Document:

Exhibit 10.2

 

 

Form of Subscription Agreement for US
Accredited Investors

 

  

 

NON-BROKERED
PRIVATE PLACEMENT OF UNITS

 

SUBSCRIPTION
AGREEMENT

 

INSTRUCTIONS

 

		1.	Complete and sign the Execution Page (which
                                            follows this cover page) of the Subscription Agreement.

 

		2.	Complete and sign Schedule “A”
                                            if you are a US individual accredited investor required to do so.

 

		3.	Provide payment of the purchase price in American
                                            dollars by delivering a wire transfer according to the wire instructions below, representing
                                            the full subscription price payable by the Subscriber for the Units set out on the first
                                            page of this Subscription Agreement:

 

	Information	Wire
    Payment Details 
	Intermediary/Correspondent
    Bank: (if required). For USD currency (U.S. Dollar) ONLY	 
	Settlement
                                            to TD Bank - Swift Code:

    (These digits are all alpha)
	 
	For
                                            further credit to Beneficiary Bank:

     

    Clearing Code:

     

    Transit #:

     

    Address:
	 
	Beneficiary’s
    information:	 

 

Any associated wire transfer fees are
the responsibility of the subscriber.

 

Subscribers will subscribe for a fixed
dollar amount with the number of units to be determined with reference to prevailing market prices and applicable foreign exchange rates.

 

		4.	Return a completed and originally executed
                                            copy of this Subscription Agreement and the other documents required to be delivered with
                                            it (including payment of the subscription price) by no later than 4:00 p.m. on Friday,
                                            October 28, 2022 to Fasken Martineau DuMoulin LLP, 333 Bay Street, Suite 2400,
                                            Bay Adelaide Centre, Toronto, ON M5H 2T6, Attention: .

 

    

     

    

 

EXECUTION
PAGE - SUBSCRIPTION FOR UNITS

 

TO:        Edesa
Biotech, Inc. (the “Corporation”)

 

The undersigned (the “Subscriber”)
hereby irrevocably subscribes for and agrees to purchase from Edesa Biotech, Inc. (the “Corporation”) that number
of units of the Corporation (individually, a “Unit” and collectively, the “Units”) as will be equal
to the Aggregate Subscription Price set out below divided by the Unit Price. The “Unit Price” shall be the lower of
(i) (A) 100% of the “Official Closing Price” of the Corporation’s common shares (the “Common Shares”)
on the NASDAQ Capital Market (“NASDAQ”) on the Closing Date (as defined herein) and (ii) the average of each
of the five trailing closing prices of the Common Shares set forth under NOCP on Nasdaq.com prior to the Closing Date, in each case expressed
in Canadian dollars using the Bank of Canada daily average exchange rate for United States dollars in terms of Canadian dollars on the
date prior to the Closing Date (the “Minimum Price”), provided that the Unit Price for officers, directors, employees
or consultants shall be made at a price no less than the consolidated closing bid price immediately preceding the Closing Date in accordance
with Listing Rule 5635(c) PLUS (ii) US$0.125 (expressed in Canadian dollars using the Bank of Canada daily average
exchange rate for United States dollars in terms of Canadian dollars on the date prior to the Closing Date) to account for the sale of
the Warrants (as defined below) in accordance with NASDAQ rules.

 

Each Unit comprises one Common Share, one-half
of one whole Class A Common Share purchase warrant (each such Class A Common Share purchase warrant, a “Class A
Warrant”), and one-half of one whole Class B Common Share purchase warrant (each such Class B Common Share purchase
warrant, a “Class B Warrant”, and collectively with the Class A Warrants, the “Warrants”).

 

The exercise price of the Class A Warrants
shall be 150% of the Minimum Price, and the Class A Warrants shall expire three years from their Initial Exercise Date (as defined
herein), upon which date the Class A Warrants shall be exercisable for cash unless a prospectus covering the Common Shares underlying
the Class A Warrants is unavailable, in which case the Class A Warrants may be exercised using cashless exercise provisions.

 

The exercise price of the Class B Warrants
shall be equal to the Minimum Price. The Class B Warrants shall expire twelve months from their Initial Exercise Date, upon which
date the Class A Warrants shall be exercisable for cash unless a prospectus covering the Common Shares underlying the Class B
Warrants is unavailable, in which case the Class B Warrants may be exercised using standard cashless exercise provisions.

 

The Corporation shall file a registration statement
with the SEC within 45 days of the Closing Date (as defined herein) to register the Common Shares and shares issuable upon exercise of
the Warrants, and use its best efforts to have the registration statement declared effective within 75 days of the Closing Date, or in
the case of review by the SEC, within 105 days of the Closing Date (the date that is the earlier to occur of 60 days from the Closing
Date or the date a registration statement for the Common Shares is declared effective, the “Initial Exercise Date”).

 

The Subscriber agrees to be bound by the terms
and conditions set forth in the attached “Terms and Conditions of Subscription for Units” including, without limitation,
the representations, warranties and covenants set forth in the applicable Schedules and Exhibits attached thereto (together with this
Execution Page, the “Subscription Agreement”). The Subscriber further agrees, without limitation, that the Corporation
(and its counsel) may rely upon the Subscriber’s representations, warranties and covenants contained in such documents.

 

[Execution Pages Follow]

 

    

     

    

 

	 	 	 	 	 	 	 
	 	(Name
    of Subscriber – please print)	 	 	 	 

    Aggregate Subscription Price: USD$
	 	 
	 	 	 	 	 	 
	 	(Signature of Subscriber or authorized Signatory)	 	 	 	 
	 	 	 	 	 	If
    the Subscriber is signing as agent for a principal, complete the following and ensure that the applicable Exhibit(s) are completed
    on behalf of such principal (the “Disclosed Principal”), UNLESS the Subscriber is deemed to be purchasing as a principal
    under National Instrument 45-106 - Prospectus Exemptions (“NI 45-106”) by virtue of being either (i) a trust
    company or trust corporation acting on behalf of a fully managed account managed by a trust company or trust corporation; or (ii) a
    person acting on behalf of a fully managed account managed by it, and in each case satisfying the criteria set forth in NI 45-106:	 
	 	 	 	 	 	 
	 	(Official Capacity or Title – please print)	 	 	 	 
	 	 	 	 	 	 
	 	 	 	 	 	 
	 	(Please print name of individual whose signature appears	 	 	 	 
	 	above if different than the name of the Subscriber	 	 	 	 
	 	printed above.)	 	 	 	 
	 	 	 	 	 	 
	 	(Subscriber’s Address)	 	 	 	 
	 	 	 	 	 	 
	(Subscriber’s Address)
	 
	 	(Telephone Number)	 	 	 	 	 
	 	 	 	 	 	(Name of Disclosed Principal)	 
	 	 	 	 	 	 	 
	 	(E-Mail Address)	 	 	 	(Disclosed Principal’s Address)	 
	 	 	 	 	 	 	 
	 	Subscriber’s Taxpayer ID / SIN / SSN	 	 	 	 	 
	 	 	 	 	 	 	 
	 	 	 	 	 	 	 	 

	 	 	 	 	 	 	 
	 	Register the Securities as set forth below:	 	 	 	Deliver the Securities as set forth
    below:	 
	 	 	 	 	 	 	 
	 	 	 	 	 	 ̈	Same as Registered Address (otherwise
    complete 	 
	 	(Name)	 	 	 	 	below)	 
	 	 	 	 	 	 	 
	 	(Account reference, if applicable)	 	 	 	(Name)	 
	 	 	 	 	 	 	 
	 	 	 	 	 	(Account reference, if applicable)	 
	 	(Address)	 	 	 	 	 
	 	 	 	 	 	(Contact Name)	 
	 	 	 	 	 	 	 
	 	(Address)	 	 	 	(Address)	 
	 	 	 	 	 	 	 
	 	 	 	 	 	(Address)	 
	 	 	 	 	 	 	 

 

	 	 	 	 	 	 	 	 
	 	Is the Subscriber (or the Disclosed Principal)
                           an “inider”

    of the Corporation (as defined in applicable securities

    laws, which generally
	 	 	 	 	Excluding securities subscribed for in this Agreement, the Subscriber owns, directly or indirectly, or exercises
    control or direction over:	 
	 	includes a director, an officer or a 10% shareholder)?	 	 	 	 	(a) ___________________Common Shares; and	 
	 	(yes/no):________________	 	 	 	 	(b)  securities convertible or exercisable into an	 
	 	Is the Subscriber registered or required to be registered	 	 	 	 	additional __________________Common Shares.	 
	 	under applicable securities laws?	 	 	 	 	 	 
	 	(yes/no):________________	 	 	 	 	 	 
	 	 	 	 	 	 	 	 

 

    

     

    

 

ACCEPTANCE:
The Corporation hereby accepts the subscription as set forth above on the terms and conditions contained in this Subscription Agreement.

 

_____________________, 2022

 

	EDESA BIOTECH, INC.

     
	 
	By:	 	 
	 	Name: Pardeep Nijhawan 	 
	 	Title: Chief Executive Officer	 

 

    

     

    

 

TERMS
AND CONDITIONS OF SUBSCRIPTION

 

Terms of the Offering

 

1.             Irrevocable
Subscription; Subject to Acceptance. By signing this Agreement, the Subscriber irrevocably offers to subscribe for the number of
Units equal to the aggregate Subscription Price set out on the cover page of this Agreement, divided by the Unit Price. The Corporation
may, in its absolute discretion, accept or reject the Subscriber’s subscription for Units set out in this Agreement, in whole or
in part, and the Corporation reserves the right to allot to the Subscriber less than the amount of Units subscribed for under this Agreement.
This Agreement is not enforceable against the Corporation unless (and except to the extent to which) it has been accepted by the Corporation.
The Subscriber waives any requirement of the Corporation to communicate its acceptance of the subscription (in whole or in part) to the
Subscriber. The Subscriber acknowledges (on its own behalf and, if applicable, on behalf of the Disclosed Principal) that the subscription
for the Units will be made in accordance with and subject to the terms and conditions of this Subscription Agreement.

 

2.             Return
of Funds. The funds for the aggregate subscription price will be held in trust by Fasken Martineau DuMoulin LLP (“Fasken”),
counsel to the Corporation, for the benefit of the Subscriber pending closing of the Offering. If the Offering is not completed for any
reason, or this Agreement is rejected in whole, any payment delivered on account of the subscription price for the Units will, following
receipt by Fasken of written notification from the Corporation of such rejection, be promptly returned to the Subscriber, without interest.
If this Agreement is accepted only in part, payment in the amount of any excess payment delivered by the Subscriber to Fasken on account
of the subscription price for the Units will, following receipt by Fasken of written notification from the Corporation of such partial
acceptance, be promptly delivered to the Subscriber, without interest. No fractions of any Securities (as defined herein) will be issued
for any subscription. Any funds in excess of the aggregate Subscription Price for the actual number of Units issued shall be promptly
delivered to the Subscriber after Closing. Any return of funds by Fasken hereunder shall be made by the issuance of a cheque sent by
regular mail to the Subscriber.

 

3.             The
Offering. The Subscriber acknowledges (on its own behalf and, if applicable, on behalf of the Disclosed Principal) that the Units
subscribed for hereunder form part of a larger offering of Units by the Corporation for aggregate gross proceeds of up to approximately
CDN$5 million (the “Offering”). The Units and the Common Shares and Warrants composing the Units as the context requires
are also referred to herein as the “Securities”.

 

4.             Description
of the Warrants.

 

The exercise price of the
Class A Warrants shall be 150% of the Minimum Price, and the Class A Warrants shall expire three years from their Initial
Exercise Date, upon which date the Class A Warrants shall be exercisable for cash unless a prospectus covering the Common Shares
underlying the Class A Warrants is unavailable, in which case the Class A Warrants may be exercised using cashless exercise
provisions.

 

The exercise price of the
Class B Warrants shall be equal to the Minimum Price. The Class B Warrants shall expire twelve months from their Initial
Exercise Date, upon which date the Class A Warrants shall be exercisable for cash unless a prospectus covering the Common Shares
underlying the Class B Warrants is unavailable, in which case the Class B Warrants may be exercised using standard cashless
exercise provisions.

 

The Warrants will be created
and issued pursuant to definitive physical warrant certificates. Additional specific attributes of the Warrants shall be set forth in
the certificates representing the Warrants, including, among other things, provisions for the appropriate adjustment in number and price
of the Warrants upon the occurrence of certain events, including any subdivision, consolidation or reclassification of the Units.

 

No fractional Warrants will
be issued in any circumstance. Any entitlement to a fraction of a Warrant in connection with the purchase of Units shall be rounded down
to the nearest whole Warrant.

 

5.             Registration
Rights. The Corporation will file a registration statement with the United States Securities and Exchange Commission (the “SEC”)
on Form S-3 or other appropriate form if necessary to comply with General Instruction I.B.6. of Form S-3 and Commission interpretations
thereof) within 45 days of the Closing Date to register the Common Shares issuable upon exercise of the Warrants and shall use its best
efforts to have the registration statement declared effective within 75 days of the Closing Date, or in the case of review by the SEC,
within 105 days of the Closing Date, and to keep such registration statement effective at all times until no Subscriber owns any Warrants
or Common Shares issuable upon exercise thereof.

 

    

     

    

 

6.             Deliveries
by Subscriber. In connection with the purchase of the Securities, the Subscriber agrees to return the following to the Corporation’s
legal counsel, Fasken Martineau DuMoulin LLP (“Fasken”), in accordance with the instructions on the cover page to
this Agreement:

 

		(a)	this Agreement, completed and signed,
                                            including, if the Subscriber is subscribing under the “accredited investor” exemption
                                            from the prospectus requirements of applicable securities laws, a completed and signed Accredited
                                            Investor Questionnaire attached as Schedule A;

 

		(b)	a wire transfer for the aggregate subscription
                                            price for the Securities, denominated in American dollars, payable to Fasken Martineau DuMoulin
                                            LLP, in trust, with wire transfer being payable as follows:

 

	Information	Wire
    Payment Details 
	Intermediary/Correspondent
    Bank: (if required). For USD currency (U.S. Dollar) ONLY	 
	Settlement
                                            to TD Bank - Swift Code:

    (These digits are all alpha)
	 
	For
                                            further credit to Beneficiary Bank:

     

    Clearing Code:

     

    Transit #:

     

    Address:
	 
	Beneficiary’s
    information:	 

 

		(c)	any further documentation required under
                                            securities laws or by NASDAQ or other regulatory authority, or otherwise contemplated by
                                            this Agreement;

 

7.             Compliance
with Laws. The Subscriber (or the Disclosed Principal) agree to comply with applicable securities laws and the policies of NASDAQ
concerning the purchase of, the holding of, and the resale restrictions applicable to, the Securities.

 

8.             Expenses.
All costs incurred by the Subscriber (including any fees and disbursements of any legal counsel or other advisors retained by the
Subscriber) relating to the subscription for Units will be borne by the Subscriber.

 

9.             Conditions
of Closing.

 

The obligation of the Corporation
to complete the sale of the Securities is subject to the fulfillment of the following conditions at or before the Closing Time:

 

		(a)	the Subscriber will have delivered the
                                            items set out in Section 6;

 

		(b)	the representations and warranties made
                                            by the Subscriber in this Agreement will have been true and correct when made and at the
                                            Closing Time with the same force and effect as if they had been made as of the Closing Time;

 

		(c)	all covenants contained in this Agreement
                                            to be performed by the Subscriber at or before the Closing Time will have been performed
                                            in all material respects;

 

		(d)	the Corporation will have received approval
                                            of the Offering from NASDAQ;

 

		(e)	all other necessary regulatory approvals
                                            will have been obtained; and

 

		(f)	the sale of the Units to the Subscribers
                                            will be exempt from prospectus requirements under applicable Canadian provincial and harmonized
                                            securities laws.

 

    

     

    

 

Closing

 

10.            Closing.
The closing of the sale of the Securities (the “Closing”) will take place at Fasken’s offices in Toronto,
Bay Adelaide Centre West, 333 Bay Street, Toronto, Ontario, M5H 2T6 at 10:00 a.m. (Eastern time), or such other time as the Corporation
may determine (the “Closing Time”) on November 1, 2022, or such other earlier or later date as the Corporation
may determine (the “Closing Date”). If, at the Closing, the terms and conditions contained in this Agreement have
been complied with to the satisfaction of the Corporation, the Corporation shall notify Fasken in writing of such and (a) Fasken
will deliver to the Corporation (i) all completed subscription agreements, including this Agreement, and (ii) the aggregate
subscription price for the Units (net of commissions and expenses) and (b) the Corporation will deliver certificates or other evidence
representing the Common Shares and Warrants composing the Units registered in accordance with the Subscriber’s instructions to
the Subscriber in accordance with the delivery instructions provided by the Subscriber.

 

11.            Failure
to Close. If the Closing does not occur on or prior to November 30, 2022, Fasken shall promptly return this Agreement and any
funds, certified cheques and bank drafts delivered by the Subscriber representing the aggregate consideration for the Securities without
interest, to the Subscriber.

 

12.            Representations,
Warranties and Covenants of the Subscriber.  The Subscriber (on its own behalf and, if applicable, on behalf of a Disclosed Principal)
represents, warrants, acknowledges and covenants to the Corporation and its counsel (and acknowledges that they are relying thereon)
both at the date hereof and at the Closing Time (as herein defined) that:

 

		(a)	it recognizes that the purchase of the
                                            Securities involves a high degree of risk including, but not limited to, the following: (i) the
                                            Corporation has a limited operating history and requires substantial funds in addition to
                                            the proceeds of the Offering; (ii) an investment in the Corporation is highly speculative
                                            and only investors who can afford the loss of their entire investment should consider investing
                                            in the Corporation and the Securities; (iii) the Subscriber may not be able to liquidate
                                            his, her or its investment; (iv) there are restrictions on the ability of the Subscriber
                                            to sell the Securities; (v) in the event of a disposition, the Subscriber could sustain
                                            the loss of its entire investment; and (vi) the Corporation has not paid any dividends
                                            since its inception and does not anticipate paying any dividends in the near future;

 

		(b)	it acknowledges and represents that it:
                                            (i) has adequate means of providing for its current financial needs and contingencies,
                                            (ii) has knowledge and experience in business and financial matters and prior investment
                                            experience, including investments in securities without the benefit of a prospectus; (iii) recognizes
                                            the speculative nature of an investment in the Securities; (iv) is able to bear the
                                            economic risk that it hereby assumes; and (v) could afford a complete loss of such
                                            investment in the Securities;

 

		(c)	the Subscriber is aware that there are
                                            restrictions on the Subscriber’s ability to resell the Securities and it is the Subscriber’s
                                            responsibility to consult the Subscriber’s own advisors to find out what those restrictions
                                            are and to comply with them before selling the Securities, and confirms that no representation
                                            has been made to it by or on behalf of the Corporation with respect thereto; acknowledges
                                            that it is aware of the characteristics of the Securities, the risks relating to an investment
                                            therein and of the fact that it may not be able to resell the Securities, except in accordance
                                            with limited exemptions under applicable securities legislation until expiry of the applicable
                                            restricted period and compliance with the other requirements of applicable law;

 

		(d)	the Subscriber is aware that any certificates
                                            representing the Securities will bear legends (or an ownership statement issued under a book-entry
                                            system will bear legend restriction notations) in substantially the following forms:

 

“UNLESS PERMITTED UNDER SECURITIES
LEGISLATION, THE HOLDER OF THIS SECURITY MUST NOT TRADE THE SECURITY BEFORE [THE DATE THAT IS 4 MONTHS AND ONE DAY AFTER THE CLOSING
DATE WILL BE INSERTED.]”

 

“THIS SECURITY HAS NOT BEEN
REGISTERED WITH THE SECURITIES AND EXCHANGE COMMISSION OR THE SECURITIES COMMISSION OF ANY STATE IN RELIANCE UPON AN EXEMPTION FROM REGISTRATION
UNDER THE SECURITIES ACT OF 1933, AS AMENDED (THE “SECURITIES ACT”), AND, ACCORDINGLY, MAY NOT BE OFFERED OR SOLD EXCEPT
PURSUANT TO AN EFFECTIVE REGISTRATION STATEMENT UNDER THE SECURITIES ACT OR PURSUANT TO AN AVAILABLE EXEMPTION FROM, OR IN A TRANSACTION
NOT SUBJECT TO, THE REGISTRATION REQUIREMENTS OF THE SECURITIES ACT AND IN ACCORDANCE WITH APPLICABLE STATE SECURITIES LAWS. THIS SECURITY
MAY BE PLEDGED IN CONNECTION WITH A BONA FIDE MARGIN ACCOUNT OR OTHER LOAN SECURED BY SUCH SECURITIES.”

 

    

     

    

 

		(e)	it hereby represents that it has been
                                            furnished by the Corporation during the course of the Offering with all information regarding
                                            the Corporation, the terms and conditions of the Offering and any additional information
                                            that it has requested or desired to know, and has been afforded the opportunity to ask questions
                                            of and receive answers from duly authorized officers or other representatives of the Corporation
                                            concerning the Corporation and the terms and conditions of the Offering;

 

		(f)	it
                                            has not received or been provided with, nor has it requested, nor does it have any need to
                                            receive, any offering memorandum, any prospectus, sales or advertising literature, or any
                                            other document describing the business and affairs of the Corporation which has been prepared
                                            for delivery to, and review by, a prospective purchaser in order to assist it in making an
                                            investment decision in respect of the Securities and the Subscriber’s decision to subscribe
                                            for the Securities was not based upon, and the Subscriber has not relied upon, any oral or
                                            written representations as to facts made by or on behalf of the Corporation, except as set
                                            forth herein and in the Corporation’s current public disclosure record available on
                                            the system for electronic document analysis and retrieval at www.sedar.com
                                            and www.SEC.gov. To the extent necessary, the Subscriber has retained, at its own
                                            expense, and relied upon appropriate professional advice regarding the investment, tax and
                                            legal merits and consequences of this Subscription Agreement and the purchase of the Securities
                                            hereunder. The Subscriber disclaims reliance on any statements made or information provided
                                            by any person or entity in the course of the Subscriber’s consideration of an investment
                                            in the Securities and the results of Subscriber’s own independent investigation;

 

		(g)	it has not become aware of any advertisement
                                            in printed media of general and regular paid circulation (or other printed public media),
                                            radio, television or other means of telecommunications or other form of advertisement (including
                                            electronic display such as the Internet) with respect to the distribution of the Securities;

 

		(h)	the Subscriber has no knowledge of a “material
                                            fact” or “material change” with respect to the Corporation (as those terms
                                            are defined in applicable securities laws, and which generally includes a fact or change
                                            which would reasonably be expected to have a significant effect on the market price of the
                                            Common Shares) that has not been generally disclosed to the public;

 

		(i)	unless disclosed to the Corporation, the
                                            Subscriber is not a “control person” of the Corporation (within the meaning of
                                            applicable securities laws, and which generally includes a person holding or controlling
                                            (alone or in concert with other persons) more than 20% of the Common Shares), and unless
                                            disclosed to the Corporation, the purchase of securities under the Offering will not result
                                            in the Subscriber becoming a “control person” (and, if the Subscriber is purchasing
                                            on behalf of a Disclosed Principal, the purchase of securities under the Offering will not
                                            result in the Disclosed Principal becoming a “control person”);

 

		(j)	it is purchasing the Securities as principal
                                            for its own account, not for the benefit of any other person, for investment only and not
                                            with a view to the resale or distribution of all or any of the Securities, it is resident
                                            in the jurisdiction set out as the “Subscriber’s Address” on the face page hereof
                                            and that address is not being used solely for the purpose of acquiring the Securities, and
                                            if the Subscriber is acting for a Disclosed Principal, such Disclosed Principal is purchasing
                                            as principal for its own account, not for the benefit of any other person, for investment
                                            only and not with a view to resale or distribution, and is resident in the jurisdiction set
                                            forth in the Subscription Agreement as the “Disclosed Principal’s Address”
                                            of the Disclosed Principal and that address is not being used solely for the purpose of acquiring
                                            the Securities, and either:

 

		(i)	the Subscriber is an Accredited Investor
                                            and has concurrently executed and delivered an Accredited Investor Questionnaire in the form
                                            attached as Schedule A to this Subscription Agreement; or

 

		(ii)	the Subscriber (or any Disclosed Principal)
                                            is purchasing pursuant to an exemption from prospectus and registration requirements (particulars
                                            of which have been enclosed herewith by the Subscriber) available to the Subscriber under
                                            applicable securities legislation of the jurisdiction of the Subscriber’s residence
                                            and shall deliver to the Corporation such further particulars of the exemption(s) and
                                            the Subscriber’s qualifications thereunder as the Corporation or its counsel may request;

 

    

     

    

 

		(k)	the Subscriber is aware that the Corporation
                                            is relying on exemptions from the requirements under Canadian securities laws to provide
                                            the Subscriber with a prospectus, and no prospectus has been filed by the Corporation with
                                            any stock exchange or regulatory authority in Canada in connection with the issuance of the
                                            Securities, and as a consequence:

 

		(i)	the Subscriber is restricted from using
                                            some of the civil remedies otherwise available under Canadian securities laws and certain
                                            protections, rights and remedies provided by securities laws, including statutory rights
                                            of rescission or damages, will not be available to the Subscriber; and

 

		(ii)	the Subscriber may not receive information
                                            that would otherwise be required to be provided to the Subscriber under Canadian securities
                                            laws;

 

		(l)	if the Subscriber is resident in or otherwise
                                            subject to applicable securities laws of a jurisdiction other than Canada, the Subscriber
                                            confirms, represents and warrants that:

 

		(i)	the Subscriber is knowledgeable with respect
                                            to, or has been independently advised as to, the applicable securities laws of the jurisdiction
                                            in which the Subscriber is resident (the “International Jurisdiction”)
                                            and which would apply to the acquisition of the Securities;

 

		(ii)	the Subscriber is purchasing the Securities
                                            pursuant to exemptions from prospectus or registration requirements or equivalent requirements
                                            under applicable securities laws or, if such is not applicable, the Subscriber is permitted
                                            to purchase the Securities under the applicable securities laws of the International Jurisdiction
                                            without the need to rely on any exemptions;

 

		(iii)	the applicable securities laws of the
                                            International Jurisdiction do not require the Corporation to make any filings or seek any
                                            approvals of any kind whatsoever from any securities regulator of any kind whatsoever in
                                            the International Jurisdiction in connection with the issue and sale or resale of the Securities;

 

		(iv)	the purchase of the Securities by the Subscriber
                                            does not trigger:

 

		(A)	any obligation to prepare and file a prospectus
                                            or similar document, or any other report with respect to such purchase in the International
                                            Jurisdiction; or

 

		(B)	any continuous disclosure reporting obligation
                                            of the Corporation in the International Jurisdiction; and

 

		(v)	the Subscriber will, if requested by the
                                            Corporation, deliver to the Corporation a certificate or opinion of local counsel from the
                                            International Jurisdiction which will confirm the matters referred to in subsections (ii),
                                            (iii) and (iv) above to the satisfaction of the Corporation acting reasonably;

 

		(m)	it acknowledges that:

 

		(i)	no stock exchange, securities commission
                                            or similar regulatory authority has reviewed or passed on the merits of the Securities;

 

		(ii)	there is no government or other insurance
                                            covering the Securities; and

 

		(iii)	there are risks associated with the purchase
                                            of the Securities;

 

		(n)	the Subscriber understands that the Securities
                                            are “restricted securities” in the United States and have not been registered
                                            under the Securities Act of 1933 (the “U.S. Securities Act”) or
                                            any applicable state securities law and is acquiring such Securities as principal for his,
                                            her or its own account and not with a view to or for distributing or reselling such Securities
                                            or any part thereof in violation of the U.S. Securities Act or any applicable state securities
                                            law, has no present intention of distributing any of such Securities in violation of the
                                            Securities Act or any applicable state securities law and has no direct or indirect arrangement
                                            or understandings with any other persons to distribute or regarding the distribution of such
                                            Securities in violation of the U.S. Securities Act or any applicable state securities law
                                            (this representation and warranty not limiting such Subscriber’s right to sell any
                                            Securities registered pursuant to a registration statement or otherwise in compliance with
                                            applicable federal and state securities laws);

 

    

     

    

 

		(o)	it understands that the Warrants will
                                            not be registered under the securities laws of the United States, and unless a registration
                                            statement is filed with the SEC registering the Class A Warrant Shares and Class B
                                            Warrant Shares and such registration statement is made effective, the Class A Warrant
                                            Shares and Class B Warrant Shares may not be offered or sold, directly or indirectly,
                                            in the United States except pursuant to registration under the U.S. Securities Act and the
                                            securities laws of all applicable states or available exemptions therefrom;

 

		(p)	it undertakes and agrees that it will
                                            not offer or sell Securities in the United States unless such securities are registered under
                                            the U.S. Securities Act and the securities laws of all applicable states of the United States
                                            or an exemption from such registration requirements is available, and further that it will
                                            not resell the Securities, except in accordance with the provisions of applicable securities
                                            legislation, regulations, rules, policies and orders and stock exchange rules, and the Subscriber
                                            is solely responsible for compliance with such legislation, rules, and regulations;

 

		(q)	if the Subscriber is a corporation, partnership,
                                            unincorporated association or other entity, it has the legal capacity and competence to enter
                                            into and be bound by this Subscription Agreement and to perform all of its obligations hereunder,
                                            and if it is a body corporate, it is duly incorporated or created and validly subsisting
                                            under the laws of the jurisdiction of its incorporation, and further certifies that all necessary
                                            approvals of directors, shareholders or otherwise have been given and obtained;

 

		(r)	the performance and compliance with the
                                            terms hereof, the subscription for the Units and the completion of the transactions described
                                            herein by the Subscriber will not result in any material breach of, or be in conflict with,
                                            or constitute a material default under, or create a state of facts that, after notice or
                                            lapse of time, or both, would constitute a material default under any term or provision of
                                            the constating documents, by-laws or resolutions of the Subscriber (if the Subscriber is
                                            not an individual), applicable securities laws or any other laws applicable to the Subscriber,
                                            any agreement to which the Subscriber is a party, or any judgment, decree, order, statute,
                                            rule or regulation applicable to the Subscriber;

 

		(s)	if the Subscriber is an individual, it
                                            is of the full age of majority and is legally competent to execute this Subscription Agreement
                                            and take all action pursuant hereto;

 

		(t)	this Subscription Agreement and any other
                                            documents contemplated hereby, have been duly and validly authorized, executed and delivered
                                            by and constitute a legal, valid, binding and enforceable obligation of the Subscriber in
                                            accordance with its terms;

 

		(u)	in the case of a subscription by it for
                                            Securities acting as agent for a Disclosed Principal, it is duly authorized to execute and
                                            deliver this Subscription Agreement and all other necessary documentation in connection with
                                            such subscription on behalf of such Disclosed Principal and this Subscription Agreement has
                                            been duly authorized, executed and delivered by or on behalf of, and constitutes a legal,
                                            valid and binding agreement of, such Disclosed Principal and the Subscriber acknowledges
                                            that the Corporation is required by law to disclose to certain principal regulatory authorities
                                            the identity of the Disclosed Principal for whom the Subscriber may be acting;

 

		(v)	the Subscriber will execute, deliver,
                                            file and otherwise assist the Corporation in filing, such reports, undertakings and other
                                            documents with respect to the issue of the Securities as may be required by any securities
                                            commission, stock exchange or other regulatory authority;

 

		(w)	the entering into of this Subscription
                                            Agreement and the transactions contemplated hereby, will not result in a violation of any
                                            of the terms or provisions of any law applicable to the Subscriber, or if the Subscriber
                                            is not a natural person, any of the Subscriber’s constating documents, or any agreement
                                            to which the Subscriber is a party or by which it is bound;

 

		(x)	none of the funds the Subscriber is using
                                            to purchase the Securities represent proceeds of crime for the purposes of the Proceeds
                                            of Crime (Money Laundering) and Terrorist Financing Act (Canada) (the “PCMLTFA”)
                                            or the United States Uniting and Strengthening America by Providing Appropriate Tools
                                            Required to Intercept and Obstruct Terrorism Act (the “Patriot Act”)
                                            and the Subscriber acknowledges that the Corporation may in the future be required by law
                                            to disclose the Subscriber’s (and if applicable, the Disclosed Principal’s) name
                                            and other information relating to this Subscription Agreement and the Subscriber’s
                                            (and if applicable, the Disclosed Principal’s) subscription hereunder, on a confidential
                                            basis, pursuant to the PCMLTFA or the Patriot Act. To the best of its knowledge:
                                            (a) none of the subscription funds to be provided by the Subscriber: (i) have
                                            been or will be derived from or related to any activity that is deemed criminal under the
                                            law of Canada, the United States or any other jurisdiction; or (ii) are being tendered
                                            on behalf of a person or entity who has not been identified to the Subscriber, and (b) it
                                            shall promptly notify the Corporation if the Subscriber discovers that any of such representations
                                            ceases to be true, and to provide the Corporation with appropriate information in connection
                                            therewith;

 

    

     

    

 

		(y)	the Subscriber acknowledges that the Corporation’s
                                            counsel is acting as counsel to the Corporation and not as counsel to the Subscriber, and
                                            acknowledges that it is solely responsible for and has been encouraged to and should obtain
                                            independent legal, income tax and investment advice with respect to its subscription for
                                            Securities and accordingly, has been independently advised as to the meanings of all terms
                                            contained herein relevant to the Subscriber for purposes of giving representations, warranties
                                            and covenants under this Subscription Agreement;

 

		(z)	no person (including the Corporation)
                                            has made to the Subscriber any written or oral representations:

 

		(i)	that any person will resell or repurchase
                                            any of the Securities;

 

		(ii)	that any person will refund the purchase
                                            price for the Securities; or

 

		(iii)	as to the future price or value of any
                                            of the Securities;

 

		(aa)	in
                                            making its decision to enter into this Agreement for the purchase of the Securities, the
                                            Subscriber has relied solely on the Corporation’s current public disclosure record
                                            available on the system for electronic document analysis and retrieval at www.sedar.com
                                            and www.SEC.gov;

 

		(bb)	the Subscriber’s offer to subscribe
                                            for Securities has not been induced by any representations with regard to the present or
                                            future value of the Securities;

 

		(cc)	the Subscriber is aware that: the Corporation
                                            may complete additional financings in the future to develop the proposed business of the
                                            Corporation and to fund its ongoing development; that there is no assurance that any financings
                                            will be available or, if available, that the financings will be available on reasonable terms;
                                            any future financings may have a dilutive effect on current securityholders, including the
                                            Subscriber (or a Disclosed Principal); and, if future financings are not available, the Corporation
                                            may be unable to fund its ongoing development and the lack of capital resources may result
                                            in the failure of its business venture;

 

		(dd)	there is no person acting or purporting
                                            to act in connection with the Offering who is entitled to any brokerage or finder’s
                                            fee and if any person establishes a claim that any fee or other compensation is payable in
                                            connection with this subscription for Units, the Subscriber covenants to indemnify and hold
                                            harmless the Corporation with respect thereto and with respect to all costs reasonably incurred
                                            in the defence thereof;

 

		(ee)	the Subscriber is not purchasing Units
                                            with knowledge of material information concerning the Corporation that has not been generally
                                            disclosed;

 

		(ff)	the Subscriber does not act jointly or
                                            in concert with any other person for the purposes of the acquisition of the Securities; and

 

		(gg)	if the Subscriber, or any person for
                                            whom it is contracting hereunder, is a corporation or a partnership, syndicate, trust, association,
                                            or any other form of unincorporated organization or organized group of persons, the Subscriber
                                            or such person was not created and is not being used solely to permit purchases of or to
                                            hold securities without a prospectus in reliance on a prospectus and registration exemption
                                            (including but not limited to the “Minimum Investment Amount” exemption provided
                                            under section 2.10 of NI 45-106 or as an accredited investor as described in paragraph (m) of
                                            the definition of “accredited investor” in section 1.1 of NI 45-106) and it pre-existed
                                            the Offering and has a bona fide purpose other than investment in the Securities.

 

    

     

    

 

General

 

13.           Accuracy
of Representations and Warranties. The Subscriber agrees that the representations, warranties and covenants of the Subscriber herein
will be true and correct both as of the execution of this Subscription Agreement and as of the Closing Time and will survive the completion
of the issuance of the Securities. The representations, warranties and covenants of the Subscriber herein are made with the intent that
they be relied upon by the Corporation in determining the eligibility of a purchaser of Securities and the Subscriber agrees to indemnify
the Corporation and its directors, officers, partners, employees and agents against all losses, claims, costs, expenses and damages or
liabilities which any of them may suffer or incur which are caused or arise from a breach thereof. The Subscriber undertakes to immediately
notify the Corporation at its head office, to the attention of the Chief Financial Officer, of any change in any statement or other information
relating to the Subscriber set forth herein which takes place prior to the Closing Time.

 

14.           Responsibility
for Costs. The Subscriber acknowledges and agrees that all costs incurred by the Subscriber (including any fees and disbursements
of any special counsel retained by the Subscriber) relating to the sale of the Securities to the Subscriber shall be borne by the Subscriber.

 

15.           Collection
of Personal Information. This Subscription Agreement requires the Subscriber to provide certain personal information to the Corporation.
Such information is being collected by the Corporation for the purposes of completing the Offering, which includes, without limitation,
determining the Subscriber’s eligibility to purchase the Securities under applicable securities legislation, preparing and registering
certificates (or other evidence of subscription) representing the Common Shares and Warrants to be issued to the Subscriber and completing
filings required by taxation authorities and any stock exchange or securities regulatory authority. Securities regulatory authorities
in each of the provinces of Canada have been granted the authority to indirectly collect this personal information pursuant to securities
legislation and this personal information is also being collected for the purpose of administration and enforcement of securities legislation.
The Subscriber hereby acknowledges and consents to the collection, use, and disclosure of certain personal information by securities
regulatory authorities in Canada. If the Subscriber is resident in or otherwise subject to the securities laws applicable in another
province of Canada, the information provided by the Subscriber on the first page of this Subscription Agreement identifying the
name, address and telephone number of the Subscriber, the Securities being purchased hereunder and the subscription price, as well as
the Closing Date and the exemption that the Subscriber is relying on in purchasing the Securities will be disclosed to the applicable
securities regulatory authority, and such information is being indirectly collected by such securities regulatory authority under the
authority granted to it under securities legislation. This information is being collected for the purposes of the administration and
enforcement of the securities legislation of the applicable province. Each Subscriber (and for certainty, including each Disclosed Principal)
hereby authorizes the indirect collection of such information by the applicable securities regulatory authority. In the event the Subscriber
has any questions with respect to the indirect collection of such information by securities regulatory authorities, the Subscriber should
contact the applicable securities regulatory authority at the addresses set out at Schedule B hereto. The Subscriber’s (and if
applicable, each Disclosed Principal’s) personal information may be disclosed by the Corporation to: (a) regulatory authorities
(including stock exchanges, if applicable); (b) the Corporation’s registrar and transfer agent; (c) taxation authorities;
and (d) any of the other parties involved in the Offering, including legal counsel. By executing this Agreement, the Subscriber
(and if applicable, any other Disclosed Principal) is deemed to be consenting to the foregoing collection (including the indirect collection
of personal information), use and disclosure of the Subscriber’s personal information. The Subscriber (and if applicable, the Disclosed
Principal) also consents to the filing of copies or originals of any of the Subscriber’s documents described in this Subscription
Agreement as may be required to be filed with any stock exchange or securities regulatory authority in connection with the transactions
contemplated hereby.

 

16.           Governing
Law. The contract arising out of this Subscription Agreement and all documents relating thereto shall be governed by and construed
in accordance with the laws of the Province of Ontario and the federal laws of Canada applicable therein. The parties irrevocably attorn
to the exclusive jurisdiction of the courts of the Province of Ontario.

 

17.           Time
of the Essence. Time shall be of the essence hereof.

 

18.           Entire
Agreement. This Subscription Agreement represents the entire agreement of the parties hereto relating to the subject matter hereof
and there are no representations, covenants or other agreements relating to the subject matter hereof except as stated or referred to
herein.

 

19.           Assignment.
The terms and provisions of this Subscription Agreement shall be binding upon and enure to the benefit of the Subscriber and the
Corporation and their respective heirs, executors, administrators, successors and assigns; provided that, except for the assignment by
a Subscriber who is acting as nominee or agent for the beneficial owner and as otherwise herein provided, this Subscription Agreement
shall not be assignable by the Subscriber without prior written consent of the other parties.

 

    

     

    

 

20.           Modification.
Neither this Subscription Agreement nor any provision hereof shall be modified, changed, discharged or terminated except by an instrument
in writing signed by the party against whom any waiver, change, discharge or termination is sought.

 

21.           Severability.
The invalidity, illegality or unenforceability of any provision of this Subscription Agreement shall not affect the validity, legality
or enforceability of any other provision hereof.

 

22.           Agreement
For Consideration. The Subscriber, on its own behalf and, if applicable, on behalf of the Disclosed Principal, agrees that this subscription
is made for valuable consideration and may not be withdrawn, cancelled, terminated or revoked by the Subscriber, on its own behalf and,
if applicable, on behalf of the Disclosed Principal.

 

23.           Currency.
In this Subscription Agreement, references to “$” or “USD$” are to American dollars.

 

*****

 

    

     

    

 

SCHEDULE
 “A”

 

ACCREDITED INVESTOR QUESTIONNAIRE

 

The undersigned understands
that the purpose of this Questionnaire is to permit Edesa Biotech, Inc. (“Edesa” or the “Company”)
to determine whether the undersigned is an “accredited investor” as such term is defined in Rule 501(a) promulgated
under the Securities Act of 1933, as amended (the “Securities Act”). The undersigned represents to Edesa that (i) the
information contained herein is complete and accurate and may be relied upon by Edesa, and (ii) the undersigned will notify Edesa
immediately of any change in any of such information.

 

All information furnished is
for the sole use of Edesa and its counsel and will be held in confidence by Edesa and its counsel, except that this Questionnaire may
be furnished to such parties as Edesa deems desirable to establish compliance with federal or state securities laws.

 

A. For Individuals:

 

The undersigned individual is an “accredited
investor” for one or more of the following reasons (check all that apply):

 

		 ̈	The
                                            undersigned is an individual (not a partnership, corporation, etc.) whose individual
                                            net worth, or joint net worth with his or her spousal equivalent (a cohabitant occupying
                                            a relationship generally equivalent to that of a spouse), presently exceeds $1,000,000. For
                                            purposes of the foregoing, “net worth” means the excess of total assets at fair
                                            market value (including personal and real property, but excluding the estimated fair market
                                            value of a person's primary home) over total liabilities. Total liabilities excludes any
                                            mortgage on the primary home in an amount of up to the home's estimated fair market value
                                            as long as the mortgage was incurred more than 60 days before the securities being offered
                                            (the “Securities”) are purchased, but includes (i) any mortgage
                                            amount in excess of the home's fair market value and (ii) any mortgage amount that
                                            was borrowed during the 60-day period before the closing date for the sale of Securities
                                            for the purpose of investing in the Securities. “Joint net worth” can be the
                                            aggregate net worth of a person and spouse or spousal equivalent; assets do not need to be
                                            held jointly to be included in the calculation.

 

		 ̈	The
                                            undersigned is an individual (not a partnership, corporation, etc.) who had (i) an
                                            individual income in excess of $200,000 or (ii) joint income together with his or her
                                            spousal equivalent (a cohabitant occupying a relationship generally equivalent to that of
                                            a spouse) in excess of $300,000, in each of the two most recent years and reasonably expect
                                            to reach the same income level in the current year. For purposes of the foregoing, “income”
                                            is not limited to “adjusted gross income” as that term is defined for federal
                                            income tax purposes, but rather includes certain items of income which are deducted in computing
                                            “adjusted gross income”. For investors who are salaried employees, the gross
                                            salary of such investor, minus any significant expenses personally incurred by such investor
                                            in connection with earning the salary, plus any income from any other source including unearned
                                            income, is a fair measure of “income” for purposes of this question. For investors
                                            who are self-employed, “income” is generally construed to mean total revenues
                                            received during the calendar year minus significant expenses incurred in connection with
                                            earning such revenues.

 

    

     

    

 

		 ̈	The
                                            undersigned is a director, executive officer, or general partner of the Company, or any director,
                                            executive officer, or general partner of a general partner of the Company.

 

		 ̈	The
                                            undersigned holds in good standing one or more of the following certifications, designations
                                            and/or credentials:

 

 ̈General
Securities Representative license (Series 7)

 

 ̈Private
Securities Offerings Representative license (Series 82)

 

 ̈Investment
Adviser Representative license (Series 65)

 

		 ̈	The undersigned is a “knowledgeable
employee” as defined in Rule 3c-5(a)(4) under the Investment Company Act as amended (the “Investment Company
Act”) with respect to the Company.

 

		 ̈	The
                                            undersigned individual is not an “accredited investor” because none of the above
                                            apply.

 

B. For Entities:

 

The undersigned is an “accredited
investor” because the undersigned falls within at least one of the following categories (check all that apply):

 

		 ̈	A
                                            bank as defined in Section 3(a)(2) of the Securities Act or a savings and loan
                                            association or other institution as defined in Section 3(a)(5)(A) of the Securities
                                            Act whether acting in its individual or fiduciary capacity.

 

		 ̈	A
                                            broker-dealer registered pursuant to Section 15 of the Securities Exchange Act of 1934,
                                            as amended.

 

		 ̈	An insurance company as defined
in Section 2(a)(13) of the Securities Act.

 

		 ̈	An
                                            investment company registered under the Investment Company Act or a business development
                                            company as defined in Section 2(a)(48) of the Investment Company Act.

 

		 ̈	A
                                            Small Business Investment Company licensed by the U.S. Small Business Administration under
                                            Section 301(c) or (d) of the Small Business Investment Act of 1958.

 

		 ̈	A
                                            plan established and maintained by a state, its political subdivisions, or any agency or
                                            instrumentality of a state or its political subdivisions, for the benefit of its employees,
                                            where such plan has total assets in excess of $5,000,000.

 

		 ̈	An
                                            employee benefit plan within the meaning of Title I of the Employee Retirement Income Security
                                            Act of 1974, as amended (the “Employee Act”), where the investment decision
                                            is made by a plan fiduciary, as defined in Section 3(21) of the Employee Act, which
                                            is either a bank, savings and loan association, insurance company, or registered investment
                                            adviser, or an employee benefit plan that has total assets in excess of $5,000,000 or a self-directed
                                            plan the investment decisions of which are made solely by persons that are accredited investors.

 

    

     

    

 

		 ̈	A
                                            private business development company, as defined in Section 202(a)(22) of the Investment
                                            Advisers Act of 1940 as amended (the “Advisers Act”).

 

		 ̈	An
                                            organization described in Section 501(c)(3) of the Internal Revenue Code, a corporation,
                                            a Massachusetts or similar business trust, a partnership, or a limited liability company,
                                            not formed for the specific purpose of acquiring the Securities, with total assets in excess
                                            of $5,000,000.

 

		 ̈	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 “sophisticated” 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.

 

		 ̈	An
                                            entity, of a type not listed above, not formed for the specific purpose of acquiring the
                                            Securities, owning “investments”, as defined in Rule 2a51-1(b) under
                                            the Investment Company Act, in excess of $5,000,000.

 

		 ̈	A
                                            “family office" (as defined in Rule 202(a)(11)(G)-1 under the Advisers Act),
                                            (i) with assets under management in excess of $5,000,000, (ii) that is not formed
                                            for the specific purpose of acquiring the Securities, and (iii) whose prospective investment
                                            is directed by a person who has such knowledge and experience in financial and business matters
                                            that such family office is capable of evaluating the merits and risks of the prospective
                                            investment (a “Family Office”).

 

		 ̈	A
                                            “family client” (as defined in Rule 202(a)(11)(G)-1 under the Advisers
                                            Act) of a Family Office whose prospective investment in the Company is directed by such Family
                                            Office pursuant to the above.

 

		 ̈	An
                                            investment adviser registered pursuant to Section 203 of the Advisers Act or registered
                                            pursuant to the laws of a state.

 

		 ̈	An
                                            investment adviser relying on the exemption from registering with the Securities and Exchange
                                            Commission under Section 203(l) or (m) of the Advisers Act.

 

		 ̈	A
                                            “Rural Business Investment Company” as defined in Section 384A of the Farm
                                            and Rural Development Act.

 

		 ̈	The
                                            undersigned is an entity all the equity owners of which, whether directory or indirectly,
                                            are “accredited investors” within one or more of the above categories. If
                                            relying upon this Category alone, each equity owner that qualifies as an “accredited
                                            investors” must complete and deliver a separate copy of this Questionnaire. (Describe
                                            the entity below).

 

Description:_____________________________________________________________________________ 

_______________________________________________________________________________________ 

_______________________________________________________________________________________ 

 

    

     

    

 

The foregoing representations are true and accurate as of the date
hereof.

 

	Dated:                     ,
    2022.	
	 	INVESTOR
	 	 
	 	
	 	(Signature)
	 	 
	 	
	 	(Printed Name)
	 	 
	 	
	 	(Title, if not a natural person)
	 	 
	 	
	 	(Name of joint investor
    or other person whose signature is required)
	 	 
	 	
	 	(Signature)
	 	 
	 	
	 	(Title, if joint
    investor is not a natural person)

 

    

     

    

 

SCHEDULE
 “B”

 

CONTACT
INFORMATION WITH RESPECT TO THE COLLECTION OF PERSONAL INFORMATION

 

	Alberta
                                            Securities Commission

    Suite 600, 250 - 5th Street SW

    Calgary, Alberta T2P 0R4

     

    Telephone: (403) 297-6454

    Toll free in Canada: 1-877-355-0585

    Facsimile: (403) 297-2082

    
	Government
                                            of Nunavut

    Department of Justice

    Legal Registries Division

    P.O. Box 1000, Station 570

    1st Floor, Brown Building

    Iqaluit, Nunavut X0A 0H0

     

    Telephone: (867) 975-6590

    Facsimile: (867) 975-6594

	British
                                            Columbia Securities Commission

    P.O. Box 10142,

    Pacific Centre

    701 West Georgia Street

    Vancouver, British Columbia V7Y 1L2

     

    Inquiries: (604) 899-6854

    Toll free in Canada: 1-800-373-6393

    Facsimile: (604) 899-6581

    Email:
inquiries@bcsc.bc.ca
	Ontario
                                            Securities Commission

    20 Queen Street West, 22nd Floor

    Toronto, Ontario M5H 3S8

    Telephone: (416) 593-8314

    Toll free in Canada: 1-877-785-1555

    Facsimile: (416) 593-8122

     

    Email:
    exemptmarketfilings@osc.gov.on.ca

    Public official contact regarding indirect collection of information:
    Inquiries Officer

	The
                                            Manitoba Securities Commission

    500 - 400 St. Mary Avenue

    Winnipeg, Manitoba R3C 4K5

     

    Telephone: (204) 945-2548

    Toll free in Manitoba: 1-800-655-5244

    Facsimile: (204) 945- 0330
	Prince
                                            Edward Island Securities Office

    95 Rochford Street, 4th Floor Shaw Building

    P.O. Box 2000

    Charlottetown, Prince Edward Island

    C1A 7N8

     

    Telephone: (902) 368-4569

    Facsimile: (902) 368-5283

	Financial
                                            and Consumer Services Commission (New Brunswick)

    85 Charlotte Street, Suite 300

    Saint John, New Brunswick E2L 2J2

     

    Telephone: (506) -658-3060

    Toll free in Canada: 1-866-933-2222

    Facsimile: (506) 658-3059

    Email:
info@fcnb.ca

     
	Autorité
                                            des marchés financiers

    800, Square Victoria, 22e étage

    C.P. 246, Tour de la Bourse

    Montréal, Québec H4Z 1G3

     

    Telephone: (514) 395-0337 or 1-877-525-0337

    Facsimile: (514) 864-6381

    (For privacy requests only)

    Email:
    financementdessocietes@lautorite.qc.ca (For corporate finance issuers)

	Government
                                            of Newfoundland and Labrador

    Financial Services Regulation Division

    P.O. Box 8700

    Confederation Building

    2nd Floor, West Block

    Prince Philip Drive

    St. John’s, Newfoundland and Labrador A1B 4J6

     

    Attention: Director of Securities

    Telephone: (709) 729-4189

    Facsimile: (709) 729-6187
	Financial
                                            and Consumer Affairs Authority of Saskatchewan

    Suite 601 - 1919 Saskatchewan Drive

    Regina, Saskatchewan S4P 4H2

     

    Telephone: (306) 787-5879

    Facsimile: (306) 787-5899

 

     

     

    

 

	Government
                                            of the Northwest Territories

    Office of the Superintendent of Securities

    P.O. Box 1320

    Yellowknife, Northwest Territories

    X1A 2L9

     

    Attention: Deputy Superintendent,

    Legal & Enforcement

    Telephone: (867) 920-8984

    Facsimile: (867) 873-0243
	Government
                                            of Yukon

    Department of Community Services

    Law Centre, 3rd Floor

    2130 Second Avenue

    Whitehorse, Yukon Y1A 5H6

     

    Telephone: (867) 667-5314

    Facsimile: (867) 393-6251

	Nova
                                            Scotia Securities Commission

    Suite 400, 5251 Duke Street

    Duke Tower, P.O. Box 458

    Halifax, Nova Scotia B3J 2P8

     

    Telephone: (902) 424-7768

    Facsimile: (902) 424-4625Document

Exhibit 10.1

Execution Version

FIFTH AMENDMENT TO SECOND AMENDED AND RESTATED 
CONSTRUCTION AND FIELD GATHERING AGREEMENT

This Fifth Amendment (this "Amendment") to the Second Amended and Restated Construction and Field Gathering Agreement is dated as of July 26, 2022 (the "Execution Date") but made effective as of July 1, 2022, by and between Ironwood Shiner Pipeline, LLC, as successor to Nuevo Dos Gathering and Transportation, LLC, as successor to Republic Midstream, LLC ("Gatherer") and Penn Virginia Oil & Gas, L.P. ("Shipper"). Gatherer and Shipper may hereinafter be referred to singularly as a "Party" and, together, as the "Parties".

RECITALS
WHEREAS, Republic Midstream, LLC and Penn Virginia Oil & Gas, L.P. entered into that certain Second Amended and Restated Construction and Field Gathering Agreement effective as of August 1, 2016 (the "Original Gathering Agreement");
WHEREAS, the Original Gathering Agreement was amended (as so amended, the “Gathering Agreement”) by that certain First Amendment to Second Amended and Restated Construction and Field Gathering Agreement, dated as of April 13, 2017, Second Amendment to Second Amended and Restated Construction and Field Gathering Agreement, dated as of July 2, 2018, Third Amendment to Second Amended and Restated Construction and Field Gathering Agreement, dated as of December 14, 2018, and Fourth Amendment to Second Amended and Restated Construction and Field Gathering Agreement, dated as of May 21, 2020; and

WHEREAS, the Parties desire to further amend the Gathering Agreement as provided in this Amendment;

NOW, THEREFORE, in consideration of the mutual covenants, terms and conditions herein contained, together with other good and valuable consideration, the receipt and sufficiency of which are hereby acknowledged, and intending to be legally bound hereby, the Parties, for themselves and for their successors and assigns, do hereby mutually covenant and agree as follows:
1.Amendment of Definitions in the Gathering Agreement.  Article I of the Gathering Agreement is hereby amended by:
(a) adding the following definitions in appropriate alphabetical order

"Hawn Holt Pad Connection Pipe” means an Additional Segment consisting of an approximately 2,038 feet low gravity (below 45 API) pipeline that will permit Crude Oil produced from the Hawn Holt Pad Wells and Tremolite Pad Wells to be delivered to Gatherer under the Agreement.

"Hawn Holt Pad Well Fee” has the meaning given such term in Section 9.2(e). 

"Hawn Holt Pad Wells” means the Hawn Holt 12H, 13H, 22H & 28H wells.

"Tremolite Pad Wells” means the Tremolite A1H & Tremolite B2H wells.
(b)deleting the word “and” before clause (c) of the definition of “Dedication Area” and adding the following before the period at the end of such definition:
“, and (d) the Hawn Holt Pad Wells and the Tremolite Pad Wells.”
2.Waiver of Construction Notice and Installation of Hawn Holt Pad Facilities.  Gatherer hereby waives the obligation set forth in Section 3.3(a) of the Gathering Agreement for Shipper to deliver a Construction Notice for the Hawn Holt Pad Connection Pipe, and hereby agrees and elects, at its sole cost and expense, to construct, install, own and operate an Additional Segment consisting of the Hawn Holt Pad Connection Pipe, and a LACT/ACT Unit at the interconnection of the Hawn Holt Pad Connection Pipe and the Hawn Holt Pad Wells (such interconnection point is referred to in this Amendment as the “Hawn Holt Pad Interconnection Point”).  Shipper shall, at its sole cost and expense, construct, install, own and operate all facilities upstream of the Hawn Holt Pad Interconnection Point that are reasonably necessary to deliver Crude Oil from the Hawn Holt Pad Wells and the Tremolite Pad Wells to the Hawn Holt Pad Interconnection Point. 
3.Receipt Point.  The Hawn Holt Pad Interconnection Point shall be a Receipt Point under the Gathering Agreement. 
747972963.5

4.Fees.  
(c)Sections 9.2(a) and 9.2(b) of the Gathering Agreement are hereby amended by deleting the parenthetical in such sections and replacing it in its entirety with “(other than from the Excluded Units, Outside Units, Other Wells, Future Wells, Hawn Holt Pad Wells and Tremolite Pad Wells)”;   
(d)Section 9.2(e) of the Gathering Agreement is hereby deleted and replaced in its entirety with the following: 

“(e)    A gathering fee on all of Shipper's Oil delivered at the Delivery Points via the Gathering System from all Future Wells equal to $1.00 per Barrel during such Month (the "Future Well Fee"), and from all Hawn Holt Pad Wells and Tremolite Pad Wells equal to $1.00 per Barrel during such Month (the "Hawn Holt and Tremolite Pad Well Fee");” and
(e)Sections 9.2(f), 9.2(g) and 9.2(h) of the Gathering Agreement are hereby amended by deleting the parenthetical in such sections and replacing it in its entirety with “(which shall in no event include Shipper's Oil from the Other Wells, Future Wells, Hawn Holt Pad Wells and Tremolite Pad Wells except as otherwise agreed by Shipper)”. 
5.Fee Adjustment.  Section 9.4 of the Gathering Agreement is hereby amended by adding the following parenthetical after the phrase “aggregate Monthly Fees” each time it appears in such Section: 
“(other than the portion of such aggregate Monthly Fees that consist of Hawn Holt and Tremolite Pad Well Fees)”
For the avoidance of doubt, Shipper's Oil delivered at the Delivery Points via the Gathering System from the Hawn Holt Pad Wells and the Tremolite Pad Wells will be (i) charged the Transportation Fee (as defined in the TSA) under the TSA, (ii) charged the Marketing Fee (as defined in the Marketing Agreement) under the Marketing Agreement, and (iii) credited towards the first 20,000 bpd minimum volume commitment specified in the Gathering Agreement, TSA and Marketing Agreement during the respective terms of the applicable agreement.

6.Ratification; Primacy. Except as expressly amended by this Amendment, all of the terms, provisions, covenants and conditions contained in the Gathering Agreement remain in full force and effect; provided, if there is ever any conflict between the Gathering Agreement and this Amendment, the terms, provisions, covenants and conditions contained in this Amendment shall govern. The terms and provisions of the Gathering Agreement as amended by this Amendment are binding upon and inure to the benefit of the Parties, their representatives, successors and assigns. As amended by this Amendment, the Gathering Agreement is ratified and confirmed by the Parties, and declared to be a valid and enforceable contract between them.
7.Counterparts. This Amendment may be executed in as many counterparts as deemed necessary. When so executed, the aggregate counterparts shall constitute one agreement and shall have the same effect as if all Parties signing counterparts had executed the same instrument.
8.Amendment; Waiver. Neither this Amendment nor the Gathering Agreement may be amended or modified except pursuant to a written instrument signed by all of the Parties. Each Party may waive on its own behalf compliance by any other Party with any term or provision hereof; provided, however, that any such waiver shall be in writing and shall not bind the non-waiving Party. The waiver by any Party of a breach of any term or provision shall not be construed as a waiver of any subsequent breach of the same or any other provision.
9.Joint Preparation. The Parties agree and confirm that this Amendment was prepared jointly by all Parties and not by any one Party to the exclusion of the other.
10.No Third Party Beneficiaries. This Amendment is not intended to confer upon any person not a party hereto any rights or remedies hereunder, and no person other than the Parties is entitled to rely on or enforce any provision hereof.
11.Miscellaneous Provisions. The provisions of Articles XVII, XIX, XX and XXI of the Gathering Agreement are incorporated herein by this reference as if set out fully herein and shall apply in all respects to this Amendment.
[Signature Page Follows]
2

IN WITNESS WHEREOF, this Amendment has been executed by the Parties effective as of the Execution Date.

IRONWOOD SHINER PIPELINE, LLC 

By: Ironwood Midstream Energy Partners II, LLC,
       Its sole member

By:  /s/ Justin Johnson______________
Name:    Justin Johnson
Title:    CCO & CFO

PENN VIRGINIA OIL & GAS, LP

By:  /s/ Jill T. Zivley________________
Name:    Jill T. Zivley
Title:    VP, Land and Marketing

Signature Page to 
Fifth Amendment to the Second Amended and Restated Construction and Field Gathering Agreement

Source: [{"source": "alea-institute/alea-institute/kl3m-data-edgar-agreements/train-00350-of-00352.parquet"}, [{"source": "alea-institute/alea-institute/kl3m-data-edgar-agreements/train-00350-of-00352.parquet"}]]