Document:

ex10-1.htm

    
      
        
          

        

      

    

    Exhibit 10.1

     

    
      NARROWSTEP
INC.

      

      SUBSCRIPTION
AGREEMENT

      

      

      

      Narrowstep
Inc.

      116
Village Boulevard, Suite 200

      Princeton,
NJ 08540

      

      Gentlemen:

      

      Reference is hereby made to the
Agreement and Plan of Merger, dated as of May 29, 2008, among Onstream Media
Corporation (“Onstream”), Onstream Merger Corp. (“Merger Sub”), Narrowstep Inc.
(the Company”) and W. Austin Lewis IV, as amended by First Amendment to
Agreement and Plan of Merger, dated of even date herewith (the “Merger
Agreement”).  The Merger Agreement provides for, among other things,
the merger of Merger Sub with and into the Company (the
“Merger”).  Capitalized terms used herein have the respective meanings
ascribed thereto in the Merger Agreement unless otherwise defined
herein.

      

      The
undersigned desires to purchase shares of the Company’s Series A Preferred Stock
having substantially the terms and conditions described in Schedule I attached
hereto (the “Preferred Stock”) for an aggregate purchase price of
$___________.  The parties hereto acknowledge that the only condition
precedent to the obligation of the undersigned to purchase the shares of
Preferred Stock subscribed for pursuant to this Subscription Agreement (this
“Agreement”) is the simultaneous consummation of the Merger and that an escrow
agent selected by the Company shall hold the above referenced purchase price in
escrow to be released upon the undersigned’s purchase of the Preferred Stock in
accordance with the terms of this Agreement.  In connection with the
foregoing, the undersigned agrees to execute and deliver an escrow agreement in
form and substance reasonably satisfactory to such escrow agent and the
Company.

      

      The
undersigned acknowledges that a certificate of relative rights, privileges and
designations of the Preferred Stock (the “Certificate of Designation”) shall be
filed by the Company with the Secretary of State of Delaware prior to the
Effective Time of the Merger.  In addition, the undersigned
acknowledges that (i) on or prior to May 29, 2008 the Company entered into
subscription agreements for the purchase by investors of an aggregate of
$300,000 of Preferred Stock (the “Original Preferred Stock Investment”); and
(ii) the Company intends to offer additional shares of Preferred Stock in such
amounts as determined by the Company  (the
"Offering").  Assuming $700,000 of Preferred Stock is purchased in the
Offering, the aggregate number of shares of Preferred Stock issued pursuant to
the Original Preferred Stock Investment and the Offering for an aggregate
purchase price of $1,000,000 will, subject to and in accordance with the terms
of the Merger Agreement, at the Effective Time, be automatically converted into
and become the right to receive 2,000,000 shares of Onstream common stock, par
value $0.0001 per share.

       

      
        
          
          

        

        
          
          

          
            

          

        

        
          
          

        

      

       

      In connection with this Agreement, the
undersigned subscriber represents and acknowledges as follows:

      

      Section 1.  Access to Information.

      

      The Company has provided access to the
undersigned and any investment advisor, attorney, accountant and/or other
purchaser representative acting on behalf of the undersigned (all of whom are
hereinafter collectively referred to as "purchaser representatives") copies of
all filings made by the Company with the Securities and Exchange Commission (the
“SEC”) on or prior to the date hereof (the “SEC Filings”), and an opportunity to
ask questions and receive answers concerning the proposed business of the
Company and the terms and conditions of the Merger and the Offering, and have
provided to the undersigned and the undersigned's purchaser representative(s),
if any, an opportunity to obtain any and all additional information necessary to
verify the accuracy of the information which has been furnished.

      

      Section 2.  Reliance on Own Knowledge and Experience or
Purchaser Representative.

      

      The undersigned represents that it is
(i) an institutional “accredited investor” within the meaning of Rule 501(a)(1),
(2), (3) or (7) of Regulation D under the Securities Act of 1933, as amended
(the “Act”), or (ii) a “qualified institutional buyer” as such term is defined
pursuant to Rule 144A promulgated under the Act, as specified by the undersigned
on the signature page to this Agreement, and that he has had prior investment
experience, including investments in unregistered securities and is qualified by
training and experience in business and financial matters to evaluate the merits
and risks of an investment such as the purchase of the Preferred Stock offered
by the Company.

      

      Section 3.  Subscriber's Acknowledgments.

      

      The Company has disclosed to me and the
undersigned understands that:

      

      (a)           There
is no present public market for the Preferred Stock and it is unlikely that a
public market for the Preferred Stock will develop in the future.

      

      (c)           Due
to the absence of a public market for the Preferred Stock: (i) the undersigned
may not be able to liquidate this investment in the event of an unexpected need
for cash; (ii) transferability of the Preferred Stock is extremely limited; and
(iii) in the event of a disposition of the Preferred Stock, the undersigned
could sustain the loss of all or part of his investment in the Preferred
Stock.

      

      (d)           The
Preferred Stock has not been registered under the Act or State securities laws
and, therefore, the Preferred Stock cannot be resold or transferred unless it is
subsequently registered under the Act and applicable State securities or "Blue
Sky" laws or exemptions from such registration are available.

      

      (e)           A
legend summarizing the restrictions on the transfer of the Preferred Stock will
be made on the Preferred Stock to be purchased by me.

       

      
        
          
          

        

        
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      (f)           The
Preferred Stock has not been registered under the Act in reliance upon an
exemption under the provisions of that Act which depends, in part, upon the
investment intention of the purchaser.  In this connection, the
undersigned understands that it is the position of the SEC that the statutory
basis for such exemption would not be present if the representation of the
purchaser merely meant that its present intention was to hold such Preferred
Stock for a short period, such as the capital gains period of the Internal
Revenue Code, for a deferred sale, for a market rise, or for a sale if the
market does not rise (assuming that a market develops) for a year, or for any
other fixed period.  The undersigned realizes that, in the view of the
SEC, a purchase now with an intent to resell would represent a purchase with an
intent inconsistent with this investment representation, and the SEC might
regard such a sale or disposition as a deferred sale to which the exemption is
not available.

      

      (g)           An
investment in the Company involves considerable risks not associated with other
investments, including without limitation, the risks identified in the SEC
Filings.

      

      (h)           No
Federal or State agency has made any finding or determination as to the fairness
of the investment, nor have they made any recommendation or endorsement
concerning the Preferred Stock.

      

      (i)           This
Subscription Agreement is not revocable by the undersigned and the undersigned
is submitting this Agreement intending to be legally bound thereby.

      

      (j)           The
undersigned acknowledges that he has reviewed the SEC Filings to the extent he
deemed necessary or advisable.  The undersigned has had an opportunity
to ask questions of and has received answers from the Company concerning any of
the information contained in the SEC Filings and any other information requested
by the undersigned regarding the Merger, the Offering and the business and
operations of the Company.

      

      Section 4.  Subscriber Representations.

      

      The undersigned represents and warrants
as follows:

      

      (a)           The
undersigned is acquiring the Preferred Stock for his own account for investment
only and not for or with a view to resale or distribution.  The
undersigned has not entered into any contract, undertaking, agreement or
arrangement with any person to sell, transfer or pledge to such person or anyone
else the Preferred Stock which he is subscribing to purchase and the undersigned
has no present plans or intentions to enter into any such contract, undertaking,
agreement or arrangement.

      

      (b)           The
undersigned can bear the economic risk of losing his entire investment in the
Preferred Stock.  The undersigned is prepared to bear the economic
risk of this investment for an indefinite time.

      

      (c)           The
overall commitment of the undersigned to investments which are not readily
marketable is not disproportionate to his net worth, and an investment in the
Preferred Stock will not cause such overall commitment to become
excessive.  The undersigned's need for diversification in his
investment portfolio will not be impaired by an investment in the
Company.

       

      
        
          
          

        

        
          -3-

          
            

          

        

        
          
          

        

      

       

      (d)           The
undersigned has adequate means of satisfying his short term needs for cash and
has no present need for liquidity which would require him to sell his Preferred
Stock.

      

      (e)           The
undersigned has substantial experience in making investment decisions of this
type and/or he is relying on his own advisors in making this investment decision
and, therefore, either alone or together with its advisors, he has such
knowledge and experience in financial and business matters that he is capable of
evaluating the merits and risks of an investment in the Company.

      

      (f)           The
principal business address of the undersigned, or if the undersigned is an
individual, his principal residence, is in the state indicated in the address
beneath his signature at the end of this Agreement.  Unless otherwise
indicated, all communications, contacts and discussions relating to the Offering
occurred in the state in which the undersigned maintains its office, or if the
undersigned is an individual, in the state in which he maintains his
residence.

      

      Section   5.  Reliance on Representations.

      

      The undersigned acknowledges and
understands that the Company and its directors, officers, employees, agents and
representatives are relying upon the information, representations and agreements
contained in this Agreement and upon any other information which has been
furnished by the undersigned in determining that the undersigned is a suitable
investor and that this investment is duly authorized and in deciding to accept
the undersigned's subscription for the Preferred Stock.

      

      Section   6.  Agreements of
the Undersigned Subscriber.

      

      The undersigned hereby agrees as
follows:

      

      (a)           This
offer may be accepted or rejected, in whole or in part, in the sole discretion
of the Company.

      

      (b)           In
the event this offer to purchase is accepted, the undersigned agrees to execute
all documents in connection therewith deemed necessary or advisable by the
Company in its sole discretion.

      

      (c)           Any
Preferred Stock acquired pursuant to the Offering will not be sold or otherwise
transferred: (i) without the prior written consent of the Company, which consent
shall be conditioned on receipt of an opinion of counsel reasonably satisfactory
to the Company to the effect that such proposed transfer is being made pursuant
to the registration requirements of the Act or pursuant to an exemption
therefrom and complies in all respects with any applicable state securities or
"Blue Sky" laws, or (ii) without registration under the Act and applicable State
securities or "Blue Sky" laws.

      

      (d)           In
the event the subscription is not accepted, any money tendered will be refunded
in full without interest and without deduction within a reasonable period of
time.

       

      
        
          
          

        

        
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      Section 7.  Representations Relating to Authority.

      

      If the undersigned subscriber is a
corporation, partnership, trust or other entity, the undersigned represents and
warrants that:

      

      (a)           It
is duly incorporated or organized, validly existing and in good standing in its
state of incorporation or organization and in all other jurisdictions in which
the character of its business makes such qualification necessary.

      

      (b)           It
has full power and authority to enter into, deliver and perform this Agreement
and it has taken all action required to authorize the execution and delivery of
this Agreement and to consummate the transactions contemplated
hereby.  This Agreement is the valid and binding obligation of the
subscriber, enforceable against it in accordance with its terms and the person
signing such documents on behalf of the subscriber has been duly authorized to
act on behalf of and to bind the subscriber.

      

      (c)           The
execution and delivery of this Agreement and the consummation of the
transactions contemplated hereby will not violate any provision of the
certificate of incorporation and by-laws or the partnership agreement, trust
agreement or limited liability company operating agreement, as applicable, or
any agreement or contract to which the subscriber is a party or by which it is
bound, or any applicable law, ordinance, rule or regulation of any governmental
body having jurisdiction over the subscriber or its business or any order,
judgment or decree applicable to the subscriber.

      

      Section 8.  Consent to
Merger.

      

      The undersigned subscriber hereby
consents to, ratifies and approves the Merger and consents to, ratifies and
approves the Merger Agreement.  If requested by the Company or
Onstream, the undersigned hereby agrees to execute a separate consent evidencing
the consent of the undersigned as a holder of Preferred Stock to the approval of
the Merger and the adoption of the Merger Agreement and to take such actions as
may be reasonably requested to evidence such consent and approval.

      

      Section 9.  Indemnification.

      

      The undersigned subscriber agrees to
indemnify and hold harmless the Company and each director, officer, employee,
agent or representative thereof from and against any and all loss, damage or
liability and all related costs and expenses (including but not limited to,
reasonable attorney's fees and costs of investigation) due to or arising out of
a breach of any covenant, representation or warranty made by him in this
Agreement.

       

      
        
          
          

        

        
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      Section 10.  Miscellaneous.

      

      (a)           All
notices or other communications given or made hereunder shall be in writing and
shall be delivered or mailed by registered or certified mail, return receipt
requested, postage prepaid to the undersigned at the address set forth below and
to the Company at the address set forth above.

      

      (b)           Notwithstanding
the place where this Agreement may be executed by any of the parties hereto, the
parties expressly agree that all the terms and provisions hereof shall be
governed by, and construed in accordance with, the laws of the State of New York
without regard to the choice of law principles thereof.

      

      (c)           This
Agreement constitutes the entire agreement between the parties hereto with
respect to the subject matter hereof and may be amended only by a writing
executed by all parties.

      

      (d)           Whenever
required by the context hereof, the singular shall include the plural, and
vice-versa; the masculine shall include the feminine and neuter genders, and
vice-versa; and the word "person" shall include an individual, corporation,
partnership, trust, estate or other entity.

      

      Section 11.  Foreign Person.  (check
one)

      

      o  The
undersigned hereby certifies that he is not a "foreign person" within the
meaning of Section 7701(a)(30) of the Internal Revenue Code and agrees to notify
the Company prior to becoming a foreign person as so defined.  A
"foreign person" is a person who is not a citizen or resident of the United
States.

      

      o  The
undersigned hereby certifies that he is a "foreign person" within the meaning of
Section 7701(a)(30) of the Internal Revenue Code.

      

      Section 12.  Subscription.

      

      The undersigned hereby subscribes for
shares of Preferred Stock at the aggregate purchase price indicated
below:

      

      Purchase
Price:   $______________

      

      The check of the undersigned in the
amount indicated above, payable to the Company, or a wire transfer or delivery
to the account of the Company, will be delivered to the Company upon demand and,
in any event, prior to the Effective Time.

       

      
        
          
          

        

        
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      THE
UNDERSIGNED SUBCRIBER HEREBY REPRESENTS AND WARRANTS TO THE COMPANY THAT IT
IS:

      

      o  an
institutional “accredited investor” within the meaning of Rule 501(a)(1), (2),
(3) or (7) of Regulation D under the Securities Act of 1933, as
amended.

      

      o  a
“qualified institutional buyer” as such term is defined pursuant to Rule 144A
under the Securities Act of 1933, as amended.

      

      

      NAME AND
ADDRESS OF
SUBSCRIBER:  ____________________________________________________________________________

      __________________________________________________________________________________________________________

      

      

      _____________________________                                         ___________________________________

      Telephone
Number                                                                           Signature,
if individual

      

      _____________________________                                         By:________________________________

      Social
Security Number

      or
Taxpayer I.D.
No.                                                                         ___________________________________

                                                                                                                 
TITLE, if applicable

      

      Company Acceptance:

      

      Accepted on ___________________,
2008

      

      NARROWSTEP INC.

      

      

      By:________________________________________

           Title:

      

      
        
          
          

        

        
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      Schedule
I

      

      Material Terms of Series A
Preferred Stock

      

      

      The
Series A Preferred Stock shall be entitled to such dividends as may be declared
by the board of Directors from time to time out of funds legally available
therefor.

      

      Upon any
liquidation, dissolution or winding up of the Company, the holders of the Series
A Preferred Stock shall be entitled to a liquidation preference equal to the
stated value of the shares of Series A Preferred Stock held by them together
with all unpaid dividends in respect thereof.

      

      Holders
of Series A Preferred Stock shall have no voting rights except as may be
provided by applicable law.

      

      No shares
of any class or series ranking prior to the Series A Preferred Stock as to
dividends or upon liquidation may be issued without the approval of the holders
of a majority of the Series A Preferred Stock then outstanding.

      

      The
holders of the Series A Preferred Stock shall have no right to convert the
Series A Preferred Stock into Common Stock or any other security of the Company
and shall have no right to force the redemption or repurchase of the Series A
Preferred Stock by the Company.

      
 

      -8-ex4-1.htm

    
      

    

    EXHIBIT
4.1

    

    THIS
NOTE AND HAS NOT BEEN REGISTERED UNDER THE SECURITIES ACT OF 1933, AS
AMENDED.  THIS NOTE MAY NOT BE SOLD, OFFERED FOR SALE, PLEDGED OR
HYPOTHECATED IN THE ABSENCE OF AN EFFECTIVE REGISTRATION STATEMENT AS TO THIS
NOTE UNDER SAID ACT OR AN OPINION OF COUNSEL REASONABLY SATISFACTORY TO THE
MEDICAL EXCHANGE INC. THAT SUCH REGISTRATION IS NOT REQUIRED.

    

    
      	
              Principal
      Amount $_________

            	
              Issue
      Date: July __, 2008

            
	
              Purchase
      Price $__________

            	 
      

    

    

    NOTE

    

    FOR VALUE RECEIVED, THE IDO SECURITY
INC., a Nevada corporation (hereinafter called “Borrower”), hereby promises to
pay to _______________ (the “Holder”) or order, without demand, the sum of
______________ Dollars ($____________), with interest accruing thereon, on
January 14, 2009, if not retired sooner.

    

    ARTICLE
I

    GENERAL
PROVISIONS

    

    1.1           Default Interest
Rate.  Following the occurrence and during the continuance of
an Event of Default, which, if susceptible to cure is not cured within ten (10)
days, otherwise then from the first date of such occurrence, the annual interest
rate on this Note shall (subject to Section 3.7) be twenty-four percent (24%)
and calculated on a 365 day year.

    

    1.2           Payment
Grace Period.  The Borrower shall have a
five (5) day grace period to pay any monetary amounts due under this Note, after
which grace period a default interest rate of twenty-four percent (24%) per
annum.

    

    1.3           Maturity
Date.  The Maturity Date of this Note shall be the earlier of
(i) January 14, 2009; or (ii) the date the Borrower receives gross of proceeds
of at least $2,000,000 from a financing consummated on or after the issue date
(“New Financing”).  If the Borrower closes a New Financing this Note
shall be paid at the closing out of the proceeds of the New
Financing.

     

    ARTICLE
II

    EVENT
OF DEFAULT

    

    The
occurrence of any of the following events of default (“Event of Default”) shall,
at the option of the Holder hereof, make all sums of principal and interest then
remaining unpaid hereon and all other amounts payable hereunder immediately due
and payable, upon demand, without presentment, or grace period, all of which
hereby are expressly waived, except as set forth below:

    

    2.1           Failure to Pay Principal or
Interest.  The Borrower fails to pay any installment of
principal or other sum due under this Note when due and such failure continues
for a period of five (5) days after the due date.  The five (5) day
period described in this Section 2.1 is the same five (5) day period described
in Section 1.2 hereof.

     

    
      
        
        

      

      
        
        

        
          

        

      

      
        
        

      

    

     

    2.2           Breach of
Covenant.  The Borrower breaches any material covenant or other
term or condition of this Note in any material respect and such breach, if
subject to cure, continues for a period of ten (10) business days.

    

    2.3           Breach of Representations
and Warranties.  Any material representation or warranty of the
Borrower made herein, or in any agreement, statement or certificate given in
writing pursuant hereto or in connection therewith shall be false or misleading
in any material respect as of the date made and the date hereof.

    

    2.4           Receiver or
Trustee.  The Borrower shall make an assignment for the benefit
of creditors, or apply for or consent to the appointment of a receiver or
trustee for it or for a substantial part of its property or business; or such a
receiver or trustee shall otherwise be appointed.

    

    2.5           Judgments.  Any
money judgment, writ or similar final process shall be entered or filed against
Borrower or any of its property or other assets for more than $500,000, and
shall remain unvacated, unbonded or unstayed for a period of forty-five (45)
days.

    

    2.6           Bankruptcy.  Bankruptcy,
insolvency, reorganization or liquidation proceedings or other proceedings or
relief under any bankruptcy law or any law, or the issuance of any notice in
relation to such event, for the relief of debtors shall be instituted by or
against the Borrower and if instituted against Borrower are not dismissed within
45 days of initiation.

    

    2.7    Delisting.   Delisting
of the Common Stock from any Principal Market; failure to comply with the
requirements for continued listing on a Principal Market for a period of 15
consecutive trading days.

    

    2.8    Non-Payment.   A
default by the Borrower under any one or more obligations in an aggregate
monetary amount in excess of $200,000 for more than twenty days after the due
date, unless the Borrower is contesting the validity of such obligation in good
faith.

    

    2.9    Stop
Trade.  An SEC or judicial stop trade order or Principal Market
trading suspension that lasts for five or more consecutive trading
days.

    

    2.10   
  Cross
Default.  A default by the Borrower of a material term,
covenant, warranty or undertaking of any other agreement to which the Borrower
and Holder are parties, or the occurrence of a material event of default under
any such other agreement which is not cured after any required notice and/or
cure period.

    

    ARTICLE
III

    MISCELLANEOUS

    

    3.1           Failure or Indulgence Not
Waiver.  No failure or delay on the part of Holder hereof in
the exercise of any power, right or privilege hereunder shall operate as a
waiver thereof, nor shall any single or partial exercise of any such power,
right or privilege preclude other or further exercise thereof or of any other
right, power or privilege.  All rights and remedies existing hereunder
are cumulative to, and not exclusive of, any rights or remedies otherwise
available.

     

    
      
        
        

      

      
        2

        
          

        

      

      
        
        

      

    

     

    3.2           Notices.  All
notices, demands, requests, consents, approvals, and other communications
required or permitted hereunder shall be in writing and, unless otherwise
specified herein, shall be (i) personally served, (ii) deposited in the mail,
registered or certified, return receipt requested, postage prepaid, (iii)
delivered by reputable air courier service with charges prepaid, or (iv)
transmitted by hand delivery, telegram, or facsimile, addressed as set forth
below or to such other address as such party shall have specified most recently
by written notice.  Any notice or other communication required or
permitted to be given hereunder shall be deemed effective (a) upon hand delivery
or delivery by facsimile, with accurate confirmation generated by the
transmitting facsimile machine, at the address or number designated below (if
delivered on a business day during normal business hours where such notice is to
be received), or the first business day following such delivery (if delivered
other than on a business day during normal business hours where such notice is
to be received) or (b) on the second business day following the date of mailing
by express courier service, fully prepaid, addressed to such address, or upon
actual receipt of such mailing, whichever shall first occur.  The
addresses for such communications shall be: (i) if to the Borrower to: IDO
Security Inc., 17 State Street, New York, NY 10004, with a copy by telecopier
only to: Aboudi & Brounstein, 3 Gavish St., Kfar Saba, Israel, Fax:
972-9-764-4834, and (ii) if to the Holder, to the name, address and telecopy
number set forth on the front page of this Note, with a copy by telecopier only
to Grushko & Mittman, P.C., 551 Fifth Avenue, Suite 1601, New York, New York
10176, telecopier number: (212) 697-3575.

    

    3.3           Amendment
Provision.  The term “Note” and all reference thereto, as used
throughout this instrument, shall mean this instrument as originally executed,
or if later amended or supplemented, then as so amended or
supplemented.

    

    3.4           Assignability.  This
Note shall be binding upon the Borrower and its successors and assigns, and
shall inure to the benefit of the Holder and its successors and
assigns.

    

    3.5           Cost of
Collection.  If default is made in the payment of this Note,
Borrower shall pay the Holder hereof reasonable costs of collection, including
reasonable attorneys' fees.

    

    3.6           Governing
Law.  This Note shall be governed by and construed in
accordance with the laws of the State of New York.  Any action brought
by either party against the other concerning the transactions contemplated by
this Agreement shall be brought only in the state courts of New York or in the
federal courts located in the state of New York.  Both parties and the
individual signing this Agreement on behalf of the Borrower agree to submit to
the jurisdiction of such courts.  The prevailing party shall be
entitled to recover from the other party its reasonable attorney's fees and
costs.  This Note shall be
deemed an unconditional obligation of Borrower for the payment of money and,
without limitation to any other remedies of Holder, may be enforced against
Borrower by summary proceeding pursuant to New York Civil Procedure Law and
Rules Section 3213 or any similar rule or statute in the jurisdiction where
enforcement is sought.  For purposes of such rule or statute, any
other document or agreement to which Holder and Borrower are parties or which
Borrower delivered to Holder, which may be convenient or necessary to determine
Holder’s rights hereunder or Borrower’s obligations to Holder are deemed a part
of this Note, whether or not such other document or agreement was delivered
together herewith or was executed apart from this Note.

    

    3.7           Maximum
Payments.  Nothing contained herein shall be deemed to
establish or require the payment of a rate of interest or other charges in
excess of the maximum permitted by applicable law.  In the event that
the rate of interest required to be paid or other charges hereunder exceed the
maximum permitted by such law, any payments in excess of such maximum shall be
credited against amounts owed by the Borrower to the Holder and thus refunded to
the Borrower.

    

    
      
        
        

      

      
        3

        
          

        

      

      
        
        

      

    

    
 

    IN WITNESS WHEREOF, Borrower
has caused this Note to be signed in its name by an authorized officer as of the
____ day of July, 2008.

    

    
      	 
      	 	IDO
      SECURITY INC.	 
      
	 
      	 	 
      	 
      	 
      
	 
      	 	 
      	 
      	 
      
	 
      	 	
              By:

            	
               

            	 
      
	 
      	 	
              Name:

            	 
      	 
      
	 
      	 	
              Title:

            	 
      	 
      
	 
      	 	 
      	 
      	 
      
	
              WITNESS:

            	 	 
      	 
      	 
      
	 
      	 	 
      	 
      	 
      
	
               

            	 	 
      	 
      	 
      

    

     

     

     

    4

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