Document:

exv10w3

Exhibit 10.3

FIRSTMERIT CORPORATION

EXECUTIVE CASH ANNUAL INCENTIVE PLAN

Amended and Restated April, 2011

	I.	 	TERM OF THE PLAN
	 
	 	 	The FirstMerit Corporation Executive Cash Annual Incentive Plan (the “Plan”) is effective
beginning January 1, 2011, and will remain in effect until revised or terminated by the
Compensation Committee of the Board of Directors of FirstMerit Corporation (“FirstMerit”).
	 
	II.	 	PLAN OBJECTIVES
	 
	 	 	FirstMerit is making available to eligible executive officers of FirstMerit and its
subsidiaries, through this Plan, compensation designated to foster superior financial
results by encouraging executive officers to meet or exceed stated goals. The objectives of
the Plan are to:

	 	1.	 	Foster superior financial results, producing a financial benefit to
FirstMerit and its shareholders;
	 
	 	2.	 	Motivate and reward executives for the achievement of superior
financial and personal performance ;
	 
	 	3.	 	Balance risk and financial rewards;
	 
	 	4.	 	Retain key executive talent in order to achieve stated financial
objectives and continue long-term growth of FirstMerit; and
	 
	 	5.	 	Provide a competitive total cash compensation incentive opportunity.

	III.	 	ELIGIBILITY
	 
	 	 	All employee members of the Executive Committee of officers and certain other employees
approved by the Compensation Committee are eligible to participate in the Plan
(“Participants”).
	 
	IV.	 	PLAN ELEMENTS
	 
	 	 	For each Participant, payments will be based on corporate and/or individual performance with
minimum performance thresholds that must be exceeded in order to receive compensation under
the Plan. Individual awards will be based on corporate and individual performance factors
determined by an assessment of the level of achievement of pre-established individual and
corporate goals.
	 
	 	 	Each year in the first quarter of the calendar year (or, for 2011, upon adoption of the
Plan): (i) the Chief Executive Officer will determine individual performance goals for each
Participant; and (ii) the Compensation Committee of the Board of Directors, taking

 

 

into consideration recommendations by the Chief Executive Officer, will determine the annual
corporate scorecard for assessing corporate performance.

The corporate scorecard will include: (1) comprehensive financial, risk and strategic
internal goals; and (ii) relative external peer comparison goals. The Chief Executive
Officer, and the Compensation Committee, as the case may be, shall identify goals relating
to one or several of the following corporate performance measures:

	 	1.	 	Revenue
	 
	 	2.	 	Net earnings or net income (before or after taxes);
	 
	 	3.	 	Earnings per share;
	 
	 	4.	 	Deposit or asset growth;
	 
	 	5.	 	Net operating income;
	 
	 	6.	 	Return measures (including return on assets and equity);
	 
	 	7.	 	Fee income;
	 
	 	8.	 	Earnings before or after taxes, interest, depreciation and/or
amortization;
	 
	 	9.	 	Interest spread;
	 
	 	10.	 	Productivity ratios;
	 
	 	11.	 	Share price (including, but not limited to, growth measures and total
shareholder return);
	 
	 	12.	 	Expense targets;
	 
	 	13.	 	Credit quality;
	 
	 	14.	 	Efficiency ratio;
	 
	 	15.	 	Market share;
	 
	 	16.	 	Customer satisfaction; and
	 
	 	17.	 	NIACC (net income after cost of capital).
	 
	 	18.	 	Strategic objectives (including, branding, mergers and acquisitions,
succession management, dynamic market response, new product build out, expense
reduction initiatives, risk management and regulatory compliance).

The corporate performance measures included in the scorecard will have designated
performance levels aligned with the corporate business plan and financial objectives. The
Compensation Committee will then review the established performance scorecard and determine the
corporate performance factor based on an assessment of the Company’s performance relative
to the performance scorecard and identified measures. In addition, overall performance must
be at a threshold level or better in the judgment of the Compensation Committee for a
Participant to receive any payment.

The individual performance factor will be based on achievement of individual goals and an
assessment of overall individual contribution. Goals will be aligned with performance

2

 

results for the applicable Participant’s area. To be eligible for any payment (either
corporate or individual), the executive must achieve at a minimum on his/her annual
performance evaluation a “Meets Standards” rating.

A Participant’s final award will be based on both the corporate and individual performance
factors. The weighting between the corporate performance factor and the individual
performance factor, as well as the percentage amounts of base salary to be paid for the
attainment of all factors, is subject to the approval of the Compensation Committee.

Factors and payment of percentage amounts of year end base salary for the Chief Executive
Officer will be determined by the Compensation Committee, subject to approval by the
independent members of the full Board of Directors, with the Chief Executive Officer
abstaining from discussion and voting.

For purpose of determining the amount of bonus, the base salary will be the annualized base
salary of the Participant on the last day of the applicable calendar year, adjusted to
reflect the Participant’s tenure with the Company during the year.

The accrual for Plan incentive payments will be established in accordance with generally
accepted accounting principles.

Notwithstanding anything else in this Section IV or elsewhere in the Plan, in its sole
discretion, the Compensation Committee may adjust any one or more award amounts before or
after the calendar year end, change goals or waive any requirements for awards pursuant to
the Plan.

	V.	 	PAYMENTS
	 
	 	 	Subject to applicable withholding, payments under the Plan are based on the corporate and
individual performance factors and/or line of business results for each calendar year and
will be made by March 15 of the following calendar year upon approval by the Compensation
Committee and, with respect to the Chief Executive Officer, the independent members of the
full Board of Directors.
	 
	VI.	 	NEWLY HIRED, TRANSFERRED, PROMOTED AND TERMINATED PARTICIPANTS
	 
	 	 	If a Participant is transferred or promoted or becomes totally disabled in accordance with
the Company’s long-term disability plan before the last day of the calendar year, the
Participant will be eligible to receive payment under the Plan only if: (i) the Participant
is employed on the last day of the calendar year; (ii) the Participant remains employed
through the payment date; and (iii) the stated threshold goals have been achieved by the
last day of the calendar year, as such goals may be revised for the individual based upon a
change in position. Payments will be prorated based upon the tenure of the Participant in
the eligible position. Newly hired eligible Plan Participants may receive a prorated
incentive payout based on their tenure during the Plan year or a predetermined payout amount
agreed upon as part of their initial employment terms.

3

 

	 	 	If the Participant’s employment is terminated before the payment date for any reason other
than retirement, the Participant will not be eligible for any payment under the Plan
regardless of employment status on the last day of the calendar year.
	 
	 	 	If the Participant retires (as retirement is defined under the FirstMerit benefit plan
providing for the earliest possible retirement) effective before the end of the calendar
year, the Participant will not be entitled to payment under the Plan. If the Participant
retires effective at any time after the end of the calendar year, but before the payment
date, the retiring Participant will be entitled to payment in accordance with the terms of
the Plan.
	 
	 	 	If a Participant dies before the end of the calendar year, neither the Participant nor their
estate will be eligible to receive any payment under the Plan. If a Participant dies after
the end of the calendar year, but before the payment date, the Participant, through their
estate, will be eligible to receive payment of an award amount under the Plan.
	 
	 	 	FirstMerit reserves the right to withhold or decrease payments to any Participant under the
Plan based on a Participant’s violation of any of FirstMerit’s policies and procedures or
failure to achieve at minimum “Meets Standards” on the annual performance evaluation, as
approved by the Compensation Committee.
	 
	VII.	 	OTHER EMPLOYEE BENEFITS
	 
	 	 	Benefits to Participants under other benefit plans will not be affected by payments under
this Plan to the extent benefits under the other plans are based upon base salary, but will
be affected by payments under this Plan to the extent benefits under the other plans are
based upon Form W-2 earnings. FirstMerit retains the right to amend, cancel or change any
other benefit plans.
	 
	VIII.	 	AMENDMENT AND ADMINISTRATION OF THE PLAN
	 
	 	 	The Plan may be terminated or amended by the recommendation of the Compensation Committee,
subject to the approval of the Board of Directors. Any question of interpretation of the
Plan will be determined by the Compensation Committee and its determinations or final,
binding and non-appealable. The Executive Vice President of Human Resources and the Manager
of Compensation are responsible for administering the Plan in accordance with the terms of
the Plan and the goals and payments determined annually by the recommendation of the
Compensation Committee and approval of the Board of Directors.

4pvct8kex4_1042011.htm

EXHIBIT 4.1

WARRANT

THESE SECURITIES HAVE NOT BEEN REGISTERED UNDER THE SECURITIES ACT OF 1933, AS AMENDED, OR THE SECURITIES LAWS OF ANY STATE AND MAY NOT BE SOLD OR OFFERED FOR SALE IN THE ABSENCE OF AN EFFECTIVE REGISTRATION STATEMENT FOR THE SECURITIES OR AN OPINION OF COUNSEL OR OTHER EVIDENCE ACCEPTABLE TO THE COMPANY THAT SUCH REGISTRATION IS NOT REQUIRED.

 

PROVECTUS PHARMACEUTICALS, INC.

 

COMMON STOCK PURCHASE WARRANT

 

1.           Issuance; Certain Definitions.  In consideration of good and valuable consideration as of April [___], 2011, the receipt of which is hereby acknowledged by PROVECTUS PHARMACEUTICALS, INC., a Nevada corporation (the "Company"), ___________________ or registered assigns (the "Holder") is hereby granted the right to purchase at any time until 5:00 p.m., New York City time, on April [___], 2012, _______________ (_________) fully paid and nonassessable shares of the Company's common stock, $0.001 par value per share (the "Common Stock"), at an initial exercise price per share (the "Exercise Price") of $1.25 per share, subject to further adjustment as set forth herein.  This Warrant is being issued pursuant to that certain Subscription Agreement by and between the Company and the Holder of even date herewith.  The Company and the Holder are collectively referred to herein as the "parties."

 

2.           Exercise of Warrants.

 

2.1           Method of Exercise.

 

	
(a)  

	
This Warrant is exercisable in whole or in part at any time and from time to time.  Such exercise shall be effectuated by submitting to the Company (either by delivery to the Company or by facsimile transmission as provided in Section 8 hereof) a completed and duly executed Notice of Exercise (substantially in the form attached to this Warrant as Exhibit A) as provided in this paragraph.  The date such Notice of Exercise is faxed to the Company shall be the "Exercise Date," provided that the Holder of this Warrant tenders this Warrant Certificate to the Company within five (5) business days thereafter.  The Notice of Exercise shall be executed by the Holder of this Warrant and shall indicate the number of shares then being purchased pursuant to such exercise. Upon surrender of this Warrant Certificate, together with appropriate payment of the Exercise Price for the shares of Common Stock purchased, the Holder shall be entitled to receive a certificate or certificates for the shares of Common Stock so purchased.  The Exercise Price may be paid in a "cashless" or "cash" exercise or a combination thereof pursuant to Section 2.1(b) and/or Section 2.1(c) below; provided, however, the Warrant may not be exercised in a cashless manner during any period in which the Company has effective a Registration Statement filed under the Securities Act of 1933, as amended, for the sale or resale of shares of Common Stock issuable pursuant to this Warrant.

 

 

  

1

 

	
(b)  

	
If the Holder elects a "cashless" exercise on its Notice of Exercise form, then the Holder shall thereby be entitled to receive a number of shares of Common Stock equal to (x) the excess of the Current Market Value (as defined below) over the total cash exercise price of the portion of the Warrant then being exercised, divided by (y) the Market Price of the Common Stock as of the trading day immediately prior to the Exercise Date. For the purposes of this Warrant, the terms (Q) "Current Market Value" shall be an amount equal to the Market Price of the Common Stock as of the trading day immediately prior to the Exercise Date, multiplied by the number of shares of Common Stock specified in such Notice of Exercise Form, and (R) "Market Price of the Common Stock" shall be the closing price of the Common Stock as reported by the OTC Bulletin Board, or if listed on a national securities exchange or quoted on an automated quotation service, such national securities exchange or automated quotation service, for the relevant date. If the Common Stock is not then listed on a national stock exchange or quoted on the OTC Bulletin Board or such other quotation system or association, the fair market value of one share of Common Stock as of the date of determination, as determined in good faith by the Board of Directors of the Company and the Holder.  If the Common Stock is not then listed on a national securities exchange, the OTC Bulletin Board or such other quotation system or association, the Board of Directors of the Company shall respond promptly, in writing, to an inquiry by the Holder prior to the exercise hereunder as to the fair market value of a share of Common Stock as determined by the Board of Directors of the Company.  In the event that the Board of Directors of the Company and the Holder are unable to agree upon the fair market value, the Company and the Holder shall jointly select an appraiser, who is experienced in such matters.  The decision of such appraiser shall be final and conclusive, and the cost of such appraiser shall be borne equally by the Company and the Holder.  Such adjustment shall be made successively whenever such a payment date is fixed.

 

	
(c)  

	
If the Holder elects a "cash" exercise on its Notice of Exercise form, the Exercise Price per share of Common Stock for the shares then being exercised shall be payable in cash or by certified or official bank check.

 

	
(d)  

	
The Holder shall be deemed to be the holder of the shares issuable to it in accordance with the provisions of this Section 2.1 on the Exercise Date.

 

2.2           Limitation on Exercise. Notwithstanding the provisions of this Warrant or the Subscription Agreement, in no event (except (i) as specifically provided in this Warrant as an exception to this provision, (ii) while there is outstanding a tender offer for any or all of the shares of the Company's Common Stock, or (iii) at the Holder's option, on at least sixty-five (65) days' advance written notice from the Holder) shall the Holder be entitled to exercise this Warrant, or shall the Company have the obligation to issue shares upon such exercise of all or any portion of this Warrant to the extent that, after such exercise the sum of (1) the number of shares of Common Stock beneficially owned by the Holder and its affiliates (other than shares of Common Stock which may be deemed beneficially owned through the ownership of the unexercised portion of the Warrants or other rights to purchase Common Stock), and (2) the number of shares of Common Stock issuable upon the exercise of the Warrants with respect to which the determination of this proviso is being made, would result in beneficial ownership by the Holder and its affiliates of more than 9.99% of the outstanding shares of Common Stock (after taking into account the shares to be issued to the Holder upon such exercise). For purposes of the proviso to the immediately preceding sentence, beneficial ownership shall be determined in accordance with Section 13(d) of the Securities Exchange Act of 1934, as amended (the "1934 Act"), except as otherwise provided in clause (1) of such sentence. The Holder, by its acceptance of this Warrant, further agrees that if the Holder transfers or assigns any of the Warrants, such assignment shall be made subject to the transferee's or assignee's specific agreement to be bound by the provisions of this Section 2.2 as if such transferee or assignee were the original Holder hereof.

 

  

2

  

 

3.           Reservation of Shares.  The Company hereby agrees that at all times during the term of this Warrant there shall be reserved for issuance upon exercise of this Warrant such number of shares of its Common Stock as shall be required for issuance upon exercise of this Warrant (the "Warrant Shares"). The Company agrees that all Warrant Shares issued upon due exercise of the Warrant shall be, at the time of delivery of the certificates for such Warrant Shares, duly authorized, validly issued, fully paid and non-assessable shares of Common Stock of the Company.

 

4.           Mutilation or Loss of Warrant.  Upon receipt by the Company of evidence satisfactory to it of the loss, theft, destruction or mutilation of this Warrant, and (in the case of loss, theft or destruction) receipt of reasonably satisfactory indemnification, and (in the case of mutilation) upon surrender and cancellation of this Warrant, the Company will execute and deliver a duplicate Warrant and any such lost, stolen, destroyed or mutilated Warrant shall thereupon become void.

 

5.           Rights of the Holder.  The Holder shall not, by virtue hereof, be entitled to any rights of a stockholder in the Company, either at law or equity, and the rights of the Holder are limited to those expressed in this Warrant and are not enforceable against the Company except to the extent set forth herein.

 

6.           Protection Against Dilution and Other Adjustments.

 

6.1           Adjustment Mechanism.  If an adjustment of the Exercise Price is required pursuant to this Section 6, the Holder shall be entitled to purchase such number of additional shares of Common Stock as will cause (i) the total number of shares of Common Stock Holder is entitled to purchase pursuant to this Warrant, multiplied by (ii) the adjusted Exercise Price per share, to equal (iii) the dollar amount of the total number of shares of Common Stock Holder is entitled to purchase before adjustment multiplied by the total Exercise Price immediately before adjustment.

 

6.2           Dividends; Distributions.  If the Company shall, at any time or from time to time while this Warrant is outstanding, pay a dividend or make a distribution on its Common Stock in shares of Common Stock, subdivide its outstanding shares of Common Stock into a greater number of shares or combine its outstanding shares of Common Stock into a smaller number of shares or issue by reclassification of its outstanding shares of Common Stock any shares of its capital stock (including any such reclassification in connection with a consolidation or merger in which the Company is the continuing corporation), then (i) the Exercise Price in effect immediately prior to the date on which such change shall become effective shall be adjusted by multiplying such Exercise Price by a fraction, the numerator of which shall be the number of shares of Common Stock outstanding immediately prior to such change and the denominator of which shall be the number of shares of Common Stock outstanding immediately after giving effect to such change and (ii) the number of Warrant Shares purchasable upon exercise of this Warrant shall be adjusted by multiplying the number of Warrant Shares purchasable upon exercise of this Warrant immediately prior to the date on which such change shall become effective by a fraction, the numerator of which is shall be the Exercise Price in effect immediately prior to the date on which such change shall become effective and the denominator of which shall be the Exercise Price in effect immediately after giving effect to such change, calculated in accordance with clause (i) above.  Such adjustments shall be made successively whenever any event listed above shall occur.

 

  

3

  

 

6.3.           Reorganization; Reclassification; Merger; Consolidation.  If any capital reorganization, reclassification of the capital stock of the Company, consolidation or merger of the Company with another corporation in which the Company is not the survivor, or sale, transfer or other disposition of all or substantially all of the Company’s assets to another corporation shall be effected, then, as a condition of such reorganization, reclassification, consolidation, merger, sale, transfer or other disposition, lawful and adequate provision shall be made whereby each Holder shall thereafter have the right to purchase and receive upon the basis and upon the terms and conditions herein specified and in lieu of the Warrant Shares immediately theretofore issuable upon exercise of the Warrant, such shares of stock, securities or assets as would have been issuable or payable with respect to or in exchange for a number of Warrant Shares equal to the number of Warrant Shares immediately theretofore issuable upon exercise of the Warrant, had such reorganization, reclassification, consolidation, merger, sale, transfer or other disposition not taken place, and in any such case appropriate provision shall be made with respect to the rights and interests of each Holder to the end that the provisions hereof (including, without limitation, provision for adjustment of the Exercise Price) shall thereafter be applicable, as nearly equivalent as may be practicable in relation to any shares of stock, securities or assets thereafter deliverable upon the exercise hereof.  The Company shall not effect any such consolidation, merger, sale, transfer or other disposition unless prior to or simultaneously with the consummation thereof the successor corporation (if other than the Company) resulting from such consolidation or merger, or the corporation purchasing or otherwise acquiring such assets or other appropriate corporation or entity shall assume the obligation to deliver to the Holder, at the last address of the Holder appearing on the books of the Company, such shares of stock, securities or assets as, in accordance with the foregoing provisions, the Holder may be entitled to purchase, and the other obligations under this Warrant.  The provisions of this Section 6.3 shall similarly apply to successive reorganizations, reclassifications, consolidations, mergers, sales, transfers or other dispositions.

 

6.4           Distributions to Holders of Common Stock.  In case the Company shall fix a payment date for the making of a distribution to all holders of Common Stock (including any such distribution made in connection with a consolidation or merger in which the Company is the continuing corporation) of evidences of indebtedness or assets (other than cash dividends or cash distributions payable out of consolidated earnings or earned surplus or dividends or distributions referred to in Section 6.2, or subscription rights or warrants), the Exercise Price to be in effect after such payment date shall be determined by multiplying the Exercise Price in effect immediately prior to such payment date by a fraction, the numerator of which shall be the total number of shares of Common Stock outstanding multiplied by the Current Market Value per share of Common Stock immediately prior to such payment date, less the fair market value (as determined by the Company’s Board of Directors in good faith) of said assets or evidences of indebtedness so distributed, or of such subscription rights or warrants, and the denominator of which shall be the total number of shares of Common Stock outstanding multiplied by such Current Market Value per share of Common Stock immediately prior to such payment date.

 

  

4

  

 

7.           Transfer to Comply with the Securities Act.  This Warrant has not been registered under the Securities Act of 1933, as amended, (the "Act") and has been issued to the Holder for investment and not with a view to the distribution of either the Warrant or the Warrant Shares.  Except for transfers to officers, employees and affiliates of the Holder, neither this Warrant nor any of the Warrant Shares or any other security issued or issuable upon exercise of this Warrant may be sold, transferred, pledged or hypothecated in the absence of an effective registration statement under the Act relating to such security or an opinion of counsel satisfactory to the Company that registration is not required under the Act.  Each certificate for the Warrant, the Warrant Shares and any other security issued or issuable upon exercise of this Warrant shall contain a legend on the face thereof, in form and substance satisfactory to counsel for the Company, setting forth the restrictions on transfer contained in this Section.

 

8.           Notices.  Any notice or other communication required or permitted hereunder shall be in writing and shall be delivered personally, telegraphed, sent by facsimile transmission or sent by certified, registered or express mail, postage pre-paid.  Any such notice shall be deemed given when so delivered personally, telegraphed, telexed or sent by facsimile transmission, or, if mailed, four days after the date of deposit in the United States mails, as follows:

 

If to the Company, to:

 

PROVECTUS PHARMACEUTICALS, INC.

7327 Oak Ridge Highway, Suite A

Knoxville, TN 37931

Attention: Peter R. Culpepper

Telephone:  (866) 594-5999 (ext. 30)

Facsimile:  (866) 998-0005

with a copy to:

Dan Huffines

Baker, Donelson, Bearman, Caldwell & Berkowitz, PC

165 Madison Avenue, Suite 2000

Memphis, Tennessee 38103

Telephone: (901) 577-2326

Facsimile: (901) 577-0724

 

  

5

  

                If to the Holder, to:

 

	
  

	
Such address or addresses set forth beside such Holder’s name on the signature page to the Subscription Agreement.

Any party may give notice in accordance with this Section to designate to another address or person for receipt of notices hereunder.

 

9. Supplements and Amendments; Whole Agreement.  This Warrant may be amended or supplemented only by an instrument in writing signed by the parties hereto.  This Warrant contains the full understanding of the parties with respect to the subject matter hereof and thereof and there are no representations, warranties, agreements or understandings other than expressly contained herein and therein.

 

10. Governing Law.  This Warrant shall be governed by, and construed in accordance with, the internal laws of the State of Tennessee without regard to the choice of law principles thereof.  Each of the parties hereto irrevocably submits to the exclusive jurisdiction of the courts of the State of Tennessee located in Knox County and the United States District Court for the Eastern District of Tennessee for the purpose of any suit, action, proceeding or judgment relating to or arising out of this Warrant and the transactions contemplated hereby.  Service of process in connection with any such suit, action or proceeding may be served on each party hereto anywhere in the world by the same methods as are specified for the giving of notices under this Warrant.  Each of the parties hereto irrevocably consents to the jurisdiction of any such court in any such suit, action or proceeding and to the laying of venue in such court.  Each party hereto irrevocably waives any objection to the laying of venue of any such suit, action or proceeding brought in such courts and irrevocably waives any claim that any such suit, action or proceeding brought in any such court has been brought in an inconvenient forum.

 

11.           Jury Trial Waiver.   EACH OF THE PARTIES HERETO WAIVES ANY RIGHT TO REQUEST A TRIAL BY JURY IN ANY LITIGATION WITH RESPECT TO THIS WARRANT AND REPRESENTS THAT COUNSEL HAS BEEN CONSULTED SPECIFICALLY AS TO THIS WAIVER.

 

12.           Counterparts.  This Warrant may be executed in any number of counterparts and each of such counterparts shall for all purposes be deemed to be an original, and all such counterparts shall together constitute but one and the same instrument.

 

13.           Descriptive Headings.  Descriptive headings of the several Sections of this Warrant are inserted for convenience only and shall not control or affect the meaning or construction of any of the provisions hereof.

 

  

6

  

 

IN WITNESS WHEREOF, the Company has executed this Warrant as of the date set forth above.

 

PROVECTUS PHARMACEUTICALS, INC.

 

By:    ___________________________________                                                            

Name: Peter R. Culpepper

Title: Chief Financial Officer and Chief Operating Officer

  

7

  

 

NOTICE OF EXERCISE

TO BE EXECUTED BY THE REGISTERED HOLDER TO EXERCISE THIS

WARRANT TO PURCHASE COMMON STOCK

PROVECTUS PHARMACEUTICALS, INC.

The undersigned holder hereby exercises the right to purchase _________________ of the shares of Common Stock ("Warrant Shares") of Provectus Pharmaceuticals, Inc., a Nevada corporation (the "Company"), evidenced by the enclosed warrant (the "Warrant").  Capitalized terms used herein and not otherwise defined shall have the respective meanings set forth in the Warrant.

1.           Form of Exercise Price.  The Holder intends that payment of the Exercise Price shall be made as:

	
  

	
____________

	
a “Cash Exercise” with respect to _________________ Warrant Shares; and/or

 

	
  

	
____________

	
a “Cashless Exercise” with respect to _______________ Warrant Shares.

 

In the event that the Holder has elected a Cashless Exercise with respect to some or all of the Warrant Shares to be issued pursuant hereto, the Holder hereby represents and warrants that this Exercise Notice was executed by the Holder at __________ [a.m.][p.m.] on the date set forth below.

2.           Payment of Exercise Price. In the event that the Holder has elected a Cash Exercise with respect to some or all of the Warrant Shares to be issued pursuant hereto, the Holder shall pay the Aggregate Exercise Price in the sum of $___________________ to the Company in accordance with the terms of the Warrant.

3.           Delivery of Warrant Shares.  The Company shall deliver to Holder, or its designee or agent as specified below, __________ Warrant Shares in accordance with the terms of the Warrant.  Delivery shall be made to Holder, or for its benefit, to the following address:

 

                                   _______________________

                                   _______________________

                                   _______________________

	
 

Name of Registered Holder

 

By:          ______________________________________

Name:

Title:

	
 

 

 

Date:     ______________________________________

Source: [{"source": "alea-institute/alea-institute/kl3m-data-edgar-agreements/train-00188-of-00352.parquet"}, [{"source": "alea-institute/alea-institute/kl3m-data-edgar-agreements/train-00188-of-00352.parquet"}]]