Document:

EX-4.6

 Exhibit 4.6 

NEITHER THIS WARRANT NOR THE SECURITIES ISSUABLE UPON EXERCISE HEREOF HAVE BEEN THE SUBJECT OF REGISTRATION UNDER THE SECURITIES ACT OF 1933, AS AMENDED
(THE “ACT”), OR UNDER THE SECURITIES LAWS OF ANY STATE, AND THE SAME HAVE BEEN (OR WILL BE, WITH RESPECT TO THE SECURITIES ISSUABLE UPON EXERCISE HEREOF) ISSUED IN RELIANCE ON EXEMPTIONS FROM THE REGISTRATION REQUIREMENTS OF THE ACT AND
APPLICABLE STATE SECURITIES LAWS. NEITHER THIS WARRANT NOR THE SECURITIES ISSUABLE UPON EXERCISE HEREOF MAY BE SOLD, TRANSFERRED, PLEDGED, HYPOTHECATED OR OTHERWISE DISPOSED OF EXCEPT AS PERMITTED UNDER SUCH SECURITIES LAWS, PURSUANT TO REGISTRATION
OR EXEMPTION THEREFROM. 
 WARRANT TO PURCHASE PREFERRED SHARES 

OF 
 VAPOTHERM, INC.

 This Warrant is issued pursuant to the Note and Warrant Purchase Agreement dated July 30, 2012 among the Company and the
Investors listed on the Schedule of Investors attached thereto as Exhibit A (the “Purchase Agreement’). Additional rights and obligations of the Holder (as defined below) and the Company are set forth in the Purchase Agreement.
Capitalized terms used and not otherwise defined herein shall have the meanings given them in the Purchase Agreement. 

1.    Issuance. This Warrant is issued to Vapotherm Investors, LLC (the “Holder”). 

2.    Certain Defined Terms. As used herein, the following terms shall have the following respective meanings: 

(a)    “Exercise Shares” means the Qualified Financing Securities or Series F Preferred (as defined
below) for which this Warrant is exercised or exercisable, as applicable. 
 (b)    “Qualified Financing
Securities” means the preferred equity securities of the Company issued in the Qualified Financing. 

(c)    “Termination Date” means September 7, 2022. 

(d)    “Warrant Share Amount” means ten percent (20%) of the sum of the aggregate outstanding principal
amount of the Notes held by the Holder. 
 3.    Exercise Price: Number of shares. 

3.1.    Subject to the terms and conditions hereinafter set forth, prior to the closing date of the Qualified Financing
(the “Closing”), the Holder is entitled to purchase from the Company, at a price per share of $0.48 (the “Exercise Price”), that number of shares of Series F Convertible Preferred Stock (“Series F
Preferred”) equal to (a) the Warrant Share Amount divided by (b) the Exercise Price. 

3.2.    Subject to the terms and conditions hereinafter set forth, on and after the Closing, the Holder is entitled to
purchase from the Company, at the price per share of the Qualified Financing Securities, that number of shares of Qualified Financing Securities equal to (a) the Warrant Share Amount divided by (b) the
per-share price of the Qualified Financing Securities. 

 3.3.    Until such time as this Warrant is exercised in full or expires,
the Exercise Price and the securities issuable upon exercise of this Warrant are subject to adjustment as hereinafter provided. 

4.    Exercise of Warrant. 

4.1.    The purchase rights represented by this Warrant are exercisable by the Holder in whole or in part at any time prior
to the Termination Date, by the surrender of this Warrant and the Notice of Exercise annexed on Exhibit A, duly completed and executed on behalf of the Holder, to the Company, upon payment of the Exercise Price of the shares to be purchased
(i) in cash, by check or by wire transfer, (ii) by cancellation by the Holder of indebtedness of the Company to the Holder, (iii) by a combination of (i) and (ii) or (iv) pursuant to the cashless exercise method described in
Section 4.2 below. This Warrant shall expire on the Termination Date. 
 4.2.    Net Issue
Election. The Holder may elect to receive Exercise Shares equal to the value of this Warrant by surrender of this Warrant to the Company, in which event the Company shall issue to the Holder that number of Exercise Shares determined by use of
the following formula: 
  

							
	X  =	 	Y(A-B)	 		 	                    
		 	     A     	 	                    	 	

  

					
	where  	 	X  =	 	the number of Exercise Shares to be issued;
			
		 	Y  =	 	the number of Exercise Shares purchasable under the Warrant or, if only a portion of the Warrant is being exercised, the portion of the Warrant being exercised;
			
		 	A  =	 	the Fair Market Value of one Exercise Share for which this Warrant is being exercised (as applicable); and
			
		 	B  =	 	the Exercise Price.

 If on the date of exercise, the Exercise Shares are listed on an established national or regional stock exchange, are admitted
to quotation on the National Association of Securities Dealers Automated Quotation System, or are publicly traded on an established securities market, then notwithstanding anything else contained in the Warrant, the Fair Market Value of one Exercise
Share shall be the closing price of one Exercise Share on such exchange or in such market (the highest such closing price if there is more than one such exchange or market) on the trading day immediately preceding the date on which such
determination is being made (or, if there is no such reported closing price, the Fair Market Value shall be the mean between the highest bid and 

 
lowest asked prices or between the high and low sale prices on such trading day), or, if no sale of any Exercise Shares of is reported for such trading day, on the next preceding day on which any
sale shall have been reported. If the Exercise Shares are not listed on such an exchange, quoted on such system or traded on such a market on the date of exercise, the Fair Market Value of the Exercise Shares shall be determined by the
Company’s Board of Directors in good faith. 
 4.3.    Issuance Date; Partial Exercise. This Warrant shall
be deemed to have been exercised immediately prior to the close of business on the date of its surrender for exercise as provided above, and the person entitled to receive the shares issuable upon such exercise shall be treated for all purposes as
the holder of record of such Exercise Shares as of the close of business on such date. As promptly as practicable on or after such date and in any event within ten (10) days thereafter, the Company shall deliver to the Holder a certificate or
certificates for the number of Exercise Shares issuable upon such exercise. In the event that this Warrant is exercised in part, the Company shall execute and deliver a new Warrant of like tenor exercisable for the number of Exercise Shares for
which this Warrant may then be exercised. 
 4.4.    Company Covenant. The Company covenants that all securities
which may be issued upon exercise of this Warrant will, upon issuance, be duly authorized, validly issued, fully paid and non-assessable and free of all taxes, liens and charges caused or created by the
Company with respect to the issuance thereof and sufficient shares of common stock of the Company shall be reserved for issuance upon conversion of the Exercise Shares. 

5.    No Fractional Shares or Scrip. No fractional shares or scrip representing fractional shares shall be issued
upon the exercise of this Warrant. 
 6.    Lost Stolen, Destroyed or Mutilated Notes. Upon receipt of evidence
reasonably satisfactory to the Company of the loss, theft, destruction or mutilation of this Warrant, the Company shall issue a new Warrant of like tenor and amount. 

7.    Rights of Holder. The Holder shall not be entitled to vote or receive dividends or be deemed the holder of
any Exercise Shares that may at any time be issuable on the exercise hereof for any purpose, nor shall anything contained herein be construed to confer upon the Holder, as such, any of the rights of a shareholder of the Company or any right to vote
for the election of directors or upon any matter submitted to shareholders at any meeting thereof, or to give or withhold consent to any corporate action or to receive notice of meetings, or to receive dividends or subscription rights or otherwise
until the Warrant shall have been exercised and the securities purchasable upon the exercise hereof shall have been issued, as provided herein. 

8.    Transfer of Warrant. 

8.1.    Warrant Register. The Company will maintain a register (the “Warrant Register”) containing
the name and address of the Holder. The Holder may change its address as shown on the Warrant Register by providing notice to the Company requesting such change. Until this Warrant is transferred on the Warrant Register, the Company may treat the
Holder as shown on the Warrant Register as the absolute owner of this Warrant for all purposes, notwithstanding any notice to the contrary. 

 8.2.    Transferability and Nonnegotiabilitv of Warrant. Without
the prior written consent of the Company, this Warrant may be transferred by the Holder only to an affiliate, as defined in the Act, a subsidiary or a successor in interest of the Holder; provided, however, that Vapotherm Investors,
LLCshall have the right to transfer the Warrant held by it, including all o its rights and obligations thereunder, to 3x5 Special Opportunity Fund, LP in connection with the initial closing of a Qualified Financing if 3x5 Special Opportunity Fund,
LP purchase shares of the Company’s prefered stock sold at the initial closing of such Qualified Financing for an aggregate purchase price of at least two million dollars ($2,000,000) in cash. For purposes of this Section 8.2, Kaiser
Foundation Hospitals and The Permanente Federation LLC shall be deemed affiliates of each other. 

9.    Notices. 

9.1.    Notices of Adjustment. Whenever the number of Exercise Shares purchasable hereunder shall be adjusted
pursuant to Section 11 hereof, the Company shall ensure that the Holder is provided notice in the form of a certificate setting forth, in reasonable detail, the event requiring the adjustment, the amount of the adjustment,
the method by which such adjustment was calculated, and the number of Exercise Shares purchasable hereunder after giving effect to such adjustment. 

9.2.    Notices of Record Date. In case: 

(i)    The Company shall take a record of the holders of the equity securities at the time receivable upon the exercise
of this Warrant for the purpose of entitling them to receive any dividend or other distribution, or any right to subscribe for or purchase any shares of stock of any class or any other securities, or to receive any other right, or 

(ii)    The Company shall propose at any time to merge with or into any other entity, to sell, lease or convey all or
substantially all its property or business, to liquidate, dissolve or wind up, or to file a registration statement relating to an initial public offering, 

then, and in each such case, the Company shall provide to the Holder at least fifteen (15) days’ prior written notice of the date on which a record
shall be taken for determining rights to vote in respect of such event or the date on which the Company expects to file a registration statement. 

9.3.    Manner of Notices. All notices, demands, requests or other communications that may be or are required to be
given, served or sent by any party pursuant to this Warrant shall be in writing, shall reference this Warrant and shall be mailed by first class, registered or certified mail, return receipt requested, postage prepaid, or transmitted by hand
delivery, overnight courier or facsimile transmission, addressed as follows: (a) if to the Company, at Vapotherm, Inc., 198 Log Canoe Circle, Stevensville, Maryland 21666, Attention: President; and (b) if to the Holder, at the address set
forth on the Warrant Register; or, in any such case, at such other address or addresses as shall have been furnished in writing by such party to the others. Each notice or other communication that is mailed, delivered or transmitted in the manner
described above shall be deemed sufficiently given, served, sent and received for all purposes at such time as it is delivered to the addressee (with the return receipt, the delivery receipt, the fax confirmation sheet or the affidavit of messenger
being deemed conclusive evidence of such delivery) or at such time as delivery is refused by the addressee upon presentation. 

 10.    Amendments. This Warrant may be amended with the written
consent of the Company and Requisite Holders, and without the consent of the Holder, provided, however, that this Warrant may not be modified and the observance of any term may not be waived with respect to the Holder without the written consent of
the Holder unless such modification or waiver applies to the express rights and obligations of all holders of Notes in the same manner. No waivers of or exceptions to any term, condition or provision of this Warrant, in any one or more instances,
shall be deemed to be, or construed as, a further or continuing waiver of any such term, condition or provision. 

11.    Adjustments. The number of Exercise Shares purchasable hereunder are subject to adjustment from time to time
as follows: 
 11.1.    Merger. Sale of Assets, Etc. If at any time while this Warrant, or any portion thereof,
is outstanding and unexpired there shall be (i) a reorganization (other than a combination, reclassification, exchange or subdivision of shares otherwise provided for herein), (ii) a merger or consolidation of the Company with or into another
entity in which the Company is not the surviving entity, or a reverse triangular merger in which the Company is the surviving entity but the capital stock of the Company outstanding immediately prior to the merger are converted by virtue of the
merger into other property, whether in the form of securities, cash, or otherwise, or (iii) a sale or transfer of the Company’s properties and assets as, or substantially as, an entirety to any other person, and if, as a part of such
reorganization, merger, consolidation, sale or transfer, provisions are made so that the holders of securities are thereafter entitled to receive shares of stock or other securities or property of the successor entity resulting from such
reorganization, merger, consolidation, sale or transfer, the Company shall then ensure that the Holder also shall be entitled to shares of stock or other securities or property of the successor entity resulting from such reorganization,
consolidation, merger, sale or transfer as if this Warrant had been exercised in full immediately before such reorganization, merger, consolidation, sale or transfer, all subject to further adjustment as provided in this
Section 11. The Company represents that the foregoing provisions of this Section 11 shall similarly apply to successive reorganizations, consolidations, mergers, sales and transfers and to the
stock or securities of any other entity which are at the time receivable upon the exercise of this Warrant. If the per share consideration payable to Holder for shares in connection with any such transaction is in a form other than cash or
marketable securities, then the value of such consideration shall be determined in good faith by the Company. In all events, appropriate adjustment shall be made in the application of the provisions of this Warrant with respect to the rights and
interests of the Holder after the transaction, to the end that the provisions of this Warrant shall be applicable after that event, as near as reasonably may be, in relation to any shares or other property deliverable after that event upon exercise
of this Warrant. 
 11.2.    Reclassification, Etc. If the Company, at any time while this Warrant, or any
portion thereof, remains outstanding and unexpired, by reclassification of securities or otherwise, intends to change any of the Exercise Shares as to which purchase rights under this Warrant exist into the same or a different number of securities
of any other class or classes, the Company represents that this Warrant shall thereafter represent the right to acquire such number 

 
and kind of securities as would have been issuable as the result of such change with respect to the securities which were subject to the purchase rights under this Warrant immediately prior to
such reclassification or other change and the Warrant Share Amount shall be appropriately adjusted, all subject to further adjustment as provided in this Section 11. 

11.3.    Split Subdivision or Combination of shares. If while this Warrant, or any portion thereof, remains
outstanding and unexpired the Company shall split, subdivide or combine the securities as to which purchase rights under this Warrant exist, into a different number of securities of the same class, the Company warrants that the Warrant Share Amount
shall be proportionately decreased in the case of a split or subdivision or proportionately increased in the case of a combination. 

11.4.    Adjustments for Dividends in Stock or Other Securities or Property. If while this Warrant, or any portion
hereof, remains outstanding and unexpired, holders of Exercise Shares, or any security into which Exercise Shares are convertible, shall have received, or, on or after the record date fixed for the determination of eligible security holders, shall
have become entitled to receive, without payment therefor, other or additional securities or property (other than cash) of the Company by way of dividend, then and in each case, this Warrant shall represent the right to acquire, in addition to the
number of Exercise Shares receivable upon exercise of this Warrant, and without payment of any additional consideration therefor, the amount of such other or additional securities or property (other than cash) of the Company which such holder would
hold on the date of such exercise had it been the holder of record of the security receivable upon exercise of this Warrant on the date thereof and had thereafter, during the period from the date hereof to and including the date of such exercise,
retained such shares and/or all other additional securities available by it as aforesaid during such period, giving effect to all adjustments called for during such period by the provisions of this Section 11.4. 

11.5.    Certificate as to Adjustments. Upon the occurrence of each adjustment or readjustment pursuant to this
Section 11, the Company shall promptly compute such adjustment or readjustment in accordance with the terms hereof and furnish to the Holder the certificate described in Section 9.1 above. The Company shall, upon the
written request, at any time, furnish or cause to be furnished to the Holder a like certificate setting forth: (i) such adjustments and readjustments and the number of shares and the amount, if any, of other property which at the time would be
received upon the exercise of the Warrant. 
 11.6.    No Impairment. The Company shall not, by any voluntary
action, avoid or seek to avoid the observance or performance of any of the terms to be observed or performed hereunder, but shall at all times in good faith assist in the carrying out of all the provisions of this Section 11 and in the taking
of all such action as may be necessary or appropriate in order to protect the rights of the Holder against impairment. 

12.    Severability. If any provision of this Warrant shall be declared void or unenforceable by any judicial or
administrative authority, the validity of any other provision and of the entire Warrant shall not be affected thereby. 

13.    Governing Law. THIS WARRANT SHALL BE GOVERNED BY AND CONSTRUED IN ACCORDANCE WITH THE LAWS OF THE STATE OF
MARYLAND, 

 
WITHOUT REGARD TO ITS CONFLICT OF LAWS PROVISIONS. Any claim, cause of action, suit or demand allegedly arising out of or related to this Note, or the relationship of the parties, shall be
brought exclusively in the state courts of Maryland or federal courts located in the State of Maryland, and the parties irrevocably consent to the exclusive jurisdiction and venue of such courts and waive any objections they may have at any time to
such exclusive jurisdiction and venue. 
 14.    Counterparts; Facsimile. This Warrant 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. Facsimile signatures shall be as effective as original signatures. 

[Signature Page Follows] 

 IN WITNESS WHEREOF, the Company and the Holder have caused this Warrant to be executed. 

 

									
	Dated: September 7, 2012	 		 	VAPOTHERM, INC.
				
		 		 	By:	 	 /s/ Joseph Army

			
		 		 	HOLDER
			
		 		 	VAPORTHERM INVESTORS, LLC
			
		 		 	By:
		 		 	Its:	 		 	
				
		 		 	By:	 	 /s/ Anthony L. Arnerich

		 		 		 	Name:	 	Anthony L. Arnerich
		 		 		 	Title:	 	Managing Member

 EXHIBIT A 

NOTICE OF EXERCISE 
 To: Vapotherm, Inc.

 (1)    The undersigned hereby elects to purchase
[                    ] shares of
[                     (type of security)] of Vapotherm, Inc., pursuant to the terms of the attached Warrant, and tenders herewith payment of the
purchase price for such shares in full. 
 (2)    [The undersigned hereby elects to pay the Exercise Price in
cash/cancellation of indebtedness pursuant to Section 4.1 of the Warrant.] OR [The undersigned hereby elects to receive shares equal to the value of the Warrant as calculated by the formula set forth in Section 4.2 of the Warrant.] 

(3)    In exercising the Warrant, the undersigned hereby confirms and acknowledges that the securities are being acquired
solely for the account of the undersigned and not as a nominee for any other party, and for investment, and that the undersigned shall not offer, sell, or otherwise dispose of any such securities except under circumstances that will not result in a
violation of the Securities Act of 1933, as amended, or any state securities laws, and at the time of such exercise the undersigned shall make all such representations and enter into such other agreements as Vapotherm, Inc. shall deem reasonably
necessary to be in compliance with federal and applicable state securities laws. 
 (4)    Please issue a certificate or
certificates representing said securities in the name of the undersigned or in such other name as is specified below: 
  

 
 Name 

(5)    Please issue a new Warrant for the unexercised portion of the attached Warrant in the name of the undersigned or in
such other name as is specified below: 
  

					
	  
	 		 	  

	Date	 		 	Name
			
		 		 	  

		 		 	SignatureEX-4.7

 Exhibit 4.7 

THIS WARRANT AND THE SHARES ISSUABLE HEREUNDER HAVE NOT BEEN REGISTERED UNDER THE SECURITIES ACT OF 1933, AS AMENDED, AND MAY NOT BE SOLD, PLEDGED, OR
OTHERWISE TRANSFERRED WITHOUT AN EFFECTIVE REGISTRATION THEREOF UNDER SUCH ACT OR PURSUANT TO RULE 144 OR AN OPINION OF COUNSEL REASONABLY SATISFACTORY TO THE CORPORATION AND ITS COUNSEL, THAT SUCH REGISTRATION IS NOT REQUIRED. 

WARRANT TO PURCHASE STOCK 
 Issuer: Vapotherm,
Inc., a Delaware corporation (the “Company”) 
 Number of Shares: 60,000, as the same may be from time to time adjusted pursuant to Article 2
hereof. 
 Class of Stock: Series A Preferred Stock 

Exercise Price: $1.00 per share, as the same may be from time to time adjusted pursuant to Article 2 hereof. 

Issue Date: September 27, 2013 
 Expiration Date:
September 27, 2020 
 THIS WARRANT CERTIFIES THAT, for the agreed upon value of $1.00 and for other good and valuable consideration, BRIDGE BANK,
NATIONAL ASSOCIATION (“Holder”) is entitled to purchase the number of fully paid and nonassessable Shares of the Company at the Exercise Price per Share set forth above, subject to the provisions and upon the terms and conditions set forth
in this Warrant. 
 ARTICLE 1    EXERCISE. 

1.1    Method of Exercise. This Warrant is exercisable, in whole or in part, at any time and from time to time on or
before the Expiration Date set forth above. Holder may exercise this Warrant by surrendering this Warrant and delivering a duly executed Notice of Exercise, in substantially the form attached as Appendix 1, to the principal office of Company.
Unless Holder is exercising the conversion right set forth in Section 1.2, Holder shall also deliver to Company a check for the aggregate Exercise Price for Shares being purchased. 

1.2    Conversion Right. In lieu of exercising this Warrant as specified in Section 1.1, Holder may from time
to time convert this Warrant, in whole or in part, into a number of Shares determined by dividing (a) the aggregate fair market value of Shares or other securities otherwise issuable upon exercise of this Warrant minus the aggregate Exercise
Price of such Shares by (b) the fair market value of one Share. The fair market value of Shares shall be determined pursuant to Section 1.3. 

1.3    Fair Market Value. If the Shares are traded in a public market, the fair market value of the Shares shall be
the closing price of the Shares (or the closing price of the Company’s stock into which the Shares are convertible) reported for the business day immediately before Holder delivers its Notice of Exercise to the Company. If the Shares are not
traded in a public market, the Board of Directors of Company shall determine fair market value in its reasonable good faith judgment. The foregoing notwithstanding, if Holder advises the Board of Directors in writing that Holder disagrees with such
determination, then Company and Holder shall promptly agree upon a reputable investment banking firm to undertake such valuation. If the valuation of such investment banking firm is greater than that determined by the Board of Directors, then all
fees and expenses of such investment banking firm shall be paid by Company. In all other circumstances, such fees and expenses shall be paid by Holder. 

1.4    Delivery of Certificate and New Warrant. Promptly after Holder exercises or converts this Warrant, and if
applicable, Company receives payment of the aggregate Exercise Price for Shares being purchased, Company shall deliver to Holder certificates for Shares acquired and, if this Warrant has not been fully exercised or converted and has not expired, a
new Warrant representing Shares not so acquired. 
 1.5    Replacement of Warrants. On receipt of evidence
reasonably satisfactory to Company of the loss, theft, destruction or mutilation of this Warrant and, in the case of loss, theft or destruction, on delivery of an indemnity agreement reasonably satisfactory in form and amount to Company or, in the
case of mutilation, on surrender and cancellation of this Warrant, Company at its expense shall execute and deliver, in lieu of this Warrant, a new warrant of like tenor. 

  
 1 

 1.6    Repurchase on Sale, Merger, or Consolidation of Company.
For the purpose of this Warrant, “Acquisition” means any sale, license, or other disposition of all or substantially all of the assets of Company, or any reorganization, consolidation, or merger of Company where the holders of
Company’s securities before the transaction beneficially own less than 50% of the outstanding voting securities of the surviving entity after the transaction. Upon the closing of any Acquisition, the successor entity shall assume the
obligations of this Warrant, and this Warrant shall be exercisable for the same securities, cash, and property as would be payable for Shares issuable upon exercise of the unexercised portion of this Warrant as if such Shares were outstanding on the
record date for the Acquisition and subsequent closing, and the Exercise Price and/or number of Shares shall be adjusted accordingly; provided that if pursuant to such Acquisition the entire outstanding class of Shares issuable upon exercise
of the unexercised portion of this Warrant are cancelled and the total consideration payable to the holders of such class of Shares consists entirely of cash, then, upon payment to the holder of this Warrant of an amount equal to the amount such
holder would receive if such holder held Shares issuable upon exercise of the unexercised portion of this Warrant and such Shares were outstanding on the record date for the Acquisition less the aggregate Exercise Price of such Shares, this
Warrant shall be cancelled. 
 1.7    Certain Agreements. Holder shall, if the Company so requests in writing,
become a party to, by execution and delivery to the Company of a counterpart signature page, joinder agreement, instrument of accession or similar instrument, the Company’s Stockholders Agreement (as defined below), as a Stockholder party
thereunder and that certain Registration Rights Agreement (as defined below) as an Investor Stockholder party thereto solely to the extent each such agreement is then by its terms in force and effect. 

ARTICLE 2    ADJUSTMENTS. 

2.1    Stock Dividends, Splits, Etc. If Company declares or pays a dividend on its common stock (or Shares if Shares
are securities other than common stock) payable in common stock or other securities, subdivides the outstanding common stock into a greater amount of common stock, or, if Shares are securities other than common stock, subdivides Shares in a
transaction that increases the amount of common stock into which Shares are convertible, then upon exercise of this Warrant, for each Share acquired, Holder shall receive, without cost to Holder, the total number and kind of securities to which
Holder would have been entitled had Holder owned Shares of record as of the date the dividend or subdivision occurred. 

2.2    Reclassification, Recapitalization, Exchange or Substitution. Except in the case of an Acquisition to which
Section 1.6 is applicable, upon any reclassification, recapitalization, exchange, substitution, or other event that results in a change of the number and/or class of the securities issuable upon exercise or conversion of this Warrant, Holder
shall be entitled to receive, upon exercise or conversion of this Warrant, the number and kind of securities and property that Holder would have received for Shares if this Warrant had been exercised immediately before such reclassification,
recapitalization, exchange, substitution, or other event. Such event shall include any automatic conversion of the outstanding or issuable securities of the Company of the same class or series as the Shares to common stock pursuant to the terms of
the Company’s Certificate of Incorporation upon the closing of a registered public offering of the Company’s common stock. Company or its successor shall promptly issue to Holder a new Warrant for such new securities or other property. The
new Warrant shall provide for adjustments which shall be as nearly equivalent as may be practicable to the adjustments provided for in this Article 2 including, without limitation, adjustments to the Exercise Price and to the number of securities or
property issuable upon exercise of the new Warrant. The provisions of this Section 2.2 shall similarly apply to successive reclassifications, recapitalizations, exchanges, substitutions, or other events. 

2.3    Adjustments for Combinations, Etc. If the outstanding Shares are combined or consolidated, by
reclassification or otherwise, into a lesser number of shares, the Exercise Price shall be proportionately increased and the number of Shares as to which this Warrant is exercisable shall be proportionately decreased. 

2.4    Adjustments for Diluting Issuances. In the event of the issuance (a “Diluting Issuance”) by
Company, after the Issue Date of the Warrant, of any Additional Shares of Common Stock (as defined in the Company’s Certificate of Incorporation) at a price per share less than the then Exercise Price, then the number of shares of common stock
issuable upon conversion of the Shares, and the conversion price, shall be 

  
 2 

 
adjusted in accordance with those provisions (the “Provisions”) of Company’s Certificate of Incorporation which apply to Diluting Issuances with the same effect as though the
shares were outstanding at the time of the diluting issuance. Under no circumstances shall the aggregate Exercise Price payable by Holder upon exercise of the Warrant increase as a result of any adjustment arising from a Diluting Issuance. 

2.5    Adjustment for Pay-to-Play
Transactions. In the event that the Company’s Certificate of Incorporation provides, or is amended to so provide, for the amendment or modification of the rights, preferences or privileges of the Shares, or the reclassification, conversion
or exchange of the outstanding shares of the Class of Stock, in the event that a holder of shares thereof fails to participate in an equity financing transaction (a
“Pay-to-Play Provision”), and in the event that such Pay-to-Play Provision
becomes operative in a transaction occurring after the date hereof, this Warrant shall automatically and without any action required become exercisable for that number and type of shares of equity securities as would have been issued or exchanged,
or would have remained outstanding, in respect of the Shares issuable hereunder had this Warrant been exercised in full prior to such event, and had the Holder participated in the equity financing to the maximum extent permitted. 

2.6    No Impairment. Company shall not, by amendment of its Certificate of Incorporation or through a
reorganization, transfer of assets, consolidation, merger, dissolution, issue, or sale of securities or any other voluntary action, avoid or seek to avoid the observance or performance of any of the terms to be observed or performed under this
Warrant by Company, but shall at all times in good faith assist in carrying out of all the provisions of this Article 2 and in taking all such action as may be necessary or appropriate to protect Holder’s rights under this Article against
impairment. If Company takes any dilutive action affecting Shares or its common stock other than as described above that adversely affects Holder’s rights under this Warrant, the Exercise Price shall be adjusted downward and the number of
Shares issuable upon exercise of this Warrant shall be adjusted upward in such a manner that such dilutive action is offset and the aggregate Exercise Price of this Warrant is unchanged. 

2.7    Fractional Shares. No fractional Shares shall be issuable upon exercise or conversion of the Warrant and the
number of Shares to be issued shall be rounded down to the nearest whole Share. If a fractional share interest arises upon any exercise or conversion of the Warrant, Company shall eliminate such fractional share interest by paying Holder an amount
computed by multiplying the fractional interest by the fair market value of a full Share. 
 2.8    Certificate as to
Adjustments. Upon each adjustment of the Exercise Price, Company at its expense shall promptly compute such adjustment, and furnish Holder with a certificate of its Chief Financial Officer setting forth such adjustment and the facts upon which
such adjustment is based. Company shall, upon written request, furnish Holder a certificate setting forth the Exercise Price in effect upon the date thereof and the series of adjustments leading to such Exercise Price. 

ARTICLE 3    REPRESENTATIONS, WARRANTIES AND COVENANTS OF COMPANY. 

3.1    Representations and Warranties. The Company hereby represents and warrants to the Holder as follows: 

(a)    The initial Exercise Price referenced on the first page of this Warrant is not greater than the lowest price per
share paid by any purchaser of the Company’s Series A Preferred Stock prior to the date of this Warrant. 

(b)    All Shares which may be issued upon the exercise of the purchase right represented by this Warrant, and all
securities, if any, issuable upon conversion of the Shares, shall, upon issuance, be duly authorized, validly issued, fully paid and nonassessable, and free of any liens and encumbrances except for restrictions on transfer provided for herein or
under applicable federal and state securities laws. 
 (c)    The Company’s capitalization table attached to this
Warrant as Appendix 2 is true and complete as of the Issue Date. 
 3.2    Valid Issuance. Company shall take all
steps necessary to insure that all Shares which may be issued upon the exercise of this Warrant, and all securities, if any, issuable upon conversion of Shares, shall, upon issuance, be duly authorized, validly issued, fully paid and nonassessable,
and free of any liens and encumbrances except for restrictions on transfer provided for herein or under applicable federal and state securities laws and as otherwise contemplated by the Sixth Amended and Restated Stockholders’ Agreement,

  
 3 

 
amended as of April 12, 2013, by and among the Company and the stockholders identified therein, as from time to time in effect (the “Stockholders Agreement,” a true copy of which
as in effect on the date hereof has been furnished by the Company to Holder). 
 3.3    Notice of Certain Events.
If Company proposes at any time (a) to declare any dividend or distribution upon its common stock, whether in cash, property, stock, or other securities and whether or not a regular cash dividend; (b) to offer for subscription pro rata to
the holders of any class or series of its stock any additional shares of stock of any class or series or other rights; (c) to effect any reclassification or recapitalization of common stock; (d) to merge or consolidate with or into any
other corporation, or sell, lease, license, or convey all or substantially all of its assets, or to liquidate, dissolve or wind up; or (e) offer holders of registration rights the opportunity to participate in an underwritten public offering of
the company’s securities for cash, then, in connection with each such event, Company shall give Holder (1) in the case of the matters referred to in (a) and (b) above at least 15 days prior written notice of the date on which a
record will be taken for such dividend, distribution, or subscription rights (and specifying the date on which the holders of common stock will be entitled thereto) or for determining rights to vote, if any, in respect of the matters referred to in
(c) and (d) above; (2) in the case of the matters referred to in (c) and (d) above at least 15 days prior written notice of the date when the same will take place (and specifying the date on which the holders of common stock will
be entitled to exchange their common stock for securities or other property deliverable upon the occurrence of such event); and (3) in the case of the matter referred to in (e) above, the same notice as is given to the holders of such
registration rights. 
 3.4    Information. So long as the Holder holds this Warrant and/or any of the Shares,
Company shall deliver to Holder (a) promptly, copies of all notices or other written communications to which Holder would be entitled if it held Shares as to which this Warrant was then exercisable and (b) such other financial statements
required under and in accordance with any loan documents between Holder and Company, or if there are no such requirements [or if the subject loan(s) are no longer outstanding, upon receipt of Holder’s good faith written request
that it requires Company financial information for regulatory or accounting valuation purposes, the Company shall provide to Holder its most recent quarterly, unaudited financial statements and its most recent annual audited financial statements.

 3.5    Notice of Expiration. Company shall give Holder written notice of Holder’s right to exercise this
Warrant in the form attached as Appendix 3 not more than 90 days and not less than 15 days before the Expiration Date and, in the case of an Acquisition to which the proviso of Section 1.6 shall be applicable, 15 days notice of
such Acquisition. If the notice is not so given, the Expiration Date shall automatically be extended until 15 days after the date Company delivers the notice to Holder. 

3.6    Registration Rights. The common stock issuable upon conversion of Shares, shall have the same
“piggyback” registration rights as are set forth in the Fifth Amended and Restated Registration Rights Agreement, dated as of March 14, 2013 between Company and its investors, as from time to time in effect (the “Registration
Rights Agreement”, a true copy of which as in effect on the date hereof has been furnished by Company to Holder) and by accepting this Warrant, Holder agrees to be subject to corresponding obligations and restrictions of the holders of
“piggyback” registration rights, including the market standoff obligations (of up to 180 days) contained therein. Company agrees that no amendments will be made to the Registration Rights Agreement which would have an adverse impact on
Holder’s registration rights thereunder. 
 Article 4    REPRESENTATIONS AND WARRANTIES. 

Holder represents and warrants to the Company with respect to this purchase as follows: 

4.1    Evaluation.    Holder has substantial experience in evaluating and investing in private
placement transactions of securities of companies similar to the Company so that Holder is capable of evaluating the merits and risks of its investment in the Company and has the capacity to protect its interests. 

4.2    Resale. Except for transfers to an affiliate of Holder, Holder is acquiring this Warrant and the Shares
issuable upon exercise of this Warrant (and the securities issuable, directly or indirectly, upon conversion of the Shares, if any) for investment for its own account and not with a view to, or for resale in connection with, any distribution
thereof. Holder understands that this Warrant and the Shares issuable upon exercise of this Warrant (and the securities issuable, directly or indirectly, upon conversion of the Shares, if any) have not been registered under the Securities Act of
1933, as amended (the “Act”), by reason of a specific exemption from the registration provisions of the Act which depends upon, among other things, the bona fide nature of the investment intent as expressed herein. 

  
 4 

 4.3    Rule 144. Holder acknowledges that this Warrant and the
Shares issuable upon exercise of this Warrant (and the securities issuable, directly or indirectly, upon conversion of the Shares, if any) must be held indefinitely unless subsequently registered under the Act or an exemption from such registration
is available. Holder is aware of the provisions of Rule 144 promulgated under the Act. 
 4.4    Accredited
Investor. Holder is an “accredited investor” within the meaning of Regulation D promulgated under the Act. 

4.5    Opportunity To Discuss. Holder has had an opportunity to discuss the Company’s business, management and
financial affairs with its management and an opportunity to review the Company’s facilities. Holder understands that such discussions, as well as the written information issued by the Company, were intended to describe the aspects of
Company’s business and prospects which the Company believes to be material but were not necessarily a thorough or exhaustive description. 
 ARTICLE
5    MISCELLANEOUS. 
 5.1    Legends. This Warrant and the Shares (and the securities
issuable, directly or indirectly, upon conversion of Shares, if any) shall be imprinted with a legend in substantially the following form: 
 THIS SECURITY
HAS NOT BEEN REGISTERED UNDER THE SECURITIES ACT OF 1933, AS AMENDED, AND MAY NOT BE SOLD, PLEDGED OR OTHERWISE TRANSFERRED WITHOUT AN EFFECTIVE REGISTRATION THEREOF UNDER SUCH ACT OR PURSUANT TO RULE 144 OR AN OPINION OF COUNSEL REASONABLY
SATISFACTORY TO COMPANY AND ITS COUNSEL THAT SUCH REGISTRATION IS NOT REQUIRED. 
 5.2    Compliance with Securities
Laws on Transfer. This Warrant and the Shares issuable upon exercise of this Warrant (and the securities issuable, directly or indirectly, upon conversion of Shares, if any) may not be transferred or assigned in whole or in part without
compliance with applicable federal and state securities laws by the transferor and the transferee (including, without limitation, the delivery of investment representation letters and legal opinions reasonably satisfactory to Company, as reasonably
requested by Company). Company shall not require Bridge Bank (“Bank”) to provide an opinion of counsel if the transfer is to Bank’s parent company, Bridge Capital Holdings, or any other affiliate of Bank, or if there is no material
question as to the availability of current information as referenced in Rule 144(c), Holder represents that it has complied with Rule 144(d) and (e) in reasonable detail, the selling broker represents that it has complied with
Rule 144(f), and the Company is provided with a copy of Holder’s notice of proposed sale. 

5.3    Transfer Procedure. After receipt by Holder of the executed Warrant, Bank will transfer all of this Warrant
to Bank’s parent company, Bridge Capital Holdings, by execution of an Assignment substantially in the form of Appendix 4. Subject to the provisions of Article 4.3 and upon providing Company with written notice, Bridge Capital Holdings and any
subsequent Holder may transfer all or part of this Warrant or the Shares issuable upon exercise of this Warrant (or the Shares issuable directly or indirectly, upon conversion of the Shares, if any) to any transferee, provided, however, in
connection with any such transfer, Bridge Capital Holdings or any subsequent Holder will give the Company notice of the portion of the Warrant being transferred with the name, address and taxpayer identification number of the transferee and Holder
will surrender this Warrant to the Company for reissuance to the transferee(s) (and Holder if applicable). 

5.4    Notices. All notices and other communications from Company to Holder, or vice versa, shall be in writing and
shall be deemed delivered and effective when given personally or mailed by first-class registered or certified mail, postage prepaid, or by overnight courier, at such address as may have been furnished to
Company or Holder, as the case may be, in writing by Company or such Holder from time to time. 
 5.5    Shareholder
Rights. Except as expressly provided herein, this Warrant does not entitle Holder to any voting rights or other rights as a shareholder of the Company prior to the exercise hereof. Holder agrees to execute a joinder to the Stockholders Agreement
upon any exercise of this Warrant (if such Stockholders Agreement is still in effect at that time). 

  
 5 

 5.6    Waiver. This Warrant and any term hereof may be changed,
waived, discharged or terminated only by an instrument in writing signed by the party against which enforcement of such change, waiver, discharge or termination is sought. 

5.7    Attorneys Fees. In the event of any dispute between the parties concerning the terms and provisions of this
Warrant, the party prevailing in such dispute shall be entitled to collect from the other party all costs incurred in such dispute, including reasonable attorneys’ fees. 

5.8    Governing Law. This Warrant shall be governed by and construed in accordance with the laws of the State of
California, without giving effect to its principles regarding conflicts of law. 
 [SIGNATURE PAGE FOLLOWS] 

  
 6 

 IN WITNESS WHEREOF, Company has caused this Warrant to be duly executed by its authorized
officers, all as of the day and year first above written. 
  

			
	COMPANY
	
	VAPOTHERM, INC.
		
	By	 	 /s/ Joseph Army

	Name:	 	Joseph Army
	Title:	 	President & CEO
	
	HOLDER
	
	BRIDGE BANK, NATIONAL ASSOCIATION
		
	By	 	 /s/ Christian Perkins

	Name:	 	Christian Perkins
	Title:	 	SVP

  
 7 

 APPENDIX 1 

Notice of Exercise 
 [Strike paragraph that does
not apply.] 
 1.    The undersigned hereby elects to purchase
                 shares of the Common/Series                     
Preferred [strike one] Stock of Vapotherm, Inc. pursuant to the terms of the attached Warrant, and tenders herewith payment of the purchase price of such shares in full. 

1.    The undersigned hereby elects to convert the attached Warrant into Shares/cash [strike one] in the manner specified in the Warrant.
This conversion is exercised with respect to                      of the Shares covered by the Warrant. 

2.    Please issue a certificate or certificates representing said shares in the name of the undersigned or in such other name as is
specified below: 
  

			
	Name:	 	  

			
	Address:	 	  

	  

  

	3.	 The undersigned represents it is acquiring the shares solely for its own account and not as a nominee for any
other party and not with a view toward the resale or distribution thereof except in compliance with applicable securities laws. By its execution below, Holder hereby restates each of the representations and warranties in Article 4 of this Warrant as
of the date hereof. 

  

	
	  
 (Signature)

	
	  
 (Date)

 APPENDIX 2 

Capitalization Table 
  

													
	 	  	With Additional Close	 
	 	  	Authorized	 	  	Issued	 	  	Reserved	 
	 Series A Preferred Stock
	  				  				  			
	 Prior to close A-F
	  	 	3,471,237	 	  	 	3,468,196	 	  	 	3,041	 
	 Bridge bank warrants
	  	 	78,354	 	  	 	—  	 	  	 	78,354	 
		  	  
	  
	 	  	  
	  
	 	  	  
	  
	 
	 Subtotal prior to closing
	  	 	3,549,591	 	  	 	3,468,196	 	  	 	81,395	 
	 New investors
	  	 	7,000,000	 	  	 	7,000,000	 	  	 	—  	 
	 Existing investors
	  	 	9,000,000	 	  	 	9,000,000	 	  	 	—  	 
	 Bridge notes & interest conversion
	  	 	11,168,885	 	  	 	11,168,885	 	  	 	—  	 
	 Bridge warrants
	  	 	2,080,004	 	  	 	—  	 	  	 	2,080,004	 
		  	  
	  
	 	  	  
	  
	 	  	  
	  
	 
	 Subtotal post closing
	  	 	32,798,480	 	  	 	30,637,081	 	  	 	2,161,399	 
	 Second closing
	  	 	3,000,000	 	  	 	3,000,000	 	  	 	—  	 
	 Grant / Storey
	  	 	417,894	 	  	 	—  	 	  	 	417,894	 
	 Line of Credit Backtop warrants
	  	 	315,654	 	  	 	—  	 	  	 	315,654	 
	 State of Maryland
	  	 	95,160	 	  	 	—  	 	  	 	95,160	 
	 Miscellaneous
	  	 	18,812	 	  				  	 	18,812	 
		  	  
	  
	 	  	  
	  
	 	  	  
	  
	 
	 Subotal
	  	 	36,646,000	 	  	 	33,637,081	 	  	 	3,008,919	 
	 Common Stock
	  				  				  			
	 Outstanding
	  	 	67,778	 	  	 	67,778	 	  	 	—  	 
	 Granted options
	  	 	286,810	 	  	 	—  	 	  	 	286,810	 
		  	  
	  
	 	  	  
	  
	 	  	  
	  
	 
	 Subtotal prior to closing
	  	 	354,588	 	  	 	67,778	 	  	 	286,810	 
	 Reserved
	  	 	6,379,412	 	  	 	—  	 	  	 	6,379,412	 
	 Conversion of preferred
	  	 	36,646,000	 	  	 	—  	 	  	 	36,646,000	 
		  	  
	  
	 	  	  
	  
	 	  	  
	  
	 
	 Total
	  	 	43,380,000	 	  	 	67,778	 	  	 	43,312,222	 

 APPENDIX 3 

Notice that Warrant Is About to Expire 

[Insert Date of Notice] 
  

	To:	 Bridge Bank, National Association 

	    	 Attn: Note Department 

	    	 55 Almaden Boulevard 

	    	 San Jose, California 95113 

The Warrant issued to you described below will expire on December 27, 2020. 

Issuer: Vapotherm, Inc. 
 Issue Date: September 27, 2013

 Class of Security Issuable: 
 Exercise Price per
Share: 
 Number of Shares Issuable: 
 Procedure for Exercise:

 Please contact                      at
(        )     -         with any questions you may have concerning exercise of the Warrant. This is your only notice of pending
expiration. 
  

			
	Vapotherm, Inc.
		
	By:	 	
                     

	Its:	 	
                     

 APPENDIX 4 

Assignment 
 For value received, Bridge Bank,
National Association hereby sells, assigns and transfers unto: 
  

					
		 	Name:	  	Bridge Capital Holdings
		 	Address:	  	55 Almaden Boulevard
		 		  	San Jose, California 95113
		 	Tax ID:	  	                    

 that certain Warrant to Purchase Stock issued by Vapotherm, Inc. (the “Company”), on September 27, 2013 (the
“Warrant”) together with all rights, title and interest therein. 
  

			
	BRIDGE BANK, NATIONAL ASSOCIATION
		
	By:	 	
                     

	Name:	 	
                     

	Title:	 	
                     

 Date:
                                         
                        
 By its
execution below, and for the benefit of the Company, Bridge Capital Holdings and agrees to all other provisions of the Warrant as of the date hereof. 
  

			
	BRIDGE CAPITAL HOLDINGS
		
	By:	 	
                     

	Name:	 	
                     

	Title:

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