Document:

Exhibit 10.8

 

CANADA,
UNITED STATES

AND
INTERNATIONAL

 

SUBSCRIPTION AGREEMENT

 

TO: XORTX THERAPEUTICS INC. (the "Corporation")

 

The undersigned (hereinafter referred to
as the "Subscriber") hereby irrevocably subscribes for and agrees to purchase the number of units of the Corporation
set forth below (the "Units") for the aggregate subscription price set forth below (the "Aggregate Subscription
Price"), representing a subscription price of Cdn. $0.14 per Unit, upon and subject to the terms and-conditions set forth
in "Terms and Conditions of Subscription for Units of the Corporation" attached hereto (the "Terms and Conditions",
and together with this page and the attached exhibits, the "Subscription Agreement"). Each Unit will be comprised
of one common share of the Corporation ("Common Share") and one Common Share purchase warrant of the Corporation
("Warrant"). Each Warrant entitles the holder to purchase one Common Share ('Warrant Share") at a
price of Cdn. $0.25 per Warrant Share for a period of one year following the Closing Date (as defined herein), provided, however,
that, if, at any time following the expiry of the statutory four month plus one day hold period (the "Hold Period"),
the closing price of the common shares on the Canadian Securities Exchange (the "Exchange") (or such other exchange
as the shares of the Corporation are listed on) is greater than $0.35 for 10 or more consecutive trading days, the Warrants will
be accelerated and the Warrants will expire on the 20th Business Day following the date of such notice. In addition to this
face page, the Subscriber must also complete the applicable sections of the Terms and Conditions and the exhibits attached hereto,
if applicable.

 

Notice
is provided to the Subscriber and the Subscriber acknowledges that unless permitted under securities legislation, the holder of
the Common Shares and Warrants underlying the Units acquired hereunder or Warrant Shares underlying the Warrants (including the
Subscriber) must not trade such securities before the date that is four months and a day after the Closing Date.

 

	Prevail
    Partners LLC	 	 	Number
    of Units: 8,571,428
	(Name
    of Subscriber - please print	 	 	 
	 	 	 	Aggregate
    Subscription Price: Cdn. $ 1,602,132
	By:
    	/s/
    Mary Schaheen 	 	 	(or
    USD 1,200,000)
	 	(Authorized signature)	 	 	 
	 	 	 	If
    the Subscriber is signing as agent for a principal and is not deemed to be purchasing as principal pursuant to NI 45-106 (as
    defined herein) by virtue of being either: (i) a trust company or trust corporation acting on behalf of a fully managed
    account managed by the trust company or trust corporation; or (ii) a person acting on behalf of a fully managed account managed
    by it, and in each case satisfying the criteria set forth in NI 45 - 106 or Section 73.3 of the Securities Act (Ontario),  as
    applicable, complete the following and ensure that Exhibits are completed in respect of such principal ("Disclosed Beneficial
    Purchaser''):
	President
    and Director	 	 
	(Official
    Capacity or Title - please print)	 	 
	 	 	 
	Mary
    Schaheen	 	 
	(Please
    print name of individual whose signature appears above if different than the name of the subscriber printed above.)	 	 
	 	 	 
	211
    North 13th Street, Sixth Floor	 	 
	(Subscriber's
    Address)	 	 
	 	 	 	 
	Philadelphia,
    PA 19107	 	 	
	 	 	 	 
		 	 	(Name
    of Disclosed Beneficial Purchaser)
	(Telephone
    Number)	 	 	 
	 	 	 	
		 	 	(Disclosed
    Beneficial Purchaser's Address)
	(E-Mail
    Address)	 	 	 
	 	 	 	 
	 	 	 	(Disclosed
    Beneficial Purchaser's E-Mail Address)
	 	 	 	 

  

	Register the Common Shares and Warrants as set forth below:	 	 	Deliver the certificates representing the Commori Shares and Warrants as set forth below:
	Prevail Partners LLC	 	 	Prevail Partners LLC
	(Name)	 	 	(Name)
	NIA	 	 	NIA
	(Account reference, if applicable)	 	 	(Account reference, if applicable)
	211 North 13th Street, Sixth Floor	 	 	Patrick Keenan
	(Address)	 	 	(Contact Name)
	Philadelphia, PA 19107 USA	 	 	211 North 13th Street, Sixth Floor
	 	 	 	(Address)
	 	 	 	Philadelphia, PA 19107 USA

 

	 	 	 	 
	 	 	 	 
	The Subscriber or, if applicable, the Disclosed Beneficial Purchaser currently holds:	 	 	The Subscriber or, if applicable, the Disclosed Beneficial Purchaser, is (please check the applicable box(es)):
	               Common Shares; and	 	 	 ̈  an "insider" of the Corporation (as such term is described in the Securities Act (British Columbia))
	               securities convertible into Common Shares.	 	 	 ̈  a "registrant" (as such term is described in the Securities Act (British Columbia))
		 	 	 ̈  a Dealer pursuant to the policies of the Canadian Securities Exchange

 

This is the
first page of an agreement comprised of 16 pages (not including Exhibits).

 

    	 		 

     

    

  

CANADA,
UNITED STATES

AND
INTERNATIONAL

 

ACCEPTANCE: The Corporation hereby accepts the subscription
as set forth above on the terms and conditions contained in this Subscription Agreement.

 

Dated                                         ,
2020.

 

XORTX THERAPEUTICS INC.

 

	By:	 	 
	 	Authorized Signatory	 

 

    	 		 

     

    

  

CANADA,
UNITED STATES

AND
INTERNATIONAL

 

TERMS AND CONDITIONS OF SUBSCRIPTION
FOR

UNITS OF THE CORPORATION

 

Terms of the Offering

 

1.            The
Subscriber acknowledges (on its own behalf and, if applicable, on behalf of each Disclosed Beneficial Purchaser on whose behalf
the Subscriber is contracting) that this subscription is subject to rejection or allotment by the Corporation in whole or in part
at any time. If this subscription is rejected by the Corporation, this subscription and all monies tendered therewith shall be
returned forthwith to the Subscriber, without interest or deduction.

 

2.            The
Subscriber acknowledges (on its own behalf and, if applicable, on behalf of each Disclosed Beneficial Purchaser on whose behalf
the Subscriber is contracting) that the Units subscribed for by it hereunder form part of a larger issuance and sale by the Corporation
of an aggregate of up to 36,000,000 Units, at an issue price of $0.14 per Unit, for aggregate gross proceeds of up to approximately

$5,040,000 (the “Offering”).

 

3.            The
Subscriber is required to deliver the Aggregate Subscription Price prior to the Closing Date (as defined herein). The Subscriber’s
obligation to provide the full amount of the Aggregate Subscription Price is irrevocable.

 

Terms of the Units

 

4.            Each
Unit is comprised of one Common Share and one Warrant. The Common Shares and the Warrants comprising the Units will separate immediately
upon the closing of the Offering.

 

5.            The
Warrants will be created and issued pursuant to the terms of a definitive certificate representing the Warrants. The Warrants shall
be subject to such other terms and conditions as may be determined by the Corporation and to the definitive terms of the warrant
certificate.

 

6.            Each
Warrant entitles the holder thereof to purchase one Warrant Share at an exercise price of

$0.25 per Warrant Share at any time prior
to 4:30 p.m. (Calgary time) on or before the date that is one year following the Closing Date, provided, however, that, if, at
any time following the expiry of the Hold Period, the closing price of the common shares on the Exchange (or such other exchange
as the shares of the Corporation are listed on) is greater than $0.35 for 10 or more consecutive trading days, the Warrants will
be accelerated and the Warrants will expire on the 20th business day following the date of
such notice.

 

Representations, Warranties and Covenants
of the Subscriber

 

7.            The
Subscriber (on its own behalf and, if applicable, on behalf of each Disclosed Beneficial Purchaser on whose behalf the Subscriber
is contracting) (and for the purpose of the following representations, warranties and covenants, any reference to the “Subscriber”
or “it” includes the Subscriber and each Disclosed Beneficial Purchaser on whose behalf the Subscriber is contracting)
represents, warrants and covenants to the Corporation and its counsel (and acknowledges that the Corporation and its counsel are
relying thereon) both at the date hereof and at the Closing Time (as defined herein) that:

 

		(a)	it has been independently advised as to restrictions with respect
to trading in the Common Shares, Warrants and Warrant Shares (collectively, the “Offered Securities”) imposed
by applicable securities legislation in the jurisdiction in which it resides, confirms that no representation (written or verbal)
has been made to it by or on behalf of the Corporation with respect to the foregoing, acknowledges that it is aware of the characteristics
of the Offered Securities, the risks relating to an investment therein and of the fact that it not be able to resell the Offered
Securities except in accordance with limited exemptions under applicable securities legislation and regulatory policy until expiry
of the applicable restricted period and compliance with the other requirements of applicable law; and it agrees that any certificates
representing the Offered Securities shall bear a legend indicating that the resale of such securities is restricted; and the
Subscriber further acknowledges that it has been advised to consult its own legal counsel in its jurisdiction of residence for
full particulars of the resale restrictions applicable to it and it is the Subscriber’s responsibility to comply
with such restrictions before selling the Offered Securities; and

 

    	 	- 3 -	 

     

    

  

CANADA,
UNITED STATES

AND
INTERNATIONAL

 

		(b)	the Subscriber acknowledges that any certificates representing the Offered Securities will bear
the following legends indicating that the resale of such securities is restricted in accordance with applicable securities legislation:

 

“UNLESS PERMITTED UNDER SECURITIES
LEGISLATION, THE HOLDER OF

THIS SECURITY MUST NOT TRADE THE SECURITY BEFORE THE DATE

THAT IS 4 MONTHS AND A DAY AFTER THE [THE CLOSING DATE].”; and

 

		(c)	the Subscriber further acknowledges that:

 

		(i)	the Subscriber, in making the decision to invest in the Offered Securities, has relied solely upon
the information provided in this Subscription Agreement and the Subscriber’s own investigation of the Corporation, which
investigation has provided the Subscriber with all the information the Subscriber has deemed necessary for the purposes of its
investment decision, and not upon any oral or other written representation as to fact or otherwise made by or on behalf of the
Corporation or otherwise;

 

		(ii)	it has not received or been provided with, nor has it requested, nor does it have any need to receive,
any offering memorandum, registration statement, prospectus, sales or advertising literature or any other document;

 

		(iii)	it has received all the information that it considers necessary or appropriate for deciding whether
to purchase the Offered Securities and understands that any discussions with representatives of the Corporation, as well as any
information issued by the Corporation, were intended to describe certain aspects of the Corporation’s business and prospects,
but were not necessarily a thorough or exhaustive description;

 

		(iv)	any business plans prepared by the Corporation have been, and continue to be, subject to change
and any projections included in such business plans or otherwise are necessarily speculative in nature, and it can be expected
that some or all of the assumptions underlying the projections will not materialize or will vary significantly from actual results;
and

 

		(v)	it has carefully read and reviewed this Subscription Agreement and has asked such questions of
management of the Corporation and received all information as deemed necessary for it to make an informed decision with respect
to the investment hereunder; and

 

		(d)	it has not become aware of and the purchase of the Units is not made through or as a result of
any general solicitation or any advertisement in printed media of general and regular paid circulation (or other printed public
media), radio, television or telecommunications or other form of advertisement (including electronic display such as the Internet)
with respect to the distribution of the Units; and

 

		(e)	unless it is purchasing under subsection 7(g), it is purchasing the Units as principal for its
own account, not for the benefit of any other person, for investment only and not with a view to the resale or distribution of
all or any of the securities, it is resident in the jurisdiction set out as the “Subscriber’s Address” on the
face page hereof and if the Subscriber is acting as agent for a Disclosed Beneficial Purchaser, such Disclosed Beneficial Purchaser
is resident in the jurisdiction set forth in the Subscription Agreement as the “Principal’s Address”, and it
or, if the Subscriber is acting as agent for a Disclosed Beneficial Purchaser, the Disclosed Beneficial Purchaser fully complies
with one or more of the criteria set forth below:

 

		(i)	it is resident in one of the provinces or territories of
                                                                                                    Canada, and it is an “accredited investor”, as such term is defined: (A) if the Subscriber is resident
                                                                                                    in or otherwise subject to the applicable securities laws of a jurisdiction of Canada other than Ontario, in National Instrument
                                                                                                    45-106 entitled “Prospectus Exemptions” (“NI 45-106”) promulgated under applicable securities
                                                                                                    legislation in such jurisdictions; or (B) if the Subscriber is resident in or otherwise subject to the applicable securities
                                                                                                    laws of Ontario, in Section 73.3(1) of the Securities Act (Ontario), it was not created or used solely to purchase or
                                                                                                    hold securities as an accredited investor as described in paragraph (m) of the definition of “accredited
                                                                                                    investor” in NI 45-106, and it has concurrently executed and delivered a Representation Letter in the form attached as Exhibit
                                                                                                    1 to this Subscription Agreement and specifically represents and warrants that one or more of the categories set forth in Appendix
                                                                                                    A attached to the Representation Letter correctly, and in all respects, describes the Subscriber, and will describe the
                                                                                                    Subscriber as at the Closing Date, and the Subscriber has so indicated by initialing beside the category in such Appendix
                                                                                                    A which so describes it, and, if applicable, has completed the Accredited Investor Risk Acknowledgment Form in the form
                                                                                                    attached as Appendix B to the Representation Letter; or

 

    	 	- 4 -	 

     

    

 

CANADA,
UNITED STATES

AND
INTERNATIONAL

 

		(ii)	it is resident in one of the provinces or territories of Canada and the acquisition cost
to the Subscriber of purchasing the Units is not less than $150,000 paid in cash at the time of the trade and it was not created
or used solely to purchase or hold securities in reliance on this exemption from the prospectus requirement and it is one of the
following and the Subscriber has so indicated by initialing the applicable paragraph:

 

____ (I)    a
corporation that pre-existed the Offering and has a bona fide purpose other than the investment in the Offered Securities;
or

 

____ (II)   a
partnership, trust, fund and or association, syndicate organization or other organized group of persons, whether incorporated or
not, that pre-existed the Offering of the Units and has a bona fide purpose other than the investment in the Offered Securities;
or

 

____ (III)  an
individual or other person in that person’s capacity as a trustee, executor, administrator or personal or other legal representative;
or

 

		(iii)	it is resident in one of the provinces or territories of Canada and is one of the following and the Subscriber has so
indicated by initialing the applicable paragraph:

 

____ (I)    a
“director”, “executive officer” or “control person” (as such terms are
defined in the Securities Act (British Columbia) or NI 45-106 and reproduced in Appendix A to Exhibit 1 of this Subscription
Agreement) of the Corporation, or of an “affiliate” (as such term is defined in NI 45-106 and reproduced in Appendix
A to Exhibit 1 of this Subscription Agreement) of the Corporation; or

 

____ (II)   a
“spouse” (as such term is defined in NI 45-106 and reproduced in Appendix A to Exhibit 1 of this Subscription
Agreement), parent, grandparent, brother, sister, child or grandchild of any person referred to in subparagraph (I) above; or

 

____ (III)  a
parent, grandparent, brother, sister, child or grandchild of the spouse of any person referred to in subparagraph (I) above; or

 

____ (IV)  a
“close personal friend” of any person referred to in subparagraph (I) above, and it certifies to the Corporation
that it has reviewed and understands the guidance respecting the meaning of the phrase "close personal friend" set forth
in Exhibit 2 hereto and has provided the details of that relationship in the Questionnaire attached hereto in Exhibit
2 and, if the Subscriber is resident in or otherwise subject to the applicable securities laws of Saskatchewan, the
Subscriber has concurrently executed and delivered a Risk Acknowledgement Form in the form attached as Exhibit 3 to this
Subscription Agreement; or

 

    	 	- 5 -	 

     

    

 

CANADA,
UNITED STATES

AND
INTERNATIONAL

 

____ (V)   a
“close business associate” of any person referred to in subparagraph (I) above, and it certifies to the Corporation
that it has reviewed and understands the guidance respecting the meaning of the phrase "close business associate" set
forth in Exhibit 2 hereto and has provided the details of that relationship in the Questionnaire attached hereto in Exhibit
2 and if the Subscriber is resident in or otherwise subject to the applicable securities laws of Saskatchewan, the Subscriber
has concurrently executed and delivered a Risk Acknowledgement Form in the form attached as Exhibit 3 to this Subscription
Agreement; or

 

____ (VI)  a
“founder” (as such term is defined in NI 45-106 and reproduced in Appendix A to Exhibit 1 of this Subscription
Agreement) of the Corporation or a spouse, parent, grandparent, brother, sister, child, close personal friend or close business
associate of a founder of the Corporation, and, if the Subscriber is a close personal friend or close business associate of a founder
of the Corporation, has provided the details of that relationship in the Questionnaire attached hereto in Exhibit 2 and
if the Subscriber is resident in or otherwise subject to the applicable securities laws of Saskatchewan, the Subscriber
has concurrently executed the Risk Acknowledgement Form attached as Exhibit 3 to this Subscription Agreement;

 

____ (VII) a
parent, grandparent, brother, sister, child or grandchild of the spouse of a founder of the Corporation; or

 

____ (VIII)a
person of which a majority of the voting securities are beneficially owned by, or a majority of directors are, persons or companies
described in subparagraphs (I) through (VII) above, and if the Subscriber is relying on persons who are close personal friends
or close business associates of a director, executive officer, control person or founder of the Corporation, has provided the details
of that relationship in the Questionnaire attached hereto in Exhibit 2 and if the Subscriber is resident in or otherwise
subject to the applicable securities laws of Saskatchewan, the Subscriber has concurrently executed the Risk Acknowledgement
Form attached as Exhibit 3 to this Subscription Agreement; or

 

____ (IX) a
trust or estate of which all of the beneficiaries or a majority of the trustees or executors are persons or companies described
in subparagraphs (I) through (VII) above, and if the Subscriber is relying on persons who are close personal friends or close business
associates of a director, executive officer, control person or founder of the Corporation, has provided the details of that relationship
in the Questionnaire attached hereto in Exhibit 2 and if the Subscriber is resident in or otherwise subject to the applicable
securities laws of Saskatchewan, the Subscriber has concurrently executed the Risk Acknowledgement Form attached as Exhibit
3 to this Subscription Agreement,

 

and in the case of a Subscriber
resident in or otherwise subject to applicable securities laws of Ontario, then the Subscriber has completed and executed
Exhibit 4 to this Subscription Agreement, which has also been completed and executed by the other persons specified as follows:

 

		(A)	an executive officer of the Corporation other than the Subscriber;

 

		(B)	if the Subscriber is a person referred to under paragraph 7(e)(iii)(II), the director, executive officer or control person
of the Corporation or an affiliate of the Corporation who has the specified relationship with the Subscriber;

    	 	- 6 -	 

     

    

 

CANADA,
UNITED STATES

AND
INTERNATIONAL

 

		(C)	if the Subscriber is a person referred to under paragraph 7(e)(iii)(III), the director, executive officer or control person
of the Corporation or an affiliate of the Corporation whose spouse has the specified relationship with the Subscriber;

 

		(D)	if the Subscriber is a person referred to under paragraph 7(e)(iii)(IV) or 7(e)(iii)(V), the director, executive officer or
control person of the Corporation or an affiliate of the Corporation who is a close personal friend or a close business associate
of the Subscriber; and

 

		(E)	the founder of the Corporation, if the Subscriber is a person referred to in paragraph 7(e)(iii)(VI) or 7(e)(iii)(VII) other
than the founder of the Corporation; or

 

		(iv)	if it is a resident or otherwise subject to applicable securities laws of any jurisdiction referred
to in the preceding paragraphs but not purchasing thereunder, it is purchasing pursuant to an exemption from prospectus and
registration requirements (particulars of which are enclosed herewith) available to it under applicable securities legislation
and shall deliver to the Corporation such further particulars of the exemption(s) and the Subscriber’s qualifications thereunder
as the Corporation or their counsel may request; or

 

		(v)	it is a "U.S. Purchaser." “U.S. Purchaser” means (a) any "U.S.
person" as defined in Regulation S of the United States Securities Act of 1933, as amended (the "U.S. Securities Act"),
(b) any person purchasing securities on behalf of any "U.S. Person" or any person in the United States, (c) any person
that receives or received an offer of the securities while in the United States, (d) any person that is in the United States at
the time the purchaser’s buy order was made or this subscription agreement was executed or delivered. "U.S. person"
includes but is not limited to (i) any natural person resident in the United States; (ii) any partnership or corporation organized
or incorporated under the laws of the United States; (iii) any partnership or corporation organized outside the United States by
a U.S. person principally for the purpose of investing in securities not registered under the U.S. Securities Act, unless it is
organized or incorporated, and owned, by accredited investors who are not natural persons, estates or trusts; and (iv) any estate
or trust of which any executor or administrator or trustee is a U.S. person; and

 

		(A)	it and each person on whose behalf the Subscriber is contracting has concurrently executed and
delivered to the Corporation the "Certification of U.S. Purchaser" in the form attached hereto as Exhibit 5 to this
Subscription Agreement, which is incorporated into and forms a part of this Subscription Agreement; and

 

		(B)	it and each person on whose behalf the Subscriber is contracting has concurrently executed and
delivered to the Corporation the Representation Letter in the form attached as Exhibit 1 to this Subscription Agreement,
which is incorporated into and forms a part of this Subscription Agreement; and.

 

		(f)	if the Subscriber is resident in or otherwise subject to applicable securities laws of a jurisdiction other than Canada
or the United States, the Subscriber confirms, represents and warrants that:

 

		(i)	it is an “accredited investor”, as such term is defined in NI 45-106, it was not created
or used solely to purchase or hold securities as an accredited investor as described in paragraph (m) of the definition of “accredited
investor” in NI 45-106 and it has concurrently executed and delivered a Representation Letter in the form attached as
Exhibit 1 to this Subscription Agreement and specifically represents and warrants that one or more of the categories set forth
in Appendix A attached to the Representation Letter correctly, and in all respects, describes the Subscriber, and will describe
the Subscriber as at the Closing Date (as defined herein) and the Subscriber has so indicated by initialing beside the category
in such Appendix A which so describes it, and,

 

    	 	- 7 -	 

     

    

 

CANADA,
UNITED STATES

AND
INTERNATIONAL

 

if applicable, has completed the Accredited Investor
Risk Acknowledgment Form in the form attached as Appendix B to the Representation Letter; and

 

		(ii)	the Subscriber is knowledgeable of, or has been independently advised as to, the applicable securities
laws of the jurisdiction in which the Subscriber is resident (the “International Jurisdiction”) and which would
apply to the acquisition of the Offered Securities; and

 

		(iii)	the Subscriber is purchasing the Units pursuant to exemptions from the prospectus or registration
requirements or equivalent requirements under applicable securities laws or, if such is not applicable, the Subscriber is permitted
to purchase the Units under the applicable securities laws of the International Jurisdiction without the need to rely on any exemptions;
and

 

		(iv)	the applicable securities laws of the International Jurisdiction do not require the Corporation
to make any filings or seek any approvals of any kind whatsoever from any securities regulator of any kind whatsoever in the International
Jurisdiction in connection with the sale of the Units or the issue or resale of the Offered Securities; and

 

		(v)	the purchase of the Units by the Subscriber does not trigger:

 

		(A)	any obligation to prepare and file a prospectus or similar document, or any other report with respect to such purchase in the
International Jurisdiction; or

 

		(B)	any continuous disclosure reporting obligation of the Corporation in the International Jurisdiction; and

 

		(vi)	the Subscriber will, if requested by the Corporation, deliver to the Corporation either or both:
(A) a certificate or opinion of local counsel from the International Jurisdiction which will confirm the matters referred to above
(and such other matters as maybe reasonably be requested by the Corporation or its legal counsel) to the satisfaction of the Corporation,
acting reasonably; and/or (B) such other evidence of compliance with all aforementioned matters as the Corporation or its legal
counsel may request; and

 

		(g)	if it is not purchasing as principal, it has disclosed the name of the Disclosed Beneficial Purchaser
on the face-page of this Subscription Agreement, it is duly authorized to enter into this Subscription Agreement and to execute
and deliver all documentation in connection with the purchase on behalf of each Disclosed Beneficial Purchaser, each of whom is
purchasing as principal for its own account, not for the benefit of any other person, and not with a view to the resale or distribution
of all or any of the Offered Securities, it acknowledges that the Corporation is required by law to disclose to certain regulatory
authorities the identity of each Disclosed Beneficial Purchaser of Units for whom it may be acting, and it is resident in the jurisdiction
set out as the “Subscriber’s Address” and each Disclosed Beneficial Purchaser is resident in the jurisdiction
set out as the “Disclosed Beneficial Purchaser’s Address” and:

 

		(i)	it is resident in or otherwise subject to applicable securities laws of one of the provinces
or territories of Canada and it is an “accredited investor” as such term is defined in paragraphs (p) or (q) of
the definition of “accredited investor” in NI 45-106 and reproduced in Appendix A to Exhibit 1 of this
Subscription Agreement (provided, however, that it is not a trust company or trust corporation registered under the laws of Prince
Edward Island that is not registered or authorized under the Trust and Loan Companies Act (Canada) or under comparable legislation
in another jurisdiction in Canada) and is therefore deemed to be purchasing as principal pursuant to NI 45-106 and it has concurrently
executed and delivered a Representation Letter in the form attached hereto as Exhibit 1 and has initialed in Appendix
A thereto indicating that the Subscriber satisfies one of the categories of “accredited investor” set out in paragraphs
(p) or (q) of Appendix A thereto; or

 

    	 	- 8 -	 

     

    

 

CANADA,
UNITED STATES

AND
INTERNATIONAL

 

		(ii)	subject to securities laws applicable to the Subscriber, it is acting as agent for one or more
Disclosed Beneficial Purchasers, each of such principals is purchasing as principal for its own account, not for the benefit of
any other person, for investment only, and not with a view to the resale or distribution of all or any of the Offered Securities,
and each of such principals complies with subparagraphs (i), (ii), (iii), (iv) or (v) of paragraph 7(e) hereof as are applicable
to it; and

 

		(h)	it (and any Disclosed Beneficial Purchaser for whom it is acting) acknowledges that:

 

		(i)	no securities commission or similar regulatory authority has reviewed or passed on the merits of
the Offered Securities; and

 

		(ii)	there is no government or other insurance covering the Offered Securities; and

 

		(iii)	there are risks associated with the purchase of Units and investment in the Offered Securities;
and

 

		(iv)	there are restrictions on the Subscriber’s ability to resell the Offered Securities and it
is the responsibility of the Subscriber to find out what those restrictions are and to comply with them before selling any of those
securities; and

 

		(v)	the Corporation may complete additional financings in the future in order to develop the proposed
business of the Corporation and to fund its ongoing development. There is no assurance that such financing will be available and
if available, on reasonable terms. Any such future financings may have a dilutive effect on current shareholders, including the
Subscriber; and

 

		(vi)	the Corporation has advised the Subscriber that the Corporation is relying on an exemption from
the requirements to provide the Subscriber with a prospectus and to sell securities through a person or company registered to sell
securities under the Securities Act (British Columbia) and other applicable securities laws and, as a consequence of acquiring
the Common Shares and Warrants pursuant to this exemption, certain protections, rights and remedies provided by those securities
laws, including statutory rights of rescission or damages, will not be available to the Subscriber; and

 

		(i)	the Subscriber has not received from the Corporation any financial assistance of any kind, directly
or indirectly, in connection with its purchase of Units hereunder; and

 

		(j)	the Subscriber has not and will not enter into any voting trust or similar agreement that has the
effect of directing the manner in which the votes attached to the Offered Securities purchased pursuant to this Subscription Agreement
may be voted following the Closing Date; and

 

		(k)	it is aware that the Offered Securities have not been and will not be registered under the U.S.
Securities Act or the securities laws of any state, territory or possession of the United States and that these securities may
not be offered or sold, directly or indirectly in the United States without registration under the U.S. Securities Act or compliance
with requirements of an exemption from registration and the applicable laws of the applicable states and acknowledges that the
Corporation has no present intention of filing a registration statement under the U.S. Securities Act in respect of the Common
Shares, Warrants or Warrant Shares; and

 

		(l)	unless the Subscriber is completing the "Certification of U.S. Purchaser" in the form
attached hereto as Exhibit 5 to this Subscription Agreement, the Units have not been offered to the Subscriber in the United
States, and the individuals making the order to purchase the Units and executing and delivering this Subscription Agreement on
behalf of the Subscriber were not in the United States when the order was placed and this Subscription Agreement was executed and
delivered; and

 

		(m)	unless the Subscriber is completing the "Certification of U.S. Purchaser" in the form
attached hereto as Exhibit 5 to this Subscription Agreement, it is not a U.S. Purchaser; and

 

    	 	- 9 -	 

     

    

 

CANADA,
UNITED STATES

AND
INTERNATIONAL

 

		(n)	it (and, if applicable, any Disclosed Beneficial Purchaser) undertakes and agrees that it will
not offer or sell any of the Offered Securities in the United States unless such securities are registered under the U.S. Securities
Act and the securities laws of all applicable states of the United States or an exemption from such registration requirements is
available and further that it will not resell any of the Offered Securities subscribed for hereunder except in accordance with
the provisions of applicable securities legislation, regulations, rules, policies and orders and stock exchange rules; and

 

		(o)	if it is not an individual: (i) it has the legal capacity to authorize, execute, be bound by and
deliver this Subscription Agreement, and (ii) the individual signing this Subscription Agreement has been duly authorized to execute
and deliver this Subscription Agreement, and (iii) all necessary approvals of directors, officers, shareholders or otherwise have
been given and obtained; and

 

		(p)	if it is an individual, it is of the full age of majority in the jurisdiction in which it is resident
and is legally capable and competent to execute and be bound by this Subscription Agreement and take all action and to perform
the covenants and obligations pursuant hereto; and

 

		(q)	the Subscriber has had adequate time to review this Subscription Agreement; and

 

		(r)	this Subscription Agreement has been duly and validly authorized, executed and delivered and, when
accepted by the Corporation, will constitute a legal, valid, binding and enforceable obligation of the Subscriber; and

 

		(s)	in the case of a subscription by it for Units acting as agent for a Disclosed Beneficial Purchaser,
it is duly authorized to execute and deliver this Subscription Agreement and all other necessary documentation in connection with
such subscription on behalf of such Disclosed Beneficial Purchaser and this Subscription Agreement has been duly authorized, executed
and delivered by or on behalf of, and constitutes a legal, valid, binding and enforceable obligation of, such Disclosed Beneficial
Purchaser and the Subscriber acknowledges that the Corporation is required by law to disclose to certain principal regulatory authorities
the identity of each Disclosed Beneficial Purchaser for whom the Subscriber may be acting; and

 

		(t)	it has such knowledge in financial and business affairs as to be capable of evaluating the merits
and risks of its investment in the Offered Securities and is able to bear the economic risk of loss of its investments or, where
it is not purchasing as principal, each Disclosed Beneficial Purchaser, is able to bear the economic risk of loss of its investment
in the Offered Securities and it has had access to such information, if any, concerning the Corporation and the terms and conditions
of the Offering as it considered necessary in connection with its investment decision; and

 

		(u)	it confirms that none of the Corporation or any of its respective directors, officers, employees
or representatives have made any representations (oral or written) to the Subscriber:

 

		(i)	that any person will resell or repurchase any of the Offered Securities;

 

		(ii)	that any person will refund the purchase price of any of the Offered Securities; or

 

		(iii)	as to the future price or value of any of the Offered Securities; and

 

		(v)	it acknowledges that the Corporation’s counsel is acting as counsel to the Corporation and
not as counsel to the Subscriber; and

 

		(w)	the Subscriber is relying solely upon this Subscription Agreement and publicly available information
relating to the Corporation and, other than as stated herein, not upon any verbal or written representation as to fact or otherwise
made by or on behalf of the Corporation; and

 

		(x)	it acknowledges that this Subscription Agreement is not enforceable by the Subscriber until the
Subscription Agreement has been accepted by the Corporation; and

 

    	 	- 10 -	 

     

    

 

CANADA,
UNITED STATES

AND
INTERNATIONAL

 

		(y)	it understands, acknowledges and is aware that Units are being offered for sale only on a “private
placement” basis and that the sale of Units and delivery of the Common Shares and Warrants is conditional upon such sale
being exempt from the requirements under applicable securities laws as to the filing of a prospectus or delivery of an offering
memorandum or upon the issuance of such orders, consents or approvals as may be required to permit such sale without the filing
of a prospectus or delivering an offering memorandum and, as a consequence: (i) it is restricted from using most of the civil remedies
available under securities legislation; (ii) the common law may not provide it with an adequate remedy in the event that it suffers
investment loss in connection with securities acquired in a private placement; (iii) it may not receive information that would
otherwise be required to be provided to it under securities legislation; and (iv) the Corporation is relieved from certain obligations
that would otherwise apply under securities legislation; and

 

		(z)	if required by applicable securities legislation, regulations, rules, policies or orders or by
any securities commission, stock exchange or other regulatory authority, the Subscriber will execute, deliver, file and otherwise
assist the Corporation in filing, such reports, undertakings and other documents with respect to the issue of the Common Shares
and Warrants including, without limitation: (i) in the case of an “accredited investor” resident in one of the provinces
or territories of Canada, a Representation Letter in the form attached as Exhibit 1, including Appendix A and, if
applicable, the Accredited Investor Risk Acknowledgment Form in the form attached as Appendix B; (ii) if the Subscriber
is purchasing under subparagraph 7(e)(iii) hereof as a “close personal friend” or “close business associate”,
the Questionnaire attached hereto in Exhibit 2 and if the Subscriber is resident in or otherwise subject to the applicable
securities laws of Saskatchewan, the Risk Acknowledgement Form attached as Exhibit 3 to this Subscription Agreement; (iii)
if the Subscriber is resident in or otherwise subject to the applicable securities laws of Ontario and is purchasing under subparagraph
7(e)(iii), Exhibit 4 to this Subscription Agreement; (iv) if the Subscriber is purchaser under subparagraph 7(e)(v) as a
U.S. Purchaser, the Certification of U.S. Purchaser in the form attached as Exhibit 5 to this subscription Agreement and
a Representation Letter in the form attached as Exhibit 1, including Appendix A and, if applicable, the Accredited
Investor Risk Acknowledgment Form in the form attached as Appendix B; and

 

		(aa)	the Subscriber does not act jointly or in concert with another subscriber for Units for the purposes
of the acquisition of the Offered Securities; and

 

		(bb)	the entering into of this Subscription Agreement and the completion of the transactions contemplated
hereby do not and will not result in a violation of any of the terms or provisions of any law applicable to the Subscriber, or
if the Subscriber is not a natural person, any of the Subscriber’s constating documents, or any agreement to which the Subscriber
is a party or by which it is bound; and

 

		(cc)	the delivery of this Subscription Agreement, the acceptance hereof by the Corporation and the issuance
of the Common Shares and Warrants to the Subscriber complies or will comply with all applicable laws of the Subscriber’s
jurisdiction of residence and domicile and will not cause the Corporation or any of its officers or directors to become subject
to or require any disclosure, prospectus or other reporting requirement; and

 

		(dd)	unless it is purchasing under Section 7(e)(iii)(I) hereof, the Subscriber is not a “control
person” of the Corporation, as that term is defined in the Securities Act (British Columbia), will not become a “control
person” of the Corporation by purchasing the number of Units subscribed for under this Subscription Agreement, and does not
intend to act jointly or in concert with any other person to form a control group in respect of the Corporation; and

 

		(ee)	no authorization, consent, order, approval or notice of any federal, provincial, territorial, municipal
or foreign regulatory body or official must be obtained or given, and no waiting period must expire, in order that this Subscription
Agreement and the transactions contemplated herein can be consummated by the Subscriber; and

 

		(ff)	the Subscriber acknowledges that it has been encouraged to obtain independent legal, income tax
and investment advice with respect to its subscription for these Units and accordingly, had the opportunity to acquire an understanding
of the meanings of all terms contained herein relevant to the Subscriber for purposes of giving representations, warranties and
covenants under this Subscription Agreement.

 

    	 	- 11 -	 

     

    

 

CANADA,
UNITED STATES

AND
INTERNATIONAL

 

Representations, Warranties and Covenants of the Corporation

 

8.            By
accepting this Subscription Agreement, the Corporation represents, warrants and covenants to the Subscriber (and acknowledges that
the Subscriber is relying thereon) both at the date hereof and at the Closing Time that:

 

		(a)	the Corporation has the full corporate right, power and authority to execute and deliver this Subscription
Agreement and to issue the Offered Securities; and

 

		(b)	this Subscription Agreement, once accepted, constitutes a binding obligation of the Corporation
enforceable in accordance with its terms; and

 

		(c)	the execution and delivery of, and the performance of the terms of, this Subscription Agreement
by the Corporation, including the issuance of the Common Shares and Warrants, does not and will not constitute a breach of or default
under the constating documents of the Corporation or any law, regulation, order or ruling applicable to the Corporation or any
agreement, contract or indenture to which the Corporation is a party or by which it is bound.

 

Closing

 

9.            The
Subscriber agrees to deliver to the Corporation’s Corporate Secretary at cmay@xortx.com not later than 4:00 p.m. (Calgary
time) on February 24, 2020, or by such other time as is acceptable to the Corporation:

 

		(a)	this duly completed and executed Subscription Agreement;

 

		(b)	if the Subscriber is an “accredited investor”, a fully executed and completed Representation
Letter in the form attached as Exhibit 1, including Appendix A and, if applicable, the Accredited Investor Risk Acknowledgment
Form in the form attached as Appendix B;

 

		(c)	if the Subscriber is purchasing under subparagraph 7(e)(iii) hereof as a “close personal
friend” or “close business associate”, the Questionnaire attached hereto in Exhibit 2 and if the Subscriber
is resident in or otherwise subject to the applicable securities laws of Saskatchewan, the Subscriber has concurrently executed
the Risk Acknowledgement Form attached as Exhibit 3 to this Subscription Agreement;

 

		(d)	if the Subscriber is resident in or otherwise subject to the applicable securities laws of Ontario
and is purchasing under subparagraph 7(e)(iii), Exhibit 4 to this Subscription Agreement;

 

		(e)	if the Subscriber is purchasing under subparagraph 7(e)(v), the Certification of U.S. Purchaser
in the form attached as Exhibit 5 to this subscription Agreement and a Representation Letter in the form attached as Exhibit
1, including Appendix A and, if applicable, the Accredited Investor Risk Acknowledgment Form in the form attached as
Appendix B; and

 

		(f)	such other documents as may be required or requested of the Subscriber by the Corporation or its
counsel as contemplated herein.

 

10.          The
Subscriber further agrees to deliver the Aggregate Subscription Price by way of wire transfer, certified cheque or bank draft payable
to “McCarthy Tétrault LLP, in trust” for an amount equal to the Aggregate Subscription Price or payment
of the same amount in such other manner as is acceptable to the Corporation not later than 4:00 p.m. (Calgary time) on February
24, 2020. If this Subscription Agreement is rejected in whole or in part, the Subscriber acknowledges that the unused portion of
the Aggregate Subscription Price will be promptly returned to it without interest.

 

    	 	- 12 -	 

     

    

 

CANADA,
UNITED STATES

AND
INTERNATIONAL

 

If sending by wire, please send as follows:

 

	
        PRIMARY BANK

        aka Final Destination bank
	TRUST ACCOUNT
	        	
	              	
	           	
	
		
	
		

 

If sending a certified cheque or bank draft, please
send to:

 

McCarthy Tétrault LLP

Suite 4000, 421 – 7th Avenue S.W. 

Calgary, Alberta
T2P 4K9 

Attention: Rick Pawluk

 

11.       The
closing of the Offering will be completed at the offices of McCarthy Tétrault LLP, the Corporation’s counsel, at Suite
4000, 421 – 7th Avenue S.W., Calgary, Alberta. The closing will occur at 8:00 a.m. (Calgary time) or such other time agreed
on by the Corporation (the “Closing Time”) on February 28, 2020 or such other date or dates agreed on by the
Corporation (the “Closing Date”).

 

12.       The
Corporation shall be entitled to rely on delivery of a facsimile or electronically scanned (PDF) copy of executed subscriptions,
and acceptance by the Corporation of such facsimile or electronically scanned subscriptions shall be legally effective to create
a valid and binding agreement between the Subscriber and the Corporation in accordance with the terms hereof. Notwithstanding the
foregoing, upon the request of the Corporation, the Subscriber shall deliver originally executed copies of the documents listed
in Section 9 hereof to the Corporation within two business days of such request. In addition, this Subscription Agreement may be
executed in counterparts, each of which shall be deemed to be an original and all of which shall constitute one and the same document.

 

General

 

13.       The
Subscriber agrees that the representations, warranties and covenants of the Subscriber herein will be true and correct both as
of the execution of this Subscription Agreement and as of the Closing Time and will survive the completion of the issuance of
the Common Shares and Warrants. The representations, warranties and covenants of the Subscriber herein are made with the intent
that they be relied upon by the Corporation and its counsel in determining the eligibility of a purchaser of Units and the Subscriber
agrees to indemnify the Corporation and its directors, officers, employees, advisors, affiliates, shareholders, partners and agents
from and against any and all loss, liability, claim, damage and expense whatsoever including, but not limited to, any fees, costs
and expenses whatsoever reasonably incurred in investigating, preparing or defending against any litigation, administrative proceeding
or investigation commenced or threatened or any claim whatsoever arising out of or based upon any representation or warranty of
the Subscriber contained herein or in any document furnished by the Subscriber to the Corporation in connection herewith being
untrue in any material respect or any breach or failure by the Subscriber to comply with any covenant or agreement made by the
Subscriber herein or in any document furnished by the Subscriber to the Corporation in connection herewith. The Subscriber undertakes
to immediately notify the Corporation, c/o McCarthy Tétrault LLP, Suite 4000, 421 - 7th Avenue S.W., Calgary, Alberta T2P
4K9, Attention: Rick Pawluk (fax:       ) of any change
in any statement or other information relating to the Subscriber set forth herein which takes place prior to the Closing Time.

 

    	 	- 13 -	 

     

    

 

CANADA,
UNITED STATES

AND
INTERNATIONAL

 

14.          The
Subscriber, on its own behalf and, if applicable, on behalf of each Disclosed Beneficial Purchaser for whom it is contracting hereunder,
acknowledges and consents to the fact that the Corporation is collecting its personal information (as that term is defined under
applicable privacy legislation, including, without limitation, the Personal Information Protection and Electronic Documents
Act (Canada) and any other applicable similar, replacement or supplemental provincial or federal legislation or laws in effect
from time to time), or that of each Disclosed Beneficial Purchaser for whom it is contracting hereunder, for the purpose of completing
the Offering, which includes, without limitation, determining the Subscriber’s eligibility to purchase the Units under applicable
securities laws, preparing and registering certificates representing the Offered Securities to be issued to the Subscriber and
completing filings required by any stock exchange or securities regulatory authority. The Subscriber, on its own behalf and, if
applicable, on behalf of each Disclosed Beneficial Purchaser for whom it is contracting hereunder, acknowledges and consents to
the Corporation retaining such personal information for as long as permitted or required by law or business practices. The Subscriber,
on its own behalf and, if applicable, on behalf of each Disclosed Beneficial Purchaser for whom it is contracting hereunder, further
acknowledges and consents to the fact that the Corporation may be required by the securities laws of the applicable jurisdictions,
the rules and policies of any securities commission, stock exchange or the rules of the Investment Dealers Association of Canada
to provide regulatory authorities with any personal information provided by the Subscriber in this Subscription Agreement. The
Subscriber represents and warrants, as applicable, that it has the authority to provide the consents and acknowledgements set out
in this paragraph on behalf of each Disclosed Beneficial Purchaser for whom it is contracting hereunder. In addition to the foregoing,
it agrees and acknowledge that the Corporation may use and disclose its personal information, or that of each Disclosed Beneficial
Purchaser for whom it is contracting hereunder, as follows:

 

		(a)	for internal use with respect to managing the relationships between and contractual obligations
of the Corporation and the Subscriber or any Disclosed Beneficial Purchaser for whom it is contracting hereunder;

 

		(b)	for use and disclosure for income tax related purposes, including without limitation, where required
by law, disclosure to Canada Revenue Agency;

 

		(c)	disclosure to securities regulatory authorities and other regulatory bodies with jurisdiction with
respect to reports of trades and similar regulatory filings;

 

		(d)	disclosure to a governmental or other authority to which the disclosure is required by court order
or subpoena compelling such disclosure and where there is no reasonable alternative to such disclosure;

 

		(e)	disclosure to professional advisors of the Corporation in connection with the performance of their
professional services;

 

		(f)	disclosure to any person where such disclosure is necessary for legitimate business reasons and
is made with the Subscriber’s prior written consent;

 

		(g)	disclosure to a court determining the rights of the parties under this Subscription Agreement;
or

 

		(h)	for use and disclosure as otherwise required or permitted by law.

 

		15.	Furthermore, the Subscriber acknowledges and agrees that:

 

		(a)	information with respect to the Subscriber’s full name, residential address (or head office)
and telephone number, the number and type of securities received, the total value of such securities, the prospectus exemption
relied upon by the Corporation and the date of distribution (collectively the “Subscriber Information”) may
be delivered to the securities regulatory authority or regulator in each Canadian jurisdiction in which the Subscriber resides,
or in circumstances where a subscription for securities is otherwise subject to such a reporting requirement under applicable securities
laws;

 

    	 	- 14 -	 

     

    

 

CANADA,
UNITED STATES

AND
INTERNATIONAL

 

		(b)	the Subscriber Information is being collected indirectly by securities regulatory authority or
regulator under the authority granted to it by applicable securities laws;

 

		(c)	the Subscriber Information is being collected for the purposes of the administration and enforcement
of applicable securities laws;

 

		(d)	the Subscriber or any Disclosed Beneficial Purchaser for whom the Subscriber is contracting hereunder
hereby authorizes the indirect collection of the Subscriber Information by the applicable securities regulatory authority or regulator
in each Canadian jurisdiction;

 

		(e)	that the title, business address and business telephone number of the public official in each province
of Canada who can answer questions about the securities regulatory authority or regulator’s indirect collection of the Subscriber
Information is set out in Exhibit 5;

 

		(f)	the Subscriber Information may become available to the public in accordance with the requirements
of applicable securities laws and the Subscriber consents to the disclosure of such information; and

 

		(g)	while Subscriber Information in the report described above is currently not expected to be placed
on the public file of any Canadian securities regulatory authority regulator, freedom of information legislation may require the
securities regulatory authority or regulator to make this information available, if requested.

 

16.          The
Subscriber represents and warrants that the funds representing the Aggregate Subscription Price which will be advanced by the Subscriber
to the Corporation hereunder will not represent proceeds of crime for the purposes of the Proceeds of Crime (Money Laundering)
and Terrorist Financing Act (Canada) (the “PCMLTFA”) or the Providing Appropriate Tools Required to Intercept
and Obstruct Terrorism Act of the United States (the "Patriot Act"), and the Subscriber acknowledges that
the Corporation may in the future be required by law to disclose the Subscriber’s name and other information relating to
this Subscription Agreement and the Subscriber’s subscription hereunder, on a confidential basis, pursuant to the PCMLTFA.
To the best of its knowledge (a) none of the subscription funds to be provided by the Subscriber (i) have been or will be derived
from or related to any activity that is deemed criminal under the law of Canada, the United States of America, or any other jurisdiction,
or (ii) are being tendered on behalf of a person or entity who has not been identified to the Subscriber, and (b) it will promptly
notify the Corporation if the Subscriber discovers that any of such representations ceases to be true, and to provide the Corporation
with appropriate information in connection therewith.

 

17.          The
Subscriber acknowledges and agrees that all costs incurred by the Subscriber (including any fees and disbursements of any special
counsel retained by the Subscriber) relating to the sale of the Units to the Subscriber shall be borne by the Subscriber.

 

18.          The
contract arising out of this Subscription Agreement and all documents relating thereto shall be governed by and construed in accordance
with the laws of the Province of Alberta and the federal laws of Canada applicable therein. The parties irrevocably attorn to the
exclusive jurisdiction of the courts of the Province of Alberta.

 

19.          Time
shall be of the essence hereof.

 

20.          This
Subscription Agreement represents the entire agreement of the parties hereto relating to the subject matter hereof and there are
no representations, covenants or other agreements relating to the subject matter hereof except as stated or referred to herein.

 

21.          The
terms and provisions of this Subscription Agreement shall be binding upon and enure to the benefit of the Subscriber and the Corporation
and their respective heirs, executors, administrators, successors and assigns; provided that, except for the assignment by a Subscriber
who is acting as nominee or agent to the beneficial owner and as otherwise herein provided, this Subscription Agreement shall not
be assignable by any party without prior written consent of the other parties.

 

    	 	- 15 -	 

     

    

 

CANADA,
UNITED STATES

AND
INTERNATIONAL

 

22.          The
Subscriber, on its own behalf and, if applicable, on behalf of others for whom it is contracting hereunder, agrees that this subscription
is made for valuable consideration and may not be withdrawn, cancelled, terminated or revoked by the Subscriber, on its own behalf
and, if applicable, on behalf of others for whom it is contracting hereunder.

 

23.          Neither
this Subscription Agreement nor any provision hereof shall be waived, modified, changed, discharged or terminated except only by
a written instrument signed by each party against whom the waiver, change, discharge or termination is sought.

 

24.          The
invalidity, illegality or unenforceability of any provision in this Subscription Agreement shall not affect the validity, legality
or enforceability of any other provision hereof.

 

25.          The
Subscriber acknowledges and agrees that acceptance of this Subscription Agreement will be conditional, among other things, upon
the sale of Units to the Subscriber being exempt from any prospectus and offering memorandum requirements of all applicable securities
laws. The Corporation will be deemed to have accepted this Subscription Agreement upon the delivery at closing of the certificates
representing the Common Shares and Warrants to or upon the direction of the Subscriber in accordance with the provisions hereof.

 

26.          The
headings used in this Subscription Agreement have been inserted for convenience of reference only and shall not affect the meaning
or interpretation of this Subscription Agreement or any provision hereof.

 

27.          The
covenants, representations and warranties contained herein shall survive the closing of the transactions contemplated hereby.

 

28.          In
this Subscription Agreement (including attachments), references to “$” or “Cdn. $” are to Canadian dollars.

 

29.          The
Subscriber and each beneficial purchaser, if any, acknowledges its consent and requests that all documents evidencing or relating
in any way to its purchase of Units be drawn up in the English language only. Nous reconnaissons par les présentes avoir
consenti et demandé que tous les documents faisant foi ou se rapportant de quelque manière à l’achat
des securities soient rédigés en anglais seulement.

 

In addition to completing the first page of this Subscription
Agreement and the applicable sections of the Terms and Conditions, please also complete the attached exhibits, as applicable.

 

    	 	- 16 -	 

     

    

 

EXHIBIT 1 

REPRESENTATION LETTER

 

(FOR ACCREDITED INVESTORS)

 

		TO:	XORTX THERAPEUTICS INC. (the “Corporation”)

 

In connection with
the agreement to purchase units of the Corporation (“Units”), each Unit comprised of one common share in the
capital of the Corporation (“Common Share”) and one half of one Common Share purchase warrant by the undersigned
subscriber or, if applicable, the principal on whose behalf the undersigned is purchasing as agent (the “Subscriber”
for the purposes of this Exhibit 1), hereby represents, warrants, covenants and certifies to the Corporation, both as at the date
hereof and as of the Closing Time (as defined in the Subscription Agreement):

 

1.            The
Subscriber is resident in or is otherwise subject to the applicable securities laws of a jurisdiction of Canada;

 

2.            The
Subscriber is an “accredited investor”, as such term is defined: (A) if the Subscriber is resident in or otherwise
subject to the applicable securities laws of a province of Canada other than Ontario, in National Instrument 45-106 entitled “Prospectus
Exemptions” (“NI 45-106”) promulgated under applicable securities legislation in such jurisdictions;
or (B) if the Subscriber is resident in or otherwise subject to the applicable securities laws of Ontario, in Section 73.3(1) of
the Securities Act (Ontario), by virtue of satisfying the indicated criterion as set out in Appendix “A” to
this Representation Letter.

 

3.            The
Subscriber fully understands the meaning of the terms and conditions of the category of "accredited investor" applicable
to it, has had an opportunity to discuss the meaning of the category of "accredited investor" applicable to it with a
representative of the Corporation, and confirms that it has reviewed and understands the definitions in Appendix “A”
to this Representation Letter in respect of the category of "accredited investor" applicable to it and, in particular,
if the Subscriber is an "accredited investor" by virtue of satisfying paragraph (j), (j.1), (k) or (l) of Appendix “A”
to this Representation Letter, it has reviewed and understands the meaning and calculation of "financial assets", "related
liabilities" and "net assets", as applicable, contained in Appendix “A” hereto;

 

4.            The
Subscriber was not created or used solely to purchase or hold securities as an accredited investor as described in paragraph (m)
of the definition of “accredited investor” in NI 45-106;

 

5.            If
the Subscriber is relying on paragraphs (j), (k) or (l) of the definition of “accredited investor” in NI 45-106, the
Subscriber has executed and delivered a Risk Acknowledgment Form set out in Appendix “B” to this Representation Letter
which, upon execution, shall be incorporated into and form a part of the Subscription Agreement and the Corporation and its counsel
shall be entitled to rely thereon; and

 

6.            Upon
execution of this Exhibit 1 by the Subscriber, this Exhibit 1 shall be incorporated into and form a part of the Subscription Agreement
and the Corporation and its counsel shall be entitled to rely thereon.

 

	Dated:                                          .	 	 
	 	 	 
	 	 	Print Name of Subscriber
	IMPORTANT: PLEASE INITIAL THE APPLICABLE PROVISION IN APPENDIX A ON THE NEXT PAGES AND, IF APPLICABLE, COMPLETE APPENDIX B	 	 	 
	 	 	By:	 
	 	 	 	Signature
	 	 	 	 
	 	 	 
	 	 	Print Name of Signatory (if different from Subscriber)
	 	 	 
	 	 	 
	 	 	Title

 

    	 		 

     

    

 

APPENDIX “A” TO EXHIBIT
1

 

NOTE: THE INVESTOR MUST INITIAL OR OTHERWISE MARK
BESIDE THE APPLICABLE PORTION OF THE DEFINITION BELOW.

 

Accredited Investor
- (defined in National Instrument 45-106 or Section 73.3(1) of the Securities Act (Ontario)) means:

 

	______	(a)	(i) except in Ontario, a Canadian financial institution, or a Schedule III bank, or (ii) in Ontario, a financial institution described in paragraph 1, 2 or 3 of subsection 73.1(1) of the Securities Act (Ontario); or
	 	 	 
	______	(b)	(i) except in Ontario, the Business Development Bank of Canada incorporated under the Business Development Bank of Canada Act (Canada), or (ii) in Ontario, the Business Development Bank of Canada; or
	 	 	 
	______	(c)	(i) except in Ontario, a subsidiary of any person referred to in paragraphs (a)(i) or (b)(i), if the person owns all of the voting securities of the subsidiary, except the voting securities required by law to be owned by directors of that subsidiary, or (ii) in Ontario, a subsidiary or any person or company referred to in paragraphs (a)(ii) or (b)(ii), if the person or company owns all of the voting securities of the subsidiary, except the voting securities required by law to be owned by directors of that subsidiary; or
	 	 	 
	______	(d)	(i) except in Ontario, a person registered under the securities legislation of a  jurisdiction of Canada as an adviser or dealer, or (ii) in Ontario, a person or company registered under the securities legislation of a province or territory of Canada as an adviser or dealer, except as otherwise prescribed by the regulations in respect of the Securities Act (Ontario); or
	 	 	 
	______	(e)	an individual registered under the securities legislation of a jurisdiction of Canada as a representative of a person referred to in paragraph (d)(i); or
	 	 	 
	______	(e.1)	an individual formerly registered under the securities legislation of a jurisdiction of Canada, other than an individual formerly registered solely as a representative of a limited market dealer under one or both of the Securities Act (Ontario) or the Securities Act (Newfoundland and Labrador); or
	 	 	 
	______	(f)	(i) except in Ontario, the Government of Canada or a jurisdiction of Canada, or any crown corporation, agency or wholly-owned entity of the Government of Canada or a jurisdiction of Canada, or (ii) in Ontario, the Government of Canada, the government of a province or territory of Canada, or any Crown corporation, agency or wholly owned entity of the Government of Canada or of the government of a province or territory of Canada; or
	 	 	 
	______	(g)	(i) except in Ontario, a municipality, public board or commission in Canada and a metropolitan community, school board, the Comité de gestion de la taxe scolaire de l’île de Montréal or an intermunicipal management board in Québec, or (ii) in Ontario, a municipality, public board or commission in Canada and a metropolitan community, school board, the Comité de gestion de la taxe scolaire de l’Île de Montréal or an intermunicipal management board in Quebec; or
	 	 	 
	______	(h)	(i) except in Ontario, any national, federal, state, provincial, territorial or municipal government of or in any foreign jurisdiction, or any agency of that government, or (ii) in Ontario, any national, federal, state, provincial, territorial or municipal government of or in any foreign jurisdiction, or any agency of that government; or

 

    	 		 

     

    

 

	______	(i)	(i) except in Ontario, a pension fund that is regulated by either the Office of the Superintendent of Financial Institutions (Canada), a pension commission or similar regulatory authority of a jurisdiction of Canada, or (ii) in Ontario, a pension fund that is regulated by either the Office of the Superintendent of Financial Institutions (Canada) or a pension commission or similar regulatory authority of a province or territory of Canada; or
	 	 	 
	______	(j)	an individual who, either alone or with a spouse, beneficially owns financial assets having an aggregate realizable value that before taxes, but net of any related liabilities, exceeds $1,000,000; or

 

(Note: Financial assets include
cash and securities, but do not include a personal residence – see the definition of "financial assets" below.
Financial assets are generally liquid or relatively easy to liquidate. You must subtract any liabilities related to your financial
assets to calculate your net financial assets—see the definition of "related liabilities" below. In the case where
financial assets are held in a trust or in another type of investment vehicle for the benefit of an individual there may be questions
as to whether the individual beneficially owns the financial assets. The following factors are indicative of beneficial ownership
of financial assets: (i) physical or constructive possession of evidence of ownership of the financial asset; (ii) entitlement
to receipt of any income generated by the financial asset; (iii) risk of loss of the value of the financial asset; and (iv) the
ability to dispose of the financial asset or otherwise deal with it as you see fit. For example, securities held in a self-directed
RRSP, for your sole benefit, are beneficially owned by you. In general, financial assets in a spousal RRSP would also be included
for the purposes of the financial assets test in this paragraph (j); however, financial assets held in a group RRSP under which
you do not have the ability to acquire the financial assets and deal with them directly are not considered to be beneficially owned
by you. If you meet the higher financial asset threshold set out in paragraph (j.1) as an individual exclusive of your spouse,
then initial paragraph (j.1) instead of this paragraph (j).)

 

Please provide the following
information to the best of your knowledge based on the most recent information available to you:

 

	 	Aggregate realizable value of financial assets before taxes	 	$                                                                                              
	 	 	 	 
	 	Related liabilities	 	$                                                                         

 

(Note: If the Subscriber
is relying on this category of Accredited Investor to purchase the Units, the Subscriber must also complete in duplicate
Appendix “B” to this Representation Letter.)

 

	______	(j.1)	an individual who beneficially owns financial assets having an aggregate realizable value that, before taxes but net of any related liabilities, exceeds $5,000,000; or

 

(Note: See the definition
of "financial assets" below and the guidance in paragraph (j) above. The financial assets of your spouse (including financial
assets in a spousal RRSP) cannot be included in the calculation of net financial assets under this paragraph (j.1).)

 

Please provide the following
information to the best of your knowledge based on the most recent information available to you:

 

	 	Aggregate realizable value of financial assets before taxes	 	$                                                                         
	 	 	 	 
	 	Related liabilities	 	$                                                                         

 

    	 	-2-	 

     

    

 

	______	(k)	an individual whose net income before taxes exceeded $200,000 in each of the two most recent calendar years or whose net income before taxes combined with that of a spouse exceeded $300,000 in each of the two most recent calendar years and who, in either case, reasonably expects to exceed that net income level in the current calendar year; or

 

Please provide the following information (based
on your two most recent notices of assessment from the Canada Revenue Agency or equivalent):

 

	 	Net income 	Last year Range – Less than $100,000 o	 	State Amount:
	 	before taxes	 	Range – $100,000 to $200,000 o	 	$                                                  
	 	 	 	Range – $201,000 to $300,000 o	 	 
	 	 	 	Range – $301,000 to $400,000 o	 	 
	 	 	 	Range – Greater than $401,000 o	 	 
	 	 	 	 	 	 
	 	 	Year prior 	 	 
	 	 	to last	Range – Less than $100,000 o	 	State Amount:
	 	 	 	Range – $100,000 to $200,000 o	 	$                               
	 	 	 	Range – $201,000 to $300,000 o	 	 
	 	 	 	Range – $301,000 to $400,000 o	 	 
	 	 	 	Range – Greater than $401,000 o	 	 
	 	 	 	 	 	 
	 	If applicable, net 	Last year Range – Less than $100,000 o	 	State Amount:
	 	income before 	 	Range – $100,000 to $200,000 o	 	$                               
	 	taxes of your	 	Range – $201,000 to $300,000 o	 	 
	 	spouse	 	Range – $301,000 to $400,000 o	 	 
	 	 	 	Range – Greater than $401,000 o	 	 
	 	 	 	 	 	 
	 	 	Year prior 	 	 
	 	 	to last	Range – Less than $100,000 o	 	State Amount:
	 	 	 	Range – $100,000 to $200,000 o	 	$                               
	 	 	 	Range – $201,000 to $300,000 o	 	 
	 	 	 	Range – $301,000 to $400,000 o	 	 
	 	 	 	Range – Greater than $401,000 o	 	 

 

(Note: If the Subscriber is relying on
this category of Accredited Investor to purchase the Units, the Subscriber must also complete in duplicate Appendix “B”
to this Representation Letter.)

 

    	 	-3-	 

     

    

  

	______	(l)	an individual who, either alone or with a spouse, has net assets of at least $5,000,000; or

 

(Note: To calculate net assets,
take the value of your total assets (which may include a personal residence) and subtract your total liabilities (which may include
a mortgage or equity line of credit). The value attributed to assets should reasonably reflect their estimated fair value. Income
tax should be considered a liability if the obligation to pay it is outstanding at the Closing Date.)

 

Please provide the following
information by subtracting your total liabilities from your total assets:

 

	 	Total Assets	  $                                  
	 	 	 
	 	Minus, Total Liabilities (including outstanding taxes)	- $                                  
	 	 	 
	 	Equals, Net Assets	= $                                  

 

(Note: If the Subscriber is relying on
this category of Accredited Investor to purchase the Units, the Subscriber must also complete in duplicate Appendix “B”
to this Representation Letter.)

 

(Note: if individual accredited investors wish
to purchase through wholly-owned holding companies or similar entities, such purchasing entities must qualify under paragraphs
(t) or (w) below, which must be initialed and the applicable information provided.)

 

	______	(m)	a person, other than an individual or investment fund, that has net assets of at least $5,000,000 as shown on its most recently prepared financial statements; or
	 	 	 
	______	(n)	an investment fund that distributes or has distributed its securities only to:

 

 

		(i)	a person that is or was an accredited investor at the time of the distribution, or

 

		(ii)	a person that acquires or acquired securities in the circumstances referred to in sections 2.10 or 2.19 of National Instrument
45-106, or

 

		(iii)	a person described in paragraph (i) or (ii) that acquires or acquired securities under section 2.18 of National Instrument
45-106; or

 

	______	(o)	an investment fund that distributes or has distributed securities under a prospectus in a jurisdiction of Canada for which the regulator or, in Quebéc, the securities regulatory authority, has issued a receipt; or
	 	 	 
	______	(p)	a trust company or trust corporation registered or authorized to carry on business under the Trust and Loan Companies Act (Canada) or under comparable legislation in a jurisdiction of Canada or a foreign jurisdiction, acting on behalf of a fully managed account managed by the trust company or trust corporation, as the case may be; or
	 	 	 
	______	(q)	a person acting on behalf of a fully managed account managed by that person, if that person is registered or authorized to carry on business as an adviser or the equivalent under the securities legislation of a jurisdiction of Canada or a foreign jurisdiction; or
	 	 	 
	______	(r)	a registered charity under the Income Tax Act (Canada) that, in regard to the trade, has obtained advice from an eligibility adviser or an adviser registered under the securities legislation of the jurisdiction of the registered charity to give advice on the securities being traded; or
	 	 	 
	______	(s)	an entity organized in a foreign jurisdiction that is analogous to any of the entities referred to in paragraphs (a) to (d) or paragraph (i) in form and function; or

 

    	 	-4-	 

     

    

 

	______	(t)	a person in respect of which all of the owners of interests, direct, indirect or beneficial, except the voting securities required by law to be owned by directors, are persons that are accredited investors (as defined in National Instrument 45-106); or

 

If you initialed (t), then
indicate the name and category of accredited investor (by reference to the applicable letter above) of each of the owners of interests
(attach additional pages if more than three):

 

	 	Name	 	Category of Accredited Investor	 
	 	 	 	 	 
	 	 	 	 	 
	 	 	 	 	 
	 	 	 	 	 
	 	 	 	 	 
	 	 	 	 	 

 

	______	(u)	an investment fund that is advised by a person registered as an adviser or a person that is exempt from registration as an adviser; or

 

	______	(v)	(i) a person that is recognized or designated by the securities regulatory authority or, except in Ontario and Québec, the regulator as an accredited investor, or (ii) in Ontario, a person or company that is recognized or designated by the Ontario Securities Commission as an accredited investor; or

 

	______	(w)	a trust established by an accredited investor for the benefit of the accredited investor’s family members of which a majority of the trustees are accredited investors and all of the beneficiaries are the accredited investor’s spouse, a former spouse of the accredited investor or a parent, grandparent, brother, sister, child or grandchild of that accredited investor, of that accredited investor’s spouse or of that accredited investor’s former spouse.

 

Note: If you initialed (w),
then indicate the name and category of accredited investor (by reference to the applicable letter above) of each of the following
(attach additional pages if more than three trustees):

 

	 	 	Name	 	Category of Accredited Investor
	 	 	 	 	 
	Individual who established trust:	 	 	 	 
	 	 	 	 	 
	Trustee	 	 	 	 
	 	 	 	 	 
	Trustee	 	 	 	 
	 	 	 	 	 
	Trustee	 	 	 	 

 

For the purposes hereof:

 

		(a)	“bank” means a bank named in Schedule I or II of the Bank Act (Canada);

 

		(b)	“Canadian financial institution” means

 

		(i)	an association governed by the Cooperative Credit Associations Act (Canada) or a central cooperative
credit society for which an order has been made under section 473(1) of that Act, or

 

		(ii)	a bank, loan corporation, trust company, trust corporation, insurance
company, treasury branch, credit union, caisse populaire, financial services cooperative, or league that, in each case,
is authorized by an enactment of Canada or a jurisdiction of Canada to carry on business in Canada
or a jurisdiction of Canada;

 

    	 	-5-	 

     

    

 

		(x)	“consultant” means, for an issuer, a person, other than an employee, executive officer, or director of the
issuer or of a related entity of the issuer, that:

 

		(i)	is engaged to provide services to the issuer or a related entity of the issuer, other than services
provided in relation to a distribution,

 

		(ii)	provides the services under a written contract with the issuer or a related entity of the issuer,
and

 

		(iii)	spends or will spend a significant amount of time and attention on the affairs and business of
the issuer or a related entity of the issuer,

 

and includes

 

		(iv)	for an individual consultant, a corporation of which the individual consultant is an employee or
shareholder, and a partnership of which the individual consultant is an employee or partner, and

 

		(v)	for a consultant that is not an individual, an employee, executive officer, or director of the
consultant, provided that the individual employee, executive officer, or director spends or will spend a significant amount of
time and attention on the affairs and business of the issuer or a related entity of the issuer;

 

		(c)	“control person” has the same meaning as in securities legislation and generally means any person that holds
or is one of a combination of persons that holds:

 

		(i)	a sufficient number of the voting rights attached to all outstanding voting securities of an issuer
to affect materially the control of the issuer, and

 

		(ii)	if a person holds more than 20% of the outstanding voting rights attached to all outstanding voting
securities of an issuer, the person is deemed, in the absence of evidence to the contrary, to hold a sufficient number of the voting
rights to affect materially the control of the issuer;

 

		(d)	“director” means:

 

		(i)	a member of the board of directors of a company or an individual who performs similar functions
for a company, and

 

		(ii)	with respect to a person that is not a company, an individual who performs functions similar to
those of a director of a company;

 

		(e)	“eligibility adviser” means:

 

		(i)	a person that is registered as an investment dealer and authorized to give advice with respect
to the type of security being distributed, and

 

		(ii)	in Saskatchewan or Manitoba, also means a lawyer who is a practicing member in good standing with
a law society of a jurisdiction of Canada or a public accountant who is a member in good standing of an institute or association
of chartered accountants, certified general accountants or certified management accountants in a jurisdiction of Canada provided
that the lawyer or public accountant must not

 

		(iii)	have a professional, business or personal relationship with the issuer, or any of its directors,
executive officers, founders, or control persons, and

 

    	 	-6-	 

     

    

 

		(iv)	have acted for or been retained personally or otherwise as an employee, executive officer, director,
associate or partner of a person that has acted for or been retained by the issuer or any of its directors, executive officers,
founders or control persons within the previous 12 months;

 

		(f)	“executive officer” means, for an issuer, an individual who is

 

		(i)	a chair, vice-chair or president,

 

		(ii)	a vice-president in charge of a principal business unit, division or function including sales,
finance or production, or

 

		(iii)	performing a policy-making function in respect of the issuer;

 

		(g)	“financial assets” means

 

		(i)	cash,

 

		(ii)	securities, or

 

		(iii)	a contract of insurance, a deposit or an evidence of a deposit that is not a security for the purposes
of securities legislation;

 

		(h)	“foreign jurisdiction” means a country other than Canada or a political subdivision
of a country other than Canada;

 

		(i)	“founder” means, in respect of an issuer, a person who,

 

		(i)	acting alone, in conjunction, or in concert with one or more persons, directly or indirectly, takes
the initiative in founding, organizing or substantially reorganizing the business of the issuer, and

 

		(ii)	at the time of the distribution or trade is actively involved in the business of the issuer;

 

		(j)	“fully managed account” means an account of a client for which a person makes
the investment decisions if that person has full discretion to trade in securities for the account without requiring the client's
express consent to a transaction;

 

		(k)	“individual” means a natural person, but does not include:

 

		(i)	a partnership, unincorporated association, unincorporated syndicate, unincorporated organization
or trust, or

 

		(ii)	a natural person in the person’s capacity as trustee, executor, administrator or other legal
representative;

 

		(l)	“insider” means:

 

		(i)	a director or an officer of an issuer,

 

		(ii)	a director or an officer of a person that is itself an insider or a subsidiary of an issuer,

 

		(iii)	a person that has:

 

		(A)	beneficial ownership of, or control or direction over, directly or indirectly, or

 

		(B)	a combination of beneficial ownership of, and control or direction over, directly or indirectly,
securities of an issuer carrying more than 10% of the voting rights attached to all the issuer's outstanding voting securities,
excluding, for the purpose of the calculation of the percentage held, any securities held by the person as underwriter in the course
of a distribution,

 

    	 	-7-	 

     

    

 

		(iv)	an issuer that has purchased, redeemed or otherwise acquired a security of its own issue, for long as it continues to hold
that security,

 

		(v)	a person designated as an insider in an order made under section 3.2, or

 

		(vi)	person that is in a prescribed class of persons;

 

		(m)	“investment fund” has the same meaning as in National Instrument 81-106 Investment Fund Continuous Disclosure;

 

		(n)	“jurisdiction” means a province or territory of Canada except when used in the term foreign jurisdiction;

 

		(o)	“local jurisdiction” means the jurisdiction in which the Canadian securities regulatory authority is situate;

 

		(p)	“permitted assign” means, for a person that is an employee, executive officer, director or consultant of
an issuer or of a related entity of the issuer,

 

		(i)	a trustee, custodian, or administrator acting on behalf of, or for the benefit of the person,

 

		(ii)	a holding entity for the person,

 

		(iii)	a RRSP, RRIF, or TFSA of the person,

 

		(iv)	a spouse of the person,

 

		(v)	a trustee, custodian, or administrator acting on behalf of, or for the benefit of the spouse of the person,

 

		(vi)	a holding entity of the spouse of the person,

 

		(vii)	a RRSP, RRIP or TFSA of the spouse of the person;

 

		(q)	“person” includes

 

		(i)	an individual,

 

		(ii)	a corporation,

 

		(iii)	a partnership, trust, fund and an association, syndicate, organization or other organized group of persons, whether incorporated
or not, and

 

		(iv)	an individual or other person in that person's capacity as a trustee, executor, administrator or personal or other legal representative;

 

		(r)	“registrant” means a person registered or required to be registered under the applicable securities laws;

 

		(s)	“regulator” means, for the local jurisdiction, the Executive Director as defined under securities legislation
of the local jurisdiction;

 

		(t)	“related entity” means, for an issuer, a person that controls or is controlled by the issuer or that is
controlled by the same person that controls the issuer;

 

    	 	-8-	 

     

    

 

		(u)	“related liabilities” means

 

		(i)	liabilities incurred or assumed for the purpose of financing the acquisition or ownership of financial
assets, or

 

		(ii)	liabilities that are secured by financial assets.

 

		(v)	“Schedule III bank” means an authorized foreign bank named in Schedule III of the Bank Act (Canada);

 

		(w)	“spouse” means, an individual who,

 

		(i)	is married to another individual and is not living separate and apart within the meaning of the
Divorce Act (Canada), from the other individual,

 

		(ii)	is living with another individual in a marriage-like relationship, including a marriage-like relationship
between individuals of the same gender, or

 

		(iii)	in Alberta, is an individual referred to in paragraph (i) or (ii) above, or is an adult interdependent
partner within the meaning of the Adult Interdependent Relationships Act (Alberta); and

 

		(x)	“subsidiary” means an issuer that is controlled directly or indirectly by another issuer and includes a
subsidiary of that subsidiary.

 

Affiliated Entities, Control and Subsidiaries

 

		1.	A person or company is considered to be an affiliated entity of another person or company if one
is a subsidiary entity of the other, or if both are subsidiary entities of the same person or company, or if each of them is controlled
by the same person or company.

 

		2.	A person or company is considered to be controlled by a person or company if

 

		(a)	in the case of a person or company,

 

		(i)	voting securities of the first mentioned person or company carrying more than 50% of the votes
for the election of directors are held, otherwise than by way of security only, by or for the benefit of, the other person or company,
and

 

		(ii)	the votes carried by the securities are entitled, if exercise, to elect a majority of the directors
of the first mentioned person or company.

 

		(b)	in the case of a partnership that does not have directors, other than a limited partnership, the second mentioned person or
company holds more than 50% of the interests in the partnership; or

 

		(c)	in the case of a limited partnership, the general partner is the second mentioned person or company.

 

		3.	A person or company is considered to be a subsidiary entity of another person or company if

 

		(a)	it is controlled by,

 

		(iii)	that other; or

 

		(iv)	that other and one or more persons or companies, each of which is controlled by that other; or

 

		(v)	two or more persons or companies, each of which is controlled by that other; or

 

    	 	-9-	 

     

    

 

		(vi)	it is a subsidiary entity of a person or company that is the other’s subsidiary entity.

 

All monetary references are in Canadian
dollars

 

    	 	-10-	 

     

    

 

APPENDIX “B” TO
EXHIBIT 1

 

RISK ACKNOWLEDGEMENT FORM FOR
CERTAIN INDIVIDUAL ACCREDITED INVESTORS

 

To be completed by individuals
investing under categories (j), (k) or (l) of the definition of "accredited investor" in National Instrument 45-106 –
Prospectus Exemptions, which are reproduced in Appendix “A” to Exhibit 1 as paragraphs (j), (k) or (l), as applicable.
Note that individuals investing under category (j.1) of the definition of "accredited investor" in National Instrument
45-106 – Prospectus Exemptions do not need to complete this form.

 

	WARNING!
	This investment is risky. Don’t invest unless you can afford to lose all the money you pay for this investment.

 

	SECTION 1 TO BE COMPLETED BY THE ISSUER OR SELLING SECURITY HOLDER
	1. About your investment
	Type  of  securities:    Units, each comprised of one Common Share and one Warrant	Issuer:
	Purchased from the Issuer
	SECTIONS 2 TO 4 TO BE COMPLETED BY THE PURCHASER
	2. Risk acknowledgement
	This investment is risky. Initial that you understand that:	Your

initials
	Risk of loss – You could lose your entire investment of $            . [Instruction: Insert the dollar amount of the investment.]	 
	Liquidity risk – You may not be able to sell your investment quickly – or at all.	 
	Lack of information – You may receive little or no information about your investment.	 
	Lack of advice – You will not receive advice from the salesperson about whether this investment is suitable for you unless the salesperson is registered. The salesperson is the person who meets with, or provides information to, you about making this investment. To check whether the salesperson is registered, go to www.aretheyregistered.ca.	 
	3. Accredited investor status
	You must meet at least one of the following criteria to be able to make this investment. Initial the statement that applies to you. (You may initial more than one statement.) The person identified in section 6 is responsible for ensuring that you meet the definition of accredited investor. That person, or the salesperson identified in section 5, can help you if you have questions about whether you meet these criteria.	Your

initials
	
        ·    Your
        net income before taxes was more than $200,000 in each of the two most recent

        calendar years, and

        ·    you
        expect it to be more than $200,000 in the current calendar year. (You can find your net income before taxes on your personal income
        tax return.)
	 
	 	 	 

    	 		 

     

    

 

	·   Your net income before taxes combined with your spouse’s was more than $300,000 in each of the two most recent calendar years, and you expect your combined net income before taxes to be more than $300,000 in the current calendar year.	 
	·   Either alone or with your spouse, you own more than $1 million in cash and securities, after subtracting any debt related to the cash and securities.	 
	·   Either alone or with your spouse, you have net assets worth more than $5 million. (Your net assets are your total assets (including real estate) minus your	 
	Your name and signature
	By signing this form, you confirm that you have read this form and you understand the risks of making this investment as identified in this form.
	First and last name (please print):
	Signature:	Date:
	SECTION 5 TO BE COMPLETED BY THE SALESPERSON
	Salesperson information
	[Instruction: The salesperson is the person who meets with, or provides information to, the purchaser with respect to making this investment. That could include a representative of the issuer or selling security holder, a registrant or a person who is exempt from the registration requirement.]
	First and last name of salesperson (please print):
	Telephone:	Email:
	Name of firm (if registered):	Dealer Rep. Code:
	SECTION 6 TO BE COMPLETED BY THE ISSUER OR SELLING SECURITY HOLDER
	For more information about this investment
	
         

        Allen Davidoff

        403 455 7727 or adavidoff@xortx.com

         

        For more information about prospectus
        exemptions, contact your local contact information at www.securities-administrators.ca.

         

	 	 	 	 

Form instructions:

 

		1.	The information in sections 1, 5 and 6 must be completed before the purchaser completes and
signs the form.

 

		2.	The purchaser must sign this form. Each of the purchaser and the issuer must receive a copy
of this form signed by the purchaser. The issuer is required to keep a copy of this form for 8 years after the distribution.

 

    	 	-2-	 

     

    

 

EXHIBIT 2

 

CLOSE PERSONAL FRIEND/CLOSE BUSINESS
ASSOCIATE QUESTIONNAIRE

 

To be completed by Subscribers to whom section 7(e)(iii)(IV),
(V), (VI), (VIII) or (IX) of the Subscription Agreement applies.

 

 

Name of director, executive
officer, control person or founder of whom Subscriber is a close personal friend/close business associate

 

 

Length of relationship

 

 

Details of relationship or prior
business dealings

 

 

 

 

 

 

The undersigned understands
that the Corporation is relying on this information in determining to sell securities to the undersigned in a manner exempt from
the registration and prospectus requirements of applicable securities laws.

 

Date:                                          .

 

 

	 	Print name of Subscriber
	 	 	 
	 	By:	 
	 	 	Signature
	 	 	 
	 	 	 
	 	 	Print name of Signatory (if different from
	 	 	Subscriber)
	 	 	 
	 	 	 
	 	 	Title

 

    	 		 

     

    

 

MEANING OF "CLOSE PERSONAL FRIEND"
AND "CLOSE BUSINESS ASSOCIATE" AS DESCRIBED IN COMPANION POLICY 45-106CP TO NATIONAL INSTRUMENT 45-106 PROSPECTUS EXEMPTIONS

 

Meaning of "close personal friend"

 

A "close personal friend" of
a director, executive officer, founder or control person of an issuer is an individual who knows the director, executive officer,
founder or control person well enough and has known them for a sufficient period of time to be in a position to assess their capabilities
and trustworthiness and to obtain information from them with respect to the investment. The term "close personal friend"
can include a family member who is not already specifically identified in the exemptions if the family member satisfies the criteria
described above.

 

The following factors are relevant in determining
whether a relationship is that of a close personal friend:

 

		(a)	the length of time the individual has known the director, executive officer, founder or control
person,

 

		(b)	the nature of the relationship between the individual and the director, executive officer, founder
or control person including such matters as the frequency of contacts between them and the level of trust and reliance in the other
circumstances, and

 

		(c)	the number of "close personal friends" of the director, executive officer, found or control
person to whom securities have been distributed in reliance on the private issuer exemption or the family, friends and business
associates exemption.

 

An individual is not a close personal friend
solely because the individual is:

 

		(a)	a relative,

 

		(b)	a member of the same organization, association or religious group,

 

		(c)	a co-worker, colleague or associate at the same workplace,

 

		(d)	a client, customer, former client or former customer,

 

		(e)	a mere acquaintance, or

 

		(f)	connected through some form of social media, such as Facebook, Twitter or LinkedIn.

 

The relationship between the individual
and the director, executive officer, founder or control person must be direct. For example, the exemption is not available to a
close personal friend of a close personal friend of a director of the issuer.

 

A relationship that is primarily founded
on participation in an Internet forum is not considered to be a relationship of a close personal friend.

 

Meaning of "close business associate"

 

A "close business associate"
is an individual who has had sufficient prior business dealings with a director, executive officer, founder or control person of
the issuer to be in a position to assess their capabilities and trustworthiness and to obtain information from them with respect
to the investment.

 

The following factors are relevant in determining
whether a relationship is that of a close business associate:

 

		(a)	the length of time the individual has known the director, executive officer, founder or control person,

 

    	 	-2-	 

     

    

 

		(b)	the nature of any specific business relationships between the individual and the director, executive
officer, founder or control person, including, for each relationship, when it began, the frequency of contact between them and
when it terminated if it is not ongoing, and the level of trust and reliance in the other circumstances,

 

		(c)	the nature and number of any business dealings between the individual and the director, executive
officer, found or control person, the length of the period during which they occurred, and the nature and date of the most recent
business dealing, and

 

		(d)	the number of "close business associates" of the director, executive officer, found or
control person to whom securities have been distributed in reliance on the private issuer exemption or the family, friends and
business associates exemption.

 

An individual is not a close business associate
solely because the individual is:

 

		(a)	a member of the same club, organization, association or religious group,

 

		(b)	a co-worker, colleague or associate at the same workplace,

 

		(c)	a client, customer, former client or former customer,

 

		(d)	a mere acquaintance, or

 

		(e)	connected through some form of social media, such as Facebook, Twitter or LinkedIn.

 

The relationship between the individual
and the director, executive officer, founder or control person must be direct. For example, the exemption is not available for
a close business associate of a close business associate of a director of the issuer.

 

A relationship that is primarily founded
on participation in an Internet forum is not considered to be a relationship of a close business associate.

 

    	 	-3-	 

     

    

 

EXHIBIT 3

 

RISK ACKNOWLEDGEMENT FORM

 

(Saskatchewan Close Friends and Close
Business Associates Only)

 

WARNING 

 

Risk Acknowledgement

Saskatchewan Close Personal Friends and
Close Business Associates

 

I acknowledge that this is a risky investment:

		·	I am investing entirely at my own risk.

		·	No securities regulatory authority has evaluated or endorsed the merits of these securities.

		·	The person selling me these securities is not registered with a securities regulatory authority and has no duty to tell me
whether this investment is suitable for me.

		·	I will not be able to sell these securities for 4 months.

		·	I could lose all the money I invest.

		·	I do not have a two-day right to cancel my purchase of these securities or the statutory rights of action for misrepresentation
I would have if I were purchasing the securities under a prospectus. I do have a two-day right to cancel my purchase of these securities
if I received an amended offering document.

 

I am investing $                     
[total consideration] in total; this includes any amount I am obliged to pay in future.

 

I am a close personal friend or
close business associate of                    
[state name], who is a                     
[state title - founder, director, executive officer or control person] of                     
[state name of issuer or its affiliate – if an affiliate state “an affiliate of the issuer” and give the issuer’s
name].

 

I acknowledge that I am purchasing
based on my close relationship with ___ ______________ [state name of founder, director, executive officer or control person]
of                      [state
name of issuer or its affiliate – if an affiliate state “an affiliate of the issuer” and give the
issuer’s name] whom I know well enough and for a sufficient period of time to be able to assess her/his capabilities
and trustworthiness.

 

I acknowledge that this is a risky
investment and that I could lose all the money I invest.

 

 

	 	 	 
	Date	 	Signature of Purchaser
	 	 	 
	 	 	 
	 	 	Print name of Purchaser

 

Sign two copies
of this document. Keep one copy for your records.

 

    	 		 

     

    

 

You are buying Exempt Market Securities

 

They are called exempt market securities because two
parts of securities law do not apply to them. If an issuer wants to sell exempt market securities to you:

 

		-	the issuer does not have to give you a prospectus (a document that describes the investment in detail and gives you some legal
protections), and

 

		-	the securities do not have to be sold by an investment dealer registered with a securities regulatory authority or regulator.

 

There are restrictions on your ability to resell exempt market
securities. Exempt market securities are more risky than other securities.

 

You may not receive any written information about the issuer
or its business

 

If you have any questions about the issuer or its business,
ask for written clarification before you purchase the securities. You should consult your own professional advisers before investing
in the securities.

 

You will not receive advice

 

Unless you consult your own professional advisors, you will
not get professional advice about whether the investment is suitable for you.

 

    	 		 

     

    

 

EXHIBIT 4

 

RISK ACKNOWLEDGEMENT FORM FOR ONTARIO
FAMILY, 

FRIENDS AND BUSINESS ASSOCIATES

 

	WARNING!
	This investment is risky. Don't invest unless you can afford to lose all the money you pay for this investment

 

 

	SECTION 1 TO BE COMPLETED BY THE ISSUER
	1.            About your investment
	Type of securities: Units, each comprised of one Common Share and one Warrant	Issuer: XORTX Therapeutics Inc.
	Purchased from the Issuer
	SECTION 2 TO 4 TO BE COMPLETED BY THE PURCHASER
	2.            Risk acknowledgement [Instruction: initial all boxes in Section 2]
	This investment is risky. Initial that you understand that:	Your

initials
	Risk
    of loss – You could lose your entire investment of $                       
    [Instruction: Insert the total dollar amount of the investment.]	 
	Liquidity risk – You may not be able to sell your investment quickly – or at all.	 
	Lack of information – You may receive little or no information about your investment.	 
	Lack of advice – You will not receive advice from the salesperson about whether this investment is suitable for you unless the salesperson is registered. The salesperson is the person who meets with, or provides information to, you about making this investment. To check whether the salesperson is registered, go to www.aretheyregistered.ca.	 
	3.            Family, friend or business associate status [Instruction: initial one or more boxes that apply]
	You must meet at least one of the following criteria to be able to make this investment. Initial the statement that applies to you.	Your

initials
	
        A.       You are:

         

        4.        1. [check
        all applicable boxes]

         

        

 ̈  a
director of the issuer or an affiliate of the issuer

 

        

 ̈ an
executive officer of the issuer or an affiliate of the issuer

 

        

 ̈ a
control person of the issuer or an affiliate of the issuer

 

        

 ̈ a
founder of the issuer

         

        5.        OR
	 
	 	 
	 	 	 

    	 		 

     

    

 

	
        2. [check all applicable boxes]

         

        

 ̈      a
person of which a majority of the voting securities are beneficially owned by, or a majority of the directors are, (i) individuals
listed in (1) above and/or (ii) family members, close personal friends or close business associates of individuals listed in (1)
above

         

        

 ̈      a
trust or estate of which all of the beneficiaries or a majority of the trustees or executors are (i) individuals listed in (1)
above and/or (ii) family members, close personal friends or close business associates of individuals listed in (1) above

	 
	
        A.           You are a
        family member of              [Instruction:
        Insert the name of the person who is your relative either directly or through his or her spouse], who holds the following
        position affiliate of the issuer:                         .

         

        You are the                                 of
        that person or that person's spouse.

         

        [Instruction: To qualify for this investment,
        the person listed above must be (a) your spouse or (b) your or your spouse's parent, grandparent, brother, sister, child or grandchild.]
	 
	
        B.            You are a
        close personal friend of                                
        [Instruction: Insert the name of your close personal friend], who holds the following position at the issuer or
        an affiliate of the issuer:                                 .

         

        You have known that person for  years.
	 
	
        C.           You
        are a close business associate of                                 [Instruction:
        Insert the name of your close business associate], who holds the following position at the issuer or an affiliate
        of the issuer:                                 .

         

        You have known that person for                              years.
	 
	6.           Your name and signature
	By signing this form, you confirm that you have read this form and you understand the risks of making this investment as identified in this form. You also confirm that you are eligible to make this investment because you are a family member, close personal friend or close business associate of the person identified in section 5 of this form.
	First and last name (please print):
	Signature:	Date:
	SECTION 5 TO BE COMPLETED BY PERSON WHO CLAIMS THE CLOSE PERSONAL RELATIONSHIP, IF APPLICABLE
	 	 	 

    	 	-2-	 

     

    

  

	7.            Contact person at the issuer or an affiliate of the issuer
	[Instruction: To be completed by the director, executive officer, control person or founder with whom the purchaser has a close personal relationship indicated under sections 3B, C or D of this form.]
	
        By signing this form, you confirm that you have,
        or your spouse has, the following relationship with the purchaser: [check the box that applies]

         

        

 ̈    family
relationship as set out in section 3B of this form

         

        

 ̈    close
personal friendship as set out in section 3C of this form

         

        

 ̈    close
business associate relationship as set out in section 3D of this form

	First and last name of contact person (please print):
	Position with the issuer or affiliate of the issuer (director, executive officer, control person or founder):
	Telephone:	Email:
	Signature:	Date:
	SECTION 6 TO BE COMPLETED BY THE ISSUER
	8.            For more information about this investment
	
         

        Allen Davidoff

        403 455 7727 or adavidoff@xortx.com

	For more information about prospectus exemptions, contact your local securities regulator.  You can find contact information at www.securities-administrators.ca.
	
         

        Signature of executive officer of the issuer (other
        than the purchaser):

         
	
         

        Date:

	 	 	 

Form instructions:

 

		1.	The information in sections 1, 5 and 6 must be completed before the purchaser completes and
signs the form.

 

		2.	The purchaser, an executive officer who is not the purchaser and, if applicable, the person
who claims the close personal relationship to the purchaser must sign this form. Each of the purchaser, contact person at the issuer
and the issuer must receive a copy of this form signed by the purchaser. The issuer is required to keep a copy of this form for
8 years after the distribution.

 

		3.	The detailed relationships required to purchase securities under this exemption are set out
in section 2.5 of National Instrument 45-106 Prospectus Exemptions. For guidance on the meaning of "close personal friend"
and "close business associate", please refer to sections 2.7 and 2.8, respectively, of Companion Policy 45-106CP Prospectus
Exemptions.

 

For the purposes of a Subscriber resident
in or otherwise subject to applicable securities laws of Ontario relying on paragraph 7(e)(iii) of the Subscription Agreement to
which this Exhibit 4 is attached, then this Exhibit must be signed by all of the following:

 

    	 	-3-	 

     

    

 

		(i)	the Subscriber; and

 

		(ii)	an executive officer of the Corporation other than the Subscriber; and

 

		(iii)	if the Subscriber is a person referred to under paragraph 7(e)(iii)(II), the director, executive officer or control person
of the Corporation or an affiliate of the Corporation who has the specified relationship with the Subscriber; or

 

		(iv)	if the Subscriber is a person referred to under paragraph 7(e)(iii)(III), the director, executive officer or control person
of the Corporation or an affiliate of the Corporation whose spouse has the specified relationship with the Subscriber; or

 

		(v)	if the Subscriber is a person referred to under paragraph 7(e)(iii)(IV) or 7(e)(iii)(V), the director, executive officer or
control person of the Corporation or an affiliate of the Corporation who is a close personal friend or a close business associate
of the Subscriber; or

 

		(vi)	the founder of the Corporation, if the Subscriber is a person referred to in paragraph 7(e)(iii)(VI) or 7(e)(iii)(VII)other
than the founder of the Corporation

 

    	 	-4-	 

     

    

 

EXHIBIT 5 

 

CERTIFICATION OF U.S. PURCHASER

 

		TO:	XORTX THERAPEUTICS INC. (the "Corporation")

 

(Capitalized terms not specifically
defined in this Exhibit have the meaning ascribed to them in the Subscription Agreement to which this Exhibit is attached.)

 

In connection with the execution of the
Subscription Agreement to which this Exhibit is attached, the undersigned (the "Purchaser") represents, warrants, covenants,
agrees and certifies (which representations, warranties, covenants, agreements and certifications shall survive the Closing) to
the Corporation, the Agents, the US Affiliates and their respective counsel (and acknowledges that the Corporation, the Agents,
the US Affiliates and their respective counsel are relying thereon) that:

 

		(a)	The Purchaser understands and agrees that the Offered Securities have not been and will not be
registered under the U.S. Securities Act, or applicable state securities laws, and the Offered Securities are being offered and
sold by the Corporation in reliance upon the exemption from the registration requirement of the U.S. Securities Act provided by
Section 4(a)(2) of the U.S. Securities Act and/or Rule 506(b) thereunder and similar exemptions under applicable state securities
laws.

 

		(b)	The Purchaser, and if applicable, each person for whose account the Purchaser is purchasing and
acquiring the Offered Securities, is an accredited investor (“Accredited Investor”) that satisfies one or more of the
categories of “accredited investor” in Rule 501(a) of Regulation D under the U.S. Securities Act (“Regulation
D”) indicated below (the Purchaser must initial the appropriate line(s) applicable to it, and insert “BP”
on the appropriate line applicable to any beneficial purchaser on behalf of whom the Purchaser is acting):

 

	______	Category 1.	A bank, as defined in Section 3(a)(2) of the U.S. Securities Act, whether acting in its individual or fiduciary capacity; or
	 	 	 
	______	Category 2.	A savings and loan association or other institution as defined in Section 3(a)(5)(A) of the U.S. Securities Act, whether acting in its individual or fiduciary capacity; or
	 	 	 
	______	Category 3.	A broker or dealer registered pursuant to Section 15 of the United States Securities Exchange Act of 1934, as amended; or
	 	 	 
	______	Category 4.	An insurance company as defined in Section 2(a)(13) of the U.S. Securities Act; or
	 	 	 
	______	Category 5.	An investment company registered under the United States Investment Company Act of 1940, as amended; or
	 	 	 
	______	Category 6.	A business development company as defined in Section 2(a)(48) of the United States Investment Company Act of 1940, as amended; or
	 	 	 
	______	Category 7.	A small business investment company licensed by the U.S. Small Business Administration under Section 301 (c) or (d) of the United States Small Business Investment Act of 1958, as amended; or
	 	 	 
	______	Category 8.	A plan established and maintained by a state, its political subdivisions or any agency or instrumentality of a state or its political subdivisions, for the benefit of its employees, with total assets in excess of U.S.$5,000,000; or

 

    	 		 

     

    

  

	______	Category 9.	An employee benefit plan within the meaning of the United States Employee Retirement Income Security Act of 1974 in which the investment decision is made by a plan fiduciary, as defined in Section 3(21) of such Act, which is either a bank, savings and loan association, insurance company or registered investment adviser, or an employee benefit plan with total assets in excess of U.S.$5,000,000 or, if a self- directed plan, with investment decisions made solely by persons who are accredited investors; or
	 	 	 
	______	Category 10.	A private business development company as defined in Section 202(a)(22) of the United States Investment Advisers Act of 1940, as amended; or
	 	 	 
	______	Category 11.	An organization described in Section 501(c)(3) of the United States Internal Revenue Code of 1986, as amended, a corporation, a Massachusetts or similar business trust, a partnership, or a limited liability company, not formed for the specific purpose of acquiring the Offered Securities, with total assets in excess of U.S.$5,000,000; or
	 	 	 
	______	Category 12.	Any director or executive officer of the Corporation; or
	 	 	 
	______	Category 13.	A natural person whose individual net worth,1 or joint net worth with that person’s spouse, at the time of purchase exceeds U.S.$1,000,000; or
	 	 	 
	______	Category 14.	A natural person who had an individual income in excess of U.S.$200,000 in each of the two most recent years or joint income with that person’s spouse in excess of U.S.$300,000 in each of those years and has a reasonable expectation of reaching the same income level in the current year; or
	 	 	 
	______	Category 15.	A trust, with total assets in excess of U.S.$5,000,000, not formed for the specific purpose of acquiring the Offered Securities, whose purchase is directed by a sophisticated person as described in Rule 506(b)(2)(ii) of Regulation D under the U.S. Securities Act; or
	 	 	 
	______	Category 16.	Any entity in which all of the equity owners meet the requirements of at least one of the above categories.

 

		(c)	The Purchaser is authorized to consummate the purchase of the Offered Securities.

 

		(d)	The Purchaser is acquiring the Offered Securities as principal for its own account or for the account of one or more Accredited
Investors for which it exercises sole investment discretion and not with the view to the resale or distribution thereof in violation
of the U.S. Securities Act or any state securities laws.

 

		(e)	The Purchaser, alone or with its representatives, has such knowledge and experience in financial and business matters as to
be capable of evaluating the merits, and risks of its investment in the Offered Securities and the Purchaser is able to bear the
loss of the entire investment.

 

		(f)	The Purchaser is not purchasing the Offered Securities as a result of any “directed selling efforts” (as defined
in Regulation S under the U.S. Securities Act (“Regulation S”)) or any “general solicitation” or “general
advertising” (as those terms are used in Regulation D), including advertisements, articles,
notices or other communications published in any newspaper, magazine or similar media or disseminated on the Internet, or broadcast
over radio or television, or any seminar or meeting whose attendees have been invited by general solicitation or general advertising.

 

 

1 “net worth” means
the excess of total assets at fair market value (including personal and real property, but excluding the estimated fair market
value of a person’s primary residence) over total liabilities. Total liabilities excludes any mortgage on the primary home
in an amount of up to the home's estimated fair market value as long as the mortgage was incurred more than 60 days before
the Offered Securities are purchased, but includes (i) any mortgage amount in excess of the home’s fair market value
and (ii) any mortgage amount that was borrowed during the 60-day period before the Offered Securities are purchased.

 

    	 	-2-	 

     

    

 

		(g)	The Offered Securities have not been and will not be registered under the U.S. Securities Act,
or the securities laws of any state, and may not be offered or sold in the United States without registration under the U.S. Securities
Act and any applicable state securities laws, unless exemptions or exclusions from such registrations are available, and in accordance
with the Subscription Agreement, including this Certification.

 

		(h)	The Offered Securities will be “restricted securities” as defined in Rule 144(a)(3)
under the U.S. Securities Act, and the Purchaser shall not offer, sell, pledge or otherwise transfer any of such securities, directly
or indirectly, unless the offer, sale, pledge or transfer is:

 

		(i)	to the Corporation (although the Corporation is under no obligation to purchase any securities);

 

		(ii)	outside the United States in accordance with Rule 904 of Regulation S and in compliance with applicable
local laws and regulations;

 

		(iii)	in compliance with (A) Rule 144A under the U.S. Securities Act to a person the seller reasonably
believes to be a Qualified Institutional Buyer (as defined in Rule 144A); or (B) Rule 144 under the U.S. Securities Act (“Rule
144”), if available;

 

		(iv)	in another transaction that does not require registration under the U.S. Securities Act or any
applicable state securities laws; or

 

		(v)	pursuant to an effective registration statement under the U.S. Securities Act; and

 

 in each
case accordance with applicable state securities laws; and

 

the Purchaser has prior to any
transfer pursuant to clauses (iii)(B) or (iv) (and, if required by the Corporation, or the transfer agent for the Corporation,
clause (ii)) above, furnished to the Corporation an opinion of counsel of recognized standing, or other evidence, reasonably satisfactory
to the Corporation, to the effect that such proposed transfer does not require registration under the U.S. Securities Act or applicable
state securities laws.

 

		(i)	Until such time as the same is no longer required under the requirements of the U.S. Securities
Act or applicable state securities laws, the certificates representing the Offered Securities, and all certificates representing
any securities issued in exchange thereof or in substitution therefor, will bear the following legend, in addition to any other
legends that may be required under applicable securities laws:

 

“THE SECURITIES REPRESENTED
BY THIS CERTIFICATE HAVE NOT BEEN REGISTERED UNDER THE UNITED STATES SECURITIES ACT OF 1933, AS AMENDED (THE “U.S. SECURITIES
ACT”), OR ANY STATE SECURITIES LAWS. THE HOLDER HEREOF, BY PURCHASING THESE SECURITIES, AGREES FOR THE BENEFIT OF XORTX THERAPEUTICS
INC. (THE “CORPORATION”) THAT SUCH SECURITIES MAY BE OFFERED, SOLD, PLEDGED OR OTHERWISE TRANSFERRED ONLY: (A) TO THE
CORPORATION, (B) OUTSIDE THE UNITED STATES IN ACCORDANCE WITH RULE 904 OF REGULATION S UNDER THE U.S. SECURITIES ACT (“REGULATION
S”), (C) IN ACCORDANCE WITH (1) RULE 144A UNDER THE U.S. SECURITIES ACT OR (2) RULE 144 UNDER THE U.S. SECURITIES ACT, IF
AVAILABLE, OR (D) PURSUANT TO ANOTHER EXEMPTION OR EXCLUSION FROM REGISTRATION UNDER THE U.S. SECURITIES ACT, AND IN EACH CASE,
IN ACCORDANCE WITH ALL APPLICABLE STATE SECURITIES LAWS, AFTER, IN THE CASE OF TRANSFERS PURSUANT TO CLAUSE (C)(2) OR (D) (OR IF
REQUIRED BY THE CORPORATION, OR ITS TRANSFER AGENT, CLAUSE (B)) ABOVE, THE HOLDER HAS PROVIDED TO THE CORPORATION A LEGAL OPINION
OF COUNSEL OF RECOGNIZED STANDING OR OTHER EVIDENCE, REASONABLY SATISFACTORY TO THE CORPORATION, TO THE EFFECT

 

    	 	-3-	 

     

    

 

THAT THE SALE OF SUCH SECURITIES
IS NOT REQUIRED TO BE REGISTERED UNDER THE U.S. SECURITIES ACT OR APPLICABLE STATE SECURITIES LAWS.

 

THESE SECURITIES MAY NOT CONSTITUTE
"GOOD DELIVERY" IN SETTLEMENT OF TRANSACTIONS ON CANADIAN STOCK EXCHANGES.”

 

provided, that if Offered Securities
are being sold under Rule 904 of Regulation S in accordance with clause (B) above, at the time of sale the legend above may be
removed by providing a duly completed and signed declaration to the Corporation and the transfer agent for the Corporation, in
the form of Exhibit I attached to this Certificate (or in such other form as the Corporation may prescribe), together with any
other evidence reasonably requested by the Corporation or transfer agent, which evidence may include an opinion of counsel of recognized
standing, in form and substance reasonably satisfactory to the Corporation, to the effect that the transfer of the Offered Securities
does not require registration under the U.S. Securities Act;

 

provided further, that if any
of the Offered Securities are being sold pursuant to Rule 144, if available, the legend may be removed by delivering to the Corporation
and the transfer agent for the Offered Securities being sold an opinion of counsel of recognized standing reasonably satisfactory
to the Corporation and transfer agent for the Offered Securities being sold, to the effect that the legend is no longer required
under applicable requirements of the U.S. Securities Act or applicable state securities laws.

 

Upon the Purchaser’s compliance
with either Rule 904 of Regulation S or Rule 144, and the Subscription Agreement, including this Certification, the Corporation
shall use its reasonable commercial efforts to cause the transfer agent to remove the foregoing legend within two business days
of receipt of the foregoing.

 

		(j)	The Warrants may not be exercised within the United States or by or on behalf of, or for the account
of, a “U.S. Person” (as that term is defined in Regulation S) unless (i) the holder is an Accredited Investor, and
(ii) such exercise is made pursuant to an available exemption from the registration requirements of the U.S. Securities Act and
any applicable state securities laws.

 

		(k)	The certificates representing the Warrants, and all certificates issued in exchange therefor or
in substitution thereof, shall bear, in addition to any legend otherwise required, the following legend:

 

THIS WARRANT AND THE SECURITIES
DELIVERABLE UPON EXERCISE HEREOF HAVE NOT BEEN AND WILL NOT BE REGISTERED UNDER THE UNITED STATES SECURITIES ACT OF 1933, AS AMENDED
(THE “U.S. SECURITIES ACT”), OR THE SECURITIES LAWS OF ANY STATE OF THE UNITED STATES. THIS WARRANT MAY NOT BE EXERCISED
IN THE UNITED STATES OR BY OR ON BEHALF OF, OR FOR THE ACCOUNT OR BENEFIT OF, A U.S. PERSON UNLESS THE SECURITIES ISSUABLE UPON
EXERCISE OF THIS WARRANT HAVE BEEN REGISTERED UNDER THE U.S. SECURITIES ACT AND THE APPLICABLE SECURITIES LEGISLATION OF ANY SUCH
STATE OR AN EXEMPTION FROM SUCH REGISTRATION REQUIREMENTS IS AVAILABLE. “UNITED STATES” AND “U.S. PERSON”
ARE AS DEFINED BY REGULATION S UNDER THE U.S. SECURITIES ACT.

 

		(l)	The Corporation may make a notation in its records and instruct the transfer agent for the Offered
Securities not to record any transfer of the Offered Securities to implement the restrictions or transfer set forth above.

 

		(m)	The Corporation has made available to the Purchaser or its agents
such additional information requested by the Purchaser or on its behalf, which the Corporation possesses or can acquire without
unreasonable effort or expense, that the Purchaser considered necessary to make an informed decision to invest in the Corporation.
The Purchaser has had the opportunity to ask questions of, and receive answers from, representatives of the Corporation concerning
the Corporation, its business and financial condition and the terms and conditions of the offering of the Offered Securities, and
all such questions have been answered to the Purchaser’s satisfaction. The Purchaser has not relied on any other representations
or other information (whether oral or written) made by or on behalf of the Corporation other than as contemplated by the
Subscription Agreement, including this Certificate.

 

    	 	-4-	 

     

    

 

		(n)	The Purchaser understands that the Corporation has no obligation to file, or present intention
of filing, with the United States Securities and Exchange Commission or with any state securities administrator any registration
statement in respect of resales of the Offered Securities.

 

		(o)	The Purchaser understands that if the Corporation were to ever be deemed to be, or to have at any
time previously been, an issuer with (i) no or nominal operations and (ii) no or nominal assets other than cash and cash equivalents,
Rule 144 may not be available with respect to transactions in the Offered Securities, and the Corporation is under no obligation
to take, and has no present intention of taking, any required action in order to make Rule 144 available with respect to transactions
in the Offered Securities.

 

		(p)	The Purchaser understands that no public market for the Offered Securities now exists in the United
States and a public market may never exist for the Offered Securities in the United States.

 

		(q)	The Purchaser understands and acknowledges that there may be material tax consequences to the Purchaser
of an acquisition or disposition of any of the Offered Securities. The Corporation gives no opinion and makes no representation
with respect to the tax consequences to the Purchaser under United States federal, state, or local tax law, or foreign tax law,
of the Purchaser’s acquisition or disposition of the Offered Securities, including, without limitation, with respect to the
potential applicability of United States federal income tax rules related to “passive foreign investment companies”
(“PFIC”) (as such term is defined in the United States Internal Revenue Code of 1986, as amended). In particular, the
Purchaser acknowledges and understands that no determination has been made as to whether the Corporation will be classified as
a PFIC for the current or any future tax year.

 

		(r)	The Purchaser is responsible for obtaining such legal and tax advice as it considers necessary
in connection with the execution, delivery and performance by it of the Subscription Agreement, including this Certification.

 

		(s)	The Purchaser understands that the financial statements of the Corporation have been prepared in
accordance with International Financial Reporting Standards, which differ in some respects from United States generally accepted
accounting principles, and thus may not be comparable to financial statements of United States companies.

 

		(t)	The Purchaser understands that its ability to enforce civil liabilities under the United States
federal securities laws may be affected adversely by, among other things, the fact that: (i) the Corporation is organized under
the laws of Canada; (ii) some or all of the directors and officers of the Corporation are residents of countries other than the
United States; and (iii) all or a substantial portion of the assets of the Corporation and said persons may be located outside
the United States.

 

		(u)	The Purchaser understands that the Offered Securities have not been recommended by any United States
federal or state securities commission or regulatory authority. The foregoing authorities have not confirmed the accuracy or determined
the adequacy of the information in the Subscription Agreement or the schedules and exhibits attached hereto, and any representation
to the contrary is a criminal offense.

 

		(v)	(a) If it is acquiring the Offered Securities as a fiduciary or agent for one or more investors,
it has full power to make the foregoing representations, warranties and agreements on behalf of each such investor, and the foregoing
representations, warranties and agreements are true and correct and will be binding upon each such investor; or (b) the undersigned
is an agent of the Purchaser duly authorized to execute and deliver this letter on behalf of the Purchaser.

 

		(w)	The Purchaser understands and acknowledges that the representations, warranties and covenants contained
in the Subscription Agreement, including this Certification, are made by it with the intent that they may be relied upon by the
Corporation in determining the Purchaser’s eligibility or the eligibility of others on whose behalf the Purchaser is contracting
hereunder to purchase the Offered Securities. The Purchaser agrees that by accepting the Offered Securities it shall be representing
and warranting that the representations and warranties above are true as at the date hereof and the Closing Date with the same
force and effect as if they had been made by it at each date and that they shall survive the purchase by it of the Offered Securities
and shall continue in full force and effect notwithstanding any subsequent disposition by it of such securities.

 

    	 	-5-	 

     

    

 

The Purchaser undertakes
to notify the Corporation, the Agents and the US Affiliates immediately of any change in any representation, warranty or other
information relating to the Purchaser or any Beneficial Purchaser set forth herein which takes place prior to the Closing.

 

Dated: _____________________________, 2020.

 

	If a Corporation, Partnership or Other Entity:	 	If an Individual:
	 	 	 
	 	 	 
	Name of Entity	 	Signature
	 	 	 
	 	 	 
	Type of Entity	 	Print or Type Name
	 	 	 
	 	 	 
	Signature of Person Signing	 	 
	 	 	 
	 	 	 
	Print or Type Name and Title of Person	 	 
	Signing	 	 

 

    	 	-6-	 

     

    

 

EXHIBIT I TO CERTIFICATION OF U.S.
PURCHASER

DECLARATION FOR REMOVAL OF LEGEND

 

		TO:	_________________________, as transfer agent for the Common Shares of XORTX Therapeutics Inc.

 

		AND TO:	XORTX THERAPEUTICS INC.

 

The undersigned (a) acknowledges that the
current sale of                 Common Shares
of XORTX Therapeutics Inc. (the “Corporation”) to which this declaration relates, represented by certificate
number              , is being made in reliance on Rule
904 of Regulation S (“Regulation S”) under the United States Securities Act of 1933, as amended (the “U.S.
Securities Act”), and (b) certifies that (1) the undersigned is not an “affiliate” (as that term is defined
in Rule 405 under the U.S. Securities Act) of the Corporation, (2) the offer of such securities was not made to a person in the
United States and either

 

(A)       at
the time the buy order was originated, the buyer was outside the United States, or the seller and any person acting on its behalf
reasonably believed that the buyer was outside the United States, or

 

(B)       the
transaction was executed in, on or through the facilities of the Toronto Stock Exchange or TSX Venture Exchange (or another “designated
offshore securities market,” as defined in Regulation S) and neither the seller nor any person acting on its behalf knows
that the transaction has been prearranged with a buyer in the United States, (3) neither the seller nor any affiliate of the seller
nor any person acting on any of their behalf has engaged or will engage in any “directed selling efforts” (as defined
in Regulation S) in the United States in connection with the offer and sale of such securities, (4) the sale is bona fide and not
for the purpose of “washing off” the resale restrictions imposed because the securities are “restricted securities”
(as is defined in Rule 144(a)(3) under the U.S. Securities Act), (5) the seller does not intend to replace such securities with
fungible unrestricted securities and (6) the contemplated sale is not a transaction, or part of a series of transactions that,
although in technical compliance with Regulation S, is part of a plan or scheme to evade the registration provisions of the U.S.
Securities Act. Unless otherwise defined herein, terms used herein have the meanings given to them by Regulation S under the U.S.
Securities Act.

 

	Dated:	 	 	 
	 	 	 	Name of Seller
	 	 	 	 	 
	 	 	 	By:	 
	 	 	 	 	 
	 	 	 	Name:	 
	 	 	 	 	 
	 	 	 	Title:	 

 

    	 	-7-	 

     

    

 

Affirmation by Seller’s Broker-Dealer (required for
sales pursuant to Section (b)(2)(B) above)

 

We have read the representation
letter
of              (the
“Seller”) dated                  ,
20    , pursuant to which the Seller has requested that we sell, for the Seller’s account,                 
[common shares] [warrants] represented by certificate number (the “Securities”) of the Corporation. We
have executed sales of the Securities pursuant to Rule 904 of Regulation S on behalf of the Seller. In that connection, we
hereby represent to you as follows:

 

		(1)	no offer to sell Securities was made to a person in the United States;

 

		(2)	the sale of the Securities was executed in, on or through the facilities of a “designated offshore securities market”
(as defined in Regulation S), and, to the best of our knowledge, the sale was not pre-arranged with a buyer in the United States.

 

		(3)	No “directed selling efforts” (as defined in Regulation S) were made in the United States by the undersigned, any
affiliate of the undersigned, or any person acting on behalf of the undersigned; and

 

		(4)	We have done no more than execute the order or orders to sell the Securities as agent for the Seller and will receive no more
than the usual and customary broker’s commission that would be received by a person executing such transaction as agent.

 

For purposes of these representations:
“affiliate” means a person that directly, or indirectly through one or more intermediaries, controls, or is
controlled by, or is under common control with, the undersigned; “directed selling efforts” means any activity
undertaken for the purpose of, or that could reasonably be expected to have the effect of, conditioning the market in the United
States for the Securities (including, but not be limited to, the solicitation of offers to purchase the Securities from persons
in the United States); and “United States” means the United Stated of America, its territories or possessions,
any State of the United States, and the District of Columbia.

 

Legal counsel to the Corporation shall
be entitled to rely upon the representations, warranties and covenants contained in this letter to the same extent as if this letter
had been addressed to them.

 

	Yours truly,	 
	 	 
	 	 
	Name of Firm	 
	 	 
	By:	 	 
	 	 
	Title:	 	 

  

    	 	-8-	 

     

    

 

EXHIBIT 6

 

	
        Alberta Securities Commission

        Suite 600, 250 – 5th Street SW

        Calgary, Alberta T2P 0R4

        Telephone: (403) 297-6454

        Toll free in Canada: 1-877-355-0585

        Facsimile: (403) 297-2082
	 	
        Government of the Northwest Territories

        Office of the Superintendent of Securities

        P.O. Box 1320

        Yellowknife, Northwest Territories X1A 2L9

        Attention: Deputy Superintendent, Legal & Enforcement

        Telephone: (867) 920-8984

        Facsimile: (867) 873-0243

	 	 	 
	
        British Columbia Securities Commission

        P.O. Box 10142, Pacific Centre

        701 West Georgia Street

        Vancouver, British Columbia V7Y 1L2

        Inquiries: (604) 899-6854

        Toll free in Canada: 1-800-373-6393

        Facsimile: (604) 899-6506

        Email: inquiries@bcsc.bc.ca
	 	
        Nova Scotia Securities Commission

        Suite 400, 5251 Duke Street

        Duke Tower

        P.O. Box 458

        Halifax, Nova Scotia B3J 2P8

        Telephone: (902) 424-7768

        Facsimile: (902) 424-4625

	 	 	 
	
        The Manitoba Securities Commission

        500 – 400 St. Mary Avenue

        Winnipeg, Manitoba R3C 4K5

        Telephone: (204) 945-2561

        Toll free in Manitoba 1-800-655-5244

        Facsimile: (204) 945-0330
	 	
        Government of Nunavut

        Department of Justice

        Legal Registries Division

        P.O. Box 1000, Station 570

        1st Floor, Brown Building

        Iqaluit, Nunavut X0A 0H0

        Telephone: (867) 975-6590

        Facsimile: (867) 975-6594

	 	 	 
	
        Financial and Consumer Services Commission (New Brunswick)

        85 Charlotte Street, Suite 300

        Saint John, New Brunswick E2L 2J2

        Telephone: (506) 658-3060

        Toll free in Canada: 1-866-933-2222

        Facsimile: (506) 658-3059

        Email: info@fcnb.ca
	 	
        Ontario Securities Commission

        20 Queen Street West, 22nd Floor

        Toronto, Ontario M5H 3S8

        Telephone: (416) 593- 8314

        Toll free in Canada: 1-877-785-1555

        Facsimile: (416) 593-8122

        Email: exemptmarketfilings@osc.gov.on.ca

	 	 	 
	
        Government of Newfoundland and Labrador

        Financial Services Regulation Division

        P.O. Box 8700

        Confederation Building

        2nd Floor, West Block

        Prince Philip Drive

        St. John’s, Newfoundland and Labrador A1B 4J6

        Attention: Director of Securities

        Telephone: (709) 729-4189

        Facsimile: (709) 729-6187
	 	
        Prince Edward Island Securities Office

        95 Rochford Street, 4th Floor Shaw Building

        P.O. Box 2000

        Charlottetown, Prince Edward Island C1A 7N8

        Telephone: (902) 368-4569

        Facsimile: (902) 368-5283

 

    	 		 

     

    

 

	
        Autorité des marchés financiers

        800, Square Victoria, 22e étage

        C.P. 246, Tour de la Bourse

        Montréal, Québec H4Z 1G3

        Telephone: (514) 395-0337 or 1-877-525-0337

        Facsimile: (514) 873-6155 (For filing purposes only)

        Facsimile: (514) 864-6381 (For privacy requests only)

        Email: financementdessocietes@lautorite.qc.ca (For

        corporate finance issuers);

        fonds_dinvestissement@lautorite.qc.ca (For investment

        fund issuers)
	 	 
	 	 	 
	
        Financial and Consumer Affairs Authority of

        Saskatchewan

        Suite 601 - 1919 Saskatchewan Drive

        Regina, Saskatchewan S4P 4H2

        Telephone: (306) 787-5842

        Facsimile: (306) 787-5899

        Public official contact regarding indirect collection of

        information: Director
	 	 
	 	 	 
	
        Office of the Superintendent of Securities

        Government of Yukon

        Department of Community Services

        307 Black Street, 1st Floor

        Box 2703, C-6

        Whitehorse, Yukon Y1A 2C6

        Telephone: (867) 667-5466

        Facsimile: (867) 393-6251

        Email: Securities@gov.yk.ca
	 	 

 

    	 	-2-EX-4.(a)

 Exhibit (4)(a) 

 

							
		  	

	  	Company Logo	  	

 Midland National® Life Insurance Company 

 

							
		  	

	 	 8300 Mills Civic Parkway

West Des Moines, IA 50266

(515) 440-5500
	  	

  
  

GROUP CONTINGENT DEFERRED ANNUITY CERTIFICATE 

This Group Certificate guarantees to make payments to the Certificate Owner during the life of the Covered Person(s). In order to receive the benefit of the
this Group Certificate, Certificate Owners must comply with all terms as described in this Certificate. 
 Midland National Life Insurance Company
(“Midland”, “We”, “Us”, “Our”, or the “Company”) in consideration of an enrollment form for a Certificate and the payment of Certificate Fees, agrees, subject to the terms and conditions of this
Certificate, to pay to the Certificate Owner the Lifetime Annuity Payment according to the terms of this Certificate. 
 THE CERTIFICATE
HAS NO CASH VALUE, NO SURRENDER VALUE AND PROVIDES 
 NO DEATH BENEFIT. 

YOUR RIGHT TO EXAMINE THE CERTIFICATE If, for any reason You are not satisfied with this Certificate, You may return it to Us within 10 days of receipt
of the Contract. 
 PLEASE READ THIS CERTIFICATE CAREFULLY 

Issued and Signed by Midland National Life Insurance Company 
  

 

  
 1 

 TABLE OF CONTENTS 

 

					
	SECTION	  	PAGE	 
	 1.   DEFINITIONS
	  			
		
	 1.1  ATTAINED AGE
	  	 	4	 
	 1.2  ADVISORY FEES
	  	 	4	 
	 1.3  ANNUITANT
	  	 	4	 
	 1.4  ASSET ALLOCATION TIER
	  	 	4	 
	 1.5  BUSINESS DAY
	  	 	4	 
	 1.6  CERTIFICATE
	  	 	4	 
	 1.7  CERTIFICATE ANNIVERSARY DATE
	  	 	4	 
	 1.8  CERTIFICATE CONTRIBUTIONS
	  	 	5	 
	 1.9  CERTIFICATE FEE
	  	 	5	 
	 1.10  CERTIFICATE ISSUE DATE
	  	 	5	 
	 1.11  CERTIFICATE OWNER
	  	 	5	 
	 1.12  CERTIFICATE YEAR
	  	 	5	 
	 1.13  CERTIFICATE ISSUE DATE
	  	 	5	 
	 1.14  COVERAGE AMOUNT
	  	 	5	 
	 1.15  COVERED ASSETS
	  	 	5	 
	 1.16  COVERED ASSET ACCOUNT
	  	 	5	 
	 1.17  COVERED ASSET ACCOUNT VALUE
	  	 	5	 
	 1.18  COVERAGE BASE STEP-UP
	  	 	6	 
	 1.19  COVERAGE PLANS
	  	 	6	 
	 1.20  COVERED PERSON
	  	 	6	 
	 1.21  EARLY WITHDRAWAL
	  	 	6	 
	 1.22  ELIGIBLE ASSET
	  	 	6	 
	 1.23  EXCESS WITHDRAWAL
	  	 	7	 
	 1.24  FINANCIAL INSTITUTION
	  	 	7	 
	 1.25  INELIGIBLE ASSET
	  	 	7	 
	 1.26  LOCK-IN DATE
	  	 	7	 
	 1.27  PAYMENT PERCENTAGE
	  	 	7	 
	 1.28  PERMITTED WITHDRAWAL
	  	 	7	 
	 1.29  TEN-YEAR CONSTANT MATURITY US TREASURY
RATE
	  	 	7	 
	 1.30  WITHDRAWAL
	  	 	8	 
	 1.31  WRITTEN NOTICE AND NOTICE
	  	 	8	 
	 1.32  SUBSEQUENT CONTRIBUTIONS
	  	 	8	 
	 1.33  FINANCIAL INSTITUTION
	  	 	8	 
		
	 2.   CERTIFICATE ELIGIBILITY AND OWNERSHIP
	  			
		
	 2.1  CERTIFICATE OWNERSHIP
	  	 	9	 
	 2.2  JOINT COVERED PERSON
	  	 	9	 
	 2.3  DIVORCE
	  	 	9	 
	 2.4  SPOUSAL CONTINUANCE AND DEATH
	  	 	10	 
		
	 3.   COVERED ASSET ACCOUNT
	  			
		
	 3.1  ELIGIBLE ASSET
	  	 	11	 

  
 2 

			
	 3.2  REQUIRED ASSET ALLOCATION AND REBALANCE
	  	11
		
	 4.   CERTIFICATE COVERAGE
	  	
		
	 4.1  COVERAGE BASE 

4.2  COVERAGE BASE STEP-UP

4.3  MAXIMUM COVERAGE BASE VALUE

4.4  PAYMENT PERCENTAGE

4.5  COVERAGE AMOUNT

4.6  COVERED ASSET ACCOUNT COMPOSITION REQUIREMENTS

4.7  LIFETIME ANNUITY PAYMENT 
	  	12
 12
 12

13
 13

13
 15

		
	 5.   CERTIFICATE CONTRIBUTION AND WITHDRAWALS
	  	
		
	 5.1  SUBSEQUENT CONTRIBUTIONS

5.2  WITHDRWALS AND TRANSFERS

5.3  PERMITTED WITHDRAWAL

5.4  EARLY WITHDRAWAL

5.5  EXCESS WITHDRAWAL
	  	16
 16
 16

17
 17

		
	 6.   FEES
	  	
		
	 6.1  CERTIFICATE FEE

6.2  CERTIFICATE FEE DUE DATE

6.3  ADVISORY FEE
	  	17
 18
 18

		
	 7.   GENERAL PROVISIONS
	  	
		
	 7.1  ENTIRE CONTRACT

7.2  CHANGE OF CONTRACT

7.3  NONPARTICIPATION

7.4  ERRORS

7.5  MISSTATEMENT AND ADJUSTMENTS

7.6  PROOF OF AGE

7.7  RESERVATION OF RIGHTS

7.8  ASSIGNMENT OF THE CERTIFICATE
	  	18
 18
 19

19
 19

19
 19

19

		
	 8.   TERMINATION
	  	
		
	 8.1  GROUP CONTRACT DISCONTINUANCE

8.2  CERTIFICATE TERMINATION
	  	20
 20

  
 3 

 SECTION 1. DEFINITIONS 

 

	1.1.	 ATTAINED AGE 

Age of a Covered Person as of his or her last birthday on the date being referenced. If there are joint Covered Persons under this Certificate,
the Covered Persons Attained Age is the age of the younger Covered Person on his or her last birthday on the date being referenced. 
  

	1.2.	 ADVISORY FEES 

Third party fees paid by You for investment advisory services with respect to the Covered Asset Account. This fee may not be withdrawn from the
Covered Asset Account unless elected prior to Certificate Issue Date. 
  

	1.3.	 ANNUITANT 

The person(s) whose life is used to determine the amount and duration of annuity payments involving life contingencies after the Covered Asset
Account goes to zero. The Annuitant(s) may not be changed during the Annuitant’s lifetime. 
 The Annuitant is the Covered Person(s).

  

	1.4.	 ASSET ALLOCATION TIER 

Asset Allocation Tier refers to the categorization of the Model Portfolio or Restricted Asset Allocation Portfolio investment allocations
chosen by You. Each tier represents a different balance of exposure to equity investments. Each tier has composition requirements that impose limitations on exposure to certain asset class categories. Asset Allocation Tier must be elected on or
before the Certificate Issue Date, but may be changed after the Certificate Issue Date with Notice to Us. A Change in Asset Allocation Tier may lead to a corresponding change to the Certificate Fee. 

 

	1.5.	 BUSINESS DAY 

Each day that the Financial Institution is open for business, We are open for business and the New York Stock Exchange (“NYSE”) is
open for trading. A Business Day ends at the close of trading (4:00 p.m. Eastern Time or, if earlier, the time that the NYSE closes). 
  

	1.6.	 CERTIFICATE 

This form issued to You, which provides a summary of the benefits, rights, and terms under this Certificate. 

 

	1.7.	 CERTIFICATE ANNIVERSARY DATE 

The same date in each year as the Certificate Issue Date. If the date is not a Business Day or does not exist in a given month (e.g. February
30), the Certificate Anniversary Date is the next Business Day. 

  
 4 

	1.8.	 CERTIFICATE CONTRIBUTIONS 

The initial Certificate Contribution is the value of the Covered Assets as of the end of the Business Day on the Certificate Issue Date. After
the Certificate Issue Date, but before the first Certificate Anniversary Date and before the first Withdrawal, additional contributions may be made into the Covered Asset Account. We refer to these as “Subsequent Contributions”. Total
Certificate Contributions is the sum of the Initial Certificate Contribution, as shown on the Certificate Schedule and any Subsequent Contributions. 
  

	1.9.	 CERTIFICATE FEE 

The fee charged on a calendar quarterly basis to You for the benefits provided under this Certificate.     

 

	1.10.	 CERTIFICATE ISSUE DATE 

The date on which the Certificate is issued to You and is shown on the Certificate Schedule. The Certificate Issue Date determines the
Certificate Anniversary Date and the Certificate Year. 
  

	1.11.	 CERTIFICATE OWNER, YOU, YOUR 

The person(s) or entity that purchases and owns the Certificate. The Certificate Owner is shown on the Certificate Schedule. 

 

	1.12.	 CERTIFICATE YEAR 

A one-year period beginning on a Certificate Anniversary Date and ending the day before the next
Certificate Anniversary Date. 
  

	1.13.	 CERTIFICATE ISSUE DATE 

The first day this Certificate is effective. The Certificate Issue Date is shown on the Certificate Schedule. 

 

	1.14.	 COVERAGE AMOUNT 

After the Lock-In Date, the annual amount that You may withdraw from the Covered Asset Account in a
Certificate Year without reducing the Coverage Amount in future years. You may withdraw the greater of the Coverage Amount or IRS required minimum distributions (RMDs) without such reduction. 

 

	1.15.	 COVERED ASSETS 

Shares of Eligible Assets purchased by You for coverage under this Certificate held within a Covered Asset Account. 

 

	1.16.	 COVERED ASSET ACCOUNT 

An investment account You established with a Financial Institution that holds the investments this Certificate provides coverage under. 

 

	1.17.	 COVERED ASSET ACCOUNT VALUE 

The current market value of all the Covered Assets held in Your Covered Asset Account as of the close of any Business Day. 

  
 5 

	1.18.	 COVERAGE BASE STEP-UP 

Coverage Base Step-Up refers to the Certificate feature under which we automatically increase the
coverage base each Certificate Anniversary Date to reflect increases in the Covered Asset Account Value. The automatic Coverage Base Step-Up terminates on the Certificate Anniversary Date when the Covered
Asset Account Value equals or exceeds the Maximum Coverage Base Value.    On the Certificate Issue Date the coverage base equals the Initial Certificate Contribution, as shown in Certificate Specifications. 

 

	1.19.	 COVERAGE PLANS 

Coverage Plans define the fee level and corresponding benefit level under this Certificate. Coverage Plans must be elected at or before the
Certificate Issue Date and may not be changed after the Certificate is issued. 
  

	1.20.	 COVERED PERSON 

The Covered Person(s) must be the Certificate Owner(s). If the Certificate Owner is a non-natural
entity, then the beneficiary of the non-natural entity is the Covered Person. 
 In the case of a
single Certificate Owner where the Certificate Owner and the Certificate Owner’s spouse are elected for purposes of a joint Payout, they shall be considered joint Covered Persons and all references in this Certificate and the Certificate
Specifications shall mean the Certificate Owner and the Certificate Owner’s spouse. When there is a single Certificate Owner, the joint Covered Person must be specified prior to the Lock-In Date. When
there are joint Certificate Owners, the Covered Persons cannot be added or removed. 
 The Coverage Amount and lifetime annuity payments
will be based on the Attained Age of the Covered Person. If there are joint Covered Persons the Coverage Amount and lifetime annuity payments will be as calculated by the Attained Age of the younger Covered Person. 

If the Covered Person’s age has been misstated, the Certificate’s Fees and benefits will be adjusted to the amounts which would have
been calculated for the correct Attained Age. 
  

	1.21.	 EARLY WITHDRAWAL 

Any partial Withdrawal taken prior to Attained Age [60] is treated as an Early Withdrawal. Early Withdrawals can reduce the value of the
coverage base and Coverage Amount on more than a dollar-for-dollar basis. 
  

	1.22.	 ELIGIBLE ASSET 

An investment that We designate as eligible for coverage under this Certificate. After the Certificate is issued, We may designate additional
investments as Eligible Assets. Once We designate an investment as an Eligible Asset, We, at any time in the future, may determine that such investment is no longer an Eligible Asset. 

  
 6 

	1.23.	 EXCESS WITHDRAWAL 

On or after the Lock-In Date, any partial Withdrawal taken above the Coverage Amount or above the
greater of the Coverage Amount or RMD, for tax qualified accounts, is treated as an Excess Withdrawal.    Excess Withdrawals can reduce the coverage base value and Coverage Amount on more than a dollar-for-dollar basis. 
  

	1.24.	 FINANCIAL INSTITUTION 

An entity approved by us to establish and maintain a Covered Asset Account on behalf of You (or
non-natural entity or Qualified Account holding the assets on Your behalf). We may designate additional approved Financial Institutions, and may, for any reason, disapprove a previously approved Financial
Institution. 
  

	1.25.	 INELIGIBLE ASSET 

An asset that is not designated as eligible for coverage under this Certificate. 

 

	1.26.	 LOCK-IN DATE 

The date used to set the Payment Percentage and is the date You initiate Your first withdrawal from the Covered Asset Account, including IRS
RMDs. The Lock-In Date may be no earlier than the date You (or if joint life coverage is selected, the date the younger spouse) reaches Attained Age [60]. 

 

	1.27.	 PAYMENT PERCENTAGE 

Percentage used to determine the Coverage Amount and lifetime annuity payments. 

The Payment Percentages for single life Certificates are shown in the table below: 

 

									
	 Years since Certificate Issue
Date
	 
	 	  	Less Than Five Years	 	  	Greater than or equal to Five Years	 
	 Covered Person’s Attained Age on Lock-In Date
	  	Payment Percentage	 	  	Payment Percentage	 
	 [60-64]
	  	 	[3.50%]	 	  	 	[4.00%]	 
	 [65-74]
	  	 	[4.50%]	 	  	 	[5.00%]	 
	 [75-79]
	  	 	[5.00%]	 	  	 	[5.50%]	 
	 [80+]
	  	 	[5.50%]	 	  	 	[6.00%]	 

 If coverage is for joint lives, each Payment Percentage will be 0.5% lower than the 

Payment Percentages for a single life. 
  

	1.28.	 PERMITTED WITHDRAWAL 

The maximum amount You may withdraw from the Covered Asset Account each Certificate Year without reducing or eliminating the benefits under the
Certificate. 
  

	1.29.	 TEN YEAR CONSTANT MATURITY US TREASURY RATE ADJUSTMENT 

The Payment Percentage adjustment used to determine the Coverage Amount and lifetime annuity payments under the [CorePlusX] Coverage Plan. 

  
 7 

 The Ten Year Constant Maturity US Treasury Rate (10 Year UST) Payment Percentage Adjustments
are shown in the table below: 
  

																					
	 	  	Ten Year Constant Maturity US Treasury Rate Adjustment	 
	 Covered Person’s Age

on Issue Date
	  	[0% to less
than 4%]	 	  	[4% to less
than 4.5%]	 	  	[4.5% to less
than 5.5%]	 	  	[5.50% to less
than 6.5%]	 	  	[6.5%+]	 
	 [<65]
	  	 	[0.0%]	 	  	 	[0.0%]	 	  	 	[0.5%]	 	  	 	[1.0%]	 	  	 	[1.5%]	 
	 [65+]
	  	 	[0.0%]	 	  	 	[0.5%]	 	  	 	[1.0%]	 	  	 	[1.5%]	 	  	 	[2.0%]	 

  

	1.30.	 WITHDRAWAL 

Any withdrawal from, or transfer out of, Your Covered Asset Account. Incidental trading and other incidental Financial Institution account
fees, such as IRA Account fees, deducted from the Covered Asset Account are not considered a Withdrawal when determining coverage benefits. 
  

	1.31.	 WRITTEN NOTICE AND NOTICE 

Written Notice means a notice of instruction provided by You that We determine provides sufficient detail and does not require Us to exercise
any discretion in satisfying the instruction or request. As We may require by Our rules then in effect, your Written Notice may be required to be any of the following: 
  

	 	1)	 In electronic format, and transmitted electronically as may be specified by Us. 

 

	 	2)	 In written format, signed by You, and transmitted electronically as may be specified by Us.

  

	 	3)	 Such other commercially acceptable means as may be specified by Us. 

Notice means information provided by Us or made available to you that may be in writing, via telephone, electronically, on a website, or
through other commercially acceptable means. 
  

	1.32.	 SUBSEQUENT CONTRIBUTIONS 

Within the first twelve months after the Certificate Issue Date, if no Withdrawals have been taken, additional Contributions may be made to the
Covered Asset Account. 
  

	1.33.	 FINANCIAL INSTITUTION 

An entity approved by us to establish and maintain an Covered Asset Account on behalf of You (or
non-natural person or Qualified Account holding the assets on the Certificate Owner’s behalf). We may designate additional approved Financial Institutions, and may, for any reason, disapprove a previously
approved Financial Institution. 

  
 8 

 SECTION 2. CERTIFICATE ELIGIBILITY AND OWNERSHIP 

Coverage under the Certificate is provided to individuals investing in Eligible Assets that meet our allocation portfolio requirements held in a Covered Asset
Account at a Financial Institution. 
  

	2.1	 CERTIFICATE OWNERSHIP 

This Certificate may be owned by an individual, by two individuals who are spouses, or may be owned by a
non-natural entity. If the Certificate Owner is a single individual, the Certificate Owner must be (i) under Attained Age [80] or younger, (ii) the sole owner of the Covered Asset Account and
(iii) the Covered Person. A Certificate may be owned jointly by two individuals if and only if the joint Certificate Owners are (i) under Attained Age [80] or younger, (ii) sole joint owners of the Covered Asset Account,
(iii) spouses, and (iv) the joint Covered Persons. If there are joint owners of the Covered Asset Account, either joint owner may be named as a Certificate Owner or, if joint coverage is elected, both may be named as joint Certificate
Owners. If the Certificate is owned by a non-natural entity, the Covered Person or joint Covered Persons must be (i) under Attained Age [80] or younger and (ii) the sole owner or the sole joint
owners of the Covered Asset Account (or if the account is held by a trust, the sole beneficiary or the sole joint beneficiaries of the trust). 
  

	2.2	 JOINT COVERED PERSON 

When there is a single Certificate Owner, You may add a joint Covered Person after the Certificate Issue Date but before the Lock-In Date. The joint Covered Person must be Your spouse and under Attained Age [80] or younger on the Certificate Issue Date. The Coverage Amount will be based on the lives of the joint Covered Persons as
calculated by the age of the younger Covered Person. 
 When there are joint Certificate Owners, the owners must be spouses and joint
Covered Persons. 
  

	2.3	 DIVORCE 

If a divorce occurs between a Certificate Owner or Covered Person and his or her spouse (whether or not such spouse is a joint Certificate
Owner or joint Covered Person), the Certificate Owner(s) or joint Covered Person(s) must immediately send Notice. We may require that the Certificate Owner provide Us with court records and other information We require. 

If the divorce occurs prior to the Lock-In Date 

The former spouse will become sole owner of the Covered Asset Account, the Certificate Owner may request the Certificate to be reissued with
the former spouse as the sole Certificate Owner and sole Covered Person; otherwise the Certificate will be terminated. In the event the Certificate is reissued, a new coverage base (calculated as of the date the new Certificate is issued) shall
apply. The then current Certificate Fee applicable to new issues will apply.     

  
 9 

 If a divorce occurs before the Covered Asset Account Value goes to zero and the Covered
Asset Account is divided between the former spouses, the Certificate Owner or Certificate Owners may request that the Certificate be reissued as one or two new single life Certificates; otherwise, the Certificate will be terminated. In all events,
any single life Certificate issued in connection with a divorce must comply with Our rules on who may be a Certificate Owner and who may be a Covered Person. In the event one or two new Certificates are issued, a new coverage base (calculated as of
the date the new Certificate is issued) shall apply to each such Certificate. The then current Certificate Fee applicable to new issues will apply. 

In the case of joint Certificate Owners, if there is a divorce and one of the joint Covered Persons dies before the date the Covered Asset
Account Value goes to zero, the Certificate will terminate as of the date of death, unless a single life Certificate or two single life Certificates have been issued before the date of death. 

If the divorce occurs after the Lock-In Date 

We will comply with any applicable law or court order regarding the Certificate. If the applicable law or the court order divides either
(i) the Covered Asset Pool Account, or (ii) any Coverage Amounts being made from the Certificate, the Certificate will terminate as of the date of the divorce. 
  

	2.4	 SPOUSAL CONTINUANCE AND DEATH 

Effect of Spousal Continuance after Lock-In Date is set 

If there is only one Certificate Owner and one Covered Person and the Certificate Owner dies, the coverage base value and Coverage Amount will
be reduced to zero and the Certificate will terminate. 
 In the case of a Joint Covered Person, whether owned by a single Certificate Owner
or joint Certificate Owner, if the Certificate Owner dies, and the surviving spouse was a joint Covered Person and sole beneficiary under the Certificate then the Certificate may be continued by the surviving spouse. The Coverage Amount will
continue to be paid to the surviving spouse until his or her death. 
 Effect of Spousal Continuance prior to the Lock-In Date 
 If there is only one Certificate Owner and one Covered Person and the Certificate
Owner dies, the coverage base value and Coverage Amount will be reduced to zero and the Certificate will terminate. 
 In the case of a
Joint Covered Person, whether owned by a single Certificate Owner or joint Certificate Owner, if a Certificate Owner dies and the surviving spouse was a joint Covered Person and sole beneficiary under the Certificate then the surviving spouse may
elect to continue the Certificate as the new Certificate Owner and Covered Person. The Coverage Amount for the surviving spouse will be determined based on the joint Payment Percentage, the Attained Age of the surviving spouse, and the number of
Certificate Years from the Certificate Issue Date until the Lock-In Date. The surviving spouse may withdraw the Coverage Amount until his or her death, according to the provisions of the Certificate. The
surviving spouse who continues the Certificate would be eligible for any remaining Coverage Base Step-Up amounts. 

  
 10 

 SECTION 3: COVERED ASSET ACCOUNT 

The Covered Asset Account is an investment account You established and maintain with a Financial Institution approved by Us that participates in an Asset
Allocation Tier with one or more Eligible Asset(s) approved by Us. Your rights and obligations with respect to the Covered Asset Account are set forth in the Financial Institution’s agreement with You. 

 

	3.1	 ELIGIBLE ASSET 

Covered Asset Account must continuously be invested in one or more Eligible Assets approved by Us. The allocation of the investment in Eligible
Assets must be continuously invested in accordance to an approved Asset Allocation Tier. 
 We reserve the right to approve additional
Eligible Assets and to remove the approval status from previously approved Eligible Assets. If we remove approval status, we will send Written Notice of the change to You and/or Your Advisor. You must reallocate that portion of Your Covered Asset
Account into one or more approved Eligible Asset and maintain conformity with an approved Asset Allocation Tier. If You fail to make this reallocation by the end of the Required Reallocation Period shown on the Written Notice, the Certificate
terminates as of the end of the Required Reallocation Period. 
 If the Financial Institution no longer maintains any approved Eligible
Assets, You may transfer the Covered Asset Account coverage base to another approved Financial Institution as long as You maintain compliance with the terms of this Certificate. 

 

	3.2	 REQUIRED ASSET ALLOCATION AND REBALANCE 

You are required to invest assets in their Covered Asset Account in Eligible Assets approved by Us in accordance with an Asset Allocation Tier
approved by Us. You must make Your initial election of the Asset Allocation Tier prior to the Certificate Issue Date. You may make changes to Your asset allocation that causes a change in tier by providing at least [five] Business Days advance
Notice. The change may result in a different Certificate Fee. 
 If You no longer meet the allocation requirements for Your tier,
rebalancing is required the next Business Day for deposits, withdrawals or if cash is added to the Covered Asset Account by means of dividends, capital gains or other distributions/deposits. If rebalancing is required but is not done, we will send
Notice. If rebalancing is not completed within [five] Business Days of receipt of the Notice, we will terminate the Certificate. 

  
 11 

 SECTION 4. CERTIFICATE COVERAGE 

Coverage for this Certificate begins on the Certificate Issue Date. However, the Coverage Amount is not immediately payable and will not become payable until
the Lock-In-Date. 
  

	4.1	 COVERAGE BASE 

We use Your coverage base to determine the Coverage Amount. On the Certificate Issue Date, the coverage base is equal to the Certificate
Contributions and is shown on the Certificate Specifications. Thereafter, during the first Certificate Year prior to any Withdrawals (including RMD’s), the coverage base is increased by any Subsequent Contributions to Your Covered Asset
Account. 
 The coverage base cannot be withdrawn as a lump sum and is not a cash value of the Certificate. It also is not a guarantee of
the value of any assets held within your Covered Asset Account. 
  

	4.2	 COVERAGE BASE STEP-UP 

The coverage base may be increased through the automatic Coverage Base Step-Up feature. Coverage Base Step-Up refers to the Certificate feature under which we automatically increase the coverage base to reflect increases in Your Covered Asset Account Value. 

On each Certificate Anniversary Date prior to the Maximum Coverage Base Value is achieved, Your coverage base will become the greater of: 

 

	 	1)	 The current coverage base; or 

 

	 	2)	 The Covered Asset Account Value on the last Business Day prior to each Certificate Anniversary Date.

 If the coverage base increases pursuant to 2 above, We will treat the increase as an automatic Coverage Base Step-Up. The Coverage Base Step-Up will cease on the Certificate Anniversary the Maximum Coverage Base Value is reached. 

 

	4.3	 MAXIMUM COVERAGE BASE VALUE 

We impose a Maximum Coverage Base Value, equal to [250%] multiplied by total Certificate Contributions. The Maximum Coverage Base Value applies
only during the time period between the Certificate Issue Date and the Certificate Anniversary date that the coverage base equals or exceeds the Maximum Coverage Base Value. Once that time period ends, we no longer check to determine whether an
automatic Coverage Base Step-Up should be implemented – even if the coverage base were to fall below the Maximum coverage base value.     

  
 12 

	4.4	 PAYMENT PERCENTAGE 

The Payment Percentage is set on the Lock-In Date, and is used to calculate the Coverage Amount and
lifetime annuity payments. The Payment Percentage is determined by the Covered Person’s Attained Age and years since Certificate Issue Date. If joint Covered Persons are named, the Payment Percentage is based on the Attained Age of the younger
joint Covered Person. 
  

	4.5	 COVERAGE AMOUNT 

The Coverage Amount is the maximum amount You can withdraw each Certificate Year from the Covered Asset Account without causing an Excess
Withdrawal. If You withdraw or transfers less than the Coverage Amount in a Certificate Year from Your Covered Asset Account, the unused portion cannot be carried over to the next Certificate Year.     

Prior to the Lock-In Date, the Coverage Amount is equal to zero. 

At the Lock-In Date, the Coverage Amount is determined each Certificate Anniversary Date and is
determined differently between the [Core], [CorePlus] and [CorePlusX] Coverage Plans. 
 When the Covered Asset Account Value is greater
than zero, the [Core], [CorePlus] and [CorePlus X] Coverage Amount is determined as follows: 
 The Coverage Amount for the [Core]
and [CorePlus] Coverage Plan is calculated by: 
  

	 	1)	 Coverage base; multiplied by 

 

	 	2)	 The Payment Percentage set on the Lock-In Date, as shown in the table
in [Section 1.28] of this Contract. 

 The Coverage Amount for the [CorePlus X] Coverage Plan is calculated by:

  

	 	1)	 Coverage base; multiplied by the sum of 2) and 3) 

 

	 	2)	 The Payment Percentage set on the Lock-In Date, as shown in [Section
1.29] of this Contract; 

  

	 	3)	 The [Payment Percentage adjustment based on the ten year Constant Maturity US Treasury Rate].

 When the Covered Asset Account Value is reduced to zero, the Coverage Amount is the amount of the lifetime annuity payments We will
make to You (or, for joint life coverage, You and Your surviving spouse) each Certificate Year. See Section [4.7] [Lifetime Annuity Payment]. 
  

	4.6	 COVERED ASSET ACCOUNT COMPOSITION REQUIREMENTS 

The assets in Your Covered Asset Account must be invested at all times in Eligible Assets in order to be covered by the Certificate. We have
divided the Eligible Assets into asset class categories as follows: 

  
 13 

 [Core Equity – Funds that invest substantially in
large-cap equity investments.] 
 [Core Fixed – Funds that invest substantially in fixed
income securities. This generally includes bonds, mortgages, and money market type investments. This category also includes cash held within the Account.] 

[International – Funds that have substantial investments outside of the United States. Certain bond funds may also be included in
this category.] 
 [Small/Mid Cap – Funds that invest substantially in small to mid-cap
stocks. We typically do not include funds in this category that invest primarily in stocks of large-cap indices such as the S&P 500.] 

[Alternative – Funds that do not fall into another asset class category. This may include funds such as REITs, emerging markets,
and commodities as well as funds that We determine have significant volatility.    ] 
 See the table below for the asset allocation
requirements for each Asset Allocation Tier. 
  

									
	Tier A	  

			
	 	  	Minimum Exposure	 	 	Maximum Exposure	 
	 Total Equity Funds
	  	 	[30	%] 	 	 	[45	%] 
	 Core Equity Funds
	  				 	 	[40	%] 
	 International Funds
	  				 	 	[15	%] 
	 Small/Mid Cap Funds
	  				 	 	[5	%] 
	 Alternative Funds
	  				 	 	[0	%] 
	 Total Fixed Funds
	  	 	[55	%] 	 	 	[70	%] 
	 Core Fixed Funds
	  				 	 	[70	%] 
	Tier B	  

			
	 	  	Minimum Exposure	 	 	Maximum Exposure	 
	 Total Equity Funds
	  	 	[45.01	%] 	 	 	[60	%] 
	 Core Equity Funds
	  				 	 	[60	%] 
	 International Funds
	  				 	 	[20	%] 
	 Small/Mid Cap Funds
	  				 	 	[10	%] 
	 Alternative Funds
	  				 	 	[5	%] 
	 Total Fixed Funds
	  	 	[40	%] 	 	 	[54.99	%] 
	 Core Fixed Funds
	  				 	 	[54.99	%] 
	Tier C	  

			
	 	  	Minimum Exposure	 	 	Maximum Exposure	 
	 Total Equity Funds
	  	 	[60.01	%] 	 	 	[75	%] 
	 Core Equity Funds
	  				 	 	[75	%] 
	 International Funds
	  				 	 	[25	%] 
	 Small/Mid Cap Funds
	  				 	 	[15	%] 
	 Alternative Funds
	  				 	 	[10	%] 
	 Total Fixed Funds
	  	 	[25	%] 	 	 	[39.99	%] 
	 Core Fixed Funds
	  				 	 	[39.99	%] 

  
 14 

 If at any time the composition of Your Covered Asset Account does not meet the composition
requirements, We will notify You of the non-compliance. If We send You a Notice of non-compliance, the Notice will indicate the current composition of the Covered Asset
Account and the required composition of Your Covered Asset Account. You will have [five (5)] Business Days from the date of receipt of the Notice to reallocate the Eligible Assets so that the required allocation composition is met. If the required
allocation composition is not met by the end of the [five (5)] Business Day period, this Certificate will be terminated and no benefits will be paid. 
  

	4.7	 LIFETIME ANNUITY PAYMENT 

If the Covered Asset Account Value has been reduced to zero, if not due to an Early Withdrawal or Excess Withdrawal We will make fixed lifetime
annuity payments to You. You may request monthly, quarterly, semi-annual or annual annuity payments. After the annuity payments begin, You cannot change the annuity payment frequency. We reserve the right to require that the annuity payments be in
an amount no less than $100.00 
 Single life Certificate: payments will be made in equal installments for the life of the Annuitant.
Annuity payments will cease upon death of the Annuitant. 
 Joint life Certificate: Annuity payments will be made in equal
installments for the life of the Annuitant and joint Annuitant. Payments cease upon the death of the surviving Annuitant. 
 Lifetime
annuity payments are calculated at the time the Covered Asset Account Value is reduced to zero, if not due to an Early Withdrawal or an Excess Withdrawal, and are equal to: 

Payments under the [Core] Coverage Plan is calculated by: 
  

	 	1)	 Coverage base; multiplied by the difference of 2) and 3) 

 

	 	2)	 The Payment Percentage set on the Lock-In Date, as shown in [Section
1.29] of this Contract; 

  

	 	3)	 [1]% 

Payments under the [CorePlus] Coverage Plan is calculated by: 
  

	 	1)	 Coverage base; multiplied by 

 

	 	2)	 The Payment Percentage set on the Lock-In Date, as shown in [Section
1.29] of this Contract. 

 Payments under the [CorePlus X] Coverage Plan is calculated by: 

 

	 	1)	 Coverage base; multiplied by the sum of 2) and 3) 

 

	 	2)	 The Payment Percentage set on the Lock-In Date, as shown in [Section
1.29] of this Contract; 

  

	 	3)	 The [Payment Percentage adjustment based on the ten year Constant Maturity US Treasury Rate] a s shown in
[Section 1.29] of this Certificate. 

 We will send the annuity payments to the Certificate Owner. 

  
 15 

 SECTION 5. CERTIFICATE CONTRIBUTION AND WITHDRAWALS 

 

	5.1	 SUBSEQUENT CONTRIBUTIONS 

Subsequent Contributions are permitted until the first Certificate Anniversary Date provided that no partial Withdrawals have been taken. After
the first Certificate Anniversary Date, subsequent Contributions will no longer be permitted. Subsequent Contributions do not include dividends or other distributions reinvested in the Covered Asset Account. 

For each Certificate, the total amount of Subsequent Contributions, plus the initial amount in the Covered Asset Account, may not exceed the
Maximum Total Contribution shown on the Certificate Schedule, unless approved by Us. If the Maximum Total Contribution is exceeded, we will send Notice. You must remove the portion of the Subsequent Contribution that exceeds the Maximum Total
Contribution from the Covered Asset Account. The Certificate Contributions and Coverage Base will not reflect the removed portion of the Subsequent Contributions. We do not consider this removal to be a withdrawal. If You fail to do so by the end of
the Withdrawal Reversal Period shown on the Certificate Schedule, this Certificate terminates as of the date the Subsequent Contribution was added to the Covered Asset Account. 

 

	5.2	 WITHDRWALS AND TRANSFERS 

A withdrawal is money deducted from Your Covered Asset Account after the Certificate Issue Date. A withdrawal may be cancelled if You notify us
of an inadvertent withdrawal and then add money to the Covered Asset Account during the Withdrawal Reversal Period shown on the Certificate Schedule. We consider the amount deposited, up to the amount of the withdrawal, to be a cancellation of the
withdrawal and not a Subsequent Contribution; we consider any amount of the deposit in excess of the withdrawal to be a Subsequent Contribution. If the amount deposited is less than the withdrawal, we cancel only the portion of the withdrawal equal
to the amount deposited. If both a Subsequent Contribution and a withdrawal occur on the same Business Day, we process the difference as either a Subsequent Contribution or as a withdrawal, as appropriate. If more than one withdrawal occurs on the
same Business Day, we add all withdrawals together and process them as one withdrawal. 
 We allow three types of withdrawals from Your Covered Asset
Account: Permitted Withdrawals, Early Withdrawals and Excess Withdrawals. 
  

	5.3	 PERMITTED WITHDRAWAL 

Permitted Withdrawals are withdrawals from Your Covered Asset Account that do not exceed the Maximum Coverage Amount for a Certificate Year.
After the Lock-In-Date, You can withdraw or transfer up to the Coverage Amount from Your Covered Asset Account each Certificate Year without causing an Excess
Withdrawal. Permitted Withdrawals do not reduce the coverage base value. However, any amount withdrawn in a Certificate Year in excess of the Coverage Amount available is considered an Excess Withdrawal. 

  
 16 

	5.4	 EARLY WITHDRAWAL 

Before the Lock-In Date, any amount withdrawn or transferred from Your Covered Asset Account is
considered an Early Withdrawal. An Early Withdrawal prior to the Lock-In Date will reduce the coverage base value pro-rata for the Early Withdrawal by: 

 

	 	1)	 The coverage base value prior to the Withdrawal; multiplied by 

 

	 	2)	 The Early Withdrawal amount; divided by 

 

	 	3)	 The Covered Asset Account Value before the Early Withdrawal 

 

	5.5	 EXCESS WITHDRAWAL 

An Excess Withdrawal is a withdrawal from the Covered Asset Account that is greater than the Permitted Withdrawal for that Certificate Year. An
Excess Withdrawal will reduce the coverage base value on a pro-rata basis for the Excess Withdrawal by: 
  

	 	1)	 The coverage base value prior to the Withdrawal; multiplied by 

 

	 	2)	 The Excess Withdrawal amount; divided by 

 

	 	3)	 The Covered Asset Account Value before the Excess Withdrawal amount 

SECTION 6. FEES 
  

	6.1	 CERTIFICATE FEE 

The Certificate Fee is an annual Fee for Certificate expenses paid on a calendar quarterly basis. The Certificate Fees may come from Your
Covered Asset Account or another account designated by You. Certificate Fees deducted from the Covered Asset Account are not considered withdrawals.     

The Certificate Fee is calculated each calendar quarter. If a day does not exist in a given month or the Certificate Fee is withdrawn on a day
that is not a Business Day, then the prior Business Day will be used. The Certificate Fee is equal to: 
  

	 	1)	 Total Certificate Contributions; multiplied by 

 

	 	2)	 The Certificate Fee Percentage; divided by 

 

	 	3)	 Four. 

For the Certificate’s first calendar quarter after the Certificate Issue Date, the Certificate Fee will be
pro-rated for the time during the calendar quarter the Certificate was inforce and is equal to: 
  

	 	1)	 Total Certificate Contributions; multiplied by 

 

	 	2)	 The Certificate Fee Percentage; divided by 

 

	 	3)	 Four; multiplied by 

  

	 	4)	 Days inforce during calendar quarter; divided by 

 

	 	5)	 The number of days in that calendar quarter. 

  
 17 

 For Subsequent Contributions made after the Certificate Issue Date, the Certificate Fee will
be pro-rated for the Subsequent Contributions and the total Certificate Fee is equal to: 
  

	 	1)	 Total Certificate Contributions (excluding Subsequent Contributions); multiplied by 

 

	 	2)	 The Certificate Fee Percentage; divided by 

 

	 	3)	 Four; plus the total of 4) though 8) 

 

	 	4)	 Subsequent Contribution; multiplied by 

 

	 	5)	 The Certificate Fee Percentage; divided by 

 

	 	6)	 Four; multiplied by 

  

	 	7)	 Days Subsequent Contributions were inforce during calendar quarter: divided by 

 

	 	8)	 Total number of days in that calendar quarter. 

 

	6.2	 CERTIFICATE FEE DUE DATE 

If the Certificate Fees are not paid by You by the end of the Certificate Fee Due Date, as shown on the Certificate Schedule, We will send a
Written Notice of non-payment. If the Certificate Fee is not paid within the due date after receipt of the Written Notice, this Certificate terminates at the end of the last Business Day of the applicable
Certificate Fee Due Date. 
  

	6.3	 ADVISORY FEE 

The third party Advisory Fee is in addition to the Certificate Fee and is based on an agreement between You and Your Advisor, We are not party
to this agreement. The Advisory Fee may not be deducted from the Covered Asset Account unless this option is elected on or prior to the Certificate Issue Date. The maximum Advisory Fee assessed for a calendar year may not exceed the Maximum Advisory
Fee, shown on Certificate Specifications. 
 Advisory Fees deducted from the Covered Asset Account are not considered withdrawals, if this
option was elected on or prior to the Certificate Issue Date.     
 SECTION 7. GENERAL PROVISIONS 

 

	7.1	 ENTIRE CERTIFICATE 

This Certificate, any endorsements, amendments, riders and any attached application together constitute the entire contract between You and
Us.  
  

	7.2	 CHANGE OF CERTIFICATE 

 

	 	1)	 Only an authorized officer of the Company at its Home Office or an employee acting pursuant to a written
delegation of authority from such officer may change the terms of this Certificate. No other employee, producer, or representative of the Company may make any change in this Contract. 

 

	 	2)	 

  
 18 

	 	2)	 The Company may change this Certificate without Your consent in order to conform to federal or state laws or
regulations by attaching an Endorsement or Rider to this Certificate. 

  

	7.3.	 NONPARTICIPATION 

This Certificate is nonparticipating and does not share in Our earnings. You will not receive any dividends. 

 

	7.4	 ERRORS 

You shall be solely responsible for the accuracy of any Notice transmitted to Us or Our agent and the transmission of any Written Notice shall
constitute your representation to Us that the Written Notice is accurate, complete and duly authorized. 
  

	7.5.	 MISSTATEMENT AND ADJUSTMENTS 

If the Covered Person’s age is misstated, Your benefits will be adjusted to what the correct age would provide. Any underpayment made by
Us will be paid with the next payment. Any overpayment made by Us will be deducted from future payments. However, if this Certificate would not have been issued had such age(s) not been misstated, this Certificate will be treated as if it never
existed and no benefits will be paid. In this case, We will refund any unearned Certificate Fee. Certificate Fees will be refunded (subject to any applicable Certificate Fee adjustment) on a prorated basis for the period beginning on the first day
We discover the misstatement of age and ending on the last day of the Certificate quarter. 
  

	7.6.	 PROOF OF AGE 

We may periodically require proof of any Covered Person’s Age. After the Lock-In Date, we may
periodically require proof that the Covered Person and if applicable the joint Covered Person is still living. 
  

	7.7.	 RESERVATION OF RIGHTS 

The Company may, in its sole discretion, elect not to exercise a right or reservation specified in this Certificate. Such election shall not
constitute a waiver of the right to exercise such right or reservation at any subsequent time. 
  

	7.8.	 ASSIGNMENT OF THE CERTIFICATE 

You may not assign or transfer any ownership rights this Certificate, including the right to any Coverage Amount or lifetime annuity payment.

  
 19 

 SECTION 8. TERMINATION 

 

	8.1	 GROUP CONTRACT DISCONTINUANCE 

The Company or the Financial Institution may discontinue the Master Group Contract at any time. To terminate the Contract, the Group Contract Holder must
provide Us Written Notice at least [30] calendar days before the termination effective date. Beginning on the date the Group Contract is discontinued, we will not accept new assets for this Certificate. Contract Discontinuance does not affect any
rights or guarantees You have with respect to Your Certificate issued under the Group Contract. Our obligations to You continues as if the Contract Discontinuance had not occurred unless this Certificate is terminated in accordance with the Group
Contract. The Financial Institution obligations under the Group Contract continue as if the Contract Discontinuance had not occurred until there are no outstanding Certificates issued under this Group Contract. If this Group Contract is
discontinued, it terminates when all Certificates issued under this Group Contract terminate. 
  

	8.2	 CERTIFICATE TERMINATION 

This Certificate terminates on the earliest of the following: 
  

	 	1)	 Upon change of Ownership under this Certificate, unless pursuant to spousal continuance; or

  

	 	2)	 The date You provide Notice to terminate this Certificate. The termination date is the later of the date You
specify termination in Your Notice, or the date We receive and accept such Notice; or 

  

	 	3)	 The date You close the Covered Asset Account with the Financial Institution and do not transfer to a new
Financial Institution and maintains compliance with the terms of the Certificate;    or 

  

	 	4)	 The date the Certificate Fee Due Date expires and Certificate Fees are outstanding; or 

 

	 	5)	 The date that the Covered Asset Account value is reduced to zero in connection with an Excess Withdrawal.

  

	 	6)	 Upon the death of the Covered Person. In the case of joint Covered Persons, upon the 2nd death of the Covered
Persons 

  

	 	7)	 Upon violation of this Certificate provisions, including but not limited to (a) a violation of the
Company’s asset allocation requirements that is not corrected within the allowed time period or (b) a violation of Certificate provisions concerning assessment of the Advisory Fee that is not corrected within the allowed time period

  

	 	8)	 Upon termination of the Group Contract all Certificates issued under the Group Contract will terminate.

 This Certificate has no cash value, unless amended by any applicable rider. Upon termination of this Certificate, our obligations to
You cease. 

  
 20

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