Document:

exv10w2

Exhibit 10.2

Execution Version

SECOND AMENDMENT TO REVOLVING CREDIT AGREEMENT

          THIS SECOND AMENDMENT TO REVOLVING CREDIT AGREEMENT is dated as of April 6, 2011 (this
“Amendment”) by and among AMSURG CORP., a Tennessee corporation (the “Borrower”),
each of the “Lenders” party to the Credit Agreement defined below (the “Lenders”) and
SUNTRUST BANK, in its capacity as administrative agent for the Lenders (the “Administrative
Agent”).

          WHEREAS, the Borrower, certain of the Lenders and the Administrative Agent are parties to that
certain Revolving Credit Agreement dated as of May 28, 2010, as amended by that certain First
Amendment to Revolving Credit Agreement dated as of the date hereof (the “First Amendment”)
among the Borrower, the Lenders party thereto and the Administrative Agent (as so amended, the
“Credit Agreement”; capitalized terms used herein and not otherwise defined herein shall
have the respective definitions given them in the Credit Agreement);

          WHEREAS, the Borrower has requested (i) modifications to its pricing pursuant to the
Applicable Margin and (ii) an extension of the Maturity Date, in each case on the terms and
conditions herein; and

          WHEREAS, the Borrower, the Lenders and the Administrative Agent desire to amend the Credit
Agreement on the terms and conditions contained herein.

          NOW, THEREFORE, for good and valuable consideration, the receipt and sufficiency of which are
hereby acknowledged by the parties hereto, the parties hereto hereby agree as follows:

     Section 1. Specific Amendments.

          (a) Section 1.1 of the Credit Agreement is hereby amended by adding the following new
definition in the appropriate alphabetical order:

          “Second Amendment Date” means April 6, 2011.

          (b) Section 1.1 of the Credit Agreement is hereby further amended by deleting the defined
terms “Applicable Margin” and “Maturity Date” in their entirety and substituting in
lieu thereof the following:

“Applicable Margin” means, as of any date, with respect to the Letter of
Credit Fee, the Commitment Fee and all Revolving Loans outstanding on such date, a
percentage per annum determined by reference to the applicable Leverage Ratio in
effect on such date in accordance with the table set forth immediately below,
provided, that a change in the Applicable Margin resulting from a change in the
Leverage Ratio shall be effective on the second Business Day after which the
Borrower delivers the financial statements required by Section 5.1(a) or
Section 5.1(b) and the Compliance Certificate required by Section
5.1(c); provided further, that if at any time the Borrower shall have failed to
deliver such financial
statements and such Compliance Certificate when so required, the Applicable

 

 

Margin
shall be at Level V as set forth immediately below until such time as such financial
statements and Compliance Certificate are delivered, at which time the Applicable
Margin shall be determined as provided above.

	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 	 	 	 	Applicable	 	Applicable	 	 	 	 
	 	 	 	 	Margin for	 	Margin for	 	 	 	 
	Pricing	 	 	 	Eurodollar	 	Base Rate	 	Commitment	 	Letter of
	Level	 	Leverage Ratio	 	Loans	 	Loans	 	Fees	 	Credit Fees
	I

	 	Less than 1.50:1.00
	 	 	1.75	%	 	 	0.75	%	 	 	0.20	%	 	 	1.75	%
	 
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	II

	 	Less than 2.00:1.00
but greater than or
equal to 1.50:1.00
	 	 	2.00	%	 	 	1.00	%	 	 	0.25	%	 	 	2.00	%
	 
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	III

	 	Less than 2.50:1.00
but greater than or
equal to 2.00:1.00
	 	 	2.25	%	 	 	1.25	%	 	 	0.375	%	 	 	2.25	%
	 
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	IV

	 	Less than 3.00:1.00
but greater than or
equal to 2.50:1.00
	 	 	2.50	%	 	 	1.50	%	 	 	0.375	%	 	 	2.50	%
	 
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	V

	 	Greater than or
equal to 3.00:1.00
	 	 	2.75	%	 	 	1.75	%	 	 	0.50	%	 	 	2.75	%

“Maturity Date” shall mean the earliest of (i) April 6, 2016 (ii) the
date on which the Revolving Commitments are terminated pursuant to Section
2.8, or (iii) the date on which all amounts outstanding under this Agreement
have been declared or have automatically become due and payable.

     Section 2. Conditions Precedent. The effectiveness of this Amendment is subject to
the satisfaction of the following conditions precedent:

(i) The Administrative Agent shall have received a counterpart of this Amendment duly
executed by the Borrower, each of the Lenders and the Administrative Agent;

(ii) No Default or Event of Default shall exist;

(iii) A Reaffirmation of Obligations Under Loan Documents (the “Reaffirmation”) duly
executed by the Borrower and each other Loan Party, in the form of Exhibit A
attached hereto;

- 2 -

 

(iv) Certified copies of resolutions of the board of directors (or equivalent thereof) of
(x) the Borrower, approving the execution, delivery and performance of this Amendment and
(y) each other Loan Party, stating that the Obligations are entitled to benefits of the
Security Documents and other Loan Documents;

(v) A favorable opinion of Bass Berry & Sims PLC, counsel to the Borrower and the other Loan
Parties, addressed to the Administrative Agent and the Lenders and covering such matters
relating to this Amendment and the transactions contemplated hereby in form and substance
satisfactory to the Administrative Agent and its counsel;

(vi) The Administrative Agent shall have received, for itself and on behalf of the Lenders,
all fees and expenses contemplated by (i) that certain engagement letter dated March 21,
2011 between SunTrust Robinson Humphrey, Inc. and the Borrower and (ii) Section 4 hereof;
and

(vii) Such other documents, instruments, agreements, certifications and opinions as the
Administrative Agent, on behalf of the Lenders, may reasonably request.

     Section 3. Representations. The Borrower represents and warrants to the
Administrative Agent and the Lenders that:

(a) Authorization. Each of the Borrower and the other Loan Parties have the right
and power, and have taken all necessary action to authorize them, to execute and deliver
this Amendment and the Reaffirmation and to perform their respective obligations hereunder
and under the Credit Agreement, as amended by this Amendment, and the other Loan Documents
to which they are a party in accordance with their respective terms. This Amendment has
been duly executed and delivered by a duly authorized officer of the Borrower and the Loan
Parties and each of this Amendment and the Credit Agreement, as amended by this Amendment,
is a legal, valid and binding obligation of the Borrower enforceable against the Borrower in
accordance with its respective terms.

(b) Compliance with Laws. The execution and delivery by the Borrower and the other
Loan Parties of this Amendment and the Reaffirmation and the performance by the Borrower of
this Amendment and the Credit Agreement, as amended by this Amendment, in accordance with
their respective terms, do not and will not, by the passage of time, the giving of notice or
otherwise: (i) require any consent or approval of, registration or filing with, or any
action by, any Governmental Authority or any other Person or violate any Requirements of Law
applicable to the Loan Parties or any judgment, order or ruling of any Governmental
Authority; (ii) violate or result in a default under any indenture, material agreement
(including the Private Placement Documents) or other material instrument binding on the Loan
Parties or any of their assets or give rise to a right thereunder to require any payment to
be made by the Loan Parties; or (iii) result in the creation or imposition of any Lien on
any asset of the Loan Parties.

(c) Reaffirmation. As of the date of this Amendment and immediately after giving
effect to this Amendment, all representations and warranties of each Loan Party set forth in
the

- 3 -

 

Loan Documents is true and correct in all material respects (except to the extent that any
such representation or warranty expressly relates to a specified earlier date, in which case
such representation or warranty shall be true and correct as of such earlier date).

(d) No Default. As of the date hereof and immediately after giving effect to this
Amendment, no Default or Event of Default shall exist.

(e) No Impairment of Liens. The execution, delivery, performance and effectiveness
of this Amendment will not: (a) impair the validity, effectiveness or priority of the Liens
granted pursuant to any Loan Document, and such Liens continue unimpaired with the same
priority to secure repayment of all of the applicable Obligations, whether heretofore or
hereafter incurred, and (b) require that any new filings be made or other action taken to
perfect or to maintain the perfection of such Liens.

(f) No Material Adverse Effect. Since the date of the most recent financial
statements of the Borrower described in Section 5.1(a) of the Credit Agreement,
there has been no change which has had or could reasonably be expected to have a Material
Adverse Effect.

(g) Loan Parties. As of the date hereof, the parties listed as signatories to the
Reaffirmation represent a true, correct and complete list of the all the Loan Parties.

     Section 4. Payment of Fees and Expenses. The Borrower agrees to pay or reimburse the
Administrative Agent for its reasonable out-of-pocket fees, costs and expenses incurred in
connection with the preparation, negotiation, execution and delivery of this Amendment and the
other documents and agreements executed and delivered in connection herewith.

     Section 5. Release. In consideration of the amendments contained herein, the
Borrower hereby waives and releases each of the Lenders, the Administrative Agent and the Issuing
Bank from any and all claims and defenses, known or unknown as of the date hereof, with respect to
the Credit Agreement and the other Loan Documents and the transactions contemplated thereby.

     Section 6. Effect; Ratification.

          (a) Except as expressly herein amended, the terms and conditions of the Credit Agreement and
the other Loan Documents remain unchanged and continue to be in full force and effect. The
amendments contained herein shall be deemed to have prospective application only, unless otherwise
specifically stated herein. The Credit Agreement is hereby ratified and confirmed in all respects.
Each reference to the Credit Agreement in any of the Loan Documents (including the Credit
Agreement) shall be deemed to be a reference to the Credit Agreement, as amended by this Amendment.

          (b) Nothing contained herein shall be deemed to constitute a waiver of compliance with any
term or condition contained in the Credit Agreement or any of the other Loan Documents, or
constitute a course of conduct or dealing among the parties. The Administrative Agent and the
Lenders reserve all rights, privileges and remedies under the Loan Documents.

- 4 -

 

          (c) Nothing in this Amendment is intended, or shall be construed, to constitute a novation or
an accord and satisfaction of any of the Obligations or to modify, affect or impair the perfection,
priority or continuation of the security interests in, security titles to or other Liens on any
collateral (including the Collateral) securing the Obligations.

          (d) This Amendment constitutes the entire agreement and understanding among the parties hereto
with respect to the subject matter hereof and supersedes any and all prior agreements and
understandings, oral or written, relating to the subject matter hereof.

          (e) This Amendment may be executed in any number of counterparts and by different parties
hereto on separate counterparts, each of which when so executed and delivered shall be deemed to be
an original, but all of which when taken together shall constitute a single instrument. Delivery
of an executed counterpart of a signature page of this Amendment by facsimile transmission or by
email in Adobe “.pdf” format shall be effective as delivery of a manually executed counterpart
hereof.

     Section 7. Further Assurances. The Borrower agrees to, and to cause any Loan Party
to, take all further actions and execute such other documents and instruments as the Administrative
Agent may from time to time reasonably request to carry out the transactions contemplated by this
Amendment, the Loan Documents and all other agreements executed and delivered in connection
herewith.

     Section 8. Miscellaneous. THIS AMENDMENT SHALL BE GOVERNED BY, AND CONSTRUED IN
ACCORDANCE WITH, THE INTERNAL LAWS OF THE STATE OF TENNESSEE WITHOUT REGARD TO CONFLICT OF LAWS
PRINCIPLES THEREOF. This Amendment shall be binding upon and shall inure to the benefit of the
parties hereto and their respective permitted successors and assigns.

     Section 9. Severability. In case any provision of or obligation under this Amendment
shall be invalid, illegal or unenforceable in any jurisdiction, the validity, legality and
enforceability of the remaining provisions or obligations, or of such provision or obligation in
any other jurisdiction, shall not in any way be affected or impaired thereby.

[Signature Pages Follow]

- 5 -

 

     IN WITNESS WHEREOF, the parties hereto have caused this Second Amendment to Revolving Credit
Agreement to be duly executed by their respective authorized officers as of the day and year first
above written.

	 	 	 	 	 
	 	BORROWER:

AMSURG CORP.

 	 
	 	By:  	/s/ Claire M. Gulmi	 
	 	Title:  	Executive
Vice President, Chief Financial Officer and Secretary	 

Signature page to Second Amendment to Revolving Credit Agreement

 

 

	 	 	 	 	 
	 	LENDER:

SUNTRUST BANK

as Administrative Agent, as Issuing Bank,

   and as a Lender

 	 
	 	By:  	/s/	 
	 	Title:  	 	 

Signature page to Second Amendment to Revolving Credit Agreement

 

 

	 	 	 	 	 
	 	LENDER:

REGIONS BANK

 	 
	 	By:  	/s/	 
	 	Title:  	 	 

Signature page to Second Amendment to Revolving Credit Agreement

 

 

	 	 	 	 	 
	 	LENDER:

BANK OF AMERICA, N.A.

 	 
	 	By:  	/s/	 
	 	Title:  	 	 

Signature page to Second Amendment to Revolving Credit Agreement

 

 

	 	 	 	 	 
	 	LENDER:

JPMORGAN CHASE BANK, N.A.

 	 
	 	By:  	/s/	 
	 	Title:  	 	 

Signature page to Second Amendment to Revolving Credit Agreement

 

 

	 	 	 	 	 
	 	LENDER:

US BANK NATIONAL ASSOCIATION

 	 
	 	By:  	/s/	 
	 	Title:  	 	 

Signature page to Second Amendment to Revolving Credit Agreement

 

 

	 	 	 	 	 
	 	LENDER:

RAYMOND JAMES BANK, FSB

 	 
	 	By:  	/s/	 
	 	Title:  	 	 

Signature page to Second Amendment to Revolving Credit Agreement

 

 

	 	 	 	 	 
	 	LENDER:

BRANCH BANKING AND TRUST COMPANY

 	 
	 	By:  	/s/	 
	 	Title:  	 	 

Signature page to Second Amendment to Revolving Credit Agreement

 

 

	 	 	 	 	 
	 	LENDER:

FIFTH THIRD BANK, N.A.

 	 
	 	By:  	/s/
	 
	 	Title:  	 	 

Signature page to Second Amendment to Revolving Credit Agreement

 

 

	 	 	 	 	 
	 	LENDER:

WELLS FARGO BANK, N.A.

 	 
	 	By:  	/s/	 
	 	Title:  	 	 

Signature page to Second Amendment to Revolving Credit Agreement

 

 

	 	 	 	 	 
	 	LENDER:

COMPASS BANK

 	 
	 	By:  	/s/	 
	 	Title:  	 	 

Signature page to Second Amendment to Revolving Credit Agreement

 

 

	 	 	 	 	 
	 	LENDER:

FIRST TENNESSEE BANK NATIONAL ASSOCIATION

 	 
	 	By:  	/s/	 
	 	Title:  	 	 

Signature page to Second Amendment to Revolving Credit Agreement

 

 

	 	 	 	 	 
	 	LENDER:

KEYBANK NATIONAL ASSOCIATION

 	 
	 	By:  	/s/	 
	 	Title:  	 	 

Signature page to Second Amendment to Revolving Credit Agreement

 

 

	 	 	 	 	 
	 	LENDER:

UNION BANK, N.A.

 	 
	 	By:  	/s/	 
	 	Title:  	 	 

Signature page to Second Amendment to Revolving Credit Agreement

 

 

	 	 	 	 	 
	 	LENDER:

THE BANK OF NASHVILLE

 	 
	 	By:  	/s/	 
	 	Title:  	 	 

Signature page to Second Amendment to Revolving Credit Agreement

 

 

	 	 	 	 	 
	 	LENDER:

GOLDMAN SACHS BANK USA

 	 
	 	By:  	/s/	 
	 	Title:  	 	 

Signature page to Second Amendment to Revolving Credit Agreement

 

 

	 	 	 	 	 
	 	LENDER:

AVENUE BANK

 	 
	 	By:  	/s/	 
	 	Title:  	 	 

Signature page to Second Amendment to Revolving Credit Agreement

 

 

EXHIBIT A

REAFFIRMATION OF OBLIGATIONS UNDER LOAN DOCUMENTS

          Reference is hereby made to that certain Revolving Credit Agreement dated as of May 28, 2010,
among AmSurg Corp. (the “Borrower”), the Lenders party thereto and SunTrust Bank, as Administrative
Agent (as amended by that certain First Amendment to Revolving Credit Agreement dated as of the
date hereof, the “Credit Agreement”; capitalized terms used herein and not defined herein
have the meanings ascribed to such terms in the Credit Agreement).

          Each of the undersigned Loan Parties hereby: (i) agrees that (A) the amendments contained in
the Second Amendment to Revolving Credit Agreement dated as of the date hereof (the “Second
Amendment”) shall not in any way affect the validity and/or enforceability of any Loan
Document, or reduce, impair or discharge the obligations of such Person thereunder and (B) nothing
in the Second Amendment is intended, or shall be construed, to constitute a novation or an accord
and satisfaction of any of the Obligations or to modify, affect or impair the perfection, priority
or continuation of the security interests in, security titles to or other Liens on any collateral
(including the Collateral) securing the Obligations; (ii) reaffirms its continuing obligations
owing to the Administrative Agent and the Lenders under each of the other Loan Documents to which
such Person is a party; and (iii) confirms that the liens and security interests created by the
Loan Documents continue to secure the Obligations.

          Each of the undersigned Loan Parties (other than the Borrower) hereby represents and warrants
to the Administrative Agent and the Lenders that each of the representations and warranties
applicable to such Loan Party made by the Borrower in Section 3 of the Second Amendment are true
and correct.

          This Reaffirmation shall be construed in accordance with and be governed by the law of the
State of Tennessee.

[Signature page follows]

 

 

          IN WITNESS WHEREOF, each of the undersigned has duly executed and delivered this Reaffirmation
of Obligations under Loan Documents as of April 6, 2011.

	 	 	 	 	 
	 	AMSURG CORP.

 	 
	 	By:  	/s/
Claire M. Gulmi	 
	 	 	Name:  	Claire M. Gulmi	 
	 	 	Title:  	Executive Vice President, Chief Financial
Officer and Secretary	 
	 
	 	 AmSurg Holdings, Inc.

AmSurg Anesthesia Management Services, LLC

AmSurg EC Topeka, Inc.

AmSurg EC St. Thomas, Inc.

AmSurg EC Beaumont, Inc.

AmSurg KEC, Inc.

AmSurg EC Santa Fe, Inc.

AmSurg EC Washington, Inc.

AmSurg Torrance, Inc.

AmSurg Abilene, Inc.

AmSurg Suncoast, Inc.

AmSurg Lorain, Inc.

AmSurg La Jolla, Inc.

AmSurg Hillmont, Inc.

AmSurg Palmetto, Inc.

AmSurg Northwest Florida, Inc.

AmSurg Ocala, Inc.

AmSurg Maryville, Inc.

AmSurg Miami, Inc.

AmSurg Burbank, Inc.

AmSurg Melbourne, Inc.

AmSurg El Paso, Inc.

AmSurg Crystal River, Inc.

AmSurg Abilene Eye, Inc.

AmSurg Inglewood, Inc.

AmSurg Glendale, Inc.

AmSurg San Antonio TX, Inc.

AmSurg San Luis Obispo CA, Inc.

AmSurg Temecula CA, Inc.

AmSurg Escondido CA, Inc.

AmSurg Scranton PA, Inc.

AmSurg Arcadia CA Inc.

AmSurg Main Line PA, Inc.

AmSurg Oakland CA, Inc.

AmSurg Lancaster PA, Inc.

 	 

 

 

	 	 	 	 	 
	 	AmSurg Pottsville PA, Inc.

AmSurg Glendora CA, Inc.

AmSurg Kissimmee FL, Inc.

AmSurg Altamonte Springs FL., Inc.

AmSurg New Port Richey FL, Inc.

AmSurg EC Centennial, Inc.

AmSurg Naples, Inc.

 	 
	 	By:  	/s/ Claire M. Gulmi	 
	 	 	Name:  	Claire M. Gulmi	 
	 	 	Title:  	Vice President, Secretory and Treasurerexv10w3

Exhibit 10.3

FIRST AMENDMENT TO NOTE PURCHASE AGREEMENT

      THIS FIRST AMENDMENT TO NOTE PURCHASE AGREEMENT (this “Amendment”), is made and
entered into as of April 6, 2011, by and among AMSURG CORP., a Tennessee corporation (the
“Company”), the other Credit Parties signatory hereto, THE PRUDENTIAL INSURANCE COMPANY OF AMERICA
and the other holders of Notes (as defined in the Note Agreement defined below) that are
signatories hereto (together with their successors and assigns, the “Noteholders”).

W I T N E S S E T H:

     WHEREAS, the Company and the Noteholders are parties to a certain Note Purchase Agreement,
dated as of May 28, 2010 (as amended, restated, supplemented or otherwise modified from time to
time, the “Note Agreement”; capitalized terms used herein and not otherwise defined shall have the
meanings assigned to such terms in the Note Agreement), pursuant to which the Noteholders have
purchased Notes from the Company;

     WHEREAS, the Company has requested that the Noteholders amend certain provisions of the Note
Agreement, and subject to the terms and conditions hereof, the Noteholders are willing to do so;

     NOW, THEREFORE, for good and valuable consideration, the sufficiency and receipt of all of
which are acknowledged, the Company and the Noteholders agree as follows:

     1. Amendments.

     (a) Paragraph 2B of the Note Agreement is hereby amended by replacing such Paragraph in its
entirety with the following:

     Increase in Interest Rate after a Major Acquisition. Commencing with
the first day of the first fiscal quarter immediately following any Major
Acquisition, the per annum stated interest rate on the outstanding Notes shall
automatically be increased by 0.75% per annum until the later of (i) the first day
of the fifth fiscal quarter immediately following such Major Acquisition and (ii)
the date on which Company has delivered to the holders of the Notes an Officer’s
Certificate (x) demonstrating that the Leverage Ratio on the last day of any Fiscal
Quarter ending after such Major Acquisition does not exceed 3.25:1.0 and (y)
certifying that no Default or Event of Default has occurred, at which time the per
annum stated interest rate on the outstanding Notes shall automatically decrease to
the original stated interest rate.

     (b) Paragraph 5A of the Note Agreement is hereby amended by replacing subsection (iii) of such
Paragraph in its entirety with the following:

     (iii) concurrently with the delivery of the financial statements referred to in
clauses (i) and (ii) above, a Compliance Certificate signed by a Responsible Officer
in the form of Schedule 5C, (1) certifying as to whether there exists a Default or
Event of Default on the date of such certificate, and if a Default or an

 

 

Event of Default then exists, specifying the details thereof and the action which
the Company has taken or proposes to take with respect thereto, (2) setting forth in
reasonable detail calculations demonstrating compliance with paragraph 6A, paragraph
6B(vii), paragraph 6E(viii), paragraph 6F (showing the amount of any dividends and
any purchases of treasury stock) and paragraph 6G (showing compliance with paragraph
6G(iii)), (3) providing a reconciliation of all calculations and determinations made
therein both before and after giving effect to the last sentence of paragraph 10C in
such detail as may be requested by any holder of the Notes and (4) stating whether
any change in GAAP or the application thereof has occurred since the date of the
Company’s audited financial statements referred to in paragraph 8D and, if any
change has occurred, specifying the effect of such change on the financial
statements accompanying such certificate;

     (c) Paragraph 6A(1) of the Note Agreement is hereby amended by replacing such Paragraph in its
entirety with the following:

     6A(1) Leverage Ratio. The Company shall maintain, on a consolidated basis and
as calculated at the end of each Fiscal Quarter, a Leverage Ratio of not greater
than 3.25 to 1.00; provided however, that if the Company closes any Major
Acquisition, then with respect to the calendar quarter in which such Major
Acquisition is closed and each of the three immediately following calendar quarters,
the Company shall maintain a Leverage Ratio of not greater than 3.75 to 1.00 instead
of 3.25 to 1.00, and for each calendar quarter thereafter, the Company shall
maintain a Leverage Ratio of not greater than 3.25 to 1.00.

     (d) Paragraph 6B of the Note Agreement is hereby amended by replacing subsection (vi) such
Paragraph in its entirety with the following:

     (vi) Indebtedness under the Credit Agreement, including refundings, refinancings and
replacements thereof, and amendments or modifications to the Note Documents;
provided, however, that the aggregate principal amount of such Indebtedness shall
not at any time exceed $600,000,000, and all Guarantees thereof by Subsidiaries of
the Company that have also guaranteed the Notes; and

     (e) Paragraph 10B of the Note Agreement is hereby amended by adding the following new
definitions in the appropriate alphabetical order:

     “First Amendment” means that certain First Amendment to Note Purchase Agreement
dated as of April 6, 2011 by and among the Company, the other Credit Parties party
thereto and the holders of the Notes party thereto.

     “NSC Acquisition” means the consummation of the acquisition pursuant to the NSC
Acquisition Agreement.

 

 

     “NSC Acquisition Agreement” that certain Merger Agreement, dated on or about April
7, 2011, by and among, among others, the Company, AmSurg Merger Corporation and
National Surgical Care, Inc.

     (f) Paragraph 10B of the Note Agreement is hereby amended by replacing the definitions of
“EBITDA” and “Noteholder Share of Net Disposition Proceeds” in their entirety with the following
definitions:

     “EBITDA” shall mean, for the Company and its Subsidiaries on a consolidated basis
for any period, an amount equal to the sum of Consolidated Net Income for such
period plus, without duplication, and to the extent deducted in computing
Consolidated Net Income for such period, the sum of (a) income taxes, (b)
Consolidated Interest Expense, (c) depreciation and amortization expense, in each
case determined on a consolidated basis in accordance with GAAP; (d) to the extent
applicable, stock option compensation costs applicable under (and calculated in
accordance with) FASB ASC 718; (e) all non-cash charges for such period taken for
the impairment of goodwill in accordance with FASB ASC 350, but excluding any
non-cash charge that will result in a cash charge in a future period; and (f) all
documented fees and expenses actually paid in connection with the First Amendment
and the NSC Acquisition in an aggregate amount not to exceed $10,000,000;
provided, however, that, to the extent included in Consolidated Net
Income, there shall be excluded the effect of any change in valuation based on the
exercise of any rights granted pursuant to the “Series 1 Contingent Value Rights
Agreement” and “Series 2 Contingent Value Rights Agreement”, as such terms are
defined in the NCS Acquisition Agreement; provided, further, with
respect to any Person that became a Subsidiary of, or was merged with or
consolidated into, the Company or any Wholly Owned Subsidiary during such period,
“EBITDA” shall also include the EBITDA of such Person during such period and prior
to the date of such acquisition, merger or consolidation; and provided, further,
with respect to any Person that ceased to be a Subsidiary, or was the subject of a
Disposition during any measurement period, “EBITDA” shall not include the EBITDA of
such Person for such measurement period, such calculations under this proviso to be
detailed with supporting documentation and measured to the Required Holders’
reasonable satisfaction.

     “Noteholder Share of the Net Disposition Proceeds” shall mean, with respect to
any offer to prepay pursuant to paragraph 4G, as determined on the date of the
relevant Disposition, an amount equal to the Net Disposition Proceeds resulting from
such Disposition multiplied by (a) the aggregate outstanding principal amount of the
Notes, divided by (b) the sum of (i) the aggregate outstanding principal amount of
the Notes, plus (ii) (A) the committed amount of the Revolving Commitments (as
defined in the Credit Agreement, provided that such amount shall not exceed
$600,000,000), until the termination of the Revolving Commitments (to the extent
that the Company has not entered into a replacement Credit Agreement with Revolving
Commitments that have not yet been terminated) and (B) thereafter, the aggregate
amount of Revolving Credit

 

 

Exposure (as defined in the Credit Agreement, provided that such amount shall not
exceed $600,000,000).

     (g) Paragraph 10C of the Note Agreement is hereby amended by inserting the following at the
end thereof:

     Notwithstanding anything herein or under GAAP to the contrary, all real property
leases of the Company and/or its Subsidiaries, whether now existing or hereafter
entered into, acquired or assumed by the Company or such Subsidiary, shall be deemed
for all purposes under this Agreement (including for accounting purposes, for the
defined terms used herein and for purposes of determining compliance with the
financial and other covenants herein) to be operating leases and shall not be
accounted for as Capital Lease Obligations.

     2. Conditions to Effectiveness of this Amendment. Notwithstanding any other provision
of this Amendment and without affecting in any manner the rights of the holders of the Notes
hereunder, it is understood and agreed that this Amendment shall not become effective, and the
Company shall have no rights under this Amendment, until the Noteholders shall have received (i) an
amendment fee in the amount of $75,000, to be allocated pro rata among the Noteholders, (ii) such
other fees as the Company has previously agreed to pay the Noteholders or any of its affiliates in
connection with this Amendment, (iii) reimbursement or payment of its costs and expenses incurred
in connection with this Amendment or the Note Agreement (including reasonable fees, charges and
disbursements of King & Spalding LLP, counsel to the Noteholders), and (iv) each of the following
documents:

     (a) Executed counterparts to this Amendment from the Company, each of the Guarantors and the
Noteholders;

     (b) Certified copies of resolutions of the board of directors (or equivalent thereof) of the
Company and each other Credit Party, approving the execution, delivery and performance of this
Amendment and the other documents to be executed in connection herewith;

     (c) A favorable opinion of Bass Berry & Sims PLC, counsel to the Company and the other Credit
Parties, addressed to the Noteholders and covering such matters relating to this Amendment and the
transactions contemplated hereby in form and substance satisfactory to Noteholders and their
counsel;

     (d) A duly executed copy of an amendment to the Credit Agreement, in form and substance
satisfactory to the Noteholders and their counsel;

     (e) Such other documents, instruments, agreements, certifications and opinions as any
Noteholder may reasonably request; and

     (f) A certificate of the chief financial officer of the Company demonstrating compliance on a
Pro Forma Basis with the financial covenants contained in Paragraph 6A of the Note Agreement after
the NSC Acquisition is completed, in form and substance satisfactory to the Required Holders.

 

 

     3. NSC Acquisition. In connection with the NSC Acquisition, the Noteholders
acknowledge that the conditions and information required to be delivered pursuant to Paragraph
6N(iv) of the Note Agreement with respect to the NSC Acquisition have been satisfied by the Company
(except for the delivery of certain pro forma calculations required to be delivered pursuant to
Section 2(f) of this Amendment).

     4. Representations and Warranties. To induce the Noteholders to enter into this
Amendment, each Credit Party hereby represents and warrants to the Noteholders that:

     (a) The execution, delivery and performance by such Credit Party of this Amendment (i) are
within such Credit Party’s power and authority; (ii) have been duly authorized by all necessary
corporate and shareholder action; (iii) are not in contravention of any provision of such Credit
Party’s certificate of incorporation or bylaws or other organizational documents; (iv) do not
violate any law or regulation, or any order or decree of any Governmental Authority; (v) do not
conflict with or result in the breach or termination of, constitute a default under or accelerate
any performance required by, any indenture, mortgage, deed of trust, lease, agreement or other
instrument to which such Credit Party or any of its Subsidiaries is a party or by which such Credit
Party or any such Subsidiary or any of their respective property is bound; (vi) do not result in
the creation or imposition of any Lien upon any of the property of such Credit Party or any of its
Subsidiaries; and (vii) do not require the consent or approval of any Governmental Authority or any
other person;

     (b) This Amendment has been duly executed and delivered for the benefit of or on behalf of
each Credit Party and constitutes a legal, valid and binding obligation of each Credit Party,
enforceable against such Credit Party in accordance with its terms;

     (c) After giving effect to this Amendment, the representations and warranties contained in the
Note Agreement and the other Note Documents are true and correct in all material respects, and no
Default or Event of Default has occurred and is continuing as of the date hereof;

     (d) The execution, delivery, performance and effectiveness of this Amendment will not: (a)
impair the validity, effectiveness or priority of the Liens granted pursuant to any Note Document,
and such Liens continue unimpaired with the same priority to secure repayment of all of the
applicable Obligations, whether heretofore or hereafter incurred, and (b) require that any new
filings be made or other action taken to perfect or to maintain the perfection of such Liens;

     (e) As of the date hereof and immediately after giving effect to this Amendment, the Company
is in compliance on a Pro Forma Basis with the financial covenants set forth in paragraph 6A of the
Note Agreement recomputed as of the last day of the most recently ended Fiscal Quarter for which
financial statements are available;

     (f) Since the date of the most recent financial statements of the Company described in
paragraph 5A(i) of the Note Agreement, there has been no change which has had or could reasonably
be expected to have a Material Adverse Effect; and

     (g) As of the date hereof, the parties listed as signatories to this Amendment represent a
true, correct and complete list of the all the Credit Parties.

 

 

     5. Reaffirmations and Acknowledgments.

     (a) Reaffirmation of Guaranty. Each Guarantor consents to the execution and delivery
by the Company of this Amendment and jointly and severally ratifies and confirms the terms of the
Guaranty Agreement with respect to the indebtedness now or hereafter outstanding under the Note
Agreement as amended hereby and all promissory notes issued thereunder. Each Guarantor acknowledges
that, notwithstanding anything to the contrary contained herein or in any other document evidencing
any indebtedness of the Company to the Noteholders or any other obligation of the Company, or any
actions now or hereafter taken by the Noteholders with respect to any obligation of the Company,
the Guaranty Agreement (i) is and shall continue to be a primary obligation of the Guarantors, (ii)
is and shall continue to be an absolute, unconditional, joint and several, continuing and
irrevocable guaranty of payment, and (iii) is and shall continue to be in full force and effect in
accordance with its terms. Nothing contained herein to the contrary shall release, discharge,
modify, change or affect the original liability of the Guarantors under the Guaranty Agreement.

     (b) Acknowledgment of Perfection of Security Interest. Each Credit Party hereby
acknowledges that, as of the date hereof, the security interests and liens granted to the
Collateral Agent under the Security Documents for the benefit of the Noteholders and other secured
parties are in full force and effect, are properly perfected and are enforceable in accordance with
the terms of the Note Agreement, the Security Documents and the other Note Documents.

     6. Release. In consideration of the amendments contained herein, each Credit Party
hereby waives and releases each of the Noteholders from any and all claims and defenses, known or
unknown as of the date hereof, with respect to the Note Agreement and the other Note Documents and
the transactions contemplated thereby.

     7. Effect of Amendment. Except as set forth expressly herein, all terms of the Note
Agreement, as amended hereby, and the other Note Documents shall be and remain in full force and
effect and shall constitute the legal, valid, binding and enforceable obligations of the Company
and the other Credit Parties party thereto to all holders of the Notes. The execution, delivery
and effectiveness of this Amendment shall not, except as expressly provided herein, operate as a
waiver of any right, power or remedy of the holders of the Notes under the Note Agreement, nor
constitute a waiver of any provision of the Note Agreement. From and after the date hereof, all
references to the Note Agreement shall mean the Note Agreement as modified by this Amendment. This
Amendment shall constitute a Note Document for all purposes of the Note Agreement.

     8. Governing Law. This Amendment shall be governed by, and construed in accordance
with, the internal laws of the State of New York and all applicable federal laws of the United
States of America.

     9. No Novation. This Amendment is not intended by the parties to be, and shall not be
construed to be, a novation of the Note Agreement or an accord and satisfaction in regard thereto.

 

 

     10. Costs and Expenses. The Company agrees to pay on demand all costs and expenses of
the Noteholders in connection with the preparation, execution and delivery of this Amendment,
including, without limitation, the reasonable fees and out-of-pocket expenses of outside counsel
for the Noteholders with respect thereto.

     11. Counterparts. This Amendment may be executed by one or more of the parties hereto
in any number of separate counterparts, each of which shall be deemed an original and all of which,
taken together, shall be deemed to constitute one and the same instrument. Delivery of an executed
counterpart of this Amendment by facsimile transmission or by electronic mail in pdf form shall be
as effective as delivery of a manually executed counterpart hereof.

     12. Binding Nature. This Amendment shall be binding upon and inure to the benefit of
the parties hereto, any other holders of Notes from time to time and their respective successors,
successors-in-titles, and assigns.

     13. Entire Understanding. This Amendment sets forth the entire understanding of the
parties with respect to the matters set forth herein, and shall supersede any prior negotiations or
agreements, whether written or oral, with respect thereto.

[remainder of page intentionally left blank]

 

 

     IN WITNESS WHEREOF, the parties hereto have caused this Amendment to be duly executed, under
seal in the case of the Company and the Guarantors, by their respective authorized officers as of
the day and year first above written.

	 	 	 	 	 
	 	COMPANY:

AMSURG CORP.

 	 
	 	By:  	 	 
	 	 	Name:  	 	 
	 	 	Title:  	 	 
	 

 

 

GUARANTORS:

AmSurg Holdings, Inc.

AmSurg Anesthesia Management Services, LLC

AmSurg EC Topeka, Inc.

AmSurg EC St. Thomas, Inc.

AmSurg EC Beaumont, Inc.

AmSurg KEC, Inc.

AmSurg EC Santa Fe, Inc.

AmSurg EC Washington, Inc.

AmSurg Torrance, Inc.

AmSurg Abilene, Inc.

AmSurg Suncoast, Inc.

AmSurg Lorain, Inc.

AmSurg La Jolla, Inc.

AmSurg Hillmont, Inc.

AmSurg Palmetto, Inc.

AmSurg Northwest Florida, Inc.

AmSurg Ocala, Inc.

AmSurg Maryville, Inc.

AmSurg Miami, Inc.

AmSurg Burbank, Inc.

AmSurg Melbourne, Inc.

AmSurg El Paso, Inc.

AmSurg Crystal River, Inc.

AmSurg Abilene Eye, Inc.

AmSurg Inglewood, Inc.

AmSurg Glendale, Inc.

AmSurg San Antonio TX, Inc.

AmSurg San Luis Obispo CA, Inc.

AmSurg Temecula CA, Inc.

AmSurg Escondido CA, Inc.

AmSurg Scranton PA, Inc.

AmSurg Arcadia CA Inc.

AmSurg Main Line PA, Inc.

AmSurg Oakland CA, Inc.

AmSurg Lancaster PA, Inc.

AmSurg Pottsville PA, Inc.

AmSurg Glendora CA, Inc.

AmSurg Kissimmee FL, Inc.

AmSurg Altamonte Springs FL., Inc.

AmSurg New Port Richey FL, Inc.

AmSurg EC Centennial, Inc.

AmSurg Naples, Inc.

	 	 	 	 	 
	 	 	 
	 	By:  	 	 
	 	 	Name:  	 	 
	 	 	Title:  	 	 
	 

 

 

	 	 	 	 	 
	 	NOTEHOLDERS:

THE PRUDENTIAL INSURANCE COMPANY 
OF AMERICA

 	 
	 	By:  	
 	 
	 	 	Vice President 	 
	 	 	 	 
	 

	 	 	 	 	 
	 	PRUCO LIFE INSURANCE COMPANY

 	 
	 	By:  	
 	 
	 	 	Assistant Vice President 	 
	 	 	 	 
	 

	 	 	 	 	 
	 	PRUDENTIAL RETIREMENT INSURANCE

AND ANNUITY COMPANY

By:     Prudential Investment Management, Inc.,

           as investment manager

 	 
	 	By:  	
 	 
	 	 	Vice President 	 
	 	 	 	 
	 

	 	 	 	 	 
	 	FORETHOUGHT LIFE INSURANCE COMPANY

By:     Prudential Private Placement Investors,

           L.P. (as Investment Advisor)

By:     Prudential Private Placement Investors, Inc.

           (as its General Partner)

 	 
	 	By:  	
 	 
	 	 	Vice President

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