Document:

Converted by EDGARwiz

EXHIBIT 10.1

SATISFACTION AND ASSIGNMENT AGREEMENT

This Satisfaction and Assignment Agreement (this “Agreement”) is made and entered into this 4th day

of  January,  2016  (the  “Effective  Date”)  by and  among  Abakan,  Inc.,  a Nevada  corporation  (“Abakan”)  and

MesoCoat,  Inc.  a  Nevada  corporation  (“MesoCoat”),  and  creditors  George  Town  Associates  S.A.  (“George

Town”),  Sonoro  Invest  S.A.  (“Sonoro”),  Joseph  T.  Eberhard  (“Eberhard”),  and  the  Abakan  Petitioning

Creditors  (as  hereinafter  defined)  (George  Town,  Sonoro,  Eberhard  and  the  Abakan  Petitioning  Creditors,

collectively, the “Creditors”, and together with Abakan and MesoCoat being hereinafter collectively referred

to as the “Parties” and individually a “Party”).

RECITALS

WHEREAS, Abakan and MesoCoat owe at least $1.78 million to secured creditor George Town as set

forth in a judgment duly entered by the United States District Court for the Southern District of New York on

August  18,  2015.   George  Town  made  an  additional  senior  secured  loan  to  MesoCoat  on  September  3,  2015

of up to $500,000, which shall survive this Agreement, remain in effect and outstanding pursuant to its terms

and is explicitly not part of this Agreement;

WHEREAS, Abakan owes at least $3.215 million to senior creditor Sonoro as set forth in a judgment

duly entered by the United States District Court for the Southern District of Florida on October 8, 2015;

WHEREAS, Abakan owes approximately $850,000.00 to Eberhard pursuant to two promissory notes

from Abakan to Eberhard;

WHEREAS,  Abakan  owes  approximately  $357,209.00  in  the  aggregate  ()  to  David  van  der  Gulik,

Warren  Lydon,  Philip Graves,  Paul  Ammon,  Ammon &  Associates,  and  Vladimir  Chernyakov  (collectively,

the “Abakan Petitioning Creditors”);

WHEREAS,   MesoCoat   owes   approximately   $42,000.00   in   the   aggregate   (together   with   the

indebtedness to George Town, Sonoro, Eberhard, and the Abakan Petitioning Creditors, the “Claims”) to Huge

Heating  &  Cooling  Co.,  Inc.,  Mark  Baumgardner  Management  Consulting,  LLC,  Ron  Hymes,  and  Sytek

Systems, Inc. (collectively, the “MesoCoat Petitioning Creditors”)

WHEREAS, MesoCoat is a wholly owned subsidiary of Abakan;

WHEREAS, judgment creditor George Town   has a security interest in all of the assets of MesoCoat

(with certain exceptions) and is authorized to and has taken possession of the assets of MesoCoat which are

currently held  in  trust  for  George  Town’s  benefit  by the  Federal  Court  appointed  receiver  of  Abakan  and

MesoCoat - Robert W. Seiden (the “Receiver”).

WHEREAS,  the  Receiver  obtained  an  independent  valuation  report  of  MesoCoat  indicating  that  the

fair value of the equity of MesoCoat is $3,584,107 as of August 31, 2015;

WHEREAS, MesoCoat guaranteed Abakan’s obligations to George Town;

WHEREAS,   as   set   forth   herein,   George   Town,   Sonoro,   Eberhard,   the   Abakan   Petitioning

Creditors, and the MesoCoat Petitioning Creditors have reached an intercreditor agreement regarding the

debts owed to each of them by Abakan and MesoCoat; and

WHEREAS, Abakan and MesoCoat  desire to satisfy the Claims in full by making certain transfers

to the Creditors, pursuant to the terms of this Agreement.

EXHIBIT 10.1

NOW, THEREFORE, for good and valuable consideration, the receipt and sufficiency of which are

hereby acknowledged, the Parties agree as follows:

1.

Consideration; Satisfaction and Discharge.

a.    Consideration. Abakan  and MesoCoat hereby make the following transfers (together  with

the   covenants   and   obligations   of   Sections   5   and   6   hereof,   the   “Consideration”)   in

consideration  of  the  Creditors’  discharge  of  Abakan  and  MesoCoat  from  their  obligations

to pay the Claims, as contemplated herein:

i.   Transfer of MesoCoat Stock. Abakan hereby conveys and transfers seventy-seven

and 50/100 percent (77.5%) of its stock and ownership in MesoCoat, free and clear

of  all  liens,  claims  and  encumbrances,  being  seventy-seven  and  50/100  percent

(77.5%)  of  all  issued  and  outstanding stock  of  MesoCoat  (“MesoCoat  Stock”),  to

the  Creditors, and  hereby irrevocably authorizes  the transfer  agent  to  transfer  such

seventy-seven    and    50/100    percent    (77.5%)    of    the    MesoCoat    Stock    (the

“Transferred  Stock”)  on  the  books  of MesoCoat,  with  full  power  of  substitution,

to the Creditors.

ii.   Claims of the MesoCoat Petitioning Creditors.  Within fourteen (14) days of the

closing  of  this  Agreement, MesoCoat  shall  pay in  full  the  claims  of  the MesoCoat

Petitioning Creditors.1

b.  Satisfaction and Discharge. The Creditors hereby accept the Consideration in full satisfaction

of  the  Claims  and  discharge  Abakan  and  MesoCoat  from  any  further  obligation  to  pay  the

Claims.

c.    Ownership  of  MesoCoat  Stock.    The  Parties  hereby  agree  that  from  and  after  the  transfer

of  MesoCoat  Stock  described  herein,  the  ownership  of  the  MesoCoat  Stock  shall  be  as

follows:

George Town:

38.75%

Sonoro:

28.17%

Eberhard:

7.44%

Abakan Petitioning Creditors:

3.14%2

Abakan:

22.50%

Total:

100.00%

1 The claims owed each of the MesoCoat Petitioning Creditors to be paid in full are as follows:  Huge Heating &

Cooling Co., Inc.:  $9,557.54; Mark Baumgardner Management Consulting, LLC:  $3,367.83; Ron Hymes:  $9,995; and

Sytek Systems, Inc.:  $18,981.72.

2 This 3.14% portion of the MesoCoat Stock shall be divided among the Abakan Petitioning Creditors on a pro rata

basis based upon the amount of their claims as follows: David van der Gulik: $81,829.60; Warren Lydon: $25,000;

Philip Graves: $94,480; Paul Ammon: $105,000; Ammon & Associates: $20,000; and Vladimir Chernyakov: $30,900.

EXHIBIT 10.1

2.

Acknowledgments.     Although  George  Town  is  a  secured  party,  it  explicitly  and  knowingly

agrees  to  this  arrangement  with  the  other  Creditors;  and  although  Sonoro’s  claim  against  Abakan  is

significantly larger than George Town’s and Eberhard’s claims, Sonoro recognizes that as a secured creditor

George Town’s claim may have priority over its own claim and therefore  explicitly and  knowingly agrees

to this arrangement with the other Creditors.  Eberhard and the Abakan Petitioning Creditors also explicitly

and knowingly agree to this arrangement given that their claims are unsecured and smaller than the claims

of the other Creditors.

3.

Abakan and MesoCoat Release. Abakan hereby releases and forever discharges MesoCoat, and

Abakan and MesoCoat hereby release and forever  discharge  George Town, Sonoro and Eberhard, and their

respective  principals,  directors,  officers,  members,  owners,  shareholders,  employees,  consultants,  advisors,

attorneys and affiliates (collectively, the “Releasees” including MesoCoat to the extent applicable) from any

and  all  demands,  claims,  liabilities,  debts,  inter-company loans  and  /or  advances,  causes  of  action,  actions,

judgments,  and  suits,  whether  based  in  law  or  equity,  whether  accruing  before  or  on  the  Effective  Date,

whether based in contract or tort or otherwise, that Abakan or MesoCoat may have against the Releasees.

4.

Abakan  Petitioning  Creditors  and  MesoCoat  Petitioning  Creditors  Release.    Except  as

otherwise  provided  herein,  the  Abakan  Petitioning  Creditors  and  the  MesoCoat  Petitioning  Creditors

(collectively, the “Petitioning Creditors”) hereby release and forever discharge Abakan, MesoCoat, George

Town,   Sonoro,   and   Eberhard   and   their   respective   principals,   directors,   officers,   members,   owners,

shareholders,  employees,  consultants,  advisors,  attorneys  and  affiliates  (collectively,  the  “Releasees  of

Petitioning  Creditors”  including  MesoCoat  to  the  extent  applicable)  from  any  and  all  demands,  claims,

liabilities,  debts,  inter-company  loans  and  /or  advances,  causes  of  action,  actions,  judgments,  and  suits,

whether based in law or equity, whether accruing before or on the Effective Date, whether based in contract

or  tort  or  otherwise,  that  Petitioning Creditors  may have  against  the Releasees  of Petitioning Creditors.   To

the  extent  any  of  the  Petitioning  Creditors  own  stock  in  Abakan,  this  Agreement  shall  not  impair  such

ownership.   George Town, Sonoro, Abakan,  and MesoCoat agree to not pursue claims  before Judge Cristol

against Petitioning Creditors or their counsel, Linda Leali, Esq., under section 303 of the Bankruptcy Code.

In  the  event  Petitioning  Creditors  participate  in  another  involuntary  bankruptcy  as  against  Abakan  and/or

MesoCoat, then the obligation of George Town, Sonoro, Abakan, and/or MesoCoat to refrain from pursuing

Petitioning Creditors and/or their counsel Linda Leali, Esq. under section 303 of the Bankruptcy Code shall

be  extinguished  and  all  monies  and  equities  received  pursuant  to  this  Agreement  shall  be  forfeited  and

remitted to George Town.  The Petitioning Creditors explicitly and knowingly agree and hereby acknowledge

that they are not released from any demands, claims, liabilities, debts, inter-company loans and /or advances,

causes  of  action,  actions,  judgments,  and  suits,  whether  based  in  law  or  equity,  whether  accruing before  or

on the Effective Date, whether based in contract or tort or otherwise.

5.

Receiver.  The  Creditors  hereby  release  and  forever  discharge  the  Receiver,  from  any  and  all

demands, claims, liabilities, causes of action, actions, judgments, and suits, whether based in law or equity,

whether  accruing  before  or  after  the  Effective  Date,  whether  based  in  contract  or  tort  or  otherwise,  that

Creditors may have against the Receiver.

6.

Garnishment  Transfer.  In  connection  with  its  Claim,  George  Town  garnished  certain  bank

accounts of Abakan and MesoCoat.  George Town hereby agrees to convey and transfer any monies received

from such garnishment(s) to MesoCoat.

7.

Powdermet,  Inc.  Payments.  Abakan  agrees  that  any  and  all  cash  installment  payments  it  is

entitled  to  receive  from  Powdermet,  Inc.  (“Powdermet”)  on  or  after  the  Effective  Date  in  accordance  with

EXHIBIT 10.1

the Settlement and Exchange Agreement between Abakan and Powdermet dated as of July 23, 2015, shall be

made by Powdermet directly to MesoCoat without offset of any kind, pursuant to instructions to be provided

from  the  Receiver.    Nothing  herein  shall  affect  any  remaining  ownership  interest  Abakan  may  have  in

Powdermet stock.

8.

Satisfactions of  Judgment.   Upon execution of this Agreement the Creditors shall, to the extent

applicable, file Satisfactions of Judgment for any judgment that they hold against Abakan or MesoCoat.

9.

Termination of Receiverships.  Ninety-one (91) days after the Effective Date, the receiverships

shall terminate and the Receiver shall file his final accountings with the Court.

10.     Entire Agreement. This Agreement, together with the schedule attached hereto, contains all of

the  agreements  of  the  Parties  hereto  with  respect  to  the  subject  matter  hereof  and  no  prior  agreement,

understanding  or  representation  pertaining  to  any  such  matter  shall  be  effective  for  any  purpose.  No

provision of this Agreement may be amended except in writing signed by the Parties hereto.

11.     Counterparts.  This  Agreement  may be  executed  in  any  number  of  counterparts  with  the  same

effect as if all Parties hereto had signed the same document. All such counterparts shall be construed together

and shall constitute one instrument.

12.     Binding Contract. The terms and provisions hereof shall be binding upon and inure to the benefit

of the Parties hereto, their transferees, representatives, successors and assigns.

13.     Authority.  The  Parties  hereby  represent  and  warrant  that  they  have  all  necessary  power  and

authority to execute and deliver this Agreement.

14.     Governing Law. This Agreement  shall  be construed and interpreted in accordance with the laws

of the State of New York. The Parties agree that venue shall only be proper in the

federal courts located in  New York, NY.

15.     Captions.  The  captions  and  headings  of  the  numbered  paragraphs  of  this  Agreement  are

inserted solely for the convenience of the Parties and are not a part of this Agreement and shall have no

effect upon the construction or interpretation of any part hereof.

16.     Severability.  If  any  provision  of  this  Agreement  or  the  application  thereof  to  any  person  or

circumstances  shall  be  invalid  or  unenforceable  to  any  extent,  the  remainder  of  this  Agreement  and  the

application of such provisions to  other persons or circumstances shall not be affected thereby and shall be

enforced to the greatest extent permitted by law.

IN  WITNESS  WHEREOF,  the  Parties  have  executed  this  Agreement  as  of  the  date  first  written

above.

EXHIBIT 10.1

ABAKAN, INC.

ACKNOWLEDGED AND AGREED TO:

MESOCOAT, INC.

/s/ Robert W. Seiden, Esq.

/s/ Robert W. Seiden, Esq.

Name: Robert W. Seiden, Esq.

Name: Robert W. Seiden

Title: As Court appointed Receiver for

Title: As Court appointed Receiver for

Abakan, Inc. and not in individual

MesoCoat, Inc. and not in individual

capacity

capacity

CREDITORS:

GEORGE TOWN ASSOCIATES S.A.:

By: /s/ Engelbert Schreiber

Name: Engelbert Schreiber

Title: Director

SONORO INVEST S.A.:

By: /s/ Anton Wyss

Name: Anton Wyss

Title: Director

EBERHARD:

/s/ Joseph T. Eberhard_____________

Joseph T. Eberhard, individually

[SIGNATURES CONTINUED ON FOLLOWING PAGE]

EXHIBIT 10.1

ABAKAN PETITIONING CREDITORS:

/s/ David van der Gulik________________

/s/ Warren Lydon

David van der Gulik

Warren Lydon

/s/ Philip Graves______________________

/s/Paul Ammon__________________

Philip Graves

Paul Ammon

/s/ Vladimir Chernyakov_________________

AMMON & ASSOCIATES

Vladimir Chernyakov

By: /s/ Paul Ammon______________

Name: Paul Ammon

Title: President

[SIGNATURES CONTINUED ON FOLLOWING PAGE]

EXHIBIT 10.1

MESOCOAT PETITIONING CREDITORS:

HUGE HEATING & COOLING CO., INC.

MARK BAUMGARDNER

MGMT. CONSULTING, LLC

By: /s/ David Brenneis__________________

By: /s/ Mark Baumgardner_________

Name:  David Brenneis

Name: Mark Baumgardner

Title: President

Title: Principal

/s/ Ron Hymes_________________________

SYTEK SYSTEMS, INC.

Ron Hymes

By: /s/ William C. Conners

Name: William C. Conners

Title: Vice-PresidentNONE
OF THE SECURITIES TO WHICH THIS SUBSCRIPTION AGREEMENT RELATES HAVE BEEN REGISTERED UNDER THE SECURITIES ACT OF 1933, AS AMENDED
(THE “1933 ACT”), OR ANY U.S. STATE SECURITIES LAWS, AND, UNLESS SO REGISTERED, NONE MAY BE OFFERED, SOLD, PLEDGED
OR OTHERWISE TRANSFERRED, DIRECTLY OR INDIRECTLY, IN THE UNITED STATES OR TO, OR FOR THE ACCOUNT OR BENEFIT OF, U.S. PERSONS (AS
DEFINED HEREIN), EXCEPT IN ACCORDANCE WITH THE PROVISIONS OF REGULATION S UNDER THE 1933 ACT, 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 U.S. STATE AND FOREIGN SECURITIES LAWS. 

 

EPIC
STORES CORP.

 

PRIVATE
PLACEMENT SUBSCRIPTION AGREEMENT

INSTRUCTIONS
TO SUBSCRIBER

			

		1.	You
                                         must complete all the information in the boxes on page 2 and sign where indicated with
                                         an “X”.

		2.	You
                                         must complete and sign Exhibit A, “U.S. Investor Questionnaire”, that starts
                                         on page 15.

		3.	You
                                         must pay for your subscription by wire transfer to the Issuer pursuant to wiring instructions
                                         to be provided by the Issuer.

 

    	 	1	 

    	 	 	 

    

EPIC STORES CORP.

PRIVATE PLACEMENT SUBSCRIPTION AGREEMENT

 

The
undersigned (the “Subscriber”) hereby irrevocably subscribes for and agrees to purchase from Epic Stores Corp.
(the “Issuer”) that number of shares of common stock of the Issuer (each, a “Share”) set
out below at a price of US$0.30 per Share. The Subscriber agrees to be bound by the terms and conditions set forth in the attached
“Terms and Conditions of Subscription for Share”.

 

	Subscriber
                                         Information

                                         

        

        Connor Clay
		Shares
                                         to be Purchased

         

        500,000

	(Name
    of Subscriber)		(Number
    of Shares)
	__________________________		
	Account
    Reference (if applicable):  		
	 

        X”Connor
        Clay”

        (Signature of Subscriber – if the Subscriber is an Individual)
		Total
                                         Subscription Price: $150,000

        (the
        “Subscription Amount”, plus wire fees if applicable)

			
	 

        
		
	X
    __________________________	 	 
	(Signature
                                         of Authorized Signatory – if the Subscriber is not an Individual)

	 	 
	__________________________	 	 
	(Name
    and Title of Authorized Signatory – if the Subscriber is not an Individual)	 	 
	__________________________	 	 
	(SIN,
    SSN, or other Tax Identification Number of the Subscriber)	 	 
	__________________________	 	 
	(Subscriber’s
    Address, including postal or zip code)	 	 
	__________________________	 	 
	(Telephone
    Number) (Email Address)	 	 

 

 

	Register
                                         the Shares as set forth below:

         

        __________________________

        (Name
        to Appear on Certificates Representing Shares)

         

        __________________________ 

        (Account
        Reference, if applicable)

         

        

        __________________________

        (Address,
        including postal or zip code)
		Deliver
                                         the Shares as set forth below:

        

        __________________________

        (Attention
        - Name)

        

        __________________________

        (Account
        Reference, if applicable)

         __________________________ 

        (Street
        Address, including postal or zip code – no PO Boxes permitted)

        

        __________________________

        (Telephone
        Number)

 

 

    	 	2	 

    	 	 	 

    

ACCEPTANCE

The
Issuer hereby accepts the Subscription (as defined herein) on the terms and conditions contained in this private placement subscription
agreement (this “Agreement”) as of the 10th day of December, 2015 (the “Closing Date”).

EPIC
STORES CORP.

Per:“Brian Davidson”

Authorized Signatory

		Address:	20805
                                         North 19th Avenue, Ste. 2

                                         Phoenix, AZ  85027

                                         Attention: Zach Bradford

Email:zach@consultbc.com

    	 	3	 

    	 	 	 

    

TERMS
AND CONDITIONS OF SUBSCRIPTION FOR SHARES

		1.	Subscription

1.1                                       
On the basis of the representations and warranties, and subject to the terms and conditions set forth in this Agreement, the Subscriber
hereby irrevocably subscribes for and agrees to purchase such number of Shares as is set forth on page 2 of this Agreement at
a price of $0.30 per Share (such subscription and agreement to purchase being the “Subscription”), for the
Subscription Amount, as set forth on page 2 of this Agreement.

1.2                                       
The Issuer hereby agrees to sell the Shares to the Subscriber on the basis of the representations and warranties and subject to
the terms and conditions set forth in this Agreement. Subject to the terms of this Agreement, this Agreement will be effective
upon its acceptance by the Issuer.

1.3                                       
The Subscriber acknowledges that the Shares have been offered to the Subscriber as part of an offer by the Issuer of such number
of Shares as may be determined by the board of directors of the Issuer in its sole discretion (the “Offering”).

1.4                                       
All dollar amounts referred to in this Agreement are in lawful money of the United States of America, unless otherwise indicated.

		2.	Payment

2.1                                       
The Subscription Amount must accompany this Subscription and will be paid by wire transfer to the Issuer pursuant to wiring instructions
to be provided by the Issuer upon request from the Subscriber. Any Subscription Amount received by the Issuer in advance of the
Closing (as defined below) will be held in trust by the Issuer for the Subscriber until the Closing and shall not bear interest.

2.2                                       
The completion of the purchase and sale, and the issuance, of the Shares subscribed for under this Agreement (the “Closing”)
will take place on the Closing Date, which will be determined at the sole discretion of the Issuer. The Subscriber acknowledges
and agrees that this Agreement, the Subscription Amount and any other documents delivered in connection herewith will be held
by the Issuer in escrow until the Closing. In the event that this Agreement is not accepted by the Issuer for whatever reason,
which the Issuer expressly reserves the right to do, the Issuer will return the Subscription Amount (without interest thereon)
to the Subscriber at the address of the Subscriber as set forth on page 2 of this Agreement, or as otherwise directed by the Subscriber.

		3.	Documents
                                         Required from Subscriber

3.1                                       
The Subscriber must complete, sign and return to the Issuer the following documents:

		(a)	this
                                         Agreement;

		(b)	the
                                         U.S. Investor Questionnaire (the “Questionnaire”) attached as Exhibit
                                         A that starts on page 18; and

		(c)	such
                                         other supporting documentation as the Issuer or the Issuer’s legal counsel (the
                                         “Issuer’s Counsel”) may request to establish the Subscriber’s
                                         qualification as a qualified investor,

    	 	4	 

    	 	 	 

    

and
the Subscriber acknowledges and agrees that the Issuer will not consider the Subscription for acceptance unless the Subscriber
has provided all of such documents to the Issuer.

3.2                                       
As soon as practicable upon any request by the Issuer, the Subscriber will complete, sign and return to the Issuer any additional
documents, questionnaires, notices and undertakings as may be reasonably required by any regulatory authorities or applicable
laws.

3.3                                       
The Issuer and the Subscriber acknowledge and agree that the Issuer’s Counsel has acted as counsel only to the Issuer and
is not protecting the rights and interests of the Subscriber. The Subscriber acknowledges and agrees that the Issuer and the Issuer’s
Counsel have given the Subscriber the opportunity to seek, and are hereby recommending that the Subscriber obtain, independent
legal advice with respect to the subject matter of this Agreement and, further, the Subscriber hereby represents and warrants
to the Issuer and the Issuer’s Counsel that the Subscriber has sought independent legal advice or waives such advice.

		4.	Closing
                                         Conditions

4.1                                       
The Closing Date will occur on such date as may be determined by the Issuer in its sole discretion. The Issuer may, at its discretion,
elect to close the Offering in one or more closings.

4.2                                       
The Closing will be conditional upon and subject to:

		(a)	the
                                         Issuer having obtained all necessary approvals and consents for the Offering;

		(b)	the
                                         Issuer having received a completed copy of this Agreement and the Subscription Amount;
                                         and

		(c)	the
                                         issue and sale of the Shares being exempt from the requirement to file a registration
                                         statement or prospectus under applicable securities laws relating to the sale of the
                                         Shares, or the Issuer having received such orders, consents or approvals as may be required
                                         to permit such sale without the requirement to file a registration statement or prospectus.

4.3                                       
The Subscriber acknowledges that the certificates representing the Shares will be available for delivery to the Subscriber within
five business days of the Closing Date.

		5.	Acknowledgements
                                         and Agreements of the Subscriber

5.1                                       
The Subscriber acknowledges and agrees that:

		(a)	none
                                         of the Shares have been or will be registered under the United States Securities Act
                                         of 1933, as amended, (the “1933 Act”), or under any securities
                                         or “blue sky” laws of any state of the United States, and, unless so registered,
                                         may not be offered or sold, directly or indirectly, in the United States or, to, or for
                                         the account or benefit of, any U.S. Person (as defined in Section 6.2), except in accordance
                                         with the provisions of Regulation S under the 1933 Act (“Regulation S”),
                                         pursuant to an effective registration statement under the 1933 Act, or pursuant to an
                                         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 or other securities
                                         laws;

		(b)	the
                                         Issuer has not undertaken, and will have no obligation, to register any of the Shares
                                         under the 1933 Act or any other securities legislation;

    	 	5	 

    	 	 	 

    
		(c)	the
                                         Issuer will refuse to register the transfer of any of the Shares to a person in the United
                                         States, to a U.S. Person or to a person acting for the account or benefit of a U.S. Person
                                         not made pursuant to an effective registration statement under the 1933 Act or pursuant
                                         to an available exemption from the registration requirements of the 1933 Act and in each
                                         case in accordance with applicable state or other securities laws;

		(d)	the
                                         decision to execute this Agreement and to acquire the Shares has not been based upon
                                         any oral or written representation as to fact or otherwise made by or on behalf of the
                                         Issuer and such decision is based entirely upon a review of any public information which
                                         has been filed by the Issuer with the United States Securities and Exchange Commission
                                         (the “SEC”) (collectively, the “Public Record”);

		(e)	the
                                         Issuer and others will rely upon the truth and accuracy of the acknowledgements, representations,
                                         warranties, covenants and agreements of the Subscriber contained in this Agreement and
                                         the Questionnaire, and agrees that if any of such acknowledgements, representations and
                                         agreements are no longer accurate or have been breached, the Subscriber will promptly
                                         notify the Issuer;

		(f)	there
                                         are risks associated with the purchase of the Securities, as more fully described in
                                         the Issuer’s periodic disclosure forming part of the Public Record, including the
                                         risk that the Subscriber may lose its entire investment;

		(g)	the
                                         Subscriber and the Subscriber’s advisor(s) have had a reasonable opportunity to
                                         ask questions of, and receive answers from, the Issuer in connection with the distribution
                                         of the Shares hereunder, and to obtain additional information, to the extent possessed
                                         or obtainable without unreasonable effort or expense, necessary to verify the accuracy
                                         of the information about the Issuer;

		(h)	finder’s
                                         fees or broker’s commissions may be payable by the Issuer to finders who introduce
                                         subscribers to the Issuer in connection with the Offering;

		(i)	the
                                         books and records of the Issuer were available upon reasonable notice for inspection,
                                         subject to certain confidentiality restrictions, by the Subscriber during reasonable
                                         business hours at its principal place of business, and all documents, records and books
                                         in connection with the distribution of the Shares hereunder have been made available
                                         for inspection by the Subscriber, its legal counsel and/or its advisor(s);

		(j)	all
                                         of the information which the Subscriber has provided to the Issuer is correct and complete
                                         and if there should be any change in such information prior to the Closing, the Subscriber
                                         will immediately notify the Issuer, in writing, of the details of any such change;

		(k)	the
                                         Issuer is entitled to rely on the representations and warranties of the Subscriber contained
                                         in this Agreement and the Questionnaire, and the Subscriber will hold harmless the Issuer
                                         from any loss or damage it or they may suffer as a result of the Subscriber’s failure
                                         to correctly complete this Agreement or the Questionnaire;

		(l)	any
                                         resale of the Shares by the Subscriber will be subject to resale restrictions contained
                                         in the securities laws applicable to the Issuer, the Subscriber and any proposed transferee,
                                         including resale restrictions imposed under United States securities laws and those of
                                         other applicable jurisdictions, and it is the responsibility of the Subscriber to find
                                         out what applicable resale restrictions are and to comply with such restrictions before
                                         selling any of the Shares;

    	 	6	 

    	 	 	 

    
		(m)	the
                                         Subscriber has been advised to consult the Subscriber’s own legal, tax and other
                                         advisors with respect to the merits and risks of an investment in the Shares and with
                                         respect to applicable resale restrictions, and it is solely responsible (and the Issuer
                                         is not in any way responsible) for compliance with:

		(i)	any
                                         applicable laws of the jurisdiction in which the Subscriber is resident in connection
                                         with the distribution of the Shares hereunder, and

		(ii)	applicable
                                         resale restrictions with respect to the Shares;

		(n)	there
                                         may be material tax consequences to the Subscriber of an acquisition or disposition of
                                         the Shares, and the Issuer gives no opinion and makes no representation to the Subscriber
                                         with respect to the tax consequences to the Subscriber under federal, state, provincial,
                                         local or foreign tax laws that may apply to the Subscriber’s acquisition or disposition
                                         of the Shares;

		(o)	the
                                         Issuer has advised the Subscriber that the Issuer is relying on an exemption from the
                                         requirements to provide the Subscriber with a prospectus and to sell the Shares through
                                         a person registered to sell securities under applicable securities laws, and, as a consequence
                                         of acquiring the Shares pursuant to such exemption, certain protections, rights and remedies
                                         provided by applicable securities laws, such as statutory rights of rescission or damages,
                                         will not be available to the Subscriber;

		(p)	no
                                         documents in connection with the issuance of the Shares have been reviewed by the SEC
                                         or any other securities regulators;

		(q)	neither
                                         the SEC nor any other securities commissions or similar regulatory authorities in any
                                         other jurisdictions have reviewed or passed on the merits of the Shares;

		(r)	there
                                         is no government or other insurance covering any of the Shares;

		(s)	the
                                         Shares are, and will be, “restricted securities” as such term is defined
                                         under Rule 144 of the 1933 Act and will be subject to a hold period in relation to offers
                                         and sales of the Shares, which may be an indefinite period of time, and it agrees that
                                         if it decides to offer, sell, pledge or otherwise transfer, directly or indirectly, any
                                         such securities absent such registration, it will not offer, sell, pledge or otherwise
                                         transfer, directly or indirectly, any of such securities, except:

		(i)	to
                                         the issuer of such securities,

		(ii)	outside
                                         the United States in an “offshore transaction” in compliance with
                                         the requirements of Rule 904 of Regulation S, if available, and in compliance with applicable
                                         local laws and regulations,

		(iii)	in
                                         compliance with the exemption from registration under the 1933 Act provided by Rule 144
                                         thereunder, if available, and in accordance with any applicable state securities laws,
                                         or

    	 	7	 

    	 	 	 

    
		(iv)	in
                                         a transaction that does not require registration under the 1933 Act or any applicable
                                         state securities laws, and

		(v)	in
                                         the case of subparagraph (iii) or (iv), it has furnished to the Issuer an opinion of
                                         counsel of recognized standing in form and substance reasonably satisfactory to counsel
                                         to the Issuer to such effect;

		(t)	if
                                         the Issuer is deemed to have been at any time previously an issuer with no or nominal
                                         operations and no or nominal assets other than cash and cash equivalents, Rule 144 under
                                         the 1933 Act may not be available for resale of the Shares; and

		(u)	this
                                         Agreement is not enforceable by the Subscriber unless it has been accepted by the Issuer
                                         and the Issuer reserves the right to reject this Subscription for any reason.

		6.	Representations
                                         and Warranties of the Subscriber

6.1                                       
The Subscriber hereby represents and warrants to the Issuer (which representations and warranties will survive the Closing) that:

		(a)	the
                                         Subscriber is resident in the jurisdiction set out on page 2 of this Agreement;

		(b)	the
                                         Subscriber: (i) has adequate net worth and means of providing for its current financial
                                         needs and possible personal contingences, (ii) has no need for liquidity in this investment,
                                         (iii) has such knowledge and experience in business matters as to be capable of evaluating
                                         the merits and risks of its prospective investment in the Shares, (iv) is able to bear
                                         the economic risks of an investment in the Shares for an indefinite period of time, and
                                         (v) can afford the complete loss of the Subscription Amount;

		(c)	the
                                         Subscriber has the legal capacity and competence to enter into and execute this Agreement
                                         and to take all actions required pursuant hereto and, if the Subscriber is a corporate
                                         entity, 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 Agreement on behalf
                                         of the Subscriber;

		(d)	the
                                         entering into of this Agreement and the transactions contemplated hereby do not result
                                         in the violation of any of the terms and provisions of any law applicable to, or, if
                                         applicable, the constating documents of, the Subscriber or of any agreement, written
                                         or oral, to which the Subscriber may be a party or by which the Subscriber is or may
                                         be bound;

		(e)	the
                                         Subscriber has duly executed and delivered this Agreement and it constitutes a valid
                                         and binding agreement of the Subscriber enforceable against the Subscriber in accordance
                                         with its terms;

		(f)	the
                                         Subscriber has received and carefully read this Agreement;

		(g)	the
                                         Subscriber is aware that an investment in the Issuer is speculative and involves certain
                                         risks, including those risks disclosed in the Public Record and that the Subscriber could
                                         lose the entire Subscription Amount;

    	 	8	 

    	 	 	 

    
		(h)	the
                                         Subscriber has made an independent examination and investigation of an investment in
                                         the Shares and the Issuer and agrees that the Issuer will not be responsible in any way
                                         for the Subscriber’s decision to invest in the Shares and the Issuer;

		(i)	the
                                         Subscriber is purchasing the Shares as principal for its own account for investment purposes
                                         only and not for the account of any other person, and not for distribution, assignment
                                         or resale to others, and no other person has a direct or indirect beneficial interest
                                         in such Shares, and the Subscriber has not subdivided its interest in any of the Shares
                                         with any other person;

		(j)	the
                                         Subscriber (i) is able to fend for itself in this Subscription, (ii) has such knowledge
                                         and experience in business matters as to be capable of evaluating the merits and risks
                                         of its prospective investment in the Shares, and (iii) has the ability to bear the economic
                                         risks of its prospective investment and can afford the complete loss of such investment;

		(k)	the
                                         Subscriber is not an underwriter of, or dealer in, any of the Shares, nor is the Subscriber
                                         participating, pursuant to a contractual agreement or otherwise, in the distribution
                                         of the Shares;

		(l)	the
                                         Subscriber is not aware of any advertisement of any of the Shares and is not acquiring
                                         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 or television, or any seminar or meeting
                                         whose attendees have been invited by general solicitation or general advertising;

		(m)	no
                                         person has made to the Subscriber any written or oral representations:

		(i)	that
                                         any person will resell or repurchase any of the Shares,

		(ii)	that
                                         any person will refund the purchase price of any of the Shares, or

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

		(n)	the
                                         funds representing the Subscription Amount will not represent proceeds of crime for the
                                         purposes of the Uniting and Strengthening America by Providing Appropriate Tools Required
                                         to Intercept and Obstruct Terrorism Act (the “PATRIOT Act”) and
                                         the Subscriber acknowledges that the Issuer may in the future be required by law to disclose
                                         the Issuer’s name and other information relating to this Agreement and the Subscription,
                                         on a confidential basis, pursuant to the PATRIOT Act; and

		(o)	no
                                         portion of the Subscription Amount to be provided by the Subscriber: (i) has been or
                                         will be derived from or related to any activity that is deemed criminal under the laws
                                         of the United States of America, or any other jurisdiction, or (ii) is being tendered
                                         on behalf of a person or entity who has not been identified to or by the Subscriber,
                                         and (iii) the Subscriber shall promptly notify the Issuer if the Subscriber discovers
                                         that any of such representations ceases to be true and will provide the Issuer with appropriate
                                         information in connection therewith.

6.2                                       
In this Agreement, the term “U.S. Person” has the meaning ascribed thereto in Regulation S, and, for the
purpose of this Agreement, includes, but is not limited to: (a) any person in the United States; (b) any natural person resident
in the United States; (c) any partnership or corporation organized or incorporated under the laws of the United States; (d) any
partnership or corporation organized outside the United States by a U.S. Person principally for the purpose of investing in securities
not registered under the 1933 Act, unless it is organized or incorporated, and owned, by accredited investors who are not natural
persons, estates or trusts; or (e) any estate or trust of which any executor or administrator or trustee is a U.S. Person.

    	 	9	 

    	 	 	 

    

		7.	Representations
                                         and Warranties will be Relied Upon by the Issuer

7.1                                       
The Subscriber acknowledges and agrees that the representations and warranties contained in this Agreement and, if applicable,
in the Questionnaire, are made by the Subscriber with the intention that such representations and warranties will be relied upon
by the Issuer and the Issuer’s Counsel in determining the Subscriber’s eligibility to purchase the Shares under applicable
laws, or, if applicable, the eligibility of others on whose behalf the Subscriber is contracting hereunder to purchase the Shares
under applicable laws. The Subscriber further agrees that, by accepting delivery of the certificate(s) representing the Shares,
it will be representing and warranting that the representations and warranties contained herein are true and correct at the time
of delivery with the same force and effect as if they had been made by the Subscriber at such time, and that they will survive
the purchase by the Subscriber of the Shares, and will continue in full force and effect thereafter for the benefit of the Issuer,
notwithstanding any subsequent disposition by the Subscriber of the Shares.

		8.	Registration
                                         Rights

8.1                                       
The Issuer will prepare and file a registration statement with respect to the Shares (the “Registration Statement”)
with the SEC within 90 days following the Closing Date. Notwithstanding the foregoing, if the Issuer receives a comment from the
SEC which effectively results in the Issuer having to reduce the number of Shares included on such Registration Statement, then
the Issuer may, in its sole discretion, reduce on a pro rata basis the number of Shares to be included in such Registration Statement.

8.2                                       
In connection with the preparation and filing of the Registration Statement, the Subscriber will furnish to the Issuer, in writing,
such information and representations with respect to itself and the proposed distribution by it as are reasonably necessary in
order to assure compliance with applicable federal and state securities laws. The Issuer will require the Subscriber to furnish
to the Issuer, among other things as may be determined by the Issuer in its sole discretion, a certified statement as to the number
of securities of the Issuer beneficially owned by the Subscriber and the name of the natural person that has voting and dispositive
control over such Shares. The Subscriber will be responsible for payment of any legal fees it incurs in connection with the Registration
Statement.

8.3                                       
The Subscriber shall indemnify and hold harmless the Issuer, its directors, officers, agents and employees, each person who controls
the Issuer (within the meaning of Section 15 of the 1933 Act and Section 20 of the 1934 Act), and the directors, officers, agents
or employees of such controlling persons, to the fullest extent permitted by applicable law, from and against all losses, as incurred,
to the extent arising out of or based solely upon: (a) the Subscriber’s failure to comply with the prospectus delivery requirements
of the 1933 Act; (b) any untrue or alleged untrue statement of a material fact contained in the Registration Statement, or in
any amendment or supplement thereto or in any preliminary prospectus, or arising out of or relating to any omission or alleged
omission of a material fact required to be stated therein or necessary to make the statements therein not misleading to the extent
that: (i) such untrue statement or omission is contained in any information so furnished in writing by the Subscriber to the Issuer
specifically for inclusion in the Registration Statement, (ii) such untrue statements or omissions are based solely upon information
regarding the Subscriber furnished in writing to the Issuer by the Subscriber expressly for use therein, or (iii) such information
relates to the Subscriber or the Subscriber’s proposed method of distribution of the Shares and was reviewed and expressly
approved in writing by the Subscriber expressly for use in the Registration Statement or in any amendment or supplement thereto;
or (c) the use by the Subscriber of an outdated or defective Registration Statement after the Issuer has notified the Subscriber
in writing that the Registration Statement is outdated or defective.

    	 	10	 

    	 	 	 

    

8.4                                       
If a claim for indemnification hereunder is unavailable to the Issuer (by reason of public policy or otherwise), then the Subscriber,
in lieu of indemnifying the Issuer, shall contribute to the amount paid or payable by the Issuer as a result of such losses, in
such proportion as is appropriate to reflect the relative fault of the Subscriber and the Issuer in connection with the actions,
statements or omissions that resulted in such losses, as well as any other relevant equitable considerations. The relative fault
of the Subscriber and the Issuer shall be determined by reference to, among other things, whether any action in question, including
any untrue or alleged untrue statement of a material fact or omission or alleged omission of a material fact, has been taken or
made by, or relates to information supplied by, the Subscriber or the Issuer, and the parties’ relative intent, knowledge,
access to information and opportunity to correct or prevent such action, statement or omission. The amount paid or payable by
a party as a result of any losses shall be deemed to include, subject to the limitations set forth in this Agreement, any reasonable
attorneys’ or other reasonable fees or expenses incurred by such party in connection with any proceeding to the extent such
party would have been indemnified for such fees or expenses if the indemnification provided for in this section was available
to such party in accordance with its terms.

		9.	Resale
                                         Restrictions

9.1                                       
The Subscriber acknowledges that any resale of the Shares will be subject to resale restrictions contained in the securities legislation
applicable to the Subscriber or proposed transferee. The Subscriber acknowledges that none of the Shares have been registered
under the 1933 Act or the securities laws of any state of the United States. None of the Shares may be offered or sold in the
United States unless registered in accordance with United States federal securities laws and all applicable state and provincial
securities laws or exemptions from such registration requirements are available.

		10.	Acknowledgement
                                         and Waiver

10.1                                   
The Subscriber acknowledges that the decision to acquire the Shares was solely made on the basis of the Public Record. The Subscriber
hereby waives, to the fullest extent permitted by law, any rights of withdrawal, rescission or compensation for damages to which
the Subscriber might be entitled in connection with the distribution of any of the Shares.

		11.	Legending
                                         of Shares

11.1                                   
The Subscriber acknowledges that, upon the issuance thereof, and until such time as the same is no longer required under applicable
securities laws, any certificates representing any of the Shares will bear a legend in substantially the following form:

“NONE
OF THE SECURITIES REPRESENTED HEREBY HAVE BEEN REGISTERED UNDER THE UNITED STATES SECURITIES ACT OF 1933, AS AMENDED (THE “1933
ACT”), OR ANY U.S. STATE SECURITIES LAWS, AND, UNLESS SO REGISTERED, NONE MAY BE OFFERED, SOLD, PLEDGED OR OTHERWISE TRANSFERRED,
DIRECTLY OR INDIRECTLY, EXCEPT IN ACCORDANCE WITH THE PROVISIONS OF REGULATION S UNDER THE 1933 ACT, PURSUANT TO AN EFFECTIVE
REGISTRATION STATEMENT UNDER THE 1933 ACT, OR PURSUANT TO AN 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 SECURITIES LAWS.”.

    	 	11	 

    	 	 	 

    

11.2                                   
The Subscriber hereby acknowledges and agrees to the Issuer making a notation on its records or giving instructions to the registrar
and transfer agent of the Issuer in order to implement the restrictions on transfer set forth and described in this Agreement.

		12.	Collection
                                         of Personal Information

12.1                                   
The Subscriber acknowledges and consents to the fact that the Issuer is collecting the Subscriber’s personal information
for the purpose of fulfilling this Agreement and completing the Offering. The Subscriber acknowledges that its personal information
(and, if applicable, the personal information of those on whose behalf the Subscriber is contracting hereunder) may be included
in record books in connection with the Offering and may be disclosed by the Issuer to: (a) stock exchanges, quotation systems,
securities commissions or other securities regulatory authorities; (b) the Issuer’s registrar and transfer agent; (c) any
applicable tax authorities; (d) authorities pursuant to any money laundering or terrorist financing legislation; and (e) any other
parties involved in the Offering. By executing this Agreement, the Subscriber is deemed to be consenting to the foregoing collection,
use and disclosure of the Subscriber’s personal information (and, if applicable, the personal information of those on whose
behalf the Subscriber is contracting hereunder) for the foregoing purposes and to the retention of such personal information for
as long as permitted or required by applicable laws. Notwithstanding that the Subscriber may be purchasing the Shares as agent
on behalf of an undisclosed principal, the Subscriber agrees to provide, on request, particulars as to the nature and identity
of such undisclosed principal, and any interest that such undisclosed principal has in the Issuer, all as may be required by the
Issuer in order to comply with the foregoing.

12.2                                   
The Subscriber is hereby notified and agrees that:

		(i)	the
                                         Issuer may deliver to any securities commission having jurisdiction over the Issuer,
                                         the Subscriber or this Subscription, including the SEC and/or any state securities commissions
                                         (collectively, the “Commissions”), certain personal information pertaining
                                         to the Subscriber, including the Subscriber’s full name, residential address and
                                         telephone number, the number of Shares or other securities of the Issuer owned by the
                                         Subscriber, the number of Shares purchased by the Subscriber, the total Subscription
                                         Amount paid for the Shares, the exemption relied on by the Issuer and the date of distribution
                                         of the Shares;

		(ii)	such
                                         information is being collected indirectly by the Commissions under the authority granted
                                         to them in applicable securities laws; and

		(iii)	such
                                         information is being collected for the purposes of the administration and enforcement
                                         of applicable securities laws.

		13.	Costs

13.1                                   
The Subscriber acknowledges and agrees that all costs and expenses incurred by the Subscriber (including any fees and disbursements
of any special counsel retained by the Subscriber) relating to the purchase of the Shares will be borne by the Subscriber.

		14.	Governing
                                         Law

14.1                                   
This Agreement is governed by the laws of the State of Nevada and the federal laws of the United States applicable therein. The
Subscriber, in its personal or corporate capacity and, if applicable, on behalf of each beneficial or undisclosed purchaser for
whom it is acting, irrevocably attorns to the exclusive jurisdiction of the courts of the State of Nevada.

    	 	12	 

    	 	 	 

    

		15.	Survival

15.1                                   
This Agreement, including, without limitation, the representations, warranties and covenants contained herein, will survive and
continue in full force and effect and be binding upon the Issuer and the Subscriber, notwithstanding the completion of the purchase
of the Shares by the Subscriber.

		16.	Assignment

16.1                                   
This Agreement is not transferable or assignable.

		17.	Severability

17.1                                   
The invalidity or unenforceability of any particular provision of this Agreement will not affect or limit the validity or enforceability
of the remaining provisions of this Agreement.

		18.	Entire
                                         Agreement

18.1                                   
Except as expressly provided in this Agreement and in the exhibits, agreements, instruments and other documents attached hereto
or contemplated or provided for herein, this Agreement contains the entire agreement between the parties with respect to the sale
of the Shares and there are no other terms, conditions, representations or warranties, whether expressed, implied, oral or written,
by statute or common law, by the Issuer or by anyone else.

		19.	Notices

19.1                                   
All notices and other communications hereunder will be in writing and will be deemed to have been duly given if mailed or transmitted
by any standard form of telecommunication, including email or other means of electronic communication capable of producing a printed
copy. Notices to the Subscriber will be directed to the address of the Subscriber set forth on page 2 of this Agreement and notices
to the Issuer will be directed to it at the address of the Issuer set forth on page 3 of this Agreement.

		20.	Counterparts
                                         and Electronic Means

20.1                                   
This Agreement may be executed in any number of counterparts, each of which, when so executed and delivered, will constitute an
original and all of which together will constitute one instrument. Delivery of an executed copy of this Agreement by electronic
facsimile transmission or other means of electronic communication capable of producing a printed copy will be deemed to be execution
and delivery of this Agreement as of the Closing Date.

		21.	Exhibits

21.1                                   
Any exhibits attached hereto form part of this Agreement.

		22.	Indemnity

22.1                                   
The Subscriber will indemnify and hold harmless the Issuer and, where applicable, its directors, officers, employees, agents,
advisors and shareholders, from and against any and all loss, liability, claim, damage and expense whatsoever (including, but
not limited to, any and all fees, costs and expenses whatsoever reasonably incurred in investigating, preparing or defending against
any claim, lawsuit, administrative proceeding or investigation whether commenced or threatened) arising out of or based upon any
representation or warranty of the Subscriber contained in this Agreement, the Questionnaire, or in any document furnished by the
Subscriber to the Issuer in connection herewith being untrue in any material respect, or any breach or failure by the Subscriber
to comply with any covenant or agreement made.

    	 	13	 

    	 	 	 

    

EXHIBIT
A

U.S.
INVESTOR QUESTIONNAIRE

TO:EPIC
STORES CORP. (the “Issuer”)

RE:Purchase
of Shares (the “Shares”) of the Issuer

Capitalized
terms used in this U.S. Investor Questionnaire (this “Questionnaire”) and not specifically defined have the
meaning ascribed to them in the Private Placement Subscription Agreement between the Subscriber (as defined herein) and the Issuer
to which this Exhibit A is attached.

This
Questionnaire applies only to persons that are U.S. Purchasers. A “U.S. Purchaser” is: (a) any U.S. Person,
(b) any person purchasing the Shares for the account or benefit of any U.S. Person, (c) any person that receives or received an
offer of the Shares while in the United States, or (d) any person that is (or whose authorized signatory is) in the United States
at the time the Subscriber’s buy order was made or this Agreement was executed or delivered.

In
connection with the purchase by the Subscriber (being the undersigned, or if the undersigned is purchasing the Shares as agent
on behalf of a disclosed beneficial Subscriber, such beneficial Subscriber, will be referred herein as the “Subscriber”)
of the Shares, the Subscriber hereby represents, warrants, covenants and certifies (which representations, warranties, covenants
and certifications will survive the Closing) to the Issuer (and acknowledges that the Issuer is relying thereon) that:

		1.	if
                                         the Subscriber is an individual (that is, a natural person and not a corporation, partnership,
                                         trust or other entity), then it satisfies one or more of the categories indicated below
                                         (please place an “X” on the appropriate lines):

	___________	a
    natural person whose individual net worth, or joint net worth with that person’s spouse, exceeds US$1,000,000. For purposes
    of this category, “net worth” means the excess of total assets at fair market value (including personal and real
    property, but excluding the estimated fair market value of a person’s primary home) over total liabilities. Total liabilities
    excludes any mortgage on the primary home in an amount of up to the home’s estimated fair market value as long as the
    mortgage was incurred more than 60 days before the Shares are purchased, but includes (i) any mortgage amount in excess of
    the home’s fair market value and (ii) any mortgage amount that was borrowed during the 60 day period before the Closing
    Date for the purpose of investing in the Shares,
	___________	a
    natural person who had an individual income in excess of US$200,000 in each of the two most recent years, or joint income
    with their spouse in excess of US$300,000 in each of those years and has a reasonable expectation of reaching the same income
    level in the current year, or
	___________	a
    director or executive officer of the Issuer;

    	 	14	 

    	 	 	 

    
		2.	if
                                         the Subscriber is a corporation, partnership, trust or other entity), then it satisfies
                                         one or more of the categories indicated below (please place an “X” on the
                                         appropriate lines):

	___________	an
    organization described in Section 501(c)(3) of the United States Internal Revenue Code, a corporation, a Massachusetts or
    similar business trust or partnership, not formed for the specific purpose of acquiring the Shares, with total assets in excess
    of US$5,000,000,
	___________	a
    “bank” as defined under Section (3)(a)(2) of the 1933 Act or savings and loan association or other institution
    as defined in Section 3(a)(5)(A) of the 1933 Act acting in its individual or fiduciary capacity; a broker dealer registered
    pursuant to Section 15 of the Securities Exchange Act of 1934 (United States); an insurance company as defined
    in Section 2(13) of the 1933 Act; an investment company registered under the Investment Company Act of 1940 (United
    States) or a business development company as defined in Section 2(a)(48) of such Act; a Small Business Investment Company
    licensed by the U.S. Small Business Administration under Section 301(c) or (d) of the Small Business Investment Act
    of 1958 (United States); a plan with total assets in excess of US$5,000,000 established and maintained by a state, a political
    subdivision thereof, or an agency or instrumentality of a state or a political subdivision thereof, for the benefit of its
    employees; an employee benefit plan within the meaning of the Employee Retirement Income Security Act of 1974 (United
    States) whose investment decisions are made by a plan fiduciary, as defined in Section 3(21) of such Act, which is either
    a bank, savings and loan association, insurance company or registered investment adviser, or if the employee benefit plan
    has total assets in excess of US$5,000,000, or, if a self-directed plan, whose investment decisions are made solely by persons
    that are accredited investors,
	___________	a
    private business development company as defined in Section 202(a)(22) of the Investment Advisers Act of 1940 (United
    States),
	___________	a
    trust with total assets in excess of US$5,000,000, not formed for the specific purpose of acquiring the Shares, whose purchase
    is directed by a sophisticated person as described in Rule 506(b)(2)(ii) under the 1933 Act, or
	___________	an
    entity in which all of the equity owners satisfy the requirements of one or more of the categories set forth in Section 1
    of this Questionnaire;

		3.	it
                                         consents to the Issuer making a notation on its records or giving instructions to any
                                         transfer agent of the Issuer in order to implement the restrictions on transfer set forth
                                         and described in this Questionnaire and the Agreement; and

		4.	it
                                         is resident in the United States of America, its territories and possessions or any state
                                         of the United States or the District of Columbia (collectively the “United States”),
                                         is a U.S. Person, is acting for the account or benefit of a U.S. Person or was (or its
                                         authorized signatory was) in the United States at the time the Shares were offered or
                                         the Agreement was executed..

The
Subscriber agrees that the above representations and warranties will be true and correct both as of the execution of this Questionnaire
and as of the Closing and that they will survive the completion of the issue of the Shares.

The
Subscriber acknowledges that the foregoing representations and warranties are made by the Subscriber with the intent that they
be relied upon in determining the suitability of the Subscriber to acquire the Shares and that this Questionnaire is incorporated
into and forms part of the Agreement, and the Subscriber undertakes to immediately notify the Issuer of any change in any statement
or other information relating to the Subscriber set forth herein which takes place prior to the Closing.

    	 	15	 

    	 	 	 

    

By
completing this Questionnaire, the Subscriber authorizes the indirect collection of this information by each applicable regulatory
authority or regulator and acknowledges that such information is made available to the public under applicable legislation. 

 

Dated
_____________________________, 2015.

			X
			Signature
    of individual (if Subscriber is an individual)
			X
			Authorized
    signatory (if Subscriber is not an individual)
			
			Name
    of Subscriber (please print)
			
			Name
    of authorized signatory (please print)

    	 	16

Source: [{"source": "alea-institute/alea-institute/kl3m-data-edgar-agreements/train-00253-of-00352.parquet"}, [{"source": "alea-institute/alea-institute/kl3m-data-edgar-agreements/train-00253-of-00352.parquet"}]]