Document:

Exhibit
4.3

[FACE
OF SECURITY]

THIS GLOBAL SECURITY IS
HELD BY THE DEPOSITARY (AS DEFINED IN THE INDENTURE GOVERNING THIS SECURITY) OR
ITS NOMINEE IN CUSTODY FOR THE BENEFIT OF THE BENEFICIAL OWNERS HEREOF.  EXCEPT AS OTHERWISE PROVIDED IN SECTION 2.11
OF THE INDENTURE, THIS SECURITY MAY BE TRANSFERRED, IN WHOLE BUT NOT IN PART,
ONLY TO ANOTHER NOMINEE OF THE DEPOSITARY OR TO A SUCCESSOR DEPOSITARY OR TO A
NOMINEE OF SUCH SUCCESSOR DEPOSITARY.

NOVAMED, INC.

	
  CUSIP: 66986WAA6

  	
  No.     1

  

ISIN: US66986WAA62

1.0% CONVERTIBLE SENIOR
SUBORDINATED NOTES DUE JUNE 15, 2012

NovaMed, Inc., a Delaware corporation (the “Company,”
which term shall include any successor corporation under the Indenture referred
to on the reverse hereof), promises to pay to Cede & Co., or registered
assigns, the principal sum of Seventy-Five Million dollars ($75,000,000) on
June 15, 2012 or such greater or lesser amount as is indicated on the Schedule
of Exchanges of Notes on the reverse of this Note.

This Note is convertible as specified on the reverse
of this Note.  Additional provisions of
this Note are set forth on the reverse of this Note.

[SIGNATURE PAGE FOLLOWS]

 F-1
 

IN WITNESS WHEREOF, the Company has caused this
instrument to be duly executed.

	
  

  	
  NOVAMED, INC.

  
	
   

  	
   

  
	
   

  	
  By:

  	
  /s/ Thomas S. Hall

  
	
   

  	
   

  	
  Name: Thomas S. Hall

  
	
   

  	
   

  	
  Title: President and Chief Executive Officer

  

 

Trustee’s
Certificate of Authentication

This is one of the Notes referred to in the within-mentioned Indenture.

LASALLE BANK NATIONAL
ASSOCIATION,

as Trustee

	
  By:

  	
  /s/ Thomas Popovics

  	
   

  
	
   

  	
  Authorized Signatory

  	
   

  

 

 F-2

[REVERSE OF SECURITY]

NOVAMED, INC.

1.0% CONVERTIBLE SENIOR
SUBORDINATED NOTES DUE JUNE 15, 2012

1.                                       INTEREST
AMOUNTS

NovaMed, Inc., a Delaware
corporation (the “Company,” which term shall include any successor corporation
under the Indenture hereinafter referred to), shall pay interest at a rate of
1.0% per annum, on the principal amount of this Note, semi-annually in arrears
on June 15 and December 15 of each year 
(each, an “Interest Payment Date”), or if any such day is not a Business
Day, the immediately following Business Day, commencing December 15, 2007.

Interest on this Note
shall be paid to the Holder of such Note at 5:00 p.m. (New York City time) on
the Business Day before the Interest Payment Date.

Interest on this Note
shall be computed on the basis of a 360-day year comprised of twelve 30-day
months.  In the event of the maturity,
conversion, or purchase of this Note by the Company at the option of the
Holder, interest shall cease to accrue on this Note.  Interest on this Note shall accrue from the
most recent date to which interest has been paid or, if no interest has been
paid, from the date of issuance.

2.                                       METHOD
OF PAYMENT

Payments of the principal
of and interest on this Note shall be made in U.S. Dollars, and the Notes shall
be denominated in U.S. Dollars.

3.                                       PAYING
AGENT, REGISTRAR AND CONVERSION AGENT

Initially, LaSalle Bank
National Association (the “Trustee,” which term shall include any successor
trustee under the Indenture hereinafter referred to) will act as Paying Agent,
Registrar and Conversion Agent.  The
Company may change any Paying Agent, Registrar or Conversion Agent without
notice to the Holder.

4.                                       INDENTURE

This Note is one of a
duly authorized issue of Securities of the Company designated as its 1.0%
Convertible Senior Subordinated Notes due June 15, 2012 (the “Notes”), issued
under an Indenture (the “Base Indenture”), dated as of June 27, 2007, between
Company and the Trustee, as supplemented by the First Supplemental Indenture
thereto (the “First Supplemental Indenture” and together with the Base
Indenture, as they may be further amended and supplemented pursuant to the
terms thereof, the “Indenture”), dated as of June 27, 2007, between Company and
the Trustee.  Terms used in this Note
without definition have the meaning given them in the Indenture.  The terms of this Note include those stated
in the Indenture and those required by or made part of the Indenture by
reference to the Trust Indenture Act of 1939, as amended, as in

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effect on the date
of the Indenture.  This Note is subject
to all such terms, and the Holder of this Note is referred to the Indenture and
said Act for a statement of them.  The
Indenture does not limit other debt of the Company, secured or unsecured.

5.                                       PURCHASE
OF NOTES AT OPTION OF HOLDER UPON A FUNDAMENTAL CHANGE

At the option of the
Holder and subject to the terms and conditions of the Indenture, the Company
shall become obligated to purchase all or any part specified by the Holder (so
long as the principal amount of such part is $1,000 or an integral multiple of
$1,000 in excess thereof) of the Notes held by such Holder on the date that is
30 Business Days after the occurrence of a Fundamental Change (as defined in
Section 3.01(a) of the First Supplemental Indenture), at a purchase price equal
to 100% of the principal amount thereof, together with any accrued and unpaid
interest up to, but excluding, the Fundamental Change Purchase Date (as defined
in Section 3.01(a) of the First Supplemental Indenture), payable in Cash.  The Holder shall have the right to withdraw
any Fundamental Change Purchase Notice (in whole or in a portion thereof that
is $1,000 or an integral multiple of $1,000 in excess thereof) at any time
prior to 5:00 p.m. (New York City time) on the Business Day next preceding the
Fundamental Change Purchase Date by delivering a written notice of withdrawal
to the Paying Agent in accordance with the terms of the Indenture.

6.                                       CONVERSION

The Holder of this Note
may convert the principal amount hereof such Note (or any portion thereof equal
to $1,000 or any integral multiple of $1,000 in excess thereof) into Cash and
Common Stock, if any, subject to the conditions set forth in Section 4.01 of
the First Supplemental Indenture; provided,
however, that, if this Note is
submitted for purchase upon a Fundamental Change, the conversion right shall
terminate at 5:00 p.m. (New York City time) on the Business Day immediately
preceding the Fundamental Change Purchase Date for such Note (unless such
submission is validly withdrawn or the Company shall default in making the
Fundamental Change Purchase Price payment when due, in which case the
conversion right shall terminate at 5:00 p.m. (New York City time) on the date
such default is cured and such Note is purchased).

The initial Conversion
Price is $6.371 per share, subject to adjustment under the circumstances
provided in the Indenture.  No fractional
shares will be issued upon conversion; in lieu thereof, the Company shall
deliver a number of shares of Common Stock equal to the aggregate of the
fractional shares otherwise deliverable for each Trading Day during the
Conversion Period (rounding down to the nearest whole number) and shall pay an
amount in Cash equal to the remainder multiplied by the Volume Weighted Average
Price of the Common Stock on the last Trading Day of the Conversion Period.

To convert this Note, a
Holder must deliver the Note by book-entry transfer to the Conversion Agent
(which initially shall be the Trustee) through the facilities of the Depositary
in accordance with the Applicable Procedures, accompanied by payment of any tax
or duty, in accordance with Section 4.04 of the First Supplemental Indenture,
which may be payable in

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respect of any
transfer involving the issue or delivery of the Common Stock in the name of a
Person other than the Holder of the Note.

A Holder may convert a
portion of a Note equal to $1,000 or any integral multiple thereof.

A Note in respect of
which a Holder had delivered a Fundamental Change Purchase Notice exercising
the option of such Holder to require the Company to purchase such Note may be
converted only if the Fundamental Change Purchase Notice is withdrawn in
accordance with the terms of the Indenture.

7.                                       SUBORDINATION

This Note is subordinated
in right of payment, as set forth in the Indenture, to the prior payment in
full of all existing and future Senior Indebtedness of the Company.  This Note in all respects ranks pari passu with, or senior to, all other
Indebtedness of the Company.  By
accepting a Note, each Holder agrees to the subordination provisions set forth
in the Indenture, authorizes the Trustee to acknowledge such subordination
provisions and give them effect and appoints the Trustee as attorney-in-fact
for such purpose.

8.                                       DENOMINATIONS,
TRANSFER, EXCHANGE

The Notes are in
registered form, without coupons, in denominations of $1,000 and integral
multiples of $1,000.  A Holder may
transfer or exchange Notes in accordance with the Indenture.  The Registrar may require a Holder, among
other things, to furnish appropriate endorsements and transfer documents and to
pay any taxes or other governmental charges that may be imposed in relation
thereto by law or permitted by the Indenture.

9.                                       PERSONS
DEEMED OWNERS

The Holder of a Note may
be treated as the owner of it for all purposes.

10.                                 UNCLAIMED
MONEY

If money for the payment
of principal or interest remains unclaimed for two years, the Trustee or Paying
Agent shall pay the money back to the Company at its request unless an
abandoned property law designates another Person. After any such payment, Holders
entitled to the money must look only to the Company or such other Person and
not to the Trustee for payment.

11.                                 AMENDMENT,
SUPPLEMENT AND WAIVER

Subject to the exceptions
set forth in the Indenture, the Notes and the Indenture may be amended or supplemented
with the written consent of the Holders of at least a majority in aggregate
principal amount of the Notes then outstanding, and an existing default or
Event of Default with respect to the Notes and its consequence or compliance
with any provision of the Notes or the Indenture may be waived in a particular
instance with the consent of the Holders of a majority in aggregate principal
amount of the Notes then outstanding. 
Without notice to or the

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consent of any
Holder, the Company and the Trustee may amend or supplement the Indenture or
the Notes to, among other things, cure any ambiguity, correct any defect or
inconsistency or make any other change that does not adversely affect the
rights of any Holder.

12.                                 SUCCESSOR
ENTITY

When a Successor Company
assumes all the obligations of its predecessor under the Notes and the
Indenture in accordance with the terms and conditions of the Indenture, the
predecessor company (except in the circumstances specified in the Indenture)
shall be released from those obligations.

13.                                 DEFAULTS

Under the Indenture,
Events of Default include (i) default by the Company in any payment of any
installment of interest on any Note when the same becomes due and payable, if
such default continues for a period of 30 days; (ii) default by the Company in
the payment of any installment of principal of any Note when the same becomes
due and payable at its stated maturity, upon declaration of acceleration,
notice of option to elect repayment or otherwise; (iii) failure by the Company
to comply with any of its covenants in the Notes or the Indenture (other than
those referred to in clause (i) or (ii) above) and continuance of such failure
for 60 days after the notice specified below; (iv) default in the payment or
acceleration of the payment of any Indebtedness of the Company or any
Significant Subsidiary in a principal amount exceeding $5,000,000, which
default or acceleration is not cured or rescinded after the applicable grace
period, if any, specified in the agreement or instrument relating to such
Indebtedness; (v) default in the payment by the Company or any Significant
Subsidiary of one or more final and non-appealable judgments entered by a court
or courts of competent jurisdiction, the aggregate uninsured or unbonded
portion of which is in excess of $5,000,000, which judgment is not paid,
discharged or stayed within 60 days; (vi) the occurrence of events of
bankruptcy or insolvency with respect to the Company that are set forth in the
Indenture;  (vii) default by the Company
in the payment of Cash or shares of Common Stock (if any) upon conversion of
any Note (including any Additional Shares) when the same becomes due and
payable; (viii) default by the Company in the payment of the purchase price of
any Note when the same becomes due and payable; and (ix) failure by the Company
to provide on a timely basis written notice of a Fundamental Change as required
by Section 3.01(b) of the First Supplemental Indenture.

Noteholders may not
enforce the Indenture or the Notes except as provided in the Indenture. The
Trustee may refuse to enforce the Indenture or the Notes unless it receives
indemnity or security satisfactory to it.

14.                                 TRUSTEE
DEALINGS WITH THE COMPANY

Subject to any applicable
limitations imposed by the TIA, LaSalle Bank National Association, the Trustee
under the Indenture, in its individual or any other capacity, may make loans
to, accept deposits from and perform services for the Company or an Affiliate
of the Company and may otherwise deal with the Company or an Affiliate of the
Company, as if it were not the Trustee.

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15.                                 NO
RECOURSE AGAINST OTHERS

A director, officer,
employee or shareholder, as such, of the Company shall not have any liability
for any obligations of the Company under the Notes or the Indenture or for any
claim based on, in respect of or by reason of such obligations or their
creation.  The Holder of this Note by
accepting this Note waives and releases all such liability.  The waiver and release are part of the
consideration for the issuance of this Note.

16.                                 AUTHENTICATION

This Note shall not be
valid until the Trustee or an authenticating agent manually or by facsimile
signs the certificate of authentication on the face of this Note.

17.                                 ABBREVIATIONS
AND DEFINITIONS

Customary abbreviations
may be used in the name of the Holder or an assignee, such as: TEN COM (=
tenants in common), TEN ENT (= tenants by the entireties), JT TEN (= joint
tenants with right of survivorship and not as tenants in common), CUST (=
Custodian) and UGMA (= Uniform Gifts to Minors Act).

All terms defined in the
Indenture and used in this Note but not specifically defined herein are used
herein as so defined.

18.                                 CUSIP
OR ISIN NUMBERS

Pursuant to a
recommendation promulgated by the Committee on Uniform Security Identification
Procedures the Company has caused CUSIP or ISIN numbers to be printed on the
Notes and has directed the Trustee to use CUSIP or ISIN numbers in notices of
redemption as a convenience to Holders. 
No representation is made as to the accuracy of such numbers either as printed
on the Notes or as contained in any notice of redemption and reliance may be
placed only on the other identification numbers placed thereon.

19.                                 INDENTURE
TO CONTROL; GOVERNING LAW

In the case of any
conflict between the provisions of this Note and the Indenture, the provisions
of the Indenture shall control.  This
Note shall be governed by, and construed in accordance with, the laws of the
State of New York without giving effect to applicable principles of conflicts
of law to the extent that the application of the laws of another jurisdiction
would be required thereby.

The Company will furnish
to any Holder, upon written request and without charge, a copy of the
Indenture.  Requests may be made to:
NovaMed, Inc., 980 North Michigan Avenue, Suite 1620 Chicago, Illinois 60611,
Attention: Chief Legal Officer.

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SCHEDULE OF EXCHANGES OF NOTES

The following exchanges,
redemptions, repurchases or conversions of a part of this Note, which is a
Global Security, have been made:

	
  Principal Amount

  of this Note

  Following Such Decrease

  Date of Exchange

  (or Increase)

  	
   

  	
  Authorized

  Signatory of

  Custodian

  	
   

  	
  Amount of Decrease in

  Principal Amount

  of this Note

  	
   

  	
  Amount of

  Increase in

  Principal Amount

  of this Note

  	
   

  
	
     

  	
   

  	
   

  	
    

  	
   

  	
    

  	
   

  	
   

  
	
     

  	
   

  	
   

  	
    

  	
   

  	
    

  	
   

  	
   

  
	
     

  	
   

  	
   

  	
    

  	
   

  	
    

  	
   

  	
   

  

 

 R-6Exhibit
4.4

Execution Copy

	
  

  	
  Deutsche Bank 

  
	
   

  	
   

  
	
   

  	
  Deutsche Bank AG London

  
	
   

  	
  Winchester house

  
	
   

  	
  1 Great Winchester St,

  
	
   

  	
  London EC2N 2DB

  
	
   

  	
  Telephone: 44 20
  7545 8000

  
	
   

  	
   

  
	
   

  	
  c/o Deutsche Bank AG New York

  
	
   

  	
  60 Wall Street

  
	
   

  	
  New York, NY 10005

  
	
   

  	
  Telephone: 212-250-2500

  

 

	
  DATE:

  	
  June 21, 2007

  
	
   

  	
   

  
	
  TO:

  	
  NovaMed, Inc.

  
	
  ATTENTION:

  	
  The Chief Executive
  Officer and the Chief Financial Officer

  
	
  TELEPHONE:

  	
  (312) 664-4100

  
	
  FACSIMILE:

  	
  (312) 664-4250

  
	
   

  	
   

  
	
  FROM:

  	
  Deutsche Bank AG London

  
	
  TELEPHONE:

  	
  44 20 7545 8000

  
	
  FACSIMILE:

  	
  44 11 3336 2009

  
	
   

  	
   

  
	
  SUBJECT:

  	
  Equity Derivatives Confirmation

  
	
   

  	
   

  
	
  REFERENCE NUMBER(S):

  	
  187988

  

 

The purpose of this facsimile agreement
(this “Confirmation”) is to confirm the terms and conditions
of the transaction entered into between Deutsche
Bank AG acting through its London branch (“Deutsche”) and NovaMed, Inc. (“Counterparty”) on
the Trade Date specified below (the “Transaction”). 
This Confirmation constitutes a “Confirmation” as referred to in the
ISDA Master Agreement specified below. 
This Confirmation constitutes the entire agreement and understanding of
the parties with respect to the subject matter and terms of the Transaction and
supersedes all prior or contemporaneous written and oral communications with
respect thereto.

DEUTSCHE
BANK AG IS NOT REGISTERED AS A BROKER OR DEALER UNDER THE U.S. SECURITIES
EXCHANGE ACT OF 1934, AS AMENDED. 
DEUTSCHE BANK AG NEW YORK (“AGENT”) HAS ACTED SOLELY AS AGENT IN
CONNECTION WITH THE TRANSACTION AND HAS NO OBLIGATION, BY WAY OF ISSUANCE,
ENDORSEMENT, GUARANTEE OR OTHERWISE WITH RESPECT TO THE PERFORMANCE OF EITHER
PARTY UNDER THE TRANSACTION.  DEUTSCHE
BANK AG LONDON IS NOT A MEMBER OF THE SECURITIES INVESTOR PROTECTION
CORPORATION (SIPC).

The definitions contained in the 2002 ISDA Equity Derivatives Definitions
(the “Equity Definitions”), as published by
the International Swaps and Derivatives Association, Inc., are incorporated
into this Confirmation.  In the event of
any 

	
  Chairman of the Supervisory
  Board: Clemens Börsig Board of Managing Directors: Hermann-Josef Lamberti,
  Josef Ackermann, Tessen von Heydebreck, Anthony DiIorio, Hugo Banziger

  	
   

  	
  Deutsche Bank AG is regulated by the FSA for the
  conduct of designated investment business in the UK, is a member of the
  London Stock Exchange and is a limited liability company incorporated in the
  Federal Republic of Germany HRB No. 30 000 District Court of Frankfurt am
  Main; Branch Registration No. in England and Wales BR000005, Registered
  address: Winchester House, 1 Great Winchester Street, London EC2N 2DB.

  

inconsistency between the Equity Definitions and the terms of this
Confirmation, the terms of this
Confirmation shall govern.  For the
purposes of the Equity Definitions, each reference herein to a Warrant shall be
deemed to be a reference to a Call or an Option, as context requires.

This Confirmation
evidences a complete and binding agreement between Deutsche and Counterparty as
to the terms of the Transaction to which this Confirmation relates.  This Confirmation shall supplement, form a
part of, and be subject to an agreement (the “Agreement”)
in the form of the ISDA 2002 Master Agreement (the “ISDA Form”)
as if Deutsche and Counterparty had executed an agreement in such form (without
any Schedule but with the “Cross-Default” provisions of Section 5(a)(vi)
applicable to Counterparty with a “Threshold” of $10,000,000 and with such
other elections set forth in this Confirmation; provided that clause (1)
of Section 5(a)(vi) is hereby amended by deleting the phrase “, or becoming
capable at such time of being declared,” from line seven).  For the avoidance of doubt, the Transaction
shall be the only transaction under the Agreement.

2.              The
Transaction is a Warrant Transaction, which shall be considered a Share Option
Transaction for purposes of the Equity Definitions, and shall have the
following terms:

	
  General:

  	
   

  
	
   

  	
   

  
	
  Trade Date:

  	
  June 21, 2007

  
	
   

  	
   

  
	
  Effective Date:

  	
  June 27, 2007

  
	
   

  	
   

  
	
  Components:

  	
  The Transaction will be divided into individual
  Components, each with the terms set forth in this Confirmation, and, in
  particular, with the Number of Warrants and Expiration Date set forth in this
  Confirmation. The payments and deliveries to be made upon settlement of the
  Transaction will be determined separately for each Component as if each
  Component were a separate Transaction under the Agreement.

  
	
   

  	
   

  
	
  Warrant Style:

  	
  European.

  
	
   

  	
   

  
	
  Warrant Type:

  	
  Call.

  
	
   

  	
   

  
	
  Seller:

  	
  Counterparty.

  
	
   

  	
   

  
	
  Buyer:

  	
  Deutsche.

  
	
   

  	
   

  
	
  Shares:

  	
  The common stock, par value USD0.01 per share, of
  Counterparty.

  
	
   

  	
   

  
	
  Number of Warrants:

  	
  For each Component, as provided in Annex C to
  this Confirmation.

  
	
   

  	
   

  
	
  Strike Price:

  	
  As provided in Annex B to this Confirmation.

  
	
   

  	
   

  
	
  Premium:

  	
  As provided in Annex B to this Confirmation.

  
	
   

  	
   

  
	
  Premium Payment Date:

  	
  The Effective Date.

  
	
   

  	
   

  
	
  Exchange:

  	
  The Nasdaq Global Select Market of the Nasdaq Stock
  Market, Inc.

  
	
   

  	
   

  
	
  Related Exchanges:

  	
  All Exchanges.

  

 

 2
 

 

	
  Calculation Agent:

  	
  Deutsche.

  
	
   

  	
   

  
	
  Procedure for Exercise:

  	
   

  
	
   

  	
   

  
	
  In respect of any Component:

  	
   

  
	
   

  	
   

  
	
  Expiration Date:

  	
  As provided in Annex C to this Confirmation
  (or, if such date is not a Scheduled Trading Day, the next following
  Scheduled Trading Day that is not already an Expiration Date for another
  Component); provided that if
  that date is a Disrupted Day, the Expiration Date for such Component shall be
  the first succeeding Scheduled Trading Day that is not a Disrupted Day and is
  not or is not deemed to be an Expiration Date in respect of any other
  Component of the Transaction hereunder; and provided
  further that if the Expiration Date has not occurred pursuant to
  the preceding proviso as of the Final Disruption Date, the Final Disruption
  Date shall be the Expiration Date (irrespective of whether such date is an
  Expiration Date in respect of any other Component for the Transaction) and,
  notwithstanding anything to the contrary in this Confirmation or the Equity
  Definitions, the Relevant Price for the Expiration Date shall be the
  prevailing market value per Share determined by the Calculation Agent in a
  commercially reasonable manner. “Final Disruption Date” means as
  provided in the Annex B. Notwithstanding the foregoing and anything to
  the contrary in the Equity Definitions, if a Market Disruption Event occurs on
  any Expiration Date, the Calculation Agent may determine that such Expiration
  Date is a Disrupted Day only in part, in which case the Calculation Agent
  shall make adjustments to the number of Warrants for the relevant Component
  for which such day shall be the Expiration Date and shall designate the
  Scheduled Trading Day determined in the manner described in the immediately
  preceding sentence as the Expiration Date for the remaining Warrants for such
  Component. Section 6.6 of the Equity Definitions shall not apply to any
  Valuation Date occurring on an Expiration Date.

  
	
   

  	
   

  
	
  Automatic Exercise:

  	
  Applicable. Solely for purposes of this provision,
  Section 3.4 of the Equity Definitions shall govern, and the Transaction shall
  be deemed to be a Cash-settled Call Option.

  
	
   

  	
   

  
	
  Market Disruption Event:

  	
  Section 6.3(a) of the Equity Definitions is hereby
  amended by deleting the words “during the one hour period that ends at the
  relevant Valuation Time, Latest Exercise Time, Knock-in Valuation Time or
  Knock-out Valuation Time, as the case may be,” in clause (ii) thereof, and by
  amending and restating clause (a)(iii) thereof in its entirety to read as
  follows: “(iii) an Early Closure that the Calculation Agent determines is
  material.”

  
	
   

  	
   

  
	
   

  	
  Section 6.3(d) of the Equity Definitions is hereby
  amended by deleting the remainder of the provision following the term
  “Scheduled Closing Time” in the fourth line thereof.

  

 

 3
 

 

	
  Settlement Terms:

  	
   

  
	
   

  	
   

  
	
  In respect of any Component:

  	
   

  
	
   

  	
   

  
	
  Net Share Settlement:

  	
  On each Settlement Date, Counterparty shall deliver
  to Deutsche a number of Shares equal to the Net Share Amount for such
  Settlement Date to the account specified by Deutsche, and cash in lieu of any
  fractional shares valued at the Relevant Price for the Valuation Date
  corresponding to such Settlement Date. If, in the good faith reasonable
  judgment of Deutsche, the Shares deliverable hereunder would not be
  immediately freely transferable by Deutsche under Rule 144(k) under the U.S.
  Securities Act of 1933, as amended (the “Securities Act”),
  then Deutsche may elect to either (x) accept delivery of such Shares
  notwithstanding the fact that such Shares are not freely transferable by
  Deutsche under Rule 144(k) or (y) require that such delivery take place
  pursuant to the provisions set forth opposite the caption “Registration/Private Placement Procedures” below.

  
	
   

  	
   

  
	
  Net Share Amount:

  	
  For any Exercise Date, a number of Shares, as
  calculated by the Calculation Agent, equal to the product of (i) the number
  of Warrants being exercised or deemed exercised on such Exercise Date, and (ii) the excess, if any, of the Relevant Price for the
  Valuation Date occurring on such Exercise Date over the Strike Price (such
  product, the “Net Share Settlement Amount”), divided by such Relevant Price.

  
	
   

  	
   

  
	
  Relevant Price:

  	
  On any Valuation Date, the volume weighted average
  price per Share for the regular trading session of the Exchange as displayed
  at 4:15 p.m. (New York City time) under the heading “Bloomberg VWAP” on
  Bloomberg Page NOVA Q <equity> AQR on such Valuation Date (or if such
  volume weighted average price is not available, the Calculation Agent’s
  reasonable, good faith estimate of such price on such Valuation Date).

  
	
   

  	
   

  
	
  Settlement Currency:

  	
  USD.

  
	
   

  	
   

  
	
  Other Applicable Provisions:

  	
  The provisions of Sections 9.1(c), 9.8, 9.9, 9.10,
  9.11 (except that the Representation and Agreement contained in Section 9.11
  of the Equity Definitions shall be modified by excluding any representations
  therein relating to restrictions, obligations, limitations or requirements
  under applicable securities laws as a result of the fact that Counterparty is
  the Issuer of the Shares) and 9.12 of the Equity Definitions will be
  applicable, except that all references in such provisions to
  “Physically-Settled” shall be read as references to “Net Share Settled”. “Net
  Share Settled” in relation to any Warrant means that Net Share Settlement is
  applicable to such Warrant.

  

 

 4
 

 

	
  Dividends:

  	
   

  
	
   

  	
   

  
	
  In respect of any Component:

  	
   

  
	
   

  	
   

  
	
  Dividend Adjustments:

  	
  Counterparty agrees to notify
  Deutsche promptly of the announcement of an ex-dividend date for any cash
  dividend by Counterparty. If an ex-dividend date for any dividend (a “Triggering Dividend”) that differs in amount from the
  Regular Dividend occurs at any time from, but excluding, the Trade Date to,
  and including, the Expiration Date, then in lieu of any adjustments as
  provided under “Method of Adjustment” below, the Calculation Agent shall make such adjustments to the Strike Price
  and/or the Number of Warrants as it deems appropriate to preserve for the
  parties the intended economic benefits of the Transaction.

  
	
   

  	
   

  
	
  Regular Dividend:

  	
  For the first Triggering Dividend for which the
  ex-dividend date occurs within any regular dividend period (based on
  quarterly dividends) of Counterparty, USD0.00 per Share, and, for any
  subsequent Triggering Dividend for which the ex-dividend date occurs within
  the same regular dividend period, zero.

  
	
   

  	
   

  
	
  Adjustments:

  	
   

  
	
   

  	
   

  
	
  In respect of any Component:

  	
   

  
	
   

  	
   

  
	
  Method of Adjustment:

  	
  Calculation Agent Adjustment; provided, however, that the Equity
  Definitions shall be amended by replacing the words “diluting or
  concentrative” in Sections 11.2(a), 11.2(c) (in two instances) and
  11.2(e)(vii) with the word “material” and by adding the words “or the
  Transaction” after the words “theoretical value of the relevant Shares” in
  Sections 11.2(a), 11.2(c) and 11.2(e)(vii); provided
  further that adjustments may be made to account for changes in
  volatility, expected dividends, expected correlation, stock loan rate and
  liquidity relative to the relevant Share.

  
	
   

  	
   

  
	
  Consequences of Merger Events:

  	
   

  
	
   

  	
   

  
	
  New Shares:

  	
  In the definition of New Shares in Section 12.1(i)
  of the Equity Definitions, the text in clause (i) thereof shall be deleted in
  its entirety and replaced with “publicly quoted, traded or listed on any of
  the New York Stock Exchange, the American Stock Exchange, the NASDAQ Global
  Select Market or the NASDAQ Global Market (or their respective successors)”.

  
	
   

  	
   

  
	
  (a) Share-for-Share:

  	
  Modified Calculation Agent Adjustment.

  
	
   

  	
   

  
	
  (b) Share-for-Other:

  	
  Cancellation and Payment (Calculation Agent
  Determination) on the portion of the Other Consideration that consists of
  cash; Modified Calculation Agent Adjustment on the remainder of the Other
  Consideration.

  

 

 5
 

 

	
  (c) Share-for-Combined:

  	
  Component Adjustment.

  
	
   

  	
   

  
	
  Tender Offer:

  	
  Applicable

  
	
   

  	
   

  
	
  Consequences of Tender Offers:

  	
   

  
	
   

  	
   

  
	
  (a) Share-for-Share:

  	
  Modified Calculation Agent Adjustment.

  
	
   

  	
   

  
	
  (b) Share-for-Other:

  	
  Cancellation and Payment on that portion of the
  Other Consideration that consists of cash; Modified Calculation Agent
  Adjustment on the remainder of the Other Consideration.

  
	
   

  	
   

  
	
  (c) Share-for-Combined:

  	
  Component Adjustment.

  
	
   

  	
   

  
	
  Nationalization, Insolvency and Delisting:

  	
  Cancellation and Payment (Calculation Agent
  Determination); provided that
  in addition to the provisions of Section 12.6(a)(iii) of the Equity
  Definitions, it shall also constitute a Delisting if the Exchange is located
  in the United States and the Shares are not immediately re-listed, re-traded
  or re-quoted on any of the New York Stock Exchange, the American Stock
  Exchange, the NASDAQ Global Select Market or the NASDAQ Global Market (or
  their respective successors); if the Shares are immediately re-listed,
  re-traded or re-quoted on any such exchange or quotation system, such
  exchange or quotation system shall be deemed to be the Exchange. For the
  avoidance of doubt, the occurrence of any event that is a Merger Event and
  would otherwise have been a Delisting will have the consequence specified for
  the relevant Merger Event.

  
	
   

  	
   

  
	
  Additional Disruption Events:

  	
   

  
	
   

  	
   

  
	
  Change in Law:

  	
  Applicable

  
	
   

  	
   

  
	
  Failure to Deliver:

  	
  Inapplicable

  
	
   

  	
   

  
	
  Insolvency Filing:

  	
  Applicable

  
	
   

  	
   

  
	
  Loss of Stock Borrow:

  	
  Applicable

  
	
   

  	
   

  
	
  Maximum Stock Loan
  Rate:

  	
  250 basis points

  
	
   

  	
   

  
	
  Increased Cost of Stock Borrow:

  	
  Applicable

  
	
   

  	
   

  
	
  Initial Stock Loan
  Rate:

  	
  Zero

  
	
   

  	
   

  
	
  Increased Cost of Hedging:

  	
  Not Applicable

  
	
   

  	
   

  
	
  Hedging Party:

  	
  Deutsche for all applicable Additional Disruption
  Events

  
	
   

  	
   

  
	
  Determining Party:

  	
  Deutsche for all applicable Additional Disruption
  Events

  

 

 6
 

 

	
  Acknowledgements:

  	
   

  
	
   

  	
   

  
	
  Non-Reliance:

  	
  Applicable

  
	
   

  	
   

  
	
  Agreements and Acknowledgements

  	
   

  
	
  Regarding Hedging Activities:

  	
  Applicable

  
	
   

  	
   

  
	
  Additional Acknowledgements:

  	
  Applicable

  

 

Mutual Representations: Each of Deutsche and Counterparty represents and warrants
to, and agrees with, the other party that:

 

(i)                                     Tax Disclosure.  Notwithstanding anything to the
contrary herein, in the Equity Definitions or in the Agreement, and
notwithstanding any express or implied claims of exclusivity or proprietary
rights, the parties (and each of their employees, representatives or other
agents) are authorized to disclose to any and all persons, beginning
immediately upon commencement of their discussions and without limitation of
any kind, the tax treatment and tax structure of the Transaction, and all
materials of any kind (including opinions or other tax analyses) that are
provided by either party to the other relating to such tax treatment and tax
structure.

 

(ii)                                  Commodity Exchange Act. 
It is an “eligible contract participant” within the meaning of Section
1a(12) of the U.S. Commodity Exchange Act, as amended (the “CEA”).  The
Transaction has been subject to individual negotiation by the parties.  The Transaction has not been executed or
traded on a “trading facility” as defined in Section 1a(33) of the CEA.  It has entered into the Transaction with the expectation and intent that the
Transaction shall be performed to its termination date.

 

(iii)                               Securities Act. 
It is a “qualified institutional buyer” as defined in Rule 144A under
the Securities Act, or an “accredited investor” as defined under the Securities
Act.

 

(iv)                              Investment Company Act. 
It is a “qualified purchaser” as defined under the U.S. Investment
Company Act of 1940, as amended.

 

(v)                                 ERISA.  The assets used in the Transaction (1) are
not assets of any “plan” (as such term is defined in Section 4975 of the U.S.
Internal Revenue Code (the “Code”)) subject
to Section 4975 of the Code or any “employee benefit plan” (as such term is
defined in Section 3(3) of the U.S. Employee Retirement Income Security Act of
1974, as amended (“ERISA”))
subject to Title I of ERISA, and (2) do not constitute “plan assets” within the
meaning of Department of Labor Regulation 2510.3-101, 29 CFR Section
2510-3-101.

 

Counterparty
Representations: In addition to the representations and warranties in the
Agreement and those contained elsewhere herein, Counterparty represents,
warrants, acknowledges and covenants that:

 

(i)                                     Counterparty
shall immediately provide written notice to Deutsche upon obtaining knowledge
of the occurrence of any event that would constitute a Potential Adjustment
Event, a Merger Event or any other Extraordinary Event; provided,
however, that should Counterparty be in possession of material
non-public information regarding Counterparty, Counterparty shall not
communicate such information to Deutsche.

 7
 

(ii)                                  (A)
Counterparty is not relying on any communication (written or oral) of Deutsche
or any of its affiliates as investment advice or as a recommendation to enter
into the Transaction (it being understood that information and explanations
related to the terms and conditions of the Transaction shall not be considered
investment advice or a recommendation to enter into the Transaction) and (B) no
communication (written or oral) received from Deutsche or any of its affiliates
shall be deemed to be an assurance or guarantee as to the expected results of
the Transaction.

 

(iii)                               Counterparty
is not entering into the Transaction for the purpose of (i) creating actual or
apparent trading activity in the Shares (or any security convertible into or
exchangeable for the Shares) or (ii) raising or depressing or otherwise
manipulating the price of the Shares (or any security convertible into or
exchangeable for the Shares), in either case in violation of the U.S.
Securities Exchange Act of 1934, as amended (the “Exchange Act”).

 

(iv)                              Counterparty’s filings under the Securities Act, the Exchange Act, and
other applicable securities laws that are required to be filed have been filed
and, as of the respective dates thereof and as of the date of this
representation, there is no misstatement of material fact contained therein or
omission of a material fact required to be stated therein or necessary to make
the statements made therein, in the light of the circumstances under which they
were made, not misleading.

 

(v)                                 Counterparty
has not violated, and shall not directly or indirectly violate, any applicable
law (including, without limitation, the Securities Act and the Exchange Act) in
connection with the Transaction.

 

(vi)                              The Shares issuable upon exercise of all Warrants (the “Warrant Shares”) have been duly authorized and, when
delivered pursuant to the terms of such Transaction, shall be validly issued,
fully-paid and non-assessable, and such issuance of the Warrant Shares shall
not be subject to any preemptive or similar rights.

 

(vii)                           Counterparty
is not as of the Trade Date, and shall not be after giving effect to the
transactions contemplated hereby, insolvent.

 

(viii)                        Counterparty
is not, and after giving effect to the transactions contemplated hereby will
not be, an “investment company” as such term is defined in the U.S. Investment
Company Act of 1940, as amended.

 

(ix)                                Without
limiting the generality of Section 13.1 of the Equity Definitions, Counterparty
acknowledges that Deutsche is not making any representations or warranties with
respect to the treatment of the Transaction under FASB Statements 133, as
amended, or 150, EITF Issue No. 00-19 (or any successor issue statements) or
under FASB’s Liabilities & Equity Project.

 

(x)                                   Counterparty understands, agrees and acknowledges that no obligations
of Deutsche to it hereunder, if any, shall be entitled to the benefit of deposit
insurance and that such obligations shall not be guaranteed by any affiliate of
Deutsche or any governmental agency.

 

(xi)                                Counterparty shall deliver to Deutsche an opinion of counsel, dated as
of the Trade Date and reasonably acceptable to Deutsche in form and substance,
with respect to the matters set forth in Section 3(a) of the Agreement.

 

Miscellaneous:

 

Effectiveness.  If, prior to the Effective Date, Deutsche
reasonably determines, upon the advice of counsel, that it is advisable to
cancel the Transaction because of concerns that Deutsche’s related hedging
activities could be 

 8
 

viewed as not complying
with applicable securities laws, rules or regulations, the Transaction shall be
cancelled and shall not become effective, and neither party shall have any
obligation to the other party in respect of the Transaction.

 

Netting
and Set-Off.  The
parties hereto agree that the Transaction shall not be subject to netting or
set off with any other transaction.

 

Qualified Financial Contracts.  It is the intention of the
parties that, in respect of Counterparty, (a) the Transaction shall constitute
a “qualified financial contract” within the meaning of 12 U.S.C. Section
1821(e)(8)(D)(i) and (b) a Non-defaulting Party’s rights under Sections 5 and 6
of the Agreement constitute rights of the kind referred to in 12 U.S.C. Section
1821(e)(8)(A).

 

Amendment.
If the underwriter party to the Underwriting Agreement exercises its right to
purchase additional Convertible Notes as set forth therein, then, at the
request of Counterparty, Deutsche and Counterparty will amend this Confirmation
to provide for a corresponding increase in the Number of Warrants, subject to
the repetition by Counterparty of the representations and warranties made by
Counterparty in this Confirmation as of the date of such amendment and
agreement on pricing terms acceptable to Deutsche and Counterparty (such
amendment to provide for the payment by Deutsche to Counterparty of the
additional premium related thereto).

 

Method of
Delivery.  Whenever delivery
of funds or other assets is required hereunder by or to Counterparty, such
delivery shall be effected through Agent. 
In addition, all notices, demands and communications of any kind
relating to the Transaction between Deutsche and Counterparty shall be
transmitted exclusively through Agent.

 

Status of
Claims in Bankruptcy. 
Deutsche acknowledges and agrees that this Confirmation is not intended
to convey to Deutsche rights with respect to the Transaction that are senior to
the claims of common stockholders in any U.S. bankruptcy proceedings of
Counterparty; provided that
nothing herein shall limit or shall be deemed to limit Deutsche’s right to
pursue remedies in the event of a breach by Counterparty of its obligations and
agreements with respect to the Transaction; provided, further, that
nothing herein shall limit or shall be deemed to limit Deutsche’s rights in
respect of any transactions other than the Transaction.

 

No
Collateral. 
Notwithstanding any provision of this Confirmation, the Agreement, Equity
Definitions, or any other agreement between the parties to the contrary, the
obligations of Counterparty under the Transaction are not secured by any
collateral.

 

Securities
Contract; Swap Agreement. 
The parties hereto agree and acknowledge that Deutsche is a “financial
institution,” “swap participant” and “financial participant” within the meaning
of Sections 101(22), 101(53C) and 101(22A) of Title 11 of the United States
Code (the “Bankruptcy Code”).  The parties hereto further agree and
acknowledge that it is their respective intention (A) that this Confirmation be
(i) a “securities contract,” as such term is defined in Section 741(7) of the
Bankruptcy Code, with respect to which each payment and delivery hereunder or
in connection herewith is a “termination value,” “payment amount” or “other
transfer obligation” within the meaning of Section 362 of the Bankruptcy Code
and a “settlement payment” within the meaning of Section 546 of the Bankruptcy
Code, and (ii) a “swap agreement,” as such term is defined in Section 101(53B)
of the Bankruptcy Code, with respect to which each payment and delivery
hereunder or in connection herewith be a “termination value,” a “payment
amount” or “other transfer obligation” within the meaning of Section 362 of the
Bankruptcy Code and a “transfer” within the meaning of Section 546 of the
Bankruptcy Code, and (B) that Deutsche is entitled to the protections afforded
by, among other sections, Section 362(b)(6), 362(b)(17), 362(b)(27), 362(o),
546(e), 546(g), 546(j), 548(d)(2), 555, 560 and 561 of the Bankruptcy Code.

 

Alternative
Calculations and Counterparty Payment on Early Termination and on Certain
Extraordinary Events. 
If Counterparty owes Deutsche any amount in connection with the
Transaction pursuant to Sections 12.2, 12.3, 12.6, 12.7 or 12.9 of the Equity
Definitions (except in the case of an Extraordinary Event in which the
consideration or proceeds to be paid to holders of Shares as a result of such
event consists solely of cash) or pursuant to Section 6(d)(ii) of the Agreement
(except in the case of an Event of Default in which Counterparty is the
Defaulting Party or a Termination Event in which Counterparty is the Affected
Party, other than (x) an Event 

 9
 

of Default of the type
described in Section 5(a)(iii), (v), (vi) or (vii) of the Agreement or (y) a
Termination Event of the type described in Section 5(b)(i), (ii), (iii), (iv),
(v) or (vi) of the Agreement that in the case of either (x) or (y) resulted
from an event or events outside Counterparty’s control) (a “Counterparty Payment Obligation”), Counterparty shall have
the right, in its sole discretion, to satisfy any such Counterparty Payment
Obligation by delivery of Termination Delivery Units (as defined below) by
giving irrevocable telephonic notice to Deutsche, confirmed in writing within
one Scheduled Trading Day, between the hours of 9:00 a.m. and 4:00 p.m. New
York time on the Early Termination Date or other date the transaction is
terminated, as applicable (“Notice of Counterparty
Termination Delivery”). 
Within a commercially reasonable period of time following receipt of a
Notice of Counterparty Termination Delivery, Counterparty shall deliver to
Deutsche a number of Termination Delivery Units having a cash value equal to
the amount of such Counterparty Payment Obligation (such number of Termination
Delivery Units to be delivered to be determined by the Calculation Agent as the
number of whole Termination Delivery Units that could be sold over a
commercially reasonable period of time to generate proceeds equal to the cash
equivalent of such payment obligation). 
In addition, if, in the good faith reasonable judgment of Deutsche, for
any reason, the Termination Delivery Units deliverable pursuant to this
paragraph would not be immediately freely transferable by Deutsche under Rule
144(k) under the Securities Act, then Deutsche may elect either to (x) accept
delivery of such Termination Delivery Units notwithstanding any restriction on
transfer or (y) require that such delivery take place pursuant to the provisions
set forth opposite the caption “Registration/Private
Placement Procedures” below. 
If the provisions set forth in this paragraph are applicable, the
provisions of Sections 9.8, 9.9, 9.10, 9.11 (modified as described above) and
9.12 of the Equity Definitions shall be applicable, except that all references
to “Shares” shall be read as references to “Termination Delivery Units.”

 

“Termination
Delivery Unit” means (a) in the case of a Termination Event, an
Event of Default or an Extraordinary Event (other than an Insolvency,
Nationalization, Merger Event or Tender Offer), one Share or (b) in the case of
an Insolvency, Nationalization, Merger Event or Tender Offer, a unit consisting
of the number or amount of each type of property received by a holder of one
Share (without consideration of any requirement to pay cash or other
consideration in lieu of fractional amounts of any securities) in such
Insolvency, Nationalization, Merger Event or Tender Offer.  If a Termination Delivery Unit consists of
property other than cash or New Shares and Counterparty provides irrevocable
written notice to the Calculation Agent on or prior to the Closing Date that it
elects to deliver cash, New Shares or a combination thereof (in such proportion
as Counterparty designates) in lieu of such other property, the Calculation
Agent shall replace such property with cash, New Shares or a combination
thereof as components of a Termination Delivery Unit in such amounts, as
determined by the Calculation Agent in its discretion by commercially
reasonable means, as shall have a value equal to the value of the property so
replaced.  If such Insolvency,
Nationalization, Merger Event or Tender Offer involves a choice of
consideration to be received by holders, such holder shall be deemed to have
elected to receive the maximum possible amount of cash.

 

Registration/Private
Placement Procedures. 
If, in the reasonable opinion of Deutsche, following any delivery of
Shares or Termination Delivery Units to Deutsche hereunder, such Shares or
Termination Delivery Units would be in the hands of Deutsche subject to any
applicable restrictions with respect to any registration or qualification
requirement or prospectus delivery requirement for such Shares or Termination
Delivery Units pursuant to any applicable federal or state securities law
(including, without limitation, any such requirement arising under Section 5 of
the Securities Act as a result of such Shares or Termination Delivery Units
being “restricted securities”, as such term is defined in Rule 144 under the
Securities Act, or as a result of the sale of such Shares or Termination
Delivery Units being subject to paragraph (c) of Rule 145 under the Securities
Act) (such Shares or Termination Delivery Units, “Restricted
Shares”), then delivery of such Restricted Shares shall be effected
pursuant to either clause (i) or (ii) of Annex A hereto at the election of
Counterparty, unless waived by Deutsche. Notwithstanding the foregoing, solely
in respect of any Warrants exercised or deemed exercised on any Exercise Date,
Counterparty shall elect, prior to the first Settlement Date for the first
Exercise Date, a Private Placement Settlement (as defined in Annex A hereto) or
Registration Settlement (as defined in Annex A hereto) for all deliveries of
Restricted Shares for all such Exercise Dates which election shall be
applicable to all Settlement Dates for such Warrants and the procedures in
clause (i) or clause (ii) of Annex A hereto shall apply for all such delivered
Restricted Shares on an aggregate basis commencing after the final Settlement
Date for such Warrants. The Calculation Agent shall make reasonable adjustments
to settlement terms and provisions 

 10
 

under this Confirmation
to reflect a single Private Placement Settlement or Registration Settlement for
such aggregate Restricted Shares delivered hereunder.  If the Private Placement Settlement or the
Registration Settlement shall not be effected as set forth in clauses (i) or
(ii) of Annex A, as applicable, then failure to effect such Private Placement
Settlement or such Registration Settlement shall constitute an Event of Default
with respect to which Counterparty shall be the Defaulting Party.

 

Share
Deliveries. 
Counterparty acknowledges and agrees that, to the extent that Deutsche
is not then an affiliate, as such term is used in Rule 144 under the Securities
Act, of Counterparty and has not been such an affiliate of Counterparty for 90
days (it being understood that Deutsche shall not be considered such an
affiliate of Counterparty solely by reason of its right to receive of Shares
pursuant to a Transaction hereunder), and otherwise satisfies all holding
period and other requirements of Rule 144 under the Securities Act applicable
to it, any Shares or Termination Delivery Units delivered hereunder at any time
after 2 years from the Premium Payment Date shall be eligible for resale under
Rule 144(k) under the Securities Act, and Counterparty agrees to promptly
remove, or cause the transfer agent for such Shares or Termination Delivery
Units to remove, any legends referring to any restrictions on resale under the
Securities Act from the certificates representing such Shares or Termination
Delivery Units.  Counterparty further
agrees that with respect to any Shares or Termination Delivery Units delivered
hereunder at any time after 1 year from the Premium Payment Date but prior to 2
years from the Premium Payment Date, to the extent that Deutsche then satisfies
the holding period and other requirements of Rule 144 under the Securities Act,
Counterparty shall promptly remove, or cause the transfer agent for such Shares
or Termination Delivery Units to remove, any legends referring to any such
restrictions or requirements from the certificates representing such Share or
Termination Delivery Units upon delivery by Deutsche to Counterparty or such
transfer agent of customary seller’s and broker’s representation letters in
connection with resales of such Shares or Termination Delivery Units pursuant
to Rule 144 under the Securities Act, without any further requirement for the
delivery of any certificate, consent, agreement, opinion of counsel, notice or
any other document, any transfer tax stamps or payment of any other amount or
any other action by Deutsche.  Counterparty further agrees and acknowledges
that Deutsche shall run a holding period under Rule 144 under the Securities
Act with respect to the Warrants and/or any Shares or Termination Delivery
Units delivered hereunder notwithstanding the existence of any other
transaction or transactions between Counterparty and Deutsche relating to the
Shares.  Counterparty further agrees that
Shares or Termination Delivery Units delivered hereunder prior to the date that
is 1 year from the Premium Payment Date may be freely transferred by Deutsche
to its affiliates, and Counterparty shall effect such transfer without any
further action by Deutsche.  Notwithstanding
anything to the contrary herein, Counterparty agrees that any delivery of
Shares or Termination Delivery Units shall be effected by book-entry transfer
through the facilities of the Clearance System if, at the time of such
delivery, the certificates representing such Shares or Termination Delivery
Units would not contain any restrictive legend as described above.  Notwithstanding anything to the contrary herein,
to the extent the provisions of Rule 144 under the Securities Act or any
successor rule are amended, or the applicable interpretation thereof by the
Securities and Exchange Commission or any court changes after the Trade Date,
the agreements of Counterparty herein shall be deemed modified to the extent
necessary, in the opinion of outside counsel of Counterparty, to comply with
Rule 144 under the Securities Act, including Rule 144(k), as in effect at the
time of delivery of the relevant Shares or Termination Delivery Units.

 

No
Material Non-Public Information.  On each day during the period beginning on
the Trade Date and ending on the earlier of (x) the day on which Deutsche has
informed Counterparty in writing that Deutsche has completed all purchases or
sales of Shares or other transactions to hedge initially its exposure with
respect to the Transaction, including any increase in the Number of Warrants
that may be agreed pursuant to “Amendment”
above and (y) the thirty-first (31st) day thereafter, Counterparty represents
and warrants to Deutsche that it is not aware of any material nonpublic
information concerning itself or the Shares other than in respect of the
transaction contemplated hereby.

 

Limit on
Beneficial Ownership. 
Notwithstanding any other provisions hereof, Deutsche may not exercise
any Warrant hereunder, Automatic Exercise shall not apply with respect thereto,
and no delivery hereunder (including pursuant to provisions opposite the
headings “Alternative Calculations and
Counterparty Payments on Early Termination and on Certain Extraordinary Events,”
“Registration/Private Placement Procedures,” “Limitation
on Delivery of Shares” or Annex A) shall be made, to the extent (but
only to the extent) that the 

 11
 

receipt of any Shares
upon such exercise or delivery would result in Deutsche directly or indirectly
beneficially owning (as such term is defined for purposes of Section 13(d) of
the Exchange Act) at any time in excess of 9.0% of the outstanding Shares.  Any purported delivery hereunder shall be
void and have no effect to the extent (but only to the extent) that such
delivery would result in Deutsche directly or indirectly so beneficially owning
in excess of 9.0% of the outstanding Shares. 
If any delivery owed to Deutsche or exercise hereunder is not made, in
whole or in part, as a result of this provision, Counterparty’s obligation to
make such delivery and Deutsche’s right to exercise a Warrant shall not be
extinguished and Counterparty shall make such delivery as promptly as
practicable after, but in no event later than one Clearance System Business Day
after, Deutsche gives notice to Counterparty that such exercise or delivery
would not result in Deutsche directly or indirectly so beneficially owning in
excess of 9.0% of the outstanding Shares.

 

Repurchase
Notices.  On any day
Counterparty effects any repurchases of Shares, Counterparty shall promptly
provide Deutsche with a written notice of such repurchase (a “Repurchase Notice”) if the Warrant Equity Percentage (as
defined below) is (a) equal to or greater than 4.5% and (b) greater by 0.5%
than the Warrant Equity Percentage set forth in the immediately preceding
Repurchase Notice (or, in the case of the first such Repurchase Notice, greater
than the Warrant Equity Percentage as of the date hereof).  The Warrant Equity Percentage as of any day
is the fraction of (1) the numerator of which is the Number of Warrants, and
(2) the denominator of which is the number of Shares outstanding on such day.  Counterparty agrees to indemnify and hold harmless
Deutsche and its affiliates and their respective officers, directors,
employees, affiliates, advisors, agents and controlling person (each, an “Indemnified Person”) from and against any
and all losses (including losses relating to Deutsche’s hedging activities as a
consequence of becoming, or of the risk of becoming, an “insider” as defined
under Section 16 of the Exchange Act, including without limitation, any
forbearance from hedging activities or cessation of hedging activities and any
losses in connection therewith with respect to this Transaction), claims,
damages, judgments, liabilities and expense (including reasonable attorney’s
fees), joint or several, which an Indemnified Person actually may become
subject to, as a result of Counterparty’s failure to provide Deutsche with a
Repurchase Notice on the day and in the manner specified herein, and to
reimburse, upon written request, each of such Indemnified Persons for any
reasonable legal or other expenses incurred in connection with investigating,
preparing for, providing testimony or other evidence in connection with or
defending any of the foregoing.  If any
suit, action, proceeding (including any governmental or regulatory
investigation), claim or demand shall be brought or asserted against the
Indemnified Person, such Indemnified Person shall promptly notify Counterparty
in writing, and Counterparty, upon request of the Indemnified Person, shall
retain counsel reasonably satisfactory to the Indemnified Person to represent
the Indemnified Person and any others Counterparty may designate in such
proceeding and shall pay the fees and expenses of such counsel related to such
proceeding.  Counterparty shall be
relieved from liability to the extent that the Indemnified Person fails
promptly to notify Counterparty of any action commenced against it in respect
of which indemnity may be sought hereunder; provided, that
failure to notify Counterparty (x) shall not relieve Counterparty from any
liability hereunder to the extent it is not materially prejudiced as a result
thereof and (y) shall not, in any event, relieve Counterparty from any
liability that it may have otherwise than on account of this indemnity
agreement.  Counterparty shall not be
liable for any settlement of any proceeding effected without its written
consent, but if settled with such consent or if there be a final judgment for
the plaintiff, Counterparty agrees to indemnify any Indemnified Person from and
against any loss or liability by reason of such settlement or judgment.  Counterparty shall not, without the prior
written consent of the Indemnified Person, effect any settlement of any pending
or threatened proceeding in respect of which any Indemnified Person is or could
have been a party and indemnity could have been sought hereunder by such
Indemnified Person, unless such settlement includes an unconditional release of
such Indemnified Person from all liability on claims that are the subject
matter of such proceeding on terms reasonably satisfactory to such Indemnified
Person.  If the indemnification provided
for in this paragraph is unavailable to an Indemnified Person or insufficient
in respect of any losses, claims, damages or liabilities referred to therein,
then Counterparty, in lieu of indemnifying such Indemnified Person thereunder,
shall contribute to the amount paid or payable by such Indemnified Person as a
result of such losses, claims, damages or liabilities.  The remedies provided for in this paragraph
are not exclusive and shall not limit any rights or remedies that may otherwise
be available to any Indemnified Person at law or in equity.  The indemnity and contribution agreements
contained in this paragraph shall remain operative and in full force and effect
regardless of the termination of the Transaction.

 12
 

Limitation
On Delivery of Shares. 
Notwithstanding anything herein or in the Agreement to the contrary, in
no event shall Counterparty be required to deliver Shares in connection with
the Transaction in excess of 23,544,185 Shares (the “Maximum Delivery Amount”). 
Counterparty represents and warrants (which shall be deemed to be
repeated on each day that the Transaction is outstanding) that the Maximum
Delivery Amount is equal to or less than the number of authorized but unissued
Shares of Counterparty that are not reserved for future issuance in connection
with transactions in the Shares (other than the Transaction) on the date of the
determination of the Maximum Delivery Amount (such Shares, the “Available Shares”).  In the event Counterparty shall not have
delivered the full number of Shares otherwise deliverable as a result of this
paragraph (the resulting deficit, the “Deficit
Shares”), Counterparty shall be continually obligated to deliver,
from time to time until the full number of Deficit Shares have been delivered pursuant
to this paragraph, Shares when, and to the extent, that (i) Shares are
repurchased, acquired or otherwise received by Counterparty or any of its
subsidiaries after the Trade Date (whether or not in exchange for cash, fair
value or any other consideration), (ii) authorized and unissued Shares reserved
for issuance in respect of other transactions prior to such date which prior to
the relevant date become no longer so reserved and (iii) Counterparty
additionally authorizes any unissued Shares that are not reserved for other
transactions.  Counterparty shall
immediately notify Deutsche of the occurrence of any of the foregoing events
(including the number of Shares subject to clause (i), (ii) or (iii) and the
corresponding number of Shares to be delivered) and promptly deliver such
Shares thereafter.

 

Additional
Termination Event.  The occurrence of any of the following shall
constitute an Additional Termination Event with respect to which (1)
Counterparty shall be the sole Affected Party and (2) the Transaction shall be
the sole Affected Transaction; provided
that with respect to any Additional Termination Event, Deutsche may choose to
treat part of the Transaction as the sole Affected Transaction, and, upon
termination of the Affected Transaction, a Transaction with terms identical to
those set forth herein except with a Number of Warrants equal to the unaffected
number of Warrants shall be treated for all purposes as the Transaction, which
shall remain in full force and effect:

 

(i)            Deutsche reasonably determines that it is
advisable to terminate a portion of the Transaction so that Deutsche’s related
hedging activities will comply with applicable securities laws, rules or
regulations;

 

(ii)           the Shares are not approved for listing on
the Nasdaq Global Market and are not listed for trading on another U.S.
national securities exchange;

 

(iii)          any “person” or “group” (as such terms are
used for purposes of Sections 13(d) and 14(d) of the Exchange Act) is or
becomes the “beneficial owner” (as that term is used in Rule 13d-3 under the
Exchange Act), directly or indirectly, of 50% or more of the total voting power
of all classes of Counterparty’s capital stock entitled to vote generally in
the election of directors (“voting stock”);

 

(iv)          Counterparty consolidates with, or merges
with or into, another person, or Counterparty assigns, conveys, transfers,
leases or otherwise disposes of all or substantially all of its assets, or any
person consolidates with, or merges with or into, Counterparty unless either
(i) the persons that “beneficially owned,” directly or indirectly, the shares
of Counterparty’s voting stock immediately prior to such transaction,
“beneficially own,” directly or indirectly, immediately after such transaction,
shares of the surviving or transferee person, or (ii) (A) at least 90% of the
consideration (other than cash payments for fractional shares or pursuant to
dissenters’ appraisal rights) in such transaction consists of common stock
traded on the Nasdaq Global Select Market or on another U.S. national
securities exchange (on which will be so traded immediately following such
transaction) and (B) as a result of such transaction, the 1.0% Convertible
Senior Subordinated Notes due 2012 issued by Counterparty would be convertible
solely into such shares of common stock;

 

(v)           (a) individuals who on the Trade Date
constituted Counterparty’s board of directors and (b) any new directors whose
election to Counterparty’s board of directors or whose nomination for election
by Counterparty’s stockholders was approved by at least a majority of the
directors then still in office either who were directors on the Trade Date or
whose election or nomination for election was previously so approved, cease for
any reason to constitute a majority of Counterparty’s board of directors; or

 

 13
 

(vi)          Counterparty is liquidated or dissolved or
holders of the Shares approve any plan or proposal for liquidation or
dissolution of Counterparty.

 

Transfer
or Assignment. 
Notwithstanding any provision of the Agreement to the contrary, Deutsche
may, subject to applicable law, freely transfer and assign all of its rights
and obligations under the Transaction without the consent of Counterparty.

 

If, as determined in
Deutsche’s sole discretion, (x) its “beneficial ownership” (within the meaning
of Section 16 of the Exchange Act and rules promulgated thereunder) exceeds 8%
of Counterparty’s outstanding Shares and (y) Deutsche is unable, after
commercially reasonable efforts, to effect a transfer or assignment on pricing
terms and within a time period reasonably acceptable to it of all or a portion
of the Transaction to reduce such “beneficial ownership” below 8%, Deutsche may
designate any Scheduled Trading Day as an Early Termination Date with respect
to a portion (the “Terminated Portion”)
of this Transaction, such that its “beneficial ownership” following such
partial termination will be approximately equal to but less than 8%.  In the event that Deutsche so designates an
Early Termination Date with respect to a portion of this Transaction, a payment
shall be made pursuant to Section 6 of the Agreement as if (i) an Early
Termination Date had been designated in respect of a Transaction having terms
identical to this Transaction and a Number of Warrants equal to the Terminated
Portion (allocated among the Components thereof in the discretion of Deutsche),
(ii) Counterparty shall be the sole Affected Party with respect to such partial
termination and (iii) such Transaction shall be the only Terminated Transaction
(and, for the avoidance of doubt, the provisions set forth under the caption “Alternative Calculations and Counterparty Payment on Early Termination
and on Certain Extraordinary Events” shall apply to any amount that is payable by Counterparty to
Deutsche pursuant to this sentence).

 

Notwithstanding any other
provision in this Confirmation to the contrary requiring or allowing Deutsche
to purchase, sell, receive or deliver any shares or other securities to or from
Counterparty, Deutsche may designate any of its affiliates to purchase, sell,
receive or deliver such shares or other securities and otherwise to perform
Deutsche’s obligations in respect of the Transaction and any such designee may
assume such obligations.  Deutsche shall
be discharged of its obligations to Counterparty to the extent of any such
performance.

 

Severability;
Illegality.  If
compliance by either party with any provision of the Transaction would be
unenforceable or illegal, (a) the parties shall negotiate in good faith to
resolve such unenforceability or illegality in a manner that preserves the
economic benefits of the transactions contemplated hereby and (b) the
other provisions of the Transaction shall not be invalidated, but shall remain
in full force and effect.

 

Waiver of
Jury Trial.   EACH
PARTY WAIVES, TO THE FULLEST EXTENT PERMITTED BY APPLICABLE LAW, ANY RIGHT IT
MAY HAVE TO A TRIAL BY JURY IN RESPECT OF ANY SUIT, ACTION OR PROCEEDING
RELATING TO THE TRANSACTION.  EACH PARTY
(I) CERTIFIES THAT NO REPRESENTATIVE, AGENT OR ATTORNEY OF THE OTHER PARTY HAS
REPRESENTED, EXPRESSLY OR OTHERWISE, THAT SUCH OTHER PARTY WOULD NOT, IN THE
EVENT OF SUCH A SUIT, ACTION OR PROCEEDING, SEEK TO ENFORCE THE FOREGOING
WAIVER AND (II) ACKNOWLEDGES THAT IT AND THE OTHER PARTY HAVE BEEN INDUCED TO
ENTER INTO THE TRANSACTION, AS APPLICABLE, BY, AMONG OTHER THINGS, THE MUTUAL
WAIVERS AND CERTIFICATIONS PROVIDED HEREIN.

 

	
  Governing law:

  	
   

  	
  This Confirmation and the Agreement shall be
  governed by and construed in accordance with law of the State of New York.

  

Contact information.
For purposes of the Agreement (unless otherwise specified in the Agreement),
the addresses for notice to the parties shall be:

(a)
Counterparty

NovaMed,
Inc.

 14
 

980
North Michigan Avenue, Suite 1620

Chicago, Illinois 60611

Attention:  The Chief Executive Officer
and the Chief Financial Officer

(b) Deutsche

Deutsche Bank AG London

c/o
Deutsche Bank AG New York

60 Wall Street 

New York, NY 10005

Attention:
Documentation Department

 15
 

This Confirmation may be
executed in several counterparts, each of which shall be deemed an original but
all of which together shall constitute one and the same instrument.

Counterparty hereby
agrees to check this Confirmation and to confirm that the foregoing correctly
sets forth the terms of the Transaction by signing in the space provided below
and returning to Deutsche a facsimile of the fully-executed Confirmation to
Deutsche at 44 113 336 2009. Originals shall be provided for your execution
upon your request.

We are very pleased to
have executed the Transaction with you and we look forward to completing other
transactions with you in the near future.

	
  Very truly yours,

  	
   

  
	
   

  	
   

  
	
  DEUTSCHE
  BANK AG LONDON

  	
   

  
	
   

  	
   

  
	
   

  	
   

  
	
  By:

  	
  /s/ Lee
  Frankenfield

  	
   

  	
   

  
	
   

  	
  Name: Lee
  Frankenfield

  	
   

  	
   

  
	
   

  	
  Title: Managing
  Director

  	
   

  	
   

  
	
   

  	
   

  	
   

  	
   

  
	
  By:

  	
  /s/ Sunil
  Hariani

  	
   

  	
   

  
	
   

  	
  Name: Sunil
  Hariani

  	
   

  	
   

  
	
   

  	
  Title: Director

  	
   

  	
   

  
	
   

  	
   

  	
   

  	
   

  
	
   

  	
   

  	
   

  	
   

  
	
  DEUTSCHE
  BANK AG NEW YORK,

  	
   

  	
   

  
	
  acting solely as
  Agent in connection with this Transaction

  	
   

  
	
   

  	
   

  
	
   

  	
   

  
	
  By:

  	
  /s/ Lee
  Frankenfield

  	
   

  	
   

  
	
   

  	
  Name: Lee
  Frankenfield

  	
   

  	
   

  
	
   

  	
  Title: Managing
  Director

  	
   

  	
   

  
	
   

  	
   

  	
   

  	
   

  
	
  By:

  	
  /s/ Andrew
  Yaeger

  	
   

  	
   

  
	
   

  	
  Name: Andrew
  Yaeger

  	
   

  	
   

  
	
   

  	
  Title: Director

  	
   

  	
   

  
	
   

  	
   

  	
   

  	
   

  
	
   

  	
   

  	
   

  	
   

  
	
  Counterparty hereby agrees to, accepts and confirms
  the terms of the foregoing as of the Trade Date.

  
	
   

  
	
  NOVAMED,
  INC.

  	
   

  	
   

  
	
   

  	
   

  	
   

  
	
  By:

  	
  /s/ Scott T.
  Macomber

  	
   

  	
   

  
	
   

  	
  Name: Scott T.
  Macomber

  	
   

  	
   

  
	
   

  	
  Title:

  	
  Executive Vice
  President and

  Chief Financial Officer

  	
   

  	
   

  
							

 

 16

ANNEX A

 

Registration Settlement and Private Placement
Settlement

(i)
                                  If
Counterparty elects to settle the Transaction pursuant to this clause (i) (a “Private Placement Settlement”), then delivery of Restricted
Shares by Counterparty shall be effected in customary private placement
procedures with respect to such Restricted Shares reasonably acceptable to
Deutsche; provided that
Counterparty may not elect a Private Placement Settlement if, on the date of
its election, it has taken, or caused to be taken, any action that would make
unavailable either the exemption pursuant to Section 4(2) of the Securities Act
for the sale by Counterparty to Deutsche (or any affiliate designated by
Deutsche) of the Restricted Shares or the exemption pursuant to Section 4(1) or
Section 4(3) of the Securities Act for resales of the Restricted Shares by
Deutsche (or any such affiliate of Deutsche). The Private Placement Settlement
of such Restricted Shares shall include customary representations, covenants,
blue sky and other governmental filings and/or registrations, indemnities to
Deutsche, due diligence rights (for Deutsche or any designated buyer of the
Restricted Shares by Deutsche), opinions and certificates, and such other
documentation as is customary for private placement agreements, all reasonably
acceptable to Deutsche. In the event of a Private Placement Settlement, the Net
Share Settlement Amount or the Counterparty Payment Obligation, respectively,
shall be deemed to be the Net Share Settlement Amount or the Counterparty
Payment Obligation, respectively, plus
an additional amount (determined from time to time by the Calculation Agent in
its commercially reasonable judgment) attributable to interest that would be
earned on such Net Share Settlement Amount or the Counterparty Payment
Obligation, respectively, (increased on a daily basis to reflect the accrual of
such interest and reduced from time to time by the amount of net proceeds
received by Deutsche as  provided herein)
at a rate equal to the open Federal Funds Rate plus 0.50% for the period from,
and including, such Settlement Date or the date on which the Counterparty
Payment Obligation is due, respectively, to, but excluding, the related date on
which all the Restricted Shares have been sold and calculated on an Actual/360
basis.

(ii)
                               If
Counterparty elects to settle the Transaction pursuant to this clause (ii) (a “Registration Settlement”), then Counterparty shall promptly
(but in any event no later than the beginning of the Resale Period) file and
use its reasonable best efforts to make effective under the Securities Act a
registration statement or supplement or amend an outstanding registration
statement in form and substance reasonably satisfactory to Deutsche, to cover
the resale of such Restricted Shares (and any Make-whole Shares) in accordance
with customary resale registration procedures, including covenants, conditions,
representations, underwriting discounts (if applicable), commissions (if
applicable), indemnities, due diligence rights, opinions and certificates, and
such other documentation as is customary for equity resale underwriting
agreements, all reasonably acceptable to Deutsche. If Deutsche, in its sole
reasonable discretion, is not satisfied with such procedures and documentation,
Private Placement Settlement shall apply. If Deutsche is satisfied with such
procedures and documentation, it shall sell the Restricted Shares (and any
Make-whole Shares) pursuant to such registration statement during a period (the
“Resale Period”) commencing on the Exchange
Business Day following delivery of such Restricted Shares (and any Make-whole
Shares) and ending on the earliest of (i) the Exchange Business Day on which
Deutsche completes the sale of all Restricted Shares or, in the case of
settlement of Termination Delivery Units, a sufficient number of Restricted
Shares so that the realized net proceeds of such sales exceed the Counterparty
Payment Obligation, (ii) the date upon which all Restricted Shares (and any
Make-whole Shares) have been sold or transferred pursuant to Rule 144 (or
similar provisions then in force) or Rule 145(d)(1) or (2) (or any similar
provision then in force) under the Securities Act and (iii) the date upon which
all Restricted Shares (and any Make-whole Shares) may be sold or transferred by
a non-affiliate pursuant to Rule 144(k) (or any similar provision then in
force) or Rule 145(d)(3) (or any similar provision then in force) under the
Securities Act.

(iii)                               If (ii) above is
applicable and the Net Share Settlement Amount or the Counterparty Payment
Obligation, as applicable, exceeds the realized net proceeds from such resale, or
if (i) above is applicable and the Freely Tradeable Value of the Shares owed
pursuant to the Net Share Settlement Amount, or the Counterparty Payment
Obligation (in each case as adjusted pursuant to (i) above), as applicable,
exceeds the realized net proceeds from such resale, 

 A-1
 

Counterparty shall transfer to Deutsche by the open of the regular
trading session on the Exchange on the Exchange Business Day immediately
following the last day of the Resale Period the amount of such excess (the “Additional Amount”), at its option, either in cash or in a
number of Shares (“Make-whole Shares”,
provided that the aggregate
number of Shares and Make-whole Shares delivered shall not exceed the Maximum
Delivery Amount) that, based on the Relevant Price on the last day of the
Resale Period (as if such day was the “Valuation Date”
for purposes of computing such Relevant Price), has a value equal to the
Additional Amount. If Counterparty elects to pay the Additional Amount in
Make-whole Shares, Counterparty shall elect whether the requirements and
provisions for either Private Placement Settlement or Registration Settlement
shall apply to such payment. This provision shall be applied successively until
the Additional Amount is equal to zero, subject to “Limitations on Delivery of Shares”.  “Freely
Tradeable Value” means the value of the number of Shares delivered
to Deutsche which such Shares would have if they were freely tradeable (without
prospectus delivery) upon receipt by Deutsche, as determined by the Calculation
Agent by reference to the Relevant Price for freely tradeable Shares as of the
Valuation Date, or other date of valuation used to determine the delivery
obligation with respect to such Shares, or by other commercially reasonable
means.

 A-2

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