0001193125-24-119736 Sample Contracts

SECURITIES PURCHASE AGREEMENT
Securities Purchase Agreement • April 29th, 2024 • Tivic Health Systems, Inc. • Electromedical & electrotherapeutic apparatus • New York

This Securities Purchase Agreement (this “Agreement”) is dated as of April __, 2024 between Tivic Health Systems, Inc., a Delaware corporation (the “Company”), and each purchaser identified on the signature pages hereto (each, including its successors and assigns, a “Purchaser” and collectively the “Purchasers”).

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PLACEMENT AGENCY AGREEMENT
Placement Agency Agreement • April 29th, 2024 • Tivic Health Systems, Inc. • Electromedical & electrotherapeutic apparatus • New York
COMMON STOCK PURCHASE WARRANT TIVIC HEALTH SYSTEMS, INC.
Common Stock Purchase • April 29th, 2024 • Tivic Health Systems, Inc. • Electromedical & electrotherapeutic apparatus • New York

THIS COMMON STOCK PURCHASE WARRANT (the “Warrant”) certifies that, for value received, _____________ or its assigns (the “Holder”) is entitled, upon the terms and subject to the limitations on exercise and the conditions hereinafter set forth, at any time on or after the date hereof (the “Initial Exercise Date”) and on or prior to 5:00 p.m. (New York City time) on [_____]1 (the “Termination Date”) but not thereafter, to subscribe for and purchase from Tivic Health Systems, Inc. a Delaware corporation (the “Company”), up to ______ shares (as subject to adjustment hereunder, the “Warrant Shares”) of Common Stock. The purchase price of one share of Common Stock under this Warrant shall be equal to the Exercise Price, as defined in Section 2(b). This Warrant shall initially be issued and maintained in the form of a security held in book-entry form and the Depository Trust Company or its nominee (“DTC”) shall initially be the sole registered holder of this Warrant, subject to a Holder’s rig

TIVIC HEALTH SYSTEMS, INC. and EQUINITI TRUST COMPANY, as Warrant Agent Warrant Agency Agreement Dated as of , 2024
Warrant Agency Agreement • April 29th, 2024 • Tivic Health Systems, Inc. • Electromedical & electrotherapeutic apparatus • New York

WARRANT AGENCY AGREEMENT, dated as of ___, 2024 (“Agreement”), by and between Tivic Health Systems, Inc., a Delaware corporation (the “Company”), and Equiniti Trust Company, LLC a New York limited liability trust company (the “Warrant Agent”).

PLACEMENT AGENT COMMON STOCK PURCHASE WARRANT TIVIC HEALTH SYSTEMS, INC.
Tivic Health Systems, Inc. • April 29th, 2024 • Electromedical & electrotherapeutic apparatus • New York

THIS PLACEMENT AGENT COMMON STOCK PURCHASE WARRANT (the “Warrant”) certifies that, for value received, _____________ or its assigns (the “Holder”) is entitled, upon the terms and subject to the limitations on exercise and the conditions hereinafter set forth, at any time on or after _______, 20242 (the “Initial Exercise Date”) and on or prior to 5:00 p.m. (New York City time) on [_____]3 (the “Termination Date”) but not thereafter, to subscribe for and purchase from Tivic Health Systems, Inc. a Delaware corporation (the “Company”), up to ______ shares (as subject to adjustment hereunder, the “Warrant Shares”) of Common Stock. The purchase price of one share of Common Stock under this Warrant shall be equal to the Exercise Price, as defined in Section 2(b).

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