Document:

EX-10.12

 Exhibit 10.12 

THIRD AMENDMENT TO LEASE 

THIS THIRD AMENDMENT TO LEASE (this “Amendment”) is dated this 26th day of July, 2018 (the “Effective Date”) by and
between 100 DOMAIN DRIVE EI, LLC, a Delaware limited liability company, as administrator of the tenancy in common with 100 DOMAIN DRIVE DD, LLC, a Delaware limited liability company (collectively, “Landlord”) and VAPOTHERM, INC., a
Delaware corporation (“Tenant”). 
 RECITALS: 

WHEREAS, Landlord’s predecessor in interest, Albany Road-100 Domain LLC, and Tenant entered into
that certain Lease Agreement dated as of September 30, 2016; as amended by that certain First Amendment to Lease dated as of September 11, 2017; as further amended by that certain Second Amendment to Lease dated as of June 6, 2018,
(collectively, the “Lease”), whereby Tenant leases certain premises consisting of approximately 82,968 rentable square feet of office and research and development space (the “Original Premises”) in the building known as 100
Domain Drive, Exeter, New Hampshire, as more particularly described in the Lease (the “Building”); 
 WHEREAS, Landlord purchased
the Building from Albany Road-100 Domain LLC as of April 3, 2018 and has succeeded to its interests as Landlord under the Lease; 

WHEREAS, pursuant to the Lease, Article XVII, as modified by the First Amendment to Lease, Section 19, Tenant has a right of first offer
on all space in the Building, including space shown on a Floor Plan attached hereto as Exhibit A and designated “New R&D Lab Area” consisting of approximately 1,172 rentable square feet of space, (the “New R&D Lab Area”);

 WHEREAS, by letter dated July 26, 2018, from Tenant to Landlord, Tenant has exercised its right of first offer on the New R&D
Lab Area, and the Superior ROFO Rights described in Exhibit F to the Lease have been waived and satisfied for purposes of this Third Amendment; 

WHEREAS, Landlord and Tenant desire to amend the Lease to incorporate the New R&D Lab Area into the Premises and subject the New R&D
Lab Area to the provisions of the Lease, as amended by this Amendment; and WHEREAS, Landlord and Tenant desire to memorialize their understanding and modify the Lease consistent therewith all subject to the terms, covenants and conditions
hereinafter set forth below. 
 AGREEMENTS: 

NOW, THEREFORE, in consideration of the mutual promises herein contained and other good and valuable consideration, the receipt and
sufficiency of which is hereby acknowledged by the parties hereto, Landlord and Tenant agree as follows: 
 1.    New
R&D Lab Area Premises. Effective as of the Effective Date, Tenant hereby leases from Landlord, and Landlord hereby leases to Tenant, the New R&D Lab Area Premises. As used herein, the term New R&D Lab Area Premises shall mean the
approximately 1,172 rentable square feet of space located on the first floor of the Building as further set forth on the New R&D Lab Area Floor Plan attached hereto as Exhibit A. As of the Effective Date, all

 
references to the “Premises” shall be deemed to include the Original Premises, the Expansion Premises, the Second Floor Premises, and the New R&D Lab Area Premises, for a total of
84,140 rentable square feet. All references to the “Lease” shall mean the Lease as amended by this Amendment. 

2.    Rent. Effective as of the Effective Date, Tenant shall commence paying Base Rent and Additional Rent on the
New R&D Lab Area Premises, which rent shall be in addition to the Base Rent and Additional Rent Tenant is currently paying on the Original Premises and the Second Floor Premises pursuant to the Lease and the First Amendment to Lease and the
Second Amendment to Lease. Tenant’s Proportionate Office Share shall be adjusted accordingly to include the New R&D Lab Area Premises for purposes of calculating Additional Rent. Tenant shall pay Base Rent on the New R&D Lab Area
Premises in the same manner as required under the Lease as follows: 
  

													
	 Lease Year
	  	Annual Fixed Rental
Rate	 	  	Annual Fixed Rental	 	  	Monthly Fixed Rental	 
	 1
	  	$	14.25	 	  	$	16,701.00	 	  	$	1,391.75	 
	 2
	  	$	14.61	 	  	$	17,122.92	 	  	$	1,426.91	 
	 3
	  	$	14.97	 	  	$	17,544.84	 	  	$	1,462.07	 
	 4
	  	$	15.35	 	  	$	17,990.16	 	  	$	1,499.18	 
	 5
	  	$	15.73	 	  	$	18,435.60	 	  	$	1,536.30	 
	 6
	  	$	16.12	 	  	$	18,892.68	 	  	$	1,574.39	 
	 7
	  	$	16.53	 	  	$	19,373.16	 	  	$	1,614.43	 

 3.    Term. The Term for the New R&D Lab Area Premises shall commence as of the
Effective Date and be coterminous with the Original Premises, with the First Lease Year being tied to - the First Lease Year of the Second Expansion Premises as defined in the First Amendment to Lease. The parties agree that the Lease Commencement
date for the New R&D Lab Area Premises is January 29, 2018. 
 4.    New R&D Lab Area Premises
Condition and Tenant Work. Landlord shall deliver and Tenant shall accept the New R&D Lab Area Premises in their “as is” condition as of the Effective Date, with all faults and without representation or warranty by Landlord. Tenant
shall be allowed to make improvements to the New R&D Lab Area Premises as set forth in this paragraph. Tenant shall perform all work necessary to permit Tenant to operate the New R&D Lab Area Premises for its intended use and in such a
manner that shall not unreasonably interfere with other tenants in the Building (“Tenant’s Work”). Tenant shall not commence any of Tenant’s Work until Tenant has developed with its architect at its sole cost and expense and
submitted to Landlord “Space Plans” (in such detail as Landlord shall reasonably require) for such work and Landlord has approved such plans in writing. Landlord acknowledges such Space Plans have been submitted by Tenant and approved by
Landlord as of the Effective Date. 
 Upon execution of this Amendment, Tenant shall thereafter engage its architect at its sole cost and
expense to prepare plans and specifications for the build-out of the New R&D Lab Area Premises (“Build-Out Plans”), which plans and specifications shall be
submitted to Landlord for its reasonable approval. Tenant’s Work shall be performed in accordance with such 

  
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approved Space Plans and Build-Out Plans and in accordance with the terms and conditions of this Lease and shall be performed by contractor(s) approved by
Landlord, which approval shall not be unreasonably withheld or delayed. 
 Tenant shall commence Tenant’s Work promptly after receipt
of Landlord’s approval of Tenant’s Space Plans and Build-Out Plans and shall diligently prosecute the same to completion. Landlord’s approval of Tenant’s Space Plans and Build-Out Plans for Tenant’s Work shall create no responsibility or liability on the part of Landlord for their completeness, design sufficiency, or compliance with all laws, rules and regulations of
governmental agencies or authorities. Prior to beginning Tenant’s Work, Tenant shall obtain all necessary permits, including but not limited to zoning and building permits, and, if required by law, obtain appropriate performance and payment
bonds covering the labor and materials required to complete Tenant’s Work. Prior to beginning Tenant’s Work, Tenant shall also deliver to Landlord and Landlord’s Mortgagee, at Tenant’s cost, a builder’s risk insurance policy
naming Landlord and Landlord’s Mortgagee as additional insureds, as their interests may appear, with the amount and type of coverage being reasonably required by Landlord and Landlord’s Mortgagee and otherwise in compliance with the
requirements for insurance set forth in the Lease, together with evidence that the premium for said insurance has been paid in full by Tenant in accordance with the terms of the policy. Tenant covenants and represents that the foregoing work shall
be completed in a good and workmanlike manner and in compliance with all applicable legal requirements. Tenant’s Work shall be deemed to be “Substantially Complete” upon delivery by Tenant’s architect of a Certificate of
Substantial Completion and the issuance of a certificate of occupancy by the applicable municipal authority. 

5.    Tenant Improvement Allowance. Landlord has agreed to provide Tenant with an allowance of $29,300.00 ($25 per
rentable square foot times 1,172 RSF) for the purpose of making improvements to the New R&S Lab Area Premises (the “Tenant Allowance”), subject to the provisions set forth herein. Landlord shall reimburse Tenant for the costs actually
incurred by Tenant in connection with Tenant’s Work, which costs may include, without limitation, costs in connection with engineering and design, as well as construction-related costs and expenses up to a maximum aggregate amount of the Tenant
Allowance. Tenant must submit a reimbursement request for payment of the Tenant Allowance in accordance with the provisions of this Paragraph 5 on or before the date that is twelve (12) months after the Effective Date, and Tenant shall not be
entitled to any credit, offset, or payment from Landlord for any portion of Tenant’s Allowance for which Tenant has not properly submitted a draw request in accordance with this Paragraph 5 on or before such date. 

Tenant shall promptly pay in full all costs and expenses associated with Tenant’s Work. Upon Substantial Completion of Tenant’s
Work, and provided that no Event of Default exists under this Lease, Landlord shall reimburse Tenant the amount requested by Tenant in a single individual written draw request submitted by Tenant to Landlord within thirty (30) days of such
request upon satisfaction of all of the following conditions: (a) all Tenant’s Work shall have been completed substantially in accordance with the approved Space Plans and Build-Out Plans;
(b) Tenant shall have submitted a detailed written draw request to Landlord itemizing the cost of Tenant’s Work and certifying that all such Tenant Work has been completed substantially in accordance with the approved Space Plans and Build-Out Plans and specifications therefor and in compliance with all applicable legal requirements; (c) Tenant shall have submitted to Landlord 

  
 -3- 

 
copies of paid invoices related to that portion of Tenant’s Work to be reimbursed together with lien waivers and releases from all material contractors, subcontractors, suppliers and other
parties furnishing labor and/or material for such portion of Tenant’s Work; and (d) Tenant has commenced to operate its business at the New R&D Lab Area Premises and delivered to Landlord a final, unconditional Certificate of Occupancy
with respect to the New R&D Lab Area Premises duly issued by the Town of Exeter, New Hampshire. Upon completion of Tenant’s Work, Tenant shall deliver to Landlord a Certificate of Substantial Completion from Tenant’s architect
certifying that all Tenant’s Work has been installed and completed substantially in accordance with the approved Space Plans and Build-Out Plans therefor and in compliance with all applicable legal
requirements. Tenant shall be responsible for the performance of Tenant’s Work to completion and the payment of any costs and expenses related to Tenant’s Work which exceed the Tenant Allowance. 

6.    Use. Tenant intends to use the New R&D Lab Area Premises for development of processes and products for
Tenant. The layout will be open floor space with benches, equipment, compressed air and power. The area will be accessible from Tenant’s Existing Premises and main hallway. Landlord has conditionally granted Tenant the right to use the New
R&D Lab Area Premises for such use, provided Tenant complies with the following conditions: (i) Tenant substantially complies with the Space Plans and Build-Out Plans set forth in Section 4
herein. 
 7.    Brokerage. Landlord and Tenant each represent and warrant to the other that it has dealt with no
agents, brokers, finders or other parties entitled to any commission or fee with respect to this Lease or the Premises or the Property. Landlord and Tenant each agree to indemnify and hold the other party harmless from any claim, demand, cost or
liability, including, without limitation, attorneys’ fees and expenses, asserted by any such party based upon dealings with that party. 

8.    Ratification of Lease: No Other Amendments. In all other respects, the terms and provisions of the Lease are
ratified and reaffirmed hereby, are incorporated herein by this reference and shall be binding upon the parties to this Third Amendment. Tenant represents and warrants to Landlord that, solely as of the date of this Third Amendment, (a) Tenant
is not in default under the terms of the Lease, (b) to the best of Tenant’s knowledge, Landlord is not in default under the terms of the Lease; and (c) Landlord has completed all work required under the Lease, if any. As of the date
of this Third Amendment, Tenant further acknowledges that Tenant currently has no defenses, offsets, claims or counterclaims against Landlord under the Lease or against the obligations of Tenant under the Lease. 

9.    Definitions. All capitalized terms used and not otherwise defined herein shall have the meanings ascribed to
them in the Lease. 
 10.    Conflicts. Any inconsistencies or conflicts between the terms and provisions of the
Lease and the terms and provisions of this Third Amendment shall be resolved in favor of the terms and provisions of this Third Amendment. 

11.    Execution. The submission of this Third Amendment shall not constitute an offer, and this Third Amendment
shall not be effective and binding unless and until fully executed and delivered by each of the parties hereto. Tenant represents and warrants for itself that all requisite organizational action has been taken in connection with this transaction,
and the individual or individuals signing this Third Amendment on behalf of Tenant represent and warrant that they have been duly authorized to bind the Tenant by their signatures. 

  
 -4- 

 12.    Counterparts. This Third Amendment may be executed in one
or more counterparts, each of which shall be deemed an original but all of which together shall constitute one and the same instrument. Additionally, telecopied or pdf signatures may be used in place of original signatures on this Third Amendment.
Landlord and Tenant intend to be bound by the signatures on the telecopied or pdf document, are aware that the other party will rely on the telecopied or pdf signatures, and hereby waive any defenses to the enforcement of the terms of this Third
Amendment based on the form of signature. 
 13.    Modifications. This Third Amendment shall not be modified
except in writing signed 
 14.    Construction. The parties acknowledge and agree that this Third Amendment was
negotiated by all parties, that this Third Amendment shall be interpreted as if it was drafted jointly by all of the parties, and that neither this Third Amendment, nor any provision within it, shall be construed against any party or its attorney
because it was drafted in whole or in part by any party or its attorney. 
 15.    Limitation of Landlord
Liability. Redress for any claims against Landlord under the Lease and this Third Amendment shall only be made against Landlord to the extent of Landlord’s interest in the property to which the Premises are a part. The obligations of
Landlord under the Lease and this Third Amendment shall not be personally binding on, nor shall any resort be had to the private properties of, any of its trustees or board of directors and officers, as the case may be, the general partners thereof
or any beneficiaries, stockholders, employees or agents of Landlord, or the investment manager. 
 16.    Amendment
to Notice of Lease. Landlord and Tenant shall record an Amendment to and Restatement of the Notice of Lease in the form attached hereto as Exhibit B. 

17.    Utilities. Tenant shall pay for all utilities in the Premises on the terms and conditions set forth in the
Existing Lease. To the extent that any utilities for any portion of the Premises are not sub-metered. Tenant shall pay its Proportionate Share for the utilities in such portions of the Premises. Landlord shall
allow separate metering in such portions of the Premises if Tenant is able to obtain separate metering for any utilities. Landlord shall, at Landlord’s sole cost and expense, install any such meter or
sub-meter. 
 18.    Right of First Offer. Landlord warrants that the
rights described in Exhibit F to the Existing Lease have been waived and satisfied for purposes of this Third Amendment. 

19.    Governing Law. This Third Amendment shall be governed, construed and interpreted in accordance with the laws
of the state in which the Property is located. 
 [signature page follows] 

  
 -5- 

 IN WITNESS WHEREOF, the parties hereto have executed this Third Amendment of Lease as
of the date first above written. 
  

			
	LANDLORD
	
	 100 DOMAIN DRIVE EI LLC,
 a Delaware
limited liability company,
 as tenancy in common administrator

		
	By:	 	 100 Domain Drive EI Managing Member LLC,
 A
Delaware limited liability company

					
			
		 	By:	 	 /s/ Vincent
MacNutt                    

		 		 	Vincent MacNutt, Its Manager
		 	Duly Authorized

			
	
	TENANT
	
	 VAPOTHERM, INC.,
 A Delaware
corporation

					
			
		 	By:	 	 /s/ Anthony Ten Haagen

		 	Name:	 	Anthony Ten Haagen
		 	Its:	 	VP Legal + Compliance
		 	Duly Authorized

 EXHIBIT A 

NEW R&D LAB AREA PREMISES 

 EXHIBIT B 

Return To: 
 Smith Duggan Buell & Rufo
LLP 
 101 Federal Street, Suite 1405 
 Boston, MA 02110-1817

 Attn: Paul Alan Rufo, Esq. 
 AMENDMENT TO AND
RESTATEMENT OF NOTICE OF LEASE 
 WITH NOTICE OF RIGHT OF FIRST OFFER TO LEASE ADDITIONAL SPACE 

Pursuant to the provisions of NH RSA 477:7-a. this notice amends and restates that certain Notice of
Lease with Notice of Right of First Offer to Lease Additional Space dated September I 1, 2017 and recorded at the Rockingham County Registry of Deeds at Book , Page 

Name and Address of Landlord Lessor: 
 100 Domain Drive EI
LLC 
 60 Thoreau Street #262 
 Concord, MA 01742 

Name and Address of Tenant Lessee: 
 Vapotherm, Inc. 

100 Domain Drive 
 Exeter, New Hampshire 03833 

Date of Execution of the Lease: 
 The original Lease was
originally executed and delivered on September 30, 2016 and has been amended by a First Amendment to Lease (the “First Amendment”) on August 31st, 2017, by a Second Amendment to
Lease (the “Second Amendment”) on June 6. 2018, and a third amendment dated July             , 2018 (the “Third Amendment”). The original Lease as amended by the First
Amendment, the Second Amendment, and Third Amendment shall be referred to herein collectively as the “Lease”. 
 Description of Lease Premises:

 A total of 84,140 ÷ - square feet of manufacturing, storage, research and development, and office space within a building containing 263,486
rentable square foot located at 100/150 Domain Drive. Exeter New Hampshire together with a non-exclusive right wit! other tenants of the Building to use all common areas and facilities, all of which are
situated on the land described in Exhibit A. All of the above-described space is depicted on plans attached to the Lease. 

 Term: Date of Commencement. Extension Options: 

The Term of the Lease will run for Seven (7) years from completion of two phases of construction as set forth in the First Amendment, which is expected to
occur on or about January 29, 2018. but no later than September 30, 2018. Thereafter, the Tenant has two additional five (5) year options to renew subject to the provisions of the Lease. 

Right of First Offer: 
 Tenant has the right of first
offer to lease all space within the Building, subject to the rights of any existing tenants. 
 THIS NOTICE IS SUBJECT TO AND WITH THE
BENEFIT OF THE SAME TERM RESTRICTIONS AND CONDITIONS CONTAINED IN THE ORIGINAL EXECUTED INSTRUMENT. THIS NOTICE OF LEASE IS EXECUTED ONLY FOR THE PURPOSE GIVING NOTICE OF THE EXISTENCE OF THE LEASE AND IS NOT INTENDED TO MODIFY. EXPAND OR REDUCE ANY
OF THE RIGHTS OF THE LANDLORD OR THE TENANT SET FORTH IN THE LEASE. IN THE EVENT OF ANY CONFLICT OR INCONSISTENCY BETWEEN THE TERMS HEREOF AND THE TERMS OF THE LEASE THE TERMS OF THE LEASE SHALL GOVERN. 

[Remainder of Page Intentionally Blank. Signature Page to Follow] 

 Executed this 31st day of July, 2018. 

 

					
	LANDLORD
	
	 100 DOMAIN DRIVE EI LLC,
 a Delaware
limited liability company,
 as tenancy in common administrator

		
	By:	 	 100 Domain Drive EI Managing Member LLC,

A Delaware limited liability company

			
		 	By:	 	 /s/ Vincent MacNutt

		 		 	Vincent MacNutt, Its Manager
		 		 	Duly Authorized

  

	
	  

	Witness
	
	COMMONWEALTH OF MASSACHUSETTS
	COUNTY OF Middlesex

 On this 31st day of July, 2018, before me, the undersigned notary public, personally appeared Vincent MacNutt,
as Manager of 100 Domain Drive EI Managing Member LLC, Manager of 100 Domain Drive EI LLC, a Delaware limited liability company, and proved to me through satisfactory evidence of identification, ☐ Driver’s License or other state or
federal governmental document bearing a photographic image, ☐ oath or affirmation of a credible witness known to me who knows the above signatory, ☐ or my own personal knowledge of the identity of the signatory, to be the person whose
name is signed on the preceding or attached document, and duly acknowledged to me that he executed the same on behalf of 100 Domain Drive EI LLC for the purposes stated therein, as his free act and deed and the free act and deed of 100 Domain Drive
EI LLC and who swore or affirmed to me that the contents of the document are truthful and accurate to the best of his knowledge and belief. 
  

	
	 /s/ Payal B. Bharucha

	Notary Public
	Print Name: Payal B. Bharucha
	My Commission Expires: April 24, 2024

					
	TENANT
	
	VAPOTHERM, INC.,
	A Delaware corporation

							
				
		 		 	By:	 	 /s/ Anthony Ten Haagen

		 		 	Name:	 	Anthony Ten Haagen
		 		 	Its:	 	VP Legal + Compliance
		 		 	Duly Authorized

  

	
	 /s/ Katherine Jeck

	Witness

 STATE OF NEW HAMPSHIRE 
 COUNTY
OF Rockingham 
 The foregoing instrument was acknowledged before me this 26th day of July, 2018, by Anthony Ten Haagen, as VP Legal + Compliance of
Vapotherm, Inc., a Delaware corporation. 
  

	
	 /s/ Lindsay Becker

	Notary Public
	Print Name: Lindsay Becker
	My Commission Expires: 9/11/18

 July 26, 2018 

Via E-Mail 

Vincent G. MacNutt 
 100 Domain Drive Asset Manager, LLC 

C/O Boulos Asset Management 
 1 Canal Plaza 

Portland, ME 04101 
 Re:    Notice of Right
of First Offer, New R&D Lab Area 
 Dear Vincent G. MacNutt, 

Please allow this letter to serve as the our notice that effective as of July 26, 2018 we are exercising our right of first offer on the New R&D Lab
Area and to-add such area to the Premises. For the purposes of this letter, the term New R&D Lab Area refers to the approximately 1,172 rentable square feet of space located on the first floor of the
building in close proximity to the Green Bean cafe. The specific area will be agreed upon by the parties and identified in the Third Amendment to our Lease. 

Please do not hesitate to contact me at 603-380-8088 or via email at
atenhaagen@vtherm.com if I can be of assistance with this or any other matter. 
  

	
	Kind regards,
	
	/s/ Anthony Ten Haagen
	
	Anthony Ten Haagen
	Director of Legal Affairs & Compliance

  

			
	CC:	 	John Coolidge; Vapotherm
		 	Sean Teague; Cushman & Wakefield

  
 Take the Work out of
Breathing 
 Vapotherm Inc. - 100 Domain Drive, Exeter, NH 03833 - (603) 658-0011
- www.vapotherm.comEX-10.13

 Exhibit 10.13 

Execution Version 

AMENDMENT NO. 1 TO CREDIT AGREEMENT AND GUARANTY 

This AMENDMENT NO. 1 TO CREDIT AGREEMENT AND GUARANTY, dated as of September 27, 2018 (this “Amendment”),
is made by and among VAPOTHERM, INC., a Delaware corporation (the “Borrower”), certain Subsidiaries of the Borrower that are signatories hereto, the Lenders signatories hereto and PERCEPTIVE CREDIT HOLDINGS II, LP, as
administrative agent for the Lenders (in such capacity, the “Administrative Agent”). Unless otherwise defined herein or the context otherwise requires, terms used in this Amendment, including its preamble and recitals, have
the meanings provided in the Credit Agreement (defined below). 
 W I T N E S S E
T H: 
 WHEREAS, the Borrower, certain Subsidiary Guarantors, the Administrative Agent and the Lenders have entered into that
certain Credit Agreement and Guaranty, dated as of April 6, 2018 (as subsequently amended or otherwise modified, the “Credit Agreement”); 

WHEREAS, pursuant to Section 2.01(c) of the Credit Agreement and subject to the satisfaction of the conditions precedent set forth in
Section 6.03 of the Credit Agreement, the Lenders have agreed to make the Second Delayed Draw Loan to the Borrower in a single Borrowing on the Second Delayed Draw Date in a principal amount equal to its Proportionate Share of $12,500,000 or
such lesser amount; 
 WHEREAS, the Borrower has requested, among other things, that (i) rather than being limited to a single
Borrowing, the Borrower be able to draw the amount available in respect of the Second Delayed Draw Loan in multiple Borrowings, and (ii) the Lenders and the Administrative Agent agree to certain other amendments and modifications to the Credit
Agreement in connection therewith; 
 NOW, THEREFORE, for good and valuable consideration, the receipt and sufficiency of which are hereby
acknowledged, the parties hereto agree as follows: 
 ARTICLE I 

AMENDMENTS TO CREDIT AGREEMENT 

SECTION 1.1. Amendments to Existing Defined Terms. Effective on the date hereof, Section 1.01 of the Credit Agreement is hereby
amended by amending and restating in full each of the following defined terms set forth in such Section as follows: 

“Borrowing” (and its derivatives) means, as the context may require, either (i) the
borrowing of the Initial Loan on the Closing Date, (ii) the borrowing of the First Delayed Draw Loan on the First Delayed Draw Date or (iii) the borrowing of the Second Delayed Draw Loan on any Second Delayed Draw Date. 

“Borrowing Date” means, as the context may require, (i) with respect to the Initial
Loan, the Closing Date, (ii) with respect to the First Delayed Draw Loan, the First Delayed Draw Date and (iii) with respect to the Second Delayed Draw Loan, the Second Delayed Draw Date on which such Loan is Borrowed. 

 “Loans” means, collectively, the
Initial Loan, the First Delayed Draw Loan, any Second Delayed Draw Loan, and any PIK Loan, and “Loan” means any of the foregoing. 

“Second Delayed Draw Date” means, with respect to any Borrowing of Second Delayed Draw
Loans, the date on which such Borrowing is made hereunder, which, for each such Borrowing, shall be (i) no sooner than the date on which each of the conditions precedent set forth in Section 6.03 shall have been
satisfied with respect to such Borrowing, and (ii) no later than March 31, 2019. 
 “Second
Delayed Draw Loan” means any term loans made by the Lenders on a Second Delayed Draw Date, which shall not exceed an aggregate original principal amount of $12,500,000. 

“Second Delayed Draw Warrant” means, with respect to any Borrowing of Second Delayed Draw
Loans, a warrant, dated as of the Second Delayed Draw Date for such Borrowing and issued pursuant to a Warrant Certificate in substantially the form of Exhibit K, that among other things, grants the holder thereof the right to purchase, at
the applicable exercise price described below, a number of shares of the Borrower’s Series D Preferred Equity Interests that is equal to three percent (3%) of the aggregate principal amount of such Borrowing of Second Delayed Draw Loans divided
by a per share exercise price equal to the lower of (i) $1.137 or (ii) in the event that after the date hereof any Series D Preferred Equity Interests or any Equity Interests of the Borrower convertible or exercisable into Series D Preferred
Equity Interests of the Borrower are issued at a per share conversion or exercise price, as the case may be, less than $1.137, such lesser price, in each case subject to adjustment as provided in the Warrant Certificate pursuant to which such Second
Delayed Draw Warrant is issued; provided that, if at the time of issuance of any Second Delayed Draw Warrant the Borrower has consummated a Qualified IPO, the exercise price for such Warrant shall be the VWAP for the Borrower’s shares of
common Equity Interests as of such time of issuance. 
 “Warrants” means the Initial
Warrant, the First Delayed Draw Warrant and any Second Delayed Draw Warrant. 
 SECTION 1.2. Amendment to
Section 2.01(c). Effective on the date hereof, Section 2.01(c) of the Credit Agreement is hereby amended and restated in its entirety to read as follows: 

“(c) On the terms and subject to the conditions of this Agreement, each Lender agrees to make a Second Delayed Draw Loan
to the Borrower on a Second Delayed Draw Date in an aggregate principal amount equal to its Proportionate Share of $12,500,000 or such lesser amount as set forth in the Borrowing Notice for such Loan; provided that (i) no individual
Borrowing of a Second Delayed Draw Loans shall be less than $2,000,000 in aggregate principal amount and each requested Borrowing of Second Delayed Draw Loans shall be in an integral multiple of $500,000; (ii) each Lender’s Commitment with
respect to the making of any Second Delayed Draw Loans shall automatically terminate on March 31, 2019; and (iii) no Second Delayed Draw Loan shall be requested by the Borrower or made by any Lender on or after March 31, 2019.”

  
 2- 

 SECTION 1.3. Amendment to Section 6. Effective on date hereof,
Section 6.03 of the Credit Agreement is hereby amended and restated in its entirety as follows: 
 “6.03 Conditions to
the Borrowing of the Second Delayed Draw Loans. The obligation of each Lender to make a Second Delayed Draw Loan on any Second Delayed Draw Date shall be subject to compliance with the terms and requirements of
Section 2.01(c), the delivery of a Borrowing Notice as required pursuant to Section 2.02, and the prior or concurrent satisfaction of each of the conditions precedent set forth below in this
Section 6.03. The obligation of each Lender to make its portion of any Second Delayed Draw Loan is not conditioned on the Borrower’s prior Borrowing of the First Delayed Draw Loan. 

(a) Second Delayed Draw Certificate. The Lenders shall have received a certificate, dated as of the applicable Second
Delayed Draw Date and in form and substance reasonably satisfactory to the Administrative Agent (a “Second Delayed Draw Certificate”), duly executed and delivered by a Responsible Officer of the Borrower, in which certificate
the Borrower shall, among other things, represent and warrant that the statements made therein are true and correct as of such Second Delayed Draw Date, and, at the time such certificate is delivered, such statements shall in fact be true and
correct. The statements in such certificate shall include, among other things, that (i) both immediately before and after giving effect to the Second Delayed Draw Loan (x) the representations and warranties set forth in this Agreement and
each other Loan Document shall, in each case, be true and correct in all material respects (or in the case of any representation and warranty subject to a materiality qualifier, true and correct in all respects), except to the extent such
representations and warranties relate to an earlier date in which case such representations and warranties shall be true and correct in all material respects or true and correct, as applicable, as of such earlier date and (y) no Event of
Default shall have then occurred and be continuing, or could reasonably be expected to result from the Second Delayed Draw Loan to be advanced on such Second Delayed Draw Date, and (ii) all of the conditions set forth in
Section 6.03 have been satisfied. All documents and agreements required to be appended to the Second Delayed Draw Certificate, if any, shall be in form and substance reasonably satisfactory to the Administrative Agent,
shall have been executed and delivered by the requisite parties, and shall be in full force and effect. 
 (b) Second
Delayed Draw Warrant. The Administrative Agent shall have received an executed counterpart of a Warrant Certificate pursuant to which a Second Delayed Draw Warrant shall have been issued for each Lender. 

(c) [Reserved] 

(d) Fees, Expenses, Etc. The Administrative Agent shall have received for its account and the account of each
Lender, all fees, costs and expenses due and payable to them as required pursuant to the Section 14.03.” 

  
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 ARTICLE II 

CONDITIONS PRECEDENT 
 This
Amendment shall become effective upon, and shall be subject to, the prior or simultaneous satisfaction of each of the following conditions in a manner reasonably satisfactory to the Lenders and the Administrative Agent (the date when all such
conditions are so satisfied being the “First Amendment Effective Date”): 
 SECTION 2.1. Initial Second Delayed
Draw Loan. A Borrowing of a Second Delayed Draw Loan shall have occurred. 
 SECTION 2.2. Counterparts. The Lenders and the
Administrative Agent shall have received counterparts of this Amendment executed on behalf of the Borrower. 
 SECTION 2.3. Effective
Date Certificate. The Lenders and the Administrative Agent shall have received a certificate, dated as of the date hereof and duly executed and delivered by a Responsible Officer of the Borrower certifying as to the matters set forth in
Articles III and IV hereof, in form and substance reasonably satisfactory to the Administrative Agent. 
 SECTION 2.4.
Costs and Expenses, etc. The Lenders and the Administrative Agent shall have received all fees, costs and expenses due and payable pursuant to Section 14.03 of the Credit Agreement (including without limitation the
reasonable and documented fees and expenses of Morrison & Foerster LLP, counsel to the Lenders and the Administrative Agent), if then invoiced, together with any other fees separately agreed to by the Borrower and the Administrative Agent.

 ARTICLE III 
 REPRESENTATIONS
AND WARRANTIES 
 To induce the Lenders and the Administrative Agent to enter into this Amendment, the Borrower represents and warrants to
the Lenders and the Administrative Agent as set forth below. 
 SECTION 3.1. Representations and Warranties, etc. Immediately prior
to, and immediately after giving effect to, this Amendment, the following statements shall be true and correct: 
 (a) the
representations and warranties set forth in each Loan Document (as defined in the Credit Agreement) shall, in each case, be true and correct in all material respects with the same effect as if then made (or in the case of any representation and
warranty subject to a materiality qualifier, true and correct in all respects), unless stated to relate solely to an earlier date, in which case such representations and warranties shall be true and correct in all material respects as of such
earlier date; 

  
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 (b) the Borrower has full power, authority and legal right to enter into
this Amendment and perform its obligations under this Amendment and each Loan Document as amended hereby or thereby; 
 (c)
the transactions contemplated by this Amendment are within the Borrower’s corporate powers and have been duly authorized by all necessary corporate and, if required, by all necessary shareholder action. This Amendment has been duly executed and
delivered by the Borrower; 
 (d) none of the transactions contemplated by this Amendment (i) requires any Governmental
Approval of, registration or filing with, or any other action by, any Governmental Authority or any other Person, except for such as have been obtained or made and are in full force and effect, (ii) will violate (1) any applicable Law, the
violation of which could reasonably be expected to result in a Material Adverse Effect, (2) any Organic Document of any Obligor or any of its Subsidiaries or (3) any order of any Governmental Authority the violation of which could
reasonably be expected to result in a Material Adverse Effect, (iii) will violate or result in a default under any Contract binding upon any Obligor or any of its Subsidiaries that, individually or in the aggregate, could reasonably be expected
(x) to result in a Material Adverse Effect or (y) solely in respect of any Material Agreement, to give rise to any rights thereunder to require any payments to be made by any such Person, any Obligor or any of their respective Subsidiaries
and (iv) will result in the creation or imposition of any Lien (other than Permitted Liens) on any asset of any Obligor or any of its Subsidiaries; and 

(e) no Default or Event of Default shall have then occurred and be continuing. 

ARTICLE IV 
 CONFIRMATION 

SECTION 4.1. Guarantees, Security Interest, Continued Effectiveness. The Borrower hereby consents to the modifications made to the Loan
Documents pursuant to this Amendment and hereby agrees that, after giving effect to this Amendment, each Loan Document to which it is a party is and shall continue to be in full force and effect and the same are hereby ratified in all respects,
except that upon the occurrence of the effectiveness of this Amendment, all references in such Loan Documents to the “Credit Agreement”, “Loan Documents”, “thereunder”, “thereof”, or words of similar import
shall mean the Credit Agreement and the other Loan Documents, as amended or otherwise modified by this Amendment. 
 SECTION 4.2.
Validity, etc. The Borrower hereby represents and warrants, as of the date hereof, that immediately after giving effect to this Amendment, each Loan Document, in each case as modified by this Amendment (where applicable and whether directly
or indirectly), to which it is a party continues to be a legal, valid and binding obligation of such Obligor, enforceable against such Person in accordance with its terms, subject to the effects of bankruptcy, insolvency, reorganization, moratorium
and other similar laws relating to or affecting creditors’ rights generally, general equitable principles (whether considered in a proceeding in equity or at law). 

  
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 ARTICLE V 

MISCELLANEOUS 
 SECTION 5.1. No
Waiver. Except as expressly provided herein, (i) nothing contained herein shall be deemed to constitute a waiver of any other existing or future Default or Event of Default or compliance with any term or condition contained in the Credit
Agreement or any of the other Loan Documents or constitute a course of conduct or dealing among the parties and (ii) the Lenders and the Administrative Agent reserve all rights, privileges and remedies under the Credit Agreement and the other
Loan Documents. 
 SECTION 5.2. Cross-References. References in this Amendment to any Article or Section are, unless otherwise
specified, to such Article or Section of this Amendment. 
 SECTION 5.3. Loan Document Pursuant to Credit Agreement. This Amendment
is a Loan Document executed pursuant to the Credit Agreement and shall (unless otherwise expressly indicated therein) be construed, administered and applied in accordance with all of the terms and provisions of the Credit Agreement, as amended
hereby. 
 SECTION 5.4. Successors and Assigns. This Amendment shall be binding upon and inure to the benefit of the parties hereto
and their respective successors and permitted assigns. 
 SECTION 5.5. Counterparts. This Amendment may be executed in any number of
counterparts, all of which taken together shall constitute one and the same instrument and any of the parties hereto may execute this Amendment by signing any such counterpart. Delivery of an executed signature page of this Amendment by facsimile
transmission or electronic transmission (in PDF format) shall be effective as delivery of a manually executed counterpart hereof. 
 SECTION
5.6. Governing Law. THIS AMENDMENT SHALL BE GOVERNED BY, AND CONSTRUED IN ACCORDANCE WITH, THE INTERNAL LAWS OF THE STATE OF NEW YORK WITHOUT REGARD TO PRINCIPLES OF CONFLICTS OF LAWS THAT WOULD RESULT IN THE APPLICATION OF THE LAWS OF ANY
OTHER JURISDICTION; PROVIDED THAT SECTION 5-1401 OF THE NEW YORK GENERAL OBLIGATIONS LAW SHALL APPLY. 

SECTION 5.7. Full Force and Effect; Limited Amendment. Except as expressly amended hereby, the Borrower agrees that all of the
representations, warranties, terms, covenants, conditions and other provisions of the Credit Agreement and the other Loan Documents shall remain unchanged and shall continue to be, and shall remain, in full force and effect in accordance with their
respective terms. The amendments and other waivers and modifications set forth in this Amendment shall be limited precisely as provided for herein to the provisions expressly amended herein or otherwise modified or waived hereby and shall not
be deemed to be an amendment to, waiver of, consent to or modification of any other term or provision of the Credit Agreement or any other Loan Document or of any transaction or further or future action on the part of any Credit Party which would
require the consent of the Lenders under the Credit Agreement or any of the Loan Documents. 
 [Signature pages to follow] 

  
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 IN WITNESS WHEREOF, the parties hereto have caused this Amendment to be duly executed and
delivered as of the day and year first above written. 
  

			
	BORROWER:
	
	VAPOTHERM, INC.
		
	By	 	 /s/ John Landry

		 	Name: John Landry
		 	Title: Chief Financial Officer

  
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	ADMINISTRATIVE AGENT:
	
	PERCEPTIVE CREDIT HOLDINGS II, LP
	
	By: Perceptive Credit Opportunities GP, LLC, its General Partner
		
	By	 	 /s/ Sandeep Dixit

		 	Name: Sandeep Dixit
		 	Title: Chief Credit Officer
		
	By	 	 /s/ Sam Chawla

		 	Name: Sam Chawla
		 	Title: Portfolio Manager

  
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	LENDER:
	
	PERCEPTIVE CREDIT HOLDINGS II, LP
	
	By Perceptive Credit Opportunities GP, LLC, its General Partner
		
	By	 	 /s/ Sandeep Dixit

		 	Name: Sandeep Dixit
		 	Title: Chief Credit Officer
		
	By	 	 /s/ Sam Chawla

		 	Name: Sam Chawla
		 	Title: Portfolio Manager

  
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