stock, with any rights, preferences and privileges as they may designate (including the right to approve an acquisition or other change in our control);
•provide that the authorized number of directors may be changed only be resolution of our board of directors;
•provide that all vacancies, including newly created directorships, may, except as otherwise required by law, be filled by the affirmative vote of a majority of directors then in office, even if less than a quorum;
•require that any action to be taken by our stockholders must be effected at a duly called annual or special meeting of stockholders and not be taken by written consent;
•provide that stockholders seeking to present proposals before a meeting of stockholders or to nominate candidates for election as directors at a meeting of stockholders must provide notice in writing in a timely manner, and also specify requirements as to the form and content of a stockholder's notice;
•do not provide for cumulative voting rights (therefore allowing the holders of a majority of the shares of common stock entitled to vote in any election of directors to elect all of the directors standing for election, if they should so choose); and
•provide that special meetings of our stockholders may be called only by the chairman of the board, our chief executive officers or by our board of directors pursuant to a resolution adopted by a majority of the total number of authorized directors.

The amendment of any of these provisions, with the exception of the ability of our board of directors to issue shares of preferred stock and designate any rights, preferences and privileges thereto, would require approval by the holders of at least 66 2/3% of our then outstanding common stock.

Choice of Forum

Our amended and restated certificate of incorporation provides that, unless we consent in writing to the selection of an alternative forum, the Court of Chancery of the State of Delaware is the exclusive forum for:

•any derivative action or proceeding brought on our behalf;
•any action asserting a claim of breach of a fiduciary duty;
•any action asserting a claim against us arising pursuant to any provision of the DGCL, our amended and restated certificate of incorporation or our amended and restated bylaws; or
•any action asserting a claim against us that is governed by the internal affairs doctrine.

The enforceability of similar choice of forum provisions in other companies' certificates of incorporation has been challenged in legal proceedings, and it is possible that, in connection with any action, a court could find the choice of forum provisions contained in our amended and restated certificate of incorporation to be inapplicable or unenforceable in such action. These provisions would not apply to suits brought to enforce a duty or liability created by the Exchange Act, Securities Act or any other claim for which the federal courts have exclusive or concurrent jurisdiction. Any person or entity purchasing or otherwise acquiring any interest in our securities shall be deemed to have notice of and consented to these provisions. Our exclusive forum provision will not relieve us of our duties to 
4

comply with the federal securities laws and the rules and regulations thereunder, and our shareholders will not be deemed to have waived our compliance with these laws, rules and regulations.

The provisions of the DGCL, our amended and restated certificate of incorporation and our amended and restated bylaws could have the effect of discouraging others from attempting hostile takeovers and may also have the effect of preventing changes in our management. It is possible that these provisions could make it more difficult to accomplish transactions that stockholders may otherwise deem to be in their best interests.

Nasdaq Capital Market Listing

Our common stock is listed on The Nasdaq Capital Market under the symbol “AVTX.”

Transfer Agent and Registrar

The transfer agent and registrar for our common stock is American Stock Transfer & Trust Company, LLC. The transfer agent and registrar's address is 6201 15th Avenue, Brooklyn, NY 11219.

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