Document:

EXHIBIT
10.3

 

VOTING
AGREEMENT

 

VOTING
AGREEMENT, dated as of April 4, 2022 (this “Agreement”), by and between PAVmed Inc., a Delaware corporation with offices
located at One Grand Central Place, Suite 4600, New York, NY 10165 (the “Company”) and [________] (the “Stockholder”).

 

WHEREAS,
the Company and certain investors (each, an “Investor”, and collectively, the “Investors”) have
entered into a Securities Purchase Agreement, dated as of March 31, 2022 (the “Securities Purchase Agreement”), pursuant
to which, among other things, the Company has agreed to issue and sell to the Investors and the Investors have, severally but not jointly,
agreed to purchase certain senior secured convertible notes of the Company (the “Notes”), which will be convertible
into shares of the Company’s common stock, $0.001 par value per share (the “Common Stock”, as converted, the
“Conversion Shares”), in accordance with the terms of the Notes;

 

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

 

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

 

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

 

ARTICLE
I

 

VOTING
AGREEMENT OF THE STOCKHOLDER

 

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

 

    	 

     

    

 

ARTICLE
II

 

REPRESENTATIONS
AND WARRANTIES OF THE STOCKHOLDER

 

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

 

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

 

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

 

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

 

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

 

    	-2-

     

    

 

ARTICLE
III

 

COVENANTS

 

SECTION
3.01. [Reserved]

 

SECTION
3.02. [Reserved]

 

ARTICLE
IV

MISCELLANEOUS

 

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

 

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

 

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

 

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

 

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

 

    	-3-

     

    

 

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

 

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

 

SECTION
4.08. No Third Party Beneficiaries. This Agreement is intended for the benefit of the parties hereto and their respective permitted
successors and assigns, and is not for the benefit of, nor may any provision hereof be enforced by, any other person.

 

[The
remainder of the page is intentionally left blank]

 

    	-4-

     

    

 

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

 

	 	THE
    COMPANY: 
	 	 
	 	PAVMED
    INC.
	 	 
	 	By:	 
	 	Name:	Lishan
    Aklog
	 	Title:	Chief
    Executive Officer
	 	 	 
	 	Address:	One
    Grand Central Place
	 	 	Suite
    4600
	 	 	New
    York, New York 10165
	 	 	 
	 	STOCKHOLDER:
    
	 	 	 
	 	[________]	 
	 	 	 
	 	By:	 
	 	 	[________]
	 	 	 
	 	Address:Exhibit 10.1

 

FIRST Amendment to License Agreement

 

This
FIRST AMENDMENT TO LICENSE AGREEMENT (this “First Amendment”) is made and entered into as of March 31, 2022 (the
 “First Amendment Effective Date”) between RVL Pharmaceuticals, Inc., a Delaware corporation (“RVL”)
and Santen Pharmaceutical Co. Ltd., a Japanese corporation (“Licensee”).  RVL and Licensee may be referred to
herein individually as a “Party” and collectively as the “Parties.”

 

WHEREAS, RVL and Licensee entered into that certain
License Agreement, dated as of July 28, 2020 (the “Original Agreement”);

 

WHEREAS, Licensee wishes to expand the Territory
to include certain countries as set forth herein and RVL wishes to include such additional countries in the Territory;

 

WHEREAS, RVL wishes to grant Licensee an option,
and Licensee wishes to receive an option, to expand the Territory further, pursuant to the terms contained herein;

 

WHEREAS, Licensee and RVL wish the amend certain
milestone events and milestone payments in the Original Agreement;

 

WHEREAS, in consideration for such expansion of
the Territory and amendment to the milestone events and milestone payments, in each case, as set forth herein, Licensee desires pay to
RVL, and RVL desires to receive, the Amendment Payments (as defined herein); and

 

WHEREAS, pursuant to and in accordance with Section 11.8
of the Original Agreement, the Parties desire to make certain amendments to the Original Agreement.

 

NOW, THEREFORE, in consideration of the promises
and covenants contained in this First Amendment, and intending to be legally bound, the Parties hereby agree as follows:

 

	1.	Interpretation. Capitalized terms not defined in this First Amendment have the meanings given such
terms in the Original Agreement. References to Sections and Schedules herein will be to Sections and Schedules of the Original Agreement,
except as otherwise noted.

 

	2.	New Definitions. The following definitions are hereby added to Article 1 of the Original Agreement:

 

		a.	“HC” means Health Canada and any successor entity thereto.

 

		b.	“MHP” means the United Arab Emirates Ministry of Health and Prevention and any successor
entity thereto.

 

	3.	Amendment Payment. Within thirty (30) days from the First Amendment Effective Date, Licensee shall
pay to RVL the following nonrefundable, noncreditable amounts:

 

		a.	An amount equal to $5,500,000 to expand the Territory as set forth in Section 5 (Territory Amendments);

 

		b.	An amount equal to $3,500,000 for deletion of the milestone payment due under the Original Agreement following
receipt of the first Regulatory Approval for a Licensed Product by any of the EMA, a Regulatory Authority of a member of the European
Union, or a Regulatory Authority of any country identified as “Other European Countries” on Schedule 1.108 in the Original
Agreement;

 

    	 	1	 

     

    

 

		c.	An amount equal to $3,500,000 for deletion of the milestone payment due under the Original Agreement following
receipt of the first Regulatory Approval by the MHLW for a Licensed Product in Japan; and

 

		d.	An amount equal to $3,000,000 for deletion of the milestone payment due under the Original Agreement following
receipt of the first Regulatory Approval by the NMPA for a Licensed Product in the People’s Republic of China (the amounts set forth
in the foregoing clauses (a) through (d), collectively, the “Amendment Payments”).

 

For clarity, other than the Amendment
Payments to be paid as set forth above in this Section 3, Licensee will not owe to RVL any payments due upon receipt of Regulatory
Approval for a Licensed Product by any of the EMA, a Regulatory Authority of a member of the European Union, a Regulatory Authority of
any country identified as “Other European Countries” on Schedule 1.108 in the Original Agreement, MHLW, or the NMPA.

 

	4.	Development and Regulatory Milestone Payment Amendments. Section 5.2.1 of the Original Agreement
is hereby deleted in its entirety and replaced with the following:

 

“5.2.1     Development
and Regulatory Milestones. In partial consideration of the rights granted by RVL to Licensee hereunder, Licensee shall notify RVL
within two (2) Business Days after the achievement of each of the following milestones for the Licensed Product and shall pay to
RVL a milestone payment for the achievement of each such milestone within thirty (30) days after receiving an invoice from RVL for such
milestone payment, calculated as follows:

 

(i)            following
receipt of the first Regulatory Approval by the MHP for a Licensed Product in the United Arab Emirates, five hundred thousand Dollars
($500,000); and

 

(ii)           if
Licensee receives Regulatory Approval by the HC in Calendar Year 2023 for a Licensed Product in Canada, five hundred thousand Dollars
($500,000).

 

Each milestone payment in this Section 5.2.1
shall be payable only upon the first achievement of such milestone and no amounts shall be due for subsequent or repeated achievements
of such milestone, whether for the same or a different Licensed Product.”

 

		5.	Territory Amendments.

 

		a.	Section 2 of Schedule 1.108 is hereby deleted in its entirety and replaced with the following:

 

“2. North Africa and Middle East

 

a.
Algeria, Bahrain, Egypt, Iran, Iraq, Israel, Jordan, Lebanon,
Kingdom of Saudi-Arabia, Kuwait, Morocco, Qatar, Turkey, United Arab Emirates.”

 

    	 	2	 

     

    

 

		b.	The following provision is hereby added to Schedule 1.108 of the Original Agreement:

 

“4. North America

 

a. Canada”

 

	6.	Option to Expand Territory. Prior to the earlier of (i) the fifth anniversary of the First
Amendment Effective Date or (ii) the expiration of ROFN period as defined below (the “Option Exercise Period”),
Licensee may elect, upon written notice to RVL, to expand the Territory to include Russia in accordance with the terms set forth in this
Section 6 (Option to Expand Territory). If Licensee so elects to expand the Territory, then:

 

		a.	In consideration of the option grant and expanding the Territory to include Russia, Licensee would pay
to RVL $2,000,000 (the “Option Exercise Payment”) no later than thirty (30) days after the date of written notice Licensee’s
election to expand the Territory to so include Russia.

 

		b.	The following definition will be added to Article 1 of the Original Agreement:

 

“MHRF” means the
Ministry of Health of the Russian Federation and any successor entity thereto.

 

		c.	The following milestone will be added Section 5.2.1 (Development and Regulatory Milestones) of the
Original Agreement, and will be subject to the terms therein:

 

“(iii) Following receipt
of the first Regulatory Approval by the MHRF for a Licensed Product in Russia, one million Dollars ($1,000,000) (such payment, the “Russia
Regulatory Approval Milestone”).”

 

	7.	Third Party Russia Offer.
If at any time during the Option Exercise Period, RVL desires to enter into, or is approached by any bona fide third party with
respect to, an agreement to license certain rights under the RVL Patents, RVL Know-How, or RVL’s interests in the Joint Patents
and Joint Know-How to Exploit the Licensed Product in Russia (a “Third Party Russia Offer”), then RVL will notify Licensee
of the Third Party Russia Offer in writing. The Licensee will have a period of forty-five (45) days following its receipt of written notice
of the Third Party Russia Offer (the “ROFN Period”) to notify RVL in writing of Licensee’s desire to either (“Russia
Terms Notice”) (i) exercise its option to expand the Territory to include Russia pursuant to Section 6 (Option to
Expand Territory) of this First Amendment, or (ii) in lieu of the Option Exercise Payment and the terms under the Original Agreement
that would be applicable to the Exploitation of the Licensed Product if the Territory were to be expanded to include Russia, in consideration
for the expansion of the Territory to include Russia, to match the terms offered to RVL by the Third Party Russia Offer (the “Matched
Terms”). If, during such ROFN Period Licensee elects to match the terms last offered to RVL by the third party in consideration
for the grant of rights to Exploit the Licensed Product in Russia, then (a) Licensee and RVL will enter into an amendment to the
Original Agreement that replaces original terms that would be due to RVL in consideration for expansion of the Territory to include Russia
(including the Option Exercise Payment) and instead includes the Matched Terms and (b)  the option set forth in Section 6 (Option
to Expand Territory) of this First Amendment will immediately terminate. During the ROFN Period, RVL will not negotiate with any
third party or enter into any agreement with any third party regarding any transfer, license, or acquisition of RVL’s rights under
the RVL Patents, RVL Know-How, or interests in the Joint Patents and Joint Know-How, in each case to Exploit the Licensed Product in Russia
unless and until Licensee notifies RVL that it has decided not to pursue the acquisition or grant of such rights. If Licensee does not
deliver to RVL a Russia Terms Notice prior to the expiration of the ROFN Period, then RVL will be free to negotiate or enter into any
transaction with any third party with no further obligation to Licensee under this Section 7 (Third Party Russia Offer).

 

    	 	3	 

     

    

 

	8.	Licensee’s Clinical Research Rights. Regardless of whether Licensee elects to exercise its
option to expand the Territory to include Russia pursuant to Section 6 (Option to Expand Territory) of this First Amendment or whether
RVL licenses certain rights under the RVL Patents, RVL Know-How or RVL’s interests in the Joint Patents and Joint Know-How to Exploit
the Licensed Product in Russia to a bona fide third party pursuant to Section 7 (Third Party Russia Offer) of this First Amendment,
Licensee may, under and consistent with the license grants contained in Article 2 of the Original Agreement, conduct clinical development
of the Licensed Product in Russia subject to RVL’s prior written approval.

 

	9.	Effect on Original Agreement. Except as specifically amended by this First Amendment, the Original
Agreement will remain in full force and effect and is hereby ratified and confirmed. Each future reference to the Original Agreement will
refer to the Original Agreement as amended by this First Amendment. To the extent a conflict arises between the terms of the Original
Agreement and this First Amendment, the terms of this First Amendment shall prevail but only to the extent necessary to accomplish their
intended purpose.

 

	10.	Binding Effect. This First Amendment will be binding upon and inure to the benefit of the Parties
and their respective permitted successors and assigns.

 

	11.	Authority. As of the First Amendment Effective Date, each Party hereby represents and warrants
that (a) it has the power and authority to execute and deliver this First Amendment, (b) the execution, delivery, and performance
of this First Amendment by it has been duly authorized by all requisite corporate action, and (c) this First Amendment has been duly
executed and delivered on behalf of such Party and constitutes a legal, valid, and binding obligation of such Party and is enforceable
against it in accordance with its terms.

 

	12.	Governing Law. This First Amendment and all amendments, modifications, alterations, or supplements
hereto, and the rights of the Parties, will be construed under and governed by the laws of the State of New York, excluding any conflicts
or choice of law rule or principle that might otherwise refer construction or interpretation of this First Amendment to the substantive
law of another jurisdiction. The Parties agree to exclude the application to this First Amendment of the United Nations Convention on
Contracts for the International Sale of Goods.

 

	13.	Amendments. This First Amendment may not be modified or amended, except by another agreement in
writing executed by duly authorized signatories of each Party.

 

	14.	Counterparts. This First Amendment may be executed in two or more counterparts, all of which taken
together will be regarded as one and the same instrument. Each Party may execute this First Amendment in AdobeTM Portable Document
Format (PDF) sent by electronic mail. PDF signatures of authorized signatories of the Parties will be deemed to be original signatures,
will be valid and binding upon the Parties, and, upon delivery, will constitute due execution of this First Amendment.

 

[Signatures Follow]

 

    	 	4	 

     

    

 

IN WITNESS WHEREOF, the Parties
have executed this First Amendment to License Agreement through their duly authorized representatives.

 

	Santen Pharmaceutical Co., Ltd.	 
	 	 
	By:	/s/
    Satoshi Suzuki	 
	 	 
	Name:	Satoshi Suzuki	 
	 	 
	Title: 	Senior Corporate Officer, Head of Corporate Development Division	 
	 	 
	RVL Pharmaceuticals, Inc.	 
	 	 
	By:	/s/ Brian Markison	 
	 	 
	Name:	Brian Markison	 
	 	 
	Title: 	Chief Executive Officer	 

 

[Signature
Page To First Amendment To License Agreement]

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