Document:

First Amendment to the Rights Agreement, dated as of January 29, 2008

 Exhibit 4.1 
 EXECUTION VERSION 
 FIRST AMENDMENT TO RIGHTS AGREEMENT 
 FIRST AMENDMENT TO RIGHTS AGREEMENT, dated as of January 29, 2008 (the “Amendment”) to the Rights Agreement, dated as of
November 12, 2007 (the “Rights Agreement”), between Quintana Maritime Limited, a Marshall Islands corporation (the “Company”), and Computershare Trust Company, N.A., as Rights Agent (the “Rights
Agent”). Terms used herein but not defined shall have the meaning assigned to them in the Rights Agreement. 
 WHEREAS, the Company
and the Rights Agent have heretofore executed and entered into the Rights Agreement; 
 WHEREAS, the Company proposes to enter into an
Agreement and Plan of Merger, dated as of January 29, 2008 (as it may be amended or supplemented from time to time, the “Merger Agreement”), among Excel Maritime Carries Ltd., a Liberian corporation (the
“Buyer”), Bird Acquisition Corp., a Marshall Islands corporation and a direct wholly-owned subsidiary of the Buyer (the “Merger Sub”), and the Company, providing for the merger (the “Merger”) of the
Company and the Merger Sub, with the Company continuing as the surviving corporation; 
 WHEREAS, concurrently with the execution and
delivery of the Merger Agreement, certain shareholders of the Company are entering into voting agreements with the Buyer (collectively, the “Voting Agreements”) pursuant to which such shareholders are agreeing, in their capacity as
shareholders of the Company, to vote to adopt the Merger Agreement and take certain other actions in furtherance of the Merger, in each case, upon the terms and conditions contained therein; 
 WHEREAS, the board of directors of the Company has determined, in connection with the Merger Agreement and the Voting Agreements, that it is necessary
and desirable to amend the Rights Agreement to exempt the Merger Agreement, the Voting Agreement and the transactions contemplated thereby, including, without limitation, the Merger, from the application of the Rights Agreement as set forth in this
Agreement; 
 WHEREAS, pursuant to Section 27 of the Rights Agreement, under circumstances set forth therein, the Company may from time
to time, and the Rights Agent shall, if the Company so directs, supplement or amend the Rights Agreement without the approval of any holders of Right Certificates; and 
 WHEREAS, the Company desires to amend the Rights Agreement as set forth herein and to direct the Rights Agent to execute this Amendment. 
 NOW, THEREFORE, in consideration of the promises and the mutual agreements herein set forth, the parties hereby agree as follows: 

 Section 1. Amendment of Rights Agreement. The Rights Agreement is hereby amended as follows:

 1.1 Amendment to Section 1. The definition of “Acquiring Person” in Section 1 of the Rights
Agreement is hereby amended by inserting the following as a new paragraph at the end thereof: 
 “Notwithstanding anything in this
Section 1 to the contrary, none of Excel Maritime Carriers Ltd., a Liberian corporation (the “Buyer”), Bird Acquisition Corp., a Marshall Islands corporation and a direct wholly-owned subsidiary of the Buyer (the
“Merger Sub”) or any of their respective Affiliates or Associates, either individually, collectively or in any combination, shall be, or shall be deemed to be, an “Acquiring Person” solely by virtue of or as a result of
the approval, execution, delivery, adoption or performance of the Agreement and Plan of Merger, dated as of January 29, 2008, among the Buyer, Merger Sub and the Company (as it may be amended or supplemented from time to time, the
“Merger Agreement”) or the consummation of the Merger (as such term is defined in the Merger Agreement) or any other transactions contemplated thereby, including without limitation, entry into or performance of the Voting Agreements
(as such term is defined in the Merger Agreement) (such actions described in this sentence, the “Permitted Events”). 
 1.2 Amendment to Section 1. The definition of “Shares Acquisition Date” in Section 1 of the Rights Agreement is hereby amended by inserting the following sentence at the end thereof:

 “Notwithstanding anything in this Agreement to the contrary, a Shares Acquisition Date shall not be deemed to have occurred solely
either (i) by virtue or as a result of the public announcement of any Permitted Event or (ii) by virtue or as a result of the public disclosure of facts relating to any Permitted Event.” 
 1.3 Amendment to Section 3(a). Section 3(a) of the Rights Agreement is hereby amended by inserting the following sentence
at the end thereof: 
 “Notwithstanding anything in this Agreement to the contrary, a Distribution Date shall not be deemed to have
occurred solely as a result of any Permitted Event.” 
 1.4 Amendment to Section 13. Section 13 is
hereby amended to add the following sentence at the end thereof: 
 “Notwithstanding anything in this Agreement to the contrary, a
consolidation, merger, sale or transfer referred to in Section 13 or otherwise in this Agreement shall not be deemed to have occurred solely by virtue of or as a result of the public announcement of any Permitted Event.” 
  

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 1.5 Addition of Section 36. A new Section 36 of the Rights Agreement is
hereby added to read in its entirety as follows: 
 “Section 36. Termination. Notwithstanding anything herein to the contrary,
immediately prior to the Effective Time, but only if the Effective Time shall occur, (a) this Agreement shall be terminated and be without further force or effect, (b) none of the parties to this Agreement will have any rights, obligations
or liabilities hereunder and (c) the holders of the Rights shall not be entitled to any benefits, rights or other interests under this Agreement, including, without limitation, the right to purchase or otherwise acquire Preferred Shares or any
other securities of the Company or of any other Person; provided, however, that notwithstanding the foregoing, Section 18, Section 20, Section 27, Section 28 and Section 29 hereof shall survive the termination
of this Agreement.” 
 Section 2. Direction to Rights Agent. The Company hereby directs the Rights Agent, in accordance with
the terms of Section 27 of the Rights Agreement, to execute this Amendment. 
 Section 4. Effectiveness and Continued
Effectiveness. In accordance with the resolutions adopted by the Company’s Board of Directors, the amendments to the Rights Agreement set forth in Section 1 above are effective as of the time at which such resolutions were adopted. The
parties hereto hereby acknowledge and agree that, except as specifically supplemented and amended, changed or modified in Section 1 above, the Rights Agreement shall be unaffected by this Amendment and remain in full force and effect in
accordance with its terms. 
 Section 5. Counterparts. This Amendment may be executed in any number of counterparts and each of
such counterparts shall for all purposes be deemed to be an original, and all such counterparts shall together constitute but one and the same instrument. 
 Section 7. Governing Law. This Amendment shall be deemed to be a contract made under the laws of the Marshall Islands and for all purposes shall be governed by and construed in accordance with such laws
applicable to contracts to be made and performed entirely within the Marshall Islands, except that the rights, duties and obligations of the Rights Agent shall be governed by and construed in accordance with the laws of the state of Delaware.

 [Signature Page Follows] 
  

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 IN WITNESS WHEREOF, the parties hereto have caused this Amendment to be duly executed as of the date set
forth above. 
  

			
	QUINTANA MARITIME LIMITED
		
	By:	 	 /s/ Corbin J. Robertson, Jr.

	Name:	 	Corbin J. Robertson, Jr.
	Title:	 	Chairman of the Board
	
	 COMPUTERSHARE TRUST COMPANY, N.A.,
 as Rights
Agent

		
	By:	 	 /s/ Dennis V. Moccia

	Name:	 	Dennis V. Moccia
	Title:	 	Managing Director

 [Signature Page to First Amendment to Rights Agreement]f8k101407ex10i_americansur.htm

    
      

       

      AMERICAN
        SURGICAL HOLDINGS, INC.

      100039
        BISSONNET #250

      HOUSTON,
        TEXAS 77036

       

      September
        14, 2007

       

      Richard
        I. Anslow, Esq.

      Gregg
        E.
        Jaclin, Esq.

      Anslow
        & Jaclin, LLP

      195
        Route
        9 South, Suite 204 

      Manalapan,
        NJ 07726

       

      Re:           
        Share Transfer Restrictions

       

      Dear
        Richard and Gregg:

       

      The
        purpose of this letter is to set forth our agreement with respect to the
        transfer of shares of the Common Stock, par value $0.001 per share, of American
        Surgical Holdings, Inc. (the "Company"), of which you are each the beneficial
        owner on the date of this letter (the "Shares"). For purposes of this agreement,
        the term "beneficial owner" will have the meaning given to such term in SEC
        Rule
        13d-3, which includes, among other things, the power to dispose or to direct
        the
        disposition of such Shares.

       

      For
        good
        and valuable consideration, the receipt and sufficiency of which is hereby
        acknowledged, the undersigned hereby agrees that, for the period described
        below
        (the "Lock-Up Period"), he will not: (i) offer, sell, contract to sell, pledge,
        grant any option to purchase, make any short sale or otherwise dispose of
        any
        Shares, or (ii) engage directly or indirectly in any transaction the likely
        result of which would involve a transaction prohibited by clause (i). The
        foregoing restriction is expressly precludes the undersigned from engaging
        in
        any hedging or other transaction which is designed to, or reasonably expected
        to
        lead to, or result in, a sale or disposition of the Shares even if such Shares
        would be disposed of by someone other than the undersigned. Such prohibited
        hedging or other transactions would include without limitation any short sale
or
        any
        purchase, sale or grant of any right (including without limitation any put
        or
        call option) with respect to any of the Shares or with respect to any security
        that includes, relates to, or derives any significant part of its value from
        the
        Shares.

       

      The
        Lock-Up Period shall begin on September 14, 2007, and shall continue until
        the
        earliest to occur of:

       

      1. September
        14, 2008;

       

      2. A
        completed registered secondary offering of $3 million or more; or 

       

      3.
        The
        Company agrees in writing to terminate this agreement.

       

       

       

      
        
          
          

        

        
          
          

          
            

          

        

        
          
          

        

      

       

       

      September
        14, 2007 Page 2

       

       

       

      Notwithstanding
        the foregoing restrictions on transfer, the undersigned may, at any time
        and
        from time to time during the Lock-Up Period, transfer the Shares (i) as bona
        fide gifts or transfers by will or intestacy, or (ii) to any trust for the
        direct or
        indirect benefit of the undersigned or the immediate family of the
        undersigned, provided that any such transfer shall not involve a disposition
        for
        value, provided, that, in the case of any gift or transfer described in clauses
        (i) or (ii), each donee or transferee agrees in writing to be bound by the
        terms
        and conditions contained herein in the same manner as such terms and conditions
        apply to the undersigned. For purposes hereof, "immediate family" means any
        relationship by blood, marriage or adoption, not more remote than first
        cousin.

       

      By
        signing this letter the undersigned acknowledges that he is legally bound
        by the
        terms of this letter.

       

      
        American Surgical Holdings, Inc.

         

         

         

        By:  /s/ 
Zak W. Elgamal        

                Zak W.
          Elgamal

                Chief Executive Officer

         

        Agreed-to and accepted: 

         

         

         

        By:  /s/  Richard I.
          Anslow      

                Richard I.
          Anslow

      

       

      

        Agreed-to and accepted: 

         

         

         

        By:  /s/  Gregg E.
          Jaclin        

                Gregg E.
          Jaclin

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