Document:

Exhibit 10.3b

 

ASSIGNMENT, ASSUMPTION AND AMENDMENT
OF LEASE AGREEMENT FOR A GAMMA KNIFE UNIT

 

This ASSIGNMENT, ASSUMPTION AND AMENDMENT
OF LEASE AGREEMENT FOR A GAMMA KNIFE UNIT (this “Amendment”) is made effective as of the close of business on June
30, 2006 (the “Amendment Effective Date”) and is entered into by and among Yale-New Haven Ambulatory Services Corporation,
a Connecticut corporation (“ASC”), Yale-New Haven Hospital, Inc. a/k/a Yale-New Haven Hospital, a Connecticut
corporation (“YNHH”) and GK Financing, LLC, a California limited liability company (“GKF”).

 

RECITALS

 

WHEREAS, on April 10, 1997 GKF and ASC entered
into a Lease Agreement For A Gamma Knife Unit (the “Lease”), which Lease was amended pursuant to an Addendum dated
as of October 25, 2005 (the “Addendum”) (the Lease, as amended by the Addendum, is hereinafter referred to as the “Amended
Lease”) ;

 

WHEREAS, YNHH is an affiliate of ASC, and
ASC desires to transfer and assign its interest in the Amended Lease (as further amended hereby) to YNHH; and

 

WHEREAS, ASC, YNHH and GKF desire to further
amend the Amended Lease with respect to reimbursement paid to GKF and certain other provisions and to effect such transfer and
assignment.

 

NOW, THEREFORE, in consideration of the
mutual covenants and agreements set forth herein, and for other good and valuable consideration, the receipt and sufficiency of
which are hereby acknowledged, the parties agree as follows:

 

		1.	Definitions. All capitalized terms used but not defined herein have the meanings given thereto in the Amended Lease.
The lease arrangement as amended and assigned to YNHH hereby is referred to as the “Assigned Lease.”

 

		2.	Additional Amendments to the Amended Lease. GKF and ASC agree to amend the Amended Lease as follows:

 

		a.	As of the Amendment Effective Date, Section 7 of the Lease (captioned “Reimbursement to GKF”) and Section 4 of
the Addendum (captioned “Lease Payment to GKF”) are deleted and of no further force or effect.

 

		b.	From and after the Amendment Effective Date, YNHH shall pay to GKF the monthly “Lease Payments” (as defined below),
plus, if applicable, the “Additional Payments” (as defined below). The Lease Payments shall be payable within
thirty (30) days after the conclusion of each calendar month in which the applicable procedures were performed. In addition to
the Lease Payments and the Additional Payments, YNHH shall pay to GKF quarterly payments in an amount equal to one quarter of YNHH’s
reasonable projection of the total property tax, service and support agreement and insurance obligations due on the Equipment and
paid by GKF for each “Contract Year” (as defined below). Within thirty (30) days after the end of each Contract Year,
the sum of such quarterly projected payments made by YNHH shall be reconciled against the actual amounts of such expenses, and
YNHH or GKF shall, within thirty (30) days thereafter, make a “true up” payment to the other as appropriate. Through
the term of the Assigned Lease, and thereafter until final settlement of all amounts owed to or claimed by either party under the
Assigned Lease, each party shall have the right at reasonable times and upon reasonable advance notice to inspect, audit and copy
the other party’s books and records which relate to scheduling and billing of, and reimbursement for, Gamma Knife procedures,
the Lease Payments and Additional Payments, and the service, insurance and property tax expenses associated with the Equipment.
Notwithstanding the foregoing, the compensation payable to GKF pertaining to procedures performed prior to the Amendment Effective
Date shall be calculated and paid by ASC in accordance with Section 4 of the Amended Lease.

 

     

     

    

 

		i.	As used herein:

 

		(A)	“Lease Payment” shall mean and be equal to Five Thousand Five Hundred Dollars ($5,500) multiplied by each and every
procedure performed after the Amendment Effective Date during the applicable calendar month using the Equipment, irrespective of
(1) whether the procedure is performed by YNHH, its representatives or affiliates, or any other person or entity; or (2) the
actual amounts billed or collected, if any, pertaining to such procedures.

 

		(B)	“Affiliate” shall mean as to any YNHH and/or ASC, (1) any Person which, directly or indirectly, is in control of,
is controlled by, or is under common control with such YNHH and/or ASC, or (2) any Person who is a director or officer (aa) of
YNHH and/or ASC, (bb) of any subsidiary of YNHH and/or ASC, or (cc) of any Person described in clause (1) above. For purposes of
this definition, control of a Person shall mean the power, direct or indirect, to direct or cause the direction of the management
and policies of such Person whether through ownership of voting securities, by contract or otherwise.

 

Without limiting the generality of the foregoing,
“Affiliate” shall expressly include the Yale-New Haven Delivery Network and all of its constituent entities, including,
without limitation, Yale-New Haven Hospital, Yale-New Haven Children’s Hospital, Yale-New Haven Psychiatric Hospital, Yale-New
Haven Ambulatory Services Corp (Temple Medical Center), Yale-New Haven Independent Practice Association (IPA), Yale-New Haven Physician
Hospital Organization (PHO), and Medical Center Pharmacy.

 

Notwithstanding the foregoing, “Affiliate”
shall expressly exclude (aaa) the Bridgeport Delivery Network, comprised of Bridgeport Hospital, Ahlbin Rehabilitation Centers,
United Visiting Nurse Association and Bridgeport Hospital Foundation, and (bbb) the Greenwich Delivery Network comprised of Greenwich
Hospital, Greenwich Physicians Association, Inc., and Greenwich Hospital Hospice services.

 

		(C)	“Contract Year” shall mean each successive twelve (12) month period commencing from the First Procedure Date.

 

		(D)	“Person” shall mean any individual, partnership, corporation, business trust, joint stock company, trust, unincorporated
association, joint venture, or other entity of whatever nature.

 

     

     

    

 

		ii.	If (A) at any time, YNHH, ASC and/or any of their respective Affiliates purchases, leases or otherwise acquires, directly or
indirectly, an ownership or other interest in one or more additional Leksell Gamma Knife units (each, an “Additional Unit”)
for use or operation within the State of Connecticut in addition to the Equipment; and (B) at any time or from time-to-time
thereafter, the number of procedures performed using the Equipment during any Contract Year is less than two hundred forty (240),
which 240 procedures shall be prorated if the Contract Year is less than 365 days (a “Shortfall Contract Year”), then,
in addition to the Lease Payments payable to GKF for procedures performed using the Equipment, YNHH shall pay to GKF an additional
amount (each, an “Additional Payment”) equal to the sum of Five Thousand Five Hundred Dollars ($5,500) multiplied by
each procedure performed using the Additional Unit(s) during the corresponding Shortfall Contract Year, up to an aggregate of two
hundred forty (240) procedures (prorated if the subject Contract Year is less than 365 days) combined between procedures performed
using the Equipment and procedures performed using the Additional Unit(s), irrespective of (1) whether such procedures are performed
by YNHH, its representatives or affiliates, or any other person or entity; or (2) the actual amounts billed or collected,
if any, pertaining to any such procedures. The Additional Payments shall be paid by YNHH to GKF quarterly in an amount equal to
one quarter of YNHH’s reasonable projection of the aggregate Additional Payment for the then current Contract Year. Within
thirty (30) days after the end of each Contract Year, the sum of such quarterly projected payments made by YNHH shall be reconciled
against the actual Additional Payment payable for the subject Contract Year, and YNHH or GKF shall, within thirty (30) days thereafter,
make a “true up” payment to the other as appropriate. Nothing set forth herein shall limit or place a ceiling on the
number of procedures that may be performed using the Equipment or on the Lease Payment that is payable in connection with procedures
performed using the Equipment.

 

		iii.	For example, if Additional Unit(s) have been acquired:

 

		1.	Assuming 200 procedures are performed using the Equipment during a Contract Year and another 100 procedures are performed in
the same Contract Year using the Additional Unit(s), then, the aggregate Lease Payments for that Contract Year would equal $1,100,000
(i.e., 200 x $5,500), and the Additional Payment for that Contract Year would equal $220,000 (i.e., 40 x $5,500).

 

		2.	Assuming 100 procedures are performed using the Equipment during a Contract Year and another 100 procedures are performed in
the same Contract Year using the Additional Unit(s), then, the aggregate Lease Payments for that Contract Year would equal $550,000
(i.e., 100 x $5,500), and the Additional Payment for that Contract Year would equal $550,000 (i.e., 100 x $5,500).

 

     

     

    

 

		3.	Assuming 150 procedures are performed using the Equipment during a Contract Year and zero (0) procedures are performed in the
same Contract Year using the Additional Unit(s), then, the aggregate Lease Payments for that Contract Year would equal $825,000
(i.e., 150 x $5,500), and the Additional Payment for that Contract Year would equal $0 (i.e., 0 x $5,500).

 

		4.	Assuming 250 procedures are performed using the Equipment during a Contract Year and zero (0) procedures are performed in the
same Contract Year using the Additional Unit(s), then, the aggregate Lease Payments for that Contract Year would equal $1,375,000
(i.e., 250 x $5,500), and the Additional Payment for that Contract Year would equal $0 (i.e., $0 x $5,500).

 

		c.	Section 11.1 (captioned “Right of First Refusal”) of the Lease is hereby deleted and of no further force or effect.

 

		d.	YNHH and GKF agree to implement Section 6 (captioned “Marketing Support”) of the Lease in accordance with the following
paragraph:

 

Marketing Support. YNHH shall provide reasonable
and customary marketing materials (i.e. brochures, announcements, etc.), marketing support, and administrative and physician support
for this clinical service (i.e. seminars by neurosurgeons and radiation oncologists to interested physicians and the like). Not
less than ninety (90) days prior to each anniversary of the Amendment Effective Date, GKF and YNHH shall develop a mutually agreed
upon marketing budget and plan for the clinical service to be supported by the Equipment for the succeeding twelve (12) month period
of the Term. Once mutually approved, the marketing budget and plan shall be implemented in accordance with its terms. As funds
are expended by YNHH in accordance with the marketing budget and plan, YNHH shall submit invoices (together with documentary evidence
supporting the invoices) for its expenditures and, promptly following the receipt of such invoices, GKF shall reimburse YNHH for
fifty percent (50%) of the expenditures up to an annual maximum reimbursement by GKF of Fifty Thousand Dollars ($50,000). It is
acknowledged by GKF and YNHH that the expenses to be reimbursed by GKF as provided in this Section have been reflected in the calculation
of the per procedure payment to be paid to GKF by YNHH pursuant to the first sentence of Section 2.b of this Amendment, and shall
not be taken into account in calculating any obligations of GKF or YNHH in connection with the payments for property tax, the service
and support agreement and insurance obligations contemplated by such Section 2.b.

 

		3.	Assignment and Assumption.

 

		a.	ASC hereby (i) transfers, sells, assigns and sets over to YNHH all of ASC’s right, title and interest in, under and to
the Assigned Lease to YNHH, its successors and assigns, from and after the Amendment Effective Date for the entire balance of the
term of the Assigned Lease, subject to the terms, covenants and conditions therein contained; and (ii) agrees to keep, carry
out and perform of all of the terms, covenants and conditions of the Amended Lease to be performed by “Yale” thereunder
and arising or accruing at any time prior to the Amendment Effective Date.

 

		b.	ASC hereby agrees to defend, indemnify and hold YNHH harmless from and against any loss, cost, damage or expense arising out
of or in connection with the Amended Lease accruing up through the Amendment Effective Date.

 

     

     

    

 

		c.	YNHH hereby (i) accepts such assignment, assumes the Assigned Lease, and agrees to keep, carry out and perform of all of the
terms, covenants and conditions of the Assigned Lease to be performed by “Yale” thereunder and arising or accruing
from and after the Amendment Effective Date, and (ii) agrees to defend, indemnify and hold ASC harmless from and against any loss,
cost, damage or expense arising out of or in connection with the Assigned Lease accruing from and after the Amendment Effective
Date.

 

		d.	GKF hereby (i) consents to such assignment of the Assigned Lease and the assumption of the Assigned Lease by YNHH; and
(ii) agrees to release ASC from any claim under the Amended Lease or the Assigned Lease first accruing from and after the Amendment
Effective Date.

 

		4.	Address of YNHH for Notices. For the purposes of any notices required by the Assigned Lease, YNHH’s address and
contact shall be:

 

Yale-New Haven Hospital

20 York Street

New Haven, CT 06510

Fax: (203) 688-6886

Attn.: John Skelly, VP Finance

 

		5.	Governing Law. This Amendment shall be governed by and construed under the laws of the State of Connecticut, without
reference to its principles of conflicts of law.

 

		6.	Counterparts. This Amendment may be executed in separate counterparts, each of which when so executed and delivered
shall be an original, but all of which counterparts shall together constitute the same instrument.

 

		7.	Captions. The captions and paragraph headings used herein are for convenience only and shall not be used in construing
or interpreting this Amendment.

 

		8.	Successors. This Amendment shall inure to the benefit of and be binding upon the parties and their respective successors
and permitted assigns.

 

		9.	Full Force and Effect. Except as amended by this Amendment, all of the terms and provisions of the Amended Lease shall
remain in full force and effect.

 

IN WITNESS WHEREOF, the undersigned have executed
this Amendment as of the day first written above.

 

	YALE-NEW HAVEN AMBULATORY	GK FINANCING, LLC
	SERVICES CORPORATION	 
	By: /s/ Gayle Capozzalo	By: /s/ Ernest A. Bates, M.D.
	Its: Executive VP, Strategy and System Development	Its: Policy Committee Member

 

	YALE-NEW HAVEN HOSPITAL, INC.	 
	By: /s/ John Skelly	 
	Its: VP of FinanceExhibit 10.7

 

LEASE AGREEMENT FOR A GAMMA KNIFE UNIT

 

THIS AGREEMENT FOR
A GAMMA KNIFE UNIT on May 28, 1999, (hereinafter, referred to as the “Agreement”) is entered into between GK Financing,
LLC, a California Limited Liability Company, (hereinafter referred to as “GKF”), and Froedtert Memorial Lutheran Hospital,
a non-profit Wisconsin corporation, (hereinafter referred to as “Medical Center”).

 

RECITALS

 

WHEREAS, Medical Center
wants to lease a Leksell Stereotactic Gamma Unit Manufactured by Elekta Instruments, Inc., (hereinafter referred to as the “Equipment”);
and

 

WHEREAS, GKF is willing
to lease the Equipment which GKF has acquired from Elekta Instruments, Inc., a Georgia corporation (hereinafter referred to as
“Elekta”), to Medical Center, pursuant to the terms and conditions of this Agreement.

 

NOW, therefore, in
consideration of the foregoing premises and the promises contained herein, the parties hereto hereby agree as follows:

 

1.          Execution
of LGK Agreement by and between Medical Center and Elekta. Medical Center agrees that simultaneously with the execution of this
Agreement it shall execute that certain LGK Agreement with Elekta, (hereinafter referred to as the “LGK Agreement”),
a copy of which is attached hereto as Exhibit A and incorporated herein by this reference. Medical Center agrees to fulfill all
of its obligations under the LGK Agreement and acknowledges that GKF is a third party beneficiary of the LGK Agreement. Medical
Center shall indemnify and hold harmless GKF in the event that GKF suffers any loss, damage, claim or expense (including reasonable
attorneys' fees) solely as a result of Medical Center's breach or alleged breach of the LGK Agreement.

 

2.          Delivery
of the Equipment and Site preparation. GKF shall arrange to have the Equipment delivered to Medical Center, at Froedtert Memorial
Lutheran Hospital, 9200 W. Wisconsin Avenue, Milwaukee, Wisconsin, 53226 (the “Site”) in coordination with Elekta.

 

Medical Center shall
provide a Site, at its own expense, in accordance with all of the Equipment manufacturer's (Elekta's) guidelines, specifications,
technical instruments and Site Planning Criteria (which Site Planning Criteria are attached hereto as Exhibit B and incorporated
herein by this reference), which criteria shall include Elekta's estimated delivery schedule when and as received by GKF, on Medical
Center controlled property (The “Site”) for the proper performance of Gamma Knife procedures. Site location shall be
reasonably acceptable to GKF. Medical Center shall prepare at its sole cost and expense the requisite site plans and specifications
and shall submit them to Elekta and GKF for approval. Medical Center shall obtain, in a timely manner, a User License from the
Nuclear Regulatory Commission and/or appropriate state agency authorizing it to take possession of the Cobalt Supply and shall
obtain such other licenses, permits, approvals, consents and authorizations, which may be required by local governmental or other
regulatory agencies for the Site, its preparation, the charging of the Equipment with its Cobalt Supply, the conduct of Acceptance
Tests, and the use of the Equipment all as more fully set forth in the LGK Agreement.

 

3.          Commencement
of Term. The Term (hereinafter defined) of this Agreement shall commence upon successful completion of the Acceptance Tests and
the performance of the first clinical Gamma Knife procedure at the Site (the “Commencement Date”). Medical Center shall
become liable to GKF for the payments referred to in Paragraph 6 herein below upon the Commencement Date.

 

     

     

    

  

4.          Costs
of Site Preparation; Costs of Installation. Medical Center's obligations shall include preparation of plans and specifications
for the construction and preparation of the Site in such form as will result in the Site, when constructed in accordance with such
plans and specifications, being in full compliance with Elekta's Site Planning Criteria. Medical Center shall at its own expense
and risk, prepare, construct and make ready the Site as necessary, for the installation of the Equipment, including, but not limited
to, providing any temporary and/or permanent shielding for the charging of the equipment and its use, selecting and preparing a
proper foundation for the Equipment and for such shielding and walls, as well as proper alignment of the Site and wiring. Medical
Center shall be financially responsible for the positioning of the Equipment on its foundation at the Site.

 

Medical Center shall
also at its own expense select, purchase and install all radiation monitoring equipment and devices, safety circuits and radiation
warning signs needed for the Equipment at the Site, required by all applicable federal, state and local laws and regulations.

 

Upon completion of
the Site, Medical Center shall warrant that the Site will be safe and suitable for its use of the Equipment. Medical Center shall
fully indemnify and hold harmless GKF from any and all loss, liability, damage, expense or claim (including attorneys' fees) which
GKF may suffer and incur and which relate to the Site and the Equipment's positioning thereon.

 

Medical Center shall
be responsible for any damage to the Equipment caused by (a) defects in construction of the Site or defects in the positioning
of the Equipment at the Site by Medical Center; (b) defects arising out of materials or parts provided, modified or designed by
Medical Center with respect to the Site; or (c) negligent or intentional acts of omission or commission by Medical Center or any
of its officers, agents, physicians, and employees in connection with the Site preparation or operation of the Equipment at the
Site.

 

Medical Center warrants
that it shall utilize its best efforts to fulfill on an expeditious basis its obligations under this Paragraph 4. Medical Center
further warrants that it shall on a regular basis keep GKF informed of Medical Center's progress in fulfilling its obligations
pursuant to this Paragraph 4. GKF shall deliver the Equipment to the Medical Center's designated loading dock on July 1, 1999.
Should GKF fail to deliver the Equipment no later than thirty (30) days after July 1, 1999 GKF shall pay Medical Center $100,000.
Should Medical Center not have all site preparations completed by the delivery date specified by a separate agreement plus a sixty
(60) day grace period such that the site is acceptable for positioning and installation of the equipment, Medical Center shall
reimburse GKF at an interest rate of Bank of America's prime rate plus 2% on GKF's equipment cost until the Site is prepared to
allow positioning and installation of the equipment.

 

5.          Term
of the Equipment. GKF agrees to provide to Medical Center the Equipment pursuant to the terms of this Agreement, for a term of
ten (10) years from the Commencement Date as described in Paragraph 3 hereinabove (the “Term”), unless terminated earlier
as provided herein.

 

6.          Per
Procedure Payments. Medical Center shall pay to GKF a per procedure payment of for the use of the Equipment pursuant to Exhibit
I. A procedure shall be defined as a single patient treatment session that may include one or more isocenters during that session.
Medical Center shall be billed on the fifteenth (15th) and the last day of each month for the actual number of procedures performed
during the first and second half of the month, respectively. Medical Center shall pay the procedures invoiced within thirty (30)
days after receipt of the invoice. Interest shall begin to accrue at the rate of 1-1/2% per month on all invoices remaining unpaid
after 45 days. After twenty four (24) months of service, and every twelve (12) months thereafter, the parties agree to review and
renegotiate the payment provisions of this paragraph, including consideration of payment as a percentage of the Medical Center's
reimbursement (although GKF shall be under no obligation to change such payment provisions).

 

     

     

    

  

7.          Use
of the Equipment. The Equipment may be used by Medical Center only at the location stated above and shall not be removed therefrom.
Medical Center shall not assign or sublease the Equipment or its rights hereunder without the prior written consent of GKF which
consent shall not be unreasonably withheld. Medical Center may, however, permit the equipment to be used by trained personnel that
are not employees of Medical Center. No permitted assignment or sublease shall relieve Medical Center of any of its obligations
hereunder. Medical Center shall not use nor permit the Equipment to be used in any manner nor for any purpose for which, in the
opinion of Elekta, the Equipment is not designed or reasonably suitable. Medical Center shall not permit any liens, whether voluntary
or involuntary, to attach to the Equipment, without the prior written consent of GKF. Medical Center shall have no interest in
the Equipment other than the rights acquired as a lessee hereunder and the Equipment shall remain the property of GKF regardless
of the manner in which it may be installed or attached at the Site. Medical Center shall, at GKF's reasonable request, affix to
the Equipment tags, decals, or plates furnished by GKF, indicating GKF's ownership of the Equipment.

 

8.          Additional
Covenants of Medical Center. In addition to the other covenants made by Medical Center, Medical Center shall at its own cost and
expense:

 

(a)          Provide
properly trained professional, technical and support personnel and supplies required for the proper performance of medical procedures
utilizing the Equipment (subject to Elekta's obligation to provide training of Medical Center personnel, as provided in the LGK
Agreement).

 

(b)          Assume
all medical and financial responsibility for the overseers' monitoring of all patients' medical condition and treatment.

 

(c)          Fully
comply with all of its obligations under the LGK Agreement.

 

(d)          Indemnify
GKF as herein provided: (i) Medical Center hereby agrees to fully indemnify and/or reimburse (including reasonable attorneys' fees)
GKF on a prompt basis for any and all damage to the Equipment (including any violations by Medical Center, its agents, officers,
physicians, employees, successors and assigns of the Service Agreement described in Paragraph 15 hereof) to the extent such damages
are caused by the negligent or wrongful acts or omissions of Medical Center, its agents, officers, physicians and employees and
are in excess of insurance proceeds recovered by GKF. In the event the Equipment is destroyed or rendered unusable, this indemnification
shall extend up to (but not exceed) the full replacement value of the Equipment at the time of its destruction less salvage value,
if any. (ii) Medical Center hereby further agrees to indemnify and hold GKF, its agents, officers, employees, successors and assigns,
harmless from and against any and all claims, liabilities, obligations, losses, damages, injuries, penalties, actions, costs and
expenses (including reasonable attorneys' fees) for all events and/or occurrences described in Article 7.3 of the LGK Agreement
to the same extent that Medical Center agrees to indemnify Elekta thereunder. Medical Center further agrees to fully indemnify
and hold harmless GKF for any loss, damage, claim, or expense (including reasonable attorneys' fees) GKF may suffer or incur as
a result of Medical Center's breach or breach alleged in litigation with regard to the LGK Agreement. GKF shall give prompt notice
to Medical Center of any claim and Medical Center at its option and expense may assume the primary defense of the claim. Any compromise
or settlement shall require the prior written consent of GKF which consent shall not be unreasonable withheld.

 

     

     

    

  

(e)          Provide
reasonable and customary marketing materials (i.e. brochures, announcements, etc.), marketing support, and an administrative and
physician (i.e. seminars by neurosurgeons and radiation oncologists to referring physicians, etc.) commitment to this clinical
service. Medical Center and GKF personnel shall jointly develop and agree upon a marketing plan and budget. Not less than ninety
(90) days prior to the First Procedure Date and the commencement of each succeeding twelve (12) month period of the Term. As funds
are expended by Medical Center shall submit invoices (together with documentary evidence supporting the invoices) for its expenditures
and, promptly following the receipt of such invoices, GKF shall reimburse Medical Center for fifty percent (50%) of the expenditures
up to the limit of Fifty Thousand Dollars ($50,000.00), unless said limit is waived by GKF.

 

9.          Additional
Covenants, Representations and Warranties of GKF. In addition to the other covenants, representations and warranties, made by GKF
in this Agreement:

 

(a)          GKF
represents and warrants that GKF has full power and authority to enter into this Agreement, and that this Agreement does not and
will not violate any agreement, contract or instrument binding upon GKF.

 

(b)          GKF
represents and warrants to Medical Center that, upon delivery of the Equipment to Medical Center, GKF shall use its best faith
efforts to require that Elekta meets its contractual obligations to GKF and in putting the Equipment, as soon as possible, into
good, safe and serviceable condition and fit for its intended use in accordance with the manufacturer's specifications, guidelines
and field modification instructions.

 

(c)          GKF
represents and warrants that throughout the term of this Agreement, subject to the second paragraph of section 10 below it has
good marketable title to the equipment, and Medical Center shall enjoy the use of the Equipment, free of the rights of any other
persons except for those rights reserved by GKF or granted to Elekta under the LGK Agreement.

 

(d)          During
the entire term of this agreement and subsequent extension thereof, GKF shall maintain in full force and effect: (i) the Service
Agreement referenced in Paragraph 15 hereof; and (ii) any other service or other agreements required to fulfill GKF's obligations
to Medical Center under this Agreement. GKF represents and warrants that during the entire term of this agreement and any subsequent
extensions thereof, that it will fully pursue any and all remedies it may have against Elekta under the Service Agreement to insure
that Elekta fully performs its obligations under the Service Agreement and that the Equipment will be in conformity with Elekta's
warranties so that it is free from defects in design, materials, and workmanship which result in noncompliance with the specifications
and/or Elekta's warranties to GKF. In no event, however, shall the warranty obligations of GKF to Medical Center with respect to
the Equipment be greater or more extensive than Elekta's warranty obligations to GKF with respect to the Equipment.

 

10.         Ownership/Title.
It is expressly understood that Medical Center shall acquire no right, title or interest in or to the Equipment, other than the
right to the possession and use of the same in accordance with the terms of this Agreement.

 

GKF may at its sole
discretion finance the Equipment. Financing may be in the form of an installment loan or a capitalized lease or other commercially
available debt instrument. Should GKF finance the Equipment through an installment loan, GKF shall be required to provide the Equipment
as collateral against the loan. Should GKF finance the Equipment through a capitalized lease title shall vest with the lessor until
GKF exercises its buy-out option. In addition, should GKF finance the Equipment, said agreement may be used as collateral against
the loan. In all of the foregoing situations, GKF shall use its best efforts to cause the entity financing the equipment to agree
not to disturb the rights of the Medical Center under this Agreement so long as the Medical Center does not default on its obligations
hereunder. In the event the financial entity forecloses on GKF's interest in the equipment of this Agreement and said foreclosure
is not cured within 45 days and the financing entity elects not to assume GKF's obligations, Medical Center may elect to purchase
the equipment for its fair market value or principal balance, whichever is higher.

 

     

     

    

  

11.         Cost
of Use of the Equipment. Except as is otherwise provided herein, Medical Center shall bear the entire cost of using the Equipment
during the Term of this Agreement. This shall include, but not be limited to, providing trained professionals, technical and support
personnel and supplies to properly operate the Equipment. Medical Center shall be fully responsible and liable for all acts and/or
omissions of such professional, technical and support personnel.

 

12.         Taxes.
GKF shall pay any personal property taxes levied against the Equipment and any other taxes or governmental fees or assessments,
however denoted, whether of the federal government, any state government or any local government, levied or based on this Agreement
or the use of the Equipment except for those taxes, if any, pertaining to the gross income or gross receipts of Medical Center.

 

13.         Maintenance
and Inspections. GKF agrees to exercise due and proper care in the maintenance of the Equipment and to keep the Equipment in a
good state of repair, reasonable wear and tear excepted. Medical Center shall be responsible for all damage to the Equipment caused
by the misuse, negligence, improper use or other intentional or negligent acts or omissions of Medical Center's employees, officers,
agents, and physicians.

 

GKF (and Elekta) shall
have the right of access to the Equipment for the purpose of inspecting and repairing the same at all reasonable times and upon
reasonable prior written notice and shall use all reasonable efforts not to interfere with Medical Center's use of the Equipment.
In the event the Equipment is improperly used by Medical Center or its employees, agents, officers, and physicians, GKF may service
or repair the same as needed and such expense shall be paid by Medical Center, unless the repair is covered by the Service Agreement
described in Paragraph 15 hereof.

 

Any work so performed
by or in the service or maintenance of the Equipment as a result of Medical Center's failure or neglect to do so shall not deprive
GKF of any of its rights, remedies or actions against Medical Center for damages caused by such failure or neglect. If, thirty
(30) days after giving of written notice by Medical Center, GKF fails to make the repairs it is required to make under this Agreement,
Medical Center may make the repairs. GKF shall reimburse Medical Center for the cost of the repairs within thirty (30) days, following
receipt of Medical Center's invoice.

 

14.         Equipment
Modifications/Additions/Upgrades. The parties agree that the necessity and financial responsibility for modifications/additions/upgrades
to the Equipment, including the reloading of the Cobalt-60 source, shall be discussed and mutually decided by GKF and Medical Center.
If GKF and Medical Center agree to reload the Cobalt-60 source (in approximately year 8 of the initial term), GKF shall be responsible
for the expenses relate to the Cobalt-60 reloading and Medical Center shall be responsible for any site costs associated with the
Cobalt-60 reload. If the reloading of the Equipment occurs, the original term shall be extended for 8 years less the number of
years remaining in the original term. GKF shall reimburse Medical Center for the cost of the repairs within thirty (30) days, following
receipt of Medical Center's invoice.

 

15.         Service
Agreement. GKF warrants that it shall simultaneously with the execution of this Agreement enter into a Service Agreement with Elekta
in the form of Exhibit C attached to this Agreement.

 

     

     

    

  

16.         Termination
If, after the initial twenty-four (24) month period of service, and subsequent 12 month periods of service, Medical Center does
not provide GKF with a reasonable economic justification to continue providing Gamma Knife services hereunder, then and in that
event, GKF shall have the option of terminating this Agreement upon the giving of written notice to Medical Center of said termination
not less than ninety (90) days prior to GKF's designated termination date.

 

17.         Options
to Extend Agreement.

 

(a)          Medical
Center shall have the option at the end of the ten (10) year initial Term to:

 

(i)          Renegotiate
this Agreement for a five (5) year renewal term.

 

(ii)         Terminate
this Agreement. If Medical Center terminates this Agreement at the end of the initial term, GKF shall remove the Gamma Knife within
an agreed upon period of time after the expiration of the ten (10) year initial Term not in excess of 90 days.

 

Medical Center shall
exercise one (1) of the two (2) options referred to above, by mailing an irrevocable written notice thereof to GKF at Four Embarcadero
Center, Suite 3620, San Francisco, California, 94111, by registered mail, postmarked on or before the end of the ninth (9th) year
of the ten (10) year initial Term of this Agreement. Any such notice shall be sufficient if it states in substance that Medical
Center elects to exercise its option and states which of the two (2) options referred to above Medical Center is exercising.

 

18.         No
Warranties by GKF. Medical Center warrants that as of the Commencement Date, it shall have (a) thoroughly inspected the Equipment;
(b) determined for itself that all items of the Equipment are of a size, design, capacity and manufacture selected by it; and (c)
satisfied itself that to the best of its knowledge the Equipment is suitable for Medical Center's stated purposes. GKF SUPPLIES
THE EQUIPMENT “AS IS” AND NOT BEING THE MANUFACTURER OF THE EQUIPMENT OR THE MANUFACTURER'S AGENT, MAKES NO WARRANTY
OR REPRESENTATION, EITHER EXPRESSED OR IMPLIED, AS TO THE EQUIPMENT'S MERCHANTABILITY, FITNESS FOR A PARTICULAR PURPOSE, DESIGN,
CONDITION, DURABILITY, CAPACITY, MATERIAL OR WORKMANSHIP OR AS TO PATENT INFRINGEMENT OR THE LIKE, it being agreed that all such
risks as between GKF and Medical Center, shall be borne by Medical Center. Medical Center agrees to look solely to the manufacturer
(Elekta) or to suppliers of the Equipment (and its software) for any and all warranty claims. Any and all warranties made by Elekta
will be in its good faith best efforts enforced by GKF on behalf of Medical Center during the ten (10) year initial Term hereof.
Medical Center agrees that GKF shall not be responsible for the delivery, installation, or operation of the Equipment or for any
delay or inadequacy of any or all of the foregoing. GKF shall not be responsible for any direct or indirect consequential loss
or damage resulting from the installation, operation or use of the Equipment or otherwise. Medical Center expressly waives any
right to hold GKF liable hereunder for any claims, demands and liabilities arising out of or in connection with the design, manufacture,
possession or operation of the Equipment.

 

19.         Events
of Default and Remedies. The occurrence of any one of the following shall constitute an Event of Default hereunder:

 

(a)          Medical
Center fails to pay any installment of semi-monthly procedure payments when due when such default continues for a period of thirty
(30) days after notice thereof from GKF or its assignee is given to Medical Center.

 

     

     

    

  

(b)          Medical
Center attempts to remove, sell, transfer, encumber, sublet or part with possession of the Equipment or any items thereof, except
as expressly permitted herein;

 

(c)          Medical
Center shall fail to observe or perform any of the other obligations required to be observed or performed by Medical Center hereunder
and such failure shall continue uncured for thirty (30) days after written notice thereof to Medical Center by GKF provided, however,
that if the nature of the default is such that it cannot reasonably be cured within the thirty (30) day period, the Medical Center
shall not be deemed to be in default if it shall commence to cure the default within the thirty (30) day period and diligently
effect the cure within a period not exceeding an additional thirty (30) days;

 

(d)          Medical
Center ceases doing business as a going concern, makes an assignment for the benefit of creditors, admits in writing its inability
to pay its debts as they become due, files a voluntary petition in bankruptcy, is adjudicated a bankrupt or an insolvent, files
a petition seeking for itself any reorganization, arrangement, composition, readjustment, liquidation, dissolution or similar arrangement
under any present or future statute, law or regulation or files an answer admitting the material allegations of a petition filed
against it in any such proceeding, consents to or acquiesces in the appointment of a trustee, receiver, or liquidator of it or
of all or any substantial part of its assets or properties, or it or its shareholders shall take any action looking to its dissolution
or liquidation.

 

(e)          Within
sixty (60) days after the commencement of any proceedings against Medical Center seeking reorganization, arrangement, readjustment,
liquidation, dissolution or similar relief under any present or future statute, law or regulation, such proceedings shall not have
been dismissed, or if within thirty (30) days after the appointment without Medical Center's consent or acquiescence of any trustee,
receiver or liquidator of it or of all or any substantial part of its assets and properties, such appointment shall not be vacated.

 

Upon the occurrence
of an Event of Default, GKF may at its option do any or all of the following: (i) by notice to Medical Center, terminate this Agreement
as to the Equipment in default, wherever situated, and for such purposes, enter upon the Site without liability for so doing or
GKF may cause Medical Center and Medical Center hereby agrees to return the Equipment to GKF at Medical Center's sole cost and
expense; (ii) recover from, as liquidated damages for the loss of the bargain and not as a penalty, an amount equal to the present
value of the unpaid estimated future lease payments by Medical Center to GKF through the end of the Agreement term discounted at
the rate of nine percent (9%), which payment shall become immediately due and payable. Unpaid estimated future lease payments shall
be based on the prior 12 months lease payments with a five percent (5%) increase; (iii) sell, dispose of, hold, use or lease the
Equipment in default, as GKF in its sole discretion may determine (and GKF shall not be obligated to give preference to the sale,
lease or other disposition of the Equipment over the sale, lease or other disposition of similar Equipment owned or leased by GKF).
In any event, Medical Center shall, without further demand, pay to GKF an amount equal to all sums due and payable for all periods
up to and including the date on which GKF had declared this Agreement to be in default.

 

In the event, that
Medical Center shall have paid to GKF the liquidated damages referred to in (iii) above, GKF hereby agrees to pay to Medical Center
promptly after receipt thereof, all rentals or proceeds received from the reletting or sale of the Equipment during the balance
of the ten (10) year initial Term (after deduction of all expenses incurred by GKF; said amount never to exceed the amount of the
liquidated damages paid by Medical Center). Medical Center agrees that GKF shall have no obligation to sell the Equipment. Medical
Center shall in any event remain fully liable for reasonable damages as provided by law for all costs and expenses incurred by
GKF on account of such default, including but not limited to, all court costs and reasonable attorneys' fees.

 

     

     

    

  

Medical Center hereby
agrees that, in any event, it shall be liable for any deficiency after any sale, lease or other disposition of the Equipment by
GKF. The rights afforded GKF hereunder shall not be deemed to be exclusive, but shall be in addition to any other rights or remedies
provided by law.

 

20.         Insurance.

 

(a)          During
the ten (10) year initial Term of this Agreement (and any successive terms) GKF shall, at its own cost and expense, keep in effect
an all risk and hazard insurance policy covering the Equipment. The all risk and hazard insurance policy shall be for an amount
not less than the replacement cost of the Equipment. During the ten (10) year initial Term of this Agreement, Medical Center shall,
at its own cost and expense keep in effect public liability and professional liability insurance policies concerning the operation
of the Equipment by Medical Center. Said policies shall be in the amounts of not less than $1,000,000 per occurrence and $5,000,000
in aggregate per year. Medical Center and GKF, their successors and assigns, shall be named as additional insureds and/or loss
payees on the insurance policies maintained hereunder by the other party. Evidence of such insurance coverages shall be furnished
by both parties to the other party upon written request, by no later than the Commencement Date.

 

(b)          If
the Equipment is rendered unusable as a result of any physical damage to, or destruction of, the Equipment, Medical Center shall
give to GKF prompt notice. GKF shall determine, within thirty (30) days after the date of occurrence of such damage or destruction,
whether the Equipment can be repaired. In the event GKF determines that the Equipment cannot be repaired, subject to section 8(d),
GKF at its sole cost and expense shall promptly replace the Equipment. This Agreement shall continue in full force and effect as
though such damage or destruction had not occurred except that the term of the Agreement shall be extended by the time the Equipment
was rendered unusable. In the event GKF determines that the Equipment can be repaired, GKF shall cause the Equipment to be promptly
repaired, subject to section 8(d).

 

21.         Notices.
Any notices required under this Agreement shall be sent in writing and shall be deemed to have been duly given if delivered by
hand or mailed by certified or registered mail to the following addresses:

 

	To GKF:	Chief Executive Officer
	 	Four Embarcadero Center, Suite 3620
	 	San Francisco, CA 94111
	 	 
	To Medical Center:	Chief Executive Officer
	 	Froedtert Memorial Lutheran Hospital
	 	9200 W. Wisconsin Avenue
	 	Milwaukee, WI 53226

 

Or to such other addresses
as either party may specify for the reception of notice from time to time in writing to the other party. Any such notice shall
be effective only when actually received by the party to whom addressed.

 

22.         Integration/Supersedure.
This Agreement contains the full and entire Agreement between the parties hereto, and no oral or written understanding is of any
force or effect whatsoever unless expressly contained in a writing executed subsequent to the date of this Agreement.

 

23.         Waivers.
To the extent that either party fails or chooses not to pursue any of its remedies under this Agreement or pursuant to applicable
law, such shall not prejudice that party's rights to pursue any of those remedies at any future time and shall not constitute a
waiver of rights.

 

     

     

    

  

24.         Assignments.
This Agreement is binding upon and shall inure to the benefit of the permitted successors or assigns of the respective parties
hereto, except that neither party may assign its rights or obligations under this Agreement without the express written consent
of the other (which consent shall not be unreasonably withheld).

 

25.         Amendments.
This Agreement shall not be amended or altered in any manner unless such amendment or alteration is in a writing signed by both
parties.

 

26.         Record-Keeping
Requirements. To the extent required by the regulations promulgated by the Health Care Financing Administration pursuant to Section
952 of the Omnibus Reconciliation Act of 1980, GKF shall:

 

(a)          Until
the expiration of four (4) years following the furnishing of services pursuant to this Agreement, GKF agrees to make available
upon written request of the Secretary of Health and Human Services or the U.S. Comptroller General or any of their duly authorized
representatives, this Agreement, any books, documents and records necessary to verify the nature and extent of costs incurred by
Medical Center by reason of the activities of GKF under this Agreement; and

 

(b)          If
GKF elects to delegate any of its duties under this Agreement (which have a cost or value of Ten Thousand Dollars ($10,000.00)
or more over a twelve (12) month period) to a related organization, GKF may do so only through a subcontractor which is consented
to by Medical Center, it being understood that, inasmuch as Medical Center is entering into this Agreement in reliance on GKF's
reputation and expertise, that Medical Center shall be the sole judge of the reputation and expertise of the proposed delegee,
and only through a subcontractor which provides that, until the expiration of four (4) years following the furnishing of services
under such subcontract, the related organization shall make available, on request of the Secretary of Health and Human Services
or the U.S. Comptroller General or any of their authorized representatives, the subcontract, and books, documents and records of
the nature and extent of costs incurred by Medical Center by reason of activities of such related organization under such subcontract.
No delegation by GKF of its duties hereunder shall relieve GKF from liability hereunder.

 

27.         Miscellaneous
Provisions.

 

(a)          The
invalidity or unenforceability of any portion or provision of this Agreement shall not effect the validity or enforceability of
any other portion, nor shall either party's implied or express consent to the breach or waiver of any provision of this Agreement
constitute a waiver of such provision as to any subsequent breach.

 

(b)          In
the event of any claim or controversy arising hereunder, the prevailing party in such claim or controversy shall be entitled to
a reasonable attorneys' fee in addition to whatever other relief said party would be otherwise entitled.

 

(c)          Force
Majeure. Failure to perform by either party will be excused in the event of any delay or inability to perform its duties under
this Agreement directly or indirectly caused by conditions beyond its reasonable control including without limitation, fires, floods,
earthquakes, snow, ice, disasters, Acts of God, accidents, riots, wars, operation of law, strikes, governmental action or regulations,
shortages of labor, fuel, power, materials, manufacturer delays or transportation problems.

 

     

     

    

  

IN WITNESS WHEREOF,
the parties have signed this Agreement on the day and year first above written.

 

	Medical Center	GK Financing, LLC
	By: /s/ William B. Petasnick	By: /s/ Craig K. Tagawa
	President & CEO	Chief Executive Officer
	Froedtert Memorial Lutheran Hospital	 
	 	 

     

     

    

 

Exhibit 1

 

PER PROCEDURE PAYMENTS

 

	Annual Procedures Performed	 	Fee Per Procedure	 
	 	 	 	 	 
	1-75	 	$	8,250	 
	76-125	 	$	8,000	 
	126-150	 	$	7,750	 
	151+	 	$	7,000	 

 

Note: Procedure counts will revert to zero
on each anniversary of the Commencement Date.

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