Document:

CONFIDENTIAL
TREATMENT REQUESTED

 

CONFIDENTIAL
PORTIONS OF THIS DOCUMENT HAVE BEEN REDACTED AND HAVE BEEN SEPARATELY FILED WITH THE SECURITIES AND EXCHANGE COMMISSION. INFORMATION
THAT WAS OMITTED IN THE EDGAR VERSION HAS BEEN NOTED IN THIS DOCUMENT WITH A PLACEHOLDER IDENTIFIED BY THE MARK “[***]”.

 

Addendum
to the Manufacturing, Supply and Development Agreement of 2016

 

entered
into between

 

MiniFAB
(Aust) Pty Ltd

 

ACN
100 768 474

 

and

 

TearLab
Research, Inc.

 

Date
of this Addendum: August 9, 2018

 

	1	Glossary
	 	 
	 	In
    this addendum, unless the context otherwise requires, the terms in the first column below have the meaning given to them in
    the second column. Terms that are capitalised in this Addendum but not defined below, have the meanings used in the Agreement.

 

	 	Addendum	 	this
    addendum to the Agreement
	 	 	 	 
	 	Agreement	 	the
    Manufacturing, Supply and Development between the parties dated March 2016 for the manufacture of the ‘Product’
    described as the TCI card
	 	 	 	 
	 	New
    Agreement	 	the
    Manufacturing, Supply and Development between the parties dated August 9, 2018 for the manufacture of the ‘Product’
    described as “Discovery Test Card, together with the Reagents, capsule and applicable packaging ...”
	 	 	 	 
	 	Aggregate
    Product Volume	 	The
    aggregate of the order volumes for the TCI cards and the Discovery Test Card, under both the Agreement and the New Agreement,
    respectively
	 	 	 	 
	 	Discovery
    Test Card	 	the
    ‘Discovery Test Card’ as described in schedule 2 of the New Agreement
	 	 	 	 
	 	TCI
    Card	 	the
    ‘Base TCI card’ (or ‘Base Card’) as described in schedule 2 of the Agreement

 

	2	Volumes
    and pricing
	 	 
	2.1	TCI
    Card pricing will remain fixed at the current price of [***], except as provided under 2.2 below.

 

[***]
Certain information in this document has been omitted and filed separately with the Securities and Exchange Commission. Confidential
treatment has been requested with respect to the omitted portions.

 

    	 

    	 -2-

    

 

	2.2	Without
    limiting clause 11.3 of the Agreement, if:

 

	 	(1)	 	the
    average monthly order volume of TCI Cards, on a rolling six month average, falls below [***] cards per month; or
	 	 	 	 
	 	(2)	 	the
    Aggregate Product Volume in the calendar year commencing 12 months after the launch of the ‘Discovery’ product
    under the New Agreement is below [***] cards; or
	 	 	 	 
	 	(3)	 	the
    Aggregate Product Volume in any calendar year after 24 months after the launch of the ‘Discovery’ product under
    the New Agreement falls below [***] cards, then
the parties will renegotiate the pricing for the supply of TCI Cards under the Agreement.

 

	3	Operative
    effect
	 	 
	 	By
        executing this addendum the parties agree that the terms of this Addendum are incorporated into the Agreement, which is
        varied accordingly, with effect from the date of execution.

        

 

	 	Executed by MiniFAB (Aust) Pty

                                                                        Ltd in accordance with section 127 of

                                                                        the Corporations Act 2001:
	 	 
	 	 	 	 
	 	/s/
    Michael Wilkinson	 	/s/
    Erol Harvey
	 	Director/company
    secretary	 	Director
	 	 	 	 
	 	MICHAEL
    WILKINSON	 	EROL
    HARVEY
	 	Name
        of director/company secretary

        (BLOCK
        LETTERS)
	 	Name
        of director

        (BLOCK
        LETTERS)

 

	 	Signed for and on behalf of TearLab Research, Inc.

                                                                        by its authorised representative in the presence of:
	 	 
	 	 	 	 
	 	/s/ Michael
                                         Marquez

	 	/s/ Seph
                                         Jensen

	 	Signature
    of witness	 	Signature
    of authorised representative
	 	 	 	 
	 	MICHAEL MARQUEZ

	 	SEPH JENSEN

	 	Name
        of witness

        (BLOCK
        LETTERS)
	 	Name
        of authorised representative

        (BLOCK
        LETTERS)

	 	 	 	 
	 	940 S. Kimball,
                                         Southlake, TX USA

	 	 
	 	Address
    of witness	 	 

 

[***]
Certain information in this document has been omitted and filed separately with the Securities and Exchange Commission. Confidential
treatment has been requested with respect to the omitted portions.KALA_Ex10_1

		
			Exhibit 10.1
		

		
			 
		

		
			KALA PHARMACEUTICALS, INC. 
		

		
			Non-qualified Stock Option Agreement
		

		
			 
		

		
			1.             Grant of Option.
		

		
			 
		

		
			This agreement evidences the grant by Kala Pharmaceuticals, Inc., a Delaware corporation (the “Company”), on [___________] (the “Grant Date”) to [___________], an employee of the Company (the “Participant”), of an option to purchase, in whole or in part, on the terms provided herein, a total of [___________] shares (the “Shares”) of common stock, $0.001 par value per share, of the Company (“Common Stock”) at $[_____] per Share.  Unless earlier terminated, this option shall expire at 5:00 p.m., Eastern time, on [___________]1 (the “Final Exercise Date”).
		

		
			 
		

		
			The option evidenced by this agreement was granted to the Participant pursuant to the inducement grant exception under Nasdaq Listing Rule 5635(c)(4), and not pursuant to the Company’s 2017 Equity Incentive Plan (the “Plan”) or any equity incentive plan of the Company, as an inducement that is material to the Participant’s employment with the Company.
		

		
			 
		

		
			It is intended that the option evidenced by this agreement shall not be an incentive stock option as defined in Section 422 of the Internal Revenue Code of 1986, as amended, and any regulations promulgated thereunder (the “Code”).  Except as otherwise indicated by the context, the term “Participant”, as used in this option, shall be deemed to include any person who acquires the right to exercise this option validly under its terms.
		

		
			 
		

		
			2.             Vesting Schedule.
		

		
			 
		

		
			Except as otherwise provided herein, this option will become exercisable (“vest”) as to 25% of the original number of Shares on one-year anniversary of the Vesting Start Date and as to an additional 2.0833% of the original number of Shares at the end of each successive month following the one-year anniversary of the Vesting Start Date until the fourth anniversary of the Vesting Start Date.  For purposes of this Agreement, the Vesting Start Date is [___________]. 
		

		
			 
		

		
			The right of exercise shall be cumulative so that to the extent the option is not exercised in any period to the maximum extent permissible it shall continue to be exercisable, in whole or in part, with respect to all Shares for which it is vested until the earlier of the Final Exercise Date or the termination of this option under Section 3 hereof.
		

		
			 
		

		
			3.             Exercise of Option.
		

		
			 
		

		
			(a)           Form of Exercise.  Each election to exercise this option shall be in writing, in the form of the Stock Option Exercise Notice attached as Annex A, signed by the Participant,  and received by the Company at its principal office, accompanied by this agreement or in such 
		

		
			 
		

		

		
			1 Termination date to be 10 years minus 1 day from Grant Date
		

		
			
		

		
			

		 

			

					

						 

					

					

						 

					

					

						 

				
	

					

						 

					

					

						 

					

					

						 

				
	

					

						 

					

					

						 

					

					

						 

				

		

			

		

 

		

		
			other form (which may be electronic) as is approved by the Company, and payment in full as follows:
		

		
			 
		

		
			(1)           in cash or by check, payable to the order of the Company;
		

		
			 
		

		
			(2)           by (i) delivery of an irrevocable and unconditional undertaking by a creditworthy broker to deliver promptly to the Company sufficient funds to pay the exercise price and any required tax withholding or (ii) delivery by the Participant to the Company of a copy of irrevocable and unconditional instructions to a creditworthy broker to deliver promptly to the Company cash or a check sufficient to pay the exercise price and any required tax withholding;
		

		
			 
		

		
			(3)           to the extent approved by the Board of Directors of the Company (the “Board”), by delivery (either by actual delivery or attestation) of shares of Common Stock owned by the Participant valued at their fair market value (valued in the manner determined by (or in a manner approved by) the Board) (the “Fair Market Value”), provided (i) such method of payment is then permitted under applicable law, (ii) such Common Stock, if acquired directly from the Company, was owned by the Participant for such minimum period of time, if any, as may be established by the Board and (iii) such Common Stock is not subject to any repurchase, forfeiture, unfulfilled vesting or other similar requirements;
		

		
			 
		

		
			(4)           to the extent approved by the Board in its sole discretion, by delivery of a notice of “net exercise” to the Company, as a result of which the Participant would receive (i) the number of shares underlying the portion of this option being exercised, less (ii) such number of shares as is equal to (A) the aggregate exercise price for the portion of this option being exercised divided by (B) the Fair Market Value on the date of exercise;
		

		
			 
		

		
			(5)           to the extent permitted by applicable law and approved by the Board, by payment of such other lawful consideration as the Board may determine; or
		

		
			 
		

		
			(6)           by any combination of the above permitted forms of payment.
		

		
			 
		

		
			The Participant may purchase less than the number of shares covered hereby, provided that no partial exercise of this option may be for any fractional share.  Share of Common Stock subject to this option will be delivered by the Company as soon as practicable following exercise, subject to the terms and conditions of this Agreement.
		

		
			 
		

		
			(b)           Continuous Relationship with the Company Required.  Except as otherwise provided in this Section 3, this option may not be exercised unless the Participant, at the time he exercises this option, is, and has been at all times since the Grant Date, an employee, director or officer of, or consultant or advisor to, the Company or any other entity the employees, officers, directors, consultants, or advisors of which are eligible to receive option grants under the Plan (an “Eligible Participant”).
		

		
			 
		

		
			(c)           Termination of Relationship with the Company.  If the Participant ceases to be an Eligible Participant for any reason, then, except as provided in paragraphs (d) and (e) below, the right to exercise this option shall terminate three months after such cessation (but in no event after the Final Exercise Date), provided that this option shall be exercisable only to the extent 

		 

			

					

						 

					

					

						 

					

					

						 

				
	

					

						 

					

					

						 

					

					

						 

				
	

					

						 

					

					

						 

					

					

						 

				

		

			

		

 

that the Participant was entitled to exercise this option on the date of such cessation.  Notwithstanding the foregoing, if the Participant, prior to the Final Exercise Date, violates the non-competition, non-solicitation or confidentiality provisions of any employment contract, restrictive covenant agreement (including, without limitation, any confidentiality or non-competition agreement) or other agreement between the Participant and the Company, the right to exercise this option, if and to the extent permitted by applicable law, shall terminate immediately upon such violation.
		

		
			 
		

		
			(d)           Exercise Period Upon Death or Disability.  If the Participant dies or becomes disabled (within the meaning of Section 22(e)(3) of the Code) prior to the Final Exercise Date while he is an Eligible Participant and the Company has not terminated such relationship for “cause” as specified in paragraph (e) below, this option shall be exercisable, within the period of one year following the date of death or disability of the Participant, by the Participant (or in the case of death by an authorized transferee), provided that this option shall be exercisable only to the extent that this option was exercisable by the Participant on the date of his death or disability, and further provided that this option shall not be exercisable after the Final Exercise Date.
		

		
			 
		

		
			(e)           Termination for Cause.  If prior to the Final Exercise Date, the Participant’s employment or other relationship with the Company is terminated by the Company for Cause (as defined below), the right to exercise this option shall terminate immediately upon the effective date of such termination of employment or other relationship.  If, prior to the Final Exercise Date, the Participant is given notice by the Company of the termination of his employment by the Company for Cause, and the effective date of such employment termination is subsequent to the date of delivery of such notice, the right to exercise this option shall be suspended from the time of the delivery of such notice until the earlier of (i) such time as it is determined or otherwise agreed that the Participant’s employment shall not be terminated for Cause as provided in such notice or (ii) the effective date of such termination of employment (in which case the right to exercise this option shall, pursuant to the preceding sentence, terminate upon the effective date of such termination of employment). If the Participant is subject to an individual employment agreement with the Company (other than any restrictive covenant or confidentiality agreement) or eligible to participate in a Company severance plan or arrangement, in any case which agreement, plan or arrangement contains a definition of “cause” for termination of employment or other relationship with us, “Cause” shall have the meaning ascribed to such term in such agreement, plan or arrangement. Otherwise, “Cause” shall mean willful misconduct by the Participant or willful failure by the Participant to perform his or her responsibilities to the Company (including, without limitation, breach by the Participant of any provision of any employment, consulting, advisory, nondisclosure, non-competition or other similar agreement between the Participant and the Company), as determined by the Company, which determination shall be conclusive. The Participant’s employment shall be considered to have been terminated for Cause if the Company determines, within 30 days after the Participant’s resignation, that termination for Cause was warranted.
		

		
			 
		

		
			4.Withholding.  No Shares will be issued pursuant to the exercise of this option unless and until the Participant pays to the Company, or makes provision satisfactory to the Company for payment of, any federal, state or local withholding taxes required by law to be withheld in respect of this option.  The Participant must satisfy all applicable federal, state, and local or other income and employment tax withholding obligations before the Company will deliver stock certificates or otherwise recognize ownership of Common Stock under this option.  The 

		 

			

					

						 

					

					

						 

					

					

						 

				
	

					

						 

					

					

						 

					

					

						 

				
	

					

						 

					

					

						 

					

					

						 

				

		

			

		

 

Company may elect to satisfy the withholding obligations through additional withholding on salary or wages.  If the Company elects not to or cannot withhold from other compensation, the Participant must pay the Company the full amount, if any, required for withholding or have a broker tender to the Company cash equal to the withholding obligations.  Payment of withholding obligations is due before the Company will issue any shares on exercise of this option or at the same time as payment of the exercise price, unless the Company determines otherwise.  If approved by the Board, a Participant may satisfy the tax obligations in whole or in part by delivery (either by actual delivery or attestation) of shares of Common Stock, including shares retained from this option, valued at their Fair Market Value; provided, however, except as otherwise provided by the Board, that the total tax withholding where stock is being used to satisfy such tax obligations cannot exceed the Company’s minimum statutory withholding obligations (based on minimum statutory withholding rates for federal and state tax purposes, including payroll taxes, that are applicable to such supplemental taxable income), except that, to the extent that the Company is able to retain shares of Common Stock having a Fair Market Value that exceeds the statutory minimum applicable withholding tax without financial accounting implications or the Company is withholding in a jurisdiction that does not have a statutory minimum withholding tax, the Company may retain such number of shares of Common Stock (up to the number of shares having a Fair Market Value equal to the maximum individual statutory rate of tax) as the Company shall determine in its sole discretion to satisfy the tax liability associated with this option.  Shares used to satisfy tax withholding requirements cannot be subject to any repurchase, forfeiture, unfulfilled vesting or other similar requirements.
		

		
			 
		

		
			5.             Transfer Restrictions.  This option may not be sold, assigned, transferred, pledged or otherwise encumbered by the Participant, either voluntarily or by operation of law, except by will or the laws of descent and distribution or pursuant to a qualified domestic relations order, and, during the lifetime of the Participant, this option shall be exercisable only by the Participant; provided, however, that, the Board may permit the gratuitous transfer of this option by the Participant to or for the benefit of any immediate family member, family trust or other entity established for the benefit of the Participant and/or an immediate family member thereof if the Company would be eligible to use a Form S-8 under the Securities Act of 1933, as amended, for the registration of the sale of the Common Stock subject to this option to such proposed transferee; provided further, that the Company shall not be required to recognize any such permitted transfer until such time as such permitted transferee shall, as a condition to such transfer, deliver to the Company a written instrument in form and substance satisfactory to the Company confirming that such transferee shall be bound by all of the terms and conditions of this option.  References to a Participant, to the extent relevant in the context, shall include references to authorized transferees.  For the avoidance of doubt, nothing contained in this Section 5 shall be deemed to restrict a transfer to the Company.
		

		
			 
		

		
			6.             Adjustments for Changes in Common Stock and Certain Other Events.
		

		
			 
		

		
			(a)           Changes in Capitalization.  In the event of any stock split, reverse stock split, stock dividend, recapitalization, combination of shares, reclassification of shares, spin-off or other similar change in capitalization or event, or any dividend or distribution to holders of Common Stock other than an ordinary cash dividend, the number and class of securities and exercise price per share of this option shall be equitably adjusted by the Company in the manner determined by the Board.  Without limiting the generality of the foregoing, in the event the 

		 

			

					

						 

					

					

						 

					

					

						 

				
	

					

						 

					

					

						 

					

					

						 

				
	

					

						 

					

					

						 

					

					

						 

				

		

			

		

 

Company effects a split of the Common Stock by means of a stock dividend and the exercise price of and the number of shares subject to this option are adjusted as of the date of the distribution of the dividend (rather than as of the record date for such dividend), then the Participant, if he exercises this option between the record date and the distribution date for such stock dividend shall be entitled to receive, on the distribution date, the stock dividend with respect to the shares of Common Stock acquired upon exercise of this option, notwithstanding the fact that such shares were not outstanding as of the close of business on the record date for such stock dividend.
		

		
			 
		

		
			(b)           Reorganization Events.  A “Reorganization Event” shall mean:  (a) any merger or consolidation of the Company with or into another entity as a result of which all of the Common Stock of the Company is converted into or exchanged for the right to receive cash, securities or other property or is cancelled, (b) any transfer or disposition of all of the Common Stock of the Company for cash, securities or other property pursuant to a share exchange or other transaction or (c) any liquidation or dissolution of the Company.  In connection with a Reorganization Event, the Board may take any one or more of the following actions with respect to this option (or any portion thereof) on such terms as the Board determines: (i) provide that this option shall be assumed, or a substantially equivalent option shall be substituted, by the acquiring or succeeding corporation (or an affiliate thereof), (ii) upon written notice to the Participant, provide that the unvested portion of this option will be forfeited immediately prior to the consummation of the Reorganization Event and/or the unexercised portion of this option will terminate immediately prior to the consummation of such Reorganization Event unless exercised by the Participant (to the extent then exercisable) within a specified period following the date of such notice, (iii) provide that this option shall become exercisable, realizable, or deliverable, or restrictions applicable to this option shall lapse, in whole or in part prior to or upon such Reorganization Event, (iv) in the event of a Reorganization Event under the terms of which holders of Common Stock will receive upon consummation thereof a cash payment for each share surrendered in the Reorganization Event (the “Acquisition Price”), make or provide for a cash payment to the Participant with respect to this option equal to (A) the number of shares of Common Stock subject to the vested portion of this option (after giving effect to any acceleration of vesting that occurs upon or immediately prior to such Reorganization Event) multiplied by (B) the excess, if any, of (I) the Acquisition Price over (II) the exercise price of this option and any applicable tax withholdings, in exchange for the termination of this option, (v) provide that, in connection with a liquidation or dissolution of the Company, this option shall convert into the right to receive liquidation proceeds (net of the exercise price thereof and any applicable tax withholdings) and (vi) any combination of the foregoing.
		

		
			 
		

		
			For purposes of clause (i) above, this option shall be considered assumed if, following consummation of the Reorganization Event, this option confers the right to purchase, for each share of Common Stock subject to this option immediately prior to the consummation of the Reorganization Event, the consideration (whether cash, securities or other property) received as a result of the Reorganization Event by holders of Common Stock for each share of Common Stock held immediately prior to the consummation of the Reorganization Event (and if holders were offered a choice of consideration, the type of consideration chosen by the holders of a majority of the outstanding shares of Common Stock); provided, however, that if the consideration received as a result of the Reorganization Event is not solely common stock of the acquiring or succeeding corporation (or an affiliate thereof), the Company may, with the consent 

		 

			

					

						 

					

					

						 

					

					

						 

				
	

					

						 

					

					

						 

					

					

						 

				
	

					

						 

					

					

						 

					

					

						 

				

		

			

		

 

of the acquiring or succeeding corporation, provide for the consideration to be received upon the exercise of this option to consist solely of such number of shares of common stock of the acquiring or succeeding corporation (or an affiliate thereof) that the Board determines to be equivalent in value (as of the date of such determination or another date specified by the Board) to the per share consideration received by holders of outstanding shares of Common Stock as a result of the Reorganization Event.
		

		
			 
		

		
			7.             Miscellaneous.
		

		
			 
		

		
			(a)           No Right To Employment or Other Status.  The grant of this option shall not be construed as giving the Participant the right to continued employment or any other relationship with the Company.  The Company expressly reserves the right at any time to dismiss or otherwise terminate its relationship with the Participant free from any liability or claim hereunder, except as otherwise expressly provided herein.
		

		
			 
		

		
			(b)           No Rights As Stockholder; Clawback.  Subject to the provisions of this option, the  Participant shall not have any rights as a stockholder with respect to any shares of Common Stock to be issued with respect to this option until becoming the record holder of such shares.  In accepting this option, the Participant agrees to be bound by any clawback policy the Company has in effect or may adopt in the future.
		

		
			 
		

		
			(c)           Entire Agreement.  This Agreement constitutes the entire agreement between the parties, and supersede all prior agreements and understandings, relating to the subject matter hereof.
		

		
			 
		

		
			(d)           Amendment.  The Board may amend, modify or terminate this Agreement, including but not limited to, substituting another option of the same or a different type and changing the date of exercise or realization.  Notwithstanding the foregoing, the Participant’s consent to such action shall be required unless (i) the Board determines that the action, taking into account any related action, would not materially and adversely affect the Participant’s rights under this Agreement, or (ii) the change is permitted under Section 6.  
		

		
			 
		

		
			(e)            Acceleration.  The Board may at any time provide that this option shall become immediately exercisable in whole or in part, free from some or all restrictions or conditions, or otherwise realizable in whole or in part, as the case may be.
		

		
			  
		

		
			(f)           Conditions on Delivery of Stock.  The Company will not be obligated to deliver any shares of Common Stock pursuant to this Agreement until (i) all conditions of this Agreement have been met to the satisfaction of the Company, (ii) in the opinion of the Company’s counsel, all other legal matters in connection with the issuance and delivery of such shares have been satisfied, including any applicable securities laws and regulations and any applicable stock exchange or stock market rules and regulations, and (iii) the Participant has executed and delivered to the Company such representations or agreements as the Company may consider appropriate to satisfy the requirements of any applicable laws, rules or regulations.
		

		
			 
		

		
			(g)            Administration by Board.  The Board will administer this Agreement and may construe and interpret the terms hereof.  The Board may correct any defect, supply any omission or reconcile any inconsistency in this Agreement in the manner and to the extent it shall deem 

		 

			

					

						 

					

					

						 

					

					

						 

				
	

					

						 

					

					

						 

					

					

						 

				
	

					

						 

					

					

						 

					

					

						 

				

		

			

		

 

expedient to carry the Agreement into effect and it shall be the sole and final judge of such expediency.  No director or person acting pursuant to the authority delegated by the Board shall be liable for any action or determination relating to or under this Agreement made in good faith.
		

		
			 
		

		
			(h)            Appointment of Committees.  To the extent permitted by applicable law, the Board may delegate any or all of its powers hereunder to one or more committees or subcommittees of the Board (a “Committee”).  All references herein to the “Board” shall mean the Board or a Committee to the extent that the Board’s powers or authority hereunder have been delegated to such Committee.
		

		
			 
		

		
			(i)           Severability.  The invalidity or unenforceability of any provision hereof shall not affect the validity or enforceability of any other provision hereof, and each such other provision shall be severable and enforceable to the extent permitted by law.
		

		
			 
		

		
			(j)            Governing Law.  This Agreement shall be governed by and interpreted in accordance with the laws of the State of Delaware, excluding choice-of-law principles of the law of such state that would require the application of the laws of a jurisdiction other than the State of Delaware.
		

		
			 
		

		
			(k)          Counterparts.  This Agreement may be executed in one or more counterparts, each of which shall be deemed to be an original but all of which together will constitute one in the same instrument.
		

		
			 
		

		
			 
		

		
			This option satisfies in full all commitments that the Company has to the Participant with respect to the issuance of stock, stock options or other equity securities. 
		

		
			 
		

		
			 
		

			
					
						 

					
					
						 

					
					
						KALA PHARMACEUTICALS, INC.

				
	
					
						 

					
					
						 

					
					
						 

				
	
					
						Signature of Participant

					
					
						 

					
					
						 

				
	
					
						 

					
					
						 

					
					
						By:

					
					
						 

				
	
					
						Street Address

					
					
						 

					
					
						 

					
					
						Name of Officer

				
	
					
						 

					
					
						 

					
					
						 

					
					
						Title:

				
	
					
						City/State/Zip Code

					
					
						 

					
					
						 

				

		
			 
		

		
			 
		

		
			 
		

		
			 
		

		
			 
		

		
			 
		

		
			 
		

		
			 
		

		
			 
		

		
			 
		

		
			 
		

		
			 
		

		
			

		 

			

					

						 

					

					

						 

					

					

						 

				
	

					

						 

					

					

						 

					

					

						 

				
	

					

						 

					

					

						 

					

					

						 

				

		

			

		

 

		

		
			ANNEX A
		

		
			 
		

		
			KALA PHARMACEUTICALS, INC.
		

		
			Stock Option Exercise Notice
		

		
			 
		

		
			Kala Pharmaceuticals, Inc.
		

		
			100 Beaver Street, Suite 201
		

		
			Waltham, MA 02453
		

		
			 
		

		
			Dear Sir or Madam:
		

		
			 I,                             (the “Participant”), hereby irrevocably exercise the right to purchase                      shares of the Common Stock, $0.001 par value per share (the “Shares”), of Kala Pharmaceuticals, Inc. (the “Company”) at $     per share pursuant to that certain stock option agreement with the Company dated                            .  Enclosed herewith is a payment of $     , the aggregate purchase price for the Shares.  The certificate for the Shares should be registered in my name as it appears below or, if so indicated below, jointly in my name and the name of the person designated below, with right of survivorship.
		

		
			 
		

			
					
						Dated:

					
					
						 

					
					
						 

				
	
					
						 

					
					
						 

				
	
					
						 

					
					
						 

				
	
					
						Signature

					
					
						 

				
	
					
						Print Name:

					
					
						 

				
	
					
						 

					
					
						 

				
	
					
						Address:

					
					
						 

				
	
					
						 

					
					
						 

				
	
					
						 

					
					
						 

				

		
			 Name and address of persons in whose name the Shares are to be jointly registered (if applicable):

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