Document:

Exhibit
10.9

 

VOTING
AGREEMENT

 

VOTING
AGREEMENT, dated as of November __, 2019 (this “Agreement”), by and between PAVmed Inc., a Delaware corporation
with offices located at One Grand Central Place, Suite 4600, New York, NY 10165 (the “Company”) and [ ] (the
“Stockholder”).

 

WHEREAS,
the Company and certain investors (each, an “Investor”, and collectively, the “Investors”)
have entered into a Securities Purchase Agreement, dated as of November 3, 2019 (the “Securities Purchase Agreement”),
pursuant to which, among other things, the Company has agreed to issue and sell to the Investors and the Investors have, severally
but not jointly, agreed to purchase certain senior secured convertible notes of the Company (the “Notes”),
which will be convertible into shares of the Company’s common stock, $0.001 par value per share (the “Common Stock”,
as converted, the “Conversion Shares”), in accordance with the terms of the Notes;

 

WHEREAS,
as of the date hereof, the Stockholder owns shares of Common Stock (the “Stockholder Shares”), which represent
(i) approximately [ %] of the total issued and outstanding Common Stock of the Company, and (ii) approximately [ %] of the total
voting power of the Company; and

 

WHEREAS,
as a condition to the willingness of each Investor to enter into the Securities Purchase Agreement and to consummate the transactions
contemplated thereby (collectively, the “Transaction”), the Investors have required that the Stockholder agree,
and in order to induce each Investor to enter into the Securities Purchase Agreement, the Stockholder has agreed, to enter into
this Agreement with respect to all the Stockholder Shares now owned and which may hereafter be acquired by the Stockholder and
any other securities of the Company (the “Other Securities”, and together with the Stockholder Shares, the
“Stockholder Securities”), if any, which Stockholder is currently entitled to vote, or after the date hereof
becomes entitled to vote, at any meeting of the stockholders of the Company.

 

NOW,
THEREFORE, in consideration of the foregoing and the mutual covenants and agreements contained herein, and intending to be legally
bound hereby, the parties hereto hereby agree as follows:

 

ARTICLE
I

 

VOTING
AGREEMENT OF THE STOCKHOLDER

 

SECTION
1.01. Voting Agreement. Subject to the last sentence of this Section 1.01, the Stockholder hereby agrees that at any meeting
of the stockholders of the Company, however called, and in any action by written consent of the Company’s stockholders,
the Stockholder shall vote the Stockholder Securities, which Stockholder is currently entitled to vote, or after the date hereof
becomes entitled to vote, at any meeting of the stockholders of the Company: (a) in favor of the Stockholder Approval (as defined
in the Securities Purchase Agreement) and the Stockholder Resolutions (as defined in the Securities Purchase Agreement), in each
case, as described in Section 4(cc) of the Securities Purchase Agreement; and (b) against any proposal or any other corporate
action or agreement that would result in a breach of any covenant, representation or warranty or any other obligation or agreement
of the Company under the Transaction Documents (as defined in the Securities Purchase Agreement) or which could result in any
of the conditions to the Company’s obligations under the Transaction Documents not being fulfilled. The Stockholder acknowledges
receipt and review of a copy of the Securities Purchase Agreement and the other Transaction Documents. The obligations of the
Stockholder under this Section 1.01 shall terminate immediately following the occurrence of the Stockholder Approval.

 

    	 	 	 

    	 

    

 

ARTICLE
II

 

REPRESENTATIONS
AND WARRANTIES OF THE STOCKHOLDER

 

The
Stockholder hereby represents and warrants to the Company and each of the Investors as follows:

 

SECTION
2.01. Authority Relative to this Agreement. The Stockholder has all requisite power and authority to execute and deliver
this Agreement, to perform its obligations hereunder and to consummate the transactions contemplated hereby. This Agreement has
been duly executed and delivered by the Stockholder and constitutes a legal, valid and binding obligation of the Stockholder,
enforceable against the Stockholder in accordance with its terms, except (a) as such enforceability may be limited by applicable
bankruptcy, insolvency, reorganization, fraudulent conveyance, moratorium or similar laws now or hereafter in effect relating
to, or affecting generally, the enforcement of creditors’ and other obligees’ rights and (b) where the remedy of specific
performance or other forms of equitable relief may be subject to certain equitable defenses and principles and to the discretion
of the court before which the proceeding may be brought.

 

SECTION
2.02. No Conflict. (a) The execution and delivery of this Agreement by the Stockholder does not, and the performance of
this Agreement by the Stockholder shall not, (i) conflict with or violate any federal, state or local law, statute, ordinance,
rule, regulation, order, judgment or decree applicable to the Stockholder or by which the Stockholder Securities owned by the
Stockholder are bound or affected or (ii) result in any breach of or constitute a default (or an event that with notice or lapse
of time or both would become a default) under, or give to others any rights of termination, amendment, acceleration or cancellation
of, or result in the creation of a lien or encumbrance on any of the Stockholder Securities owned by the Stockholder pursuant
to, any note, bond, mortgage, indenture, contract, agreement, lease, license, permit, franchise or other instrument or obligation
to which the Stockholder is a party or by which the Stockholder or the Stockholder Securities owned by the Stockholder is bound.

 

(b)
The execution and delivery of this Agreement by the Stockholder does not, and the performance of this Agreement by the
Stockholder shall not, require any consent, approval, authorization or permit of, or filing with or notification to, any
governmental entity by the Stockholder.

 

SECTION
2.03. Title to the Stock. As of the date hereof, the Stockholder is the owner of [ ] shares of Common Stock, entitled to
vote, without restriction, on all matters brought before holders of capital stock of the Company, which shares of Common Stock
represent on the date hereof approximately [ ]% of the outstanding stock and approximately [ ]% of the voting power of the Company.
Such shares of Common Stock are all the securities of the Company owned, either of record or beneficially, by the Stockholder.
Such Common Stock is owned free and clear of all Encumbrances (as defined below). The Stockholder has not appointed or granted
any proxy, which appointment or grant is still effective, with respect to the Common Stock or Other Securities owned by the Stockholder.

 

    	 	- 2-	 

    	 

    

 

ARTICLE
III

 

[COVENANTS

 

SECTION
3.01. No Disposition or Encumbrance of Stock. The Stockholder hereby covenants and agrees that the Stockholder shall not
offer or agree to sell, transfer, tender, assign, hypothecate or otherwise dispose of, grant a proxy or power of attorney with
respect to, or create or permit to exist any security interest, lien, claim, pledge, option, right of first refusal, agreement,
limitation on the Stockholder’s voting rights, charge or other encumbrance of any nature whatsoever (“Encumbrance”)
with respect to the Stockholder Securities, directly or indirectly, or initiate, solicit or encourage any person to take actions
which could reasonably be expected to lead to the occurrence of any of the foregoing.

 

SECTION
3.02. Company Cooperation. The Company hereby covenants and agrees that it will not, and the Stockholder irrevocably and
unconditionally acknowledges and agrees that the Company will not (and waives any rights against the Company in relation thereto),
recognize any Encumbrance or agreement (other than this Agreement) on any of the Stockholder Securities subject to this Agreement.]

 

ARTICLE
IV

 

MISCELLANEOUS

 

SECTION
4.01. Further Assurances. The Stockholder shall execute and deliver such further documents and instruments and take all
further action as may be reasonably necessary in order to consummate the transactions contemplated hereby.

 

SECTION
4.02. Specific Performance. The parties hereto agree that irreparable damage would occur in the event any provision of
this Agreement was not performed in accordance with the terms hereof and that any Investor (without being joined by any other
Investor) shall be entitled to specific performance of the terms hereof, in addition to any other remedy at law or in equity.
Any Investor shall be entitled to its reasonable attorneys’ fees in any action brought to enforce this Agreement in which
it is the prevailing party.

 

SECTION
4.03. Entire Agreement. This Agreement constitutes the entire agreement between the Company and the Stockholder (other
than the Securities Purchase Agreement and the other Transaction Documents) with respect to the subject matter hereof and supersedes
all prior agreements and understandings, both written and oral, among the Company and the Stockholder with respect to the subject
matter hereof.

 

SECTION
4.04. Amendment. This Agreement may not be amended except by an instrument in writing signed by the parties hereto.

 

    	 	- 3-	 

    	 

    

 

SECTION
4.05. Severability. If any term or other provision of this Agreement is invalid, illegal or incapable of being enforced
by any rule of law, or public policy, all other conditions and provisions of this Agreement shall nevertheless remain in full
force and effect so long as the economic or legal substance of this Agreement is not affected in any manner materially adverse
to any party. Upon such determination that any term or other provision is invalid, illegal or incapable of being enforced, the
parties hereto shall negotiate in good faith to modify this Agreement so as to effect the original intent of the parties as closely
as possible in a mutually acceptable manner in order that the terms of this Agreement remain as originally contemplated to the
fullest extent possible.

 

SECTION
4.06. Governing Law. All questions concerning the construction, validity, enforcement and interpretation of this Agreement
shall be governed by the internal laws of the State of Delaware, without giving effect to any choice of law or conflict of law
provision or rule (whether of the State of Delaware or any other jurisdictions) that would cause the application of the laws of
any jurisdictions other than the State of Delaware. The Company hereby irrevocably submits to the exclusive jurisdiction of the
state and federal courts sitting in the Borough of Manhattan in the City of New York, New York, for the adjudication of any dispute
hereunder or in connection herewith or under any of the other Transaction Documents or with any transaction contemplated hereby
or thereby, and hereby irrevocably waives, and agrees not to assert in any suit, action or proceeding, any claim that it is not
personally subject to the jurisdiction of any such court, that such suit, action or proceeding is brought in an inconvenient forum
or that the venue of such suit, action or proceeding is improper. The parties consent to the jurisdiction and venue of the foregoing
courts and consent that any process or notice of motion or other application to any of said courts or a judge thereof may be served
inside or outside the State of New York or the Southern District of New York by registered mail, return receipt requested, directed
to the party being served at its address set forth on the signature ages to this Agreement (and service so made shall be deemed
complete three (3) days after the same has been posted as aforesaid) or by personal service or in such other manner as may be
permissible under the rules of said courts. Each of the Company and the Stockholder irrevocably waives, to the fullest extent
permitted by law, any objection which it may now or hereafter have to the laying of the venue of any such suit, action, or proceeding
brought in such a court and any claim that suit, action, or proceeding has been brought in an inconvenient forum. EACH PARTY
HEREBY IRREVOCABLY WAIVES ANY RIGHT IT MAY HAVE, AND AGREES NOT TO REQUEST, A JURY TRIAL FOR THE ADJUDICATION OF ANY DISPUTE HEREUNDER
OR IN CONNECTION WITH OR ARISING OUT OF THIS AGREEMENT OR ANY TRANSACTION CONTEMPLATED HEREBY.

 

SECTION
4.07. Termination. This Agreement shall automatically terminate immediately following the occurrence of the Shareholder
Approval.

 

[The
remainder of the page is intentionally left blank]

 

    	 	- 4-	 

    	 

    

 

IN
WITNESS WHEREOF, the Stockholder and the Company have duly executed this Voting Agreement as of the date first written above.

 

	 	THE COMPANY:
	 	 	 
	 	PAVMED INC.
	 	 	 
	 	By:	           
	 	Name:	 
	 	Title:	 

 

	 	Address:
    	One
    Grand Central Place
	 	 	Suite
    4600
	 	 	New
    York, New York 10165

 

	 	STOCKHOLDER:	 

 

	 	By:
    	 
	 	Name:
    	 
	 	Title:
    	 

 

	 	Address:Exhibit 10.10

 

[COMPANY
LETTERHEAD]

 

November
4, 2019

 

Alto
Opportunity Master Fund, SPC

-
Segregated Master Portfolio B

c/o
Ayrton Capital LLC

222
Broadway, 19th Floor

New
York, NY 10038

Attention:
Waqas Khatri

 

Alto
Opportunity Master Fund, SPC

-
Segregated Master Portfolio C

c/o
Ayrton Capital LLC

222
Broadway, 19th Floor

New
York, NY 10038

Attention:
Waqas Khatri

 

Dear
Sirs:

 

This
agreement (the “Leak-Out Agreement”) is being delivered to you in connection with that certain understanding
by and among PAVmed Inc., a Delaware corporation with offices located at One Grand Central Place, Suite 4600, New York, NY 10165
(the “Company”) and the undersigned investors (“Holders”), and amends and restates that
certain Leak-Out Agreement, by and between the Company and Alto Opportunity Master Fund, SPC - Segregated Master Portfolio B (the
“Original Holder”), dated December 27, 2018.

 

The
Company has entered into (i) a Securities Purchase Agreement with the Original Holder, dated as of December 27, 2018 (the “2018
Securities Purchase Agreement”), pursuant to which, among other things, the Company has issued and sold to the Original
Holder and the Original Holder purchased a senior secured convertible note of the Company (the “2018 Note”),
which is convertible into shares of the Company’s common stock, $0.001 par value per share (the “Common Stock”,
as converted, the “2018 Conversion Shares”), in accordance with the terms of the 2018 Notes and (ii) a Securities
Purchase Agreement with the Holders, dated as of November 3, 2019 (the “New Securities Purchase Agreement”),
pursuant to which, among other things, the Company has agreed to issue and sell to the Holders and the Holders have agreed to
purchase certain senior secured convertible notes of the Company (the “New Note”), which will be convertible
into shares of Common Stock (as converted, the “New Conversion Shares”), in accordance with the terms of the
New Notes. Capitalized terms not defined herein shall have the meaning as set forth in the New Securities Purchase Agreement.

 

    	 

     

    

 

During
the period commencing on the date hereof (“Execution Date”) and ending on the date no 2018 Notes or New Notes
remain outstanding, neither of the Holders, nor any of their Affiliates, collectively, shall sell, directly or indirectly, any
Conversion Shares issued pursuant to an Acceleration (as defined in the 2018 Note) and/or an Acceleration (as defined in the New
Notes) to either Holder (or its Affiliate) or both Holders (or any of their Affiliates), as applicable (collectively, the “Restricted
Securities”) on any Trading Day (each date of determination, each a “Measuring Date”), if such sale,
together with all prior sales of Restricted Securities by the Holders (and/or any of their Affiliates, as applicable) on such
Measuring Date, exceed 25% of the daily average composite trading volume of the Common Stock (as reported by Bloomberg, LP for
such Measuring Date) (the “Daily Limit”); provided that (x) any such sales of Restricted Securities at a price
greater than or equal to 96% of the Closing Sale Price (as defined in the New Notes) of the Common Stock as of the Trading Day
immediately prior to such Measuring Date (the “Excluded Acceleration Shares”) shall not be included in the
Daily Limit calculation above and (y) any other sales of shares of Common Stock on such Measuring Date (excluding any sales of
Restricted Securities) shall not be included in the Daily Limit calculation above.

 

For
the purpose of this Leak-Out Agreement, the following definitions shall apply:

 

“Affiliate”
means, with respect to any specified Person, (x) any other Person who or which, directly or indirectly, controls, is controlled
by, or is under common control with such specified Person, including, without limitation, any partner, officer, director, member
of such Person and any fund now or hereafter existing that is controlled by or under common control with one or more general partners
or managing members of, or shares the same management company with, such Person or (y) if such Person is a natural person, such
Person’s spouse, lineal descendant (including any adopted child or adopted grandchild) or other family member, or a custodian
or trustee of any trust, partnership or limited liability company for the benefit of, in whole or in part, or the ownership interests
of which are, directly or indirectly, controlled by, such Person or any other member or members of such Person’s family.

 

“Person”
means an individual, a limited liability company, a partnership, a joint venture, a corporation, a trust, an unincorporated organization,
any other entity and any governmental or any department or agency thereof.

 

Notwithstanding
anything herein to the contrary, on or after the date hereof, any Holder may, directly or indirectly, sell or transfer all, or
any part, of the Restricted Securities (or any securities convertible or exercisable into Restricted Securities, as applicable)
to any Person (an “Assignee”) without complying with (or otherwise limited by) the restrictions set forth in
this Leak-Out Agreement; provided, that as a condition to any such sale or transfer an authorized signatory of the Company and
such Assignee duly execute and deliver a leak-out agreement in the form of this Leak-Out Agreement with respect to such transferred
Restricted Securities (or such securities convertible or exercisable into Restricted Securities, as applicable) (an “Assignee
Agreement”) and sales of such Holder and its Affiliates and all Assignees shall be aggregated for all purposes of this
Leak-Out Agreement and all Assignee Agreements.

 

Any
notices, consents, waivers or other communications required or permitted to be given under the terms of this Leak-Out Agreement
must be in writing.

 

This
Leak-Out Agreement constitutes the entire agreement among the parties hereto with respect to the subject matter hereof and supersedes
all prior negotiations, letters and understandings relating to the subject matter hereof and are fully binding on the parties
hereto.

 

    	 

     

    

 

This
Leak-Out Agreement may be executed simultaneously in any number of counterparts. Each counterpart shall be deemed to be an original,
and all such counterparts shall constitute one and the same instrument. This Leak-Out Agreement may be executed and accepted by
facsimile or PDF signature and any such signature shall be of the same force and effect as an original signature.

 

The
terms of this Leak-Out Agreement shall be binding upon and shall inure to the benefit of each of the parties hereto and their
respective successors and assigns.

 

This
Leak-Out Agreement may not be amended or modified except in writing signed by each of the parties hereto.

 

All
questions concerning the construction, validity, enforcement and interpretation of this letter agreement shall be governed by
the internal laws of the State of New York, without giving effect to any choice of law or conflict of law provision or rule (whether
of the State of New York or any other jurisdictions) that would cause the application of the laws of any jurisdictions other than
the State of New York. Each party hereby irrevocably submits to the exclusive jurisdiction of the state and federal courts sitting
in The City of New York, Borough of Manhattan, for the adjudication of any dispute hereunder or in connection herewith or with
any transaction contemplated hereby or discussed herein, and hereby irrevocably waives, and agrees not to assert in any suit,
action or proceeding, any claim that it is not personally subject to the jurisdiction of any such court, that such suit, action
or proceeding is brought in an inconvenient forum or that the venue of such suit, action or proceeding is improper.

 

Each
party hereby irrevocably waives personal service of process and consents to process being served in any such suit, action or proceeding
by mailing a copy thereof to such party at the address for such notices to it under this letter agreement and agrees that such
service shall constitute good and sufficient service of process and notice thereof. Nothing contained herein shall be deemed to
limit in any way any right to serve process in any manner permitted by law. Nothing contained herein shall be deemed to limit
in any way any right to serve process in any manner permitted by law. Each party hereby irrevocably waives any right it may have,
and agrees not to request, a jury trial for the adjudication of any dispute hereunder or in connection with or arising out of
this letter agreement or any transaction contemplated hereby.

 

Each
party hereto acknowledges that, in view of the uniqueness of the transactions contemplated by this letter agreement, the other
parties hereto would not have an adequate remedy at law for money damages in the event that this Leak-Out Agreement has not been
performed in accordance with its terms, and therefore agrees that such other parties shall be entitled to specific enforcement
of the terms hereof in addition to any other remedy to which it may be entitled, at law or in equity.

 

The
obligations of each Holder under this Agreement are several and not joint with the obligations of any other holder of 2018 Notes
or New Notes, from time to time (each, an “Other Holder”) under any other agreement, and the Holders shall
not be responsible in any way for the performance of the obligations of any Other Holder under any such other agreement. Nothing
contained herein or in this Agreement, and no action taken by a Holder pursuant hereto, shall be deemed to constitute such Holder
and Other Holders as a partnership, an association, a joint venture or any other kind of entity, or create a presumption that
any Holder and the Other Holders are in any way acting in concert or as a group with respect to such obligations or the transactions
contemplated by this Agreement and the Company acknowledges that each Holder and the Other Holders are not acting in concert or
as a group with respect to such obligations or the transactions contemplated by this Agreement or any other Agreement. The Company
and each Holder confirms that such Holder has independently participated in the negotiation of the transactions contemplated hereby
with the advice of its own counsel and advisors. Each Holder shall be entitled to independently protect and enforce its rights,
including, without limitation, the rights arising out of this Agreement, and it shall not be necessary for the other Holder or
any Other Holder to be joined as an additional party in any proceeding for such purpose.

 

[Signature
page follows]

 

    	 

     

    

 

[SIGNATURE
PAGE TO LEAK-OUT]

 

Agreed
to and Acknowledged:

 

	PAVMED,
    INC.	 
	 	 	 
	By:
    	 	 
	Name:	 	 
	Title:	 	 

 

	ALTO
    OPPORTUNITY MASTER FUND, SPC – 	 
	SEGREGATED
    MASTER PORTFOLIO B	 
	 	 	 
	By:
    	        	 
	Name:	 	 
	Title:
    	 	 

 

	ALTO
    OPPORTUNITY MASTER FUND, SPC – 	 
	SEGREGATED
    MASTER PORTFOLIO C	 
	 	        	 
	By:
    	 	 
	Name:	 	 
	Title:

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