EXHIBIT
10.4
NAME OF
SUBSCRIBER :_____________________________
|
To:
|
VirtualScopics
350 Linden
Oaks
Rochester, New
York 14625
|
SUBSCRIPTION
AGREEMENT
This Subscription Agreement (this
“Agreement”) is being delivered to you in connection
with your investment in a publicly-traded company, which will
subsequently change its name to VirtualScopics, Inc.
(“Pubco”), and the anticipated acquisition by exchange
offer (the “Acquisition”) by Pubco of all of the
outstanding membership interests and business of VirtualScopics,
LLC, a New York limited liability company. Brookshire Securities
Corporation (the “Placement Agent”) shall serve as the
placement agent of Pubco in conducting a private placement (the
“Private Placement”) of units (“Units”),
each Unit consisting of (i) one share of Pubco’s Series A
Convertible Preferred Stock (“Preferred Stock”),
convertible into 400 shares of Pubco’s common stock
(“Common Stock”), and (ii) a detachable, four-year
warrant to purchase 200 shares of Common Stock
(“Warrant”), at an exercise price of $4.00
per share. The purchase price per Unit is $1,000.
The Private Placement is being conducted on a “best efforts -
3,000 Units or none” basis with a maximum of 6,000 Units
being offered, subject to a 1,000 Unit oversubscription option. All
funds received in the Private Placement prior to the initial
closing of the Private Placement (the “Initial
Closing”) shall be held in escrow by Signature Bank (the
“Escrow Agent”) and, upon fulfillment of the other
conditions precedent set forth herein, shall be released from
escrow and delivered to Pubco at which time the securities
subscribed for as further described below shall be delivered,
subject to Section 8 hereof, to you. The Company and the Placement
Agent may continue to offer and sell Units and conduct additional
closings (each, a “Closing”) for the sale of additional
Units after the Initial Closing until the termination of the
Offering.
1 .
SUBSCRIPTION AND PURCHASE
PRICE
1.1 Subscription . Subject to the conditions set forth in Section
2 hereof, the undersigned hereby subscribes for and agrees to
purchase the number of Units indicated on page F-10 hereof on the
terms and conditions described herein. The minimum number of Units
that may be purchased is fifty (50). Subscriptions for lesser
amounts may be accepted at the discretion of Pubco and the
Placement Agent.
1.2 Purchase of Securities . The undersigned understands and acknowledges
that the purchase price to be remitted to the Placement Agent in
exchange for the Units shall be $1,000 per Unit, for an aggregate
purchase price as set forth on page F-10 hereof (the
“Aggregate Purchase Price”). The undersigned’s
delivery of this Agreement to the Placement Agent shall be
accompanied by payment for the Units subscribed for hereunder,
payable in United States dollars, by check or wire transfer, to
“Signature Bank, as Escrow Agent for VirtualScopics,”
with the undersigned’s delivery of this Agreement to the
Placement Agent. The undersigned understands and agrees that,
subject to Sections 2.1(a) and applicable laws, by executing this
Agreement, he, she or it is entering into a binding
agreement.
2.
ACCEPTANCE AND CLOSING
PROCEDURES
2.1 Acceptance or Rejection .
(a) The obligation of the undersigned to purchase
the Units shall be irrevocable, and the undersigned shall be
legally bound to purchase the Units subject to the terms set forth
in this Agreement.
(b) The undersigned understands and agrees that
Pubco and the Placement Agent reserve the right to reject this
subscription for the Units in whole or part in any order at any
time prior to the closing (the “Closing”) of the
purchase and sale of the Units if, in their reasonable judgment,
they deem such action to be in the best interest of Pubco,
notwithstanding the undersigned’s prior receipt of notice of
acceptance of the undersigned’s subscription.
(c) In the event of rejection of this subscription
by Pubco or the Placement Agent in accordance with Section 2.1(b),
or the sale of the Units is not consummated by the Placement Agent
for any reason, this Agreement and any other agreement entered into
between the undersigned and the Placement Agent relating to this
subscription shall thereafter have no force or effect, and the
Placement Agent shall promptly return or cause to be returned to
the undersigned the purchase price remitted to the Escrow Agent,
without interest thereon or deduction therefrom.
Each Closing shall take place at the offices of
Greenberg Traurig, LLP, counsel to Pubco, at 200 Park Avenue, 15th
Floor, New York, New York 10166, or such other place as determined
by the Placement Agent. The Initial Closing shall take place on a
Business Day promptly following the satisfaction of the conditions
set forth in Section 8 below. Each subsequent Closing shall take
place at such times as determined by Pubco (each closing date
referred to as a “Closing Date”), or such other date as
is mutually agreed to by the parties and the undersigned.
“Business Day” shall mean from the hours of 9:00 a.m.
(E.S.T.) through 5:00 p.m. (E.S.T.) of a day other than a Saturday,
Sunday or other day on which commercial banks in New York, New York
are authorized or required to be closed.
3.
INVESTOR’S
REPRESENTATIONS AND WARRANTIES
The undersigned hereby acknowledges, agrees with
and represents and warrants to Pubco and the Placement Agent and
its affiliates, as follows:
(a) The undersigned has full power and authority to
enter into this Agreement, the execution and delivery of which has
been duly authorized, if applicable, and this Agreement constitutes
a valid and legally binding obligation of the
undersigned.
(b) The undersigned acknowledges his, her or its
understanding that the offering and sale of the Units is intended
to be exempt from registration under the Securities Act of 1933, as
amended (the “Securities Act”), by virtue of Section
4(2) of the Securities Act and the provisions of Regulation D
promulgated thereunder (“Regulation D”). In furtherance
thereof, the undersigned represents and warrants to Pubco and the
Placement Agent and its affiliates as follows:
(i) The undersigned realizes that the basis for the
exemption from registration may not be available if,
notwithstanding the undersigned’s representations contained
herein, the undersigned is merely acquiring the Units for a fixed
or determinable period in the future, or for a market rise, or for
sale if the market does not rise. The undersigned does not have any
such intention.
(ii) The undersigned is acquiring the Units solely
for the undersigned’s own beneficial account, for investment
purposes, and not with view to, or resale in connection with, any
distribution of the shares of Preferred Stock, or shares of Common
Stock into which the Preferred Stock is convertible and the
Warrants are exercisable.
(iii) The undersigned has the financial ability to
bear the economic risk of his, her or its investment, has adequate
means for providing for their current needs and contingencies, and
has no need for liquidity with respect to the investment in
Pubco;
(iv) The undersigned and the undersigned’s
attorney, accountant, purchaser representative and/or tax advisor,
if any (collectively, “Advisors”), have received the
Confidential Private Placement Memorandum, dated October 3, 2005,
together with all appendices thereto (as such documents may be
amended or supplemented, the “Memorandum”), relating to
the private placement by Pubco of the Units, and all other
documents requested by the undersigned or Advisors, if any, have
carefully reviewed them and understand the information contained
therein, prior to the execution of this Agreement; and
(v) The undersigned (together with his, her or its
Advisors, if any) has such knowledge and experience in financial
and business matters as to be capable of evaluating the merits and
risks of the prospective investment in the Units. If other than an
individual, the undersigned also represents it has not been
organized solely for the purpose of acquiring the Units.
(c) The information in the Investor Questionnaire
completed and executed by the undersigned (the “Investor
Questionnaire”) is true and accurate in all respects, and the
undersigned is an “accredited investor,” as that term
is defined in Rule 501(a) of Regulation D.
(d) The undersigned (and his, her or its Advisors,
if any) has been furnished with a copy of the
Memorandum.
(e) The undersigned is not relying on the Placement
Agent or its affiliates or sub-agents with respect to economic
considerations involved in this investment. The undersigned has
relied on the advice of, or has consulted with, only his Advisors.
Each Advisor, if any, is capable of evaluating the merits and risks
of an investment in the Units as such are described in the
Memorandum, and each Advisor, if any, has disclosed to the
undersigned in writing (a copy of which is annexed to this
Agreement) the specific details of any and all past, present or
future relationships, actual or contemplated, between the Advisor
and the Placement Agent or any affiliate or sub-agent
thereof.
(f) The undersigned represents, warrants and agrees
that he, she or it will not sell or otherwise transfer the shares
of Preferred Stock or Warrants (including such shares of Common
Stock into which the Preferred Stock is convertible and Warrants
are exercisable, and collectively with the Preferred Stock and
Warrants, the “Securities”) without registration under
the Securities Act or an exemption therefrom, and fully understands
and agrees that the undersigned must bear the economic risk of his,
her or its purchase because, among other reasons, the Securities
have not been registered under the Securities Act or under the
securities laws of any state and, therefore, cannot be resold,
pledged, assigned or otherwise disposed of unless they are
subsequently registered under the Securities Act and under the
applicable securities laws of such states, or an exemption from
such registration is available. In particular, the undersigned is
aware that the Securities are “restricted securities,”
as such term is defined in Rule 144 promulgated under the
Securities Act (“Rule 144”), and they may not be sold
pursuant to Rule 144 unless all of the conditions of Rule 144 are
met. The undersigned also understands that, except as otherwise
provided herein, Pubco is under no obligation to register the
Securities on his, her or its behalf or to assist them in complying
with any exemption from registration under the Securities Act or
applicable state securities laws. The undersigned understands that
any sales or transfers of the Securities are further restricted by
state securities laws and the provisions of this
Agreement.
(g) No representations or warranties have been made
to the undersigned by Pubco, VirtualScopics, LLC or the Placement
Agent, or any of their respective officers, employees, agents,
sub-agents, affiliates or subsidiaries, other than any
representations of Pubco or the Placement Agent contained herein
and in the Memorandum, and in subscribing for Units the undersigned
is not relying upon any representations other than those contained
herein or in the Memorandum.
(h) The undersigned understands and acknowledges
that his, her or its purchase of the Units is a speculative
investment that involves a high degree of risk and the potential
loss of their entire investment and has carefully read and
considered the matters set forth in the Memorandum and in
particular the matters under the caption “Cautionary Language
Regarding Forward-Looking Statements and Industry Data” and
“Risk Factors” therein, and, in particular,
acknowledges that VirtualScopics has a limited operating history
and is engaged in a highly regulated business, including required
compliance with the Food, Drug and Cosmetic Act and the rules and
regulations of the Food and Drug Administration.
(i) The undersigned’s overall commitment to
investments that are not readily marketable is not disproportionate
to the undersigned’s net worth, and an investment in the
Units will not cause such overall commitment to become
excessive.
(j) The undersigned understands and agrees that the
certificates for the Securities shall bear substantially the
following legend until (i) such Securities shall have been
registered under the Securities Act and effectively disposed of in
accordance with a registration statement that has been declared
effective or (ii) in the opinion of counsel for Pubco such
Securities may be sold without registration under the Securities
Act, as well as any applicable “blue sky” or state
securities laws:
THE SECURITIES REPRESENTED BY THIS CERTIFICATE
HAVE NOT BEEN REGISTERED UNDER THE SECURITIES ACT OF 1933, AS
AMENDED (THE “SECURITIES ACT”), OR ANY APPLICABLE STATE
SECURITIES LAWS. SUCH SECURITIES HAVE BEEN ACQUIRED FOR INVESTMENT
PURPOSES AND MAY NOT BE OFFERED FOR SALE, SOLD, DELIVERED AFTER
SALE, TRANSFERRED, PLEDGED OR HYPOTHECATED IN THE ABSENCE OF AN
EFFECTIVE REGISTRATION STATEMENT FILED BY THE ISSUER WITH THE U.S.
SECURITIES AND EXCHANGE COMMISSION COVERING SUCH SECURITIES UNDER
THE SECURITIES ACT OR AN OPINION OF COUNSEL SATISFACTORY TO THE
ISSUER THAT SUCH REGISTRATION IS NOT REQUIRED.
(k) Neither the U.S. Securities and Exchange
Commission (the “SEC”) nor any state securities
commission has approved the Units or the Securities, or passed upon
or endorsed the merits of the Offering or confirmed the accuracy or
determined the adequacy of the Memorandum. The Memorandum has not
been reviewed by any Federal, state or other regulatory
authority.
(l) The undersigned and his, her or its Advisors,
if any, have had a reasonable opportunity to ask questions of and
receive answers from a person or persons acting on behalf of Pubco
and VirtualScopics, LLC concerning the offering of the Units and
the business, financial condition, results of operations and
prospects of Pubco, and all such questions have been answered to
the full satisfaction of the undersigned and his, her or its
Advisors, if any.
(m) The undersigned is unaware of, is in no way
relying on, and did not become aware of the offering of the Units
through or as a result of, any form of general solicitation or
general advertising including, without limitation, any article,
notice, advertisement or other communication published in any
newspaper, magazine or similar media or broadcast over television,
radio or electronic mail through the Internet, in connection with
the offering and sale of the Units and is not subscribing for Units
and did not become aware of the offering of the Units through or as
a result of any seminar or meeting to which the undersigned was
invited by, or any solicitation of a subscription by, a person not
previously known to the undersigned in connection with investments
in securities generally.
(n) The undersigned has taken no action which would
give rise to any claim by any person for brokerage commissions,
finders’ fees or the like relating to this Agreement or the
transactions contemplated hereby (other than commissions to be paid
by Pubco to the Placement Agent, its sub-agents or as otherwise
described in the Memorandum) and, in turn, to be paid to other
selected dealers.
(o) The undersigned is not relying on Pubco, the
Placement Agent or any of their respective employees, agents or
sub-agents with respect to the legal, tax, economic and related
considerations of an investment in the Units, and the undersigned
has relied on the advice of, or has consulted with, only his, her
or its own Advisors.
(p) The undersigned acknowledges that any estimates
or forward-looking statements or projections included in the
Memorandum were prepared by the future management of Pubco in good
faith, but that the attainment of any such projections, estimates
or forward-looking statements cannot be guaranteed by Pubco or its
management and should not be relied upon.
(q) No oral or written representations have been
made, or oral or written information furnished, to the undersigned
or his, her or its Advisors, if any, in connection with the
offering of the Units which are in any way inconsistent with the
information contained in the Memorandum.
(r) The undersigned’s substantive
relationship with the Placement Agent or sub-agents through which
the undersigned is subscribing for Units predates the Placement
Agent’s or such sub-agents’ contact with the
undersigned regarding an investment in the Units.
(s) The foregoing representations, warranties and
agreements shall survive the Closing.
4.
PUBCO’S
REPRESENTATIONS AND WARRANTIES
Pubco hereby acknowledges, agrees with and
represents and warrants to each of the undersigned, as
follows:
(a) Pubco has the corporate power and authority to
execute and deliver this Agreement and to perform its obligations
hereunder. This Agreement has been duly authorized, executed and
delivered by Pubco and is valid, binding and enforceable against
Pubco in accordance with its terms.
(b) The Preferred Stock and Warrants to be issued
to the undersigned pursuant to this Agreement, when issued and
delivered in accordance with the terms thereof and this Agreement,
will be duly and validly issued and will be fully paid and
non-assessable.
(c) Pubco has duly and validly reserved, out of its
authorized and unissued Common Stock, for issuance upon conversion
of the Preferred Stock and exercise of the Warrants, a number of
shares sufficient for such purpose. The Common Stock to be issued
to the undersigne