Document:

Exhibit 10.4

 

THE
SECURITIES REPRESENTED HEREBY HAVE NOT BEEN REGISTERED WITH THE SECURITIES AND EXCHANGE COMMISSION OR THE SECURITIES COMMISSION
OF ANY STATE IN RELIANCE UPON AN EXEMPTION FROM REGISTRATION UNDER THE SECURITIES ACT OF 1933, AS AMENDED, AND, ACCORDINGLY, MAY
NOT BE TRANSFERRED UNLESS (I) SUCH SECURITIES HAVE BEEN REGISTERED FOR SALE PURSUANT TO THE SECURITIES ACT OF 1933, AS AMENDED,
(II) SUCH SECURITIES MAY BE SOLD PURSUANT TO RULE 144, OR (111) THE COMPANY HAS RECEIVED AN OPINION OF COUNSEL REASONABLY SATISFACTORY
TO IT THAT SUCH TRANSFER MAY LAWFULLY BE MADE WITHOUT REGISTRATION UNDER THE SECURITIES ACT OF 1933, AS AMENDED.

 

PURSUANT
TO THE TERMS OF SECTION 1 OF THIS WARRANT, ALL OR A PORTION OF THIS WARRANT MAY HAVE BEEN EXERCISED, AND THEREFORE THE ACTUAL NUMBER
OF WARRANT SHARES REPRESENTED BY THIS WARRANT MAY BE LESS THAN THE AMOUNT SET FORTH ON THE FACE HEREOF.

 

Pursuant
to an Agreement and Plan of Merger by and between Canfield Medical Supply Inc. (the “Company”) SBG Acquisition Inc.
(the “Sub”), a wholly-owned subsidiary of the Company and Splash Beverage Group, Inc. (“Splash”), pursuant
to which Sub will be merged into Splash (the “Merger”). 

 

THIS WARRANT IS
BEING ISSUED IN CONNECTION WITH THE MERGER AND REPLACES THE WARRANT THAT WAS ORIGINALLY ISSUED BY SPLASH TO THE HOLDER ON______________.

 

 

CANFIELD
MEDICAL SUPPLY, INC

 

FORM
OF WARRANT TO PURCHASE COMMON STOCK

 

Warrant No.: ______-__

Number
of Shares of Common Stock: _______

Date of lssuance: February
__, 2020 ("Issuance Date")

 

Canfield
Medical Supply, Inc., a Colorado corporation (the "Company"),
hereby certifies that, for good and valuable consideration, the receipt and sufficiency of which are hereby acknowledged,____________,
the registered holder hereof or its permitted assigns (the "Holder"), is entitled, subject to the terms set
forth below, to purchase from the Company, at the Exercise Price (as defined below) then in effect, upon surrender of this Warrant
to Purchase Common Stock (including any Warrants to Purchase Common Stock issued in exchange, transfer or replacement hereof, the
"Warrant"), at any time or
times on or after the Issuance Date, but not after 11:59 p.m., New York time, on the Expiration
Date (as defined below), __________fully paid non-assessable
shares of Common Stock (as defined below) (the "Warrant Shares").
Except as otherwise defined herein, capitalized terms in this Warrant shall have the meanings
set forth in Section 15. This Warrant is one of a series of warrants containing substantially identical terms and conditions
issued to purchasers in connection with a Unit Purchase Agreement dated,  by
and among the Company and the respective purchasers thereto (collectively, the "Warrants"). For avoidance of doubt,
all Warrants issued in connection with the Unit Purchase Agreement, are considered one and the same series and are all "Warrants"
hereunder.

 

1.                          
EXERCISE OF WARRANT.

 

    	 	1	 

     

    

(a)                                                
Mechanics of Exercise. Subject to the terms and conditions hereof (including,
without limitation, the limitations set forth in Section l(e)), this Warrant may be exercised by the Holder on any day on
or after the Issuance Date, in whole or in part (but not as to fractional shares), by (i) delivery of a written notice, in the
form attached hereto as Exhibit A (the "Exercise Notice"),
of the Holder's election to exercise this Warrant and (ii) if the Holder
is not electing a Cashless
Exercise (as defined
below) pursuant to Section 1(d) of this Warrant, payment to the Company of an amount equal to the applicable Exercise Price multiplied
by the number of Warrant
Shares as to which this Warrant is being exercised (the "Aggregate Exercise
Price") in
cash or wire transfer
of immediately available funds (a "Cash Exercise")
(the items under (i) and
(ii) above, the "Exercise
Delivery Documents"). The Holder
shall not be required to surrender this Warrant in order to affect an exercise
hereunder; provided, however, that in the event that this Warrant is exercised in full or for the remaining unexercised portion
hereof, the Holder shall deliver this Warrant to the Company for cancellation within a reasonable time after such exercise. On
or before the first Trading Day following the date on which the Company has received the Exercise Delivery Documents (the date
upon which the Company has received all of the Exercise Delivery Documents, the "Exercise Date"), the Company
shall transmit by facsimile or e-mail transmission an acknowledgment of confirmation of receipt of the Exercise Delivery Documents
to the Holder and the Company's transfer agent for the Common Stock (the "Transfer Agent"). The Company shall
deliver any objection to the compliance of Exercise Delivery Documents to the requirements hereof on or before the second Trading
Day following the date on which the Company has received all of the Exercise Delivery Documents. On or before the second Trading
Day following the date on which the Company has received all of the Exercise Delivery Documents (or, if later, the second Trading
Day after the resolution of any reasonable objection by the Company to the Exercise Delivery Documents) (the "Share Delivery
Date"), for any Cash Exercise or Cashless Exercise, the Company shall, provided that the Transfer Agent is participating
in The Depository Trust Company ("DTC") Fast Automated Securities Transfer Program (the "FAST Program"),
upon the request of the Holder, credit such aggregate number of shares of Common Stock to which the Holder is entitled pursuant
to such exercise to the Holder's or its designee's balance account with OTC through its Deposit Withdrawal Agent Commission system;
provided, however, if (i) the Transfer Agent is not participating in the FAST Program, (ii) a Cash Exercise is made and no effective
registration statement for the resale of the Warrant Shares is available or (iii) a Cashless Exercise is made and the Warrant Shares
cannot be sold without restriction under Rule 144 under the Securities Act of 1933, as amended ,
the Company shall issue and dispatch by overnight courier to the address as
specified in the Exercise Notice, a certificate, registered in the Company's share register in the name of
the Holder or its designee, for the number of shares of Common Stock to which
the Holder is entitled pursuant to such exercise. Upon
the delivery of the Exercise Delivery Documents (or, if the Company reasonably objects to the Exercise Delivery Documents, upon
the resolution of such objection), the Holder shall be deemed for all corporate purposes to have become the holder of record of
the Warrant Shares with respect to which this Warrant has been exercised, irrespective of the date such Warrant Shares are credited
to the Holder's OTC account or the date of delivery of the certificates evidencing such Warrant Shares, as the case may be. If
this Warrant is submitted in connection with any exercise pursuant to this Section l(a) and the number of Warrant Shares
represented by this Warrant submitted for exercise is greater than the number of Warrant Shares being acquired upon an exercise,
then the Company shall as soon as practicable and in no event later than
three Trading Days after any such submission and at its own expense, issue a new Warrant (in accordance with Section 7(e)) representing
the right to purchase the number of Warrant Shares purchasable immediately prior to such exercise under this Warrant, less the
number of Warrant Shares with respect to which this Warrant has been and/or is exercised. The Company shall pay any and all taxes
and other expenses of the Company (including overnight delivery charges) that may be payable with respect to the issuance and delivery
of Warrant Shares upon exercise of this Warrant; provided, however, that the Company shall not be required to pay any tax
which may be payable
in respect of any transfer involved in the registration of any certificates for Warrant Shares or Warrants in a name other than
that of the Holder or an affiliate thereof. The Holder shall be responsible
for all other tax liability that may arise as a result of holding or transferring this Warrant or receiving Warrant Shares
upon exercise hereof.

 

(b)                                              
Exercise Price. For purposes of this Warrant, "Exercise Price"
means $1.50, subject
to adjustment as provided herein.

    	 	2	 

     

    

(c)                                                 
Company's Failure to Timely Deliver Securities. If the Company shall
fail for any reason or for no reason to issue to
the Holder within three
(3) Business Days of the Exercise Date a certificate for the number of shares of Common Stock to which the Holder is
entitled and register
such shares of Common Stock on the Company's share register or to credit the
Holder's balance account with OTC for such number of
shares of Common Stock to which the Holder is entitled upon the Holder's exercise
of this Warrant, and
if on or after such Trading Day the Holder, or any third party
on behalf of the Holder
or for the Holder's account,
purchases (in an open market transaction or otherwise) shares of Common Stock to deliver in satisfaction of a sale by the Holder
of shares of Common Stock issuable upon such
exercise that the Holder
anticipated receiving from the Company (a "Buy-In"), then the
Company shall, within three (3) Business Days after the Holder's written request
and in the Holder's discretion, either (i) pay cash to the Holder in an amount equal to the Holder's total purchase price (including
brokerage commissions, if any) for the shares of Common Stock so purchased (the "Buy-In Price"), at which point
the Company's obligation to deliver such certificate (and to issue such
Warrant Shares) shall terminate, or (ii) promptly honor its obligation
to deliver to the Holder a certificate or certificates representing such Warrant Shares and pay cash to
the Holder in an amount equal to the excess (if any) of the Buy-In Price over
the product of (A) such number of shares of Common Stock, times (B) the Closing Bid Price on the date of exercise.

 

(d)                                               
Cashless Exercise. Notwithstanding anything contained herein to the
contrary, from and after
the date hereof, (while
this warrant is outstanding and not terminated), the Holder may, in
its sole
discretion, exercise this Warrant in whole
or in part and, in lieu of making the cash payment otherwise contemplated to be made to the Company upon such exercise in
payment of the Aggregate Exercise Price, elect instead to receive upon such
exercise the "Net Number" of shares of
Common Stock determine according to the following formula (a "Cashless
Exercise"):

 

Net
Number= (Ax B) - (A x C)

B

 

For
purposes of the foregoing formula:

 

A=
the total number of
shares with respect to which this Warrant is then being exercised.

 

B=
the arithmetic average of the Closing Sale Prices of the shares of Common Stock for the five (5) consecutive
Trading Days ending on
the date immediately preceding
the date of the Exercise Notice.

 

C=
the Exercise Price then in effect for the applicable Warrant Shares
at the time of such
exercise.

 

(e)                                              
Rule 144. For purposes of Rule 144(d) promulgated under the Securities
Act, as in effect
on the date hereof, assuming the Holder is not an affiliate of the Company,
it is intended that the
Warrant Shares issued
in a Cashless Exercise shall be deemed to have been acquired by the
Holder, and the holding period for the Warrant Shares shall be deemed to have commenced,
on the Issuance Date.

 

(f)                                               
Disputes. In the case of a dispute as to the determination of the Exercise
Price or the arithmetic calculation of the Warrant
Shares, the Company shall
promptly issue to the
Holder the number of Warrant Shares that are
not disputed.

 

(g)                                                   
Reserved.

 

2.                         
ADJUSTMENT OF EXERCISE
PRICE AND NUMBER OF WARRANT SHARES. The
Exercise Price and the
number of Warrant Shares shall be adjusted from time to time as follows:

 

(a)                                               
Adjustment upon Subdivision or Combination of Common Stock.
If the Company at any
time on or after the Issuance Date subdivides (by
any stock split, stock dividend,
recapitalization, reorganization, scheme, arrangement or otherwise)
one or more classes of its
outstanding shares of
Common Stock into a greater number
of shares, the Exercise
Price in effect immediately
prior to such subdivision will be proportionately reduced and the number of Warrant Shares will be proportionately increased. If
the Company at any time
on or after the Issuance Date combines (by any stock split,
stock dividend, recapitalization, reorganization, scheme, arrangement or otherwise)
one or more classes of
its outstanding shares of
Common Stock into a smaller number
of shares,
the Exercise Price in
effect immediately
prior to such combination will be proportionately increased and the number
of Warrant Shares will be proportionately decreased. Any adjustment under this Section 2(a) shall become effective
at the close of business
on the date the subdivision or combination becomes
effective.

    	 	3	 

     

    

(b)                                                   
Dilutive
Issuances. If at any time after the Issuance Date other than in connection with the Merger, the Company
shall issue or sell shares of Common Stock or Convertible Securities, without
consideration or for a consideration
per share less than the then-current
Exercise Price, the Exercise
Price shall be reduced,
concurrently with such issue, as provided herein. Following any such dilutive sale
or issuance, the Exercise Price shall be reduced to a price equal
to one hundred percent (100%)
of the price at which
such shares of
Common Stock are
issued (or, in the case of Convertible
Securities, the price at which the Common Stock issuable upon the exercise,
conversion or exchange of such Convertible
Securities is deemed issued).

 

(c)                                                  
Other Events. If any event occurs of the type contemplated by the provisions
of this Section 2 but not expressly provided for by
such provisions (including, without limitation,
the granting of stock appreciation
rights or phantom stock rights),
then the Company's Board of Directors will make
an appropriate adjustment in the Exercise
Price and the number
of Warrant Shares
so as to protect the rights of the Holder; provided that no such
adjustment pursuant to this
Section 2(b) will increase
the Exercise Price or decrease the number of Warrant Shares
as otherwise determined pursuant to this Section 2.

 

3.                           
RIGHTS UPON DISTRIBUTION OF ASSETS.

 

(a)                                                
If the Company shall
declare or make any dividend
or other distribution of its
assets (or rights to acquire
its assets) to holders
of shares of Common Stock,
by way of return of capital
or otherwise (including,
without limitation, any distribution of cash, stock or
other securities, property or
options by way of a dividend, spin off,
reclassification, corporate rearrangement, scheme of arrangement or other
similar transaction)
(a "Distribution"), at
any time after
the issuance of this Warrant,
then, in each such case, the Holder shall be entitled to participate in
such Distribution to the same
extent that the Holder would have participated
therein if the Holder
had held the number of shares of
Common Stock acquirable upon complete exercise of this Warrant (without regard
to any limitations on exercise hereof,
including without limitation, the Maximum Percentage) immediately
before the date of which
a record
is taken for such Distribution, or,
if no such record is
taken, the date as
of which the record holders of shares of Common
Stock are to be determined for the
participation in such Distribution
(provided, however, to
the extent that the Holder's right to participate in any such
Distribution would result
in the Holder exceeding
the Maximum Percentage, then the
Holder shall not be entitled to participate
in such Distribution to
such extent (or in the beneficial ownership of
any shares of Common Stock
as a result of such Distribution
to such extent) and the portion of such Distribution
shall be held in abeyance
for the benefit of the
Holder until such time,
if ever, as its right
thereto would not result in the Holder exceeding
the Maximum Percentage.

 

4.                         
PURCHASE RIGHTS;
FUNDAMENTAL TRANSACTIONS.

 

(a)                                               
Purchase Rights.
In addition to
any adjustments pursuant
to Section 2
above, if at any time the
Company grants, issues or
sells any Options, Convertible Securities
or rights to purchase stock, warrants, securities
or other property pro
rata to the record holders
of any class of Common
Stock (the "Purchase Rights"), then
the Holder will be entitled
to acquire, upon the
terms applicable to such
Purchase Rights, the
aggregate Purchase Rights
which the Holder could
have acquired if the
Holder had held the number of shares of
Common Stock acquirable upon
complete exercise of
this Warrant (without regard
to any limitations on
the exercise of this
Warrant) immediately before
the date on which a record
is taken for
the grant, issuance
or sale of such Purchase Rights, or, if
no such record is taken, the
date as of which the record
holders of shares of
Common Stock are to be
determined for the grant, issue or sale of such
Purchase Rights.

 

    	 	4	 

     

    

(b)                                              
Fundamental Transactions. The
Company shall not enter
into or be party to a
Fundamental Transaction unless (i) the
Successor Entity assumes
in writing (unless the
Company is the Successor
Entity) all of the obligations of the Company under this Warrant and the other Transaction Documents in accordance with the provisions
of this Section (4)(b) pursuant to written agreements in form and substance reasonably satisfactory to the Required Holders and
approved by the Required Holders prior to such Fundamental Transaction, including agreements to deliver to each holder of the Warrants
in exchange for such Warrants a security of the Successor Entity evidenced by a written instrument substantially similar in form
and substance to this Warrant, including, without limitation, an adjusted exercise price equal to the value for the shares of Common
Stock reflected by the terms of such Fundamental Transaction, and exercisable for a corresponding number of shares of capital stock
equivalent to the shares of Common Stock acquirable and receivable upon exercise of this Warrant (without regard to any limitations
on the exercise of this Warrant) prior to such Fundamental Transaction, and reasonably satisfactory to the Required Holders and
(ii) the Successor Entity (including its Parent Entity) is a publicly traded corporation whose common stock is quoted on or listed
for trading on an Eligible Market. Upon the occurrence of any Fundamental Transaction, the Successor Entity shall succeed to, and
be substituted for (so that from and after the date of such Fundamental Transaction, the provisions of this Warrant referring to
the "Company" shall refer instead to the Successor Entity), and may exercise every right and power of the Company and
shall assume all of the obligations of the Company under this Warrant with the same effect as if such Successor Entity had been
named as the Company herein. Upon consummation of the Fundamental Transaction, the Successor Entity shall deliver to the Holder
confirmation that there shall be issued upon exercise of this Warrant at any time after the consummation of the Fundamental Transaction,
in lieu of the shares of Common Stock (or other securities, cash, assets or other property) issuable upon the exercise of the Warrant
prior to such Fundamental Transaction, such shares of the publicly traded common stock or common shares (or its equivalent) of
the Successor Entity (including its Parent Entity) which the Holder would have been entitled to receive upon the happening of such
Fundamental Transaction had this Warrant been converted
immediately prior to such Fundamental Transaction, as adjusted in accordance with the provisions of this Warrant. In addition to
and not in substitution for any other rights hereunder, prior to the consummation of any Fundamental Transaction pursuant to which
holders of shares of Common Stock are entitled to receive securities or other assets with respect to or in exchange for shares
of Common Stock (a "Corporate Event"), the Company shall make appropriate provision
to insure that the Holder will thereafter have the right to receive upon an exercise of this Warrant at any time after the consummation
of the Corporate Event but prior to the Expiration Date, in lieu of shares of Common Stock (or other securities, cash, assets or
other property) purchasable upon the exercise of this Warrant prior
to such Corporate Event, such shares of stock, securities, cash, assets
or any other property whatsoever (including
warrants or other purchase or subscription rights) which the Holder would have been entitled to receive upon the happening of such
Corporate Event had this Warrant been exercised immediately prior to such Corporate Event. Provision made pursuant to the preceding
sentence shall be in a form and substance reasonably satisfactory to the Required Holders. The provisions of this Section 4(b)
shall apply similarly and equally to successive Fundamental Transactions and Corporate Events and shall be applied without regard
to any limitations on the exercise of this Warrant.

 

(c)                                              
Applicability to Successive Transactions. The provisions of this
Section shall apply similarly and equally to successive Fundamental Transactions
and Corporate Events and shall be applied without regard to any limitations on the exercise of this Warrant.

 

5.                       
NONCIRCUMVENTION. The Company hereby covenants
and agrees
that the Company will not, by amendment of its Certificate of Incorporation, Bylaws
or through any reorganization,
transfer of assets,
consolidation, merger,
scheme of arrangement, dissolution, issue or sale of securities, or any other voluntary action, avoid or seek to avoid the observance
or performance
of any of the terms of this Warrant, and will at all times in good faith comply
with all the provisions of this Warrant and take all actions consistent with effectuating the purposes of this Warrant. Without
limiting
the generality of the foregoing,
the Company (i) shall not increase the par value of any shares of
Common Stock receivable upon the exercise
of this Warrant above the Exercise
Price e then in effect,
(ii) shall take
all
such actions as may be necessary or appropriate in order that the Company
may validly and leg
ally issue fully paid and non-assessable shares of Common Stock upon the exercise
of this Warrant, and (iii) shall, so long as this
Warrant is outstanding, take all action necessary to reserve and keep
available out of its authorized and unissued shares of Common Stock,
solely for the purpose of effecting the exercise of this Warrant, 100% of the number of shares of Common Stock issuable upon exercise
of this Warrant then outstanding (without regard to any limitations on exercise).

 

6.                            
WARRANT HOLDER NOT DEEMED A STOCKHOLDER. Except as otherwise
specifically provided herein, the Holder, solely in
such Person's capacity as a holder of this Warrant, shall not be entitled
to vote or receive dividends or be deemed the holder of share capital of the Company for any purpose, nor shall anything contained
in this Warrant be construed to confer upon the Holder, solely in such Person's capacity as the Holder of this Warrant, any of
the rights of a stockholder
of the Company or any right to
vote, give or withhold consent to any corporate action (whether any reorganization, issue of stock,
reclassification of stock, consolidation, merger,
conveyance or otherwise), receive notice of meetings, receive dividends or subscription
rights, or otherwise,
prior to the issuance to the Holder of the Warrant Shares which such Person
is then entitled to receive upon the due exercise of this Warrant. In addition, nothing contained in this Warrant shall be construed
as imposing any liabilities on the
Holder to purchase any securities (upon exercise of this Warrant or otherwise) or as a stockholder of the Company, whether such
liabilities are
asserted by the Company
or by creditors of the Company.

 

    	 	5	 

     

    

7.                          
REISSUANCE OF
WARRANTS.

 

(a)                                               
Transfer of Warrant. If this Warrant is to be transferred, the Holder
shall surrender this Warrant to the Company and deliver the completed
and executed Assignment Form, in the form attached hereto as Exhibit B,
whereupon the Company will forthwith issue and deliver upon the
order of the Holder
a new Warrant (in accordance with Section 7(d)),
registered as the Holder may request, representing the right to purchase the
number of Warrant Shares being transferred by the Holder and, if less than the total number of Warrant Shares then underlying this
Warrant is being transferred, a new
Warrant (in accordance with Section 7(d)) to the Holder representing the right to purchase the
number of Warrant Shares not being transferred.

 

(b)                                               
Lost, Stolen
or Mutilated Warrant.
Upon receipt by the Company of
evidence reasonably satisfactory to the Company of the loss, theft, destruction or mutilation of this Warrant, and, in the case
of loss, theft or destruction, of any indemnification undertaking by the Holder
to the Company in
customary form and, in
the case of mutilation, upon surrender and cancellation of this Warrant, the
Company shall execute and deliver to the
Holder a new Warrant
(in accordance with Section
7(d)) representing
the right to purchase the Warrant Shares then underlying this
Warrant.

 

(c)                                               
Exchangeable for Multiple Warrants. This Warrant is exchangeable, upon
the surrender hereof
by the Holder at the principal office of the Company,
for a new Warrant or Warrants (in accordance with Section 7(d)) representing in the aggregate the right to purchase the
number of Warrant Shares then underlying this
Warrant, and each such
new Warrant will represent the right to purchase
such portion of such
Warrant Shares as is
designated by the
Holder at the time of such surrender;
provided, however, that
no Warrants for fractional shares of Common
Stock shall be
given. Notwithstanding
anything to the contrary herein,
in no event shall the
original Warrant be subdivided into
more than three (3) separate Warrants
and such new Warrants
shall not be further
subdivided.

 

(d)                                              
Issuance of New Warrants.
Whenever the Company
is required
to issue
a new
Warrant pursuant to the terms of this Warrant, such new Warrant
(i) shall be of like tenor with this Warrant, (ii) shall
represent, as indicated on the face of such new Warrant, the right to purchase
the Warrant Shares then underlying this Warrant (or in the
case of a new Warrant being issued pursuant
to Section 7(a) or Section 7(c). the Warrant Shares designated by the Holder which, when added to the number of shares
of Common Stock underlying the other new Warrants issued in connection with such issuance,
does not exceed
the number of Warrant Shares then underlying this Warrant), (iii) shall have an issuance date, as indicated on the face of such
new Warrant which is the same as the Issuance Date, and (iv) shall have the
same rights and conditions as this Warrant.

 

8.                    
NOTICES. Whenever notice is required
to be given under this Warrant, unless
otherwise provided herein,
such notice shall be given
in accordance with the Purchase Agreement.

 

9.                  
AMENDMENT AND WAIVER. Except as otherwise provided herein, the provisions
of this Warrant may be amended
and the Company may take any action herein prohibited, or omit to perform
any act herein required to be performed by it, only if the Company has obtained
the written consent of
the Required Holders;
provided, that the number of Warrant Shares subject to this Warrant, the Exercise Price and the
Expiration Date may not be amended, and the right to exercise this Warrant
may not be altered or waived, without the written consent of the Holder. Any such amendment shall apply to all Warrants and be
binding upon all registered holders
of such Warrants, whether or not they have
individually consented.

 

    	 	6	 

     

    

10.               
GOVERNING LAW; CONSENT TO JUSRISDICTION. WAIVER OF JURY TRIAL.
This Warrant shall be governed by, and construed in
accordance with, the internal laws of
the State of Florida, without reference to the choice of law provisions thereof. The Company and, by accepting this Warrant, the
Holder, each irrevocably
submits to the exclusive jurisdiction of the courts of the State of Florida and the United States District
Court for the District of Florida for the purpose of any suit, action, proceeding or judgment
relating to or arising out of this Warrant and the transactions
contemplated hereby. Service of process in connection with any such suit, action or proceeding may be served on each party hereto
anywhere in the world by the same methods as are specified
for the giving of notices under this Warrant. The Company
and, by accepting this Warrant, the Holder, each irrevocably
consents to the jurisdiction
of any such court in any such suit, action or proceeding and to the laying of venue in such court. The Company and, by accepting
this Warrant, the Holder, each irrevocably waives any objection
to the laying of venue of any such suit, action or proceeding brought in such courts
and irrevocably waives any claim that any such suit, action
or proceeding brought in any such court has been brought in an inconvenient forum. EACH OF THE COMPANY AND, BY ITS ACCEPTANCE HEREOF,
THE HOLDER HEREBY WAIVES ANY RIGHT TO
REQUEST A TRIAL BY JURY IN ANY LITIGATION WITH RESPECT TO THIS WARRANT AND REPRESENTS THAT
COUNSEL HAS BEEN CONSULTED SPECIFICALLY AS TO THIS WAIVER.

 

11.                     
CONSTRUCTION; HEADINGS.
This Warrant shall be deemed to be jointly drafted by the Company and the Holder and shall not be construed against any
person as the drafter hereof. The
headings of this Warrant are for convenience of
reference and shall not
form part of, or affect the interpretation of,
this Warrant.

 

12.                     
DISPUTE RESOLUTION. In the case of a
dispute as to
the determination of the Exercise Price or the arithmetic calculation of the Warrant Shares, the Company shall
submit the disputed determinations or arithmetic calculations via facsimile
within two (2) Business Days of receipt of the Exercise Notice giving rise to such dispute, as the
case may be, to the
Holder. If the Holder and
the Company are unable to
agree upon such determination
or calculation of the
Exercise Price or the
Warrant Shares within three Business
Days of such disputed
determination or arithmetic calculation being
submitted to the Holder, then the
Company shall, within
two (2) Business Days
submit via facsimile
(a) the disputed determination
of the Exercise Price
to an independent, reputable investment bank selected
by the Company and
approved by the Holder, which approval shall
not be unreasonably withheld, or (b) the disputed
arithmetic calculation of the Warrant Shares to the Company's
independent, outside accountant. The Company shall cause the investment bank or the accountant, as the case may be, to perform
the determinations or calculations and notify the Company and the Holder of the results no later
than ten Business Days from the time it receives the disputed determinations or calculations. The prevailing party in any dispute
resolved pursuant to this Section 12 shall be entitled to the full amount of all reasonable expenses, including all costs and fees
paid or incurred in good faith, in relation to the resolution of such dispute. Such investment bank's or accountant's determination
or calculation, as the case may be, shall be binding upon all parties absent demonstrable error.

 

13.               
REMEDIES, OTHER OBLIGATIONS, BREACHES AND INJUNCTIVE RELIEF. The remedies
provided in this Warrant shall be cumulative and in addition to all other remedies available under this Warrant, at law or in equity
(including a decree of specific performance and/or other injunctive relief), and nothing herein shall limit the right of the Holder
to pursue actual damages for any failure by the Company to comply with the terms of this Warrant.

 

14.       TRANSFER.
Subject to applicable law and the restrictions on transfer set forth in the Purchase Agreement, this Warrant may not be offered
for sale, sold, transferred or assigned without the consent of the Company, such consent not to be unreasonably withheld or delayed.

 

15.       For
purposes of this Warrant, the following terms shall have the following meanings:

 

(a)                
"Bloomberg" means Bloomberg Financial Markets.

 

(b)                
"Business Day" means any day other than Saturday, Sunday or other day on
which commercial banks in The City of New York are authorized or required by law to remain closed.

 

    	 	7	 

     

    

(c)                
"Closing Bid Price" and "Closing Sale Price"
means, for any security as of any date,
the last closing bid price and last closing trade price, respectively, for such security on the Principal
Market, as reported by Bloomberg, or, if the Principal Market begins to operate on an extended hours basis and does not designate
the closing bid price or the closing trade price, as the case may be, then the
last bid price or the last trade price, respectively, of such security prior to 4:00:00
p.m., New York time, as
reported by Bloomberg, or,
if the Principal Market is not the principal securities exchange or trading
market for such security, the last closing bid price or last trade price, respectively, of such security on the principal securities
exchange or trading market where such security is listed or traded as reported by Bloomberg, or if the foregoing do not apply,
the last closing
bid price or last trade price, respectively, of such security in the over-the-counter
market on the electronic
bulletin board for such
security as reported by Bloomberg, or,
if no closing bid price or last trade price, respectively, is reported for such security by Bloomberg, the average of the bid prices,
or the ask prices, respectively,
of any market makers for such security as reported
in the "pink sheets" by Pink Sheets LLC (formerly the
National Quotation Bureau, Inc.) . If
the Closing Bid Price or the Closing Sale Price cannot be calculated for a security on a particular date on any of the foregoing
bases, the Closing Bid Price or the
Closing Sale Price,
as the case may be, of such security on such date shall be the fair market
value as mutually determined
by the Company and the Holder. All such determinations to be appropriately adjusted for any stock dividend, stock split, stock
combination or other
similar transaction during the applicable calculation period.

 

(d)                
"Common Stock" means (i) the Company'
s shares of Common Stock, par
value

$0.001
per share, and (ii) any share capital into which such Common Stock shall have been changed
or any share capital resulting
from a reclassification of such Common Stock.

 

(e)                
"Convertible Securities"
means any stock or securities (other than Options) directly or indirectly
convertible into or exercisable
or exchangeable for shares
of Common Stock. "Eligible Market" means the Principal Market, the OTC Markets QB tier, The New York Stock Exchange,
Inc., NYSE MKT, The NASDAQ Global Market, The
NASDAQ Global Select Market, or The NASDAQ Capital Market.

 

(f)                 
"Expiration Date" means _____________ or, if such date falls on a day other
than a Trading Day or on which trading does not take place on the Principal Market, or, if the Principal Market is not the principal
trading market for the Common Stock, then on the principal securities exchange or securities market on which the Common Stock is
then traded (a "Holiday"), the next date that is not a Holiday.

 

(g)                
"Fundamental Transaction" means that the Company shall,
directly or indirectly, in one or more related transactions, (i) consolidate
or merge with or into (whether or not the Company is the surviving corporation) another Person (but excluding a migratory merger
effected solely for the purpose of changing the jurisdiction of incorporation of the Company), or (ii) sell, assign, transfer,
convey or otherwise dispose of all or substantially all of the properties or assets of the Company to another Person, or (iii)
allow another Person to make a purchase, tender or exchange offer that is accepted by the holders of more than the 50% of the outstanding
shares of Common Stock (not including any
shares of Common Stock held by the Person or Persons making or party to, or associated or affiliated with the Persons making or
party to, such purchase, tender or exchange offer), or (iv) consummate a stock purchase agreement or other business combination
(including, without limitation, a reorganization, recapitalization, spin-off or scheme of arrangement) with another Person whereby
such other Person acquires more than the 50% of the outstanding shares of Common Stock (not including any shares of Common Stock
held by the other Person or other Persons making or party to, or associated or affiliated with the other Persons making or party
to, such stock purchase agreement or other business combination), (v) reorganize, recapitalize or reclassify its Common Stock,
or (vi) any "person" or "group"
(as these terms are used for purposes of Sections 13(d) and 14(d) of the Exchange Act) is or shall become the "beneficial
owner" (as defined in Rule l3d-3 under the Exchange Act), directly or
indirectly, of 50% of the aggregate ordinary voting power represented by issued and outstanding Common Stock.

 

(i)           
"Options" means any rights, warrants or options to subscribe
for or purchase shares of Common Stock or Convertible Securities.

 

(j)                 
"Parent Entity" of a Person means an entity that, directly
or indirectly, controls the applicable Person and whose common stock or equivalent equity security is quoted or listed on an Eligible
Market, or, if there is more than one such Person or Parent Entity, the
Person or Parent Entity with the largest public market capitalization as of the date of consummation of the Fundamental Transaction.

 

(k)               
"Person" means an individual, a limited liability company, a partnership,
a joint venture, a corporation, a trust, an unincorporated organization, any other entity and a government or any department or
agency thereof.

 

    	 	8	 

     

    

(l)                 
“Principal Market” means the OTC Markets QB tier.

 

(m)             
"Required Holders" means, as of any time of determination,
the Holders of at least a majority of the Warrant Shares issuable upon exercise of all of the outstanding
Warrants.

 

(n)               
"Successor
Entity" means the Person (or, if so elected by the Holder,
the Parent Entity) formed by, resulting from or surviving any Fundamental
Transaction or the Person
(or, if so elected by
the Holder, the Parent
Entity) with which such Fundamental Transaction shall have been
entered into.

(o)               
"Trading
Day" means any day on which the Common Stock are traded on the Principal Market, or, if the Principal Market is not the
principal trading market for the Common Stock, then on the principal securities exchange or securities market on which the Common
Stock are then traded; provided that "Trading Day" shall not include any day on which the Common
Stock are scheduled to trade on such exchange or market for less than 4.5 hours or any day that the Common Stock are suspended
from trading during the final hour of trading on such exchange or market (or if such exchange or market does not designate in advance
the closing time of trading on such exchange or market, then during the hour ending at 4:00:00 p.m., New York time).

 

 

    	 	9	 

     

    

IN WITNESS WHEREOF, the
Company has caused this Warrant to Purchase Common Stock to be duly executed as of the Issuance Date set out above.

 

 

CANFIELD
MEDICAL SUPPLY, INC.

 

By:____________________________ 

 

Name: ____________________________

 

 

Title: ____________________________

 

    	 	10	 

     

    

  

EXHIBIT
A

 

EXERCISE
NOTICE

TO
BE EXECUTED BY THE REGISTERED HOLDER TO EXERCISE THIS WARRANT TO PURCHASE COMMON STOCK

 

CANFIELD
MEDICAL SUPPLY, INC.

 

The
undersigned holder hereby exercises the right to purchase _ _
_ _ _ _ _ _ of
the shares of Common Stock ("Warrant Shares")
of Canfiled Medical Supply Inc., a Colorado corporation (the "Company"),
evidenced by the attached Warrant to Purchase Common Stock
(the "Warrant"). Capitalized terms used
herein and not otherwise defined shall have the respective meanings set forth
in the Warrant.

 

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

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

b.
“Cash-less Exercise” with respect to the Warrant Shares.

 

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

Warrant.

 

3.       Delivery
of Warrant Shares. The Company shall deliver to the holder Warrant
Shares in accordance with the terms of the Warrant
and, after delivery of such Warrant Shares, the
Warrant Shares remain subject to the Warrant. 

 

 

Date:____________________________

 

 

 

By:
____________________________

(Name
of Registered Holder)

 

Name:____________________________

 

Title:
____________________________

 

    	 	11	 

     

    

 

 

EXHIBITB

ASSIGNMENT
FORM

CANFIELD MEDICAL SUPPLY INC.

 

(To assign
the foregoing Warrant, execute this form and supply required information. Do not use
this form to purchase shares.)

FOR
VALUE RECEIVED, the foregoing Warrant and all
rights evidenced thereby are hereby assigned to
Name:

 

Address:

____________________________

____________________________

 

Dated: ___________, __________  

 

Holder's Signature:

____________________________

 

Holder's
Address:

____________________________

____________________________

____________________________

 

 

NOTE:
The signature to this Assignment
Form must correspond with the name as it appears on the face
of the Warrant, without alteration or enlargement or any change whatever. Officers
of corporations and those acting in a fiduciary or other representative capacity should file proper evidence of authority to assign
the foregoing Warrant.

 

    	 	12Exhibit 10.5

 

THIS WARRANT AND THE SECUROITIES UNDERLYING
THIS WARRANT HAVE NOT BEEN REGISTERED UNDER THE SECURITIES ACT OF 1933, AS AMENDED (THE "SECURITIES ACT") OR THE
SECURITIES LAWS OF ANY STATE, AND MAY NOT BE OFFERED FOR SALE, SOLD, TRANSFERRED, ASSIGNED OR HYPOTHECATED UNLESS (A) THERE IS
AN EFFECTIVE REGISTRATION STATEMENT UNDER THE SECURITIES ACT COVERING SUCH SECURITIES AND THERE IS FULL COMPLIANCE WITH THE APPLICABLE
STATE SECURITIES LAWS, (B) THE SALE IS MADE IN ACCORDANCE WITH RULE 144 UNDER THE SECURITIES ACT OR (C) ____________, INC. (THE
"CORPORATION") RECEIVES AN OPINION OF COUNSEL SELECTED BY THE HOLDER OF THE SECURITIES REASONABLY SATISFACTORY TO THE
CORPORATION STATING THAT SUCH SALE IS EXEMPT FROM THE REGISTRATION AND PROSPECTUS DELIVERY REQUIREMENTS OF THE SECURITIES ACT AND
COMPLIES WITH APPLICABLE STATE SECURITIES LAWS.

 

THIS WARRANT MAY NOT BE TRANSFERRED OR
ASSIGNED BY THE REGISTERED HOLDER TO A NON-AFFILIATE OF THE HOLDER WITHOUT THE PRIOR WRITTEN CONSENT OF THE CORPORATION.

 

 

 

FORM OF COMMON STOCK PURCHASE WARRANT

 

	Date of Issuance:	March __, 2020	Warrant No W _,___.____

FOR VALUE RECEIVED, _______________________________________________________

(the "Corporation"),
hereby grants to _____________ or its registered assigns (the "Registered Holder") the right to purchase from
the Corporation _______________ shares of Common Stock, par value $0.001_ per share ("Common Stock") of the Corporation
(the "Warrant Stock") at a price of Twenty-Five Cents ($0.25) per share (the "Exercise Price")
(subject to adjustment as provided herein) to such Registered Holder.

 

This Warrant is subject to the following provisions:

 

1.                  
Exercise of Warrant.

 

A.                 
Number of Shares. Subject to the terms and conditions hereinafter set forth, the Registered
Holder is entitled, upon surrender of this Warrant, to purchase from the Corporation ________ shares of Warrant Stock (subject
to adjustment as provided herein) at an exercise price of $_____ per share.

 

B.                 
Exercise Period. The Registered Holder may exercise, in whole or in part, the purchase
rights represented by this Warrant at any time and from time to time after the Date of Issuance through and including 5:30 p.m.,
Florida time, on the date that is the three year anniversary of the issuance of this Warrant (the "Expiration Date").
At 5:30 p.m., Eastern Standard Time , on the Expiration Date, the portion of this Warrant not exercised prior thereto shall be
and become void and of no value and this Warrant shall be terminated and no longer outstanding.

 

C.                 
Exercise Procedure.

    	 	1	 

     

    

(i)                 
This Warrant or any part hereof specified by the Registered Holder shall be deemed to have
been exercised at the time the Corporation receives all of the following items (the "Exercise Time"):

 

(a)              
a completed Exercise Notice, as described in Section l(E) below, executed by the Person exercising
all or part of the rights represented by this Warrant;

 

(b)              
this Warrant; and

 

(c)              
the aggregate Exercise Price for the number of shares of Warrant Stock being purchased through
such exercise, such aggregate Exercise Price to be payable by check or a wire transfer in immediately available funds to the Corporation
in an amount equal to the product of the Exercise Price multiplied by the number of shares of Warrant Stock being purchased with
the proceeds of such check or wire transfer.

 

(ii)                     
Certificates for shares of Warrant Stock purchased upon exercise of all or part of this Warrant
shall be promptly delivered by the Corporation to the Registered Holder. Unless this Warrant has expired or all of the purchase
rights represented hereby have been fully exercised, the Corporation shall prepare a new warrant certificate, substantially identical
hereto, representing the rights formerly represented by this Warrant which have not expired or been exercised and shall promptly
deliver such new Warrant to the Person designated for delivery in the Exercise Notice.

 

(iii)                   
The Warrant Stock issuable upon the exercise of all or part of this Warrant shall be deemed
to have been issued to the Registered Holder at the Exercise Time, and the Registered Holder shall be deemed for all purposes to
have become the record holder of such Warrant Stock at the Exercise Time.

(iv)             
Upon payment in full of the Exercise Price, each share of Warrant Stock issuable upon exercise
of all or part of this Warrant shall be fully paid and nonassessable and free from all liens and charges with respect to the issuance
thereof.

 

(v)               
The Corporation shall at all times reserve and keep available out of its authorized but unissued
shares of Common Stock such number of shares of Common Stock as are from time to time issuable upon the exercise of this Warrant.

 

D.                 
Cashless Exercise. Notwithstanding any provisions herein to the contrary, if at any
time after the Date of Issuance, there is no effective registration statement registering or no current prospectus available for
the resale of the Warrant Stock and the fair market value of one (1) share of Warrant Stock is greater than the Exercise Price,
in lieu of exercising this Warrant for cash, the Registered Holder may elect to receive Warrant Stock equal to the value (as determined
below) of this Warrant (or the portion thereof being canceled) by surrender of this Warrant at the principal office of the Corporation
together with the properly executed subscription form and notice of such election in which event the Corporation shall issue to
the Holder a number of shares of Warrant Stock computed using the following formula:

 

X=Y(A-B)

 

 

     A

 

WhereX = the
number of shares of Warrant Stock issued to the Registered Holder.

Y = the number ofshares
of Warrant Stock purchasable under the Warrant or, if only a portion of the Warrant is being exercised, the portion of the Warrant
being canceled (at the date of such calculation).

A = the fair market
value of one share of Common Stock of the Corporation (at

the date of such calculation)
B = Exercise Price

 

For purposes
of the above calculation, the fair market value of one share of Common Stock shall be (i) the last reported sale price of the Common
Stock or the closing price quoted on the Nasdaq, NYSE, or OTC Markets, as published in The Wall Street Journal for the five (5)
trading days prior to the date of determination of fair market value, or (ii) the fair market value of one share of Common Stock
as determined in good faith by the Corporation's Board of Directors.

 

E. Exercise Notice.
Upon any exercise of all or part of this Warrant, the Exercise Notice shall be substantially in the form set forth in Exhibit A
hereto. Such Exercise Notice shall be dated the actual date of execution thereof.

 

    	 	2	 

     

    

 

2.                  
Definitions. The following terms have meanings set forth below:

 

A.               
"Date of lssuance"
means the date of initial issuance of this Warrant (as of immediately after such issuance) regardless of the number of times new
certificates representing the unexpired and unexercised rights formerly represented by this Warrant shall be issued.

 

B.                
"Person" means an individual, a partnership,
a joint venture, a corporation, a trust, an unincorporated organization and a government or any department or agency thereof.

 

C.                
"Registered Holder" with respect to
this Warrant means the Person who is reflected as the holder thereof on the register maintained by the Corporation.

 

3.                  
No Rights; Limitations of Liability. Prior to the exercise of this Warrant and except as otherwise specifically provided
herein or in the Agreement, this Warrant shall not entitle the Registered Holder hereof to any rights as a stockholder of the
Corporation.

 

4.                  
Replacement. Upon receipt of evidence reasonably satisfactory to the Corporation (an
affidavit of the Registered Holder shall be satisfactory) of the loss, theft, destruction or mutilation of any certificate evidencing
this Warrant, and in the case of any such loss, theft or destruction, upon receipt of an indemnity reasonably satisfactory to the
Corporation, or in the case of any such mutilation, upon surrender and cancellation of such certificate, the Corporation shall
(at its expense) execute and deliver in lieu of such certificate a new certificate of like tenor and dated the date of such lost,
stolen, destroyed or mutilated certificate.

 

5.                  
Legend. The certificates representing shares of Warrant Stock issued upon exercise
of the Warrants (unless at the time of exercise such Warrant Stock are acquired pursuant to a registration statement that has been
declared effective under the Securities Act) and applicable blue sky laws, shall bear a legend substantially as follows:

"THESE
SECURITIES HAVE NOT BEEN REGISTERED WITH THE SECURITIES AND EXCHANGE COMMISSION OR THE SECURITIES COMMISSION OF ANY STATE IN RELIANCE
UPON AN EXEMPTION FROM REGISTRATION UNDER THE SECURITIES ACT OF 1933, AS AMENDED (THE "SECURITIES ACT"), AND, ACCORDINGLY,
MAY NOT BE OFFERED FOR SALE, SOLD, PLEDGED, HYPOTHECATED OR OTHERWISE TRANSFERRED EXCEPT PURSUANT TO AN EFFECTIVE REGISTRATION
STATEMENT UNDER THE SECURITIES ACT OR PURSUANT TO AN AVAILABLE EXEMPTION FROM, OR IN A TRANSACTION NOT SUBJECT TO, THE REGISTRATION
REQUIREMENTS OF THE SECURITIES ACT AND IN ACCORDANCE WITH APPLICABLE STATE SECURITIES LAWS AS ESTABLISHED BY EVIDENCE TO SUCH EFFECT,
THE FORM AND SUBSTANCE OF WHICH SHALL BE REASONABLY ACCEPTABLE TO THE CORPORATION.

 

6.                  
Charges, Taxes and Expenses. Issuance and delivery of certificates for representing
shares of Warrant Stock upon exercise of this Warrant shall be made without charge to the Registered Holder for any issue or transfer
tax, transfer agent fee or other incidental tax or expense in respect of the issuance of such certificates, all of which taxes
and expenses shall be paid by the Corporation; provided, however, that the Corporation shall not be required to pay any tax that
may be payable in respect of any transfer involved in the registration of any certificates for shares of Warrant Stock or the Warrant
in a name other than that of the Registered Holder. The Registered Holder shall be responsible for all other tax liability that
may arise as a result of holding or transferring this Warrant or receiving shares of Warrant Stock upon exercise hereof.

 

    	 	3	 

     

    

 

7.                  
Certain Adjustments. The Exercise Price and number of shares of Warrant Stock issuable
upon exercise of this Warrant are subject to adjustment from time to time as set forth in this Section 7.

 

(a)              
Stock Dividends and Splits. If the Corporation, at any time while this Warrant is outstanding,
(i) pays a stock dividend on its Common Stock or otherwise makes a distribution on any class of capital stock that is payable in
shares of Common Stock, (ii) subdivides its outstanding shares of Common Stock into a larger number of shares, or (iii) combines
its outstanding shares of Common Stock into a smaller number of shares, then in each such case the Exercise Price shall be adjusted
to a price determined by multiplying the Exercise Price in effect immediately prior to the effective date of such event by a fraction,
the numerator of which shall be the number of shares of Common Stock outstanding on such effective date immediately before giving
effect to such event and the denominator of which shall be the number of shares of Common Stock outstanding immediately after giving
effect to such event. Any adjustment made pursuant to clause (i) of this paragraph shall become effective immediately after the
record date for the determination of stockholders entitled to receive such dividend or distribution, and any adjustment pursuant
to clause (ii) or (iii) of this paragraph shall become effective immediately after the effective date of such subdivision, combination
or reclassification.

 

(b)              
Fundamental Transactions. Other than with respect to a merger or reverse merger with
Canfield Medical Supply, Inc. if, at any time while this Warrant is outstanding, (i) the Corporation effects (A) any merger of
the Corporation with (but not into) another Person, in which stockholders of the Corporation immediately prior to such transaction
own less than a majority of the outstanding stock of the surviving entity, or (B) any merger or consolidation of the Corporation
into another Person, (ii) the Corporation effects any sale of all or substantially all of its assets in one or a series of related
transactions, (iii) any tender offer or exchange offer approved or authorized by the Corporation's Board of Directors is completed
pursuant to which holders of at least a majority of the outstanding Common Stock tender or exchange their shares for other securities,
cash or property, or (iv) the Corporation effects any reclassification of the Common Stock or any compulsory share exchange pursuant
to which the Common Stock is effectively converted into or exchanged for other securities, cash or property (other than as a result
of a subdivision or combination of shares of Common Stock covered by Section 7(a) above) (in any such case, a "Fundamental
Transaction"), then the Registered Holder shall have the right thereafter to receive, upon exercise of this Warrant, the same
amount and kind of securities, cash or property as it would have been entitled to receive upon the occurrence of such Fundamental
Transaction if it had been, immediately prior to such Fundamental Transaction, the holder of the number of shares of Warrant Stock
then issuable upon exercise in full of this Warrant without regard to any limitations on exercise contained herein (the "Alternate
Consideration"), and the Registered Holder shall no longer have the right to receive shares of Warrant Stock upon exercise
of this Warrant. For avoidance of doubt this Section shall not apply to any transaction with Canfield Medical Supply, Inc. including
any merger, reverse merger or other transaction pursuant to which the Company becomes a subsidiary of Canfield Medical Supply,
Inc. 

(c)              
Number of Warrant Shares. Simultaneously with any adjustment to the Exercise Price
pursuant to paragraph (a) of this Section 7, the number of shares of Warrant Stock that may be purchased upon exercise of this
Warrant shall be increased or decreased proportionately, so that after such adjustment the aggregate Exercise Price payable hereunder
for the increased or decreased number of shares of Warrant Stock shall be the same as the aggregate Exercise Price in effect immediately
prior to such adjustment.

(d)              
Calculations. All calculations under this Section 7 shall be made to the nearest cent
or the nearest share, as applicable. The number of shares of Common Stock outstanding at any given time shall not include shares
owned or held by or for the account of the Corporation.

(e)              
Notice of Adjustments. Upon the occurrence of each adjustment pursuant to this Section
7, the Corporation at its expense will, at the written request of the Registered Holder, promptly compute such adjustment, in good
faith, in accordance with the terms of this Warrant and prepare a certificate setting forth such adjustment, including a statement
of the adjusted Exercise Price and adjusted number or type of shares of Warrant Stock or other securities issuable upon exercise
of this Warrant (as applicable), describing the transactions giving rise to such adjustments and showing in reasonable detail the
facts upon which such adjustment is based. Upon written request, the Corporation will promptly deliver a copy of each such certificate
to the Registered Holder and to the Corporation' s transfer agent.

(f)               
Reserved.

 

8.                  
No Fractional Shares. No fractional shares of Warrant Stock will be issued in connection
with any exercise of this Warrant. In lieu of any fractional shares that would otherwise be issuable, the number of shares of Warrant
Stock to be issued shall be rounded up to the next whole number.

 

    	 	4	 

     

    

9.                  
Notices. Except as otherwise expressly provided herein, all notices referred to in
this Warrant shall be in writing and shall be delivered personally, sent by reputable express courier service (charges prepaid)
or sent by registered or certified mail, return receipt requested, postage prepaid and shall be deemed to have been given when
so delivered, sent or deposited in the

U.S. Mail (i) to the Corporation, at its
principal executive offices with a copy by email to ___________ (which shall not constitute notice) and (ii) to the Registered
Holder of this Warrant, at such holder's address as it appears in the records of the Corporation (unless otherwise indicated by
any such holder).

 

10.              
Restrictions on Transfer.

(a)               
The Registered Holder represents, by accepting this Warrant that it understands that this
Warrant and any securities obtainable upon exercise of this Warrant have not been registered for sale under Federal or state securities
laws and are being offered and sold to the Registered Holder pursuant to one or more exemptions from the registration requirements
of such securities laws. Certificates representing Warrant Stock must bear the restrictive legend set forth herein. The Registered
Holder understands that the Registered Holder must bear the economic risk of such Registered Holder's investment in this Warrant
and any Warrant Stock or other securities obtainable upon exercise of this Warrant for an indefinite period of time, as this Warrant
and such Warrant Stock or other securities have not been registered under Federal or state securities laws and therefore cannot
be sold unless subsequently registered under such laws, or an exemption from such registration is available.

 

(b)              
The Registered Holder, by such Registered Holder's acceptance of this Warrant, represents
to the Corporation that such Registered Holder is acquiring this Warrant and will acquire any Warrant Stock or other securities
obtainable upon exercise of this Warrant for such Registered Holder's own account for investment and not with a view to, or for
sale in connection with, any distribution thereof in violation of the Securities Act. The Registered Holder agrees that this Warrant
will not be sold or otherwise transferred unless (i) a registration statement with respect to such transfer is effective under
the Securities Act of 1933, as amended (the "Securities Act") or (ii) such sale or transfer is made pursuant to one or
more exemptions from the Securities Act, and (iii) such sale or transfer to a non-affiliate of the Registered Holder is approved
by the prior written consent of the Corporation. The Registered Holder agrees the Warrant Stock will not be sold or otherwise transferred
unless (i) a registration statement with respect to such transfer is effective under the Securities Act or (ii) such sale or transfer
is made pursuant to one or more exemptions from the Securities Act.

(c)               
The Corporation shall not effect any exercise of this Warrant, and the Holder shall not have
the right to exercise any portion of this Warrant, pursuant to Section 1 or otherwise, to the extent that after giving effect
to such issuance after exercise as set forth on the applicable Exercise Notice, the Holder (together with the Holder’s affiliates,
and any other person or entity acting as a group together with the Holder or any of the Holder’s affiliates), as set forth
on the applicable Exercise Notice, would beneficially own in excess of the Beneficial Ownership Limitation (as defined below). For
purposes of the preceding sentence, the number of shares of Common Stock beneficially owned by the Holder and its affiliates shall
include the number of shares of Common Stock issuable upon exercise of this Warrant with respect to which such determination is
being made, but shall exclude the number of shares of Common Stock which would be issuable upon (1) exercise of the remaining,
nonexercised portion of this Warrant beneficially owned by the Holder or any of its affiliates and (2) exercise, conversion,
or exchange of the unexercised, unconverted, or non-exchanged portion of any other securities of the Corporation (including, without
limitation, any other warrants) subject to a limitation on conversion, exercise, or exchange analogous to the limitation contained
herein beneficially owned by the Holder or any of its affiliates. Except as set forth in the preceding sentence, for purposes
of this Section, beneficial ownership shall be calculated in accordance with Section 13(d) of the Securities Exchange Act
of 1934, as amended (the “Exchange Act”), and the rules and regulations promulgated thereunder, and the determination
of whether a person or entity is an “affiliate” of the Holder shall also be made in accordance with the Exchange Act,
the Securities Act of 1933, as amended (the “Securities Act”), and the rules and regulations under such acts.
To the extent that the limitation contained in this Section applies, the determination of whether this Warrant is exercisable
(in relation to other securities owned by the Holder together with any affiliates) and of which a portion of this Warrant is exercisable
shall be in the sole discretion of the Holder, and the submission of a Notice of Exercise shall be deemed to be the Holder’s
determination of whether this Warrant is exercisable (in relation to other securities owned by the Holder together with any affiliates)
and of which portion of this Warrant is exercisable, in each case subject to such aggregate percentage limitation, and the Corporation
shall have no obligation to verify or confirm the accuracy of such determination. In addition, a determination as to any group
status as contemplated above shall be determined in accordance with Section 13(d) of the Exchange Act and the rules and regulations
promulgated thereunder. For purposes of this Section, in determining the number of outstanding shares of Common Stock, the Holder
may rely on the number of outstanding shares of Common Stock as reflected in (x) the Corporation’s most recent Form
10-Q report or Form 10-K report, as the case may be, (y) a more recent public announcement by the Corporation, or (z) any
other notice by the Corporation or the Corporation’s transfer agent setting forth the number of shares of Common Stock outstanding. Upon
the written or oral request of the Holder, the Corporation shall within one trading day confirm orally and in writing to the Holder
the number of shares of Common Stock then outstanding. In any case, the number of outstanding shares of Common Stock shall
be determined after giving effect to the conversion or exercise of securities of the Corporation, including this Warrant, by the
Holder or its affiliates since the date as of which such number of outstanding shares of Common Stock was reported. The “Beneficial
Ownership Limitation” shall be 4.99% of the number of shares of Common Stock outstanding immediately after giving effect
to the issuance of shares of Common Stock issuable upon exercise of this Warrant. The provisions of this paragraph shall be construed
and implemented in a manner otherwise than in strict conformity with the terms of this Section to correct this paragraph (or any
portion hereof) which may be defective or inconsistent with the intended Beneficial Ownership Limitation herein contained or to
make changes or supplements necessary or desirable to properly give effect to such limitation. The limitations contained in this
paragraph shall apply to a successor holder of this Warrant.

    	 	5	 

     

    

(d)              
Notwithstanding the provisions of the immediately preceding paragraph, the Holder, upon not
less than sixty-one days’ prior written notice to the Corporation, may elect (1) to change the Beneficial Ownership
Limitation to 9.9% of the number of shares of Common Stock outstanding immediately after giving effect to the issuance of shares
of Common Stock issuable upon exercise of this Warrant or (2) to eliminate the Beneficial Ownership Limitation in its entirety.

 

11.              
Amendment. Except as expressly provided herein, neither this Warrant nor any term hereof
may be amended, waived, discharged or terminated other than by a written instrument signed by the Board of Directors of the Corporation
and the holders of at least a majority of the aggregate principal amount outstanding under the Notes.

 

12.              
Successors and Assigns. Subject to the restrictions on transfer set forth in this Warrant,
and compliance with applicable securities laws, and provided that the Registered Holder surrenders this Warrant along with any
other appropriate documentation or legal opinions that he Corporation may request, this Warrant may be assigned by the Registered
Holder. 

13.              
Descriptive Headings: Governing Law. The descriptive headings of the several Sections
and paragraphs of this Warrant are inserted for convenience only and do not constitute a part of this Warrant. All questions concerning
the construction, validity and interpretation of this Warrant shall be governed by and construed and enforced in accordance with
the laws of the State of Florida, without giving effect to any choice of law or conflict provision or rule that would cause the
application of the laws of any jurisdiction other than the State of Florida.

 

 

    	 	6	 

     

    

IN WITNESS WHEREOF, the Corporation executed this Warrant as
of the Date of Issuance hereof.

 

 

By:                                                             

Name:                                                        

Title:                                                        

    	 	7	 

     

    

 

EXHIBIT A

 

EXERCISE NOTICE

The undersigned, pursuant to the provisions
set forth in the attached Warrant (Warrant No. W-___, hereby agrees to subscribe for the purchase of shares of the Warrant
Stock covered by such Warrant and makes payment in full at the price per share provided by such Warrant.

 

The undersigned requests that certificates for such shares
be issued in the name of, and delivered to:

 

 

 

(Name)

 

 

 

 

(Address)

 

 

 

 

 

 (Signature and Date)

 

(Signature must conform in all
respects to name of

holder as specified on the face of the Warrant)

 

 

 (Insert Social Security Number or EIN)

 

    	 	8

Source: [{"source": "alea-institute/alea-institute/kl3m-data-edgar-agreements/train-00307-of-00352.parquet"}, [{"source": "alea-institute/alea-institute/kl3m-data-edgar-agreements/train-00307-of-00352.parquet"}]]