Common use of FORM OF SECRETARY’S CERTIFICATE Clause in Contracts

FORM OF SECRETARY’S CERTIFICATE. This Secretary’s Certificate (“Certificate”) is being delivered pursuant to Section 8(k) of that certain Purchase Agreement dated as of July 24, 2023 (“Purchase Agreement”), by and between TENON MEDICAL, INC., a Delaware corporation (the “Company”), and LINCOLN PARK CAPITAL FUND, LLC (the “Investor”), pursuant to which the Company may sell to the Investor up to Ten Million Dollars ($10,000,000) of the Company’s common stock, par value $0.001 per share (the “Common Stock”). Capitalized terms used herein and not otherwise defined shall have the meanings ascribed to them in the Purchase Agreement. The undersigned, ____________, Assistant Secretary of the Company, hereby certifies, on behalf of the Company and not in his individual capacity, as follows:

FORM OF SECRETARY’S CERTIFICATE. This Secretary’s Certificate (“Certificate”) is being delivered pursuant to Section 8(k8(j) of that certain Purchase Agreement dated as of July 24June 25, 2023 2021 (“Purchase Agreement”), by and between TENON MEDICALMOLECULIN BIOTECH, INC., a Delaware corporation (the “Company”), ) and LINCOLN PARK CAPITAL FUND, LLC (the “Investor”), pursuant to which the Company may sell to the Investor up to Ten Twenty Million Dollars ($10,000,00020,000,000) of the Company’s common stock's Common Stock, $0.001 par value $0.001 per share (the “"Common Stock”"). Capitalized terms Terms used herein and not otherwise defined shall have the meanings ascribed to them in the Purchase Agreement. The undersigned, ____________, Assistant Secretary of the Company, hereby certifies, on behalf of the Company and not in his individual capacity, as follows:

FORM OF SECRETARY’S CERTIFICATE. This Secretary’s Certificate (“Certificate”) is being delivered pursuant to Section 8(k) of that certain Purchase Agreement dated as of July 24September 19, 2023 2014 (“Purchase Agreement”), by and between TENON MEDICALxG TECHNOLOGY, INC., a Delaware corporation (the “Company”), ) and LINCOLN PARK CAPITAL FUND, LLC (the “Investor”), pursuant to which the Company may sell to the Investor up to Ten Fifteen Million Dollars ($10,000,00015,000,000) of the Company’s common stock's Common Stock, $0.00001 par value $0.001 per share (the “"Common Stock”"). Capitalized terms Terms used herein and not otherwise defined shall have the meanings ascribed to them in the Purchase Agreement. The undersigned, ____________, Assistant Secretary of the Company, hereby certifies, on behalf of the Company and not in his individual capacity, certifies as follows:

FORM OF SECRETARY’S CERTIFICATE. This Secretary’s Certificate (“Certificate”) is being delivered pursuant to Section 8(k) of that certain Purchase Agreement dated as of July 24June 8, 2023 2020 (“Purchase Agreement”), by and between TENON VIVEVE MEDICAL, INC., a Delaware corporation (the “Company”), ) and LINCOLN PARK CAPITAL FUND, LLC (the “Investor”), pursuant to which the Company may sell to the Investor up to Ten Million Dollars ($10,000,000) of the Company’s common stock's Common Stock, $0.0001 par value $0.001 per share (the “"Common Stock”"). Capitalized terms Terms used herein and not otherwise defined shall have the meanings ascribed to them in the Purchase Agreement. The undersigned, ____________Xxxxx Xxxxx, Assistant Secretary of the Company, hereby certifies, on behalf of the Company and not in his her individual capacity, hereby certifies as follows:

FORM OF SECRETARY’S CERTIFICATE. This Secretary’s Certificate (“Certificate”) is being delivered pursuant to Section 8(k) of that certain Purchase Agreement dated as of July 24April 30, 2023 2020 (“Purchase Agreement”), by and between TENON MEDICAL, ACER THERAPEUTICS INC., a Delaware corporation (the “Company”), ) and LINCOLN PARK CAPITAL FUND, LLC (the “Investor”), pursuant to which the Company may sell to the Investor up to Ten Fifteen Million Dollars ($10,000,00015,000,000) of the Company’s common stock's Common Stock, $0.0001 par value $0.001 per share (the “"Common Stock”"). Capitalized terms Terms used herein and not otherwise defined shall have the meanings ascribed to them in the Purchase Agreement. The undersigned, ____________Xxxxxx X. Xxxxxx, Assistant Secretary of the Company, hereby certifies, on behalf of the Company and not in his individual capacity, certifies as follows:

FORM OF SECRETARY’S CERTIFICATE. This Secretary’s Certificate (“Certificate”) is being delivered pursuant to Section 8(k) of that certain Purchase Agreement dated as of July 24March 22, 2023 2016 (“Purchase Agreement”), by and between TENON MEDICALSOLIGENIX, INC., a Delaware corporation (the “Company”), and LINCOLN PARK CAPITAL FUND, LLC (the “Investor”), pursuant to which the Company may sell to the Investor up to Ten Twelve Million Dollars ($10,000,00012,000,000) of the Company’s common stock's Common Stock, par value $0.001 per share per share (the “"Common Stock”"). Capitalized terms Terms used herein and not otherwise defined shall have the meanings ascribed to them in the Purchase Agreement. The undersigned, ____________, Assistant Secretary of the Company, hereby certifies, on behalf of the Company and not in his individual capacity, certifies as follows:

FORM OF SECRETARY’S CERTIFICATE. This Secretary’s Certificate (“Certificate”) is being delivered pursuant to Section 8(k8(j) of that certain Purchase Agreement dated as of July 24December __, 2023 2011, (“Purchase Agreement”), by and between TENON MEDICALPURE BIOSCIENCE, INC., a Delaware corporation (the “Company”), ) and LINCOLN PARK CAPITAL FUND, LLC (the “Investor”), pursuant to which the Company may sell to the Investor up to Ten Two Million Five Hundred Thousand Dollars ($10,000,0002,500,000) of the Company’s common stock's Common Stock, $0.01 par value $0.001 per share (the “"Common Stock”"). Capitalized terms Terms used herein and not otherwise defined shall have the meanings ascribed to them in the Purchase Agreement. The undersigned, ____________Xxxxxx X. Xxxxxxx, Assistant Secretary of the Company, hereby certifies, on behalf of the Company and not in his individual capacity, certifies as follows:

FORM OF SECRETARY’S CERTIFICATE. This Secretary’s Certificate (the “Certificate”) is being delivered pursuant to Section 8(k7(k) of that certain Common Stock Purchase Agreement dated as of July 24December 14, 2023 2010, (the “Common Stock Purchase Agreement”), by and between TENON MEDICALCARDICA, INC., a Delaware corporation (the “Company”), ) and LINCOLN PARK ASPIRE CAPITAL FUND, LLC (the “InvestorBuyer”), pursuant to which the Company may sell to the Investor Buyer up to Ten Million Dollars ($10,000,000) of the Company’s common stockCommon Stock, par value $0.001 per share (the “Common Stock”). Capitalized terms Terms used herein and not otherwise defined shall have the meanings ascribed to them in the Common Stock Purchase Agreement. The undersigned, ____________Xxxxxx X. Xxxxxx, Assistant Secretary of the Company, hereby certifies, on behalf of the Company and not in his individual capacity, certifies as follows: