Document:

Exhibit 10.24.2

September 12, 2006

Mr. Jouko Karvinen, Chairman of the Board of Directors

Mr. John Underwood, Chairman of the Compensation Committee

Mr. Frank Lavelle, President

MedQuist Inc.

1000 Bishops Gate Blvd., Suite 300

Mt. Laurel,  NJ 08054-4632

Gentlemen:

In response to various discussions, Nightingale &
Associates, LLC (“Nightingale”) has been asked to submit this proposed
Amendment to our Engagement Letter with MedQuist Inc. (“MedQuist” or the “Company”)
dated July 29, 2004 as amended on December 16, 2004 (collectively, the “Amended
Engagement Letter”).  This Amendment (i)
provides revisions to the cost structure and term associated with the continued
retention of Mr. Howard Hoffmann as the Company’s Interim Chief Executive
Officer.  All other terms and conditions
for the retention of Nightingale, as detailed in the Amended Engagement Letter,
including but not limited to the Release and Indemnification agreement, will
remain in force and effect.  It is our
understanding that Howard Hoffmann, on behalf of Nightingale, will continue to
be engaged by MedQuist as the Company’s Interim Chief Executive Officer and
will continue to report to the Company’s Board of Directors.

I.                                         SCOPE
OF WORK:

Effective as of July 1, 2006 Nightingale will extend
the term of Howard Hoffmann’s role as MedQuist’s Interim Chief Executive
Officer until December 31, 2006.  Following
termination of Mr. Hoffmann’s role as Interim Chief Executive Officer, Mr.
Hoffmann and MedQuist agree that Mr.  Hoffmann,
on a consultancy basis, shall be available to MedQuist one day a week, based on
a ten-hour workday, for the period January 1, 2007 to through the week ending
Friday, March 16, 2007.  Following March
16, 2007, Mr. Hoffmann will endeavor to make himself available for ongoing
consultancy work on an as needed basis, subject to negotiation of a mutually
agreeable Scope of Work.  It should be
noted that Mr.  Hoffmann expects to be
working on other engagements upon his departure as the full time Interim Chief
Executive Officer of MedQuist, and thus his availability cannot be guaranteed
(i) for more than one day a week for the period from January 1, 2007 through
March 16, 2007, and (ii) following March 16, 2007.

 

 

II.                                     FEE
STRUCTURE:

Fixed Monthly Fee:

Effective as of July 1,
2006, Nightingale’s fees for Mr.  Hoffmann’s
role as Interim Chief Executive Officer will be a fixed rate of $120,000 per
month payable in arrears.  If Mr.
Hoffmann’s role is terminated during the course of a month, Nightingale’s fees
for the final month will be prorated based on the actual number of calendar
days elapsed during the month up to and including Mr. Hoffmann’s final day of
work.  Mr. Hoffmann’s fees for
consultancy services following his departure as the Interim Chief Executive
Officer of MedQuist will be billed at his current hourly rate of $525/hour.

Discretionary Bonus:

Nightingale may be
entitled to an additional discretionary bonus payment of up to $240,000, which
will be paid no later than March 16, 2007 (the “2006 Discretionary Bonus”) in
connection with Mr. Hoffmann’s service in 2006 as Interim Chief Executive
Officer.  The amount, if any, of the 2006
Discretionary Bonus that Nightingale is to receive will be decided upon by a
special committee of the Board of Directors of MedQuist (the “Committee”), made
up of the Chairman of the Board, the Chairman of the Compensation Committee and
the Chairman of the Audit Committee.  It
is understood by the parties that the determination of whether to pay all or a
portion of the 2006 Discretionary Bonus shall be at the sole discretion of the
Committee and is not a function of the attainment of any particular objectives.
 The Committee will inform Nightingale of
its determination by January 31, 2007.  If
the Committee’s decision is that Nightingale will be paid all or a portion of
the 2006 Discretionary Bonus, said bonus will be paid by wire transfer no later
than March 16, 2007; which is the date the filing of the Company’s Form 10-K
for the year ended December 31, 2006 is due.

Performance Bonus:

If the Company has become
current in its Forms 10-Q and Forms 10-K filing requirements with the
Securities Exchange Commission (“SEC”) by a mutually agreed upon date with the
Company’s Board of Directors, Nightingale will be entitled to a bonus payment
of $240,000 (the “SEC Filing Performance Bonus”).  If earned, the SEC Filing Performance Bonus
will be paid by wire transfer within ten (10) days of the date on which the
Company becomes current in its Forms 10-Q and Forms 10-K filing requirements.

 2
 

 

 

Availability Guaranty Fee:

By December 29, 2006,
MedQuist will pay a non-refundable fee to Nightingale in the amount of $57,750
(the “Availability Guaranty Fee”), guaranteeing the availability of Mr. Hoffmann
for one day a week, based on a ten-hour workday, during the period from January
1, 2007 to March 16, 2007 (the “Guaranteed Availability Period”).  During the Guaranteed Availability Period,
Nightingale will invoice MedQuist in accordance with its normal billing
practices for reimbursement of out of pocket expenses as well as for Professional
Time Fees generated by Mr. Hoffmann for his services to MedQuist to the extent
that such Professional Time Fees exceed the Availability Guaranty Fee and are
incurred at the direction of the Company’s Board of Directors.

Additional Nightingale Personnel:

Nightingale will continue
to make available the services of Mr. Michael C. Yeager and Ms. Jeanine
Cobonpue to perform selected services in connection with the Company’s billing
matter related activities.  Mr. Yeager’s
professional time fee services have been and will continue to be invoiced to
MedQuist at his prevailing hourly rate of $350/hour.  Ms. Cobonpue’s professional time fee services
have been and will continue to be invoiced to MedQuist at her prevailing hourly
rate of $175/hour.  Should it become
necessary to utilize the services of additional Nightingale personnel on the
project, it is agreed that Nightingale will invoice professional time fees for
such personnel at their prevailing hourly rates.  Nightingale agrees that it will obtain the
advance approval of the Board of Directors, which shall be conveyed by the
Board of Directors to Frank Lavelle, before adding additional personnel to the
project team.

In addition to
professional time fees, out-of-pocket expenses are billed at cost, and generally
range from 10% to 20% of professional time fees, depending on the amount of
travel involved.  Out-of-pocket expenses
consist primarily of transportation, meals, lodging, telephone, specifically
assignable secretarial and office assistance, and report production.

III.                                 ADVANCE
DEPOSIT

Nightingale requires an
Advance Deposit for all assignments of the type described above.  Given this situation, Nightingale will not
require an increase of its existing Advance Deposit of $75,000 that has been
paid by the Company.  At the completion
of the project and at the direction of the Company, Nightingale will either
apply the Advance Deposit to any outstanding invoices or, if there are no
unpaid invoices owing to Nightingale, promptly return the Deposit to the Company.

*  * 
*  *  * 
*  *  * 
*  *  *

 3
 

 

 

If this Amendment conforms
to your understanding of the terms and conditions of our retention, please have
the appropriate party signify agreement by signing and returning the enclosed
extra copy of this Amendment

We look forward to
continue working with you and the Company.

	
   

  	
  Sincerely,

  
	
   

  	
   

  
	
   

  	
   

  
	
   

  	
  /s/ Howard S. Hoffmann

  	
   

  
	
   

  	
  Howard S.
  Hoffmann,

  
	
   

  	
  in the capacity
  as Principal and

  
	
   

  	
  Managing Partner
  of Nightingale &

  
	
   

  	
  Associates, LLC

  

 

 

	
  READ, UNDERSTOOD AND AGREED TO BY:

  
	
   

  
	
  MedQuist Inc.

  
	
   

  
	
  By:

  	
  /s/ Jouko
  Karvinen

  	
   

  
	
   

  	
  Jouko Karvinen

  
	
   

  	
  Chairman of the
  Board of Directors of MedQuist Inc.

  
	
   

  
	
  Date:

  	
  September 18, 2006

  	
   

  
	
   

  	
   

  
	
   

  
	
  By:

  	
  /s/ John
  Underwood

  	
   

  
	
   

  	
  John Underwood

  
	
   

  	
  Chairman of the
  Compensation Committee of the Board of Directors of MedQuist Inc.

  
	
   

  
	
  Date:

  	
  September 19, 2006

  	
   

  
	
   

  	
   

  
	
   

  
	
  By:

  	
  /s/ Frank W.
  Lavelle

  	
   

  
	
   

  	
  Frank W.
  Lavelle, President

  
	
   

  	
   

  
	
   

  	
   

  
	
  Date:

  	
  September 25, 2006

  	
   

  
							

 

 4Exhibit
10.24.3

Nightingale &

Associates, LLC

Soundview Plaza

1266 East Main Street

Stamford, Connecticut

06902

Tel:   203.359.3855

Fax: 203.359.4551

Email:

info@nightingale-

associates.org

Principals:

Michael R. D’Appolonia

Howard S. Hoffmann

James D. Neidhart

Senior Principals

Pierre Benoit

January
8, 2007

Mr. Stephen H. Rusckowski, Chairman of the Board of
Directors

Mr. John Underwood, Chairman of the Compensation
Committee

Mr. Frank Lavelle, President

MedQuist Inc.

1000 Bishops Gate Blvd., Suite 300

Mt.
Laurel, NJ  08054-4632

Gentlemen:

In response to various discussions, Nightingale &
Associates, LLC (“Nightingale”) has been asked to submit this proposed
Amendment to our Engagement Letter with MedQuist Inc. (“MedQuist” or the “Company”)
dated July 29, 2004 as amended on December 16, 2004 and on September 25, 2006
(collectively, the “Amended Engagement Letter”).  This Amendment (i)
provides revisions to the cost structure and term associated with the continued
retention of Mr. Howard Hoffmann as the Company’s Interim Chief Executive
Officer.  All other terms and conditions for the retention of Nightingale,
as detailed in the Amended Engagement Letter, including but not limited to the
Release and Indemnification agreement, will remain in force and effect. 
It is our understanding that Howard Hoffmann, on behalf of Nightingale, will
continue to be engaged by MedQuist as the Company’s Interim Chief Executive
Officer and will continue to report to the Company’s Board of Directors.

I.                                         SCOPE OF
WORK:

Effective
as of January 1, 2007 Nightingale will extend the term of Howard Hoffmann’s
role as MedQuist’s Interim Chief Executive Officer until June 30, 2007.
 Following termination of Mr. Hoffmann’s role as Interim Chief Executive
Officer, Mr. Hoffmann will endeavor to make himself available for ongoing
consultancy work on an as needed basis, subject to negotiation of a mutually
agreeable Scope of Work.  It should be noted that Mr. Hoffmann expects to
be working on other client engagements upon his departure as the full time
Interim Chief Executive Officer of MedQuist, and thus his availability for work
beyond June 30, 2007 cannot be guaranteed.

II.                                     FEE STRUCTURE:

Fixed Monthly Fee:

Effective
as of January 1, 2007, Nightingale’s fees for Mr. Hoffmann’s role as Interim
Chief Executive Officer will be a fixed rate of $120,000 per month payable in
arrears.  If Mr. Hoffmann’s role is terminated during the course of a
month, Nightingale’s fees for the final month will be prorated based on the
actual number of calendar days elapsed during the month up to and including Mr.
Hoffmann’s final day of work.  Mr. Hoffmann’s fees for consultancy
services following his departure as the Interim Chief Executive Officer of
MedQuist will be billed at an hourly rate of $525/hour.

2007 Performance Bonus:

Nightingale
may be entitled to an additional performance related bonus payment of up to
$480,000, which will be paid no later than July 16, 2007 (the “2007 Performance
Bonus”) in connection with Mr. Hoffmann’s service in 2007 as Interim Chief
Executive Officer.  The amount, if any, of the 2007 Performance Bonus that
Nightingale is to receive will be based on the achievement of certain
operational objectives that have been established by the Board of Directors of
MedQuist and Nightingale, which operational objectives involve confidential
strategic, commercial and financial information, the disclosure of which would
result in competitive harm to the Company.

2006 Discretionary Bonus:

Nightingale
remains eligible for the 2006 Discretionary Bonus as described in the September
12, 2006 amendment to our Engagement Letter (the “September 2006 Amendment”). 
Nightingale agrees to extend the date by which the Committee will inform
Nightingale of its determination of the amount, if any, of the 2006
Discretionary Bonus that is to be paid until fourteen days following completion
of the filing of the Company’s periodic filings covering the years 2003, 2004
and 2005 and its forms 10-Q for the first three quarters of 2006 with the
Securities and Exchange Commission.  All other terms associated with the
2006 Discretionary Bonus are as described in the September 2006 Amendment.

Availability Guaranty Fee:

Given
that this amendment extends Mr. Hoffmann’s role as MedQuist’s full time Interim
Chief Executive Officer, the Availability Guaranty Fee requirement described in
the September 2006 Amendment is no longer in force and effect.

 2
 

Additional Nightingale Personnel:

Nightingale
will continue to make available the services of Mr. Michael C. Yeager and Ms.
Jeanine Cobonpue to perform selected services in connection with the Company’s
billing matter and operations related activities.  Mr. Yeager’s professional
time fee services have been and will continue to be invoiced to MedQuist at his
prevailing hourly rate of $350/hour.  Ms. Cobonpue’s professional time fee
services have been and will continue to be invoiced to MedQuist at her
prevailing hourly rate of $175/hour.  Should it become necessary to
utilize the services of additional Nightingale personnel on the project, it is
agreed that Nightingale will invoice professional time fees for such personnel
at their prevailing hourly rates.  Nightingale agrees that it will obtain
the advance approval of the Board of Directors, which shall be conveyed by the
Board of Directors to Frank Lavelle, before adding additional personnel to the
project team.

In
addition to professional time fees, out-of-pocket expenses are billed at cost,
and generally range from 10% to 20% of professional time fees, depending on the
amount of travel involved.  Out-of-pocket expenses consist primarily of
transportation, meals, lodging, telephone, specifically assignable secretarial
and office assistance, and report production.

III.                                 ADVANCE
DEPOSIT

Nightingale
requires an Advance Deposit for all assignments of the type described
above.  Given this situation, Nightingale will not require an increase of
its existing Advance Deposit of $75,000 that has been paid by the
Company.  At the completion of the project and at the direction of the
Company, Nightingale will either apply the Advance Deposit to any outstanding
invoices or, if there are no unpaid invoices owing to Nightingale, promptly return
the Deposit to the Company.

v  v  v  v  v  v  v  v  v  v  v  v  v  v  v

 3
 

If this Amendment conforms to your understanding of
the terms and conditions of our retention, please have the appropriate party
signify agreement by signing and returning the enclosed extra copy of this
Amendment.

We look forward to continue working with you and the
Company.

	
   

  	
  Sincerely,

  
	
   

  	
   

  
	
   

  	
  /s/ Howard S. Hoffmann

  	
   

  
	
   

  	
   

  
	
   

  	
  Howard S. Hoffmann,

  
	
   

  	
  in the capacity as
  Principal and

  
	
   

  	
  Managing Partner of
  Nightingale &

  
	
   

  	
  Associates, LLC

  

 

READ, UNDERSTOOD AND AGREED TO BY:

MedQuist Inc.

	
  By: 

  	
  /s/ Stephen H.
  Rusckowski

  	
   

  
	
   

  	
  Stephen H. Rusckowski

  
	
   

  	
  Chairman of the Board
  of Directors of MedQuist Inc

  
	
   

  	
   

  
	
   

  	
  Date: January 8, 2007

  
	
   

  
	
   

  
	
  By: 

  	
  /s/ John Underwood

  	
   

  
	
   

  	
  John Underwood

  
	
   

  	
  Chairman of the
  Compensation Committee of the Board of Directors of MedQuist Inc.

  
	
   

  
	
   

  	
  Date: January 8, 2007

  
	
   

  
	
   

  
	
  By: 

  	
  /s/ Frank W. Lavelle

  	
   

  
	
   

  	
  Frank W. Lavelle,
  President

  
	
   

  	
   

  
	
   

  	
  Date: January 8, 2007

  
						

 

 4

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