0001193125-10-151594 Sample Contracts

INFUSYSTEM HOLDINGS, INC. Restricted Stock Award Agreement
Restricted Stock Award Agreement • July 1st, 2010 • InfuSystem Holdings, Inc • Surgical & medical instruments & apparatus • Delaware

This Award Agreement by and between Timothy Kopra (the “Participant”) and InfuSystem Holdings, Inc. (the “Company”) evidences the grant to the Participant of shares of the Company, par value $0.0001 per share (“Shares”).

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Re: Share Award Agreement and Restricted Stock Award Agreements
InfuSystem Holdings, Inc • July 1st, 2010 • Surgical & medical instruments & apparatus

We have acted as counsel to InfuSystem Holdings, Inc., a Delaware corporation (the “Company”), in connection with the filing of a Registration Statement on Form S-8 (the “Registration Statement”) under the Securities Act of 1933, as amended (the “Securities Act”), with the Securities and Exchange Commission (the “SEC”). This Registration Statement relates to the registration of 2,300,000 shares of common stock, par value $0.0001 per share (the “Common Stock”) under the Share Award Agreement between Sean McDevitt and InfuSystem Holdings, Inc. and the Restricted Stock Award Agreements between InfuSystem Holdings, Inc. and each of Timothy Kopra, Sean Whelan, Jan Skonieczny, Bryan Russo, David Haar and Scott Chesky (collectively, the “Agreements”).

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