This medal refers to the talks and subsequent concordat between Leo X and King Francis I of France following the French victory at the Battle of Marignano of September 13-14, 1515. Personal meetings between pope and king occurred on December 11-15, 1515, in Bologna, and the Concordat of Bologna was signed on August 18, 1516, in Rome. The concordat recognized the authority of the Church of Rome, that the pope and his powers were not subject to any council, and that the pope was allowed to collect all the income made by the Catholic Church in France. On the other hand, the king was allowed to tithe clerics and restrict their right of appeal to Rome. The king would also be permitted to nominate appointments of bishops and abbots, though canonical installation of church officers was reserved for the pope himself.

The reverse inscription is taken from Psalm 45:10, Auferens bella usque ad finem terrae. Arcum conteret, et confringet arma, et scuta comburet igni (Making wars to cease even to the end of the earth. He shall destroy the bow, and break the weapons: and the shield he shall burn in the fire).

The scholar Ernst Kris attributed this medal to Pier Maria Serbaldi da Pescia, called Tagliacarne, an attribution which Hill noted to be probable. However, Modesti does not agree with this attribution, based on a lack of stylistic evidence.