Assured Pharmacy, Inc. Sample Contracts

Assured Pharmacy, Inc. – Contracted Party Agreement Type Date of Agreement Outstanding Balance Remaining Lease Obligation Effect of Default Hillair Capital Investments, LP Convertible Debenture 2/7/14 $1,150,000.00 In the event of Bankruptcy, the outstanding principal amount of the debenture, plus accrued but unpaid interest, liquidated damages and other amounts owing in respect thereof through the date of acceleration, shall become, at the Holder's election, immediately due and payable in cash at the Mandatory Default Rate. Commencing 5 days after the occurrence of any Event of Default that results in the eventual ac (March 9th, 2015)
Assured Pharmacy, Inc. – August 22, 2013 Joseph McDevitt (March 31st, 2014)
Assured Pharmacy, Inc. – FORBEARANCE AGREEMENT (March 31st, 2014)

THIS FORBEARANCE AGREEMENT (“Agreement”), dated the 26th day of March, 2014, is entered into by and between H. D. Smith Drug Co., a Delaware corporation (“H.D. Smith”), with its principal place of business located at 3063 Fiat Ave., Springfield, Illinois 62703, and Assured Pharmacy, Inc., a Nevada corporation (“Assured”), having an office located at 5600 Tennyson Parkway, Suite 290, Plano, Texas 75024.

Assured Pharmacy, Inc. – AMENDMENT AGREEMENT (March 31st, 2014)

THIS AMENDMENT AGREEMENT, dated as of December 23, 2013 (this "Agreement"), by and between by Assured Pharmacy, Inc., a Nevada corporation (the "Borrower") and Brockington Securities, Inc., a New York corporation (the "Lender"), amends that revolving line of credit agreement, dated March 10, 2009 (the "Line of Credit"), as amended pursuant to the terms of that certain modification and extension agreement dated March 10, 2010, November 10, 2011, June 22, 2012 and November 12, 2012 (the "Line of Credit Amendments" and together with the Line of Credit, the "Prior Agreements").

Assured Pharmacy, Inc. – PROMISSORY NOTE (March 31st, 2014)

FOR VALUE RECEIVED, Assured Pharmacy, Inc., a Nevada corporation (the “Corporation”), promises to pay to the order of Pinewood Trading Fund, L.P., or its assigns (the “Shareholder”), the principal sum of Two Hundred Thousand Dollars ($200,000) 1029 East Drive, Beaumont, Texas 77706, or such place as the Shareholder may from time to time designate in writing, payable as hereinafter provided.

Assured Pharmacy, Inc. – FOURTH AMENDMENT TO PURCHASE AGREEMENT (March 31st, 2014)

THIS FOURTH AMENDMENT TO PURCHASE AGREEMENT (this "Fourth Amendment") is made as of this 19th day of December, 2013, by and between TPG, L.L.C. a Louisiana limited liability company ("Seller") and ASSURED PHARMACY, INC., a Nevada corporation ("Buyer"), and amends that certain Purchase Agreement dated as of December 15, 2006 by and between Seller and Buyer, as amended (the "Purchase Agreement").

Assured Pharmacy, Inc. – FORM OF PROMISSORY NOTE (March 31st, 2014)

FOR VALUE RECEIVED, Assured Pharmacy, Inc., a Nevada corporation (the “Corporation”), promises to pay to the order of Pinewood Trading Fund, L.P., or its assigns (the “Shareholder”), the principal sum of ___________ Dollars ($___,___), at 1029 East Drive, Beaumont, Texas 77706 or such place as the Shareholder may from time to time designate in writing, payable as hereinafter provided.

Assured Pharmacy, Inc. – FORM OF AMENDED AND RESTATED 10% SENIOR CONVERTIBLE DEBENTURE DUE JUNE 30, 2016 (March 31st, 2014)

THIS 10% SENIOR CONVERTIBLE DEBENTURE is one of a series of duly authorized and validly issued 10% Senior Convertible Debentures of Assured Pharmacy, Inc., a Nevada corporation, (the “Company”), having its principal place of business at 5600 Tennyson Parkway, Suite 390, Plano, TX 75024, designated as its 10% Senior Convertible Debenture, due June 30, 2016 (this debenture, the “Debenture” and, collectively with the other debentures of such series, the “Debentures”).

Assured Pharmacy, Inc. – PROMISSORY NOTE (November 14th, 2013)

FOR VALUE RECEIVED, Assured Pharmacy, Inc., a Nevada corporation (the “Corporation”), promises to pay to the order of Pinewood Trading Fund, L.P., or its assigns (the “Shareholder”), the principal sum of Two Hundred Thousand Dollars ($200,000), at 1029 East Drive, Beaumont, Texas 77706 or such place as the Shareholder may from time to time designate in writing, payable as hereinafter provided.

Assured Pharmacy, Inc. – PROMISSORY NOTE (August 14th, 2013)

FOR VALUE RECEIVED, Assured Pharmacy, Inc., a Nevada corporation (the “Corporation”), promises to pay to the order of Pinewood Trading Fund, L.P., or its assigns (the “Shareholder”), the principal sum of Two Hundred Thousand Dollars ($200,000), at 1029 East Drive, Beaumont, Texas 77706 or such place as the Shareholder may from time to time designate in writing, payable as hereinafter provided.

Assured Pharmacy, Inc. – AMENDMENT TO PROMISSORY NOTE AGREEMENT (August 14th, 2013)

This amendment ("Amendment"), dated and effective on July 1, 2013 ("the Effective Date"), is made to that certain Promissory Note Agreement dated February 1, 2013 ("the Note"), by and between H. D. Smith Wholesale Drug Co. ("Lender") and Assured Pharmacy, Inc., ("Borrower"), with regard to the following:

Assured Pharmacy, Inc. – AMENDMENT AGREEMENT (April 1st, 2013)

THIS AMENDMENT AGREEMENT, dated as of November 12, 2012 (this “Agreement”), by and between by Assured Pharmacy, Inc., a Nevada corporation (the “Borrower”) and Brockington Securities, Inc., a New York corporation (the “Lender”), amends that revolving line of credit agreement, dated March 10, 2009 (the “Line of Credit”), as amended pursuant to the terms of that certain modification and extension agreement dated March 10, 2010, as amended pursuant to the terms of that certain modification and extension agreement dated March 10, 2010, as amended pursuant to the terms of that certain modification and extension agreement dated March 10, 2010 (the “Line of Credit Amendment” and together with the Line of Credit, the “Prior Agreements”).

Assured Pharmacy, Inc. – FORM OF SECURITIES PURCHASE AGREEMENT for common stock (April 1st, 2013)

This Securities Purchase Agreement (this “Agreement”) is dated as of January 25, 2013, (the “Agreement Date”) between Assured Pharmacy, Inc., a Nevada corporation (the “Company”), and each purchaser identified on the signature pages hereto (each, including its successors and assigns, a “Purchaser” and collectively, the “Purchasers”).

Assured Pharmacy, Inc. – PROMISSORY NOTE AGREEMENT (April 1st, 2013)

AGREEMENT made this 1st day of February, 2013 by and among H.D. Smith Wholesale Drug Co., having its principal place of business at 3063 Fiat Ave., Springfield, IL, a corporation formed under the laws of the State of Delaware, (hereinafter "Lender" or "Supplier"), and Assured Pharmacy, Inc., having an office located at 2595 Dallas Parkway, Suite 206, Hall Office Park, Frisco, TX 75034, a corporation formed under the laws of the State of Nevada (hereinafter "Borrower" or "Purchaser"),

Assured Pharmacy, Inc. – FORM OF COMMON STOCK PURCHASE WARRANT (April 1st, 2013)

THIS COMMON STOCK PURCHASE WARRANT (the “Warrant”) certifies that, for value received, ___________________________ (the “Purchaser”) or his or its assigns (collectively with the Purchaser, 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 Final Closing Date under the Purchase Agreement (the “Initial Exercise Date”) and on or prior to the close of business on the three (3) year anniversary of the Initial Exercise Date (the “Termination Date”) but not thereafter, to subscribe for and purchase from Assured Pharmacy, Inc., a Nevada 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).

Assured Pharmacy, Inc. – FORM OF SUBSCRIPTION AGREEMENT FOR COMMON STOCK (April 1st, 2013)

This subscription booklet contains your Subscription Agreement and other documents that, if you wish to invest in Units, must be executed and returned to Mark Elenowitz at TriPoint Global Equities, LLC via mail: 17 State Street, Suite 2000, New York, NY 10004; Fax: +1 212 202 6380; or email: mark@tripointglobalequities.com. TriPoint Global Equities, LLC is acting as Placement Agent. You should consult with an attorney, accountant, investment adviser or other adviser regarding an investment in the Company and its suitability for you. All subscription documents must be completed correctly and thoroughly or they will not be accepted. If you wish to invest, please complete, sign and return the documents included herein.

Assured Pharmacy, Inc. – FORM OF REGISTRATION RIGHTS AGREEMENT (April 1st, 2013)

This Registration Rights Agreement (this “Agreement”) is made and entered into as of January 25, 2013 by and among Assured Pharmacy, Inc., a Nevada corporation (the “Company”), and the purchasers listed on Schedule I hereto (the “Purchasers”).

Assured Pharmacy, Inc. – CONSULTING AGREEMENT (October 10th, 2012)

This Consulting Agreement (this "Agreement") is made and entered into this 1st day of June, 2012, by and between Assured Pharmacy Inc., a Nevada corporation (the "Company"), with offices located at 2595 Dallas Parkway, Suite 206, Frisco, TX, 75034, and Jack Edward Brooks, and individual residing at 1029 East Drive, Beaumont TX 77706 ("Consultant"), with reference to the following facts:

Assured Pharmacy, Inc. – THIRD AMENDMENT TO PURCHASE AGREEMENT (July 5th, 2012)

THIS THIRD AMENDMENT TO PURCHASE AGREEMENT (this "Third Amendment") is made as of this 25th day of June, 2012, by and between TPG, L.L.C. a Louisiana limited liability company ("Seller") and ASSURED PHARMACY, INC., a Nevada corporation ("Buyer"), and amends that certain Purchase Agreement dated as of December 15, 2006 by and between Seller and Buyer, as amended by that certain First Amendment dated as of July 15, 2009 and that certain Second Amendment dated as of January 31, 2011 (the "Purchase Agreement").

Assured Pharmacy, Inc. – FORM OF AMENDMENT AGREEMENT (July 5th, 2012)

THIS AMENDMENT AGREEMENT (this “Agreement”), dated as of June ___, 2012, is entered into by and between Assured Pharmacy, Inc., a Nevada corporation (the “Company”) and the holder identified on the signature page hereto (the “Holder”). Capitalized terms used herein, but not otherwise defined, shall have the meanings ascribed to such terms in the Transaction Documents.

Assured Pharmacy, Inc. – AMENDMENT AGREEMENT (July 5th, 2012)

THIS AMENDMENT AGREEMENT, dated as of June 22, 2012 (this "Agreement"), by and between by Assured Pharmacy, Inc., a Nevada corporation (the "Borrower") and Brockington Securities, Inc., a New York corporation (the "Lender"), amends that revolving line of credit agreement, dated March 10, 2009 (the "Line of Credit"), as amended pursuant to the terms of that certain modification and extension agreement dated March 10, 2010 and November 10, 2011 (the "Line of Credit Amendments" and together with the Line of Credit, the "Prior Agreements").

Assured Pharmacy, Inc. – DEBENTURE AMENDMENT (July 5th, 2012)

This DEBENTURE AMENDMENT, dated as of July 2, 2012 (this “Amendment”), is hereby made by and between ASSURED PHARMACY, INC., a Nevada corporation (the “Company”), and JOSEPH V. MCDEVITT (the “Purchaser”).

Assured Pharmacy, Inc. – CJE Holdings (May 11th, 2012)
Assured Pharmacy, Inc. – FORM OF COMMON STOCK PURCHASE WARRANT ASSURED PHARMACY, INC. (May 11th, 2012)

THIS COMMON STOCK PURCHASE WARRANT (the “Warrant”) certifies that, for value received, (the “Purchaser”) or his or its assigns (collectively with the Purchaser, 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 the close of business on the anniversary of the Initial Exercise Date (the “Termination Date”) but not thereafter, to subscribe for and purchase from Assured Pharmacy, Inc., a Nevada 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).

Assured Pharmacy, Inc. – EMPLOYMENT AGREEMENT (May 11th, 2012)

THIS EMPLOYMENT AGREEMENT (the “Agreement”), effective as of May 9, 2012, is by and between Assured Pharmacy, Inc., a Nevada corporation with its principal place of business at 2595 Dallas Parkway, Suite 206, Frisco, Texas 75034, (the “Company”) and Mike Schneidereit (the “Employee”).

Assured Pharmacy, Inc. – EMPLOYMENT AGREEMENT (May 11th, 2012)

THIS EMPLOYMENT AGREEMENT (the “Agreement”), effective as of May 9, 2012, is by and between Assured Pharmacy, Inc., a Nevada corporation with its principal place of business at 2595 Dallas Parkway, Suite 206, Frisco, Texas 75034, (the “Company”) and Robert DelVecchio (the “Employee”).

Assured Pharmacy, Inc. – FORM OF ASSURED PHARMACY, INC. 2012 INCENTIVE COMPENSATION PLAN (May 11th, 2012)

This Agreement (the "Agreement") is made as of _________________, ______ (the "Grant Date") by and between Assured Pharmacy, Inc., a Nevada corporation (the “Company”), and ____________________ (the “Optionee”).

Assured Pharmacy, Inc. – CONFIDENTIAL ASSURED PHARMACY, INC. (May 11th, 2012)

This subscription booklet contains your Subscription Agreement and other documents that, if you wish to invest in Units, must be executed and returned to Mark Elenowitz at TriPoint Global Equities, LLC via mail: 17 State Street, Suite 2000, New York, NY 10004; Fax: +1 212 202 6380; or email: mark@tripointglobalequities.com. TriPoint Global Equities, LLC is acting as Placement Agent. You should consult with an attorney, accountant, investment adviser or other adviser regarding an investment in the Company and its suitability for you. All subscription documents must be completed correctly and thoroughly or they will not be accepted. If you wish to invest, please complete, sign and return the documents included herein in accordance with the instructions below.

Assured Pharmacy, Inc. – ASSURED PHARMACY, INC. FORM OF CONVERTIBLE DEBENTURE DUE DATE (May 11th, 2012)

FOR VALUE RECEIVED, upon the terms and subject to the conditions set forth in this convertible debenture (this “Debenture”), ASSURED PHARMACY, INC., a Nevada corporation with its principal place of business located at 2595 Dallas Parkway, Suite 206, Hall Office Park, Frisco, TX 75034 (the “Company”), absolutely and unconditionally promises to pay to the order of (the “Holder”), upon due presentation and surrender of this Debenture, on MONTH DAY,YEAR (the “Maturity Date”), the principal amount of less any principal amount of this Debenture converted or prepaid by the Company prior to the Maturity Date and to pay interest to the Holder on the aggregate unconverted and then outstanding principal amount of this Debenture in accordance with the terms hereof. This Debenture is issued in connection with a certain Debenture Purchase Agreement, of even date herewith, between the Company and the Holder (the “Purchase Agreement”), all terms of which are incorporated herein by this reference and h

Assured Pharmacy, Inc. – AMENDED AND RESTATED ARTICLES OF INCORPORTION OF ASSURED PHARMACY, INC. (May 11th, 2012)

The undersigned, for the purposes of amending and restating the Articles of Incorporation of Assured Pharmacy, Inc., a Nevada corporation (the “Corporation”), does hereby certify that:

Assured Pharmacy, Inc. – STOCK PURCHASE AGREEMENT (May 11th, 2012)

THIS STOCK PURCHASE AGREEMENT is made as of the 30th day of June, 2011 by and between TAPG, L.L.C., a Louisiana limited liability company (the “Seller”) and ASSURED PHARMACY, INC., a Nevada corporation (the “Buyer”).

Assured Pharmacy, Inc. – EMPLOYMENT AGREEMENT (May 11th, 2012)

THIS EMPLOYMENT AGREEMENT (the “Agreement”), effective as of May 9, 2012, is by and between Assured Pharmacy, Inc., a Nevada corporation with its principal place of business at 2595 Dallas Parkway, Suite 206, Frisco, Texas 75034, (the “Company”) and

Assured Pharmacy, Inc. – REVOLVING LINE OF CREDIT AGREEMENT (May 11th, 2012)

This Revolving Line of Credit Agreement (the "AGREEMENT") is made and entered into in this 10th day of March, 2009, by and between Brockington Securities, Inc. ("LENDER"), and Assured Pharmacy, Inc., a Nevada corporation ("BORROWER").

Assured Pharmacy, Inc. – DEBENTURE PURCHASE AGREEMENT (May 11th, 2012)

This DEBENTURE PURCHASE AGREEMENT (the “Agreement”), dated this 15th day of July, 2010, is made by and between ASSURED PHARMACY, INC., a Nevada corporation (the “Company”), and JOSEPH V. MCDEVITT (the “Purchaser”).

Assured Pharmacy, Inc. – THE TRANSFER OF THIS WARRANT IS RESTRICTED AS DESCRIBED HEREIN. ASSURED PHARMACY, INC. Warrants for the Purchase of Shares of Common Stock, Par Value $0.001 Per Share (May 11th, 2012)

THIS CERTIFIES that, for consideration, the receipt and sufficiency of which are hereby acknowledged, and other value received _______________(the"Holder") is entitled to subscribe for, and purchase from, ASSURED PHARMACY, INC., a Nevada corporation (the "Company"), upon the terms and conditions set forth herein, at any time or from time to time on or after the date hereof(the "Effective Time") until 5:00P.M. New York City local time on the tenth anniversary of the Effective Time (the "Exercise Period''), an aggregate of _______________ shares of common stock, par value $0.001 per share (the "Common Stock') of the Company. This Warrant is initially exercisable at a price per share equal to $0.0005, subject to adjustment as provided herein; provided, however, that upon the occurrence of any of the events specified in Section 8 hereof, the rights granted by this Warrant, including the exercise price and the number of shares of Common Stock to be received upon such exercise, shall be adju