0001193125-16-695754 Sample Contracts

FORM OF SECURITIES PURCHASE AGREEMENT
Form of Securities Purchase Agreement • August 29th, 2016 • Ampio Pharmaceuticals, Inc. • Pharmaceutical preparations • New York

This SECURITIES PURCHASE AGREEMENT (this “Agreement”), dated as of , 2016, is by and among Ampio Pharmaceuticals, Inc., a Delaware corporation with headquarters located at 373 Inverness Parkway, Suite 200, Englewood, Colorado 80112 (the “Company”), and each of the investors listed on the Schedule of Buyers attached hereto (individually, a “Buyer” and collectively, the “Buyers”).

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