Document:

Third Amendment to Lease, dated as of August 12, 2004

 EXHIBIT 10.1 
  
 ALTON PLAZA 
 THIRD AMENDMENT TO LEASE 
 (Extension of Term; Expansion of Premises) 
  
 THIS THIRD AMENDMENT TO LEASE (this “Amendment”) dated for
reference purposes only as of August 12, 2004, is entered into by and between ALTON PLAZA PROPERTY, INC., a Delaware corporation (“Lessor” or “Landlord”), and ISTA PHARMACEUTICALS, INC., a Delaware corporation
(“Lessee” or “Tenant”). 
  
 RECITALS 
  
 A. Lessor’s predecessor in
interest, Aetna Life Insurance Company, and Lessee entered into that certain Lease Agreement dated September 13, 1996 (the “Original Lease”) for certain premises located at 15279 Alton Parkway, Suite 100, Irvine, California 92618
(the “Existing Premises”), which are located in the industrial complex commonly known as Alton Plaza Industrial Park (hereinafter, the “Park” or the “Complex”). The Existing Premises contain
approximately 13,448 square feet. Landlord and Tenant entered into that certain First Amendment to Lease dated as of June 27, 2001 (the “First Amendment”) and that certain Second Amendment to Lease dated as of February 13, 2002 (the
“Second Amendment”). Pursuant to the Second Amendment, the Expansion Premises (located in the building commonly known as 15273 Alton Parkway, as more specifically described in the Second Amendment) were added to the Existing
Premises. The Original Lease as amended by the First Amendment and the Second Amendment is hereinafter referred to as the “Lease”. The Existing Premises Expiration Date is September 30, 2004. The Expansion Premises Expiration Date
is June 30, 2005. 
  
 B. Landlord and Tenant presently desire to
amend the Lease to, among other things, provide for: (i) the extension of the term of the Lease, (ii) the deletion of the Expansion Premises, and (iii) the addition of certain new premises to the Lease. 
  
 NOW, THEREFORE, in consideration of the mutual covenants and conditions
contained herein and other good and valuable consideration, the receipt and sufficiency of which is hereby acknowledged, the parties hereto agree as follows: 
  
 1. Definitions. Unless otherwise specifically set forth herein, all capitalized terms used herein shall have the same meanings as set forth in the
Lease. 
  
 2. Deletion of Expansion Premises. Landlord
shall provide Tenant with thirty (30) days prior written notice (“Delivery Notice”) of the date the New Premises (as defined in Section 3 below) are estimated to be Substantially Completed (as defined below). Landlord shall
then notify Tenant when the New Premises are Substantially Completed (the “Completion Notice”). The Completion Notice shall also specify the date by which Tenant is to relocate to the New Premises (the “Relocation
Date”), which Relocation Date shall be at least three (3) business days following the date the New Premises are Substantially Completed and in no event prior to the date set forth in the Delivery Notice. Tenant shall remove all of
Tenant’s personal property from the Expansion Premises on the Relocation Date. The Expansion Premises shall be surrendered by Tenant on or before 11:59 p.m. of the Relocation Date. Notwithstanding anything to the contrary set forth in the
Lease, if Tenant fails to deliver possession of the 

  

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Expansion Premises to Landlord on or before 11:59 p.m. on the Relocation Date, Tenant’s continued possession of the Expansion Premises shall be on the
basis of a tenancy at sufferance at a rate equal to 150% of the Base Rent amount for the period from the Relocation Date to the Surrender Date, as defined below, plus all rent adjustments under the Lease, charged and payable on a per diem basis. In
addition, Tenant shall indemnify, protect, defend and hold Landlord harmless from all claims arising from or in connection with all damages sustained by Landlord as a result of any holdover beyond the Relocation Date by Tenant in the Expansion
Premises including, but not limited to, any claims by another tenant resulting from a delay by Landlord in delivering possession of the Expansion Premises to such other tenant. Tenant shall remain liable for all of Tenant’s rental and other
obligations under the Lease with regard to the Expansion Premises until such time as Tenant actually vacates and surrenders the Expansion Premises to Landlord as required by this Section 2 (the “Surrender Date”). Tenant shall
be released from its obligations under the Lease solely with respect to the Expansion Premises accruing after the Surrender Date except for such indemnities and other liabilities which expressly survive the termination thereof. 
  
 3. Addition of the New Premises. The increment of space located at
15295 Alton Parkway and labeled “New Premises” on the attached Exhibit A-3 shall be added to the Premises covered by the Lease on the date (the “New Commencement Date”) Landlord has Substantially Completed the Phase
I Work (as defined below), and shall remain a portion of the “Premises” (as defined below) throughout the New Extended Term (as defined below); provided, however, in no event shall the New Commencement Date occur before September 1, 2004.
Landlord and Tenant agree that initially for the purpose of the Lease and this Amendment, the New Premises shall be deemed to contain approximately 21,429 square feet of space. As of the New Commencement Date, the Basic Lease Information Page of the
Lease shall be modified to provide that the “Premises” consists of approximately 34,877 square feet (the combined Existing Premises and New Premises shall hereinafter be referred to as the “Premises”). The parties hereto
acknowledge that the term of the Lease with respect to the Existing Premises is scheduled to expire on September 30, 2004 (the “Existing Premises Expiration Date”). If the Phase I Work has not been completed by such date, then Tenant shall
continue to pay Base Rent and all other charges under the Lease at the rates in effect applicable immediately prior to such date and Tenant shall not be deemed to be “holding over” in the Expansion Premises or the Existing Premises during
the period after the Existing Premises Expiration Date through and including the day before the New Commencement Date. 
  
 4. Premises Condition. For the period which is twelve (12) months following the date of Substantial Completion (the “Warranty
Period”), Landlord shall be responsible at its sole cost and expense for: (i) any failure of the New Premises and/or the Work (as defined below) to comply with all applicable laws, statutes, codes, governmental regulations and private
restrictions then in effect as of the date of Substantial Completion (“Legal Requirements”), and (ii) any defects in material or workmanship in any of the Work. Landlord shall repair any defective or malfunctioning component of such
items of which Landlord has received written notice from Tenant describing the failure or malfunction within the Warranty Period. Except for the foregoing, the provisions of Section 9 below and Landlord’s maintenance obligations under
the Lease, Landlord shall have no obligation to make or pay for any improvements or renovations in or to the New Premises or to otherwise prepare the New Premises or the Existing Premises for Tenant’s occupancy, except as specifically provided
in this Amendment. 
  

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 5. Planning and Phasing of Work. 
  
 5.1 Phasing of Work. The parties hereto acknowledge that the Work (as defined below) shall be performed in two
stages: (1) “Phase I” which shall include all tenant improvements to be constructed in the New Premises as described in Section 5.4 below, and (2) “Phase II” which shall include all tenant improvements to be
constructed in the Existing Premises as described in Section 5.7 below. 
  
 5.2 Architect. The architect for the tenant improvements to be constructed in the Premises shall be H. Hendy (“Architect”). The parties acknowledge that Tenant has already engaged H. Hendy to
perform certain programming, test fitting, furniture assessments and some preliminary design work in connection with the proposed Work, the cost of which shall be included in Total Construction Costs (as defined below). Prior to the date hereof,
Tenant met with the Architect to discuss its program and facility requirements (“Program”) and the nature and extent of all improvements that Tenant proposes to install in the New Premises and the Existing Premises and at such
meeting, provided the Architect with all necessary data and information requested by the Architect to prepare initial Program documents and then space plans therefor as required by this Section 5. 
  
 A. PHASE I: IMPROVEMENTS IN NEW PREMISES 
  
 5.3 Preparation and Delivery of Phase I Space Plan. Prior to the date
hereof, with respect to Phase I, Tenant has delivered to Landlord: (a) a Program document indicating the square footage requirements for each department, and (b) a space plan prepared by the Architect depicting improvements to be installed in the
New Premises (the “Phase I Space Plan”), with any deficiencies between the space plan and the required Program clearly identified. On or before July 28, 2004, Landlord shall deliver to Tenant (i) a preliminary cost estimate to
complete the work depicted in the Phase I Space Plan (“Phase I Budget”), and (ii) a preliminary project schedule (“Phase I Project Schedule”). Tenant shall notify Landlord whether it approves of the scope of the
Phase I work outlined in the submitted Budget and Project Schedule within three (3) business days after Landlord’s submission thereof. If Tenant disapproves of the scope of the Phase I work outlined in the submitted Budget and/or Project
Schedule within such three (3) business day period, then Tenant shall notify Landlord thereof specifying in reasonable detail the reasons for such disapproval, in which case Landlord shall within three (3) business days after such notice, revise
such Phase I Budget and/or Project Schedule, as the case may be, in accordance with Tenant’s objections and submit the revised Phase I Budget and/or Project Schedule, as the case may be, to Tenant for its review and approval. Tenant shall
notify Landlord in writing whether it approves of the scope of the Phase I work outlined in the resubmitted Budget and/or Project Schedule, as the case may be, within two (2) business days after its receipt thereof. This process shall be repeated
until the Budget and Project Schedule have been finally approved by Tenant and Landlord. If Tenant fails to notify Landlord that it disapproves of the initial Phase I Budget and/or Project Schedule within three (3) business days (or, in the case of
a resubmitted Phase I Budget and/or Project Schedule within two (2) business days after the submission thereof), then Tenant shall be deemed to have approved the Phase I Budget and/or Project Schedule in question. Concurrently with preparation of
the Phase I Budget and Project Schedule, Landlord shall prepare a preliminary budget and project schedule for the Phase II Work (as defined below) (the “Preliminary Phase II Budget & Schedule”). 

  

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Tenant shall notify Landlord whether it approves of the scope of the Phase II work outlined in the submitted Preliminary Phase II Budget & Schedule
within three (3) business days after Landlord’s submission thereof. If Tenant disapproves of the scope of the Phase II work outlined in the submitted Preliminary Phase II Budget & Schedule within such three (3) business day period, then
Tenant shall notify Landlord thereof specifying in reasonable detail the reasons for such disapproval, in which case Landlord shall within three (3) business days after such notice, revise such Preliminary Phase II Budget & Schedule in
accordance with Tenant’s objections and submit the revised Preliminary Phase II Budget & Schedule to Tenant for its review and approval. Tenant shall notify Landlord in writing whether it approves of the scope of the Phase II work outlined
in the resubmitted Preliminary Phase II Budget & Schedule within two (2) business days after its receipt thereof. This process shall be repeated until the Preliminary Phase II Budget & Schedule have been finally approved by Tenant and
Landlord. If Tenant fails to notify Landlord that it disapproves of the initial Preliminary Phase II Budget & Schedule within three (3) business days (or, in the case of a resubmitted Preliminary Phase II Budget & Schedule within two (2)
business days after the submission thereof), then Tenant shall be deemed to have approved the Preliminary Phase II Budget & Schedule in question. Notwithstanding such approval, the parties hereto acknowledge that the Preliminary Phase II Budget
& Schedule may be subject to revision pending approval of the Phase II Working Drawings as described in Section 5.8 below. 
  
 5.4 Phase I Working Drawings. On or before July 30, 2004, Landlord shall cause to be prepared final working drawings of all improvements to be
installed in the New Premises based on the approved Phase I Space Plan and deliver the same to Tenant for its review and approval (which approval shall not be unreasonably withheld, delayed or conditioned). Such Phase I working drawings shall be
prepared by the Architect (and if necessary, engineers) (whose fees shall be included in the Total Construction Costs (as defined below)). Tenant shall notify Landlord whether it approves of the submitted Phase I working drawings within two (2)
business days after Landlord’s submission thereof. If Tenant disapproves of such Phase I working drawings, then Tenant shall notify Landlord thereof specifying in reasonable detail the reasons for such disapproval, in which case Landlord shall,
within three (3) business days after such notice, revise such Phase I working drawings in accordance with Tenant’s objections and submit the revised Phase I working drawings to Tenant for its review and approval. Tenant shall notify Landlord in
writing whether it approves of the resubmitted Phase I working drawings within one (1) business day after its receipt thereof. This process shall be repeated until the working drawings have been finally approved by Landlord and Tenant. If Tenant
fails to notify Landlord that it disapproves of the initial Phase I working drawings within three (3) business days (or, in the case of resubmitted working drawings, within one (1) business day) after the submission thereof, then Tenant shall be
deemed to have approved the working drawings in question. Any delay caused by Tenant’s failure to respond within the time periods set forth in this Section 5.4 as to such Phase I working drawings shall constitute a Tenant Delay (defined
below). As used herein, “Phase I Working Drawings” shall mean the final Phase I working drawings approved by Landlord and Tenant, as amended from time to time by any approved changes thereto approved by Landlord and Tenant, and
“Phase I Work” shall mean all improvements to be constructed in the New Premises in accordance with and as indicated on the Phase I Working Drawings. Landlord’s approval of the Phase I Working Drawings shall not be a
representation or warranty of Landlord that such drawings are adequate for any use or comply with any law, but shall merely be the consent of Landlord thereto. Tenant shall, at Landlord’s 

  

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request, sign the Phase I Working Drawings to evidence its review and approval thereof. After the Phase I Working Drawings have been approved, Landlord shall
cause the Phase I Work to be performed in accordance with the Phase I Working Drawings. Landlord shall cause the Contractor to construct the Phase I Work to comply with the Phase I Working Drawings and Legal Requirements. 
  
 5.5 Phase I Budget. Upon approval of the Phase I Working Drawings by
Tenant and Landlord, and subject to the provisions of Section 5.4 above, Landlord shall provide to Tenant, prior to commencement of construction of the Phase I Work, a complete budget (“Phase I Final Budget”) showing all line
items of the Phase I Work and the schedule of distribution of the Construction Allowance (as defined below) with respect to the Phase I Work. Tenant shall approve or disapprove the Phase I Final Budget within five (5) business days of receipt, such
approval not to be unreasonably conditioned or withheld. If Tenant fails to notify Landlord that it disapproves of the Phase I Final Budget within such five (5) business day period, then Tenant shall be deemed to have approved the Phase I Final
Budget. 
  
 B. PHASE II: IMPROVEMENTS IN EXISTING PREMISES 
  
 5.6 Preparation and Delivery of Phase II Space Plan. Within ten (10)
business days of the full execution of this Amendment by Landlord and Tenant, with respect to Phase II, Tenant shall deliver to Landlord: (a) a Program document indicating the square footage requirements for each department, and (b) a space plan
prepared by the Architect depicting improvements to be installed in the Existing Premises (the “Phase II Space Plan”). 
  
 5.7 Phase II Working Drawings. Within ten (10) business days after Landlord and Tenant’s approval of the Phase II Space Plan, Landlord shall
cause to be prepared final working drawings of all improvements to be installed in the Existing Premises based on the approved Phase II Space Plan and deliver the same to Tenant for its review and approval, which approval shall not be unreasonably
withheld, delayed or conditioned. Such working drawings shall be prepared by the Architect, and if necessary, engineers (whose fees shall be included in the Total Construction Costs). Tenant shall notify Landlord whether it approves of the submitted
Phase II working drawings within two (2) business days after Landlord’s submission thereof. If Tenant disapproves of such Phase II working drawings, then Tenant shall notify Landlord thereof specifying in reasonable detail the reasons for such
disapproval, in which case Landlord shall, within three (3) business days after such notice, revise such Phase II working drawings in accordance with Tenant’s objections and submit the revised working drawings to Tenant for its review and
approval. Tenant shall notify Landlord in writing whether it approves of the resubmitted Phase I working drawings within one (1) business day after its receipt thereof. This process shall be repeated until the working drawings have been finally
approved by Landlord and Tenant. If Tenant fails to notify Landlord that it disapproves of the initial Phase II working drawings within three (3) business days (or, in the case of resubmitted working drawings, within one (1) business day) after the
submission thereof, then Tenant shall be deemed to have approved the working drawings in question. Any delay caused by Tenant’s failure to respond within the time periods set forth in this Section 5.7 as to such Phase II working drawings
shall constitute a Tenant Delay (defined below). As used herein, “Phase II Working Drawings” shall mean the final Phase II working drawings approved by Landlord and Tenant, as amended from time to time by any approved changes
thereto approved by Landlord and Tenant, and “Phase II Work” 

  

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shall mean all improvements to be constructed in the Existing Premises in accordance with and as indicated on the Phase II Working Drawings. Landlord’s
approval of the Phase II Working Drawings shall not be a representation or warranty of Landlord that such drawings are adequate for any use or comply with any law, but shall merely be the consent of Landlord thereto. Tenant shall, at Landlord’s
request, sign the Phase II Working Drawings to evidence its review and approval thereof. After the Phase II Working Drawings have been approved, Landlord shall cause the Phase II Work to be performed in accordance with the Phase II Working Drawings.
Landlord and Tenant presently contemplate that construction of the Phase II Work would commence on or about December 1, 2004. Landlord shall cause the Contractor to construct the Phase II Work to comply with the Phase II Working Drawings and Legal
Requirements. As used herein, “Work” shall mean the Phase I Work and the Phase II Work. As used herein, “Working Drawings” shall mean the Phase I Working Drawings and the Phase II Working Drawings. 
  
 5.8 Phase II Budget. Upon approval of the Phase II Working Drawings by
Tenant and Landlord, and subject to the provision of Section 5.7 above, Landlord shall provide to Tenant, prior to commencement of construction of the Phase II Work, a revised draft of the Preliminary Phase II Budget & Schedule
(“Phase II Final Budget”) showing all line items of the Phase II Work and the schedule of distribution of the Construction Allowance with respect to the Phase II Work. Tenant shall approve or disapprove the Phase II Final Budget
within five (5) business days of receipt, such approval not to be unreasonably conditioned or withheld. If Tenant fails to notify Landlord that it disapproves of the Phase II Final Budget within such five (5) business day period, then Tenant shall
be deemed to have approved the Phase II Final Budget. 
  
 6.
Selection of General Contractor. As soon as reasonably practicable following the later to occur of Landlord and Tenant’s approval of the Phase I Working Drawings and the Preliminary Phase II Budget & Schedule but in any event no
later than the date which is five (5) business days following such approval, Landlord shall seek competitive bids from DPR Construction, Howard Building Corporation, ROEL Construction and Caliber Construction for the cost of constructing the Work
(to be completed on or before October 15, 2004). Landlord shall request that each bid include a provision providing for liquidated damages in the approximate amount of Two Thousand Dollars ($2,000.00) per day for each day after November 1, 2004 that
the New Premises are not Substantially Completed until the day before the date on which the Phase I Work is Substantially Completed, such sum to be passed through from Landlord to Tenant; provided, however, if all of the contractors indicate that
such liquidated damages provision is not commercially reasonable or economically feasible, Landlord shall be under no obligation to provide a liquidated damages clause in the contract with the general contractor selected to perform the Work. At the
completion of the bidding process, Landlord shall submit to Tenant copies of all bids received and a trade by trade comparison analysis of each bidder’s proposal. Landlord and Tenant shall select the general contractor to perform the Work.
Landlord and Tenant shall make such selection based on the following criteria: (i) lowest qualified cost to complete the Work, (ii) completion schedule, (iii) the reputation and experience of the contractor’s specific team assembled for this
project, and in constructing the type of improvements which Tenant contemplates installing in the Premises, and (iv) Landlord’s prior experience with such general contractor in providing first class materials and/or service to the Complex. If
after receipt of all bids, the estimated cost of the Work, including architectural and engineering, construction management, permits, cabling and other items included within the 

  

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Phase I Working Drawings and the Preliminary Phase II Budget & Schedule exceed the Construction Allowance, Tenant may select the contractor in its sole
discretion. If after receipt of the bids, the estimated cost for the Work is equal to or less than the Construction Allowance, Landlord shall be entitled to make the selection of the Contractor provided the bid of the contractor selected called for
Substantial Completion of the Phase I Work on or before October 15, 2004. The contractor selected is hereinafter referred to as the “Contractor”. 
  
 7. Construction Warranties. The Contractor shall guarantee that the Work shall be free from any defects in
workmanship and materials for a period of not less than one (1) year from the date of completion thereof. The Contractor shall be responsible for the replacement or repair, without additional charge, of all work done or furnished in accordance with
its contract which shall become defective within one (1) year after completion of the Work. The correction of such Work shall include, without additional charge, all additional expenses and damages in connection with such removal or replacement of
all or any part of the Work, and/or the building and/or common areas of work which may be damaged or disturbed thereby. All such warranties or guarantees as to materials or workmanship of or with respect to the Work shall be contained in the
contract with the Contractor which shall be so written that such guarantees or warranties shall inure to the benefit of both Landlord and Tenant, as their respective interests may appear, and can be directly enforced by either. 
  
 8. Construction. Landlord shall cause the Contractor to perform
construction of the Work in accordance with the Working Drawings, in a good and workmanlike manner. Subject to Tenant’s payment of the Excess Costs (as defined in Section 13 below), Landlord will bear all costs and expenses to perform the Work
shown on the Working Drawings, including the cost of all permits and other governmental approvals, except as otherwise expressly provided herein. “Substantial Completion” of the Work shall be deemed to have occurred on the date on
which (i) the Architect certifies that the Work has been completed pursuant to the Working Drawings, subject only to the completion or correction of the Punch List Items (as defined below); (ii) a certificate of occupancy or temporary certificate of
occupancy (or its equivalent) for the New Premises (and the Existing Premises, if applicable) has been issued by the governmental agency responsible for issuing such certificate in Orange County; and (iii) Landlord has delivered possession of the
New Premises to Tenant in the condition required under this Amendment. Landlord or its affiliate or agent shall supervise the Work, make disbursements required to be made to the Contractor and other vendors as required to complete the Work, and act
as a liaison between the Contractor and Tenant’s representative and coordinate the relationship between the Work, the Building and the Complex. Kathy McGinley shall be designated as “Tenant’s Representative” in connection
with the Work. In the event Tenant disputes whether or not Substantial Completion has occurred, Tenant shall notify Landlord within five (5) business days after receipt of the Completion Notice. Such dispute shall be mutually resolved by Landlord
and Tenant, each using its good faith commercially reasonable business judgment. Any change orders shall require the approval of Landlord and Tenant’s Representative. In consideration for Landlord’s construction supervision services,
Tenant shall pay to Landlord a construction supervision fee equal to four percent (4%) of the Total Construction Costs (excluding the construction supervision fee). Tenant acknowledges that the Phase II Work will be performed while Tenant is in
occupancy of the Existing Premises. Tenant shall not be entitled to any rental abatement during the performance of the Phase II Work in the Existing Premises; provided, however, Landlord shall use reasonable efforts to minimize any disturbance to
the operation of 

  

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Tenant’s business during the performance of the Phase II Work. Notwithstanding the foregoing, Landlord shall not be obligated to engage overtime labor;
provided, however, if the Final Budget is in excess of $650,000, then Landlord shall engage overtime labor if necessary in order to avoid a material interruption of Tenant’s business caused by the Phase II Work and the cost of such overtime
labor shall be deemed an “Excess Cost” payable by Tenant pursuant to Section 13 below. 
  
 9. Limited Warranty. Landlord warrants that for ninety (90) days following the New Commencement Date, the existing heat, air conditioning and
ventilating (“HVAC”) equipment, and the existing electrical and plumbing and other building systems serving the New Premises are in good working order. Landlord shall repair any defective or malfunctioning component of such systems
of which Landlord has received written notice from Tenant describing the failure or malfunction within ninety (90) days of the New Commencement Date and the cost of repairing such failure or malfunction shall not be charged to Tenant as an operating
expense, repair cost or maintenance cost. Any new or replaced HVAC equipment, electrical equipment and plumbing systems and labor and materials furnished as part of the Work shall be subject to the provisions of Section 4 above. 

 
 10. Punch List. “Punch List Items” shall mean
minor items of incomplete or defective work or materials in the improvements called for in the Working Drawings, which do not materially impair Tenant’s use of the New Premises or the Existing Premises for the conduct of Tenant’s business
therein. When Landlord considers: (A) the Phase I Work in the New Premises to be Substantially Completed and (B) the Phase II Work in the Existing Premises to be Substantially Completed, Landlord will notify Tenant and within three (3) business days
thereafter in each case, Landlord’s representative and Tenant’s Representative shall conduct a walk-through of the Premises and identify any Punch List Items with respect to the Phase I Work or the Phase II Work, as the case may be.
Neither Landlord’s representative nor Tenant’s Representative shall unreasonably withhold his or her agreement on Punch List Items. Landlord shall use diligent and reasonable efforts to cause the Contractor to complete all Punch List Items
within thirty (30) days after agreement thereon. 
  
 11.
Definition of Total Construction Costs. The entire cost of performing the Work including design of the Work and preparation of the Tenant’s programming documents and test fits, Phase I Space Plan, the Phase II Space Plan and the Working
Drawings, including revisions, costs of construction labor and materials, generator, dumb waiter, trenching between the Existing Premises and the New Premises, plan check and permit fees, electrical usage during construction and additional
janitorial services, which costs shall be included in Contractor’s general conditions, general tenant signage, related taxes, insurance costs, costs to repair and reuse or install new telephone and data equipment, and the construction
supervision fee referenced in Section 8 of this Amendment, shall herein collectively called the “Total Construction Costs”. The Total Construction Costs in excess of the Construction Allowance (hereinafter defined) shall be
paid by Tenant. Upon approval of the Phase I Working Drawings and selection of the Contractor, Tenant shall promptly (a) execute a work order agreement prepared by Landlord which identifies such drawings and itemizes the Total Construction Costs and
sets forth the Construction Allowance, and (b) pay to Landlord the amount by which the Total Construction Costs is expected to exceed the Construction Allowance (such prepaid amount is hereinafter referred to as the “Pre-Paid
Amount”) on a pro rata basis monthly (based on percentage of 

  

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completion) as construction of the Work progresses. No changes in the Total Construction Costs, change order approvals or additions to any contracts shall be
made by Landlord after the approval of the Phase I Final Budget by Tenant with respect to the Phase I Work and approval of the Phase II Final Budget by Tenant with respect to the Phase II Work, in either case without Tenant’s written approval,
which approval shall not be unreasonably withheld, conditioned or delayed. 
  
 12. Construction Allowance. Landlord shall provide to Tenant a construction allowance not to exceed $650,000.00 (the “Construction Allowance”) to be applied toward the Total Construction Costs,
as adjusted for any changes to the Work approved by Landlord and Tenant. The Construction Allowance shall not be disbursed to Tenant in cash, but shall be applied by Landlord to the payment of the Total Construction Costs, if, as, and when the cost
of the Work is actually incurred and paid by Landlord. The Construction Allowance must be used within twelve (12) months following the date of this Amendment or shall be deemed forfeited with no further obligation by Landlord with respect thereto.
The foregoing twelve (12) month limitation shall be extended one day for each day of Landlord Delay (as defined in Section 15 below). 
  
 13. Excess Costs. As of the date of this Amendment, the parties anticipate that the Total Construction Costs will exceed the amount of the
Construction Allowance. During the course of construction, once the cost of constructing the Work has exceeded the amount of the Construction Allowance plus the Pre-Paid Amount, Landlord shall provide written notice thereof to Tenant. Following
Landlord’s delivery of such notice to Tenant, Tenant shall be obligated to pay for all billings from Landlord for the cost of the Work in excess of the Construction Allowance and the Pre-Paid Amount (collectively, the “Above-Allowance
Amounts”). The payment of the Above-Allowance Amounts shall be accomplished by increasing Tenant’s share of monthly disbursements provided in Section 11 above. Under no circumstances shall Landlord be required to pay for the
Above-Allowance Amounts. Following Substantial Completion of the Work, if the amount of the Total Construction Costs exceeds the sum of (i) the Construction Allowance, (ii) the Pre-Paid Amount, and (iii) the Above-Allowance Amounts, then Tenant
shall be responsible for such excess costs (collectively, the “Excess Costs”). Under no circumstances (except if to correct deficiencies in the Work which are brought to Landlord’s attention within the Warranty Period) shall
Landlord be required to pay for any Excess Costs. Landlord will invoice Tenant for such Excess Costs; such invoice shall include adequate supporting documentation for the Excess Costs. Tenant shall pay Landlord the amount of the Excess Costs within
twenty (20) days of receipt of such invoice, provided that Tenant approves the amount of the Excess Costs, such approval not to be unreasonably withheld, conditioned or delayed. 
  
 14. Payment of Costs. Except as otherwise set forth herein, Tenant shall pay Landlord for amounts due under this
Amendment within twenty (20) days of billing. Any unpaid portions, whether undisputed or disputed on which Landlord ultimately prevails, shall bear interest from the due date at the annual rate of two percent (2%) above the prime interest rate then
being charged by Bank of America, N.T. & S.A., Los Angeles Main Office, but not to exceed the maximum legal rate permitted to be charged on the date such interest shall commence to accrue. 
  

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 15. Delays. Tenant shall be responsible for, and shall pay to Landlord any and all costs and
expenses incurred by Landlord in connection with any delay in Substantial Completion caused by Tenant and any increase in the cost of Work caused by (i) any changes requested by Tenant in the Work shown on the Working Drawings (including any cost or
delay resulting from proposed changes that are not ultimately made), (ii) any failure by Tenant to timely pay any amounts due from Tenant hereunder, including any additional costs resulting from any change (it being acknowledged that if Tenant fails
to make or otherwise delays making such payments, Landlord may stop work on the Work rather than incur costs which Tenant is obligated to fund but has not yet done so and any delay from such a work stoppage will be a Tenant Delay), (iii) the
inclusion in the Work of any so-called “long lead” materials (such as fabrics, panellings, carpeting or other items that must be imported or are of unusual character or limited availability) which Landlord has informed Tenant, at the time
Tenant selects such item(s), are long-lead items, (iv) any failure by Tenant to respond to inquiries within the time provided in this Amendment or, if not specified, within commercially reasonable time periods, regarding the construction of the Work
or in granting Tenant’s approval of materials or finishes for the Work, or (v) any other delay requested or proximately caused solely by Tenant. Each of the foregoing is referred to herein as a “Tenant Delay”. Tenant Delays do
not include delays in governmental processing or delays caused by Landlord’s failure to perform its obligations hereunder (including preparing items and/or responding within the time periods set forth herein). Landlord shall provide Tenant
written notice promptly following the occurrence of any Tenant Delay specifying Landlord’s good faith estimate of the duration thereof. If Substantial Completion of the Phase I Work is delayed as a result of a Tenant Delay, then the New
Commencement Date shall be deemed to be the date that Substantial Completion of the Phase I Work would have occurred but for any Tenant Delay. In addition, if Tenant requests any changes to the Work described in the Space Plan or the Working
Drawings, then the net increased costs and any additional design costs incurred in connection therewith as the result of any such change shall be added to the Total Construction Costs. In addition, Tenant shall indemnify, protect, defend and hold
Landlord harmless from all claims arising from or in connection with all damages sustained by Landlord as a result of any Tenant Delay. As used herein, a “Landlord Delay” shall mean any delay in the Substantial Completion of the
Work that occurs due to Landlord’s failure to complete any action item on or before the due date required hereunder. In calculating the date of Substantial Completion of the Work, one day shall be deducted from the aggregate of Tenant Delay
days for each day of Landlord Delay. 
  
 16. Early Occupancy
Period. Landlord shall: (i) use commercially reasonable efforts to provide Tenant with early access to the New Premises, (ii) provide written notice to Tenant of the date such early access shall commence (the “Access Date”), and
(iii) use commercially reasonable efforts to provide such early access commencing on the date which Landlord estimates to be thirty (30) business days for telecom and cabling work and fifteen (15) business days for all other Tenant work prior to the
estimated date of Substantial Completion of the Phase I Work. Such early occupancy shall be subject to all of the terms and conditions of the Lease, except for Tenant’s obligation to pay Base Rent and Tenant’s Share of Operating Expenses,
Tax Expenses and Common Area Utility Costs with respect to the New Premises (which obligation shall commence upon the New Commencement Date). Such period of early occupancy, if any, shall commence on the Access Date and continue through the date
immediately preceding the New Commencement Date (“Early Occupancy Period”). During the Early Occupancy Period, Tenant may enter the New Premises for the purpose of installing telephones, electronic 

  

 10 

 
communication or related equipment, fixtures, furniture and equipment, provided that Tenant shall be solely responsible for any of such equipment, fixtures
and furniture and for any loss or damage thereto from any cause whatsoever, except to the extent caused solely by Landlord’s gross negligence or willful misconduct. Such early access to the New Premises and such installation shall be permitted
only to the extent that Landlord reasonably determines that such early access and installation activities will not delay Landlord’s completion of the Phase I Work. Landlord and Tenant shall cooperate in the scheduling of Tenant’s early
access to the New Premises and of Tenant’s installation activities in an attempt to maximize the benefits to Tenant of this Section 5 without interfering with Landlord’s completion of the construction of the Phase I Work. The
provisions of Section 10 and Section 12 of the Original Lease shall apply in full during the Early Occupancy Period, and Tenant shall (i) provide certificates of insurance evidencing the existence and amounts of liability insurance carried by Tenant
and its agents and contractors, reasonably satisfactory to Landlord, prior to such early entry, and (ii) comply with all applicable laws, regulations, permits and other approvals applicable to such early entry work in the New Premises.
Notwithstanding the foregoing, if such early access or installation delays or interferes with Landlord’s construction of the Phase I Work, or increases the cost of the Phase I Work, the same shall be a Tenant Delay. 
  
 17. Extension of Term. Upon the New Commencement Date, the term of the
Lease for the Premises shall be extended (the “New Extended Term”) so that the expiration date of the Lease shall be the last day of the sixtieth (60th) full calendar month following the New Commencement Date (such date is hereinafter referred to as the “New Expiration Date”). The New
Commencement Date and the New Expiration Date shall be confirmed in writing by the parties following the occurrence of the New Commencement Date. The New Extended Term may be extended, at Tenant’s election, in accordance with the provisions of
Exhibit I attached hereto. 
  
 18. Base Rent. To
reflect the addition of the New Premises to the Lease, effective as of the New Commencement Date, and continuing thereafter throughout the New Extended Term, Tenant shall pay to Landlord Base Rent in advance on or before the first day of each
calendar month, for the entirety of the Premises, as follows: 
  

			
	 Lease Months:

	  	 Monthly Base Rent:

	 1          
	  	$32,375.95
	 2 – 4    
	  	$         0.00
	 5 – 12  
	  	$32,375.95
	 13 – 24
	  	$41,852.40
	 25 – 36
	  	$43,596.25
	 37 – 48
	  	$45,340.10
	 49 – 60
	  	$47,083.95

  
 The first “Lease
Month” shall be the period commencing on the New Commencement Date (as such date may be accelerated pursuant to Section 15) and ending on the last day of the first (1st) full calendar month thereafter. The first (1st) monthly
installment of Base Rent in the amount of $32,375.95 shall be payable contemporaneously with the execution of this Amendment by Tenant; payment for a partial month following the New Commencement Date shall be payable within five (5) days of the New
Commencement Date. Thereafter, Base Rent shall be payable on 

  

 11 

 
the first (1st) day of each month beginning on the first (1st) day of the fifth (5th) full calendar month of the New Extended Term. Effective as of the New Commencement Date, Section 5 of the Second Amendment is hereby deleted in its entirety.

  
 19. Modification of Tenant’s Share. To reflect the
addition of the New Premises to the Lease, effective as of the New Commencement Date, the provisions of Article 6 of the Lease shall apply to the combined New Premises and the Existing Premises and Tenant’s Share shall be 16.2% with respect to
the combined New Premises and Existing Premises. The first (1st) monthly installment of Operating Expenses, Tax Expenses and Common Area Utility Costs in the amount of $10,502.00 for the entirety of the Premises (which amount represents the sum of
$4,050.00 with respect to the Existing Premises and $6,452.00 with respect to the New Premises) shall be payable contemporaneously with the execution of this Amendment by Tenant; thereafter, the estimated amount of Tenant’s Share of the
foregoing costs shall be payable on the first (1st) day of each month beginning on the first (1st) day of the second (2nd) full calendar month of the New Extended Term and otherwise in accordance with the terms of the Lease, as amended hereby.

  
 20. Security Deposit/Letter of Credit. 
  
 20.1 Existing Security Deposit. The parties hereto acknowledge that
Landlord is currently holding a security deposit in the amount of $26,575.00 and shall continue to hold such deposit in accordance with the terms of the Lease during the New Extended Term. As of the date hereof, Paragraph 39 of Addendum I to the
Lease shall be void and of no further force and effect. 
  
 20.2
Letter of Credit. Tenant acknowledges that Landlord is unwilling to execute this Amendment unless Tenant provides Landlord with additional security for Tenant’s obligations under the Lease, as amended hereby. Therefore, Tenant shall
deliver to Landlord, on the date that Tenant executes and delivers this Amendment to Landlord, an Irrevocable Standby Letter of Credit (“Letter of Credit”) which shall (1) be issued by a bank reasonably acceptable to Landlord with
minimum assets of Ten Billion Dollars ($10,000,000,000.00), upon which presentment may be made in San Francisco or Los Angeles, California, (2) be in an amount equal to Two Hundred Fifty Thousand and 00/100 Dollars ($250,000.00), (3) allow for
partial and multiple draws thereunder, and (4) have an expiration date not earlier than sixty (60) days after the New Premises Expiration Date or in the alternative, have a term of not less than one (1) year and be automatically renewable for an
additional one (1) year period unless, on or before the date thirty (30) days prior to the expiration of the term of such Letter of Credit, the issuer of such Letter of Credit gives notice via U.S. registered mail to Landlord of its election not to
renew such Letter of Credit for any additional period pursuant thereto. In addition, the Letter of Credit shall provide that, in the event of Landlord’s assignment of its interest in the Lease, as amended hereby, the Letter of Credit shall be
freely transferable by Landlord, without charge, to the assignee. The Letter of Credit shall provide for same day payment to Landlord upon the issuer’s receipt of a sight draft from Landlord together with Landlord’s certificate certifying
that either: (i) the requested sum is due and payable from Tenant and Tenant has failed to pay, or (ii) Landlord has received notice of nonrenewal of the Letter of Credit and a replacement Letter of Credit has not been received, and with no other
conditions. Tenant agrees that it shall from time to time, 

  

 12 

 
as necessary, whether as a result of a draw on the Letter of Credit by Landlord pursuant to the terms hereof or as a result of the expiration of the Letter
of Credit then in effect, renew or replace the original and any subsequent Letter of Credit so that a Letter of Credit, in the amount required hereunder, and satisfying all the conditions hereof, is in effect until a date which is at least sixty
(60) days after the New Expiration Date. If Tenant fails to furnish such renewal or replacement at least thirty (30) days prior to the stated expiration date of the Letter of Credit then held by Landlord, Landlord may draw upon such Letter of Credit
and hold the proceeds thereof (and such proceeds need not be segregated) as a security deposit pursuant to the terms of Section 20.6 below. 
  
 20.3 Additional Letter of Credit. In the event that Tenant is in default of its obligations under the Lease after the expiration of any applicable
grace period set forth in the Lease, then Landlord shall have the right, at any time after such event, without giving any further notice to Tenant, to draw upon said Letter of Credit (or Additional Letter of Credit, as defined below, as the case may
be) (a) the amount necessary to cure such default or (b) if such default cannot reasonably be cured by the expenditure of money, to exercise all rights and remedies Landlord may have on account of such default, the amount which, in Landlord’s
opinion, is necessary to satisfy Tenant’s liability in account thereof. In the event of any such draw by Landlord, Tenant shall, within twenty (20) days of written demand therefor, deliver to Landlord an additional Letter of Credit satisfying
the conditions specified in Section 20.2 above (“Additional Letter of Credit”), except that the amount of such Additional Letter of Credit shall be the amount of such draw. Tenant’s failure to provide the Additional
Letter of Credit upon written notice from Landlord shall be a material breach of the Lease, as amended hereby. In addition, in the event of a termination based upon the default of Tenant under the Lease, as amended hereby, or a rejection of the
Lease, as amended hereby, pursuant to the provisions of the Federal Bankruptcy Code, Landlord shall have the right to draw upon the Letter of Credit (from time to time, if necessary) to cover the full amount of damages and other amounts due from
Tenant to Landlord under the Lease, as amended hereby. Any amounts so drawn shall, at Landlord’s election, be applied first to any unpaid rent and other charges which were due prior to the filing of the petition for protection under the Federal
Bankruptcy Code. Any such draw on the Letter of Credit shall not constitute a waiver of any other rights of Landlord with respect to Tenant’s default under the Lease, as amended hereby. Tenant hereby covenants and agrees not to oppose, contest
or otherwise interfere with any attempt by Landlord to draw upon said Letter of Credit including, without limitation, by commencing an action seeking to enjoin or restrain Landlord from drawing upon said Letter of Credit. Tenant also hereby
expressly waives any right or claim it may have to seek such equitable relief. In addition to whatever other rights and remedies it may have against Tenant if Tenant breaches its obligations under this paragraph, Tenant hereby acknowledges that it
shall be liable for any and all damages which Landlord may suffer as a result of any such breach. 
  
 20.4 Reduction in Letter of Credit. Notwithstanding the foregoing provisions of this Section 9 to the contrary, on the date which is the
first to occur of: (i) the date on which Tenant receives governmental (FDA) approval of its experimental drug commonly known as “Istalol”, (ii) the date on which Tenant receives governmental (FDA) approval of its experimental drug commonly
known as “Vitrase”, (iii) the date on which Tenant provides evidence to Landlord that Tenant has raised an additional $25,000,000.00 in additional cash, 

  

 13 

 
or (iv) August 31, 2006 (the “Reduction Date”), Tenant may replace the then current Letter of Credit either: (y) with a letter of credit in
the amount of $47,083.75, but in all other respects in conformance with the Letter of Credit described in Section 20.2 above, or (z) with a cash security deposit in the amount of $47,083.75, (which is inclusive of the twenty-six thousand five
hundred seventy-five dollars ($26,575.00) already held by Landlord), which deposit shall be held by Landlord in accordance with the terms of Section 20.6 below; provided, however, that Tenant may not reduce the amount of the Letter of Credit
if Tenant has been in default of any provision of the Lease, as amended hereby, more than two (2) times during the Term of the Lease (including the New Extended Term), preceding the date of the proposed reduction. 
  
 20.5 Cash Proceeds. In the event that Tenant fails timely to deliver
to Landlord a replacement letter of credit when required hereunder, then Landlord shall have the right, at any time after such event, without giving any further notice to Tenant, to draw down the entire Letter of Credit (and/or Additional Letter(s)
of Credit) and to hold the proceeds thereof in the same manner as a security deposit pursuant to the terms of Section 20.6 below. 
  
 20.6 Security Deposit. In the event that Landlord holds any cash proceeds from the Letter of Credit, such proceeds (hereinafter, a
“Security Deposit”) shall be held by Landlord in accordance with the terms of this Section 20.6. Such proceeds shall be held by Landlord as security for the faithful performance and observance by Tenant of all the terms,
covenants and conditions of the Lease, as amended hereby, it being expressly understood that the Security Deposit shall not be considered an advance payment of rental or measure of Landlord’s damages in case of default by Tenant. Upon default
by Tenant which is not cured within the applicable grace period set forth in the Lease, Landlord, from time to time, without prejudice to any other remedy, may (but shall not be required to) apply the Security Deposit against any arrearages of Base
Rent, Additional Rent, or any other damage, injury, loss, cost, expense or liability caused to Landlord by such default on the part of Tenant. Should all or any part of the Security Deposit be used for the purposes described above during the New
Extended Term, then Tenant shall remit to Landlord immediately (and in all events within not more than five (5) business days) after Landlord’s request therefor, the amount necessary to restore the Security Deposit to its original balance.
Tenant’s failure to restore the Security Deposit upon written notice from Landlord shall be a material breach of the Lease, as amended hereby. Upon any termination of Landlord’s interest in the Premises, Landlord shall have no further
obligation to Tenant with respect to the Security Deposit or any other sums due hereunder and prepaid by Tenant upon transfer of the Security Deposit and any other such sums to Landlord’s successor in interest. No interest shall be payable on
the Security Deposit and Landlord shall have no obligation to keep the Security Deposit separate from its general funds unless otherwise required by applicable law. To the extent that Landlord has not previously drawn upon any Letter of Credit,
Additional Letter of Credit or funds being held as a Security Deposit (collectively, “Collateral”) held by Landlord, and to the extent that Tenant is not otherwise in default of its obligations under the Lease as of the New
Expiration Date (as it may be extended), Landlord shall return such Collateral to Tenant following the expiration of the New Extended Term; provided, however, that in no event shall any such return be construed as an admission by Landlord that
Tenant has performed all of its covenants and obligations hereunder. In no event shall the proceeds of any Letter of Credit be deemed to be a prepayment of rent nor shall it be considered as a measure of liquidated damages. 
  

 14 

 21. Insurance. The references to $2,000,000.00 for “combined single limit” and
“$1,000,000.00” for bodily injury limit in the Basic Lease Information of the Original Lease are hereby deleted and “$5,000,000.00” is hereby substituted therefor in each instance. The following change is hereby made to Section
12.A. of the Original Lease: 
  
 The phrase “One Million
Dollars ($1,000,000.00) for injury or death of one person in any one accident or occurrence and in the amount of not less than Two Million Dollars ($2,000,000.00) for injury or death of more than one person in any one accident or occurrence”
shall be deleted and the following language shall be substituted therefor: “a combined single limit of not less than Five Million Dollars ($5,000,000.00) per occurrence”. 
  
 Tenant may satisfy the insurance requirements set forth in the Lease, as amended hereby, through the provision of an umbrella policy.

  
 22. Temporary Premises. Notwithstanding anything to the
contrary in this Amendment, if Landlord is unable to tender possession of the New Premises to Tenant in the condition required by this Amendment on or before October 15, 2004, then Landlord shall lease to Tenant, and Tenant shall lease from
Landlord, those certain premises in the Complex located at 15273 Alton Parkway, Suite 200, Irvine, California, containing approximately 4,705 square feet, as temporary premises (the “Temporary Premises”) for the operation of
Tenant’s business. The Temporary Premises shall be leased to Tenant in its “as is” condition under all the terms and conditions of the Lease, including without limitation Sections 10 and 12, subject to the following: 
  
 22.1 Base Rent. Tenant shall not be obligated to pay Base Rent for the
Temporary Premises unless Tenant fails to surrender the Temporary Premises on the date which is fifteen (15) days following the New Commencement Date in which event Tenant shall be obligated to pay $500.00 per day until the date on which Tenant
surrenders the Temporary Premises to Landlord. 
  
 22.2
Tenant’s Share. Commencing on the date that Tenant takes occupancy of the Temporary Premises, Tenant shall be obligated to pay Operating Expenses, Tax Expenses and Common Area Utility Costs. Tenant’s Share with respect to the
Temporary Premises is 2.18%. 
  
 22.3 Alterations. Tenant
shall not make any Alterations to the Temporary Premises, except that Tenant may install, at Tenant’s sole cost and expense, its data and telecommunications wiring and cabling and its own security system (the “Temporary Premises
Improvements”), all in accordance with the provisions of the Lease. Upon execution of this Amendment by Landlord and Tenant, Landlord shall provide Tenant with access to the Temporary Premises for the sole purpose of installing the
Temporary Premises Improvements; such early access shall be subject to all of the terms and conditions of the Lease, except for the payment of Base Rent for the Temporary Premises which shall not be payable except as required pursuant to Section
22.1 above. 
  

 15 

 22.4 Term for Temporary Premises. Tenant’s lease of the Temporary Premises shall terminate on
the date which is fifteen (15) days following the New Commencement Date; provided, however, that if the New Commencement Date does not occur by November 1, 2004, on such date the lease of the Temporary Premises shall convert to a month-to-month
tenancy, which may be terminated by either party upon not less than thirty (30) days prior written notice to the other party. 
  
 23. Antenna Installation. Tenant shall be permitted, at no additional charge to Tenant, to install a satellite antenna on the roof of the building
in which the New Premises and the roof of the Existing Premises are located, subject to the following terms and conditions: 
  
 (a) Subject to Tenant obtaining and maintaining all required governmental approvals, Tenant shall be permitted to install (i) a satellite
antenna upon a location on the roof of the Building as designated by Landlord in Landlord’s sole discretion, having a diameter not to exceed 48” (the “Antenna”), in a location reasonably satisfactory to Landlord, as well
as (ii) cabling in the building conduits as reasonably necessary for the operation of the Antenna, all of the foregoing to be subject to the following terms and conditions (the “Antenna Installation”); provided, however, such
Antenna Installation shall not penetrate the roof of the building on which the Antenna is installed if there is an existing conduit for such cabling. In the event that no such conduit exists, then: (A) any new roof penetration must be approved by
Landlord prior to the Antenna Installation, such approval not to be unreasonably withheld so long as the proposed roof penetration will not impair or invalidate Landlord’s roof warranty, (B) such roof penetration shall be performed by
Landlord’s approved roofing contractor in order to preserve Landlord’s roof warranty, and (C) Tenant shall reimburse Landlord for any out of pocket costs actually incurred by Landlord in reviewing Tenant’s plans for such roof
penetration and in inspecting the roof after the Antenna Installation. Tenant acknowledges that Landlord’s considerations in determining such approval include engineering, structural and aesthetic considerations. All roof penetrations and roof
repairs shall be performed by a duly licensed and bonded roofer approved in writing by Landlord. The screen wall shall completely shield the Antenna from view except from a vantage point directly above same. 
  
 (b) Tenant shall submit to Landlord, for Landlord’s
prior written approval, which approval shall not be unreasonably withheld or delayed, complete plans and specifications for the Antenna and Antenna Installation not less than thirty (30) days prior to its estimated installation. Tenant shall be
responsible for determining the sufficiency of the roof structure to support the live and static load of the Antenna and screen wall. Landlord shall provide such information concerning the same in Landlord’s possession or control promptly
following Tenant’s request therefor. Tenant shall install the Antenna without voiding Landlord’s roofing bond and, if required by Landlord, Tenant shall employ the services of Landlord’s designated roofing contractor. If required by
Landlord, Tenant shall, at its own cost and expense, install catwalks to the location of the Antenna. Within a period of thirty (30) days after Landlord has given its approval of Tenant’s aforesaid plans and specifications, Tenant shall
complete the Antenna Installation. 
  
 (c) Upon
reasonable notice to Landlord, Tenant shall be permitted access to the Antenna and the roof of the building, subsequent to the Antenna Installation and during the term of the Lease, as necessary for the proper maintenance thereof. 
  

 16 

 (d) Prior to the expiration (or sooner termination) of the Lease, so long as Tenant is
not in default, upon reasonable notice to Landlord, Tenant shall be permitted access to the roof of the Building to remove the Antenna; provided, however, that Tenant, at Tenant’s sole cost and expense, shall repair any damage related thereto
and shall restore the roof to the same condition as existed prior to the Antenna Installation, ordinary wear and tear excepted. 
  
 (e) Under no circumstances will Tenant knowingly permit the operation of the Antenna to interfere with or otherwise impede the operations
of any other communication, electronic transmission or other similar system operating in, to or from the Complex; and, in the event operation of Tenant’s Antenna does so interfere with or otherwise impede any other communication, transmission
or similar system and Tenant fails to remove the Antenna or otherwise abate such interference or impedance within five (5) business days of receipt of written notice thereof from Landlord, then Landlord shall be permitted to remove the Antenna, at
Tenant’s sole cost and expense, as if the term of the Lease had expired. 
  
 (f) Under no circumstances shall Tenant use the Antenna and Antenna Installation for any purpose other than Tenant’s ordinary business use in furtherance of Tenant’s use as permitted under the Lease, for the
sole benefit of Tenant. In clarification and not limitation of the immediately preceding sentence, Tenant shall not “re-sell” or lease, sublease, license or otherwise permit the use of all or any portion of the signals or bandwidth or
other electromagnetic emissions from or to the Antenna, by any other tenant in the Complex or by any other party or person whatsoever (other than Tenant), unless so permitted by Landlord in its sole and absolute discretion. 
  
 (g) During the period of time that the Antenna is in use by
Tenant, the Antenna Installation and the Antenna shall be subject to all of the provisions of the Lease, as amended hereby, including, without limitation, the insurance coverage requirements of Article 12 and the indemnification provisions in
Article 13 of the Lease, as amended hereby. Tenant shall indemnify Landlord and hold Landlord harmless from and against all loss, claims, actions, damages, liability and expense in connection with loss of life, personal injury, damage to property,
or any other loss or injury whatsoever arising from, or out of, the Antenna Installation and/or Tenant’s use of the Antenna. 
  
 24. Real Estate Brokers. Tenant represents and warrants that it has negotiated this Amendment directly with Studley, Inc. (“Tenant’s
Broker”) and CB Richard Ellis (“Landlord’s Broker”) and has not authorized or employed, or acted by implication to authorize or to employ, any other real estate broker or salesman to act for Tenant in connection with
this Amendment. Tenant shall indemnify, defend and hold Landlord harmless from and against any and all claims by any other real estate broker or salesman claiming to represent Tenant and claiming entitlement to a commission, finder’s fee or
other compensation as a result of Tenant’s entering into this Amendment. Landlord shall pay a commission to Landlord’s Broker and Tenant’s Broker pursuant to separate agreements. Notwithstanding the foregoing, in no event shall
Landlord be required to pay Tenant’s Broker any construction management, space planning or project management fees in connection with this Amendment. 
  

 17 

 25. Parking. Effective as of the New Commencement Date, Tenant shall have use of one hundred and
eighteen (118) nonexclusive and undesignated parking spaces (for the combined Existing Premises and the New Premises), subject to the terms of the Lease. 
  
 26. Signage. Subject to (i) compliance with Landlord’s signage criteria, (ii) compliance with all applicable rules, regulations and laws, and
(iii) the approval of any governmental authority with jurisdiction over the building in which the New Premises are located, Tenant shall have the right to install building-side signage similar to that on the Existing Premises and building door
signage with respect to the New Premises. 
  
 27. SNDA.
Concurrently with the execution of this Amendment, Landlord shall use diligent commercially reasonable efforts to provide Tenant with a commercially reasonable nondisturbance agreement for Tenant’s benefit (on its Lender’s standard form
which is attached hereto as Exhibit J [the “SNDA”]) from the beneficiary of that certain Deed of Trust, Security Agreement, Fixture Filing and Financing Statement dated January 27, 2000 naming The Prudential Insurance Company
of America (“Lender”) as the beneficiary and covering the Complex which was recorded on January 27, 2000, as Document No. 20000047965, in the Official Records of Orange County, California (the “Mortgage”).
Notwithstanding the foregoing, Landlord’s failure to obtain such agreement shall not constitute a default by Landlord hereunder provided Landlord has employed diligent commercially reasonable efforts to obtain same from Lender. If Lender
notifies Tenant that either (a) Lender is exercising its rights under the Mortgage following a default under the Mortgage, or (b) of Lender’s succeeding to the Landlord’s interest under the Lease, and in either event, Tenant pays rents due
under the Lease directly to Lender, then Landlord waives any and all claims against Tenant if Tenant responds to any such requests by Lender and such payment to Lender shall be deemed a payment to Landlord for the purposes of the Lease. Tenant shall
reimburse Landlord within ten (10) days of demand therefor for all costs charged by Lender in connection with Lender’s review and execution of the SNDA. 
  
 28. Authority. Each party hereto hereby covenants and warrants on its own behalf that (a) it is in good standing under the laws of the States of
California and Delaware, (b) it has full corporate power and authority to enter into this Amendment and to perform all its obligations under the Lease, as amended by this Amendment, and (c) each person (and all of the persons if more than one signs)
signing this Amendment on behalf of such party is duly and validly authorized to do so. 
  
 29. No Offer. Submission of this instrument for examination and signature by Tenant does not constitute an offer to lease or a reservation of or option for lease, and this instrument is not effective as a lease
amendment or otherwise until executed and delivered by both Landlord and Tenant. 
  
 30. Exhibits. Exhibits A3, I and J attached hereto shall be incorporated into the Lease, as amended hereby. 
  
 31. Entire Agreement. This Amendment, together with the Lease, constitutes the entire agreement between Landlord and
Tenant regarding the Lease and the subject matter 

  

 18 

 
contained herein and supersedes any and all prior and/or contemporaneous oral or written negotiations, agreement or understandings. 
  
 32. Incorporation. The Lease, as modified herein, remains in full
force and effect, and the parties hereby ratify the same. This Amendment shall be binding upon the parties and their respective successors and assigns. 
  
 IN WITNESS WHEREOF, Landlord and Tenant have executed this Amendment as of the day and year first written above. 
  

									
	 LANDLORD:
	 	 	 	 TENANT:

			
	 ALTON PLAZA PROPERTY, INC.,
 a Delaware corporation
	 	 	 	 ISTA PHARMACEUTICALS, INC.,
 a Delaware corporation

					
	By:	 	/s/ Daniel J. Bradley	 	 	 	By:	 	/s/ Vicente Anido, Jr., Ph.D.
					
	Name:	 	Daniel J. Bradley	 	 	 	Name:	 	Vicente Anido, Jr., Ph.D.
					
	Title:	 	President	 	 	 	Title:	 	President and Chief Executive Officer
					
	 	 	 	 	 	 	By:	 	 
					
	 	 	 	 	 	 	Name:	 	 
					
	 	 	 	 	 	 	Title:	 	 

  

 19 

 EXHIBIT A-3 
  
 Plan of New Premises 
  

 EXHIBIT I 
  

Renewal Option 
  
 Tenant shall have the right to renew the term of the Lease for one (1) five (5)-year term upon prior written notice (“Tenant’s Election
Notice”) to Landlord given not sooner than nine (9) months nor later than six (6) months prior to the expiration of the New Extended Term; provided that at the time Tenant gives such notice to Landlord and for the remainder of the New
Extended Term (i) the Lease has not been assigned and Tenant (or its corporate successor) continues to occupy at least eighty percent (80%) of the Premises and (ii) Tenant is not in default under the Lease beyond any applicable cure period. During
the renewal term, the provisions of the Lease, as it may be amended in writing prior to the date of the commencement of such renewal term, shall continue in full force and effect except that Tenant shall occupy the Premises in its then “AS
IS” condition and there shall be no abatement of rent, nor shall there be credit or allowances given to Tenant for improvements to the Premises, and the Base Rent will be the then fair market rent determined as provided herein; provided,
however, in no event shall the Base Rent for such renewal term be less than the amount of Base Rent payable by Tenant immediately prior to the commencement of such renewal term. On request, Landlord shall give Tenant the rates it is quoting to
prospective tenants for new leases of comparable space in the Complex for a comparable term (as confirmed by written statement to Tenant by a representative of Landlord). It is understood and agreed that Tenant’s submittal of Tenant’s
Election Notice shall bind Tenant to a five (5)-year extension of the Lease. At Landlord’s request, the parties shall promptly memorialize the Base Rent for the renewal term in a writing to be prepared by Landlord. 
  
 The “fair market rent” shall be based on the rental amounts
that tenants are paying in then-current transactions between landlords and non-affiliated parties for new or renewal, non-expansion (unless the expansion is pursuant to a comparable definition of fair rent), and non-equity tenants, for comparable
space (in size and height), for a comparable use for a comparable period of time within the City of Irvine (Irvine Spectrum submarket), California, as of the expiration of the New Extended Term (“Comparable Transactions”). In any
determination of Comparable Transactions, appropriate consideration shall be given to the annual rental rates per square foot (e.g., whether increases in additional rent are determined on a net or gross basis), parking rights and obligations,
signage rights, abatement provisions reflecting free rent and/or no rent during the period of construction or subsequent to the commencement date as to the space in question, brokerage commissions, if any, which would be payable by Landlord in
similar transactions, length of lease term, size and location of premises being leased, building standard work letter and/or tenant improvement allowances, if any, the condition of the base building and the landlord’s responsibility with
respect thereto, the value, if any, of the existing tenant improvements (with such value being judged with respect to the utility of such existing tenant improvements to a general business tenant and not to a particular tenant) and other generally
applicable conditions of tenancy for such Comparable Transactions. 
  
 If by the
date thirty (30) days following delivery of Tenant’s Election Notice, Landlord and Tenant have not agreed in writing as to the amount of the Base Rent for such renewal term, the parties shall determine the fair market rent in accordance with
the following procedure. Landlord and Tenant shall each appoint one real estate appraiser, and the two so appointed shall select a third. Said real estate appraisers shall each be licensed in the State of California, specializing in the field of
commercial real estate in the City of Irvine, California, having no less than ten (10) years experience in such field, unaffiliated with either Landlord or Tenant, and recognized as ethical and reputable within their field. Landlord and Tenant agree
to make their appointments promptly within ten (10) days after expiration of the thirty (30) day negotiation period, or sooner if mutually agreed upon. The two appraisers selected by Landlord and Tenant shall promptly select a third appraiser within
fifteen (15) days after they both have been appointed, and each appraiser, within thirty (30) days after the third appraiser is selected, shall submit his or her determination of the then projected fair market rent. The Base Rent shall be the mean
of the two closest rental determinations. 
  

 EXHIBIT J 
  

Form of SNDA 
  
 Prudential Loan No. 6103765 
  
 SUBORDINATION, NON-DISTURBANCE AND ATTORNMENT AGREEMENT 
  
 THIS AGREEMENT (“Agreement”) made as of the      day of
            , 2004, between THE PRUDENTIAL INSURANCE COMPANY OF AMERICA (together with its successors or assigns in interest, collectively “Lender”) and ISTA
PHARMACEUTICALS, INC., a Delaware corporation (“Tenant”). 
  
 R E C I T A L S: 
  
 A. Lender is
the owner and the holder of a loan evidenced by a promissory note (the “Note”) dated January 27, 2000 in the face amount of $7,500,000.00. The Note is secured by a Deed of Trust, Security Agreement, Fixture Filing and Financing Statement
(the “Mortgage”) dated the same date as said Note, and recorded on January 27, 2000 as Document No. 20000047965 in the Real Property Records of Orange County, California, covering the real property described therein (the
“Mortgaged Premises”). 
  
 B. Tenant is the
tenant under that certain Lease Agreement dated September 13, 1996 (as amended, the “Lease”), between Tenant and ALTON PLAZA PROPERTY, INC., a Delaware corporation as landlord (said landlord and its successors and assigns under the
Lease hereinafter called “Landlord”), covering all or part of the Mortgaged Premises as set forth under the Lease (hereinafter called the “Demised Premises”). 
  
 C. Tenant and Lender desire to confirm their understanding with respect to
the Lease and the Mortgage. 
  
 THEREFORE, in consideration of the
mutual covenants and agreements herein contained and other good valuable consideration, the receipt and sufficiency of which are hereby acknowledged by all parties, Lender and Tenant agree as follows: 
  
 1. Subordination. The Lease is now, and will at all times and for all
purposes be, subject and subordinate, in every respect, to the Mortgage, with the provisions of the Mortgage and this Agreement controlling over the provisions of the Lease. The Lease is subordinate and subject, in each and every respect, to any and
all increases, renewals, modifications, extensions, substitutions, replacements and/or consolidations of the Mortgage, (collectively a “Modification”), and all other loan documents securing the Note, provided that any and all
Modifications shall nevertheless be subject to the terms of this Agreement. 
  
 2. Non-Disturbance. So long as Tenant complies with all of the terms, provisions, agreements, covenants, and obligations set forth in the Lease after the expiration of any applicable cure period, Tenant’s
possession of the Demised Premises under said Lease shall not be disturbed or interfered with by Lender. 
  

 3. Attornment. If Lender or any other party succeeds to the interest of Landlord under the Lease
in any manner, including but not limited to foreclosure, exercise of any power of sale, succession by deed in lieu or other conveyance (a “Succession”), Tenant will attorn to and be bound to such party (whether Lender or another
party) upon such Succession and will recognize Lender or such other party as the landlord under the Lease. Such attornment is effective and self-operative without the execution of any further instrument. Tenant, upon request, will sign and deliver
any instruments reasonably requested to evidence such attornment. Tenant waives the provisions of any statute or rule of law, now or hereafter in effect, which may give or purport to give Tenant any right or election to terminate or otherwise
adversely affect the Lease and the obligations of Tenant thereunder as a result of any such foreclosure or trustee’s sale. 
  
 4. Limitation On Lender’s Liability. Upon any Succession, Lender shall not be (a) liable for any act or omission of the Landlord under said
Lease, (b) subject to any offsets or defenses which Tenant may have against the Landlord arising or occurring due to an event prior to the Succession, (c) bound by any rent or additional rent which Tenant may have paid to Landlord for more than the
current month, (d) bound by any amendment or modification of the Lease made without Lender’s prior written consent, (e) liable for any security deposit paid by Tenant to Landlord unless such deposit is delivered to Lender, (f) liable for or
obligated to pay for repairs, replacements, damages or allowances not made, performed or paid by the Landlord if such performance or payment was due prior to the Succession, or (g) liable for the payment of any leasing commissions, the triggering
event for which arose or occurred prior to the Succession. Any reference to Landlord includes all prior landlords under the Lease. Neither Lender nor any party taking under a Succession shall be liable for the performance of the obligations of the
Landlord under the Lease, except for those obligations which arise during the period of Lender’s or such entity’s or person’s ownership of the Mortgaged Premises. 
  
 5. Tenant’s Warranty. Tenant warrants to Lender, as of the date hereof, that (a) attached is a true, correct and
complete copy of the Lease, (b) there are no known defaults on the part of Landlord, (c) the Lease is a complete statement of the agreement of the parties with respect to the leasing of the Demised Premises, (d) the Lease is validly executed by
Tenant and in full force and effect. Tenant acknowledges and warrants to Lender that it has not subordinated the Lease or any of its rights under the Lease to any lien or mortgage other than the Mortgage. 
  
 6. Lender Cure Rights. Thirty (30) days before exercising any of its
rights and remedies under the Lease for a landlord default, Tenant will send written notice to Lender at Suite 4900E, 2200 Ross Avenue, Dallas, Texas 75201, referencing Loan Number
                     by certified mail, return receipt requested, of the occurrence of any default by Landlord and will specify with
reasonable clarity the events constituting such default. If the referenced default would entitle Tenant to cancel the Lease or abate the rent payable thereunder, no such cancellation or abatement of rent will be effective unless Lender receives
notice in the form and manner required by this Paragraph 6 and fails (a) within thirty (30) days of the date of the receipt of such notice by Lender to cure or cause to be cured any default which can be cured by the payment of money and (b) to cure
or caused to be cured within sixty (60) days of the receipt of such notice any default which cannot be cured by the payment of money (“Non-Monetary Default”); provided, however, that if the Non-Monetary Default is not
capable of cure within such sixty-day period, no cancellation or abatement by Tenant will be effective as to Lender unless Lender fails within the original sixty (60) day period to commence and diligently 

  

 
prosecute the cure of such default to completion. Tenant will accept cure of any Landlord default by Lender. 
  
 7. Rent Payment. Immediately upon written notice to Tenant (a) that
Lender is exercising its rights under the Mortgage or any other loan documents acting to secure the Note following a default under the Loan, or (b) of Lender’s succeeding to the Landlord’s interest under the Lease, Tenant agrees to pay all
rents due under the Lease directly to Lender (in accordance with the Lease). 
  
 8. Complete Agreement. This Agreement supersedes, as between the parties hereto, all of the terms and provisions of the Lease which are inconsistent herewith. 
  
 9. No Oral Modification/Binding Effect. This Agreement may not be
modified orally or in any manner other than by an agreement in writing signed by the parties hereto or their respective successors in interest. This Agreement shall inure to the benefit of and be binding upon the parties hereto and their successors
and assigns. 
  
 10. Laws. This Agreement shall be
construed in accordance with the laws of the State where the Mortgaged Premises are located. 
  
 11. Automatic Amendment of Lease. Upon a Succession, the Lease is automatically amended as follows: 
  
 a. Hazardous Materials. All representations, warranties, indemnities or hold harmless provisions in favor of Tenant from Landlord
dealing with the presence, use, transportation, disposal, contamination, exposure to or in any way arising out of hazardous or toxic materials, chemicals or wastes (“Hazardous Materials”) are deleted as to Lender. Lender, however,
as Landlord, covenants and agrees to (a) comply with all laws governing Hazardous Materials (“Hazardous Materials Laws”), (b) store, use and dispose of all Hazardous Materials at the Mortgaged Premises in accordance with all
applicable Hazardous Materials Laws, and (c) remove, remediate and/or clean up, as applicable, in accordance with all applicable Hazardous Materials Laws, all Hazardous Materials at the Mortgaged Premises (to the extent not caused by Tenant or its
employees, contractors or agents) impairing Tenant’s use or access to the Demised Premises. 
  
 b. Insurance. Tenant will at all times carry comprehensive general liability coverage for its activities and operations at the
Demised Premises, listing Lender and Landlord as additional insureds, in such coverage amounts as are required by the Lease but in no event less than One Million Dollars. Lender will have no liability to Tenant for any indemnity or hold harmless
provision under the Lease where Lender is otherwise covered by Tenant’s comprehensive general liability coverage(s) as carried by Tenant or which Tenant is required to carry under the Lease. All insurance required to be carried by Landlord
under the Lease may be effected by Lender by self-insurance or by a policy or policies of blanket insurance covering additional items or locations or assureds and with such deductibles as Lender may from time to time determine. Tenant has no rights
in any policy or policies maintained by Lender. 
  

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

									
	 	 	 	 	 LENDER:

			
	 	 	 	 	THE PRUDENTIAL INSURANCE COMPANY OF AMERICA
			
	 ATTEST:
	 	 	 	 
				
	 	 	 	 	By:	 	 
	Assistant Secretary	 	 	 	 	 	Vice President
	 	 	 	 	 	 	 (Corporate Seal)

	 	 	 	 	 	 	 
	 	 	 	 	 TENANT:

			
	 	 	 	 	ISTA PHARMACEUTICALS, INC.,
			
	 ATTEST:
	 	 	 	 
				
	 	 	 	 	By:	 	 
	Secretary	 	 	 	 	 	President
	 	 	 	 	 	 	 (Corporate Seal)Referral Testing Agreement

 Exhibit 10.1 
  
 [*] = CERTAIN CONFIDENTIAL INFORMATION CONTAINED IN
THIS DOCUMENT, MARKED BY BRACKETS, HAS BEEN OMITTED AND FILED SEPARATELY
WITH THE SECURITIES AND EXCHANGE COMMISSION PURSUANT TO RULE 24B-2 OF
THE SECURITIES EXCHANGE ACT OF 1934, AS AMENDED. 
  
 Referral Testing Agreement 
 Between

 Virologic, Inc. and 
 Quest Diagnostics Incorporated 
  
 THIS AGREEMENT is
entered into effective as of April 1, 2004 (the “Effective Date”), between Virologic, Inc. (Virologic), with offices located at 345 Oyster Point Blvd., South San Francisco, CA 94080 (“Contractor”) and Quest Diagnostics
Incorporated, a Delaware corporation with offices located at 1 Malcolm Avenue, Teterboro, New Jersey 07608 (“Quest Diagnostics”). 
  
 Quest Diagnostics is the owner and/or operator of certain clinical laboratories located in various states throughout the United States. 
  
 Contractor operates a referral testing laboratory that is duly licensed to perform clinical
laboratory testing. 
  
 Quest Diagnostics wishes to engage Contractor as its
preferred provider for HIV phenotypic resistance testing to perform laboratory testing services upon the terms and conditions set forth in this Agreement and Contractor wishes to provide to Quest Diagnostics those services upon those terms and
conditions. 
  
 In consideration of the mutual covenants hereinafter set forth,
the parties, intending to be legally bound, agree as follows: 
  

	1.	Term 

  
 The term of this Agreement shall commence on the Effective Date and shall continue for a period of (1) year, subject to the early termination
provisions of Section 13 of this Agreement and to the following renewal option: Quest Diagnostics shall have two one-year options to extend the Agreement on the condition that the annual minimum volume term of [*], as set forth on Exhibit A hereto,
is met in the preceding year of this Agreement and upon written notice thereof to Contractor. 
  

	2.	Services; Contractor Certification and Standard of Work 

  

	 	(a)	Services: Upon the request of Quest Diagnostics, Contractor shall provide Quest Diagnostics with laboratory testing services. Contractor represents and warrants to Quest
Diagnostics that it will perform all testing services under this Agreement in a professional, accurate, and timely manner. 

  
 Turn Around Time/Non Reportable Rate: Contractor shall use its best efforts to ensure that its turn around time for delivering laboratory test
results to Quest Diagnostics shall not exceed twenty-four (24) hours from the time of specimen receipt at Contractor’s location to the time that a detailed lab report is received by the requesting lab site (unless a longer turn around time is
specified on Exhibit B with respect to particular tests, in which event Contractor shall use its best efforts to meet the turn around times set forth on Exhibit B for those tests). Contractor represents and warrants that it has not and will not
offer another distributor a shorter or enhanced Turn Around Time or otherwise differentiate to the disadvantage of Quest in sample Turn Around Time and will make best efforts to meet the Turn Around Time for Results set forth on Exhibit B. If there
is a delay in reported results or additional testing is required to confirm or clarify the result of a specific test, and cannot be performed within the applicable turn around time, Contractor shall notify the Quest Diagnostics’ laboratory that
referred the test to Contractor of the time when results will be available to Quest Diagnostics. Repeat testing, when necessary or requested, will be performed at no charge. Quest Diagnostics and Contractor will work together to reduce
non-reportable results through mutual efforts to educate physicians and phlebotomists on appropriate specimen collection and handling requirements as set forth on Exhibit D hereto. 

	 	(b)	Changes: Contractor shall provide Quest Diagnostics with at least sixty (60) days’ prior written notice before making any change to test methods for tests performed
under this Agreement (except for changes necessitated by causes beyond the control of Contractor or for changes necessary to maintain or improve quality levels, which changes shall be communicated to the parties referenced below immediately upon
Contractor’s knowledge of such changes). Contractor shall provide such notice to Quest Diagnostics via electronic mail with hard copy follow-up to the parties identified below or as directed by the applicable Quest Diagnostics’ Sourcing
Manager. The requirement to provide such notice is a material term, any breach of which shall be deemed a material breach of this Agreement. If it is Contractor’s practice to perform data base changes/updates on a regular schedule, the
implementation timeline shall be communicated to Quest Diagnostics at least ninety (90) days in advance of implementation. 

  
 Unless otherwise designated by Quest Diagnostics from time to time, parties to be notified under this Section 2(c) are as follows: 
  
 1. Database Management: 
  
 (a) Corporate - DB.Requests@questdiagnostics.com

  
 (b) Nichols Institute/SJC:
sjctsohd@questdiagnsotics.com; and 
  
 (c) Nichols Institute/Chantilly:mary.a.goodspeed@questdiagnostics.com 
  
 2. Sourcing Manager – tramposj@questdiagnostics.com 
  
 3. National Director of Test Referral Networking - humesm@questdiagnostics.com 
  

	 	(d)	Certifications: All testing performed by Contractor shall be in accordance with applicable state and federal testing requirements for clinical reference laboratories.
Contractor shall maintain, and hereby certifies its and its employees are in possession of, all necessary licenses, permits, accreditation and certifications, including approvals for specialties or subspecialties (all such licenses, permits,
accreditation and certifications, including approvals for specialties or subspecialties being collectively referred to hereafter as “Required Approvals”) required under applicable law, rule or regulation for Contractor and its clinical
laboratories to perform the tests referred to Contractor by Quest Diagnostics, including, without limitation, Required Approvals under the Clinical Laboratory Improvement Amendments (“CLIA”) of 1988, and any applicable state laws and
regulations, including the States identified on Exhibit B. Contractor shall maintain all Required Approvals for the duration of the term of this Agreement and any renewals. Before commencing laboratory testing under this Agreement, and within thirty
(30) days after the renewal date for any Required Approval, Contractor shall provide to Quest Diagnostics at its address provided above, Attn: Virginia Sturmfels, Manager, Medical Compliance, or such other address that Quest Diagnostics may direct
in accordance with the notice requirements of Section 14(b) of this Agreement, copies of all Required Approvals or any renewals thereof, under CLIA, from the States identified on Exhibit C and from Contractor’s applicable accreditation agency
or agencies. If for any reason Contractor loses or is denied any Required Approval to perform one or more tests pursuant to this Agreement, Contractor shall immediately notify Quest Diagnostics at the address provided above and Quest Diagnostics
shall discontinue referral of any such test or tests, in the state, or states, affected until such time as Contractor can demonstrate it has the Required Approval. Recurrent loss of Required Approvals shall constitute a breach of this Agreement
authorizing Quest Diagnostics to terminate the Agreement under Section 13. Contractor shall provide Quest Diagnostics at the address provided above with a copy of any new Required Approval that it obtains during the term of this Agreement and any
renewals within thirty (30) days of receipt thereof. 

  
 (e) Reports: Contractor shall furnish utilization reports monthly to Quest Diagnostics’ Sourcing Manager and other personnel designated by it from time to time. At a minimum, Contractor shall include in each utilization report
test names, Contractor’s test codes, and the volume and dollar amount of each test. 
  
 [*] = CERTAIN CONFIDENTIAL INFORMATION CONTAINED IN THIS DOCUMENT, MARKED BY
BRACKETS, HAS BEEN OMITTED AND FILED SEPARATELY WITH THE SECURITIES AND
EXCHANGE COMMISSION PURSUANT TO RULE 24B-2 OF THE SECURITIES EXCHANGE ACT
OF 1934, AS AMENDED. 
  

 2 

 Utilization reports shall present this information separately for each Quest Diagnostics’ Business
Unit. This report shall be submitted by Contractor electronically to email addresses designated by Quest Diagnostics from time to time. 
  

	3.	Pricing 

  
 Pricing Generally: Pricing for laboratory testing services provided by Contractor to Quest Diagnostics shall be in accordance with the Pricing
Schedule attached as Exhibit Quest A. 
  

	 	(a)	Most Favored Nations: Quest Diagnostics shall receive most favored nation pricing PhenoSense GT testing services provided by Contractor under this Agreement as follows: If at any
time during the term of this Agreement, Contractor provides pricing (including the effect of any discounts, credits or other allowances) that is lower than the pricing provided to Quest Diagnostics for PhenoSense GT performed by Contractor under
this Agreement to any commercial laboratory customer of Contractor that is a commercial local or regional laboratory, that purchases similar or lesser volumes of those tests, Contractor shall immediately (i) decrease Quest Diagnostics’ pricing
so that pricing afforded to Quest Diagnostics is equal to or lower than the prices afforded to that commercial local or regional laboratory customer, and (ii) notify Quest Diagnostics of the price decrease. Throughout the term of this Agreement,
Quest Diagnostics shall have the right, at its expense and subject to confidentiality undertakings reasonably satisfactory to Contractor, to cause a major independent auditing firm, not doing business with either Quest Diagnostics or Contractor, to
audit Contractor’s prices to its customers to ensure compliance with this Section. If any discrepancies are found, Quest Diagnostics shall receive, at its option, a refund or credit for all monies paid in excess of the amount that would have
been payable had Contractor afforded Quest Diagnostics pricing consistent with this most favored nations pricing provision beginning from the date the other customer was afforded lower pricing and continuing for so long as Quest Diagnostics paid the
excess amounts. However, Quest Diagnostics agrees that in the event that any of its individual business units do not make available all of the ViroLogic products listed on Exhibit A in accordance with this agreement, these obligations with respect
to Most Favored Nations pricing for PhenoSense GT shall be null and void. 

  

	4.	Invoicing 

  
 Contractor shall invoice Quest Diagnostics on a monthly basis for all testing performed at the request of Quest Diagnostics. Invoices shall be provided to
such physical or email addresses as Quest Diagnostics may designate from time to time. Accrued, undisputed fees shall be paid to Contractor within thirty (30) days of Quest Diagnostics’ receipt of invoices. All invoices shall be in sufficient
detail, as reasonably requested by Quest Diagnostics, to identify the tests completed and the price per test. Failure of Contractor to submit invoices in the time required or to provide sufficient documentation as requested shall be a basis to deny
a claim for payment. Contractor will not be entitled to receive payment for services that produce invalid test results, except where the cause of such invalid result is Quest Diagnostics referring of an untestable specimen to Contractor (e.g., the
specimen was too old). If services are rendered on behalf of a Medicaid patient residing in a state in which applicable Medicaid regulations require that laboratory services rendered to a Medicaid recipient be billed only by the laboratory
performing the testing services, Contractor shall, if requested by Quest Diagnostics, bill such services to Medicaid, and accept payment from Medicaid as full payment for those services. 
  
 [*] = CERTAIN CONFIDENTIAL INFORMATION CONTAINED IN
THIS DOCUMENT, MARKED BY BRACKETS, HAS BEEN OMITTED AND FILED SEPARATELY
WITH THE SECURITIES AND EXCHANGE COMMISSION PURSUANT TO RULE 24B-2 OF
THE SECURITIES EXCHANGE ACT OF 1934, AS AMENDED. 
  

 3 

	5.	Preferred Provider Relationship 

  

	 	a)	Customer Support: Contractor will provide Payor Relations support with all payor types to establish medical policy for HIV RT and increase reimbursement rates where needed.
Contractor will educate HIV providers regarding the availability of its products through Quest Diagnostics. 

  

	 	b)	Exclusivity and Product Offering: Within 10 business days upon execution of this Agreement Quest Diagnostic’s will make unique test codes available throughout it’s
network of laboratories for Contractors products listed on Exhibit A hereto and will use best efforts to ensure that those product test codes are the same across all Quest business units. Contractor agrees to make Quest Diagnostics its exclusive
nationwide distributor for the term of this agreement, (nationwide distributor is defined for purposes of this agreement as a laboratory offering full scope of testing services including routine diagnostics and esoteric testing, anatomic pathology,
drug testing, clinical trials throughout the majority of the United States) for its PhenoSense GT assay nothing herein is intended to prohibit Contractor from distributing its products directly or through local or regional laboratories. Quest
Diagnostics agrees that in the event that any of its individual business units do not make available all ViroLogic products listed on Exhibit A in accordance with this agreement, ViroLogic may, in its sole discretion, terminate this nationwide
exclusivity of the PSGT offering at any time during this Agreement. 

  

	6.	Non-solicitation of Clients Trade Secrets: 

  

	 	(a)	Trade Secrets: Contractor understands and acknowledges that should Quest Diagnostics provide any client-identifiable information to Contractor, such information shall be
considered a confidential trade secret of Quest Diagnostics that shall be treated and protected with the same care that Contractor would treat similar information of its own, but with no less than a reasonable degree of care.

  

	 	(b)	Non-Solicitation: Contractor agrees that during the term of this Agreement, or any renewals thereof, and for a period of one year thereafter, it will not knowingly utilize
information acquired from the business relationship with Quest Diagnostics to directly solicit business from Quest Diagnostics’ clients. 

  

	7.	Tests Added During the Contract Period 

  
 From time to time, Quest Diagnostics may request Contractor to provide additional tests not currently performed by Contractor and/or to consolidate
additional tests with Contractor that Quest Diagnostics currently sends to other reference laboratories. Upon mutual written agreement between Contractor and Quest Diagnostics, Contractor shall set up the test(s) requested within its laboratory,
within six (6) to ten (10) weeks of Quest Diagnostics’ request, and shall obtain all necessary legal and regulatory approvals required to perform such test(s) and to sell such testing services to Quest Diagnostics. If more than six (6) to ten
(10) weeks are required to set up such test(s), Contractor shall notify Quest Diagnostics of the necessary set up time when Quest Diagnostics requests such test(s) and Quest Diagnostics and Contractor shall negotiate in good faith regarding the
appropriate pricing for such tests. 
  

	8.	Business Reviews 

  
 Contractor agrees that Quest Diagnostics shall have the right to perform quality assurance audits. All audits will be used by Quest Diagnostics solely to
evaluate Contractor’s performance of the services under this Agreement. Such audits may include onsite inspections to evaluate 
  
 [*] = CERTAIN CONFIDENTIAL INFORMATION CONTAINED IN THIS
DOCUMENT, MARKED BY BRACKETS, HAS BEEN OMITTED AND FILED SEPARATELY WITH
THE SECURITIES AND EXCHANGE COMMISSION PURSUANT TO RULE 24B-2 OF THE
SECURITIES EXCHANGE ACT OF 1934, AS AMENDED. 
  

 4 

 Contractor’s processes against a Quest Diagnostics’ checklist used for reference laboratory
providers to monitor compliance with regulatory standards and all Quest Diagnostics’ quality assurance requirements. Quest Diagnostics reserves the right to hold formal performance reviews every six months. These reviews shall include, but not
be limited to, contract performance, customer satisfaction, issues/opportunities, new test requirements, technology/overview and general operational issues. 
  

	9.	Promotional Material 

  
 Neither party shall use the name, symbol, logo or any trademark or service mark of the other party in any promotional or advertising material, nor for any
other purpose unless advance written consent has been received from the other party. Except that, for the purposes of educating physicians, Contractor may issue client letters, marketing information and other promotional materials that reference
Quest Diagnostics and the Agreement. Contractor will seek Quest Diagnostics review and approval of all such materials which approval shall not be unreasonably withheld. The terms of this Agreement may require SEC disclosure on behalf of Contractor
and in such event Contractor will comply with such disclosure requirements, however, Contractor agrees to provide a draft of any such 8K or press release to Quest Diagnostics for comments. 
  

	10.	Proprietary Information 

  

	 	(a)	Confidential Information: Contractor and Quest Diagnostics acknowledge that they may gain access to the other’s confidential business information in the course of
performing their obligations under this Agreement. Except as required by law or legal process, Contractor and Quest Diagnostics each agrees that it will not use (except as required by those employees, officers, directors, or consultants, acting
pursuant to this Agreement or as required by law or legal process) or disclose to third parties the following information: client lists, information related to proprietary research techniques and technology, types of supplies, pricing for supplies,
patient information (including but not limited to, social security numbers, addresses, insurance information, results, and diagnosis information), and any information that the disclosing party marks with the word “confidential” at the time
of disclosure (together “Confidential Information”). Contractor and Quest Diagnostics each agrees to treat such Confidential Information it receives from the other with the same degree of care that it treats its own proprietary
information, but with no less than a reasonable degree of care. 

  

	 	(b)	Exceptions to Confidential Information: Notwithstanding subsection (a) above, information shall not be deemed Confidential Information if it (i) is or becomes generally known
to the public through no unlawful act of the recipient; (ii) was known to the recipient at the time of disclosure; (iii) is disclosed with the prior written approval of the disclosing party; (iv) was independently developed by the recipient without
any use of the disclosing party’s Confidential Information; (v) becomes known to the recipient from a source other than the disclosing party without breach of this Agreement and otherwise not in violation of the disclosing party’s rights;
or (vi) is required to be disclosed in accordance with law or court order. 

  

	 	(c)	Return of Confidential Information: Each party shall promptly return all Confidential Information of the other party it holds in written form and all copies of it upon the
other party’s written demand, except for Confidential Information that may be incorporated in any information that the recipient is required to maintain by law to verify the work that it performed, which may be retained by the recipient subject
to the restrictions contained in this Section 9. 

  
 [*] =
CERTAIN CONFIDENTIAL INFORMATION CONTAINED IN THIS DOCUMENT, MARKED BY BRACKETS, HAS
BEEN OMITTED AND FILED SEPARATELY WITH THE SECURITIES AND EXCHANGE COMMISSION
PURSUANT TO RULE 24B-2 OF THE SECURITIES EXCHANGE ACT OF 1934, AS
AMENDED. 
  

 5 

	11.	Indemnification, Insurance and Notice 

  

	 	(a)	Indemnification: Contractor agrees to indemnify, defend and hold Quest Diagnostics, including its subsidiaries and affiliates and their employees, agents, servants and
representatives, harmless from any claim, liability, loss, suit, damage, cost or expense, including reasonable attorneys’ fees and expenses (collectively “Claims”), including wrongful death, to the extent arising out of or
attributable to the negligence, breach of this Agreement or willful misconduct of Contractor, its employees, subcontractors, directors and officers related to this Agreement, including, but not limited to, any third party billing Claims brought
against Quest Diagnostics arising out of Contractor’s failure to inform Quest Diagnostics of a test methodology change, and any Claims brought against Quest Diagnostics based upon, arising out of or attributable to Quest Diagnostics’
hiring or supervision of Contractor. 

  

	 	(b)	Indemnification Procedure: Quest Diagnostics shall notify Contractor of any Claim for which indemnification is sought. Contractor shall have the right to control the
investigation, trial and defense of any lawsuit or action (including all negotiations to effect settlement) and any appeal arising there from and to employ or engage attorneys of its own choice. Quest Diagnostics may, at its own cost, participate in
such investigation, trial and defense of such lawsuit or action and may take an appeal from any resulting adverse judgment. Quest Diagnostics shall cooperate with Contractor, at Contractor’s expense, at all times during the pendency of the
Claim or lawsuit, including, without limitation, providing it with all available information concerning the Claim. Contractor shall not enter into any settlement agreement, consent judgment or admission of liability on behalf of Quest Diagnostics
without its prior written consent, which consent shall not be unreasonably withheld. 

  

	 	(c)	Insurance: Contractor agrees to maintain professional liability and commercial general liability insurance to cover its services provided hereunder in the minimum amounts of
Three Million Dollars ($3,000,000) per claim and Five Million Dollars ($5,000,000) annual aggregate. Contractor agrees to furnish Quest Diagnostics with a current and valid certificate of insurance from Contractor’s insurance carrier verifying
the nature and amounts of coverage (or if Contractor self insures, documented proof of the existence of a self-insurance program meeting the requirements hereof), and Contractor agrees to keep and maintain such insurance (or self-insurance) coverage
in full force and effect during the term of this Agreement. If such insurance is of the “claims made” type, Contractor agrees that the insurance shall be continued for a period of at least four (4) years after the termination of this
Agreement, or Contractor shall purchase extended reporting period insurance (also known as “tail coverage”) to extend the insurance for a minimum of four (4) years after the termination of this Agreement. 

  

	12.	Regulatory Compliance 

  

	 	(a)	Compliance with Law/Material Breach: Each party represents and warrants that in the performance of its obligations under this Agreement, it will comply with all applicable
laws, rules or regulations (“Applicable Laws”), including, but not limited to, the federal Physician Self-Referral Law, 42 U.S.C. 1395nn (“Stark Law”), and the regulations promulgated thereunder, similar state physician
self-referral laws and regulations, the federal Medicare/Medicaid Anti-kickback Law (42 USC 13202-7b) and regulations promulgated thereunder and similar state Anti-kickback laws and regulations, the Health Insurance Portability and Accountability
Act (“HIPAA”) regulations. Failure by either party to comply with any Applicable Law as required hereby shall be considered a material breach of this Agreement. In the event of a determination that this Agreement is not in compliance with
any Applicable Law, then the parties shall negotiate in good faith to bring this Agreement into compliance. All amendments to this Agreement to bring this Agreement into 

  
 [*] = CERTAIN CONFIDENTIAL INFORMATION CONTAINED IN
THIS DOCUMENT, MARKED BY BRACKETS, HAS BEEN OMITTED AND FILED SEPARATELY
WITH THE SECURITIES AND EXCHANGE COMMISSION PURSUANT TO RULE 24B-2 OF
THE SECURITIES EXCHANGE ACT OF 1934, AS AMENDED. 
  

 6 

 compliance must be mutually agreed to by both parties in writing. If such agreement cannot be reached,
either party may terminate this Agreement by written notice to the other party. 
  

	 	(b)	HIPAA Compliance: Each party represents and warrants that with respect to all protected health information (as that term is defined in the Privacy Regulations), it is a
covered entity (and not a business associate of the other party) under the Privacy Regulations and that it shall protect the privacy, integrity, security, confidentiality and availability of the protected health information disclosed to, used by, or
exchanged by the parties by implementing and maintaining privacy and security policies, procedures, and practices, and administrative, physical and technological safeguards and security mechanisms that reasonably and adequately protect the
confidentiality, integrity and availability of the protected health information created, received, maintained or transmitted under this Agreement, all as required by, and set forth more specifically in, the Privacy Regulations and the Security
Regulations, as each may be amended from time to time. In the event HIPPA or the Privacy Regulations or Security Regulations require any addition to or modification of this Agreement, the parties shall use commercially reasonable efforts to agree
upon such additions or modifications in a timely manner. If such agreement cannot be reached in a timely manner, either party may terminate this Agreement by written notice to the other party. 

  

	 	(c)	Federal Program Access to Records: If payment for any laboratory services performed hereunder is made by a Federal Program, to assure compliance with 42 USC 1395X(v)(I),
until the expiration of four (4) years after the furnishing of laboratory services pursuant to this Agreement, Contractor shall, upon written request, make available to the Secretary of the Department of Health and Human Services (HHS), the
Comptroller General, or any of their duly authorized representatives, this Agreement, and any books, documents and records that are necessary to certify the nature and extent of the costs incurred by a health care provider that were performed under
this Agreement. This provision shall apply if the amount paid under this Agreement is $10,000 or more over a twelve (12) month period. 

  
 The availability of Contractor’s books, documents and records shall at all times be subject to such criteria and procedures for seeking or obtaining
access as may be promulgated by the Secretary of HHS in regulations, and other applicable laws. Contractor’s disclosure under this provision will not be construed as a waiver of any legal rights to which Quest Diagnostics or Contractor may be
entitled under statute or regulation. 
  

	 	(d)	Excluded Provider: Each party represents and warrants that it is not an Excluded Provider. For purposes of this Section, the term “Excluded Provider” means a person
or entity that either (1) has been convicted of a crime related to health care, or (ii) is currently listed by a federal agency as debarred, excluded or otherwise ineligible for participation in federally funded programs (including without
limitation federally-funded health care programs such as Medicare and Medicaid). Either party shall notify the other within 5 days after the party receives notice that it is an Excluded Provider. The party receiving such notice shall have the right
to terminate this Agreement at any time after learning that the notifying party is an Excluded Provider. For purposes of this Section, “Quest Diagnostics” and “Contractor” shall include, as applicable, the (1) person entering
into this Agreement any partners, associates, or agents of that person (including without limitation subcontractors or employees providing Testing), or (2) the entity entering into this Agreement and any such entity’s parent, principals,
shareholders, directors, and officers of such entity (including, without limitation, subcontractors or employees providing Testing). 

  
 [*] = CERTAIN CONFIDENTIAL INFORMATION CONTAINED IN THIS
DOCUMENT, MARKED BY BRACKETS, HAS BEEN OMITTED AND FILED SEPARATELY WITH
THE SECURITIES AND EXCHANGE COMMISSION PURSUANT TO RULE 24B-2 OF THE
SECURITIES EXCHANGE ACT OF 1934, AS AMENDED. 
  

 7 

	 	(e)	EEO, Small Business, Affirmative Action: To the extent Contractor’s services will be used by Quest Diagnostics in the performance of a federal government contract,
Contractor hereby certifies that all services provided in the United States are provided in compliance with all applicable requirements, orders and regulations of the United States Federal Government pertaining to nondiscrimination, equal employment
opportunity and affirmative action, including, without limitation, the following, as the same may be amended from time to time: (1) Executive Order 11246, as amended by Executive Order 11375, including 41 CFR Part 60.1 et seq. and 48 CFR
52.222-26, Equal Opportunity; (2) the Rehabilitation Act of 1973 (29 USC 793), as amended, including 41 CFR Part 60-741 et seq. and 48 CFR 52.222-36, Affirmative Action for Workers With Disabilities; (3) the Vietnam Era Veterans Readjustment
Assistance Act of 1974 (38 USC 4212), including 41 CFR Part 60-250 et seq. and 48 CFR 52.222-35, Equal Opportunity for Special Disabled Veterans, Veterans of the Vietnam Era, and Other Eligible Veterans; (4) the certification requirements for
nonsegregated facilities as ordered by the Secretary of Labor (32 F.R. 7439) and as required by 41 CFR Part 60-1 et seq.; (5) Executive Order 11141 (proscribing age discrimination); (6) the Service Contract Act of 1965, as amended (41 USC 351
et seq.) including 48 CFR 52.222-41; (7) 48 CFR 52.237-7, Indemnification and Medical Liability Insurance; and (8) all regulations, rules, orders and applicable contract clauses promulgated under (1) through (7) above and/or required by
federal, state or local law, rule or regulation to be included in this Agreement. Contractor agrees that until four years after payment under this Agreement Contractor will afford the Secretary of Health and Human Services, Comptroller General of
the United States or any of their duly authorized representatives, access to, and the right to examine, any pertinent books, documents, papers and records of the successful bidder or offer or involving transactions relating to this
Agreement. 

  

	13.	Legislative / Regulatory Modification 

  
 In the event any Medicare and/or Medicaid laws, rules, regulations or payment policies; or any rules or policies of any third-party payer; or any other
federal, state or local law, rule, regulation or policy; or any interpretation thereof at any time during the term of this Agreement is modified, implemented, threatened to be implemented, or determined to prohibit or in any way materially change
the method or amount of reimbursement or payment (1) for services under this Agreement, or (2) for services to patients of a party necessitated as a result of this Agreement, or by virtue of the existence of this Agreement has or will materially
affect the ability of Quest Diagnostics to engage in any commercial activity on terms at least as favorable to Quest Diagnostics as those reasonably attributable as of the date hereof (all of the foregoing being hereinafter collectively referred to
as “Changes,” and individually, a “Change”), then the parties to this Agreement shall negotiate in good faith to amend this Agreement to provide for payment of compensation hereunder, while at the same time preserving the
economic expectations of the parties to the greatest extent possible in a manner consistent with any such Change(s). All amendments to this Agreement necessitated by such Change(s) must be mutually agreed to by both parties in writing. If such
agreement cannot be reached, either party may terminate this Agreement by written notice to the other party. 
  

	14.	Termination 

  
 This Agreement may be terminated as follows: 
  
 (a) Upon the filing of a petition in bankruptcy by either party or the making by either party of an assignment for the benefit of creditors, or if any
involuntary petition in bankruptcy or petition for an arrangement pursuant to the Bankruptcy Act is filed against either party and is not dismissed within thirty (30) days; or if a receiver is appointed for the business of either party, or any part
thereof, the other party may immediately terminate this Agreement; 
  
 [*] =
CERTAIN CONFIDENTIAL INFORMATION CONTAINED IN THIS DOCUMENT, MARKED BY BRACKETS, HAS
BEEN OMITTED AND FILED SEPARATELY WITH THE SECURITIES AND EXCHANGE COMMISSION
PURSUANT TO RULE 24B-2 OF THE SECURITIES EXCHANGE ACT OF 1934, AS
AMENDED. 
  

 8 

 (b) If action is taken against Contractor to revoke, suspend, or terminate its applicable federal or
state license(s) to operate a clinical laboratory, or to revoke, suspend or terminate participation in Medicaid, Medicare or other federally funded programs; and such action is not resolved within thirty (30) days of initiation thereof, Quest
Diagnostics may immediately terminate this Agreement; 
  
 (c)
Either party may terminate this Agreement immediately on written notice if the other party has committed a material breach of this Agreement and has not cured such breach within thirty (30) days after written notice thereof by the non-breaching
party; and 
  
 (d) In accordance with Sections 2(d), 12(a), 12(b)
and 13. 
  

	15.	Miscellaneous 

  
 (a) Assignment: Without the prior written consent of the other party hereto, which consent shall not be unreasonably withheld, neither party may
assign any of its rights or obligations hereunder. Notwithstanding anything to the contrary herein contained, either party may assign its rights or obligations hereunder in the entirety to its parent or any subsidiary or successor corporation
without prior written consent; provided, however, that nothing contained herein shall release the assigning party from its obligations hereunder. Subject to the foregoing, this Agreement inures to the benefit of, and is binding upon, the successors
and assigns of the parties hereto. 
  
 (b) Notice: Except
as otherwise expressly provided in this Agreement, all notices hereunder shall be in writing, personally delivered, sent by certified mail, return receipt requested, or by confirmed facsimile, addressed to the other party as follows: 
  

			
	 If to Contractor:
	 	Kathy Hibbs, Esq
	 	 	Vice President and General Counsel
	 	 	ViroLogic, Inc.
	 	 	 Phone: (650)624-4243

	 	 	 Facsimile: (650) 635-1111

		
	 If to Quest Diagnostics:
	 	Jerry Tramposh, Ph.D.
	 	 	Materials and Services Management
	 	 	Quest Diagnostics, Nichols Institute
	 	 	San Juan Capistrano, CA
	 	 	Phone: (800) 642-4657 ext. 4005
	 	 	Facsimile: (949) 728-4998

  
 Either party may
change its address to which notices shall be sent by a notice that conforms to the requirements of this subsection. 
  
 (c) Entire Agreement: This Agreement, including Exhibits A, B, and C, contains the entire understanding between Quest Diagnostics and Contractor
and supersedes any and all prior agreements, understandings, and arrangements between them relating to the subject matter hereof. No amendment, change modification or alteration of the terms and conditions hereof shall be binding unless in writing
and signed by the parties to be bound. 
  
 (d) Choice of
Law: This Agreement shall be governed by and construed in accordance with the laws of the Commonwealth of Pennsylvania, without regard to its conflict of law principles. 
  
 (e) Waiver: The failure of either party to this Agreement to exercise or enforce any right conferred upon it
hereunder shall not be deemed to be a waiver of any such right nor operate to bar the exercise or performance thereof at any time or times thereafter, nor shall a waiver of any right hereunder at any given time be deemed a waiver thereof for any
other time. 
  
 [*] = CERTAIN CONFIDENTIAL
INFORMATION CONTAINED IN THIS DOCUMENT, MARKED BY BRACKETS, HAS BEEN OMITTED
AND FILED SEPARATELY WITH THE SECURITIES AND EXCHANGE COMMISSION PURSUANT TO
RULE 24B-2 OF THE SECURITIES EXCHANGE ACT OF 1934, AS AMENDED. 
  

 9 

 (f) Severability: It is the intention of the parties that the provisions of this Agreement shall
be enforceable to the fullest extent permissible under applicable laws, and that the invalidity or unenforceability of any provisions under such laws will not render unenforceable, or impair, the remainder of the Agreement. If any provisions hereof
are deemed invalid or unenforceable, either in whole or in part, this Agreement will be deemed amended to modify, or delete, as necessary, the offending provisions and to alter the bounds thereof in order to render it valid and enforceable.

  
 (g) Non-Exclusive Arrangement: Contractor acknowledges
that this is a non-exclusive arrangement and that this Agreement places no restrictions on Quest Diagnostics’ ability to refer laboratory testing to other laboratories and that Quest Diagnostics does not guarantee any minimum volume of
specimens to be referred to Contractor for testing under this Agreement. 
  
 (h) Parties Bound: For purposes of this Agreement, “Quest Diagnostics” shall include all direct and indirect subsidiaries, business units or affiliates of Quest Diagnostics engaged in the laboratory
services business in the continental United States in which Quest Diagnostics owns a majority of the equity interest. Any subsidiary or affiliate of Quest Diagnostics that is not a party to this Agreement shall have the option severally to join in
the terms hereof by providing at least thirty (30) days written notice to Contractor. Quest Diagnostics may, at its option, obtain services pursuant to the terms hereof on behalf of laboratories for which it provides management services only.

  
 (i) Relationship of the Parties: Nothing contained in
this Agreement shall be construed as creating a joint venture, partnership, or employment relationship between the parties. Neither party is an agent of the other, and neither party has any authority whatsoever to bind the other party, by contract
or otherwise. 
  
 (j) Force Majeure: Either party
shall be excused from non-performance or delay in performance to the extent that such non-performance or delay in performance arises out of causes beyond the control and without the fault or negligence of the non-performing party. Such cases
include, but are not limited to, acts of God, the public enemy or terrorism, acts of any government in either its sovereign or contractual capacity, fires, floods, epidemics, strikes or freight embargo. Each party shall promptly notify the other of
any such circumstances and its probable duration as a result of which such party claims its inability to perform this Agreement. 
  
 (k) Section Headings: Section headings contained in this Agreement are for reference purposes only and shall not affect, in any way, the meaning
and interpretation of this Agreement. 
  
 (l) Execution in
Counterparts: This Agreement may be executed simultaneously in one or more counterparts, each of which shall be deemed an original, but all of which shall constitute the same instrument. 
  
 (m) Survival: The provisions of this Agreement which by their nature
are intended to survive termination of this Agreement shall so survive, including the provisions of Sections 4, 8, 9, 10, 11 and 15. 
  
 [*] = CERTAIN CONFIDENTIAL INFORMATION CONTAINED IN THIS
DOCUMENT, MARKED BY BRACKETS, HAS BEEN OMITTED AND FILED SEPARATELY WITH
THE SECURITIES AND EXCHANGE COMMISSION PURSUANT TO RULE 24B-2 OF THE
SECURITIES EXCHANGE ACT OF 1934, AS AMENDED. 
  

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	16.	Medicare+Choice Regulations 

  
 (This Section applies only when patients served under this Agreement include Medicare+Choice Beneficiaries under contracted Medicare+Choice Benefit
programs.) 
  
 (a) Compliance with Medicare+Choice.
The terms and conditions herein are included to meet federal statutory and regulatory requirements of the federal Medicare+Choice Program under Part C of Title XVIII of the Social Security Act (“Medicare+Choice Program”). Notwithstanding
Section 11, Contractor understands that the specific terms as set forth herein are subject to amendment in accordance with federal statutory and regulatory changes to the Medicare+Choice Program. 
  
 (b) Definitions: For the purposes of this Agreement, the following
terms shall have the meanings set forth: 
  
 (1) “CMS”
means the U.S. Centers for Medicare and Medicaid Services (formerly known as the Health Care Financing Administration). 
  
 (2) “Health Plans” shall mean those plans, which have entered into a Medicare+Choice Contract with CMS. 
  
 (3) “Medicare+Choice Contracts” means the agreements entered into
between CMS and Health Plans pursuant to which Health Plans provide health care coverage to Medicare Covered Persons. 
  
 (4) “Medicare+Choice Regulations” means those regulations promulgated by CMS at 42 C.F.R. § 422.100 et. seq., as amended.

  
 (5) “Medicare Covered Beneficiaries” means an
individual who is entitled to receive benefits pursuant to Title XVIII of the Social Security Act and is enrolled in Health Plan pursuant to the Medicare Contract. The term “Covered Persons,” “Members” or “Enrollees” in
the Agreement shall refer to Medicare Covered Persons unless the context clearly indicates otherwise. 
  
 (c) Compliance Requirements: Notwithstanding any other provisions in this Agreement, the following terms and conditions apply to laboratory
services rendered under this Agreement. 
  
 (1) Quest Diagnostics
delegates to Contractor its responsibility under its Medicare+Choice Contracts with Health Plans to provide the services set forth in the Agreement to Medicare Covered Persons. Quest Diagnostics or Healthplan may revoke this delegation, and thereby
terminate the Agreement if Quest Diagnostics or Health Plan reasonably determines that Contractor has not performed satisfactorily. Such revocation shall be consistent with the termination provisions of the Agreement. Performance of Contractor shall
be monitored by Quest Diagnostics and Health Plan on an ongoing basis. Contractor acknowledges that Health Plan shall oversee and is accountable to CMS for the functions and responsibilities described in the Medicare+Choice Program regulatory
standards. 
  
 (2) Contractor agrees to comply, and to require
any of its permitted subcontractors to comply, with all Medicare laws, the Medicare + Regulations and CMS instructions submitted. Further, Contractor agrees that any services provided by the Contractor or its subcontractors to Medicare Covered
Persons, to the extent required by applicable laws and regulations, will be consistent with and will comply with Health Plan’s Medicare+Choice contractual obligations. 
  
 (3) Contractor agrees to maintain records, documents and any other information relating to Covered Persons and this
Agreement for six (6) years or such longer period as required by law. Contractor acknowledges that Health and Human Services, the Comptroller General, or their designees have the right to audit, evaluate, or inspect any books, contracts, medical
records, patient care documentation, and other records of Contractor, or its subcontractors or transferees involving transactions related to Quest Diagnostics’ Medicare+Choice contracts with Health Plans through 6 years from the final date of
the contract period or from the date of 
  
 [*] = CERTAIN
CONFIDENTIAL INFORMATION CONTAINED IN THIS DOCUMENT, MARKED BY BRACKETS, HAS BEEN
OMITTED AND FILED SEPARATELY WITH THE SECURITIES AND EXCHANGE COMMISSION PURSUANT
TO RULE 24B-2 OF THE SECURITIES EXCHANGE ACT OF 1934, AS AMENDED. 
  

 11 

 the completion of any audit, or for such longer period provided for in 42 CFR 422.502(e)(4) or other
applicable law, whichever is later. Contractor agrees to make available its premises, physical facilities and equipment, records elating to its Medicare members and any additional relevant information. 
  
 (4) Contractor agrees to maintain records and other information with respect
to Medicare Covered Persons in an accurate and timely manner; to ensure timely access by Medicare Covered Persons to the records and information that pertain to them; and to safeguard the privacy of any information that identifies a particular
Medicare Covered Person in accordance with applicable laws and regulations and Medicare+Choice requirements. Contractor agrees to abide by all federal and state laws applicable to Contractor regarding confidentiality and disclosure for mental health
records, medical records, other health information, and patient information. 
  
 (5) Contractor agrees to provide services in a manner consistent with professionally recognized standards of health care. Contractor agrees to provide services in a culturally competent manner to all enrollees.
Contractor shall be paid for the services provided under this Agreement in the manner and at the rates contemplated by the Agreement. Contractor may obtain additional information by requesting same from Quest Diagnostics. The period for payment of
fees by Quest Diagnostics is set forth in the Agreement. 
  
 (6)
Contractor agrees to comply and cooperate with an independent quality review and improvement activities pertaining to the provision of services for Medicare Covered Persons. Contractor agrees to comply with Quest Diagnostics’ and/or Health
Plan’s medical policies, quality assurance and performance improvement programs, and medical management programs. Contractor agrees to comply with all applicable Health Plan credentialing requirements. Contractor also agrees that the
credentialing process will be reviewed by Health Plan and/or Quest Diagnostics and Health Plan and/or Quest Diagnostics will audit the process on an ongoing basis. 
  
 (7) Contractor agrees that in no event, including but not limited to nonpayment by Quest Diagnostics or Health Plan,
insolvency of Quest Diagnostics or Health Plan or breach of the Agreement, shall the Contractor bill, charge, collect a deposit from, seek compensation, remuneration or reimbursement from, or have any recourse against a Medicare Beneficiary or
persons or person acting on behalf of Medicare Beneficiary for services provided pursuant to the Agreement. Contractor agrees that in the event of Quest Diagnostics’ or Health Plan’s insolvency or other cessation of operations, services to
Medicare Covered Persons will continue through the period CMS premiums have been paid to Health Plan. Contractor further agrees that (i) the Hold Harmless and Continuation of Benefits provisions shall survive the termination of the Agreement
regardless of the cause giving rise to the termination and shall be construed to be for the benefit of the Medicare Covered Person, and that (ii) these provisions supersede any oral or written contrary agreement now existing or hereafter entered
into between Contractor and a Medicare Covered Person or persons acting on their behalf that relates to liability for payment for, or continuation of, services provided under the terms and conditions of these clauses. 
  
 (8) Contractor acknowledges that the Agreement shall be terminated if
Contractor, or a person with an ownership or control interest in Contractor, is excluded from participation in Medicare under Section 1128 or 1128A of the Social Security Act or from participation in any other federal health care program. Neither
Contractor nor Quest Diagnostics may employ or subcontract with an individual, or with an entity that employs or contracts with an individual, who is excluded from participation in Medicare under Section 1128 or 1128A of the Social Security Act or
from participation in a federal health care program. 
  
 [*] =
CERTAIN CONFIDENTIAL INFORMATION CONTAINED IN THIS DOCUMENT, MARKED BY BRACKETS, HAS
BEEN OMITTED AND FILED SEPARATELY WITH THE SECURITIES AND EXCHANGE COMMISSION
PURSUANT TO RULE 24B-2 OF THE SECURITIES EXCHANGE ACT OF 1934, AS
AMENDED. 
  

 12 

 (9) Contractor acknowledges that payments Contractor receives from Quest Diagnostics to provide Covered
Services to Medicare Covered Persons are, in whole or part, from federal funds. Contractor and any of its subcontractors are subject to certain laws that are applicable to individuals and entities receiving federal funds, including but not limited
to, Title VI of the Civil Rights Act of 1964 as implemented by 45 CFR Part 84; The Age Discrimination Act of 1975 as implemented by 45 CFR Part 91; the Rehabilitation Act of 1973; and the Americans With Disabilities Act. Contractor shall not deny,
limit or condition the furnishing of health care Covered Services to Medicare + Choice Beneficiaries on the basis of any factor that is related to health status or source of payment. 
  
 IN WITNESS WHEREOF, the duly authorized representatives of the parties have executed this Agreement effective as of the Effective
Date. 
  

							
	CONTRACTOR	 	QUEST DIAGNOSTICS INCORPORATED
				
	By:	 	 /s/ William D. Young

	 	By:	 	 /s/ David M. Zewe

	 	 	(Signature)	 	 	 	(Signature)
				
	 	 	 William D. Young

	 	 	 	 David M. Zewe

	 	 	(Print Name)	 	 	 	(Print Name)
				
	 	 	 Chairman and CEO

	 	 	 	 Senior VP Operations

	 	 	(Title)	 	 	 	(Title)
				
	 	 	 April 29, 2004

	 	 	 	 April 29, 2004

	 	 	(Date)	 	 	 	(Date)

  
 [*] = CERTAIN
CONFIDENTIAL INFORMATION CONTAINED IN THIS DOCUMENT, MARKED BY BRACKETS, HAS BEEN
OMITTED AND FILED SEPARATELY WITH THE SECURITIES AND EXCHANGE COMMISSION PURSUANT
TO RULE 24B-2 OF THE SECURITIES EXCHANGE ACT OF 1934, AS AMENDED. 
  

 13 

 EXHIBIT A 
  
 Volume based pricing per 12 month period 
  

			
	 Number of PS/PSGT Billable Units
	 	[ * ]
		
	 PS/PSGT Pricing
	 	[ * ]

  
 Other Pricing Features 
  

	 	•	The parties agree that upon date of issuance of an updated policy guideline from AMA or other favorable coverage decision or action by a payor or group of payors which results in an
increase in the reimbursement rates for Quest Diagnostics for the testing services listed on Exhibit A hereto they will negotiate in good faith to agree to pricing increase to the prices set forth herein be mutually agreed to. Quest Diagnostics will
provide a quarterly report of its reimbursement rates for Contractor’s testing services throughout the term of this Agreement and any extension period. Quest Diagnostics will provide a quarterly report of its reimbursement rates for
Contractor’s testing services throughout the term of this Agreement and any extension period. 

  

	 	•	Volume pricing in any extension period shall be calculated as follows and shall begin at the lower price level of either: i) the volume discount level of the prior period’s
volume for the total of the 12 month period or ii) a projected annualized volume rate based upon the last three months of the twelve month period immediately preceding the extension. For Example, if in the first twelve month term the total billable
samples is [ * ] which would mean a price level of [ * ], however in months 10, 11 and 12, the monthly volumes were [ * ] respectively, the projected annualized volume for the extension year would be [ * ] therefore a price level of [ * ] would
apply as it is a lower price. During the term of any extension period, the volume discount shall be adjusted on a quarterly basis to the price level of the projected annualized volume rate based upon the actual volume of the prior three months.

  

	 	•	Virologic agrees to provide Quest Diagnostics with 60 days advanced notice of any price tier changes. 

  
 [*] = CERTAIN CONFIDENTIAL INFORMATION CONTAINED IN
THIS DOCUMENT, MARKED BY BRACKETS, HAS BEEN OMITTED AND FILED SEPARATELY
WITH THE SECURITIES AND EXCHANGE COMMISSION PURSUANT TO RULE 24B-2 OF
THE SECURITIES EXCHANGE ACT OF 1934, AS AMENDED. 
  

 14 

 EXHIBIT B 
  

Turn around time for PhenoSense and PhenoSense GT is fourteen days, from receipt at Contractor’s 
 laboratory to shipment of test results to Quest Diagnostics. 
  
 [*] = CERTAIN CONFIDENTIAL INFORMATION CONTAINED IN THIS
DOCUMENT, MARKED BY BRACKETS, HAS BEEN OMITTED AND FILED SEPARATELY WITH
THE SECURITIES AND EXCHANGE COMMISSION PURSUANT TO RULE 24B-2 OF THE
SECURITIES EXCHANGE ACT OF 1934, AS AMENDED. 
  

 15 

 EXHIBIT C 
  

STATES WHERE LICENSE, PERMIT OR CERTIFICATION NECESSARY 
  
 In addition to the certification set forth in Section 2(d), Contractor specifically represents that it currently maintains Required Approvals in the states identified in
(1) below, and should Contractor perform tests referred to in (2) or (3) below, in the states referred to in (2) or (3) below for those tests. 
  
 (1) The state in which Contractor is domiciled, together with the States of Pennsylvania, Maryland, Florida, Rhode Island and New York. 
  
 (2) If Contractor performs HIV testing under this Agreement: North Carolina, Mississippi and
West Virginia. 
  
 (3) If Contractor performs lead testing under this Agreement:
Ohio 
  
 [*] = CERTAIN CONFIDENTIAL
INFORMATION CONTAINED IN THIS DOCUMENT, MARKED BY BRACKETS, HAS BEEN OMITTED
AND FILED SEPARATELY WITH THE SECURITIES AND EXCHANGE COMMISSION PURSUANT TO
RULE 24B-2 OF THE SECURITIES EXCHANGE ACT OF 1934, AS AMENDED. 
  

 16 

 EXHIBIT D 
  

Sample Collection and Handling Requirements for: 
  
 PhenoSense GTTMand PhenoSenseTM HIV 
  
 This document
describes the requirements for collection, handling, and shipment of blood 
 samples prior to testing in the PhenoSenseTM HIV and PhenoSense GTTM assays. HIV RNA is 
 especially vulnerable to degradation, therefore proper collection and handling of blood specimens 
 is essential for successful performance of the assays. Samples with lower viral loads are more 
 susceptible to degradation than samples with higher viral loads. 
  
 Specimen Volume and Identification Requirements: 
  
 3.0 mL of plasma must be sent for optimal performance of the assays. Either sterile PPT (pearl top) or tubes
containing EDTA (lavender top) may be used for sample collection. 
  
 Proper identification of specimens is extremely important. Confirm patient identification and print the patient’s first and last name or unique identifier as they appear on the test request form on the tubes in the patient’s
presence. The patient’s name or unique identifier on the specimen must be identical to the patient’s name on the test request form. 
  
 Please indicate on the test request form the patient’s most recent viral load with viral load collection date. For best results, viral loads should
be confirmed within the two weeks prior to submission for testing at ViroLogic. NOTE: PhenoSenseTM GT, PhenoSenseTM HIV assays are intended for use only for patients with viral loads greater than or equal to 500 copies/mL.  
  
 Sample Collection and Processing: 
  
 Draw whole blood into either two 5.0 mL PPT (pearl top) or tubes containing EDTA anticoagulant (lavender top). 
  
 Immediately centrifuge blood (within 2 hours of collection) at
1000-1200 x g at room temperature (18 – 25o C) for 10-15 minutes. 
  
 Do not allow samples to remain in centrifuge after centrifugation. 
  
 For EDTA samples: after centrifugation, immediately remove plasma from cells and transfer to a screw cap top tube. 
  

Immediately after centrifugation, freeze plasma sample at or below - 20o C in a standard laboratory freezer. Sample should be frozen when courier
arrives to pick it up. 
  
 DO NOT THAW SAMPLE AFTER
FREEZING! 
  
 [*] = CERTAIN CONFIDENTIAL
INFORMATION CONTAINED IN THIS DOCUMENT, MARKED BY BRACKETS, HAS BEEN OMITTED
AND FILED SEPARATELY WITH THE SECURITIES AND EXCHANGE COMMISSION PURSUANT TO
RULE 24B-2 OF THE SECURITIES EXCHANGE ACT OF 1934, AS AMENDED. 
  

 17

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