Document:

Form of Subscription Agreement

 Exhibit 10.14 
 THIS PRIVATE PLACEMENT SUBSCRIPTION AGREEMENT (THE “AGREEMENT”) RELATES TO AN OFFERING OF COMMON STOCK RELYING UPON ONE OR MORE EXEMPTIONS FROM THE REGISTRATION REQUIREMENTS OF THE FEDERAL
SECURITIES LAWS PURSUANT TO SECTION 4(2) AND/OR RULE 506 OF REGULATION D (“REGULATION D”) AS PROMULGATED BY THE U.S. SECURITIES AND EXCHANGE COMMISSION (THE “SEC”) UNDER THE SECURITIES ACT OF 1933, AS AMENDED (THE
“SECURITIES ACT”). NONE OF THE SHARES TO WHICH THIS SUBSCRIPTION AGREEMENT RELATES HAVE BEEN REGISTERED UNDER THE SECURITIES ACT, OR ANY U.S. STATE SECURITIES LAWS, AND, UNLESS SO REGISTERED NONE MAY BE OFFERED OR SOLD, EXCEPT PURSUANT TO
AN EFFECTIVE REGISTRATION STATEMENT UNDER THE 1933 ACT, OR PURSUANT TO AN AVAILABLE EXEMPTION FROM, OR IN A TRANSACTION NOT SUBJECT TO, THE REGISTRATION REQUIREMENTS OF THE 1933 ACT AND IN EACH CASE ONLY IN ACCORDANCE WITH APPLICABLE STATE
SECURITIES LAWS. IN ADDITION, HEDGING TRANSACTIONS INVOLVING THE SHARES MAY NOT BE CONDUCTED UNLESS IN COMPLIANCE WITH THE SECURITIES ACT. 

THIS DOCUMENT INCLUDES A POWER OF ATTORNEY UNDER WHICH THE SUBSCRIBER APPOINTS DONALD B. WINGERTER, JR. AS ATTORNEY-IN-FACT FOR THE PURPOSES OF
EXECUTING AN EXTENSTION, IF REQUIRED, TO THE LOCK-UP AGREEMENT CONTAINED HEREIN. 
 PRIVATE PLACEMENT SUBSCRIPTION
AGREEMENT 
 (Accredited and Up To 35 Non-Accredited, Sophisticated Investors) 

Ampio Pharmaceuticals, Inc. 
 5445 DTC Parkway,
P4 
 Greenwood Village, Colorado 80111 

Attention: Donald B. Wingerter, Jr., Chief Executive Officer 
 Ladies and Gentlemen: 
 Ampio Pharmaceuticals, Inc. (the
“Company”) is offering, on an exempt private placement basis, up to an aggregate of 4,400,000 shares of its common stock (each a “Share” or collectively, “Shares”). The Shares
are being offered exclusively through Fordham Financial Management, Inc. (the “Placement Agent”) under a placement agency agreement (the “Placement Agreement”) to eligible investors (a
“Subscriber” or collectively, “Subscribers”) at a subscription price of U.S. $2.50 per Share (the “Purchase Price”). The Subscriber will purchase a minimum of 20,000 Shares
($50,000), subject to the right of the Company to accept subscriptions for a lesser number of shares in the Company’s sole and absolute discretion. The Shares are being offered solely to Subscribers who are accredited investors via this
subscription agreement (the “Agreement”). The Company will receive gross proceeds of up to $11,000,000 from sale of the offered Shares (the “Offering”). 

The Shares will be offered through April 30, 2011, subject to the right of the Company to extend the Offering for up to two
consecutive additional 30-day periods with the consent of the Placement Agent. 
  

	 	1.	Subscription. 

1.1 Based upon the terms of this Agreement, the Subscriber hereby irrevocably subscribes for and agrees to purchase the number of
Shares set forth on the signature page of this Agreement from the Company at a subscription price of U.S. $2.50 per Share, for aggregate consideration also set forth on the signature page of this Agreement (the “Subscription
Proceeds”), subject to a minimum subscription of 20,000 Shares ($50,000) unless the Company in its sole discretion agrees to accept a subscription for a lesser number of Shares. 

  
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 1.2 Payment. 

(a) The Subscription Proceeds must accompany this Agreement and shall be paid by wire transfer of immediately available funds in
U.S. dollars (or in the form of a personal or cashier’s check) in accordance with the wire and delivery instructions attached hereto as Exhibit A. If the Subscription Proceeds are held by, or wired to, the Placement Agent, the Subscriber
hereby provides written irrevocable authorization to the Placement Agent to withdraw and release from the Subscriber’s account maintained with the Placement Agent, and deliver to the Escrow Agent (defined below), the Purchase Price for the
Shares covered by this Subscription Agreement. 
 (b) The Subscriber acknowledges and agrees that this Agreement and any
other documents delivered in connection herewith will be held by the Placement Agent on behalf of the Company, and any Subscription Proceeds will be deposited by American Stock Transfer & Trust Company, LLC (the “Escrow
Agent”) in an escrow account established by the Escrow Agent with JPMorgan Chase (the “Escrow Account”). In the event that this Agreement is not accepted by the Company for whatever reason within 10 days of the
delivery of an executed Agreement by the Subscriber, this Agreement and any other documents delivered in connection herewith will be returned to the Subscriber by the Placement Agent at the address of the Subscriber as set forth in this Agreement,
and any Subscription Proceeds shall be returned to the Subscriber by the Escrow Agent in accordance with the payment information provided by the Placement Agent or the Subscriber to the Escrow Agent. 

1.3 Documents Required from Subscriber. 
 (a) The Subscriber must complete, sign and return to the Company one (1) executed copy of this Agreement and the Accredited and Sophisticated Investor Questionnaire attached as Schedule A; and

 (b) The Subscriber shall complete, sign and return to the Company as soon as possible, on request by the Company, any
documents, questionnaires, notices and undertakings as may be required by regulatory authorities, the OTC Bulletin Board, stock exchanges and applicable law. 
 1.4 The Subscription Proceeds shall be deposited by the Placement Agent in the Escrow Account pursuant to the instructions in Exhibit A. The Subscriber agrees that the Escrow Agent shall have
no accountability or obligations to the Subscriber whatsoever, and acknowledges that the Escrow Agent is accountable only to the Company and the Placement Agent. The Subscriber agrees that when the Subscription Proceeds are deposited in the Escrow
Account, the Escrow Agent’s only duty shall be to deliver the Subscription Proceeds to the Company or its designees, all solely according to payment instructions submitted jointly by the Company and the Placement Agent (the “Payment
Instructions”), and the Escrow Agent shall require no further instructions from the Subscriber in delivering the same to the Company or its designees. In the event the Company rejects this subscription in whole or in part, the Escrow
Agent shall return the Subscription Proceeds directly to the investor without interest or deduction there from. 
 The proceeds
of the Escrow Account shall be distributed in accordance with Section 1.5. 
 1.5 The consummation of the purchase and
sale of the Shares shall occur at one or more closing (a “Closing”) which shall occur on such date or dates as may be agreed upon by the Company and the Placement Agent (individually or collectively, the “Closing
Date”). The final Closing will occur not later than April 30, 2011, subject to extension by the Company with the consent of the Placement Agent for up to two consecutive 30-day periods to not later than June 29, 2011. For
purposes of this Agreement, a “business day” means a day (A) other than Saturday or Sunday and (B) on which commercial banks are open for business in New York City, New York. Closing of the offering of the Shares
shall occur in the following manner: 
 (a) The Escrow Agent shall upon notice of a Closing Date or Dates jointly from the
Company and the Placement Agent, release to the Company or its designees the proceeds of the Offering in accordance with the Payment Instructions. Pursuant to the Placement Agreement, the Company is obligated to, and shall at the Closing, pay the
Placement Agent pursuant to the Payment Instructions a commission in the amount of 10% of the gross proceeds of the Offering; a non-accountable expense allowance equal to 1% of the gross proceeds of the Offering; shall issue to the Placement Agent
five-year warrants to purchase one share of the Company’s common stock for 

  
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every ten (10) Shares sold in the Offering, each of which shall have an exercise price of $3.125 per share (125% of the Purchase Price); and shall pay all such blue sky fees and expenses of
Placement Agent counsel approved by the Company. 
 (b) On each Closing Date (as defined herein), the Company shall
irrevocably instruct its transfer agent to deliver to the Subscriber one or more stock certificates bearing the restrictive legends described below, evidencing the number of Shares the Subscriber is purchasing as is set forth on Subscriber’s
signature page to this Agreement next to the heading “Shares Issued” within two (2) business days after the Closing Date (the “Subscribed Shares”). 

 

	 	2.	Conditions to Offering. 

 This Offering is being conducted on a “best efforts” basis. Closing of the Offering shall occur as described in and subject to the provisions of Section 1.5 hereof. 

 

	 	3.	Representations, Warranties and Covenants. 

 3.1 The Subscriber hereby represents and warrants to, and covenants with, the Company (which representation, warranties and covenants shall survive the closing of this Agreement) and acknowledges that the
Company is relying thereon that: 
 (a) The undersigned is resident, or if not an individual, has a headquarters office, in
the jurisdiction set out under the heading “Address of subscriber” above the signature set forth on the execution page of this Agreement, which address is the undersigned’s principal residence or place of business, and such
address was not obtained or used solely for the purpose of acquiring the Shares. 
 (b) The Company has not undertaken, and
will have no obligation, to register any of the Shares under the Securities Act or any other securities legislation, except as set forth under Section 10 of this Subscription Agreement. 

(c) The Subscriber has received and carefully read this Agreement and the private placement memorandum dated March 17, 2011
(the “Memorandum”). The Subscriber has relied only on the contents of the Memorandum in and, as may be applicable, the information in the Company’s filings with the U.S. Securities and Exchange Commission (the
“SEC”) that are available to any member of the public on the EDGAR database maintained by the SEC at www.sec.gov. In making its investment decision, the Subscriber has received no written or oral
representations or information that is inconsistent with, or outside of, the Memorandum, and has relied solely on the Memorandum in making such investment decision. 
 (d) The Subscriber is representing and warranting that the Subscriber is (i) an “Accredited Investor”, as the term is defined in Rule 501(a) of the Securities Act, or (ii) a
sophisticated non-accredited investor, as more completely set forth on the Accredited and Sophisticated Investor Questionnaire attached as Schedule B hereto, which is incorporated by reference as if more fully set forth herein. The Subscriber shall
submit to the Company such further assurances of accredited or sophisticated status as may reasonably be requested by the Company or the Placement Agent. 
 (e) The Subscriber has the legal capacity and competence to enter into and execute this Subscription Agreement and to take all actions required pursuant hereto and, if the Subscriber is a
corporation, it is duly incorporated and validly subsisting under the laws of its jurisdiction of incorporation and all necessary approvals by its directors, shareholders and others have been obtained to authorize execution and performance of this
Subscription Agreement on behalf of the Subscriber. 
 (f) The Company has not made any other representations or warranties
to the undersigned with respect to the Company or rendered any investment or tax advice except as specifically contained herein. 
 (g) The undersigned has such knowledge and experience in financial, investment and business matters to be capable of evaluating the merits and risks of the prospective investment in the Shares of the
Company. 

  
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The undersigned has consulted with such independent legal counsel or other advisers as the undersigned has deemed appropriate to assist the undersigned in evaluating the proposed investment in
the Shares. By accepting these documents, the undersigned agrees that the information contained herein, and in all related and ancillary documents, shall be kept confidential (except as may be properly disclosed to the Subscriber’s counsel,
accountants, and investment representatives, if any, to which disclosure is made in connection with an evaluation of whether to invest in the Shares) and will not be reproduced, made available or accessible, or used for any other purpose other than
in connection with considering the purchase of the Shares or as required by law or order of a court of competent jurisdiction. The Subscriber agrees that it and its representatives shall not use, and will not permit the use of, all of the
information in the Memorandum in a manner or for a purpose detrimental to the Company. The Subscriber acknowledges that until public announcement, the terms and existence of this Subscription Agreement may be deemed material non-public information
under the Securities Exchange Act of 1934, and shall govern its activities accordingly. 
 (h) The Subscriber (i) has
adequate means of providing for its current financial needs and possible personal contingencies and does not have a need for liquidity of this investment in the Shares; (ii) can afford (a) to hold the Shares for an indefinite period of
time; and (b) to sustain a complete loss of the entire amount of the Subscription Proceeds for the Shares; and (iii) has not made an overall commitment to investments which are not readily marketable which is disproportionate so as to
cause such overall commitment to become excessive. If the Subscriber is not an accredited investor, the Subscriber (i) has at least five years’ investment experience in investments similar to the Shares, including investments in securities
listed on the OTC Bulletin Board, (ii) has adequate means of providing for its current financial needs and possible personal contingencies and does not have a need for liquidity of this investment in the Shares for the foreseeable future;
(iii) can afford (a) to hold the Shares for an indefinite period of time; and (b) to sustain a complete loss of the entire amount of the Subscription Proceeds for the Shares; (iii) has not made an overall commitment to
investments which are not readily marketable which is disproportionate so as to cause such overall commitment to become excessive, and (iv) is fully aware that the purchase of the Shares is a high risk investment. 

(i) The Subscriber has been afforded the opportunity to ask questions of, and receive answers from, the officers and/or directors of
the Company acting on its behalf concerning the terms and conditions of a purchase of the Shares and to obtain any additional information, to the extent that the Company possesses such information or can acquire it without unreasonable effort or
expense, necessary to verify the accuracy of the information furnished; and the undersigned has received satisfactory answers to all such questions to the extent deemed appropriate in order to evaluate the merits and risks of an investment in the
Shares. 
 (j) The Subscriber acknowledges that the none of the Shares are currently registered under the Securities Act
and, except as provided in Section 10 hereof, the Company has not undertaken to register any of such Shares under U.S. Federal or State law, and, unless so registered, may only be offered or sold pursuant to an effective registration statement
under the Securities Act, or pursuant to an exemption from, or in a transaction not subject to, the registration requirements of the Securities Act and in each case in accordance with applicable state securities laws. 

(k) The undersigned further understands that it is purchasing all such Shares without being furnished a prospectus setting forth all
of the information that may be required to be furnished under applicable securities laws in a registered public offering and, as a consequence, certain protections, rights and remedies provided in applicable securities legislation, including
statutory rights of rescission or damages, may not be available to it. 
 (l) The undersigned further acknowledges that no
agency, governmental authority, securities commission or similar regulatory body, stock exchange or other entity has reviewed, passed on or made any finding or determination as to the merit for investment of the Shares nor have any such agencies or
governmental authorities made any recommendation or endorsement with respect to the Shares. 
 (m) The Subscriber
understands that the Shares are being offered and sold to it in reliance on specific exemptions from the registration requirements of United States federal and state securities laws and that the Company is relying in part upon the truth and accuracy
of, and the Subscriber’s compliance with, the representations and warranties set forth herein in order to determine the availability of such exemptions and the eligibility of the Subscriber to acquire the Shares. 

  
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 (n) This Agreement has been duly executed and delivered and, when accepted by the
Company, will constitute a legal, valid and binding obligation of the undersigned enforceable against it in accordance with the terms hereof, except as enforceability may be limited by except as enforcement may be limited by insolvency and similar
laws affecting the enforcement of creditors’ rights generally and the effect of rules of law governing equitable remedies. 

(o) The social security number or Tax Identification Number of the Subscriber set forth herein is true, accurate and complete. The
Subscriber understands and agrees that there may be material tax consequences to it of an acquisition, holding or disposition of the Shares. The Company gives no opinion and makes no representation with respect to the tax consequences under U.S,
state, local or foreign tax law of the acquisition, holding or disposition of the Shares and the Subscriber acknowledges that it is solely responsible for determining the tax consequences of its investment. 

(p) There are risks associated with an investment in the Company, including, by way of example and not in limitation, the specific
risks identified in the Memorandum and in the Company’s most recent periodic reports filed with the SEC and available for viewing at the SEC’s website at www.sec.gov. 

(q) The Memorandum reflects the Company’s current intentions and business, financial and other information currently available
to the Company and, as such, the Subscriber understands and acknowledges that the precise nature of the Company’s operations, use of proceeds, capital needs, and other factors inherent in the Company’s business can be expected to change
from time to time. 
 (r) If required by applicable securities legislation, regulations, rules, policies or orders or by
any securities commission, stock exchange or other regulatory authority, the undersigned will execute, deliver, file and otherwise assist the Company in filing such reports, undertakings and other documents with respect to the issuance of the
Shares. 
 (s) The undersigned hereby agrees that the Company will insert the following legends on the face of the Shares
in compliance with applicable securities laws: 
 “THE SHARES REPRESENTED BY THIS CERTIFICATE HAVE NOT BEEN REGISTERED UNDER THE
SECURITIES ACT OF 1933, AS AMENDED, OR APPLICABLE STATE SECURITIES LAWS. THE SHARES HAVE BEEN ACQUIRED SOLELY FOR INVESTMENT PURPOSES AND NOT WITH A VIEW TOWARD RESALE AND MAY NOT BE OFFERED FOR SALE, SOLD, TRANSFERRED OR ASSIGNED IN THE ABSENCE OF
AN EFFECTIVE REGISTRATION STATEMENT FOR THE SHARES UNDER THE SECURITIES ACT OF 1933, AS AMENDED, OR APPLICABLE STATE SECURITIES LAWS, OR AN OPINION OF COUNSEL, IN A GENERALLY ACCEPTABLE FORM, THAT REGISTRATION IS NOT REQUIRED UNDER SAID ACT OR
APPLICABLE STATE SECURITIES LAWS.” 
 (t) The undersigned has not purchased the Shares as a result of any form of
general solicitation or general advertising, including advertisements, articles, notices or other communications published in any newspaper, magazine or similar media or broadcast over radio, television or other form of telecommunications, or any
seminar or meeting whose attendees have been invited by general solicitation or general advertising. 
 (u) The undersigned
additionally represents that the undersigned is not a registered broker-dealer and is not affiliated with FINRA unless the question in (i) below is answered yes (if question (i) is answered yes, then you need to complete questions
(ii) through (viii); if question (i) is no, then no response to this question is necessary: 
 (i) Are
you a registered broker-dealer*?  

YES   ̈    NO ̈ 

  
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 (ii) Are you an affiliate* of a broker-dealer*?  

 

			
	 YES   ̈     NO   ̈
	 	(if the answer to this question and the immediately preceding question is “NO,” you are NOT required to answer the following
questions.)

 If your answer is “YES” to (a) or (b) above, please provide the
following information (provide responses to ALL items, including if “N/A” or “None”): 
 (1) Did you
receive the shares as underwriting compensation? 

YES   ̈    
NO   ̈ 
 (2) Did you acquire the shares with a view toward
distribution? 
 YES   ̈     NO   ̈ 
 (3) Did you acquire the securities in the ordinary course of business?

 YES   ̈     NO   ̈ 
 (iii) At the time of acquisition of the securities, did you have any agreements,
arrangements or understandings, directly or indirectly, with any person to distribute the securities; and if so, please provide the details of such agreements, arrangements or understandings (e.g., parties, volume limitations, conditions of
termination):? 
 YES   ̈     NO   ̈ 
 (iv) The nature of your affiliation or association with such broker-dealer*,
if applicable: 
 (v) Information as to your relationship with the Company (including participation in any capacity in the
Placement of the Shares): 
 (vi) Whether you are in the business of underwriting securities: 

(vii) The date such securities were acquired: 
 (viii) The price paid or other consideration provided for your securities: 

(v) The undersigned certifies that each of the foregoing representations and warranties set forth in this Section 3.1 are true
as of the date hereof and shall survive such date. 
 3.2 The Company hereby represents and warrants and covenants to the
Subscriber that: 

  
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 (a) The Company is a corporation duly organized, validly existing and in good standing
under the laws of the State of Delaware. The Company has all necessary corporate power and authority to own, lease, use and operate its properties and to carry on its business as now being conducted and presently proposed to be conducted. The
Company and each of its subsidiaries is duly qualified to do business as a foreign corporation and is in good standing in each jurisdiction in which its ownership or leasing of assets, or the conduct of its business, makes such qualification
necessary. 
 (b) The Company has all necessary corporate power and authority to execute and deliver this Agreement, to
issue the Shares and to carry out the provisions of this Agreement. All corporate action on the part of the Company required for the lawful execution and delivery of this Agreement, issuance and delivery of the Shares and the performance by the
Company of its obligations hereunder has been taken. Upon execution and delivery, this Agreement constitutes valid and binding obligations of the Company enforceable in accordance with their respective terms, except as enforcement may be limited by
insolvency and similar laws affecting the enforcement of creditors’ rights generally and the effect of rules of law governing equitable remedies. The Shares, when issued in compliance with the provisions of this Agreement will be duly
authorized and validly issued, fully paid, non-assessable, subject to no lien, claim or encumbrance and issued in compliance with federal securities laws and applicable state securities laws. No stockholder of the Company or other person has any
preemptive, anti-dilution, “poison-pill” or similar right with respect to the Shares. The Company has reserved such number of shares of its common stock necessary for issuance of the Shares. 

(c) The Memorandum, as of its date or such later date on which the Memorandum is amended or supplemented, did not contain any untrue
statement of a material fact or omit to state a material fact required to be stated therein or necessary to make the statements made therein, in light of the circumstances under which they were made, not misleading. The financial statements included
in the Memorandum comply as to form in all material respects with applicable accounting requirements and with the published rules and regulations of the SEC with respect thereto. Except as may be indicated therein, the financial statements included
in the Memorandum have been prepared in accordance with generally accepted accounting principles consistently applied and fairly present the consolidated financial position of the Company and its subsidiaries at the dates thereof and the
consolidated results of their operations and consolidated cash flows for the periods then ended. 
 (d) Since the
respective dates as of which information is given in the Memorandum, except as otherwise stated therein: (i) there has been no material adverse change in the financial condition, or in the results of operations, affairs or prospects of the
Company, whether or not arising in the ordinary course of business, and (ii) there have been no transactions entered into by the Company, other than those in the ordinary course of business, which are material to the Company.

(e) The Company hereby covenants to use the monies raised from the Offering as described in the “Use of Proceeds” section
of the Memorandum. 
 (t) The Company certifies that each of the foregoing representations and warranties set forth in this
Section 3.2 are true as of the date hereof and shall survive such date. 
 4. Indemnification. The
parties hereto understand that the Shares are being offered in reliance upon representation, warranties and covenants of each of the parties hereto, the exemptions under applicable securities laws; that the availability of such exemptions are, in
part, dependent upon the truthfulness and accuracy of the representations made by the undersigned herein; that the Company will rely on such representations in accepting any subscriptions for the Shares, and that the Company may take such steps as
it considers reasonable to verify the accuracy and truthfulness of such representations in advance of accepting or rejecting the undersigned’s subscription. The undersigned agrees to indemnify and hold harmless the Company and the Placement
Agent, as a third party beneficiary hereof, against any damage, loss, expense or cost, including reasonable attorneys’ fees, sustained as a result of any misstatement or omission on the undersigned’s part in this Agreement. 

5. No Waiver. Notwithstanding any of the representations, warranties, acknowledgments or agreements made herein by the
undersigned, the undersigned does not thereby, or in any manner, waive any rights granted to it under applicable securities laws. 

  
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 6. Revocation. The undersigned agrees that he, she or it shall not
cancel, terminate or revoke this Agreement or any agreement of the undersigned made hereunder, and this Agreement shall survive the death or disability of the undersigned. 
 7. Termination of Agreement. If the Company elects to cancel this Agreement, provided that it returns to the undersigned, without interest and without deduction, all sums paid by the
undersigned, this Offering shall be null and void and of no further force and effect, and no party shall have any rights against any other party hereunder. 
 8. Miscellaneous. 
 8.1 All notices or other
communications given or made hereunder shall be in writing and shall be mailed by registered or certified mail, return receipt requested, postage prepaid, to the undersigned at their address set forth below and to the Company at 5545 DTC Parkway,
P4, Greenwood Village, Colorado 80111. 
 8.2 This Agreement constitutes the entire agreement among the parties hereto with
respect to the subject matter hereof and may be amended only by a writing executed by all parties. 
 8.3 The provisions of
this Agreement shall survive the execution thereof. 
 8.4 This Agreement shall be governed by and construed in accordance
with the domestic laws of the State of Delaware without giving effect to any choice or conflict of law provision or rule (whether of the State of Delaware or any other jurisdiction) that would cause the application of the laws of any jurisdiction
other than the State of Delaware. The parties further: (a) agree that any legal suit, action or proceeding arising out of or relating to this Agreement shall be instituted exclusively in any Federal or State court of competent jurisdiction
within the State of Colorado, (b) waive any objection that they may have now or hereafter to the venue of any such suit, action or proceeding, and (c) irrevocably consent to the in personam jurisdiction of any Federal or State court of
competent jurisdiction within the State of Colorado in any such suit, action or proceeding. The parties each further agree to accept and acknowledge service of any and all process which may be served in any such suit, action or proceeding in a
Federal or State court of competent jurisdiction within the State of Colorado, and that service of process upon the parties mailed by certified mail to their respective addresses shall be deemed in every respect effective service of process upon the
parties, in any action or proceeding. 
 9. Collection of Personal Information. The undersigned (on its own
behalf and, if applicable, on behalf of any person for whose benefit the undersigned is subscribing) acknowledges and consents to the fact the Company is collecting the undersigned’s (and any beneficial purchaser’s) personal information
for the purpose of completing the undersigned’s subscription. The undersigned (on its own behalf and, if applicable, on behalf of any person for whose benefit the undersigned is subscribing) acknowledges and consents to the Company retaining
the personal information for as long as permitted or required by applicable law or business practices. The undersigned (on its own behalf and, if applicable, on behalf of any person for whose benefit the undersigned is subscribing) further
acknowledges and consents to the fact the Company may be required by applicable securities laws and stock exchange rules to provide regulatory authorities any personal information provided by the undersigned respecting itself (and any
beneficial purchaser). By executing this Agreement, the undersigned is deemed to be consenting to the foregoing collection, use and disclosure of the undersigned’s (and any beneficial purchaser’s) personal information. The undersigned also
consents to the filing of copies or originals of any of the undersigned’s documents described herein as may be required to be filed with any stock exchange or securities regulatory authority in connection with the transactions contemplated
hereby. The undersigned represents and warrants that it has the authority to provide the consents and acknowledgments set out in this paragraph on behalf of all beneficial purchasers. 

10. Registration of Shares. The Company has undertaken to the Placement Agent, and agrees with the Subscriber, that
the Company will file a registration statement (the “Registration Statement”) covering the Shares, as well as 1,281,852 shares of common stock issued to the former holders of the Company’s debentures and 256,389 shares underlying
warrants issued to the debenture holders, not later than 90 days after the final closing of this Offering. All shares sold in this Offering will be included in such Registration Statement. The Company will use its commercially reasonable efforts to
secure the effectiveness of the Registration Statement as promptly as 

  
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practicable. Unless otherwise directed by the Subscriber, the Shares issued to the Subscriber in this Offering will be included on the Registration Statement. Such registration shall be without
cost to the Subscriber, except if the Subscriber desires to obtain its own counsel, in which case the fees of such counsel shall be paid by the Subscriber. Once the Registration Statement is declared effective, the Company will not be required to
maintain the effectiveness of such Registration Statement once all or a majority of the Shares registered become eligible for sale under Rule 144 or another exemption from the registration requirements. . 

11. Lock-Up Agreement and Power of Attorney. In consideration of the issuance of the Shares and the acceptance of the
undersigned’s subscription agreement, and in consideration of the agreement of the Company to register the Subscribed Shares in accordance with Section 10 above, the Subscriber hereby agrees as follows (the “Lock-Up
Agreement”): 
 (a) The undersigned will not directly or indirectly offer, sell, contract to sell, pledge or
otherwise dispose of, or enter into any transaction which is designed to, or might reasonably be expected to, result in the disposition (whether by actual disposition or effective economic disposition due to cash settlement or otherwise) of any of
the Shares purchased under this Subscription Agreement including by establishing or increasing a put equivalent position or liquidating or decreasing a call equivalent position within the meaning of Section 16 of the Securities Exchange Act of
1934, as amended, and the rules and regulations of the SEC, or publicly announce an intention to effect any such transaction, during the period commencing on the Closing Date applicable to the Subscriber’s purchase of Shares and expiring on a
uniform expiration date that shall be 60 days from the effective date of the Registration Statement; provided, however, that this Lock-Up Agreement will not prohibit the undersigned from making (a) bona fide gifts of Shares to family
members or family trusts or (b) any transfer of Shares for estate planning purposes to persons immediately related to such transferor by blood, marriage or adoption, or any trust solely for the benefit of such transferor and/or the persons
described in the preceding clause, provided further, however, that with respect to each of the transfers described in clauses (a) or (b) of this sentence, prior to such transfer, the transferee, or the trustee or legal guardian on
behalf of any transferee, agrees in writing to be bound by the terms of this Lock-Up Agreement. For purposes hereof, “immediate family” shall mean any relationship by blood, marriage or adoption not more remote than first cousin.

 (b) The undersigned also agrees and consents to the entry of stop transfer instructions with the Company’s stock
transfer agent and registrar against the transfer of the undersigned’s Shares, except in compliance with this Lock-Up Agreement. In furtherance of the foregoing, the Company and its transfer agent are hereby authorized to decline to make any
transfer of securities if such transfer would constitute a violation or breach of this Lock-Up Agreement. 
 (c) The Subscriber
hereby appoints Donald B. Wingerter, Jr., his, her or its attorney-in-fact, with full power of substitution, delegation and revocation (the “Attorney-In-Fact”), for the purpose of executing, swearing to, acknowledging and
delivering, for and in the name of the Subscriber, any further documents, certificates or instructions in connection with, or any extensions to, the Lock-Up Agreement that are reasonably requested by the Placement Agent; provided, however,
that (i) the terms of any extension to the Lock-Up Agreement executed by the Attorney-In-Fact for the Subscriber shall be identical to the terms of all Lock-Up Agreement extensions for all Subscribers in the Offering, and (ii) the
Attorney-In-Fact shall execute a Lock-Up Agreement extension for each Subscriber in the Offering if the Attorney-In-Fact executes an extension for any Subscriber. 
 12. Certification. The undersigned has read this entire Agreement and certifies that every statement on the part of the undersigned is true and complete. 

[remainder of page intentionally left blank] 

  
 9 

 IN WITNESS WHEREOF, subject to acceptance by the Company, the undersigned has
executed this Agreement on the date their signature has been subscribed and sworn to below. 
 DATED as of this
    day of             , 2011. 
  

					
	 Number of Shares to be

purchased at $2.50 each:
	 		  	 
		 		  	 
	 Total Subscription Proceeds:
	 	$	  	 
		 		  	
	 Name (full legal name of

Subscriber):
	 		  	 
		 		  	(print name of subscriber)
	 Address of Subscriber:
	 		  	
		 		  	 
		 		  	 
		 		  	 
		 		  	(address, including postal code)
		 		  	 
		 		  	(telephone number)
		 		  	 
		 		  	(facsimile number, if any)
		 		  	 
		 		  	(e-mail address)
		 		  	By:
		 		  	 
		 	                           
       ___________________________________
		 		  	(signature)
		 		  	 
		 		  	(if corporation, print name of authorized signatory)
		 		  	 
		 		  	(official capacity)
		 		  	 
		 		  	(social security number or federal corporate/business account number)

 ACCEPTED as of the     day of             , 2011. 

AMPIO PHARMACEUTICALS, INC.
  

									
					
	By:	 	 	 		 		 	Shares Issued:
	Name:	 	Donald B. Wingerter, Jr.	 		 		 	
	Title:	 	Chief Executive Officer	 		 		 	

  
 10 

 EXHIBIT A 
 INSTRUCTIONS FOR WIRING OR DELIVERING FUNDS 
 For the Benefit of: 

Bank Name: JPMorgan Chase 
 ABA
Number: 021 000 021 
 Swift code: 
 Account Number: 
 Account Name: 

Checks Payable:  
 Contact
Information for Placement Agent in case of questions: 
 Fordham Financial Management, Inc. 

  
 11Form of United Rentals, Inc. 2010 Long Term Incentive Plan

 Exhibit 10(a) 
 2010 LONG TERM INCENTIVE PLAN 
 RESTRICTED STOCK UNIT AGREEMENT

 (PERFORMANCE-BASED) 
 Awardee: 
 Date of Grant: 
 Target Number of Restricted Stock Units: 
 This RESTRICTED STOCK UNIT
AGREEMENT (this “Agreement”) is made as of the Date of Grant set forth above by and between UNITED RENTALS, INC., a Delaware corporation, having an office at Five Greenwich Office Park, Greenwich, CT 06831 (the
“Company”), and Awardee, currently an employee of the Company or an affiliate of the Company. 
 In
consideration of the mutual promises and covenants contained herein, and for other good and valuable consideration, the receipt and sufficiency of which are hereby acknowledged, the parties hereto agree as follows: 

1. Grant of Restricted Stock Units. The Company, pursuant to its 2010 Long Term Incentive Plan (the
“Plan”), which is incorporated herein by reference, and subject to the terms and conditions thereof, hereby grants to Awardee (also referred to as “you”) the Target Number of Restricted Stock Units (the
“Units”). The number of Units granted represents the number of Units that would be earned if the Company were to achieve the target level of performance for the Company Performance Measures (as hereinafter defined) for each calendar
year during the period from January 1, 2011 through December 31, 2013 (each calendar year during such period, a “Performance Period”). The number of Units earned, if any, is subject to increase or decrease based on the
Company’s actual performance against the Company Performance Measures and may range from 0% to 200% of the Units. Your failure to sign and return a copy of this Agreement within 30 days of receipt shall automatically effect a cancellation and
forfeiture of the Units, except as determined by the Company in its sole discretion. 
 2. Company Performance
Measure; Certification; 
 Change in Control; Forfeiture. 

 

	 	(i)	Company Performance Measures. Provided you have remained continuously employed by the Company through the last day of a Performance Period (each such day, a
“Vesting Date”), one-third of the Target Number of Restricted Stock Units granted hereunder may be earned for each Performance Period based on the achievement of annual goals related to EBITDA and EBTIDA Margin (each as adjusted for
restructuring charges and stock compensation) set forth in Schedule I (the “Company Performance Measures”). The Compensation Committee of the Board of Directors of the Company (the “Compensation Committee”) shall
approve the Company Performance Measures and the formula to determine the number of Units earned based upon the level of achievement of the Company Performance Measures for each Performance Period no later than 90 days after the commencement of the
Performance Period to which the Company Performance Measures relate. The Company shall notify you of the Company Performance Measures and formula as soon as practicable thereafter. 

	 	(ii)	Certification. The Compensation Committee shall certify the achievement of the Company Performance Measures in accordance with Section 2.8.2(c) of the Plan
and the percentage of Units earned for a Performance Period as soon as administratively practicable after the end of the Performance Period but no later than 45 days after the end of the calendar year in which the Performance Period ends (the
“Certification Date”). The percentage of Units earned for a Performance Period will be determined as follows: 

  

					
	 Performance
	  	Percentage of Units earned
for a Performance Period*	 
	 Performance less than Threshold
	  	 	0	% 
	 Performance at Threshold
	  	 	50	% 
	 Performance at Target
	  	 	100	% 
	 Performance at or above Maximum
	  	 	200	% 

  

	*	If the performance is between the amounts shown, the percentage of Units earned will be appropriately adjusted to a percentage determined by linear interpolation
between the respective amounts shown. 

 The Company shall advise you of the percentage of Units earned for the
Performance Period as soon as practicable following the Certification Date. All earned Units for the Performance Period shall be settled in accordance with Section 4 and any Units not earned for the Performance Period shall be canceled and
forfeited as of the Certification Date. 
  

	 	(iii)	Change in Control. Except as set forth in Section 7, following a Change in Control (as defined below), notwithstanding the provisions of Sections 2(i) and
2(ii), the Units will convert to time-based Units and will be deemed earned at the target level with respect to any then open Performance Period on the anniversary of the Date of Grant following the end of the applicable Performance Period, provided
that Awardee has remained continuously employed by the Company through the applicable Vesting Date. 

  
 -2-

	 	(iv)	Forfeiture. Except as set forth in Section 7, if your employment with the Company terminates for any reason whatsoever, including, but not limited to, a
termination by the Company with or without “Cause” (as hereinafter defined), a resignation by you with or without “Good Reason” (as hereinafter defined), or your retirement, prior to the Vesting Date for any Performance Period,
all Units that could have been earned for such Performance Period and for any remaining Performance Period shall be canceled and forfeited as of the date of such termination. 

3. Transfer. Except as may be effected by will or other testamentary disposition or by the laws of descent and
distribution, the Units are not transferable, whether by sale, assignment, exchange, pledge, or hypothecation, or by operation of law or otherwise before they earned and are settled, and any attempt to transfer the Units in violation of this
Section 3 will be null and void. 
 4. Settlement of Units. 

 

	 	(i)	General. Earned Units shall be settled in shares of the common stock, $.01 par value, of the Company (“Shares”), on a one-for-one basis,
(1) as soon as practicable following the Certification Date (but in no event later than March 1st in the calendar year after the calendar year in which the Performance Period ends) or (2) following a Change in Control, as soon as
practicable following the anniversary of the Date of Grant Units are deemed earned in accordance with Section 2(iii), provided in each case that Awardee has satisfied their tax withholding obligations with respect to the earned Units as
described in this Agreement. Shares, in a number equal to the number of Units that have been earned, will be issued by the Company in the name of Awardee by electronic book-entry transfer or credit of such shares to an account of Awardee maintained
with such brokerage firm or other custodian as the Company determines. Alternatively, in the Company’s sole discretion, such issuance may be effected in such other manner (including through physical certificates) as the Company may determine
and/or by transfer or credit to such other account of Awardee as the Company or Awardee may specify. 

  

	 	(ii)	Section 409A. The Company intends that the Units shall not constitute “nonqualified deferred compensation” subject to Section 409A of the
Internal Revenue Code of 1986, as amended (“Section 409A”), and this Agreement shall be interpreted, administered and construed consistent with such intent. If, and only to the extent that, (1) the Units constitute “deferred
compensation” within the meaning of Section 409A and (2) Awardee is deemed to be a “specified employee” (as such term is defined in Section 409A and as determined by the Company), the payment of Units on account of
Awardee’s termination of employment shall not be made until the first business day of the seventh month after Awardee’s “separation from service” (as such term is defined and used in Section 409A) with the Company, or if
earlier, the date of Awardee’s death. 

 5. Forfeiture. You acknowledge that an
essential purpose of the grant of the Units is to ensure the utmost fidelity by yourself to the Company’s interests and to your diligent performance of all of your understandings and commitments to the Company. Accordingly,

  
 -3-

 
YOU SHALL NOT BE ENTITLED TO RETAIN THE UNITS OR RECEIVE SHARES IN SETTLEMENT THEREOF, EITHER DURING OR AFTER TERMINATION OF YOUR EMPLOYMENT WITH THE COMPANY IF THE COMPANY, IN ITS SOLE
DISCRETION, BELIEVES THAT YOU HAVE AT ANY TIME ENGAGED IN “INJURIOUS CONDUCT” (AS HEREINAFTER DEFINED). 
 In the
event of any such determination: 
  

	 	(i)	the Units shall terminate and be forfeited as of the date of such determination; and 

 

	 	(ii)	Awardee shall (1) transfer back to the Company, for consideration of $.01 per Share, all Shares that are held, as of the date of such determination, by Awardee and
that were acquired upon settlement of the Units on or after the date which is 180 days prior to the date of such conduct (Shares so acquired, the “Acquired Shares”) and (2) to the extent such Acquired Shares have previously
been sold or otherwise disposed of by Awardee, repay to the Company the aggregate Fair Market Value (as defined in the Plan) of such Acquired Shares on the date of such sale or disposition, less the number of such Acquired Shares times $.01.

 For purposes of the preceding clause (ii)(2) of this Section 5, the amount of the repayment described therein shall not be
affected by whether Awardee received such Fair Market Value with respect to such sale or other disposition, and repayment may, without limitation, be effected, at the discretion of the Company, by means of offset against any amount owed by the
Company to Awardee. 
 “Injurious Conduct” for purposes of this Agreement shall mean (i) Awardee’s fraud,
misappropriation, misconduct or dishonesty in connection with his or her duties, (ii) any act or omission which is, or is reasonably likely to be, materially adverse or injurious (financially, reputationally or otherwise) to the Company or any
affiliate of the Company, (iii) Awardee’s breach of any material obligations contained in Awardee’s employment agreement or offer letter with the Company, including, but not limited to, any restrictive covenants or obligations of
confidentiality contained therein, (iv) conduct by Awardee that is in material competition with the Company or any affiliate of the Company or (v) conduct by Awardee that breaches Awardee’s duty of loyalty to the Company or any
affiliate of the Company. 
 6. Securities Laws Restrictions. You represent that when the Units are
settled, you will be acquiring Shares for your own account and not on behalf of others. You understand and acknowledge that federal and state securities laws govern and restrict your right to offer, sell or otherwise dispose of any Shares so
received unless otherwise covered by a Form S-8 or unless your offer, sale or other disposition thereof is otherwise registered under the Securities Act of 1933, as amended (the “1933 Act”) and state securities laws or, in the
opinion of the Company’s counsel, such offer, sale or other disposition is exempt from registration thereunder. You agree that you will not offer, sell or otherwise dispose of any such Shares in any manner which would: (i) require the
Company to file any registration statement with the Securities and Exchange Commission (or similar filing under state laws) or to amend or supplement any such filing or (ii) violate or cause the Company to violate the 1933 Act, the rules and
regulations promulgated thereunder or any other state or federal law. You further understand that (i) any sale of the Shares 

  
 -4-

 
you acquire upon settlement of the Units are subject to the Company’s insider trading rules and policies, as they exist from time to time, and (ii) the certificates for such Shares will
bear such legends as the Company deems necessary or desirable in connection with the 1933 Act or other rules, regulations or laws. 
 If you are a director, officer or principal shareholder, Section 16(b) of the Securities Exchange Act of 1934, as amended (the “1934 Act”) further restricts your ability to sell or
otherwise dispose of Shares acquired upon settlement of the Units. 
 7. Change in Control; Death or
Disability. 
  

	 	(i)	In the event of either (1) a Change in Control that results in none of the common stock of the Company or any direct or indirect parent entity being publicly
traded or (2) a termination of Awardee’s employment by the Company without Cause, or by Awardee for Good Reason, within 12 months after any Change in Control, then all Units shall be deemed earned at the target level with respect to each
remaining open Performance Period and nonforfeitable upon the occurrence of such event. 

  

	 	(ii)	In the event of a termination of Awardee’s employment as a result of Awardee’s death or permanent disability (as defined under the Company’s long-term
disability policies), a pro rata portion of the Units that could have been earned for the Performance Period in which such termination occurs shall be deemed earned on the date of such termination equal to — multiplied by a fraction (the
denominator of which is 365 and the numerator of which is the number of days since the first day of the current Performance Period until the date of termination). All Units that are not earned as of the date of such termination (including as a
result thereof) shall be forfeited on the date of such termination. 

  

	 	(iii)	For purposes of this Agreement, “Change in Control” means (1) any person or business entity is or becomes a “beneficial owner” (as
defined in Rule 13d-3 under the 1934 Act), directly or indirectly, of securities of the Company representing more than 50% of the total voting power represented by then outstanding voting securities of the Company or (2) there shall be
consummated a merger of the Company, the sale or disposition by the Company of all or substantially all of its assets within a 12-month period, or any other business combination of the Company with any other corporation or business entity, but not
including any merger or business combination of the Company which would result in the voting securities of the Company outstanding immediately prior thereto continuing to represent (either by remaining outstanding or by being converted into voting
securities of the surviving entity) more than 50% of the total voting power represented by the voting securities of the Company or such surviving entity outstanding immediately after such merger or business combination. 

  
 -5-

	 	(iv)	For purposes of this Agreement, “Cause” means (1) Awardee’s continued failure to substantially perform his or her duties (other than as a
result of total or partial incapacity due to physical or mental illness), (2) Awardee’s commission of a crime constituting (x) a felony under the laws of the United States or any state thereof or (y) a misdemeanor involving moral
turpitude, (3) Awardee’s fraud, misappropriation, misconduct or dishonesty in connection with his or her duties, (4) any act or omission which is, or is reasonably likely to be, materially adverse or injurious (financially,
reputationally or otherwise) to the Company or any affiliate of the Company, (5) Awardee’s breach of any material obligations contained in Awardee’s employment agreement or offer letter with the Company, including, but not limited to,
any restrictive covenants or obligations of confidentiality contained therein, (6) Awardee’s breach of the Company’s Code of Conduct or (7) Awardee’s material breach of any Company policies and procedures applicable to
Awardee. 

  

	 	(v)	For purposes of this Agreement, “Good Reason” shall exist if Awardee resigns his or her employment following the Company’s (1) material
reduction of Awardee’s base salary, or (2) requirement that Awardee relocate more than 50 miles from Awardee’s current principal location of employment; “Good Reason” shall exist only if Awardee has given written notice to
the Company within 30 days after the initial occurrence of the event, with a reference to this Agreement, the Company has not cured such event by the 15th day after the date of such notice, and Awardee’s employment terminates within 60 days of
Awardee’s giving of such notice to the Company. 

  

	 	(vi)	For purposes of this Agreement, in the event Awardee has an employment agreement with the Company that provides definitions for the terms “Cause” and/or
“Good Reason,” then, during the time in which Awardee’s employment agreement is in effect, the definitions provided within Awardee’s employment agreement shall be used instead of the definitions provided above.

 8. Withholding Taxes. Awardee shall pay to the Company, or make provision satisfactory to
the Company for payment of, the minimum aggregate federal, state and local taxes required to be withheld by applicable law or regulation in respect of the settlement of any portion of the Units hereunder, or otherwise as a result of your receipt of
the Units, no later than the date of the event creating the tax liability. The Company may, and, in the absence of other timely payment or provision made by Awardee that is satisfactory to the Company, shall, to the extent permitted by law, deduct
any such tax obligations from any payment of any kind otherwise due to Awardee, including, but not limited to, by withholding Shares which otherwise would be delivered hereunder. In the event that payment to the Company of such tax obligations is
made by delivering or withholding of Shares, such Shares shall be valued at their Fair Market Value (as determined in accordance with the Plan) on the date of such delivery or withholding. 

9. No Rights as a Stockholder. Neither the Units nor this Agreement shall entitle Awardee to any voting rights or
other rights as a stockholder of the Company unless and until Shares have been issued in settlement thereof. Without limiting the generality of the foregoing, no dividends or dividend equivalents shall accrue or be paid with respect to any Units.

  
 -6-

 10. Conformity with Plan. This Agreement, and the Units awarded
hereby, are intended to conform in all respects with, and are subject to all applicable provisions of, the Plan, which is incorporated herein by reference. Any inconsistencies between this Agreement and any mandatory provisions of the Plan shall be
resolved in accordance with the terms of the Plan, and this Agreement shall be deemed to be modified accordingly. By executing and returning this Agreement, you acknowledge your receipt of the Plan and agree to be bound by all the terms and
conditions of the Plan as it shall be amended from time to time. 
 11. Employment and Successors.
Nothing herein confers any right or obligation on you to continue in the employ of the Company or any affiliate of the Company or shall affect in any way your right or the right of the Company or any affiliate of the Company, as the case may be, to
terminate your employment at any time. The agreements contained in this Agreement shall be binding upon and inure to the benefit of any successor to the Company by merger or otherwise. Subject to the restrictions on transfer set forth herein, all of
the provisions of the Plan and this Agreement will be binding upon Awardee and Awardee’s heirs, executors, administrators, legal representatives, successors and assigns. 
 12. Awardee Advised To Obtain Personal Counsel and Tax Representation. IMPORTANT: The Company and its employees do not provide any guidance or advice to individuals who
may be granted Units under the Plan regarding the federal, state or local income tax consequences or employment tax consequences of participating in the Plan. Notwithstanding any withholding by the Company of taxes hereunder, Awardee remains
responsible for determining Awardee’s own personal tax consequences with respect to the Units, their being earned, the receipt of Shares upon settlement, any subsequent disposition of Shares and otherwise of participating in the Plan, and also
ultimately remains liable for any tax obligations in connection therewith (including any amounts owed in excess of withheld amounts). Accordingly, Awardee may wish to retain the services of a professional tax advisor in connection with the Units and
this Agreement. 
 13. Beneficiary Designation. Awardee may designate one or more beneficiaries, from time to
time, to whom any benefit under this Agreement is to be paid in case of Awardee’s death. Each designation must be in writing, signed by Awardee and delivered to the Company. Each new designation will revoke all prior designations. 

14. Adjustments for Changes in Capital Structure. In the event any change is made to the Shares by reason of any dividend
of shares or extraordinary cash dividend, stock split or reverse stock split, recapitalization, reorganization, merger, consolidation, split-up, combination or exchange of shares, or other change affecting the outstanding Shares as a class without
the Company’s receipt of consideration, the Company shall make such appropriate adjustments to the Units as it determines are equitable and reasonably necessary or desirable to preserve the intended benefits under this Agreement. 

15. Disputes. Any question concerning the interpretation of or performance by the Company or Awardee under this
Agreement, including, but not limited to, the Units, their being earned, settlement or forfeiture, or the issuance or delivery of Shares upon settlement, or any other dispute or controversy that may arise in connection herewith or therewith, shall
be determined by the Company in its sole and absolute discretion; provided, however, that, 

  
 -7-

 
following a Change in Control, any determinations by the Company or a successor entity with respect to the existence or not of Injurious Conduct, Cause or Good Reason, or any other post-Change in
Control determination that would effect a forfeiture of all or a portion of the Units, must be objectively reasonable. 
 16.
Miscellaneous. 
  

	 	(i)	References herein to determinations or other decisions or actions to be taken or made by the Company shall be made by the Compensation Committee or such other person or
persons to whom the Compensation may from time to time delegate authority or otherwise designate, and any such determinations, decisions or actions shall be final, conclusive and binding on Awardee and all persons claiming under or through Awardee.

  

	 	(ii)	This Agreement may not be changed or terminated except by a written agreement expressly referencing this Agreement and signed by the President or Chief Executive
Officer of the Company and Awardee. 

  

	 	(iii)	This Agreement, together with the Plan, constitutes the entire understanding of the parties, and supersedes and cancels all prior agreements, with respect to the
subject matter hereof. 

  

	 	(iv)	This Agreement may be signed in one or more counterparts, each of which shall be an original, with the same effect as if the signature thereto and hereto were upon the
same instrument. 

  

	 	(v)	This Agreement will be governed by and construed in accordance with the laws of the State of Connecticut, without regard to principles of conflicts of laws. The
interpretation and enforcement of the provisions of this Agreement shall be resolved and determined exclusively by the state court sitting in Fairfield County, Connecticut or the federal courts in the District of Connecticut and Awardee hereby
consents that such courts be granted exclusive jurisdiction for such purpose. 

  
 -8-

 IN WITNESS WHEREOF, the parties hereto have executed this Agreement as of the Date of
Grant. 
  

			
	UNITED RENTALS, INC.
		
	By:	 	  

	Michael J. Kneeland
	Chief Executive Officer
	
	AWARDEE:
	
	  

	NAME

  
 -9-

 Schedule I 
 to 
 Restricted Stock Unit Agreement 

Company Performance Measures 
 The Compensation Committee has determined that the number of Units earned based on the achievement of the Company Performance Measures, weighted equally, for the Performance Period beginning on
January 1, 2011 and ending on December 31, 2011 shall be determined as set forth in the following schedule: 
  

					
	 Performance Level
	 	 EBITDA**
 ($M)
	 	EBITDA Margin**
	 Maximum
	 	880	 	37.3%
	 Target
	 	800	 	33.3%
	 Threshold
	 	750	 	30.0%

  

	*	If the performance is between the amounts shown, the percentage of Units earned will be appropriately adjusted to a percentage determined by linear interpolation
between the respective amounts shown. 

	**	Each as adjusted for restructuring charges and stock compensation. 

  
 -10-

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