X0306 4 2015-12-29 0 0001029581 Modsys International Ltd MDSY 0001569608 Columbia Pacific Advisors, LLC 1910 FAIRVIEW AVE E SUITE 200 SEATTLE WA 98102 0 0 1 0 Ordinary Shares 2016-01-05 4 P 0 1200 2.25 A 5179807 I General Partner Ordinary Shares 2016-01-06 4 P 0 100 2.25 A 5179907 I General Partner Warrants (Right to Buy) 0.01 2015-12-29 4 J 0 256148 0 A 2015-12-29 2018-12-29 Ordinary Shares, NIS 0.04 par value 256148 256148 I General Partner Warrants (Right to Buy) 0.01 2015-12-31 4 P 0 100000 1.3333 A 2015-12-31 2017-12-31 Ordinary Shares, NIS 0.04 par value 100000 356148 I General Partner Preferred Shares, NIS 0.04 par value 0 2015-12-31 4 P 0 200000 1.3333 A Ordinary Shares, NIS 0.04 par value 200000 200000 I General Partner Acquired by Columbia Pacific Opportunity Fund, L.P. Columbia Pacific Opportunity Fund, L.P. owns 5,141,967 Ordinary Shares Columbia Pacific Partners Fund, Ltd. owns 37,940 Ordinary Shares These warrants vested 50% on the date of grant (December 29, 2015) and will vest 50% on February 24, 2016. In the event that the Issuer has repaid in full the guaranteed amount owed pursuant to a credit agreement between Modern Systems Corporation and MS Modernization Services, Inc., a wholly owned subsidiary and a majority owned subsidiary of the Issuer, and Comerica Bank (the "Credit Agreement") to below $1,000,000 prior to February 24, 2016, the unvested portion of the warrants held by the Reporting Persons will be automatically cancelled. These warrants were issued in exchange for the Reporting Persons and certain other shareholders providing a guaranty with respect to the Credit Agreement. The convertible Preferred Shares is convertible into Ordinary Shares at any time on a one-for-one basis, and has no expiration date. Alexander Washburn 2016-01-07