Document:

Form of Note Amendment

 Exhibit 4.2 
 NOTE AMENDMENT 
 This Note Amendment (this “Amendment”) is made as of this 20th day of July, 2009 by
and among Cardium Therapeutics, Inc., a Delaware corporation (the “Company”), and the holders (each a “Holder”) of an unsecured promissory note issued pursuant to the terms of that certain Note and Warrant Purchase
Agreement dated June 11, 2009 (“Purchase Agreement”). Capitalized terms used but not defined herein shall have the meanings ascribed to such terms in the Notes. 
 W I T N E S S E T H 
 WHEREAS, the Company issued and sold an aggregate principal
amount of $750,000 of unsecured promissory notes pursuant to the Purchase Agreement, of which an aggregate principal amount of $600,000 of such notes are dated June 11, 2009 and an aggregate principal amount of $150,000 of such notes are dated
June 23, 2009, and each of which were amended by that certain Amendment to Promissory Notes dated as of July 10, 2009 by and among the Company and the holders of such notes (such senior subordinated secured promissory notes as amended are
referred to herein as the “Notes”); 
 WHEREAS, on July 10, 2009, the Company and InnerCool entered into an Asset Purchase
Agreement (the “Philips APA”) with Philips Electronics North America Corporation, a Delaware corporation (“Philips”), pursuant to which Philips will purchase substantially all of the InnerCool Assets (the
“Philips Transaction”), and the Company and Holders wish to facilitate the consummation of the Philips Transaction; 
 WHEREAS,
certain Holders of the Notes wish to take advantage of an offer by the Company to extend the term of all or a portion of their Note as set forth in Section 2 below (the “Optional Term Extension”) in exchange for the receipt of
the following payments (collectively the “Term Extension Payments”): 
  

	a)	A first payment at the time of Closing of the Philips Transaction (the “First Payment”) comprising the sum of the following: (i) all currently accrued but
unpaid interest on their Note; (ii) a Note Origination Fee (as defined in the Note); plus (iii) at the Holder’s election, up to 50% of the outstanding principal of the Note; 

  

	b)	Continuing monthly interest payments following the consummation of the Philips Transaction (the “Monthly Payments”) comprising monthly interest on the outstanding
principal balance of their Note at the rate of Twelve Percent (12%) per annum; and 

  

	c)	A final payment (the “Final Pay-Off Amount”), due no later than November 5, 2009, and comprising any remaining accrued but unpaid interest plus the outstanding
principal balance of their Note. 

  

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 NOW, THEREFORE, for good and valuable consideration, the receipt and sufficiency of which are hereby acknowledged,
the parties hereto hereby agree as follows: 
 1. Acknowledgement and Note Extension. Holder acknowledges that each holder of Notes is being afforded
an opportunity to individually elect to extend the maturity of such holder’s Note to November 5, 2009 and to otherwise modify and amend such Note as set forth in Section 2 below. In addition, Holder and the Company agree that,
effective as of the date hereof, all of the Notes shall be amended as follows: 
 (a) Section 3 of each Note is hereby amended to read
in its entirety as follows: 
 3. Maturity. Unless sooner paid in accordance with the terms hereof, the entire unpaid
principal amount and all unpaid accrued interest shall become fully due and payable on the earlier of (i) July 23, 2009, or (ii) the acceleration of the maturity of this Note by the Holder upon the occurrence of an Event of Default
(such earlier date, the “Maturity Date”). 
 (b) Section 5(a)(i) of each Note is hereby amended to delete the words
“twenty-three (23) days” and in place thereof insert the words “two (2) Business Days” so that Section 5(a)(i) of the Note shall read in its entirety as follows: 
 (i) any indebtedness under this Note is not paid when and as the same shall become due and payable, whether at maturity, by acceleration,
thirty-five (35) days following notice of prepayment or otherwise, and any such amount shall remain unpaid for a period of two (2) Business Days after the due date thereof 
 2. Optional Term Extension; Term Extension Payments. 
 Please indicate below whether you wish to have this
Section 2 apply to your Note in exchange for which you will be entitled to receive the Optional Term Extension Payments (including the First Payment, Monthly Payments and Final Pay-Off Amount as described above), with respect to that portion of
your Note that you elect to extend (minimum amount for extension 50%). 
  

			
	  
             

	  	 Yes – I wish to have the provisions of this Section 2 apply to my Note and to receive the corresponding Optional Term Extension Payments with
respect to the following portion of my Note:
  
     % of
Principal to be extended (minimum amount 50%)

		
	            	  	No – I decline to have the provisions of this Section 2 apply to my Note.

  

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 (a) Note Extension and Amendments. The Company and the undersigned holder agree that, effective as
of the satisfaction of the Effectiveness Conditions (as defined below), the Note shall be amended as follows: 
 (1) Section 3 of the
Note shall be amended to read in its entirety as follows: 
 3. Maturity. Unless sooner paid in accordance with the
terms hereof, the entire unpaid principal amount and all unpaid accrued interest shall become fully due and payable on the earlier of (i) November 5, 2009, or (ii) the acceleration of the maturity of this Note by the Holder upon the
occurrence of an Event of Default (such earlier date, the “Maturity Date”). 
 (2) Section 4(b) of the Note shall be amended
to read in its entirety as follows: 
 (b) Interest Payments. The Company shall pay to Holder accrued interest and
unpaid interest on the last Business Day of each month commencing with July 31, 2009 and on the Maturity Date. Interest at the rate first set forth above shall accrue on any interest which has not been paid on the date on which it is payable
until such time as payment therefor is actually delivered to Holder 
 (3) Section 4(c) of the Note shall be deleted in its entirety.

 As used herein, “Effectiveness Conditions” shall mean the following conditions: (i) the Company shall pay all interest accrued but
unpaid on the Note through and including the date of payment and (ii) the Company shall pay Holder the full amount of the Origination Fee. 
 3.
Execution in Counterparts. This Amendment may be executed in any number of counterparts, each of which when so executed and delivered shall be deemed an original, and such counterparts together shall constitute one instrument. Delivery by
facsimile or other electronic means of an executed counterpart hereof shall have the same force and effect as delivery of an originally executed counterpart hereof. 
 IN WITNESS WHEREOF, the undersigned, by their duly authorized representatives, have executed this Amendment as of the date first above written. 
  

			
	Company:
	
	CARDIUM THERAPEUTICS, INC.
		
	By:	 	 /s/    Tyler Dylan

		 	Tyler Dylan, Chief Business Officer, General Counsel, Executive Vice President and Secretary

  

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	Holder:
	
	  
 (Print Name of Individual or
Entity)

		
	By:	 	  

		 	(Signature)
		
	Name:	 	  

	Title:	 	  

	
	Principal Amount of Note: $        

  

 4Form of Letter Amendment

 Exhibit 4.3 
 

 
 Dear Cardium Note Holder: 
 I am pleased to report that this morning we announced the sale of our InnerCool Therapies business unit to the U.S. subsidiary of Royal Philips Electronics (NYSE: PHG, AEX: PHI), which is based in the Netherlands but operates in more than
60 countries worldwide as Philips. Copies of the press releases issued by Cardium and Philips announcing this transaction are provided for your information. As you may know, Philips is a global leader in healthcare, lifestyle and lighting and a
market leader in cardiac care, acute care and home healthcare. The transaction is subject to customary conditions but is expected to close shortly. 
 The Philips-InnerCool transaction is our first asset monetization within Cardium’s biomedical investment portfolio, and our sale of InnerCool (with less than $2M in annual sales) to a global player such as Philips – despite a very
challenging business environment – not only validates the importance of our world class technology but affirms the potential of our business model to strategically reposition businesses in a manner that makes them attractive targets for major
healthcare providers. 
 The Philips-InnerCool asset purchase transaction for $11,250,000, as well as the transfer and assumption of
approximately $1,500,000 in outstanding InnerCool trade payables, greatly improves Cardium’s balance sheet and also allows us to eliminate the substantial operating burn associated with InnerCool as we move forward with our key Tissue Repair
Company opportunity, the ExcellarateTM product candidate, which is designed for the potential treatment of diabetic ulcers and other tissue wounds. In May 2009, we announced completion of enrollment of our MATRIX clinical study for Excellarate,
and we now expect to announce results from that study around the end of September 2009. 
 Important additional information about these and
other matters, including any investment in the company, can be found in Cardium’s recent press releases and in our filings with the U.S. Securities and Exchange Commission. 
 In accordance with the attached Confirmation of Waiver and Consent, Note Holders are entitled to receive up to one half of the outstanding principal
amount of their Note, following the closing of the Philips-InnerCool Transaction, which we expect to occur shortly. If you elect to receive this early repayment of one half of the outstanding principal balance of your Note, please be aware that:
(i) no interest “Make Whole Payment” (as defined in the Note) would apply, and (ii) your subsequent monthly interest payments would be proportionately reduced based on your election to retire up to one half of your Note through
early repayment. 
 In connection with these events, some Note Holders have indicated an interest in maintaining the entire balance of their
Note, i.e. not seeking early repayment of up to half of their Note (the “Early Repayment Amount”) in exchange for continuing to receive the full amount of their current interest payments plus an additional Note Extension Payment to be paid
in connection with the Philips-InnerCool transaction, as described below. 
  

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 Extending Note Holders would receive each of the following payments (the “Term Extension
Payments”): 
  

	 	1.	A First Payment – to be paid promptly following closing of the Philips-InnerCool Transaction and equal to the sum of the following: (i) all currently accrued but
unpaid interest on their Note; plus (ii) an additional “Note Extension Payment” equal to Five Percent (5%) of the total Early Repayment Amount that is deferred; 

  

	 	2.	Continuing Monthly Interest Payments – to be paid each month following the consummation of the Philips Transaction comprising monthly interest payments on the full
outstanding principal balance of their Note at the rate of Twelve Percent (12%) per annum; and 

  

	 	3.	A Final Pay-Off Amount – to be paid no later than November 5, 2009, and comprising any remaining accrued but unpaid interest plus the outstanding principal balance
of their Note. 

 If you wish to participate in the optional term extension for all or a portion of your Notes in exchange for
receipt of the corresponding Term Extension Payments, please confirm your election by checking the first option shown below 
  

			
	  
             

	  	Yes – I wish to receive the Term Extension Payments (including the First Payment, Monthly Interest Payments and Final Pay-Off Amount on or before November 5, 2009) in connection
with my election to defer payment of the Early Repayment Amount.
		
	  
             

	  	No – I decline to receive the Term Extension Payments. I will instead receive formal notice following the closing of the Qualified Transaction and make an election at that time regarding
the original Early Payment Option for return (without additional payment or interest) of up to 50% of the principal amount of my Note.

  

							
	Signed:	 	  
	 		 	
				
	Name:	 	  
	 		 	
				
	Dated:	 	                    	 		 	

 The other provisions of the attached document are designed to facilitate the Philips-InnerCool
transaction and the making of corresponding Note payments. 
 Whichever election you make with respect to Term Extension Payments, we would
appreciate your timely review and consideration of the attached document – and your completion of the above-referenced election. In order to facilitate resolution and payments, we would greatly appreciate receiving your instructions and
completed paperwork no later than Thursday, July 16, 2009. 
  

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 You may transmit the completed documents to me by Fax (at 858-436-1011) or by PDF-email
(creinhard@cardiumthx.com). If you have any questions, please give me a call (858-414-1477) or contact Gregg Zeoli at Empire Asset Management (212-417-8247). Thank you again for your investment. 
  

	
	Most sincerely,
	
	 /s/    Christopher J. Reinhard

	Christopher J. Reinhard
	Chairman & Chief Executive Officer

  

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