Common Stock Purchase Warrant (Expiring on December 14, 2018)Common Stock Purchase Warrant • December 28th, 2011 • Delta Mutual Inc • Services-business services, nec
Contract Type FiledDecember 28th, 2011 Company IndustryThis is to certify that, for value received and subject to the conditions herein set forth, ____________________ (the "Warrantholder") is entitled to purchase, at a price per share of Twenty Cents ($0.20) per share, ________________ (_____________) shares of common stock, par value $0.0001 per share (the "Common Stock"), of Delta Mutual, Inc., a Delaware corporation (the "Company"), subject to adjustment as provided below (such shares purchasable upon exercise of this Warrant are herein called the "Warrant Stock"). The amount per share specified above, as adjusted from time to time pursuant to the provisions hereinafter set forth, is herein called the "Purchase Price." This Warrant will be immediately exercisable and may be exercised anytime after its issuance. In the event of a exercise of this Warrant, the Warrantholder shall surrender this Warrant to the Company with payment of the Purchase Price, together with a notice of exercise (the date of such surrender being herein referred t