Amended & Restated Service Agreement



 Exhibit 10(nnn) 
 AMENDED AND RESTATED 
 SERVICE AGREEMENT 
 AMONG 
 NORTHLAND DENTAL PARTNERS, PLLC 
 FAMILY PERIODONTIC SPECIALISTS, P.L.C., 
 FAMILY
ORAL SURGERY SPECIALISTS, PLC, 
 FAMILY ENDODONTIC SPECIALISTS, PLC 
 and 
 PDHC, LTD. 
 Effective Date: January 1, 2009 







 TABLE OF CONTENTS 
  


					
	 	  	 	  	Page
	 ARTICLE I
	  	     DEFINITIONS
	  	2
			
	 ARTICLE II
	  	     ENGAGEMENT AND AUTHORITY OF SERVICE COMPANY
	  	2
			
	 2.1
	  	 Engagement
	  	2
			
	 2.2
	  	 Authority
	  	2
			
	 2.3
	  	 Patient Referrals
	  	2
			
	 2.4
	  	 Internal Management of Provider
	  	2
			
	 2.5
	  	 Practice of Dentistry
	  	3
			
	 ARTICLE III
	  	     POLICY BOARD
	  	3
			
	 3.1
	  	 Formation and Operation of Policy Board
	  	3
			
	 3.2
	  	 Responsibilities of the Policy Board
	  	4
			
	 3.3
	  	 Dental Decisions
	  	5
			
	 ARTICLE IV
	  	     RESPONSIBILITIES OF SERVICE COMPANY
	  	5
			
	 4.1
	  	 Clinics
	  	5
			
	 4.2
	  	 Equipment
	  	6
			
	 4.3
	  	 Laboratory Services
	  	6
			
	 4.4
	  	 Supplies
	  	6
			
	 4.5
	  	 Capital Investment
	  	7
			
	 4.6
	  	 Support Services
	  	7
			
	 4.7
	  	 Quality Assurance, Risk Management, and Utilization Review
	  	7
			
	 4.8
	  	 Licenses and Permits
	  	7
			
	 4.9
	  	 Personnel
	  	7
			
	 4.10
	  	 Contract Negotiations
	  	8
			
	 4.11
	  	 Billing and Collection
	  	8
			
	 4.12
	  	 Provider Account
	  	9
			
	 4.13
	  	 Financial Matters
	  	10
			
	 4.14
	  	 Reports and Records
	  	11
			
	 4.15
	  	 Recruitment of Provider Dentists
	  	12
			
	 4.16
	  	 Service Company’s Insurance
	  	12
			
	 4.17
	  	 License of Name and Marks
	  	12
			
	 4.18
	  	 No Warranty
	  	12

  

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 TABLE OF CONTENTS 
 (continued) 
  

					
	 	  	 	  	Page
	 ARTICLE V
	  	     RESPONSIBILITIES OF PROVIDER
	  	13
			
	 5.1
	  	 Organization and Operations
	  	13
			
	 5.2
	  	 Provider Personnel
	  	13
			
	 5.3
	  	 Professional Standards
	  	14
			
	 5.4
	  	 Dental Care
	  	14
			
	 5.5
	  	 Peer Review and Quality Assurance
	  	14
			
	 5.6
	  	 Provider’s Insurance
	  	15
			
	 5.7
	  	 Noncompetition
	  	17
			
	 5.8
	  	 Use of Names
	  	17
			
	 ARTICLE VI
	  	     CONFIDENTIALITY
	  	18
			
	 6.1
	  	 Confidential and Proprietary Information
	  	18
			
	 6.2
	  	 Use of Practice Statistics
	  	18
			
	 ARTICLE VII
	  	     FINANCIAL ARRANGEMENTS
	  	18
			
	 7.1
	  	 Clinic Expense Reimbursement
	  	18
			
	 7.2
	  	 Repayment of Advances
	  	19
			
	 7.3
	  	 Service Fee
	  	19
			
	 7.4
	  	 Reasonable Value
	  	19
			
	 7.5
	  	 Payment
	  	19
			
	 7.6
	  	 Accounts Receivable
	  	19
			
	 ARTICLE VIII
	  	     TERM AND TERMINATION
	  	20
			
	 8.1
	  	 Initial and Renewal Term
	  	20
			
	 8.2
	  	 Termination
	  	20
			
	 8.3
	  	 Effects of Termination
	  	22
			
	 8.4
	  	 Purchase Obligation
	  	22
			
	 8.5
	  	 Closing of Purchase
	  	23
			
	 ARTICLE IX
	  	     GENERAL
	  	24
			
	 9.1
	  	 Nature of Services
	  	24
			
	 9.2
	  	 Relationship of Parties
	  	24
			
	 9.3
	  	 Notices
	  	24
			
	 9.4
	  	 Execution of Documents
	  	25

  

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 TABLE OF CONTENTS 
 (continued) 
  

					
	 	  	 	  	Page
			
	 9.5
	  	 Governing Law
	  	25
			
	 9.6
	  	 Severability
	  	25
			
	 9.7
	  	 Setoff
	  	25
			
	 9.8
	  	 Remedies
	  	25
			
	 9.9
	  	 Non-waiver
	  	26
			
	 9.10
	  	 Indemnification
	  	26
			
	 9.11
	  	 No Third Party Benefit
	  	26
			
	 9.12
	  	 Captions
	  	26
			
	 9.13
	  	 Genders and Numbers
	  	26
			
	 9.14
	  	 Complete Agreement
	  	26
			
	 9.15
	  	 Counterparts
	  	27
			
	 9.16
	  	 Assignment
	  	27
			
	 9.17
	  	 Successors
	  	27
			
	 9.18
	  	 Force Majeure
	  	27
			
	 9.19
	  	 Interpretation
	  	27
			
	 9.20
	  	 Jury Trial Wavier
	  	28
		
	Exhibit A, Definitions	  	A-1

  

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 AMENDED AND RESTATED 
 SERVICE AGREEMENT 
 This Amended and Restated Service Agreement (the
“Agreement”) is made effective January 1, 2009, among Northland Dental Partners, PLLC, a Minnesota professional limited liability company, fka James Ludke, D.D.S., PLLC (“Northland”), its wholly owned subsidiaries, Family
Periodontic Specialists, P.L.C., Family Oral Surgery Specialists, PLC, and Family Endodontic Specialists, PLC, all Minnesota professional limited liability companies (the “Subsidiaries,” and with Northland, collectively
“Provider”), and PDHC, Ltd., a Minnesota corporation (“Service Company”). 
 Background Information 
 A. Provider operates dental practices providing dental services to the general public in and around the Minneapolis, Minnesota area
through individual dentists who are licensed to practice dentistry in the State of Minnesota and who are employed or otherwise retained by Provider. 
 B. Service Company is engaged in the business of providing assets, personnel, and services to dental practices, other than such services as are directly related to or would improperly influence the provision of dental
care or the practice of dentistry. Service Company’s services are intended to permit the dentists in such practices to focus their efforts primarily on rendering quality dental care. 
 C. Prior to December 31, 2008, Northland was the sole member in Metro Dentalcare, P.L.C., a Minnesota professional limited liability
company (“Metro”), and Metro was the sole member in each Subsidiary. On December 31, 2008, Metro was merged with and into Northland, with the result that, among other things, Northland is now the sole member in each Subsidiary.

 D. Metro, the Subsidiaries, and Metropolitan Dental Management, Inc., a Minnesota corporation (“MDMI”), are the
parties to a Service Agreement dated September 25, 2007 (the “Metro Service Agreement”). Metro, the Subsidiaries, and MDMI have terminated the Metro Service Agreement as of the date of this Agreement. 
 E. Northland and Service Company are the parties to a Service Agreement dated January 1, 2008 (the “Original Agreement”),
pursuant to which Provider engaged Service Company to provide such services as are necessary and appropriate for the day-to-day administration of the non-clinical aspects of Provider’s dental practice. 
 F. Northland desires to continue focusing its energies, expertise and time on the practice of dentistry and on the delivery of dental
services to patients. Northland also desires to have Service Company provide its services to the dental practice formerly operated by Metro, which is now part of Northland’s practice, and to the dental practices operated by the Subsidiaries. As
a result, Provider and Service Company (the “Parties”) desire to amend and restate the Original Agreement to provide for Service Company to provide its services to all of Provider’s dental practices, all as set forth in this
Agreement. 
  

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 Statement of Agreement 
 The Parties hereby acknowledge the accuracy of the foregoing Background Information and agree as follows: 
 ARTICLE I 
 DEFINITIONS 
 Capitalized terms used in this Agreement but not otherwise defined herein shall have the respective meanings given those terms in the
attached Exhibit A. 
 ARTICLE II 
 ENGAGEMENT AND AUTHORITY OF SERVICE COMPANY 
 2.1 Engagement. Provider hereby engages Service
Company as its sole and exclusive provider of the Services, and Service Company hereby accepts such engagement, subject at all times to the provisions of this Agreement. 
 2.2 Authority. Service Company shall have all power, authority, and responsibility reasonably necessary to provide the Services and carry out Service Company’s other obligations under
this Agreement. Without limiting the foregoing, Service Company shall have the authority to provide the Services in any reasonable manner Service Company deems appropriate to meet the day-to-day requirements of the business functions of Provider.
Provider shall give Service Company 30 days prior written notice of Provider’s intent to execute any agreement obligating Provider to perform Dental Care or otherwise creating a binding legal obligation on Provider. Unless an expense is
expressly designated as a Service Company Expense in this Agreement, all expenses incurred by Service Company in providing Services pursuant to this Agreement shall be Clinic Expenses. 
 2.3 Patient Referrals. The Parties agree that the benefits to Provider hereunder do not require, are not payment for, and are not
in any way contingent upon the referral, admission, treatment, or any other arrangement for the provision of any item or service offered by Service Company to patients of Provider in any facility, laboratory, or dental care operation controlled,
managed, or operated by Service Company. Likewise, the Parties agree that Service Company is not engaging, does not intend to engage, and is not required to engage in any referrals of patients to Provider or any similar activities, and neither the
Service Fee nor any other amount paid to Service Company by Provider pursuant to this Agreement is being paid as consideration for or in connection with any such activities. 
 2.4 Internal Management of Provider. Matters involving the tax planning, investment planning, and internal management, control, or finances of Provider, including without limitation the
compensation of dentists employed or retained by Provider, shall remain the sole and exclusive responsibility of Provider and its members. 
 The operations of Northland and the Subsidiaries, as Provider under this Agreement, shall to the extent practicable be treated as one operation for purposes of this Agreement, including without limitation for purposes
of budgeting. Northland and the Subsidiaries shall be jointly and severally liable for all of Provider’s obligations to Service Company under this Agreement. However, Northland shall have the sole responsibility and authority for all decisions,
consents, appointments, and other actions (hereinafter simply “actions”) to be made, taken, or given by Provider pursuant to or in connection with this Agreement, and each Subsidiary hereby irrevocably appoints Northland as such
Subsidiary’s attorney-in-fact and agent, with full power of substitution, to take all such actions without any further involvement of such Subsidiary. All such actions shall be binding on the Subsidiaries, and Service Company shall have the
absolute right to rely on all such actions taken by Northland. 
  

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 2.5 Practice of Dentistry. The Parties acknowledge and agree that:
(a) Service Company is not authorized or qualified to engage in any activity that may be construed or deemed to constitute the practice of dentistry; and (b) notwithstanding anything in this Agreement to the contrary: (i) Provider,
through its dentists, shall be solely responsible for and shall have complete authority, responsibility, supervision, and control over the provision of all Dental Care and that all Dental Care shall be provided and performed exclusively by or under
the supervision of dentists as such dentists, in their sole discretion, deem appropriate, consistent with applicable law; (ii) Service Company shall not have or exercise any control or supervision over the provision of Dental Care; and
(iii) to the extent any act or service required of Service Company under this Agreement is reasonably likely to be construed by a court of competent jurisdiction or by any applicable governmental agency to constitute the practice of dentistry,
the requirement to perform that act or service by Service Company shall be deemed waived and unenforceable. For purposes of this Agreement and as the context permits, the term “dentist” shall be deemed to include those individuals licensed
by the Minnesota Board of Dentistry to practice general dentistry or a dental care specialty such as orthodontics, endodontics, periodontics, prosthodontics, pediatric dentistry, oral surgery, public health dentistry, and oral pathology. 

ARTICLE III 
 POLICY BOARD

 3.1 Formation and Operation of Policy Board. The Parties hereby establish a policy board (the “Policy
Board”) which shall be responsible for developing and implementing management and administrative policies for the overall operation of Clinics, subject to Section 3.3, below. The Policy Board shall initially consist of six members, of
which three members shall be designated by Service Company, in its sole discretion, and three members shall be designated by Provider, in its sole discretion; provided that, unless otherwise agreed by the Parties the Policy Board members designated
by Provider shall be licensed dentists employed by Provider. Each Party shall have the right to designate, remove, and replace its Policy Board designees at any time and from time to time upon notice to the other Party. 
 Any decision made by a Party’s Policy Board representatives shall be binding on that Party. Except as may otherwise be expressly
provided in this Agreement or any rules, bylaws, or regulations adopted by the Policy Board, the act of a majority of the members of the Policy Board shall be the act of the Policy Board. The Policy Board’s decisions may be evidenced by either
minutes of a Policy Board meeting or written action taken by the Policy Board members making the decision; provided that no written action signed by less than all of the Policy Board members shall be effective unless notice of such action is given
to each Policy Board member who is not signing such action at least two business days prior to the effective date of such action. The decisions, resolutions, actions or recommendations of the Policy Board within its authority shall be implemented by
Service Company or Provider, as appropriate. 
 The Policy Board shall hold regular meetings at such places and at such times
(not less often than quarterly) as the Policy Board may determine from time to time. Special Policy Board meetings may be called by either Party or any two Policy Board members; provided that notice of any meeting which is not a regularly scheduled
meeting shall be given to all Policy Board members at least five business days prior to the meeting, unless such notice is waived by the Policy Board members. Policy Board meetings may be held through the use of remote communications equipment so
long as all members can participate with each other clearly during the meeting. 
  

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 3.2 Responsibilities of the Policy Board. The Policy Board shall have the
following duties, responsibilities, and authority: 
 (a) Capital Improvements and Expansion. Any
renovation and expansion plans and capital equipment expenditures with respect to Clinics shall be reviewed and approved by the Policy Board and shall be based upon economic feasibility, dentist support, productivity, and then-current market
conditions. 
 (b) Annual Budgets. All annual capital and operating budgets prepared in accordance with
Section 4.13(a) by Service Company (in consultation with Provider) shall be subject to the review, comment, and approval of the Policy Board. Notwithstanding the foregoing sentence, such budgets shall be subject to the review, comment, and
approval of Parent. 
 (c) Marketing and Advertising. All advertising and other marketing of the dental
services performed at any Clinic shall be subject to the prior review and approval of the Policy Board. 
 (d)
Patient Fees; Collection Policies. Subject to Section 3.3, as a part of the annual operating budget, in consultation with Provider and Service Company, the Policy Board shall review and make recommendations concerning the fee schedules
and collection policies for all dental and ancillary services rendered by Provider. Approval of the fee schedules shall be a Dental Decision. 
 (e) Provider and Payor Relationships. Subject to Section 3.3: (i) decisions regarding the establishment or maintenance of contractual relationships between Provider and outside
or institutional dental care providers and third-party payors shall be subject to the review and recommendations of the Policy Board; and (ii) all discounted fee practices and schedules, including individual provider or specialty discount
arrangements, preferred provider organization discounts and capitated fee arrangements, shall be subject to the review and recommendations of the Policy Board. Where there is no clear methodology for the allocation of capitated fees among
Provider’s Dental Care Professionals, the Policy Board shall recommend the methodology intended to result in the equitable and appropriate allocation of all related fees consistent with the type and utilization of Dental Care covered under the
capitation arrangement. 
 (f) Strategic and Operational Planning. The Policy Board shall review and
approve the long-term strategic and short-term operational goals, objectives and plans developed by Service Company. 
 (g) Capital Expenditures. The Policy Board shall determine the priority of major capital expenditures. Notwithstanding the preceding sentence or any other provisions of this Agreement to the contrary, all capital expenditures must be
approved by Parent. 
 (h) Personnel Planning. The Policy Board shall review and approve personnel
manpower plans for Provider and Clinic-level support personnel developed by Service Company. 
  

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 (i) Risk Management. The Policy Board shall cause to be developed
and implemented claims reporting procedures intended to ensure timely reporting to each Party of all patient claims made against either Party or its employees or independent contractors, as well as procedures for the timely review and monitoring of
such claims, including without limitation reporting the resolution of such claims, including any Provider reimbursement decisions (collectively, the “Risk Management Procedures”); provided that any Dental Care related patient concern or
claims reimbursement decision shall be a Dental Decision. 
 (j) Environmental Health and Safety. The
Policy Board shall review, approve and monitor environmental and workplace health and safety guidelines, the goal of which is to achieve compliance with current national, state and local laws and regulations regarding environmental and workplace
health and safety. 
 (k) Emergency Care Services. The Policy Board shall review, approve and
periodically make suggestions for improving (i) the organization and delivery of emergency Dental Care by Provider, and (ii) the process and guidelines for ensuring an appropriate response by Provider to dental and in-Clinic medical
emergencies as they may occur from time to time. 
 (l) Financial Review. The Policy Board shall review
and monitor the financial performance of Provider with respect to the attainment of its budgeted goals. 
 (m)
Provider Acquisitions. The Policy Board shall have the authority to approve or disapprove any merger or combination with or acquisition of any dental practice by Provider. 
 (n) Other. The Policy Board shall have such other duties, responsibilities, and authority as may be set forth in
this Agreement or agreed upon by the Parties from time to time. 
 3.3 Dental Decisions. Notwithstanding the preceding
section or any other provisions of this Agreement to the contrary, all Dental Decisions (defined below) shall be made solely by the dentist members of the Policy Board; provided that non-dentist members of the Policy Board may participate in the
related analysis and discussion. For purposes of this Agreement, “Dental Decisions” shall mean decisions relating directly to: (a) types and levels of Dental Care to be provided and methodologies and techniques for the provision of
Dental Care; (b) recruitment of dentists for Provider, including the evaluation of the background, experience, qualifications, specialties, and other credentials of such recruited individuals; (c) fee schedules for Provider’s
services, including without limitation Provider’s usual and customary fee schedule; (d) to the extent required by applicable law, third party payor contracting; and (e) any other Dental Care related functions or decisions agreed upon
by the Parties. 
 ARTICLE IV 
 RESPONSIBILITIES OF SERVICE COMPANY 
 During the Term, Service Company shall provide all such
Services as are necessary and appropriate for the day-to-day administration of the business aspects of Provider’s operations, including without limitation those services set forth in this Article, provided that all such services shall be
subject to the applicable Budget. 
 4.1 Clinics 
 (a) Service Company shall lease, acquire or otherwise procure Clinics at such locations as are approved by the Policy
Board, taking into consideration the professional concerns of Provider. The expenses associated with any such leasing, acquisition, or procurement shall be Clinic Expenses. Any Clinic procured by Service Company for use by Provider shall be procured
at commercially reasonable rates. Any move from a present Provider practice location shall be made only after Service Company has received Provider Consent. 
  

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 (b) In the event Provider is the lessee of a Clinic under a lease with an
unrelated and nonaffiliated lessor, Service Company may require Provider to assign such lease to Service Company upon receipt of consent from the lessor. Provider shall exercise all reasonable efforts to assist in obtaining the lessor’s consent
to the assignment. Any expenses incurred in the assignment shall be Clinic Expenses. 
 (c) Service Company
shall be responsible for the repair and maintenance of each Clinic, in a manner consistent with Service Company’s responsibilities under the terms of any lease or other use arrangement relating to that Clinic, the costs and expenses of which
shall be a Clinic Expense; provided that the costs and expenses of any repairs or maintenance necessitated by the negligence or willful misconduct of dentists or other personnel employed or otherwise retained by Provider shall be a Provider Expense,
but one that is ignored for purposes of calculating the Calculated Margin and that therefore must be paid out of the Provider Retained Earnings. 
 4.2 Equipment 
 (a) Service Company shall provide all non-dental
equipment, fixtures, office supplies, furniture and furnishings deemed reasonably necessary by Service Company for the operation of each Clinic and reasonably necessary for the provision of Dental Care. 
 (b) Service Company shall provide, finance, or cause to be provided or financed such dental related equipment as is
reasonably required by Provider. Provider shall have final authority in all dental equipment selections, subject to economic feasibility as set forth in the budgets approved pursuant to this Agreement. Service Company may, however, advise Provider
on the relationship between its dental equipment decisions and the overall administrative and financial operations of the Clinics. Except for Special Dental Supplies, all dental and non-dental equipment acquired for the use of Provider shall be
owned by Service Company. 
 (c) Service Company shall be responsible for repairing, maintaining, and keeping
in reasonably good condition (ordinary wear and tear excepted), and replacing (as necessary), all equipment provided by Service Company under this Agreement, ordinary wear and tear excepted, the cost and expense of which shall be a Clinic Expense;
provided that the costs and expenses of any repairs, maintenance and replacement necessitated by the negligence or willful misconduct of dentists or other personnel employed or otherwise retained by Provider shall be a Provider Expense, but one that
is ignored for purposes of calculating the Calculated Margin and that therefore must be paid out of the Provider Retained Earnings. 
 4.3 Laboratory Services. Unless otherwise prohibited by federal or state law, Service Company shall arrange for laboratory services (consistent with the requirements of applicable law), including without limitation dental appliance
laboratory service, pathology laboratory service, medical laboratory service, and such other laboratory services as are reasonably necessary and appropriate for the operation of each Clinic and the provision of Dental Care therein. 
 4.4 Supplies. Service Company shall order, procure, purchase, own, and provide to Provider a reasonable inventory of Ordinary
Dental Supplies and office supplies as are reasonably necessary and appropriate for the operation of each Clinic and the provision of Dental Care therein. Unless otherwise prohibited by federal or state law, Service Company shall also order,
procure, purchase and 

  

 6 








 
provide on behalf of and as agent for Provider all reasonable Special Dental Supplies required by Provider to provide Dental Care, the cost of which shall be
a Clinic Expense. Service Company shall exercise commercially reasonable efforts to ensure that each Clinic is at all times adequately stocked with all such supplies. The ultimate oversight, supervision and ownership of (a) all office and
Ordinary Dental Supplies is and shall remain the sole responsibility of Service Company, and (b) all Special Dental Supplies is and shall remain the sole responsibility of Provider. 
 4.5 Capital Investment. Access to all needed working capital and capital expenditures approved by the Policy Board will be
provided by Service Company. Service Company shall determine the source of capital to be invested, which may include (a) inter-company borrowings from Parent, and (b) borrowings, leases, or other financing methods through independent
third-party financial institutions. 
 4.6 Support Services. Service Company shall provide or arrange for all
printing, stationery, forms, postage, duplication, facsimile, photocopying, and data transmission and processing services, information services (including providing a computer system for clinic functions, billing, communications, and management),
and other support services as are reasonably necessary and appropriate for the operation of each Clinic and the provision of Dental Care therein. 
 4.7 Quality Assurance, Risk Management, and Utilization Review. Service Company shall assist Provider in Provider’s establishment and implementation of procedures to ensure the consistency, quality,
appropriateness, and necessity of Dental Care provided by Provider, and shall provide administrative support for Provider’s overall quality assurance, risk management, and utilization review programs. Service Company shall have the authority to
monitor Provider’s level of conformance with such procedures and to report its findings to Provider. 
 4.8 Licenses
and Permits. Although Provider shall be solely responsible for obtaining and maintaining all federal, state, and local licenses and regulatory permits required for or in connection with the operation of Provider and in connection with the
operation of all dental equipment located in each Clinic, Service Company shall assist Provider with the implementation of a plan designed to ensure that all such licenses and permits are obtained and shall provide reasonable assistance to Provider
in obtaining the same. Service Company also shall maintain all licenses and permits required for all equipment (existing and future) located at each Clinic. 
 4.9 Personnel. Except as provided in Section 5.2(d) of this Agreement and subject to Section 3.3: (a) Service Company shall employ or otherwise retain and shall be
responsible for recruiting, hiring, and terminating all management, administrative, supervisory, clerical, secretarial, bookkeeping, accounting, and payroll personnel, laboratory technicians and personnel, dental hygienists, dental assistants, and
other non-dentist personnel as Service Company deems necessary and appropriate for Service Company’s performance of its duties and obligations under this Agreement; and (b) the selection, training and supervision of all such personnel to
be employed by Service Company shall be the responsibility of Service Company. Consistent with reasonably prudent personnel management policies, Service Company shall seek and consider the advice, input, and requests of Provider in regard to
personnel matters. Service Company shall have sole responsibility for determining the salaries and fringe benefits of such non-professional personnel and for withholding all appropriate amounts for income taxes, unemployment insurance, social
security, workers’ compensation, and any other withholding required by applicable law. 
  

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 4.10 Contract Negotiations. Subject to Section 3.2(e), above, Service Company
shall advise Provider with respect to and negotiate, either directly or on Provider’s behalf, as appropriate, such contractual arrangements with third parties as are reasonably necessary and appropriate for Provider’s provision of Dental
Care, including without limitation negotiated price agreements with third party payors, alternative delivery systems, or other purchasers of group dental care services; provided that no contract or arrangement regarding the provision of Dental Care
shall be entered into without Provider Consent. 
 4.11 Billing and Collection. On behalf of and for the account of
Provider, Service Company shall establish and maintain credit and billing and collection policies and procedures, and shall exercise reasonable efforts to bill and collect in a timely manner (and to the extent permitted by applicable law) all
professional and other fees for all billable Dental Care provided by Dental Care Professionals. Service Company shall advise and consult with Provider regarding the fees for Dental Care provided by Provider (including any related discounting
policy), it being understood, however, that Provider shall establish the fees (subject to Section 3.2(d), above) to be charged for Dental Care and that Service Company shall have no authority whatsoever with respect to the establishment of such
fees. In connection with the billing and collection services to be provided hereunder, Provider hereby grants to Service Company, to the extent permitted by applicable law, throughout the Term (and thereafter as provided in Section 8.3), an
exclusive special power of attorney and appoints Service Company, to the extent permitted by applicable law, as Provider’s exclusive true and lawful agent and attorney-in-fact, and Service Company hereby accepts such special power of attorney
and appointment, for the following purposes: 
 (a) To bill Provider’s patients, in Provider’s name
and on Provider’s behalf, for all billable Dental Care provided by or on behalf of Provider to patients. 
 (b) To bill, in Provider’s name and on Provider’s behalf, all claims for reimbursement or indemnification from insurance companies and plans, all state or federally funded dental benefit plans, and all other third party payors or
fiscal intermediaries for all covered billable Dental Care provided by or on behalf of Provider to patients. 
 (c) To collect and receive, in Provider’s name and on Provider’s behalf, all accounts receivable generated by such billings and claims for reimbursement, to administer such accounts including, but not limited to, extending the
time of payment of any such accounts for cash, credit or otherwise; discharging or releasing the obligors of any such accounts; suing, assigning or selling at a discount such accounts to collection agencies; or taking other measures to require the
payment of any such accounts; provided, however, that extraordinary collection measures, such as filing lawsuits, discharging or releasing obligors, or assigning or selling accounts at a discount to collection agencies shall not be undertaken
without Provider Consent. 
 (d) To deposit all amounts collected into the Provider Account which shall be and
at all times remain in Provider’s name. Provider shall transfer and deliver to Service Company all funds received by Provider from patients or third party payors for Dental Care. Upon receipt by Service Company of any funds from patients or
third party payors or from Provider for Dental Care pursuant to this Agreement, Service Company shall promptly deposit the same into the Provider Account. 
  

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 (e) To take possession of, endorse in the name of Provider, and deposit
into the Provider Account any notes, checks, money orders, insurance payments, and any other instruments received in payment of accounts receivable for Dental Care. 
 (f) To sign checks, drafts, bank notes or other instruments on behalf of Provider, and to make withdrawals from the
Provider Account for payments specified in this Agreement and as requested from time to time by Provider. 
 (g) To designate, remove, and change such signatories on the Provider Account as Service Company deems necessary or appropriate from time to time. 
 Upon request of Service Company, Provider shall execute and deliver to the financial institution at which the Provider Account is maintained such additional documents or instruments as Service
Company may reasonably request to evidence or effect the special power of attorney granted to Service Company by Provider pursuant to this section and Section 4.12. The special power of attorney granted herein is coupled with an interest and
shall be irrevocable except with Service Company’s written consent. The irrevocable power of attorney shall expire when this Agreement has been terminated, all accounts receivable purchased by Service Company pursuant to Section 7.6, if
any, have been collected, and all amounts due to Service Company as described in Article VII have been paid. 
 4.12
Provider Account 
 (a) Power of Attorney. Service Company shall have access to the Provider
Account solely for the purposes stated herein and shall use all funds on deposit therein in accordance with the terms of this Agreement. Provider hereby grants to Service Company an exclusive special power of attorney and appoints Service Company as
Provider’s true and lawful agent and attorney-in-fact, throughout the Term (and thereafter as provided in Section 8.3), and Service Company hereby accepts such special power of attorney and appointment, to make withdrawals from the
Provider Account for: (i) payments described in this Agreement; and (ii) such other purposes as Service Company deems appropriate (consistent with this Agreement), including without limitation daily transfers to one or more accounts owned
by Service Company or its affiliates as part of cash management procedures established or adopted by Service Company or its affiliates from time to time; provided that to the extent that the aggregate funds withdrawn by Service Company from the
Provider Account pursuant to this section (the “Aggregate Withdrawals”) exceed the aggregate amounts paid or payable to Service Company under this Agreement (the “Aggregate Payments”), then such excess shall be deemed to be held
by Service Company as agent for Provider. Notwithstanding this exclusive special power of attorney, Provider may, upon reasonable advance notice to Service Company, request that Service Company draw checks on the Provider Account for Provider
Expenses and such other amounts as may be due to Provider under this Agreement, subject to Section 4.12(b) of this Agreement. 
 (b) Priority of Payments. Payments described in this Agreement to be made from funds in the Provider Account shall be applied (to the extent available) in the following order of priority: 
  

	 	(i)	 Reimbursement of Clinic Expenses to Service Company pursuant to Section 7.1; 


  

 9 









	 	(ii)	 Repayment of advances made by Service Company to Provider pursuant to Section 7.2; 


  

	 	(iii)	 Payment of the Service Fee to Service Company pursuant to Section 7.3; 


  

	 	(iv)	 Payment of Provider Expenses other than those to be paid out of Provider Retained Earnings; and 


  

	 	(v)	 Payment of remaining Provider Expenses and, to the extent requested by Provider, distribution of the remaining Provider Retained Earnings.



 (c) Further Assurances. Promptly upon request by Service Company, Provider shall
execute a separate power of attorney in form reasonably satisfactory to Service Company for the purpose of further confirming or evidencing the rights granted to Service Company under Sections 4.11 and 4.12. 
 4.13 Financial Matters 
 (a) Annual Budget. At least 30 days prior to the commencement of each calendar year, Service Company, in consultation with Provider, shall prepare and deliver to the Policy Board for its
review and approval a proposed Budget, setting forth an estimate of Provider’s revenue and expenses for the upcoming calendar year (including without limitation the Service Fee associated with the services provided by Service Company
hereunder). 
 In the event that a proposed Budget is not approved by either the Policy Board or Parent
(pursuant to Section 3.2(b)), Service Company, in consultation with Provider, shall promptly revise such Budget, taking into consideration the comments of the Policy Board or Parent, as applicable, and shall deliver such revised Budget to the
Policy Board for approval. In the event that a proposed Budget has not been approved by both the Policy Board and Parent by the beginning of the calendar year, then, until a new Budget has been approved by both the Policy Board and Parent, the
Budget for the prior year shall be deemed to be adopted as the Budget for the then-current year except that (i) the Budget for Clinic Expenses shall be adjusted to account for any changes beyond the reasonable control of Service Company,
including without limitation changes in laboratory fees or supply costs and automatic increases in rent or other occupancy costs, (ii) Service Company shall have the right to adjust the Budget for reasonable compensation increases for its
employees, for changes in employee benefits or related costs, and for expenses related to new employees reasonably necessary for Service Company to perform the Services, and (iii) the Budget for capital expenditures shall include only
expenditures for maintenance or emergency needs and any other capital expenditures expressly approved by both the Policy Board and Parent from time to time. 
 Notwithstanding any provisions of this Agreement to the contrary, for purposes of all calculations related to the Service Fee for any period the amount of Provider Expense used in such
calculations for that period shall be determined by applying the methodology for compensating dentists and paying other budgeted Provider Expenses contained in the then-applicable Budget (e.g., if the Budget requires a dentist to be paid a base
salary, that salary shall be used for purposes of such calculations, and if the Budget requires that a dentist be paid formula-based compensation, that formula shall be used for purposes of such calculations); provided that the Parties shall
exercise reasonable efforts to adjust the Budget from time to time as necessary to 

  

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reflect changes in Provider’s staff of dentists and/or compensation and/or other budgeted Provider Expenses (it being understood that neither Party
shall be obligated to agree to Budget adjustments deemed by such Party to be unreasonable under the then-relevant circumstances). 
 (b) Accounting and Financial Records. Service Company shall establish and administer accounting policies and procedures, internal controls, and systems for the development, preparation and safekeeping of
administrative or financial records and books of account relating to the business and financial affairs of Provider, all of which shall be prepared and maintained in accordance with GAAP. Service Company shall prepare and deliver to Provider, within
45 days after the end of each of the first three calendar quarters during each year and within 90 days after the end of each calendar year, a balance sheet and an income statement reflecting the financial status of Provider in regard to the
provision of Dental Care as of the end of each such calendar quarter and each such calendar year, as applicable, all of which shall be prepared in accordance with GAAP. In addition, Service Company shall prepare or assist in the preparation of any
other financial statements or records as Provider may reasonably request. 
 (c) Review of
Expenditures. One of Provider’s representatives to the Policy Board shall review all expenditures related to the operation of Provider, but such representative shall not have the power to prohibit or invalidate any expenditure. 

(d) Tax Matters 
 (i) General. Service Company shall prepare or arrange for the preparation of all tax returns and reports of Provider required by applicable law, which returns and reports shall be prepared
by an accountant reasonably acceptable to Provider. 
 (ii) Sales and Use Taxes. Service Company and
Provider acknowledge and agree that to the extent that any of the services to be provided by Service Company hereunder may be subject to any state sales and use taxes, Service Company may have a legal obligation to collect such taxes from Provider
and to remit the same to the appropriate tax collection authorities. Provider agrees to pay any and all applicable state sales, use, gross receipts, and other similar taxes and charges (other than taxes on Service Company’s net income) with
respect to any amount paid to Service Company hereunder and that such amounts shall be a Clinic Expense. 
 4.14 Reports
and Records 
 (a) Dental Records. Service Company shall establish, monitor and maintain procedures
and policies for the timely creation, preparation, filing and retrieval of all dental records generated by Provider in connection with Provider’s provision of Dental Care; and, subject to applicable law, shall ensure that dental records are
promptly available to dentists and any other appropriate persons. All such dental records shall be retained and maintained in accordance with all applicable state and federal laws relating to the confidentiality and retention thereof. 
 (b) Other Reports and Records. Service Company shall timely create, prepare, and file such additional reports and
records as are reasonably necessary and appropriate for Provider’s provision of Dental Care and shall analyze and interpret such reports and records upon the reasonable request of Provider. 
  

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 4.15 Recruitment of Provider Dentists. Upon Provider’s request, Service
Company shall perform all services reasonably necessary and appropriate in connection with the recruitment of dentists. Service Company shall provide Provider with model agreements to document Provider’s employment, retention or other service
arrangements with such individuals. However, it shall be and remain the sole and complete responsibility of Provider to interview, select, contract with (subject to Section 5.2, below), supervise, control and terminate all dentists performing
Dental Care or other professional services, and Service Company shall have no authority whatsoever with respect to such activities. 
 4.16 Service Company’s Insurance. Throughout the Term, Service Company shall, as a Clinic Expense, obtain and maintain with commercial carriers, or through self-insurance, or some combination thereof: (a) appropriate
worker’s compensation coverage for the employees of Service Company provided pursuant to this Agreement; and (b) professional, casualty and comprehensive general liability insurance covering Service Company, Service Company’s
personnel, and all of Service Company’s equipment in such amounts and on such terms and conditions as Service Company deems appropriate. Service Company shall cause Provider to be named as an additional insured on Service Company’s
property and casualty insurance policies. Upon the request of Provider, Service Company shall provide Provider with a certificate evidencing such insurance coverage. Service Company may also carry, at Service Company’s option and as a Clinic
Expense, key person life and disability insurance on any member or dentist employee of Provider in amounts determined to be reasonable and sufficient by Service Company. Service Company shall be the owner and beneficiary of any such insurance.

 4.17 License of Name and Marks. Service Company hereby grants to Provider, for the Term, a non-exclusive
royalty-free license to use the Approved Names (as defined in Section 5.8) and all related marks and logos owned by Service Company for the purpose of fulfilling its obligations hereunder, including without limitation providing Dental Care to
its patients (it being understood and agreed that Service Company or one of its affiliates owns such names, marks and logos). 
 4.18 No Warranty. Provider acknowledges that Service Company has not made and will not make any representations or warranties, express or implied, regarding Service Company’s services under this Agreement or the results of those
services, including without limitation any representations or warranties that the Services will result in any particular amount or level of dental practice or income to Provider. 
  

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 ARTICLE V 
 RESPONSIBILITIES OF PROVIDER 
 5.1 Organization and Operations. As a
continuing condition of Service Company’s obligations under this Agreement, Provider shall at all times during the Term: (a) be and remain legally organized and operated to provide Dental Care in a manner consistent with all state and
federal laws; (b) operate and maintain within the Practice Territory a full time practice of dentistry providing Dental Care in compliance with all applicable federal, state, and local laws, rules, regulations, ordinances, and orders;
(c) maintain and use its best efforts to enforce its articles or certificate of incorporation (or other instrument of organization), bylaws, member control agreements, and other organizational documents (hereafter in this Section 5.1
simply “organizational documents”) in the respective forms provided to Service Company prior to execution of this Agreement; (d) have at least one executive officer at the level of vice president or above who is also an active
practicing dentist employee of Provider; (e) maintain and use its best efforts to enforce the written employment agreements and independent contractor agreements described in Section 5.2(a), below; and (f) not, without Service Company
Consent, (i) amend any of its employment agreements or organizational documents in any material respect or waive any material rights thereunder, or (ii) engage in any transaction constituting a merger, consolidation, reorganization, sale
or purchase of assets outside of the ordinary course of business, liquidation, or dissolution. Provider hereby acknowledges that Service Company would not have entered into this Agreement but for Provider’s covenant to maintain such
organizational documents and employment agreements, and Provider shall pay to Service Company, in addition to the amounts set forth in Article VII, any damages, compensation, payment, or settlement amounts received by Provider from a dentist who
receives consideration directly or indirectly from Service Company or Parent as an inducement to become or remain affiliated with Service Company through his employment by Provider and who thereafter terminates his employment agreement in violation
thereof or whose employment agreement is terminated by Provider for cause. 
 5.2 Provider Personnel 
 (a) Dentist Personnel. Provider shall retain, as a Provider Expense and not as a Clinic Expense, that number of
dentists during the Term which are necessary and appropriate, in Provider’s sole discretion, to provide Dental Care to reasonably meet the demand therefor. Provider shall cause each dentist retained by Provider to hold and maintain a valid and
unrestricted license to practice dentistry in the State of Minnesota, including without limitation any licenses required for the provision of any specialty dental services, together with all necessary or appropriate board or other certifications.
Provider shall be responsible for paying the compensation and benefits, as applicable, for all dentists and any other dentist personnel or other contracted or affiliated dentists, and for withholding all sums for income tax, unemployment insurance,
social security, or any other withholding required by applicable law. Service Company may, on behalf of Provider, administer the compensation and benefits with respect to such individuals in accordance with the written agreement between Provider and
each dentist. Service Company shall neither control nor direct any dentist in the performance of Dental Care for patients. Provider shall provide to Service Company evidence of such licensing, certifications, and other credentials of the dentists
retained by Provider as Service Company may request from time to time. 
 (b) Provider and Patient
Scheduling. Provider shall, with the reasonable assistance of Service Company: (i) develop a set of Provider and patient scheduling guidelines and a corresponding scheduling system; and (ii) support Service Company in the
implementation of such guidelines and effective operation of such system. 
  

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 (c) Paid Hours Reporting. Provider shall support the development
and effective operation by Service Company of a system to monitor and report hours of dental service provided. 
 (d) Non-Dentist Dental Care Personnel. Notwithstanding any other provision of this Agreement to the contrary, all non-dentist personnel who provide Dental Care, including without limitation dental hygienists, dental assistants and
other clinical staff (whether licensed or unlicensed), and other licensed or certified personnel, shall be under such control, supervision and direction of Provider and the dentists retained by Provider in the performance of or in connection with
Dental Care for patients as is required under applicable state law and regulations. 
 5.3 Professional Standards. As
a continuing condition of Service Company’s obligations hereunder, each dentist retained by Provider to provide Dental Care must: (a) have and maintain a valid and unrestricted license to practice dentistry in the State of Minnesota; and
(b) comply with, be controlled and governed by, and otherwise provide Dental Care in accordance with applicable federal, state, and municipal laws, rules, regulations, ordinances and orders, and the ethics and standard of care of the dental
profession. All specialty Dental Care shall be provided by a dentist who is either board certified or board eligible in that specialty or by another dentist licensed to provide such specialty Dental Care operating under the general supervision of a
dentist who is either board certified or board eligible in that specialty. 
 5.4 Dental Care. Subject to Service
Company’s responsibilities under §4.9 of this Agreement, Provider shall ensure that dentists are available in sufficient numbers as are necessary or appropriate to provide Dental Care to reasonably meet the demand for such Dental Care. In
addition, Provider shall provide advice, input, and requests to Service Company for its consideration with respect to the recruiting and staffing of dental hygienists and other licensed or unlicensed non-dentist dental care personnel (including
unlicensed dental assistants and other clinical staff) necessary or appropriate to provide Dental Care to reasonably meet the demand for such Dental Care. In the event that dentists employed by, or members of, Provider are not available to provide
Dental Care coverage, Provider shall engage and retain dentists on a temporary coverage basis, which dentists shall meet or exceed the qualifications required for Provider’s Dental Care Professionals under this Agreement. All costs and expenses
associated with the retention of such temporary coverage shall be Provider Expenses. With the assistance of the Service Company, Provider and the dentists shall be responsible for scheduling dentist and non-dentist dental care personnel coverage of
all dental procedures. Provider shall cause all dentists to exert their best efforts to develop and promote Provider in such a manner as to ensure Provider is able to serve the diverse needs of the community. Provider shall organize and maintain a
high quality, cost-effective process for ensuring that patients will have timely access to emergency Dental Care on a 24-hour per day, seven day per week basis. 
 5.5 Peer Review and Quality Assurance. Provider shall conduct its peer review and quality assurance activities in a manner that is consistent with maintaining the confidentiality of the
related processes, actions, and documentation. 
 (a) Provider shall designate a committee of dentists to
function as a dental peer review committee to review credentials of potential dentist recruits, periodically review the credentials of Provider’s existing dentists, determine the practice privileges of the dentists retained by Provider, perform
quality assurance, utilization review, and Provider profiling functions, and otherwise 

  

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resolve dental competency issues. The dental peer review committee shall function pursuant to formal written policies and procedures established by Provider
upon consultation with and assistance of Service Company. 
 (b) Provider also shall adopt a quality assurance
program to monitor and evaluate the quality and cost-effectiveness of the Dental Care provided by Provider’s dentists and by non-dentist personnel providing Dental Care under the supervision of Provider’s dentists. Upon request of
Provider, Service Company shall provide administrative assistance to Provider in performing its quality assurance activities. All costs and expenses incurred in connection with this Section 5.5(b) shall be deemed Clinic Expenses. 
 (c) Provider shall cooperate fully with Service Company in an effort to achieve and maintain full accreditation status for
Provider. For purposes of facilitating accreditation and other related processes and without limiting Provider’s responsibilities under the preceding sentence, subject to Section 3.3, Provider shall (i) develop and maintain a
philosophy of practice and a set of practice guidelines which are reasonably acceptable to the Policy Board, and (ii) cause all personnel retained by it to abide by such philosophy and guidelines at all times. 
 (d) Provider shall support the Risk Management Procedures implemented pursuant to this Agreement, and shall take all
actions related to such Risk Management Procedures as may be reasonably requested by Service Company. Provider shall cause all personnel retained by it to comply fully with such process at all times. 
 (e) Provider shall, with the assistance of Service Company, develop a set of quality standards and utilization, process
monitoring, and reporting guidelines. Provider shall cause all personnel retained by it to comply with such standards and guidelines. 
 (f) Provider shall, with the assistance of Service Company, develop patient grievance procedures to the extent not specifically addressed in this Agreement. Provider shall cause all personnel retained by it to comply
with such procedures. 
 5.6 Provider’s Insurance. 
 (a) Provider shall obtain and maintain with commercial carriers reasonably acceptable to Service Company or through self
insurance or some combination thereof (reasonably acceptable to Service Company) appropriate workers’ compensation coverage for Provider’s employed personnel (which, with respect to dental hygienists and other non-dentist licensed dental
personnel employed by Provider, shall be a Clinic Expense, and which, with respect to all other employees of Provider, including without limitation dentists, shall be a Provider Expense) and professional liability and comprehensive general liability
insurance covering Provider and each of the dentists, dental hygienists, and other licensed dental personnel Provider retains to provide Dental Care (which, including any applicable deductibles, shall be a Clinic Expense). All costs, expenses, and
liabilities incurred by Provider or Service Company in excess of the limits of such policies shall be a Provider Expense. Provider shall actively support the participation of all dentists, dental hygienists, and other licensed dental personnel
retained by Provider in training and continuing education programs in order to reduce the risk of exposure to and the related cost of obtaining and maintaining such coverage. The comprehensive general liability coverage and professional liability
coverage shall be in such 

  

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minimum amounts and with such deductibles as Service Company may establish from time to time. In addition, Provider shall cause each dentist retained by
Provider as an independent contractor to obtain comparable professional and comprehensive general liability insurance coverage. 
 (b) All such insurance policies shall (a) name Service Company as an additional insured and with respect to policies provided by independent contractors under the preceding sentence, name Provider as additional
insured as well, and (b) provide for at least 30 days advance written notice to Provider and Service Company from the insurer with respect to any alteration of coverage, cancellation, or proposed cancellation for any reason. Provider shall
cause to be issued to Service Company by such insurer or insurers a certificate reflecting such coverage. 
 (c) Provider shall enter into employment or other agreements with all dentists employed or otherwise retained by Provider which provide, among other things, that (i) upon the termination of the employment or retention of any such
dentist, such dentist shall be required to (A) purchase, at such dentist’s expense, “tail” professional liability coverage meeting the requirements of this §5.6, including without limitation those relating to coverage
amounts and insureds, for an unlimited extended reporting period, or (B) obtain retroactive coverage meeting the same requirements from such dentist’s new employer, and (ii) if such dentist does not provide satisfactory evidence of
such coverage prior to such termination, Provider shall have the right, without limiting any other rights of Provider, to withhold the cost of the “tail” coverage described in the immediately preceding clause (i)(A) from any amounts owed
to such dentist by Provider and purchase such “tail” coverage on such dentist’s behalf; provided that if Provider does not have such agreements in place with dentists employed or otherwise retained by Provider as of the date of
execution of this Agreement, Provider shall not be in breach of this Agreement so long as it (1) exercises commercially reasonable efforts to enter into such agreements with the dentists currently employed or retained by Provider, and
(2) enters into such agreements with all new dentists employed or retained by Provider. 
 (d) Upon the
termination of this Agreement for any reason, Provider shall continue to carry professional liability insurance in the amounts specified in this §5.6 for 10 years after termination, or, if Provider dissolves or ceases to practice dentistry,
Provider shall obtain and maintain as a Provider Expense “tail” professional liability coverage in the amounts specified in this §5.6 for an unlimited extended reporting period. Provider shall be responsible for paying all premiums
for such “tail” insurance coverage. Notwithstanding the foregoing, if Provider fails to obtain such “tail” insurance coverage, Service Company shall have the right, without limiting any other rights of Service Company, to
purchase such coverage on Provider’s behalf out of funds otherwise owed to Provider under this Agreement. 
 (e) In no event shall a professional liability insurance carrier be replaced or changed without Service Company Consent. Service Company shall provide reasonable assistance to Provider to obtain the insurance coverages described in this
§5.6. 
 (f) Each Party shall, and shall cause it employees, agents, and other representatives to,
cooperate in all ways reasonably requested by the other Party in connection with the handling and disposition of claims covered by the insurance described in this §5.6. This requirement shall continue, notwithstanding any termination of this
Agreement, until all such claims have been resolved. 
  

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 5.7 Noncompetition. Provider acknowledges that Service Company will incur
substantial costs in providing the equipment, support services, personnel, and other items and services that are the subject matter of this Agreement and that in the process of providing services under this Agreement, Provider will learn or have
access to financial and other Confidential Information of Service Company to which Provider would not otherwise be exposed. Provider also recognizes that the services to be provided by Service Company will be feasible only if Provider operates an
active practice to which the dentists associated with Provider devote their full time and attention. Accordingly, Provider further agrees as follows: 
 (a) During the Term, except for any Clinic or other office or facility covered by this Agreement, Provider shall not establish, operate, or provide Dental Care at any dental office, clinic or
other dental care facility anywhere within the Practice Territory nor have any ownership interest, direct or indirect, in any entity, or participate in any joint venture, which operates any such office, clinic or facility; and 
 (b) Except as specifically approved by Service Company in writing, during the Term and for a period of five years
immediately following the date this Agreement is terminated for any reason, Provider shall not directly or indirectly own (excluding ownership of less than five percent (5%) of the equity of any publicly traded entity), manage, operate,
control, lend funds to, lend its name to, maintain any interest in, or otherwise enter into, engage in, or promote or assist (financially or otherwise) any entity, business, or enterprise which (i) provides, distributes, or promotes any type of
management or administrative services or products to third parties in competition with Service Company in the Practice Territory, or (ii) offers any type of service or product to third parties substantially similar to those offered by Service
Company to Provider in the Practice Territory. Notwithstanding the above restriction, nothing herein shall prohibit Provider or any of its members from providing management and administrative services to its or their own dental practices after the
termination of this Agreement, and nothing herein shall prohibit Provider or its members from contracting with a third party manager to provide administrative or management services for its or their dental practices after termination of this
Agreement as long as such relationship complies with the provisions of this section. 
 5.8 Use of Names. At all times
during the Term, Provider shall operate its dental practice under the names “Metro Dentalcare,” “Family Orthodontic Specialists,” “Metro Dentalcare Orthodontics,” Riverdale Family Orthodontics,” “Midway Family
Orthodontics,” “Woodlake Family Orthodontics,” “Burnsville Family Orthodontics,” Family Periodontic Specialists,” “Metro Dentalcare Periodontics,” “Family Pediatric Dental Specialists,” “Metro
Dentalcare Children’s Dentistry,” “Family Oral Surgery Specialists,” “Focus Dental Management,” Family Endodontics Specialists,” and “Merit Dental Lab” or such other trade name or names as may be agreed
upon by the Parties from time to time (all such names, the “Approved Names”), including without limitation using the related marks and logos as are licensed to Provider pursuant to Section 4.17, above. Provider shall file appropriate
assumed or fictitious name applications or registrations with all appropriate governmental agencies. Notwithstanding the preceding provisions of this section, Provider shall, immediately upon the expiration of the Term, abstain from using such
names, marks and logos and shall take such steps as are necessary to terminate such applications and registrations and Provider’s rights thereunder, except to the extent otherwise provided in Article VIII, below. 
  

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 ARTICLE VI 
 CONFIDENTIALITY 
 6.1 Confidential and Proprietary Information. Neither
Party shall, in any manner or at any time, directly or indirectly, disclose any of the Confidential Information of the other Party to any person, firm, association, organization, or entity, or use, or permit or assist any person, firm, association,
organization, or entity to use, any such Confidential Information, excepting only: (a) disclosures (i) required by law, as reasonably determined by the disclosing Party or its legal counsel, or (ii) made on a confidential basis to the
disclosing Party’s shareholders, directors, officers, employees (limited to those who need to know such Confidential Information), and legal, accounting, and other professional advisors (collectively, the “Permitted Recipients”); or
(b) use of such Confidential Information by Permitted Recipients in connection with this Agreement; provided that each Party shall (i) make its Permitted Recipients aware of the requirements of this Agreement, (ii) take reasonable
steps to prohibit disclosure of such Confidential Information by any Permitted Recipient to any other person or entity except another Permitted Recipient, including without limitation taking such steps as that Party customarily takes to protect its
own Confidential Information, and (iii) be responsible and liable for any disclosure or use of such Confidential Information by any of its Permitted Recipients, except disclosures or uses permitted by this Agreement. 
 6.2 Use of Practice Statistics. Notwithstanding Section 6.1, above, but subject to the restrictions of this section and
applicable law, Service Company or its affiliates may: (a) share with other professional corporations, associations, dental practices, or dental care delivery entities, or their representatives, the practice statistics and other information
relating to the operation of Provider’s dental practice, including utilization review data, quality assurance data, revenue and cost data, outcomes data, or other practice data or information, provided that such information shall only be
disclosed to (i) affiliates of Service Company, (ii) other dental groups with whom Service Company or any of its affiliates has a management or service relationship, (iii) managed care dental benefit providers and other third party
payors for the purpose of obtaining or maintaining third party payor contracts, (iv) financial analysts and underwriters, (v) employers and employee benefit associations, (vi) quality assurance and accrediting organizations, or
(vii) financial institutions; and (b) disclose all practice-related information necessary or desirable in connection with any public or private offering of any security of Service Company or any of its affiliates. In addition, subject to
the restrictions of this section and applicable law (including without limitation federal and state law and regulation relating to confidentiality), Service Company or its affiliates may disclose practice-related information and data in connection
with any survey, presentation, published material, study, or research project which Service Company deems appropriate for the purpose of gaining insight into existing and changing patterns in the organization and delivery of Dental Care and related
issues. In no event will any such data disclose or divulge the identity of any patient or, to the extent reasonably practicable, any dentist. 
 ARTICLE VII 
 FINANCIAL ARRANGEMENTS 
 7.1 Clinic Expense Reimbursement. Service Company shall be reimbursed for the amount of all Clinic Expenses incurred by Service Company. 
  

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 7.2 Repayment of Advances. Service Company shall be reimbursed for any and all
amounts advanced to Provider by Service Company pursuant to the terms and conditions of this Agreement. 
 7.3 Service
Fee. Provider and Service Company acknowledge and agree that the compensation set forth in this Article is being paid by Provider to Service Company in consideration of the substantial commitment being made by Service Company hereunder and that
such fee is fair and reasonable in all respects in consideration of (a) the services performed by Service Company hereunder, and (b) the capital being made available by Service Company. Service Company shall be paid by Provider an annual
Service Fee (determined on a calendar year basis) equal to 89% of the Calculated Margin, which shall be calculated and be earned and accrue daily, and shall be payable monthly. 
 7.4 Reasonable Value. Payment of the Service Fee is not intended to be and shall not be interpreted or applied as permitting Service Company to share in Provider’s fee for Dental Care
or any other services, but is the Parties’ negotiated agreement as to the reasonable fair market value of the equipment, contract analysis and support, other support services, purchasing, personnel, office space, management, administration,
strategic management, and other items and services furnished by Service Company pursuant to this Agreement, considering the nature and volume of the services required and the risks assumed by Service Company. Provider and Service Company acknowledge
that: (a) Service Company’s administrative expertise will contribute great value to Provider’s performance; (b) Service Company will incur substantial costs and business risks in arranging for Provider’s use of each Clinic
and in providing the equipment, support services, personnel, marketing, office space, management, administration, and other items and services that are the subject matter of this Agreement; and (c) certain of such costs and expenses can vary to
a considerable degree according to the extent of Provider’s business and services. It is the intent of the Parties that the Service Fee reasonably compensate Service Company for the value to Provider of Service Company’s administrative
expertise, given the considerable business risk to Service Company in providing the items and services that are the subject of this Agreement. 
 7.5 Payment. The amounts to be paid to Service Company under this Article shall be paid monthly. To facilitate the payments due to Service Company under this Article, Provider hereby expressly authorizes
Service Company to make withdrawals of such amounts from the Provider Account during the Term in accordance with Section 4.12(b), and after termination as provided in Section 8.3. 
 7.6 Accounts Receivable. To assure that Provider receives the entire amount of professional fees for its services and to assist
Provider in maintaining reasonable cash flow for the payment of Clinic Expenses, Service Company may, during the Term, purchase, with recourse to Provider for the amount of the purchase, the accounts receivable of Provider arising during the
previous month, except for any receivables due to Provider from Medicaid or any other governmental health care reimbursement program which Service Company is not permitted to receive under applicable law (the “Restricted Receivables”), by
transferring the amount set forth below into the Provider Account. The consideration for the purchase shall be an amount equal to the Adjusted Gross Revenue recorded each month, less the Adjusted Gross Revenue related to Restricted Receivables.
Service Company shall be entitled to offset Clinic Expense reimbursement plus all fees and advances due to Service Company under this Article against the amount payable for such accounts receivable. Although it is the intention of the Parties that
Service Company purchase and thereby become the owner of the accounts receivable of Provider, in the event such purchase shall be ineffective or prohibited for any reason, Provider hereby 

  

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grants to Service Company a security interest in the accounts receivable, to the extent permitted by applicable law, and Provider shall cooperate with
Service Company and execute all documents which may be reasonably requested by Service Company in connection with such security interest. All collections in respect of such accounts receivable purchased by Service Company shall be received by
Provider as the agent of Service Company and shall be endorsed to Service Company and deposited in a bank account at a bank designated by Service Company. To the extent Provider comes into possession of any payments in respect of such accounts
receivable, Provider shall direct such payments to Service Company for deposit in bank accounts designated by Service Company. 
 ARTICLE
VIII 
 TERM AND TERMINATION 
 8.1 Initial and Renewal Term. The Term of this Agreement shall be for an initial period of 39 years beginning on the date of this Agreement, and shall renew automatically for successive five-year periods
thereafter unless and until either Party gives notice to the other Party at least 120 days prior to the expiration of the then-current term of its intent to terminate this Agreement at the end of the then-current term or unless otherwise terminated
as provided in Section 8.2 of this Agreement. 
 8.2 Termination 
 (a) Termination By Service Company. Service Company may terminate this Agreement immediately upon notice to
Provider upon the occurrence of any one of the following events: 
 (i) The dissolution of Provider;

 (ii) Provider admits in writing its inability to pay generally its debts as they become due or makes an
assignment for the benefit of creditors; 
 (iii) A receiver, trustee, liquidator, or conservator is appointed
for Provider or to take possession of all or substantially all of Provider’s property or a petition for insolvency, dissolution, liquidation, or reorganization, or order for relief in which Provider is named as debtor, is filed by, against, or
with respect to Provider pursuant to any federal or state statute, regulation, or law for the protection of debtors, and, with respect to any such appointment or filing, Provider fails to secure a stay or discharge thereof within 45 days after such
appointment or filing; 
 (iv) Provider fails to pay when due any payment to be made by Provider under this
Agreement, which failure continues for 10 days after notice is given by Service Company to Provider thereof, provided that such failure is not directly attributable to Service Company’s failure to apply available funds in the Provider Account
according to Section 4.12(b); or 
 (v) Provider fails to comply with or perform any of its other
material duties or obligations under this Agreement, which failure continues for 30 days after notice is given by Service Company to Provider thereof, or if because of the nature of such failure it cannot reasonably be corrected within such 30 day
period, failure by Provider to commence such correction promptly following its receipt of notice from Service Company and thereafter to expeditiously and continuously prosecute the correction to completion. 
  

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 (b) Termination By Provider. Provider may terminate this Agreement
immediately upon notice to Service Company upon the occurrence of any of the following events: 
 (i) A
receiver, trustee, liquidator, or conservator is appointed for Service Company or to take possession of all or substantially all of Service Company’s property or a petition for insolvency, dissolution, liquidation, or reorganization, or order
for relief in which Service Company is named as debtor, is filed by, against, or with respect to Service Company pursuant to any federal or state statute, regulation, or law for the protection of debtors, and, with respect to any such appointment or
filing, Service Company fails to secure a stay or discharge thereof within 45 days after such appointment or filing; 
 (ii) Service Company fails to comply with or perform any of its material duties or obligations under this Agreement, which failure continues for 30 days after notice is given by Provider to Service Company thereof, or if because of the
nature of such failure it cannot reasonably be corrected within such 30 day period, failure by Service Company to commence such correction promptly following its receipt of notice from Provider and thereafter to expeditiously and continuously
prosecute the correction to completion; or 
 (iii) A court of competent jurisdiction makes a final
determination that Service Company has materially breached a fiduciary duty owed to Provider. 
 Notwithstanding the foregoing, any termination by Provider under this section shall require the affirmative vote of three-fourths of the then-outstanding membership interests of Provider entitled to vote on such a matter. 
 (c) Termination by Agreement. Provider and Service Company may mutually agree to terminate this Agreement at any
time, such agreement to be in writing and signed by both Parties. 
 (d) Legislative, Regulatory or
Administrative Change. If (a) there is (i) any change in any federal, state, or local statute, law, regulation, legislation, rule, policy, or general instruction, or a change in any third party reimbursement system, or (ii) any
ruling, judgment, decree, or interpretation by any court, agency, or other governing body having jurisdiction over either Party (in any such case, for purposes of this clause (d), a “Regulatory Matter”), and (b) such Regulatory Matter
materially and adversely affects, or is reasonably likely to affect, the manner in which either Party is to perform or be compensated for its services under this Agreement or which shall make this Agreement unlawful, the Parties shall immediately
use their best efforts to enter into a new service arrangement or basis for compensation for the services furnished pursuant to this Agreement that complies with such Regulatory Matter and approximates as closely as possible the economic position of
the Parties prior to such Regulatory Matter. 
 If the Parties are unable to reach a new agreement within a
reasonable period of time following the date upon which it becomes reasonably certain that such Regulatory Matter will arise, then either Party may submit the issue to arbitration which shall be binding on the Parties and subject to the
then-applicable Commercial Arbitration Rules of the American Arbitration Association. In any such arbitration, the arbitrators shall consist of a panel of three arbitrators, which shall act by majority vote and which shall consist of one arbitrator
selected by the Party on one side of the issue subject to the arbitration, one arbitrator selected by the Party on the other side of the issue, and a third arbitrator selected by the two arbitrators so selected, who shall be either a certified
public accountant or an attorney at law licensed to practice in the State of Minnesota and who shall act as 

  

 21 








 
chairman of the arbitration panel; provided that if the Party on one side of the issue selects its arbitrator for the panel and the other Party fails so to
select its arbitrator within 10 business days after being requested by the first Party to do so, then the sole arbitrator shall be the arbitrator selected by the first Party. 
 All costs and expenses of arbitration shall be borne by the Parties as determined by the arbitrator or arbitration panel,
except that the fees of any arbitrator on an arbitration panel who is selected individually by a Party shall be borne separately by the Party appointing him; provided that if one Party fails to select an arbitrator for a panel, and the sole
arbitrator is the arbitrator selected by the other Party, then the fees of that arbitrator shall be borne by the Parties as determined by that arbitrator. 
 8.3 Effects of Termination. Upon termination of this Agreement as herein provided, neither Party shall have any further obligations under this Agreement, except for: (a) obligations accruing prior to the
date of termination, including without limitation payment of the amounts set forth in Article VII relating to services provided prior to the termination of this Agreement; (b) obligations set forth in this Agreement that expressly extend beyond
the Term, including without limitation indemnities and noncompetition provisions, which provisions shall survive the expiration or termination of this Agreement; (c) the obligations of each Party set forth in Article VI; and (d) the
obligation of Provider described in Section 8.4. Provider specifically acknowledges and agrees that Service Company shall continue to collect and receive on behalf of Provider all cash collections from accounts receivable in existence at the
time this Agreement is terminated (which have not otherwise been purchased by Service Company pursuant to Section 7.6), and that all such cash collections shall be disbursed in accordance with Section 4.12(b), it being understood that such
cash collections will represent, in part, compensation to Service Company for Services already rendered and compensation on accounts receivable purchased by Service Company, if any. Upon the expiration or termination of this Agreement for any reason
or cause whatsoever, Service Company shall surrender to Provider all books and records pertaining to Provider’s dental practice; provided that Service Company may retain copies of such documents to the extent reasonably necessary for Service
Company to complete its post-termination obligations and activities under this Agreement. 
 8.4 Purchase Obligation.
Upon termination of this Agreement for any reason Provider shall, at Service Company’s option (subject to any consent rights of Parent’s senior creditor): 
 (a) Purchase from Service Company at book value the intangible assets, deferred charges, goodwill, and all other amounts
on the books of the Service Company relating to this Agreement or the items or services provided by Service Company pursuant to this Agreement, including without limitation the amount, if any, for the covenants described in Section 5.7, above,
as adjusted through the last day of the month most recently ended prior to the date of such termination in accordance with GAAP to reflect amortization or depreciation of all such amounts, provided the foregoing shall not apply to any trade names,
trademarks, service marks, or similar items owned by Service Company or its affiliates and used at any time during the term of this Agreement in connection with the operation of Provider’s dental practice (the “Marks”); 
 (b) Purchase from Service Company any real estate owned by Service Company and used as a Clinic at the greater of the
appraised fair market value thereof or the then book value thereof; 
  

 22 








 (c) Purchase, at the greater of the appraised fair market value or the
then book value, all improvements, additions, or leasehold improvements that have been made by Service Company at any Clinic and that relate to the performance of Service Company’s obligations under this Agreement; 
 (d) Assume all debt, and all contracts, payables, and leases that are obligations of Service Company and that relate to
the performance of Service Company’s obligations under this Agreement or the properties leased or subleased by Service Company in connection with its obligations under this Agreement; 
 (e) Purchase from Service Company, at the greater of the appraised fair market value or the then book value, all of the
equipment then being supplied by Service Company pursuant to Service Company’s obligations under this Agreement, and all other assets, including inventory and supplies, tangibles and intangibles (other than the Marks), set forth on the books of
Service Company as adjusted through the last day of the month most recently ended prior to the date of such termination in accordance with GAAP to reflect operations of each Clinic, depreciation, amortization, and other adjustments of assets shown
on the books of the Service Company; and 
 (f) Purchase from Service Company, at the greater of appraised
fair market value or then book value, all Marks designated by Service Company. 
 For purposes of subsections (b), (c), (e),
and (f) above, the appraised value shall be determined by an appraiser mutually agreed upon by the Parties. In the event the Parties are unable to agree upon an appraiser within 10 days following the date upon which either Party requests the
other Party to agree to an appraiser, then each Party shall appoint an appraiser, who shall in turn select a third appraiser who shall serve as the appraiser hereunder. In the event either Party fails to select an appraiser within 15 days of the
selection of an appraiser by the other Party, the appraiser selected by the other Party shall serve as the appraiser hereunder. The determination of the appraised value of the assets identified in such subsections, by the appraiser or appraisers
selected hereunder shall be binding on both Parties. 
 8.5 Closing of Purchase. If Provider purchases assets pursuant
to Section 8.4, Provider shall pay cash for the purchased assets; provided that the amount of the purchase price allocable to an asset shall be reduced by the amount of debt and liabilities of Service Company, if any, relating directly to that
asset which are assumed by Provider in connection with such purchase. Any asset which is purchased by Provider pursuant to Section 8.4 and with respect to which the purchase price reduction described in the preceding sentence does not apply
shall be transferred to Provider free and clear of all liens and encumbrances at closing. Provider and any dentist associated with Provider shall execute such documents as may be required for Provider to assume the liabilities set forth in
Section 8.4(d) and to remove Service Company from any liability with respect to such purchased asset and with respect to any property leased or subleased by Service Company. The closing date for the purchase shall be determined by the Parties
but shall in no event occur later than 180 days from the date of the notice of termination. Provider shall be released from the covenants described in Section 5.7, above, upon the successful consummation of such closing. 
  

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 ARTICLE IX 
 GENERAL 
 9.1 Nature of Services. Nothing in this Agreement is intended
or shall be construed to allow Service Company to exercise control or direction over the manner or method by which Provider and its dentists or the dental hygienists and other licensed dental personnel and unlicensed dental assistants and other
personnel supervised by Provider or its dentists, perform Dental Care or other professional dental care services. The rendition of all Dental Care shall be the sole responsibility of Provider and its dentists and the dental hygienists and other
licensed dental personnel and unlicensed dental assistants supervised by Provider and its dentists, and Service Company shall not interfere in any manner or to any extent therewith. Nothing contained in this Agreement shall be construed to permit
Service Company to engage in the practice of dentistry, it being the sole intention of the Parties hereto that the services to be rendered to Provider by Service Company are solely for the purpose of providing non-dental administrative and
management services to Provider so as to enable Provider to devote its full time and energies to the professional conduct of its dental practice and provision of Dental Care to its patients and not to administration or practice management.

 9.2 Relationship of Parties. The relationship of the Parties is and shall be that of independent contractors, and
nothing in this Agreement is intended, and nothing shall be construed, to create an employer/employee, partnership, or joint venture relationship between the Parties, or to allow either to exercise control or direction over the manner or method by
which the other performs the services that are the subject matter of this Agreement; provided always that the services to be provided hereunder shall be furnished in a manner consistent with the standards governing such services and the provisions
of this Agreement. 
 9.3 Notices. All notices and other communications under this Agreement to any Party shall be in
writing and shall be deemed given when delivered personally, transmitted by facsimile (which is confirmed) to that Party at the facsimile number for that Party set forth below, mailed by certified mail (return receipt requested) to that Party at the
address for that Party set forth below (or at such other address for such Party as such Party shall have specified in notice to the other Party), or delivered to Federal Express, UPS, or any similar express delivery service for delivery to that
Party at that address: 
 (a) If to Service Company: 
                       PDHC, Ltd. 
                       c/o American Dental
Partners, Inc. 
                       401
Edgewater Place, Suite 430 
                       Wakefield, Massachusetts 01880-1249 

					
		 	 Attention:
	  	 Gregory A. Serrao, President

		 		  	 and Chief Executive Officer

		 	 Facsimile No.:
	  	 (781) 224-0837


                       with a copy to: 
                       Baker & Hostetler, LLP 

	                      65	 East State Street, Suite 2100 


                       Columbus, Ohio 43215 
                       Attention:         Gary A. Wadman, Esq.

                       Facsimile No.: (614) 462-2616 
  

 24 








 (b) If to Provider: 
  

							
		  	 Northland Dental Partners, PLLC
	  	
		  	 1717 Paramount Drive
	  	
		  	 Waukesha, WI 53186
	  	
		  	Attention:    James Ludke	  	

 Any Party may change the address to which notices and other communications are to
be given by giving the other Party notice of such change. 
 9.4 Execution of Documents. Each Party shall execute,
acknowledge or verify, and deliver any and all documents, and take any and all other actions, which from time to time may be reasonably requested by the other Party to carry out the purposes and intent of this Agreement. 
 9.5 Governing Law. All questions concerning the validity, intention, or meaning of this Agreement or relating to the rights and
obligations of the Parties with respect to performance under this Agreement shall be construed and resolved under the laws of Minnesota without reference to conflict of law principles. 
 9.6 Severability. The intention of the Parties is to comply fully with all applicable laws and public policies, and this Agreement
shall be construed consistently with all laws and public policies to the extent possible. If and to the extent that any court of competent jurisdiction determines that it is impossible to construe any provision of this Agreement consistently with
any law or public policy and consequently holds that provision to be invalid, such holding shall in no way affect the validity of the other provisions of this Agreement, which shall remain in full force and effect. With respect to any provision in
this Agreement finally determined by such a court to be invalid or unenforceable, such court shall have jurisdiction to reform this Agreement (consistent with the intent of the Parties) to the extent necessary to make such provision valid and
enforceable, and, as reformed, such provision shall be binding on the Parties. 
 9.7 Setoff. Notwithstanding any
provision of this Agreement to the contrary, Service Company shall have the right from time to time to setoff any amounts owed by Service Company to Provider against any amounts owed by Provider to Service Company. 
 9.8 Remedies. All rights and remedies of each Party under this Agreement are cumulative and in addition to all other rights and
remedies which may be available to that Party from time to time, whether under any other agreement, at law, or in equity. 
 Each Party hereby acknowledges that: (a) the provisions of Sections 5.7 and 6.1 of this Agreement are fundamental for the protection of the other Party’s legitimate business interests; (b) such provisions are reasonable and
appropriate in all respects; and (c) in the event it violates any such provisions, the other Party would suffer irreparable harm and its remedies at law would be inadequate. Accordingly, in the event either Party violates or attempts to violate
any such provisions, the other Party shall be entitled 

  

 25 








 
to a temporary restraining order, temporary and permanent injunctions, specific performance, and other equitable relief without any showing of irreparable
harm or damage or the posting of any bond, in addition to any other rights or remedies which may then be available to the other Party. 
 9.9 Non-waiver. No failure by any Party to insist upon strict compliance with any term of this Agreement, to exercise any option, enforce any right, or seek any remedy upon any default of any other Party shall
affect, or constitute a waiver of, the first Party’s right to insist upon such strict compliance, exercise that option, enforce that right, or seek that remedy with respect to that default or any prior, contemporaneous, or subsequent default;
nor shall any custom or practice of the Parties at variance with any provision of this Agreement affect or constitute a waiver of, any Party’s right to demand strict compliance with all provisions of this Agreement. 
 9.10 Indemnification. To the extent not covered by and paid from its insurance coverage, each Party (the “Indemnifying
Party”) shall indemnify and hold harmless the other Party and its shareholders, members, managers, directors, officers, employees, agents, representatives, and affiliates (the “Indemnified Parties”) from and against any and all
losses, liabilities, damages, demands, claims, suits, actions, judgments, assessments, costs and expenses, including without limitation interest, penalties, attorneys’ fees, any and all expenses incurred in investigating, preparing, or
defending against any litigation, commenced or threatened, or any claim whatsoever, and any and all amounts paid in settlement of any claim or litigation (collectively, “Damages”), asserted against, imposed upon, or incurred or suffered by
the Indemnified Parties, directly or indirectly, as a result of or arising from: (i) any failure of any representation or warranty of the Indemnifying Party in this Agreement to be accurate and complete in all material respects when made; or
(ii) any failure by the Indemnifying Party to perform and observe fully all obligations and conditions to be performed or observed by the Indemnifying Party under this Agreement. In addition, Provider shall indemnify Service Company and its
shareholders, members, managers, directors, officers, employees, agents, representatives, and affiliates from and against any and all Damages asserted against, imposed upon, or incurred or suffered by any of them, directly or indirectly, as a result
of or arising from the acts or omissions of Provider or its employees, contractors, or other agents or representatives. 
 9.11 No Third Party Benefit. This Agreement is intended for the exclusive benefit of the Parties and their respective successors and assigns, and nothing contained in this Agreement shall be construed as creating any rights or
benefits in or to any third party. 
 9.12 Captions. The captions of the various sections of this Agreement are not
part of the context of this Agreement, are only labels to assist in locating and reading those sections, and shall be ignored in construing this Agreement. 
 9.13 Genders and Numbers. When permitted by the context, each pronoun used in this Agreement includes the same pronoun in other genders or numbers and each noun used in this Agreement
includes the same noun in other numbers. 
 9.14 Complete Agreement. This document (including its exhibits and all
other documents referred to herein, all of which are hereby incorporated herein by reference) contains the entire agreement among the Parties with respect to the subject matter of this Agreement and supersedes all prior or contemporaneous
discussions, negotiations, representations, or agreements relating to the subject matter of this Agreement. No changes to this Agreement shall be made or be binding upon any Party unless made in writing and signed by each Party to this Agreement.

  

 26 








 9.15 Counterparts. This Agreement may be executed in multiple counterparts, each
of which shall be deemed to be an original, but all of which taken together shall constitute one and the same Agreement, and any photocopy, facsimile, or electronic reproduction of the executed Agreement shall constitute an original. 
 9.16 Assignment. Provider may not assign this Agreement without the prior written consent of Service Company, which consent may be
withheld for any reason. The sale, transfer, pledge, or assignment of any of the membership interests of Provider held by any member of Provider, the issuance by Provider of voting membership interests to any other person, or any combination of such
transactions within any period of two years, such that the members in Provider at the beginning of that two-year period fail to maintain a majority of the voting interest in Provider, shall be deemed an attempted assignment by Provider, and shall be
null and void unless consented to in writing by Service Company prior to any such transfer or issuance. Any breach of this provision, whether or not void or voidable, shall constitute a material breach of this Agreement, and in the event of such
breach, Service Company may terminate this Agreement upon 24 hours notice to Provider. Service Company shall have the right to (i) assign its rights and obligations hereunder to any third party and (ii) collaterally assign its interest in
this Agreement and its right to collect the amounts set forth in Article VII hereunder to any financial institution or other third party without the consent of Provider. Service Company shall notify Provider of any assignment of this Agreement of
the type described in the immediately preceding clause (i). 
 9.17 Successors. Subject to Section 9.16, above,
this Agreement shall be binding upon, inure to the benefit of, and be enforceable by and against the successors and assigns of each Party. 
 9.18 Force Majeure. Neither Party shall be liable or deemed to be in default for any delay or failure in performance under this Agreement or other interruption of service deemed to result, directly or
indirectly, from acts of God, civil or military authority, acts of public enemy, war, accidents, fires, explosions, earthquakes, floods, failure of transportation, strikes or other work interruptions by either Party’s employees, or any other
similar cause beyond the reasonable control of either Party unless such delay or failure in performance is expressly addressed elsewhere in this Agreement. 
 9.19 Interpretation. This Agreement supersedes the Original Agreement in its entirety from and after the date of this Agreement; provided that this Agreement shall not modify or otherwise
affect any rights or obligations of the Parties under the Original Agreement which are based upon acts or omissions occurring prior to the date of this Agreement, which rights and obligations shall survive the execution of this Agreement. If and to
the extent any provision of this Agreement conflicts with the obligations of either Northland or Service Company under the Definitive Settlement Agreement dated February 29, 2008 among Northland, Service Company, PDG, P.A., and Dental
Specialists of Minnesota, P.A., or any other agreement or document executed by either of them pursuant to such Definitive Settlement Agreement, then that Party’s obligation to perform or observe such provision of this Agreement shall be
modified to the extent necessary for that Party to be in compliance with such Definitive Settlement Agreement or such other agreement or document. 
  

 27 








 9.20 JURY TRIAL WAIVER. TO THE FULLEST EXTENT PERMITTED BY APPLICABLE LAW, EACH
PARTY HEREBY WAIVES ANY AND ALL RIGHTS TO HAVE A JURY PARTICIPATE IN RESOLVING ANY DISPUTE `BETWEEN THEM, WHETHER SOUNDING IN CONTRACT, TORT, OR OTHERWISE, ARISING OUT OF, IN CONNECTION WITH, RELATED TO, OR INCIDENTAL TO THIS AGREEMENT OR THE
INITIAL AGREEMENT OR THE RELATIONSHIP ESTABLISHED PURSUANT TO THIS AGREEMENT OR THE INITIAL AGREEMENT. 
  

									
	PROVIDER:	 		 	SERVICE COMPANY:
			
	NORTHLAND DENTAL PARTNERS, PLLC(1)	 		 	PDHC, LTD.
					
	By:	 	/s/ James Ludke	 		 	By:	 	/s/ Gregory A. Serrao
		 	James Ludke, DDS, President	 		 		 	Gregory A. Serrao, Chairman

  

	 (1)
	 For itself and on behalf of each Subsidiary as its sole member 


  

 28 








 Exhibit A 
 DEFINITIONS 
 Adjusted Gross Revenue. The term “Adjusted Gross Revenue”
shall mean Gross Revenue less Adjustments. 
 Adjustments. The term “Adjustments” shall mean all adjustments
on the accrual basis for (a) third party payor contractual allowances, adjustments, discounts, and professional courtesies, (b) uncollectible accounts and related expenses, and (c) other activities that do not result in collectible
charges (provided that Adjustments for any period beginning on or after the effective date of this Agreement shall exclude adjustments which relate to (i) Dental Care that was rendered prior to the effective date of this Agreement,
(ii) Capitation Revenue that was recorded prior to the effective date of this Agreement, or (iii) any other revenue recorded prior to the effective date of this Agreement). 
 Ancillary Revenue. The term “Ancillary Revenue” shall mean all other revenue actually recorded each month that is not
Professional Service Revenue. 
 Budget. The term “Budget” shall mean an operating budget and capital
expenditure budget for each calendar year as prepared by Service Company, in consultation with Provider, and approved by each of the Policy Board and Parent. 
 Calculated Margin. The term “Calculated Margin” shall mean, for any period, the actual Adjusted Gross Revenue for that period, less the sum of (a) the actual Clinic Expense
for that period and (b) the actual Provider Expense for that period to the extent included as described in the definition of Provider Expense below. 
 Capitation Revenue. The term “Capitation Revenue” shall mean all revenue recorded under GAAP from managed care organizations or third party payors where such revenue is recorded periodically on a per
member basis for the partial or total dental needs of an enrolled patient. 
 Clinic. The term “Clinic”
shall mean any of the facilities, including satellite facilities, that Service Company owns, leases or otherwise procures and provides for the use of Provider for the provision of Dental Care. 
 Clinic Expense. The term “Clinic Expense” shall mean any operating or nonoperating expense incurred by Service Company
or Parent in the provision of services to Provider and any expense incurred by Provider which is expressly identified in this Agreement as a Clinic Expense, including without limitation any expense described in this definition for which Provider is
required by applicable law to be financially liable. Clinic Expense shall not include any state or federal income tax of Provider, any expense related to any Dental Assets or the maintenance or protection of the same, or any other expense reasonably
designated by Service Company as a Provider Expense. Without limiting the foregoing, Clinic Expense shall include: 
 (a) The salaries, benefits, and other direct costs of all employees of Provider or Service Company at a Clinic, but not the salaries, benefits, or other direct costs of the dentists; 
  

 A-1 








 (b) The cost of any employee or consultant that provides services at or
in connection with a Clinic for improved Clinic performance, such as management, billing and collections, business office consultation, accounting and legal services, including salaries, benefits, other compensation, travel costs, and other
expenses, but only when such services are coordinated by Service Company; 
 (c) Reasonable recruitment costs
and out-of-pocket expenses of Service Company or Provider associated with the recruitment of additional dentists, dental hygienists, or other licensed dental personnel or unlicensed dental assistants; 
 (d) Dental malpractice liability insurance expenses for dentists, dental hygienists, or dental assistants, Service Company
employees, and non-dentist employees; workers’ compensation premiums for Service Company employees at each Clinic; and comprehensive general liability insurance expenses covering each Clinic and employees of Provider and Service Company at each
Clinic; 
 (e) The cost of laboratory services; 
 (f) The cost of dental supplies (including but not limited to products, substances, items, or dental devices), and office
supplies; 
 (g) The expense of using, leasing, or otherwise procuring Clinics and related equipment,
including utilities, depreciation, and repairs and maintenance, provided that such expense shall not include the cost of acquiring goodwill, noncompete covenants, or other intangible assets in connection with such procurement; 
 (h) Without limiting the foregoing, expenses related to the practice management and other information systems provided,
made available, or arranged for by Service Company for use in connection with Provider’s practice, including without limitation expenses associated with third party systems, amortization of internal development costs, costs of facilities and
hardware (including occupancy costs and hardware for off site data centers), costs of establishing and maintaining a wide area network and similar expenses, costs and expenses of personnel involved in any system conversion, and costs and expenses of
the helpdesk and database administrator personnel. 
 (i) Personal property and intangible taxes assessed
against Service Company’s assets which are provided or otherwise employed by Service Company for the benefit of Provider; 
 (j) The reasonable travel expenses (except for the corporate staff of Service Company and Parent) associated with attending meetings, conferences, or seminars to benefit Provider; 
 (k) Other expenses incurred by Service Company or Parent in carrying out its obligations under this Agreement in
accordance with the policies and budgets established by the Policy Board, including without limitation the write-off of any tangible or intangible assets on the balance sheet of Service Company or any portion thereof other than costs incurred in
connection with the execution of this Agreement and the issuance by Parent of stock options to Provider or its dentists; 
 (l) Any tax assessed against Service Company (other than income taxes) in connection with the services provided by Service Company hereunder; and 
  

 A-2 








 (m) Any other cost or expense designated as a Clinic Expense pursuant to
this Agreement. 
 To the extent any cost or expense of the type includable in Clinic Expense results from a service or other
item provided by Service Company or Parent to multiple dental practices affiliated with Service Company or Parent (including Provider), the costs and expenses of such services or other items included in Clinic Expense under this Agreement shall be
limited to a reasonable allocation of a portion of the total of such costs and expenses. 
 Confidential Information.
The term “Confidential Information” shall mean, with respect to a Party, all trade secrets, proprietary data, and other information (whether written or oral) of a confidential nature relating directly or indirectly to that Party or its
business, including without limitation all business management, marketing, and economic studies and methods, patient lists, proprietary forms, marketing data, fee schedules, customer lists, financial, tax, accounting, and other information regarding
business operations or structure, business plans, ideas, concepts, policies, and procedures, and any other information which that Party is obligated to treat as confidential pursuant to any law, agreement, or course of dealing by which that Party is
bound, whether or not such Confidential Information is disclosed or otherwise made available pursuant to this Agreement. Confidential Information shall also include the terms and provisions of this Agreement and any transactions or documents
executed by the Parties pursuant to this Agreement. Confidential Information shall not include any information which (a) is or becomes known or available to the public and did not become so known through the breach of this Agreement by either
Party, (b) has been lawfully acquired from a third party without any breach of any confidentiality restriction, or (c) is already in the possession of the receiving Party at the time it was disclosed to the receiving Party by the
disclosing Party. 
 Dental Assets. The term “Dental Assets” shall mean the following assets of Provider:

 (a) All of Provider’s rights, title and interest in, to or under, or possession of, all drugs,
pharmaceuticals, products, substances, items or devices whose purchase, possession, maintenance, administration, prescription or security requires the authorization or order of a Dental Care Professional or requires a permit, registration,
certification or any other governmental authorization held by a Dental Care Professional as specified under any federal or state law, or both; 
 (b) All of Provider’s rights, title and interest in and to records of identity, diagnosis, evaluation or treatment of patients; 
 (c) All of Provider’s rights, title and interest in, to or under insurance policies covering or relating to dental
malpractice; 
 (d) The name of Provider; 
 (e) All franchises, licenses, permits, certificates, approvals and other governmental authorizations necessary or
desirable to own and operate any of the other Dental Assets; 
 (f) All of Provider’s rights, title and
interest in, to or under any contract or agreement that requires performance by a licensed dental care provider under federal or applicable state law. 
  

 A-3 








 Dental Care. The term “Dental Care” shall mean such intra-oral
diagnostic and therapeutic procedures, operations, and services as are included under the definition of the “practice of dentistry” under the laws and regulations of the state in which such procedures, operations, and services are
performed and which are provided by Provider to its patients through Provider’s dentists and through dental hygienists, dental assistants, and other professional dental care personnel operating under the supervision of Provider’s dentists,
including but not limited to the practice of general dentistry, endodontics, periodontics, orthodontics, prosthodontics, pediatric dental care, and oral surgery, and all dental care associated with any of the foregoing. 
 Dental Care Professional. The term “Dental Care Professional” shall mean any individual holding a current, unrestricted
license issued by the appropriate dental licensing board in the state in which the Dental Care Professional renders Dental Care, which permits such individual to provide Dental Care, including without limitation dentists (as that term is defined in
Section 2.5) and denturists, dental hygienists, and dental assistants. 
 First Group Employment Agreements. The
term “First Group Employment Agreements” shall mean Northland’s initial employment agreements with dentists identified on the attached Schedule A-1 as contemplated by the Initial Agreement. 
 GAAP. The term “GAAP” shall mean generally accepted accounting principles set forth in the opinions and pronouncements
of the Accounting Principles Board of the American Institute of Certified Public Accountants and statements and pronouncements of the Financial Accounting Standards Board and the Securities and Exchange Commission or in such other statements by such
other entity or other practices and procedures as may be approved by a significant segment of the accounting profession, which are applicable to the circumstances as of the date of the determination. All financial definitions in this exhibit are
intended to be construed in accordance with GAAP, whether or not expressly so stated. 
 Gross Revenue. The term
“Gross Revenue” shall mean the sum of all Professional Service Revenue and Ancillary Revenue before Adjustments. 
 Guaranteed Payments. The term “Guaranteed Payments” shall mean (a) the Guaranteed Payments as defined in the Initial Agreement, except that, for any period, such term shall include Minimum Base Compensation (as defined
in the First Group Employment Agreements) only to the extent the Minimum Base Compensation for that period exceeds the actual Base Compensation for that period (as defined in the First Group Employment Agreements), plus (b) $5,000 a month.

 Initial Agreement. The term “Initial Agreement” shall mean the Agreement Regarding Service Agreement
dated July 17, 2007 between Northland and Service Company. 
 Ordinary Dental Supplies. The term “Ordinary
Dental Supplies” shall mean all products, substances, items, or devices which (a) are necessary or appropriate for Provider’s provision of Dental Care, and (b) are not Special Dental Supplies. 
 Parent. The term “Parent” shall mean American Dental Partners, Inc., a Delaware corporation. 
  

 A-4 








 Practice Territory. The term “Practice Territory” shall mean the
geographic area within which Provider provides Dental Care, which geographic area shall include all of the following territories: (a) with respect to each Clinic which offers general dentistry services only, the geographic area within a radius
of 30 miles of such Clinic, and (b) with respect to each Clinic which offers specialty dental services, the geographic area within a radius of 50 miles of such Clinic. 
 Preliminary Settlement Agreement. The term “Preliminary Settlement Agreement” shall mean the Settlement Agreement dated December 26, 2007, among PDG, P.A., Dental
Specialists of Minnesota, P.A., Service Company, Parent, and Provider. 
 Professional Service Revenue. The term
“Professional Service Revenue” shall mean the sum of all (a) professional fees actually recorded each month on an accrual basis under GAAP as a result of the Dental Care rendered by the Dental Care Professionals retained by Provider,
and (b) Capitation Revenue. 
 Provider Account. The term “Provider Account” shall mean the bank
account of Provider established by Provider promptly following the execution of this Agreement at a financial institution reasonably acceptable to Service Company, which account shall be administered by Service Company according to Sections 4.11 and
4.12 of this Agreement. 
 Provider Consent. The term “Provider Consent” shall mean the consent granted by a
majority of Provider’s representatives who serve on the Policy Board. When any provision of this Agreement requires Provider Consent, Provider Consent shall not be unreasonably withheld and shall be binding on Provider. 
 Provider Expense. The term “Provider Expense” shall mean any expense (other than an expense for which Provider is
required by applicable law to be financially liable and which is expressly identified in this Agreement as a Clinic Expense) incurred by the Service Company or Provider and for which Provider, and not the Service Company, is financially liable.
Provider Expense shall include dentist (as defined in Section 2.5) salaries, benefits (which includes workers’ compensation coverage), and other direct costs related to the dentists employed or otherwise retained by Provider for the
provision of its Dental Care (including professional dues, subscriptions, continuing dental education expenses, and travel costs for continuing dental education or other business travel, but excluding business travel requested by Service Company,
which shall be a Clinic Expense), together with any expense related to any Dental Assets or the maintenance or protection of the same and any other cost or expense designated as a Provider Expense in or pursuant to this Agreement. In the event
Provider incurs any consulting, accounting, legal or other similar fee without Service Company’s approval of such engagement through Service Company, any fee or expense so incurred shall be a Provider Expense, but one that is ignored for
purposes of calculating the Calculated Margin and therefore must be paid out of Provider Retained Earnings. Any Provider Expense which is not within the then-applicable Budget or the parameters described in the third paragraph of
Section 4.13(a) and is not approved by either the Policy Board or the Service Company shall be ignored for purposes of calculating the Calculated Margin and therefore must be paid out of Provider Retained Earnings. In addition, and
notwithstanding any other provisions of this Agreement or the Initial Agreement to the contrary, the Guaranteed Payments shall not be deemed to be Provider Expenses for purposes of calculating the Calculated Margin and also must be paid out of
Provider Retained Earnings; provided that to the extent Provider Retained Earnings are insufficient for Provider to make the Guaranteed Payments, Service Company shall advance funds to Provider in an amount equal to such insufficiency (which
advances shall be deemed made under Section 7.2). 
  

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 Provider Retained Earnings. The term “Provider Retained Earnings” shall
mean, for any period, the Calculated Margin for that period, less the Service Fee for that period. 
 Representatives.
The term “Representatives” shall mean a Party’s officers, directors, managers, employees, and other agents or representatives, and attorneys, accountants, and other professional advisors. 
 Service Company Consent. The term “Service Company Consent” shall mean the consent granted by a majority of Service
Company’s representatives who serve on the Policy Board. When any provision of this Agreement requires Service Company Consent, Service Company Consent shall not be unreasonably withheld and shall be binding on Service Company. 
 Service Company Expense. The term “Service Company Expense” shall mean an expense or cost incurred by Service Company or
Parent and for which Service Company or Parent, and not Provider, is financially liable. Without limiting the generality of the foregoing, Service Company Expense shall specifically include: 
 (a) The costs of Service Company’s and Parent’s corporate personnel and the travel costs of such corporate
personnel; and 
 (b) General overhead costs of Service Company or Parent that neither directly benefit
Provider nor are otherwise incurred by Service Company or Parent in providing services pursuant to this Agreement, such as (by way of illustration and not limitation) rent expense for Parent’s corporate headquarters. 
 Service Company Expense shall specifically exclude any expense incurred by Service Company or Parent that directly benefits Provider or
is otherwise incurred by Service Company or Parent in providing services pursuant to this Agreement. 
 Service Fee.
The term “Service Fee” shall mean the fee payable to Service Company by Provider as described in Section 7.3. 
 Services. The term “Services” shall mean the business, administrative, and management services to be provided for Provider by Service Company as set forth in this Agreement, including without limitation the provision of
equipment, supplies, support services, non-dentist personnel, office space, financial recordkeeping and reporting, billing and collection and other business office services. Services shall not include the provision of Dental Care to patients of the
Provider or the supervision or control of persons while they are providing Dental Care to patients. 
 Special Dental
Supplies. The term “Special Dental Supplies” shall mean all products, substances, items or devices, the purchase, possession, maintenance, administration, prescription or security of which requires the authorization or order of a
Dental Care Professional or requires a permit, registration, certification or other governmental authorization held by a Dental Care Professional as specified under any federal or state law (or both). 
 Term. The term “Term” shall mean the initial term and any renewal periods of this Agreement as described in
Section 8.1, subject to termination pursuant to Section 8.2. 
  

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 SCHEDULE A-1 
 DENTISTS WITH FIRST GROUP EMPLOYMENT AGREEMENTS 
  

					
		  	 Davis, Dr. Bart
 Elvecrog, Dr. Mark
 Gearhart, Dr. Kyle
 Giddings, Dr. Nicole
 Haas, Dr. Thomas
 Hamilton, Dr. Craig
 Healy, Dr. James
 Hom,
Dr. Michael
 Kottas, Dr. Katherine
 Kottke,
Dr. Steven
 Le, Dr. Mai-Trinh
 Ludwig, Dr. Cobi

 Rounds, Dr. Noah
 Sawyer, Dr. Stephen
 Siskoff, Dr. Luke
 Tran, Dr. Thomas
 Welch, Dr. Sarah
 Wilcox, Dr. Andrew
	  	

  

 A-1