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EXHIBIT 10.09

(Quintiles Transnational Corp. Logo)

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| |  | Quintiles Transnational Corp.
Post Office Box 13979
Research Triangle Park, NC 27709-3979
919 998 2000 / Fax 919 998 9113
http://www.quintiles.com                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
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| |  | December 5, 2003                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                       
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| |  | PERSONAL AND CONFIDENTIAL                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
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| |  | Oppel Greeff                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                           
| |  | 111 Beaver Dam Run                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
| |  | Durham, NC 27703                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                       
| |  |                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        
| |  | Re: Amendment to Executive Employment Agreement                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        
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| |  | Dear Oppel:                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            
| |  |                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        
| |  | Reference is made to the amendment to your Executive Employment
Agreement (the Employment Agreement) dated as of November 17,
2003 (the Amendment). This will confirm our agreement that
Section 5.2 of the Employment Agreement, as amended by paragraph
4 of the Amendment, will be further amended to provide that,
subject to the satisfaction of the conditions contained therein,
the post-employment benefits payable thereunder will also be
payable upon a termination of your employment prior to September
25, 2006 pursuant to Section 4.3(i) (death) or Section 4.3(ii)
(disability) of the Employment Agreement. However, as to such
benefits payable upon disability, (i) the 36 month period
referred to in Section 5.2 shall be reduced by any preceding
period during which you were receiving short-term disability
benefits from the Company or otherwise were compensated by the
Company while you were physically or mentally unable to perform
the essential functions of your duties, and (ii) the monthly
payments shall be reduced by the monthly payments you receive
pursuant to the Companys long-term disability program. Prior to
September 25, 2006, references to Sections 4.3(i) and (ii)
contained in Section 5.4 of the Employment Agreement shall be
ignored.
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| |  | You represent to the Company that you are not aware of any
illness or condition that could reasonably be expected to result
in your death or disability prior to September 25, 2006, and the
Company is agreeing to provide you the benefits set forth in the
preceding paragraph based on such representation. You further
agree to submit, upon the Companys request, to a medical
examination for purposes of the Companys obtaining insurance to
fund its obligations under the preceding paragraph, provided
that the Companys failure to obtain such insurance shall have
no effect on such obligations.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                      





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(Quintiles Transnational Corp. Logo)

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| |  | ------------------------------------------------------------------------------------------
| |  | Greeff  Amendment Employment Agreement Ltr.                                              
| |  | December 5, 2003                                                                          
| |  | Page 2                                                                                    
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| |  | Please confirm that this conforms to your understanding of our
agreement by signing below.
| |  |                                                                                           
| |  | Sincerely yours,                                                                          
| |  |                                                                                           
| |  | -s- Michael Mortimer                                                                      
| |  |                                                                                           
| |  | Michael Mortimer                                                                          
| |  | Executive Vice President, Global Human Resources                                          
| |  |                                                                                           
| |  | Agreed to and Accepted by:                                                                

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| | ---------------- |  | --------
| | -s- Oppel Greeff |  | 12/06/03
| | Oppel Greeff     |  | Date