Subscription Particulars. The aggregate number of the Special Warrants being subscribed for is _______________________________. At a price equal to $1.40 per Special Warrant, the aggregate price of the Special Warrants being subscribed for is $__________________________________.
Subscription Particulars. The aggregate number of Units subscribed for is . ------------------------- The Preferred Shares, Short Term Warrants and Two Year Warrants are to be registered in the name of: ------------------------------------------------------------ (if space is insufficient, attach a list) The certificates representing the Preferred Shares, Short Term Warrants and Two Year Warrants are to be delivered to: ------------------------------------------------------------ ------------------------------------------------------------ at its office at: ------------------------------------------------------------ ------------------------------------------------------------ Contact Name and Number: If the Purchaser is signing as agent for a principal and not as agent for a fully managed account, the name and address of the beneficial purchaser is: ------------------------------------------------------------ ------------------------------------------------------------ (if space is insufficient, attach a list) DATED at this day of , 2003. -------------------- ----------- ------------------- ------------------------------------------ Name of Purchaser (please type or print) By: ---------------------------------------- (Signature of Authorized Representative) ---------------------------------------- (Name of Person Signing) ---------------------------------------- Office or Title ---------------------------------------- ---------------------------------------- Address of Purchaser
Subscription Particulars. (a) The aggregate number of Shares being subscribed for is 1,333,333. At a price of $6.00 per share, the aggregate purchase price of the Shares is $7,999,998.
(b) The Purchased Shares are to be registered in the name of Genzyme Corporation.
(c) The certificate representing the Shares is to be delivered to: Genzyme Corporation at its office at: One Xxxxxxx Square, Building 1400, Xxxxxxxxx, Xxxxxxxxxxxxx 00000 Contact Name and Number: Xxxxxx X. Xxxxx, Esq., Corporate Counsel (000) 000-0000 DATED at Cambridge, Massachusetts, this 4th day of September, 1998. GENZYME CORPORATION By: /s/ G Jan van Heek ------------------------------------- (Signature of Authorized Representative) G Jan van Heek ---------------------------------------- (Name of Person Signing) Executive Vice President ---------------------------------------- Office or Title
Subscription Particulars. INFORMATION IN RESPONSE TO THIS SECTION WILL BE KEPT STRICTLY CONFIDENTIAL
Subscription Particulars. The aggregate number of Shares subscribed for is . The Shares are to be registered in the name of: The certificate(s) representing the Shares are to be delivered to: at its office at: Contact Name and Number: If the Purchaser is signing as agent for a principal and not as agent for a fully managed account, the name and address of the beneficial purchaser is: DATED at this day of , 2007. Name of Purchaser (please type or print) By: (Signature of Authorized Representative) (Name of Person Signing) Office or Title Address of Purchaser
Subscription Particulars. (a) The Purchaser hereby agrees to purchase Shares as set forth below: Number of Shares: 11,100,000 Aggregate Purchase Price: $0.36036 ($0.36036 x 11,100,000 Shares): $4,000,000 Name of Purchaser: Rob McEwen Federal Tax ID No. or SS No:__________________________________________ Street Address: ______________________________________________________ City and Country: ____________________________________________________ Postal Code: _________________________________________________________ Contact Name: ________________________________________________________ Alternate Contacts Name: _____________________________________________ Phone No.: ___________________________________________________________ Fax No.: _____________________________________________________________ E-mail:________________________________________________________________
(b) Registration of the certificates representing the Shares should be made as follows (if space is insufficient, attach a list) - or leave blank if registration is to be as detailed in sub-clause (a) above. Name: _______________________________________________________________ Registration Address: _______________________________________________ City and Country: ___________________________________________________ Postal Code: ________________________________________________________
(c) Number of common shares of the Company owned by the Purchaser: ________________________
Subscription Particulars. (a) The aggregate price of the Common Shares being subscribed for is $_________. The Common Shares are to be registered in the name of (same as name of Purchaser): .
(b) Subject to paragraph 18 below, the Certificates representing the Common Shares are to be delivered to: Name of Purchaser: Please Print ___________________________________________________ Number of Common Shares: ____________________________ Address of Purchaser: __________________________________ Province/State: ______________________ Country: _________
Subscription Particulars. The aggregate number of Shares subscribed for is ______________ for an aggregate subscription price of US$ ;
Subscription Particulars. BOX A: BOX B: BOX C: BOX D: BOX E:
Subscription Particulars. (a) The Purchaser hereby agrees to purchase Units as set forth below: Number of Units: Aggregate Purchase Price: (US$0.50 x number of Units): US$ --- Name of Purchaser: __________________________________________________ Street Address: _____________________________________________________ City and Country: ___________________________________________________ Postal Code: ________________________________________________________ Contact Name: _______________________________________________________ Alternate Contacts Name: ____________________________________________ Phone No.: __________________________________________________________ Fax No.: ____________________________________________________________ E-mail: _____________________________________________________________
(b) Registration of the certificates representing the Shares and Warrants should be made as follows (if space is insufficient, attach a list) - or leave blank if registration is to be as detailed in sub-clause (a) above. Name: ________________________________________________________________ Registration Address: ________________________________________________ City and Country: ____________________________________________________ Postal Code: _________________________________________________________
(c) The certificates representing the Shares and Warrants are to be delivered as follows (if different from the address set forth in sub-clause (b) above): Name: ________________________________________________________________ Address: _____________________________________________________________ City and Country: ____________________________________________________ Postal Code: _________________________________________________________ Telephone/Contact: ___________________________________________________
(d) Number of common shares of the Company owned by the Purchaser: ________________________ 18. Signature of Purchaser Signature of Purchaser (on its own behalf and, if applicable, on behalf of each principal for whom it is contracting hereunder). ___________________________________________________________________________ (Signature or Authorized Signature) ___________________________________________________________________________ (Name and Official Capacity - please print)
