Document:

EX-4.1.1

 Exhibit 4.1.1 

NATIONAL FUEL GAS COMPANY 

OFFICER’S CERTIFICATE 

Establishing 2.95% Notes due 2031 

February 24, 2021 

Karen M. Camiolo, the Treasurer of National Fuel Gas Company, a New Jersey corporation (the “Company”), pursuant to the authority
granted in the resolutions of the Board of Directors (the “Board”) of the Company adopted on April 23, 2020 and December 11, 2020 and the Financing Committee of the Board on February 2, 2021 and Sections 102, 201 and 301 of
the Indenture (as defined below), does hereby certify to The Bank of New York Mellon (formerly The Bank of New York), as Trustee (the “Trustee”) under the Indenture of the Company (For Unsecured Debt Securities) dated as of October 1,
1999 (the “Indenture”), that: 
  

	1.	 The Securities of the twelfth series to be issued under the Indenture shall be designated 2.95% Notes due 2031
(the “Notes of the Twelfth Series”); the Notes of the Twelfth Series shall be in substantially the form set forth in Exhibit A hereto. All capitalized terms used in this certificate which are not defined herein shall have the meanings set
forth in the Indenture. 

  

	2.	 The Notes of the Twelfth Series shall be initially authenticated and delivered in the aggregate principal
amount of $500,000,000 (the “Initial Notes of the Twelfth Series”); provided, however, that the Company may, without consent of the Holders of the Initial Notes of the Twelfth Series, create and issue additional Notes of the Twelfth Series
ranking equally with, and otherwise identical in all respects to, the Initial Notes of the Twelfth Series (except for the issue date, issue price, the date from which interest first accrues thereon and, if applicable, the first interest payment date
therefor), which additional Notes of the Twelfth Series shall form a single series with the Initial Notes of the Twelfth Series. 

  

	3.	 The Notes of the Twelfth Series shall mature, and the principal thereof shall be due and payable, together with
all accrued and unpaid interest thereon, on March 1, 2031. 

  

	4.	 The Notes of the Twelfth Series shall be issued in the denominations of $2,000 and integral multiples of $1,000
in excess thereof. 

  

	5.	 The Notes of the Twelfth Series shall bear interest as provided in the form thereof set forth in Exhibit A.

  

	6.	 The principal of and premium, if any, and interest on the Notes of the Twelfth Series shall be payable at, and
registration of transfers and exchanges in respect of the Notes of the Twelfth Series may be effected at, the office or agency of the Company in The City of New York; provided, however, that payment of interest may be made at the option of the
Company by check mailed to the address of the persons entitled thereto or, in certain circumstances described in the form of Notes of the Twelfth Series hereto attached as Exhibit A, by wire transfer to an account designated by the person entitled
thereto. 

	 	
Notices and demands to or upon the Company in respect of the Notes of the Twelfth Series and the Indenture may be served at the office or agency of the Company in The City of New York. The
Corporate Trust Office of the Trustee shall initially be the agency of the Company for such payment, registration and registration of transfers and exchanges and service of notices and demands and the Company hereby appoints the Trustee as its agent
for all such purposes; provided, however, that the Company reserves the right to change, by one or more Officer’s Certificates, any such office or agency and such agent. The Trustee shall initially be the Security Registrar and the Paying Agent
for the Notes of the Twelfth Series. 

  

	7.	 The Notes of the Twelfth Series are subject to optional redemption as provided in the form thereof set forth in
Exhibit A. 

  

	8.	 The Notes of the Twelfth Series shall not be entitled to the benefit of any sinking fund.

  

	9.	 If a “Change of Control Triggering Event” (as defined in Exhibit A hereto) occurs, each Holder of the
Notes of the Twelfth Series may require the Company to repurchase all or a portion of such Holder’s Notes of the Twelfth Series at a price equal to 101% of the aggregate principal amount, plus accrued and unpaid interest, if any, to, but not
including, the date of purchase, on the terms and subject to the conditions set forth in Exhibit A hereto. 

  

	10.	 The Notes of the Twelfth Series shall be issued initially in global form registered in the name of
Cede & Co. (as nominee for The Depository Trust Company, New York, New York). 

  

	11.	 Beneficial interests in the Notes of the Twelfth Series issued as Global Notes may not be exchanged in whole or
in part for individual certificated Notes of the Twelfth Series in definitive form, and no transfer of a Global Note of the Twelfth Series in whole or in part may be registered in the name of any Person other than the Depository or its nominee,
except that if (A) the Depository has notified the Company that it is unwilling or unable to continue as Depository for the Global Notes of the Twelfth Series, (B) the Depository has ceased to be a clearing agency registered under the
Exchange Act and, in either case, a successor depository for such Global Notes of the Twelfth Series has not been appointed within 90 days of (i) that notice or (ii) the Company becoming aware that the Depository is no longer registered,
(C) an Event of Default occurred and is continuing, and the Depository requests the issuance of certificated Notes of the Twelfth Series in definitive form or (D) the Company determines not to have the Notes of the Twelfth Series
represented by Global Notes, the Company shall execute, and the Trustee, upon receipt of a Company Order for the authentication and delivery of the definitive Notes of the Twelfth Series, shall authenticate and deliver, Notes of the Twelfth Series
in definitive certificated form in an aggregate principal amount equal to the principal amount of the Global Notes of the Twelfth Series representing such Notes of the Twelfth Series in exchange for such Global Notes of the Twelfth Series, such
definitive Notes of the Twelfth Series to be registered in the names provided by the Depository. 

  
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	12.	 No service charge shall be made for the registration of transfer or exchange of the Notes of the Twelfth
Series; provided, however, that the Company may require payment of a sum sufficient to cover any tax or other governmental charge that may be imposed in connection with the exchange or transfer. 

 

	13.	 The Trustee, the Security Registrar and the Company shall have no responsibility under the Indenture for
transfers of beneficial interests in the Notes of the Twelfth Series, for any depository records of beneficial interests or for any transactions between the Depository and beneficial owners. 

 

	14.	 If the Company shall make any deposit of money and/or Eligible Obligations with respect to any Notes of the
Twelfth Series, or any portion of the principal amount thereof, as contemplated by Section 701 of the Indenture, the Company shall not deliver an Officer’s Certificate described in clause (z) in the first paragraph of said
Section 701 unless the Company shall also deliver to the Trustee, together with such Officer’s Certificate, either: 

(A) an instrument wherein the Company, notwithstanding the satisfaction and discharge of its indebtedness in respect of the
Notes of the Twelfth Series, shall assume the obligation (which shall be absolute and unconditional) to irrevocably deposit with the Trustee or Paying Agent such additional sums of money, if any, or additional Eligible Obligations (meeting the
requirements of Section 701), if any, or any combination thereof, at such time or times, as shall be necessary, together with the money and/or Eligible Obligations theretofore so deposited, to pay when due the principal of and premium, if any,
and interest, if any, due and to become due on such Notes of the Twelfth Series or portions thereof, all in accordance with and subject to the provisions of said Section 701; provided, however, that such instrument may state that the obligation
of the Company to make additional deposits as aforesaid shall be subject to the delivery to the Company by the Trustee of a notice asserting the deficiency accompanied by an opinion of an independent public accountant of nationally recognized
standing, selected by the Company and acceptable to the Trustee, showing the calculation thereof; or 
 (B) an Opinion of
Counsel to the effect that, as a result of (i) the receipt by the Company from, or the publication by, the Internal Revenue Service of a ruling or (ii) a change in law occurring after the date of this certificate, the Holders of such Notes
of the Twelfth Series, or portions of the principal amount thereof, will not recognize income, gain or loss for United States federal income tax purposes as a result of the satisfaction and discharge of the Company’s indebtedness in respect
thereof and will be subject to United States federal income tax on the same amounts, at the same times and in the same manner as if such satisfaction and discharge had not been effected. 

  
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	15.	 The Notes of the Twelfth Series shall have such other terms and provisions as are provided in the form thereof
set forth in Exhibit A hereto. 

  

	16.	 All conditions precedent, if any, provided for in the Indenture (including any covenants compliance with which
constitutes a condition precedent), relating to the authentication and delivery of the Notes of the Twelfth Series requested in the accompanying Company Order No. 12 have been complied with. 

 

	17.	 The undersigned has read all of the covenants and conditions contained in the Indenture, and the definitions in
the Indenture relating thereto, relating to the Company’s issuance of the Notes of the Twelfth Series and the Trustee’s authentication and delivery of the Notes of the Twelfth Series, and in respect of compliance with which this
certificate is made. 

  

	18.	 The statements contained in this certificate are based upon the familiarity of the undersigned with the
Indenture, the documents accompanying this certificate, and upon discussions by the undersigned with officers, employees and counsel of the Company familiar with the matters set forth herein. 

 

	19.	 In the opinion of the undersigned, he has made such examination or investigation as is necessary to enable him
to express an informed opinion as to whether or not such covenants and conditions have been complied with. 

  

	20.	 In the opinion of the undersigned, such conditions and covenants have been complied with.

  

	21.	 Solely with respect to the Notes of the Twelfth Series, the Trustee’s certificate of authentication on the
Notes of the Twelfth Series, and any other document delivered in connection with the Indenture, this officer’s certificate or the issuance and delivery of the Notes of the Twelfth Series may be signed on behalf of the Trustee by manual or pdf
or other electronically imaged signature. 

 Capitalized terms used herein and not otherwise defined shall have the
meaning prescribed to them in the Indenture. 

  
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 IN WITNESS WHEREOF, I have executed this Officer’s Certificate as of the date first
written above. 
  

	
	 /s/ Karen M. Camiolo

	Karen M. Camiolo
	Treasurer and Principal Financial Officer

 EXHIBIT A 

[depositary legend] 
 [Unless
this Certificate is presented by an authorized representative of The Depository Trust Company, a New York corporation (“DTC”), to the Company or its agent for registration of transfer, exchange, or payment, and any certificate issued is
registered in the name of Cede & Co. or in such other name as is requested by an authorized representative of DTC (and any payment is made to Cede & Co. or to such other entity as is requested by an authorized representative of
DTC), ANY TRANSFER, PLEDGE, OR OTHER USE HEREOF FOR VALUE OR OTHERWISE BY OR TO ANY PERSON IS WRONGFUL inasmuch as the registered owner hereof, Cede & Co., has an interest herein.] 

[FORM OF FACE OF NOTE] 
 NATIONAL
FUEL GAS COMPANY 
 2.95% NOTES DUE 2031 
  

			
	NO. R-1	  	CUSIP NO.: 636180 BR1
		
	ORIGINAL ISSUE DATE: February 24, 2021	  	PRINCIPAL AMOUNT: $                
		
	 ORIGINAL INTEREST
 ACCRUAL
DATE: February 24, 2021
	  	INTEREST RATE: 2.95%
		
	MATURITY DATE: March 1, 2031	  	
		
	INTEREST PAYMENT DATES: March 1 and September 1, commencing September 1, 2021	  	
		
	REDEEMABLE AT OPTION OF THE COMPANY:	  	YES X  NO ___
		
	REDEEMABLE AT OPTION OF THE HOLDER:	  	YES ___  NO X
		
	(See the Reverse of this Note for redemption provisions)	  	

 NATIONAL FUEL GAS COMPANY, a corporation duly organized and existing under the laws of the State of New Jersey
(herein referred to as the “Company,” which term includes any successor Person under the Indenture referred to on the reverse hereof), for value received, hereby promises to pay to _______________ or registered assigns, the principal sum
of ________________________ on the Maturity Date specified above, and to pay interest thereon at the Interest Rate specified above, subject to adjustment as set forth on the reverse hereof under “Interest Rate Adjustment,” semiannually on
the Interest Payment Dates specified above of each year and on the Maturity Date, from the Original Interest Accrual Date specified above or from the most recent Interest Payment Date to which interest has been paid, unless the Company shall

 
default in the payment of interest due on such Interest Payment Date, in which case interest shall be payable from the next preceding Interest Payment Date to which interest has been paid, or, if
no interest has been paid on this Security, from the Original Interest Accrual Date. In the event that the Maturity Date or any date fixed for redemption is not a Business Day, then payment of principal and interest payable on such date shall be
made on the next succeeding day which is a Business Day (and without any interest or other payment in respect of such delay) with the same force and effect as if made on such Maturity Date or date fixed for redemption. In the event that any Interest
Payment Date is not a Business Day, then payment of interest payable on such date will be made on the next succeeding day which is a Business Day (and without any interest or other payment in respect of such delay) with the same force and effect as
if made on such Interest Payment Date. The Initial Interest Payment Date shall be September 1, 2021, and the payment on that date shall include all interest accrued from the Original Interest Accrual Date. The interest so payable, and
punctually paid or duly provided for, on any Interest Payment Date shall, as provided in the Indenture, be paid to the Person in whose name this Security (or one or more Predecessor Securities) is registered at the close of business on the Regular
Record Date for such interest, which shall be (a) the Business Day immediately preceding such Interest Payment Date so long as Securities of this series remain in book-entry only form or (b) the 15th calendar day prior to such Interest
Payment Date if Securities of this series do not remain in book-entry only form; provided, however, that interest payable at Maturity shall be paid to the Person to whom principal shall be paid. Any such interest not so punctually paid or duly
provided for shall forthwith cease to be payable to the Holder on such Regular Record Date and may either be paid to the Person in whose name this Security (or one or more Predecessor Securities) is registered at the close of business on a Special
Record Date for the payment of such Defaulted Interest to be fixed by the Trustee, notice of which shall be given to Holders of Securities of this series not less than 10 days prior to such Special Record Date, or be paid at any time in any other
lawful manner not inconsistent with the requirements of any securities exchange on which the Securities of this series may be listed, and upon such notice as may be required by such exchange, all as more fully provided in the Indenture. 

Payment of the principal of and premium, if any, and interest on this Security shall be made at the office or agency of the Company maintained
for that purpose in The City of New York, the State of New York in such coin or currency of the United States of America as at the time of payment is legal tender for payment of public and private debts; provided, however, that (a) at the
option of the Company, interest on this Security may be paid by check mailed to the address of the person entitled thereto, as such address shall appear on the Security Register or by wire transfer to an account designated by the person entitled
thereto, and (b) upon the written request of a Holder of not less than $10 million in aggregate principal amount of Securities of this series delivered to the Company and the Paying Agent at least ten days prior to any Interest Payment
Date, payment of interest on such Securities to such Holder on such Interest Payment Date shall be made by wire transfer of immediately available funds to an account maintained within the continental United States specified by such Holder or, if
such Holder maintains an account with the entity acting as Paying Agent, by deposit into such account. 
 Reference is hereby made to the
further provisions of this Security set forth on the reverse hereof, which further provisions shall for all purposes have the same effect as if set forth at this place. 

  
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 Unless the certificate of authentication hereon has been executed by the Trustee referred to
on the reverse hereof by manual, pdf or other electronically imaged signature, this Security shall not be entitled to any benefit under the Indenture or be valid or obligatory for any purpose. 

[Signature Page Follows] 

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

 

			
	NATIONAL FUEL GAS COMPANY
		
	By:	 	  

		 	Karen M. Camiolo
		 	Treasurer and Principal Financial Officer

 [FORM OF CERTIFICATE OF AUTHENTICATION] 

CERTIFICATE OF AUTHENTICATION 

This is one of the Securities of the series designated therein referred to in the within-mentioned Indenture. 

Dated: February 24, 2021 
  

			
	THE BANK OF NEW YORK MELLON, as Trustee
		
	By:	 	  

		 	Authorized Signatory

 [FORM OF REVERSE OF NOTE] 

This Security is one of a duly authorized issue of securities of the Company (herein called the “Securities”), issued and to be
issued in one or more series under an Indenture (For Unsecured Debt Securities), dated as of October 1, 1999 (herein, together with any amendments or supplements thereto, called the “Indenture,” which term shall have the meaning
assigned to it in such instrument), between the Company and The Bank of New York Mellon (formerly known as The Bank of New York), as Trustee (herein called the “Trustee,” which term includes any successor trustee under the Indenture), and
reference is hereby made to the Indenture, including the Board Resolutions and Officer’s Certificate filed with the Trustee on February 24, 2021 creating the series designated on the face hereof, for a statement of the respective rights,
limitations of rights, duties and immunities thereunder of the Company, the Trustee and the Holders of the Securities and of the terms upon which the Securities are, and are to be, authenticated and delivered. This Security is one of the series
designated on the face hereof. The acceptance of this Security shall be deemed to constitute the consent and agreement by the Holder hereof to all terms and provisions of the Indenture. 

Optional Redemption 
 The Securities shall
be redeemable at the option of the Company, in whole or in part, at its option, at any time prior to December 1, 2030 in each case at a redemption price (the “Redemption Price”) equal to the greater of 

 

	 	(a)	 100% of the principal amount of the Securities being redeemed; and 

 

	 	(b)	 the sum of the present values of the remaining scheduled payments of principal and interest on the Securities
being redeemed that would be due if such Securities matured on December 1, 2030 but for the redemption (excluding the portion of any such interest accrued to the Redemption Date, as hereinafter defined), discounted to the date fixed for
redemption (“Redemption Date”) on a semi-annual basis (assuming a 360-day year consisting of twelve 30-day months) at the Treasury Rate plus 0.30%;

 plus, in each case, accrued but unpaid interest on those Securities to, but not including, the Redemption Date. 

The Securities shall be redeemable at the option of the Company, in whole or in part, at its option, at any time on or after December 1,
2030 at a Redemption Price equal to 100% of the principal amount of the Securities then outstanding to be redeemed, plus accrued but unpaid interest on those Securities to, but not including, the Redemption Date. The Company will notify the Trustee
of the Redemption Price promptly after the calculation thereof, and the Trustee shall not be responsible or liable for any such calculation. 

“Treasury Rate” means, with respect to any Redemption Date, the rate per annum equal to the semi-annual equivalent yield to
maturity of the Comparable Treasury Issue, assuming a price for the Comparable Treasury Issue (expressed as a percentage of its principal amount) equal to the Comparable Treasury Price for such Redemption Date. 

 “Comparable Treasury Issue” means the United States Treasury security
selected by the Independent Investment Banker as having a maturity comparable to the remaining term of the Securities to be redeemed (assuming for this purpose that the Securities matured on December 1, 2030) that would be utilized, at the time
of selection and in accordance with customary financial practice, in pricing new issues of corporate debt securities of comparable maturity to the remaining term of the Securities. 

“Comparable Treasury Price” means, with respect to any Redemption Date, (i) the average of the Reference Treasury Dealer
Quotations for such Redemption Date, after excluding the highest and lowest of such Reference Treasury Dealer Quotations or (ii) if the Company obtains fewer than four such Reference Treasury Dealer Quotations, the average of all such
quotations. 
 “Independent Investment Banker” means an independent investment banking institution of national standing
appointed by the Company. 
 “Reference Treasury Dealer” means a primary U.S. Government securities dealer in New York City
appointed by the Company. 
 “Reference Treasury Dealer Quotation” means, with respect to each Reference Treasury Dealer
and any Redemption Date, the average, as determined by the Company, of the bid and asked prices for the Comparable Treasury Issue (expressed in each case as a percentage of its principal amount) quoted in writing to the Company by the Reference
Treasury Dealer at 5:00 p.m., New York City time, on the third Business Day preceding such Redemption Date. 
 In lieu of stating the
Redemption Price, notices of redemption of the Securities with respect to a Redemption Date occurring prior to December 1, 2030, shall state substantially the following: “The Redemption Price of the Securities of this series to be redeemed
shall equal the sum of (a) the greater of (i) 100% of the principal amount of such Securities of this series, and (ii) the sum of the present values of the remaining scheduled payments of principal and interest on the Securities of this
series being redeemed that would be due if the Securities matured on December 1, 2030 (excluding the portion of any such interest accrued to the Redemption Date), discounted to the Redemption Date on a semi-annual basis (assuming a 360-day year consisting of twelve 30-day months) at the Treasury Rate plus 0.30%, plus accrued interest on the principal amount hereof to the Redemption Date.” 

Notice of redemption shall be given by mail to Holders of Securities, not less than 10 nor more than 60 days prior to the Redemption Date, all
as provided in the Indenture. As provided in the Indenture, notice of redemption at the election of the Company as aforesaid may state that such redemption shall be conditional upon the receipt by the applicable Paying Agent or Agents of money
sufficient to pay the principal of and premium, if any, and interest, if any, on this Security on or prior to the date fixed for such redemption; a notice of redemption so conditioned shall be of no force or effect if such money is not so received
and, in such event, the Company shall not be required to redeem this Security. 

  
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 In the event of redemption of this Security in part only, a new Security or Securities of
this series of like tenor representing the unredeemed portion hereof shall be issued in the name of the Holder hereof upon the cancellation hereof. 

Interest Rate Adjustment 
 The interest
rate payable on the Securities will be subject to adjustments from time to time if an Interest Rate Adjustment Triggering Event occurs or, if following an Interest Rate Adjustment Triggering Event, any of Moody’s, S&P or Fitch, or any
Substitute Rating Agency, subsequently upgrades the debt rating assigned to the Securities, in each case in the manner described below. The interest rate payable on the Securities is also subject to adjustments if any of the Rating Agencies ceases
to rate the Securities or fails to make a rating of the Securities publicly available for reasons outside the Company’s control, subject to the conditions described below. 

If an Interest Rate Adjustment Triggering Event occurs, the interest rate payable on the Securities will increase from the interest rate
payable on the Securities on the date of their issuance by an amount equal to the sum of the percentages set forth in the following tables opposite the ratings of the Securities immediately following such Interest Rate Adjustment Triggering Event;
provided, that only the two lowest ratings assigned to the Securities will be taken into account for purposes of any interest rate adjustment: 
  

					
	 Moody’s Rating*
	  	Percentage	 
	 Ba1
	  	 	0.25	% 
	 Ba2
	  	 	0.50	% 
	 Ba3
	  	 	0.75	% 
	 B1 or below
	  	 	1.00	% 

  

	*	 Including successor ratings of Moody’s or the equivalent ratings of any Substitute Rating Agency for
Moody’s. 

  

					
	 S&P Rating*
	  	Percentage	 
	 BB+
	  	 	0.25	% 
	 BB
	  	 	0.50	% 
	 BB-
	  	 	0.75	% 
	 B+ or below
	  	 	1.00	% 

  

	*	 Including successor ratings of S&P or the equivalent ratings of any Substitute Rating Agency for S&P.

  

					
	 Fitch Rating*
	  	Percentage	 
	 BB+
	  	 	0.25	% 
	 BB
	  	 	0.50	% 
	 BB-
	  	 	0.75	% 
	 B+ or below
	  	 	1.00	% 

  

	*	 Including successor ratings of Fitch or the equivalent ratings of any Substitute Rating Agency for Fitch.

  
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 If at any time after an Interest Rate Adjustment Triggering Event has occurred, any Rating
Agency (or, in any case, a Substitute Rating Agency therefor), as the case may be, subsequently increases its rating of the Securities to any of the threshold ratings set forth above, the interest rate payable on the Securities will be decreased
such that the interest rate payable for the Securities equals the interest rate payable on the Securities on the date of their issuance plus (if applicable) the percentages set forth opposite the ratings from the tables above with respect to the two
lowest ratings assigned to the Securities in effect immediately following the increase. If at any time after an Interest Rate Adjustment Triggering Event has occurred, Moody’s (or any Substitute Rating Agency therefor) subsequently increases
its rating of the Securities to Baa3 (or its equivalent, in the case of a Substitute Rating Agency) or higher, S&P (or any Substitute Rating Agency therefor) increases its rating to BBB- (or its
equivalent, in the case of a Substitute Rating Agency) or higher and Fitch (or any Substitute Rating Agency therefor) increases its rating to BBB- (or its equivalent, in the case of a Substitute Rating Agency)
or higher, the interest rate payable on the Securities will be decreased to the interest rate payable on the Securities on the date of their issuance (and if any two Rating Agencies increase their ratings assigned to the Securities to Baa3, BBB- or BBB- or higher, as the case may be, and the third Rating Agency does not, the interest rate payable on the Securities will be decreased so that it does not reflect any
increase attributable to the upgrading Rating Agencies). In addition, the interest rates on the Securities will permanently cease to be subject to any adjustment described above (notwithstanding any subsequent decrease in the ratings by any or all
Rating Agencies) if the Securities become rated Baa1, BBB+ or BBB+, as the case may be (or the equivalent of any such rating, in the case of a Substitute Rating Agency), or higher by any two of Moody’s, S&P and Fitch (or, in any case, a
Substitute Rating Agency thereof), respectively. 
 Each adjustment required by any decrease or increase in a rating set forth above,
whether occasioned by the action of any of the Rating Agencies (or, in any case, a Substitute Rating Agency therefor), shall be made independent of any and all other adjustments. In no event shall (1) the interest rate for the Securities be
reduced to below the interest rate payable on the Securities on the date of their issuance or (2) the total increase in the interest rate payable on the Securities exceed 2.00% above the interest rate payable on the Securities on the date of
the issuance. 
 No adjustments in the interest rate payable on the Securities shall be made solely as a result of a Rating Agency ceasing
to provide a rating of the Securities. If at any time a Rating Agency ceases to provide a rating of the Securities for a reason beyond the Company’s control, the Company will use its commercially reasonable efforts to obtain a rating of the
Securities from another Rating Agency, to the extent one exists, and if another such Rating Agency rates the Securities (such Rating Agency, a “Substitute Rating Agency”), for purposes of determining any increase or decrease in the
interest rate payable on the Securities pursuant to the tables above (a) such Substitute Rating Agency will be substituted for the last Rating Agency to provide a rating of the Securities but which has since ceased to provide such rating and
(b) the relative ratings scale used by such Substitute Rating Agency to assign ratings to senior unsecured debt will be determined in good faith by an independent investment banking institution of national standing appointed by the Company and,
for purposes of determining the applicable ratings included in the applicable table above with respect to such Substitute Rating Agency, such ratings will be deemed to be the equivalent ratings used by Moody’s, S&P or Fitch, as

  
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applicable, in such table. If a Rating Agency has ceased to provide a rating of the Securities for any reason and the Company is unable to or otherwise does not designate a successor Rating
Agency, that Rating Agency shall be deemed to have rated the Securities at the lowest level contemplated by the tables above; however, if only one of the Rating Agencies ceases to provide a rating of the Securities for any reason, the deemed rating
of that Rating Agency shall be disregarded for purposes of all interest rate adjustments. If two of the Rating Agencies cease to provide a rating of the Securities for any reason and the Company is unable to or otherwise does not designate a
successor Rating Agency for both Rating Agencies, the deemed rating of only one of such two Rating Agencies shall be disregarded. If all three Rating Agencies cease to provide a rating of the Securities for any reason and the Company is unable to or
otherwise does not designate a successor Rating Agency for all three Rating Agencies, the interest rate on the Securities will increase to, or remain at, as the case may be, 2.00% above the interest rate payable on the Securities on the date of
their issuance. 
 Any interest rate increase or decrease described above will take effect from the first day of the semi-annual interest
period commencing after the date on which a rating change occurs that requires an adjustment in the interest rate. 
 If the interest rate
payable on the Securities is increased as described in this “Interest Rate Adjustment,” the term “interest,” as applicable to the Securities, will be deemed to include any such additional interest unless the context otherwise
requires. 
 The Company shall give the Trustee prompt written notice of any such increase or decrease, pursuant to this section, in the
interest rate on the Securities, which notice shall set forth the amount of such increase or decrease, the basis therefor and the date from which such increase or decrease shall take effect. The Trustee shall have no duty to independently monitor or
determine whether any such increase or decrease has occurred, the amount of such increase or decrease or the date from which such increase or decrease shall take effect and shall be fully-protected in relying on an officer’s certificate stating
that an interest rate adjustment has occurred and the amount of such adjustment. 
 For purposes of the interest rate adjustment
provisions of the Securities, the following terms will be applicable: 
 “Fitch” means Fitch Ratings Inc., or any
successor thereto. 
 “Fundamental Change” means the occurrence of any of the following: (1) any transaction of merger
or consolidation or amalgamation of any Material Subsidiary (other than a merger or consolidation with or into (i) the Company, if the Company shall be the continuing or surviving corporation, or (ii) any other Subsidiary of the Company,
provided that the Subsidiary shall be the continuing or surviving corporation); (2) any liquidation, winding up or dissolution of any Material Subsidiary; or (3) the direct or indirect conveyance, sale, lease, transfer or other disposition of,
in one or more series of related transactions, all or substantially all of any Material Subsidiary’s assets, whether now owned or hereafter acquired (other than to (i) the Company or (ii) a Subsidiary of the Company). Notwithstanding
the foregoing, the Company or any Material Subsidiary may, directly or indirectly convey, sell, lease, transfer or otherwise dispose of, in one or more series of related transactions: (1) any or all of its interest in any Subsidiary to any
other Subsidiary of the Company; or (2) up to 10% of the Total Consolidated Assets of the Company and its Subsidiaries. 

  
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 “Fundamental Change Rating Event” means the rating on the Securities is
lowered by at least one Rating Agency such that the rating on the Securities is below investment grade on any day during the period (which period will be extended so long as the rating of the Securities is under publicly announced consideration for
a possible downgrade by any of the Rating Agencies) commencing 60 days prior to the first public notice of the occurrence of a Fundamental Change or the Company’s intention to effect a Fundamental Change and ending 60 days following
consummation of such Fundamental Change. 
 “Interest Rate Adjustment Triggering Event” means the occurrence of both a
Fundamental Change and a Fundamental Change Rating Event. 
 “Material Subsidiary” means, at any time, a Subsidiary of the
Company whose assets exceed 10% of the Total Consolidated Assets of the Company and its Subsidiaries, other than any Subsidiary that is not a U.S. Person. 

“Moody’s” means Moody’s Investors Service, Inc., or any successor thereto. 

“Rating Agencies” means (1) each of Fitch, Moody’s and S&P and (2) if any of Fitch, Moody’s or
S&P ceases to rate the Securities or fails to make a rating of the Securities publicly available for reasons outside of the Company’s control, a “nationally recognized statistical rating organization” within the meaning of
Section 3(a)(62) under the Exchange Act selected by the Company (as certified by a resolution of the Company’s Board of Directors) as a replacement agency for Fitch, Moody’s or S&P, or all of them, as the case may be. 

“S&P” means S&P Global Ratings, a division of S&P Global, Inc., or any successor thereto. 

“Subsidiary” means, with respect to any person (the “parent”) at any date, any corporation, limited liability
company, partnership, association or other entity the accounts of which would be consolidated with those of the parent in the parent’s consolidated financial statements if such financial statements were prepared in accordance with generally
accepted accounting principles in the United States of America as of such date, as well as any other corporation, limited liability company, partnership, association or other entity (a) of which securities or other ownership interests
representing more than 50% of the equity or more than 50% of the ordinary voting power or, in the case of a partnership, more than 50% of the general partnership interests are, as of such date, owned, controlled or held, or (b) that is, as of
such date, otherwise controlled, by the parent or one or more subsidiaries of the parent or by the parent and one or more subsidiaries of the parent. 

“Total Consolidated Assets” means, as of any date, the total consolidated assets of the Company and its Subsidiaries, as set
forth on the Company’s most recently available consolidated balance sheet filed with the United States Securities and Exchange Commission as of such date. 

  
 - 6 - 

 “U.S. Person” means a “United States Person” within the meaning
of Section 7701(a)(30) of the Internal Revenue Code of 1986, as amended. 
 Change of Control Offer 

If a Change of Control Triggering Event occurs, unless the Company has exercised its option to redeem the Securities as described above, the
Company shall make an offer (a “Change of Control Offer”) to each Holder of the Securities to repurchase all or any part (equal to $2,000 or an integral multiple of $1,000 in excess thereof) of that Holder’s Securities on the terms
set forth herein. In the Change of Control Offer, the Company shall offer payment in cash equal to 101% of the aggregate principal amount of Securities repurchased, plus accrued and unpaid interest, if any, on the Securities repurchased to, but not
including, the date of repurchase (a “Change of Control Payment”), subject to the right of Holders of record on the applicable record date to receive interest due on the next Interest Payment Date. 

Within 30 days following any Change of Control Triggering Event or, at the Company’s option, prior to any Change of Control, but after
public announcement of the transaction that constitutes or may constitute the Change of Control, the Company shall mail a notice to Holders of the Securities describing the transaction that constitutes or may constitute the Change of Control
Triggering Event and offer to repurchase such Securities on the date specified in the applicable notice, which date shall be no earlier than 30 days and no later than 60 days from the date such notice is mailed (a “Change of Control Payment
Date”). The notice, if mailed prior to the date of consummation of the Change of Control, shall state that the Change of Control Offer is conditioned on the Change of Control Triggering Event occurring on or prior to the applicable Change of
Control Payment Date. 
 Upon the Change of Control Payment Date, the Company shall, to the extent lawful: 

 

	 	(a)	 accept for payment all Securities or portions of Securities properly tendered and not withdrawn pursuant to the
Change of Control Offer; 

  

	 	(b)	 deposit with the Paying Agent an amount equal to the Change of Control Payment in respect of all Securities or
portions of Securities properly tendered; and 

  

	 	(c)	 deliver or cause to be delivered to the Trustee the Securities properly accepted together with an
Officer’s Certificate stating the aggregate principal amount of Securities or portions of Securities being repurchased. 

The Company need not make a Change of Control Offer upon the occurrence of a Change of Control Triggering Event if a third party makes such an
offer in the manner, at the times and otherwise in compliance with the requirements for an offer made by the Company and the third party repurchases all Securities properly tendered and not withdrawn under its offer. In addition, the Company shall
not repurchase any Securities if there has occurred and is continuing on the Change of Control Payment Date an Event of Default under the Indenture, other than a default in the payment of the Change of Control Payment upon a Change of Control
Triggering Event. 

  
 - 7 - 

 The Company shall comply with the applicable requirements of Rule 14e-1 under the Securities Exchange Act of 1934, as amended (the “Exchange Act”), and any other securities laws and regulations thereunder to the extent those laws and regulations are applicable in
connection with the repurchase of the Securities as a result of a Change of Control Triggering Event. To the extent that the provisions of any securities laws or regulations conflict with the Change of Control Offer provisions of the Securities, the
Company shall comply with those securities laws and regulations and shall not be deemed to have breached its obligations under the Change of Control Offer provisions of the Securities by virtue of any such conflict. 

The Trustee shall have no duty or obligation to monitor whether or not a Change of Control Triggering Event has occurred, and the Trustee may
conclusively presume that no such event shall have occurred unless and until the Trustee shall have received from the Company the officer’s certificate stating the aggregate principal amount of the Securities or portions of Securities being
repurchased referred to above. 
 For purposes of the Change of Control Offer provisions of the Securities, the following terms are
applicable: 
 “Change of Control” means the occurrence of any of the following: (1) the direct or indirect sale,
lease, transfer, conveyance or other disposition (other than by way of merger or consolidation), in one or more series of related transactions, of all or substantially all of the Company’s assets and the assets of its subsidiaries, taken as a
whole, to any person, other than. the Company or one of its subsidiaries; (2) the consummation of any transaction (including, without limitation, any merger or consolidation) the result of which is that any person becomes the beneficial owner
(as defined in Rules 13d-3 and 13d-5 under the Exchange Act), directly or indirectly, of more than 50% of the Company’s outstanding Voting Stock or other Voting
Stock into which the Company’s Voting Stock is reclassified, consolidated, exchanged or changed, measured by voting power rather than number of shares; (3) the Company consolidates with, or merges with or into, any person, or any person
consolidates with, or merges with or into, the Company, in any such event pursuant to a transaction in which any of the Company’s outstanding Voting Stock or the Voting Stock of such other person is converted into or exchanged for cash,
securities or other property, other than any such transaction where the shares of the Company’s Voting Stock outstanding immediately prior to such transaction constitute, or are converted into or exchanged for, a majority of the Voting Stock of
the surviving person or any direct or indirect parent company of the surviving person, measured by voting power rather than number of shares, immediately after giving effect to such transaction; or (4) the adoption of a plan relating to the
Company’s liquidation or dissolution. 
 The term “person,” as used in this definition, has the meaning given thereto
in Section 13(d)(3) of the Exchange Act. 
 “Change of Control Triggering Event” means the occurrence of both a Change
of Control and a Rating Event. 

  
 - 8 - 

 “Fitch” means Fitch Ratings Inc., or any successor thereto. 

“Investment Grade Rating” means a rating equal to or higher than BBB- (or the
equivalent) by Fitch, Baa3 (or the equivalent) by Moody’s and BBB- (or the equivalent) by S&P, and the equivalent investment grade credit rating from any replacement Rating Agency or Rating Agencies
selected by the Company. 
 “Moody’s” means Moody’s Investors Service, Inc., or any successor thereto. 

“Rating Agencies” means (1) each of Fitch, Moody’s and S&P and (2) if any of Fitch, Moody’s or
S&P ceases to rate the Securities or fails to make a rating of the Securities publicly available for reasons outside of the Company’s control, a “nationally recognized statistical rating organization” within the meaning of
Section 3(a)(62) under the Exchange Act selected by the Company (as certified by a resolution of the Company’s Board of Directors) as a replacement agency for Fitch, Moody’s or S&P, or all of them, as the case may be. 

“Rating Event” means the rating on the Securities is lowered by at least two of the three Rating Agencies and the Securities
are rated below an Investment Grade Rating by at least two of the three Rating Agencies, in any case on any day during the period (which period shall be extended so long as the rating of the Securities is under publicly announced consideration for a
possible downgrade by any of the Rating Agencies) commencing 60 days prior to the first public notice of the occurrence of a Change of Control or the Company’s intention to effect a Change of Control and ending 60 days following consummation of
such Change of Control. 
 “S&P” means S&P Global Ratings, a division of S&P Global, Inc., or any successor
thereto. 
 “Voting Stock” means, with respect to any specified “person” (as that term is used in
Section 13(d)(3) of the Exchange Act) as of any date, the capital stock of such person that is at the time entitled to vote generally in the election of the board of directors of such person. 

Unless the Company defaults in the Change of Control Payment, on and after the Change of Control Payment Date, interest shall cease to accrue
on the Securities or portions of the Securities tendered for repurchase pursuant to the Change of Control Offer. 
 The Indenture contains
provisions for defeasance at any time of the entire indebtedness of the Company in respect of this Security, or any portion of the principal amount thereof, upon compliance with certain conditions set forth in the Indenture, including the
Officer’s Certificate described above. 
 If an Event of Default with respect to Securities shall occur and be continuing, the
principal of the Securities may be declared due and payable in the manner and with the effect provided in the Indenture. 

  
 - 9 - 

 The Indenture permits, with certain exceptions as therein provided, the amendment thereof
and the modification of the rights and obligations of the Company and the rights of the Holders of the Securities of each series to be affected under the Indenture at any time by the Company and the Trustee with the consent of the Holders of a
majority in principal amount of the Securities at the time Outstanding of all series to be affected. The Indenture also contains provisions permitting the Holders of specified percentages in principal amount of the Securities of each series at the
time Outstanding, on behalf of the Holders of all Securities of such series, to waive compliance by the Company with certain provisions of the Indenture and certain past defaults under the Indenture and their consequences. Any such consent or waiver
by the Holder of this Security shall be conclusive and binding upon such Holder and upon all future Holders of this Security and of any Security issued upon the registration of transfer hereof or in exchange herefor or in lieu hereof, whether or not
notation of such consent or waiver is made upon this Security. 
 As provided in and subject to the provisions of the Indenture, the Holder
of this Security shall not have the right to institute any proceeding with respect to the Indenture or for the appointment of a receiver or trustee or for any other remedy thereunder, unless (a) such Holder shall have previously given the
Trustee written notice of a continuing Event of Default with respect to the Securities of this series, (b) the Holders of a majority in aggregate principal amount of the Securities of all series at the time Outstanding in respect of which an
Event of Default shall have occurred and be continuing shall have made written request to the Trustee to institute proceedings in respect of such Event of Default in its own name as Trustee, (c) such Holder shall have offered the Trustee
reasonable indemnity, (d) the Trustee shall have failed to institute any such proceeding for 60 days after receipt of such notice, request and offer of indemnity, and (e) the Trustee shall not have received from the Holders of a majority
in aggregate principal amount of Securities of all series at the time Outstanding in respect of which an Event of Default shall have occurred and be continuing a direction inconsistent with such request. The foregoing shall not apply to any suit
instituted by the Holder of this Security for the enforcement of any payment of principal hereof and premium, if any, or interest hereon on or after the respective due dates expressed herein. 

No reference herein to the Indenture and no provision of this Security or of the Indenture shall alter or impair the obligation of the
Company, which is absolute and unconditional, to pay the principal of and premium, if any, and interest on this Security at the times, place and rate, and in the coin or currency, herein prescribed. 

The Securities are issuable only in registered form without coupons in denominations of $2,000 and integral multiples of $1,000 in excess
thereof. As provided in the Indenture and subject to certain limitations therein set forth, Securities are transferable to a transferee or transferees, as designated by the Holder surrendering the same for such registration of transfer, and
exchangeable for a like aggregate principal amount of Securities and of like tenor and of authorized denominations, as requested by the Holder surrendering the same. 

No service charge shall be made for any such registration of transfer or exchange, but the Company may require payment of a sum sufficient to
cover any tax or other governmental charge payable in connection therewith. 
 The Company, the Trustee and any agent of the Company or the
Trustee may treat the Person in whose name this Security is registered as the absolute owner hereof for all purposes, whether or not this Security be overdue, and neither the Company, the Trustee nor any such agent shall be affected by notice to the
contrary. 

  
 - 10 - 

 All terms used in this Security which are defined in the Indenture shall have the meanings
assigned to them in the Indenture. 

  
 - 11 -Exhibit 4.2

 

EXECUTION

 

AMENDMENT TO INNOVAGE HOLDING CORP.

STOCK PURCHASE WARRANT AGREEMENT

 

This Amendment dated as of February 9,
2021 (this “Amendment”) to the TCO Group Holdings, Inc. Stock Purchase Warrant Agreement, with an issuance
date of March 18, 2019, (the “Warrant Agreement”), is made by and between ADVENTIST HEALTH SYSTEM/WEST,
a California nonprofit religious corporation, d/b/a ADVENTIST HEALTH (the “Holder”), and INNOVAGE HOLDING CORP.
(F.K.A. TCO GROUP HOLDINGS, INC.), a Delaware corporation (the “Company”).

 

WHEREAS, subject to the terms and conditions
set forth in this Amendment, and pursuant to Section 11 of the Warrant Agreement, the parties hereto desire to amend certain
terms of the Warrant Agreement by entering into, and as set forth in, this Amendment.

 

NOW THEREFORE, in consideration of the mutual
promises and conditions contained herein, and for other good and valuable considerations, the receipt and sufficiency of which
hereby are acknowledged, the parties hereby agree as follows:

 

Section 1.           Definitions.
Capitalized terms used herein without definition shall have the meanings ascribed to such terms in the Warrant Agreement unless
otherwise indicated.

 

Section 2.            Amendment
to the Warrant Agreement.

 

(a)         The
preamble of the Warrant Agreement is amended and restated as follows:

 

THIS IS TO CERTIFY that ADVENTIST HEALTH SYSTEM/WEST, a California
nonprofit religious corporation, d/b/a ADVENTIST HEALTH, and its permitted transferees, successors and assigns (the “Holder”),
for good and valuable consideration, the receipt and sufficiency of which are hereby acknowledged, is entitled to purchase from
INNOVAGE HOLDING CORP. (F.K.A. TCO GROUP HOLDINGS, INC.), a Delaware corporation (the “Company”), shares
of Company Common Stock, par value $0.001 per share, of the Company representing an aggregate number of Company Common Stock equal
to $15,000,000 divided by the price per share of Company Common Stock in the Initial Public Offering, rounded down to the nearest
whole share, at any time on or after the Exercise Date and expiring on the Expiration Date.

 

(b)         Sections
2.1(a), 2.1(b) and 2.1(c) of the Warrant Agreement are amended and restated as follows:

 

(a)          Right
to Exercise.

 

(i)          At
any time on or prior to the Expiration Date, the Holder may exercise this Warrant Agreement, in whole or in part, by delivering
the Notice of Exercise, in the form of Exhibit A attached hereto and made a part hereof (the “Notice of Exercise”),
duly executed. The aggregate Exercise Price (the “Aggregate Exercise Price”) to be paid for the shares of Warrant
Common Stock to be purchased (the “Exercise Amount”) shall be equal to the product of (A) the Exercise
Amount multiplied by (B) the Exercise Price. If the Expiration Date is not a Business Day, then this Warrant Agreement may
be exercised on the next succeeding Business Day.

 

(ii)         Subject
to all other terms and conditions hereof, the Holder only may exercise this Warrant Agreement and deliver a Notice of Exercise
if the Aggregate Exercise Price in respect of such exercise is more than $5,000,000, unless such exercise is for all of the, or
the remainder of any, outstanding, unexercised Warrant Common Stock.

 

     

     

    

 

(b)          Payment
of the Aggregate Exercise Price. Payment of the Aggregate Exercise Price shall be made to the Company in cash or other immediately
available funds or as provided in Section 2(c) or a combination thereof. In the case of payment of all or a portion
of the Aggregate Exercise Price pursuant to Section 2(c), the direction by the Holder to make a “Cashless Exercise”
shall serve as accompanying payment for that portion of the Exercise Price.

 

(c)         Cashless
Exercise. Until the occurrence of any Reorganization Event, the Holder shall have the right to pay all or a portion of the
Aggregate Exercise Price by making a “Cashless Exercise,” by instructing the Company to withhold a number of shares
of Warrant Common Stock then issuable upon exercise of this Warrant with an aggregate Fair Market Value as of the Exercise Date
equal to such Aggregate Exercise Price or such other amount as the Holder so provides. In the event of any withholding of shares
of Warrant Common Stock pursuant to this Section 2(c) where the number of shares whose value is equal to the Aggregate
Exercise Price is not a whole number, the number of shares withheld by the Company shall be rounded up to the nearest whole share
and the Company shall make a cash payment to the Holder (by delivery of a certified or official bank check or by wire transfer
of immediately available funds) based on the incremental fraction of a share being so withheld by the Company in an amount equal
to the product of (x) such incremental fraction of a share being so withheld multiplied by (y) the Fair Market Value
as of the Exercise Date.

 

(c)         Section 5(c) of
the Warrant Agreement is deleted.

 

(d)        Section 6
of the Warrant Agreement is amended by (i) amending and replacing the definitions of “Exercise Date,” “Exercise
Price,” “Expiration Date” and “Fair Market Value” with the respective definition set forth below,
and (ii) adding the defined terms “3-Day Daily VWAP,” “Bloomberg,” “Business Day,” “Closing
Price,” “Company Capital Stock,” “Company Common Stock,” “Company Equity Securities,”
 “Company Stock Plans,” “Daily VWAP,” “Fully Diluted,” “Initial Public Offering,”
 “Market Disruption Event,” “Options or Convertible Securities,” “Person,” and “Trading
Day” in each case, as follows:

 

“3-Day
Daily VWAP” means the average of the Daily VWAP per share of Company Common Stock for each of three consecutive full
Trading Days.

 

“Bloomberg”
means Bloomberg Financial Markets.

 

“Business
Day” means a day other than a day on which commercial banks in New York, New York are authorized or required by law to
close.

 

“Closing
Price” of the Company Common Stock on any date of determination means the closing sale price or, if no closing sale
price is reported, the last reported sale price, of the shares of the Company Common Stock on the Nasdaq Global Select Market
on such date, in each case, as reported by Bloomberg. If the Company Common Stock is not traded on the Nasdaq Global Select
Market on any date of determination, the Closing Price of the Company Common Stock on such date of determination means the
closing sale price in the composite transactions for the principal United States securities exchange or automated quotation
system on which the Company Common Stock is so listed or quoted as reported by Bloomberg, or, if no closing sale price is
reported, the last reported sale price on the principal United States securities exchange or automated quotation system on
which the Company Common Stock is so listed or quoted, or if the Company Common Stock is not so listed or quoted on a United
States securities exchange or automated quotation system, the last quoted bid price for the Company Common Stock in the
over-the-counter market as reported by OTC Market Group, Inc. or any similar organization, or, if that bid price is not
available, the market price of the Company Common Stock on that date as determined by a nationally recognized investment
banking firm (unaffiliated with the Company) retained by the Company for such purpose.

 

    -2-

     

    

 

“Company
Capital Stock” means Company Common Stock and any other shares of capital stock of the Company.

 

“Company
Common Stock” means common stock, par value $0.001 per share, of the Company.

 

“Company
Equity Securities” means all shares of Company Capital Stock now or hereafter issued and all Options or Convertible Securities
now or hereafter issued.

 

“Company
Stock Plans” means all stock option plans, restricted stock purchase plans, stock option agreements, restricted stock
purchase agreements and other stock-based incentive plans and agreements relating to the issuance of Company Equity Securities.

 

“Daily
VWAP” means, for any Trading Day, the per share volume-weighted average price of the Company-Common Stock as displayed
under the heading “Bloomberg VWAP” on Bloomberg (or, if Bloomberg ceases to publish such price, any successor service
reasonably chosen by the Company) page “InnovAge Holding Corp.” (or its equivalent successor if such page is
not available) in respect of the period from the scheduled open of trading on the relevant Trading Day until the scheduled close
of trading on such Trading Day (or if such volume-weighted average price is unavailable, the market price of one share of Company
Common Stock on such Trading Day determined, using a volume-weighted average method, by a nationally recognized investment banking
firm (unaffiliated with the Company) retained by the Company for such purpose). The Daily VWAP will be determined without regard
to after-hours trading or any other trading outside of the regular trading session.

 

“Exercise
Date” means the date on which the Company consummates its Initial Public Offering.

 

“Exercise
Price” means the price per share of Company Common Stock in the Initial Public Offering.

 

“Expiration
Date” means the date that is 12 months after the date of consummation of the Company’s Initial Public Offering.

 

“Fair
Market Value” means, as of any particular Exercise Date, the 3-Day Daily VWAP ending on the Trading Day immediately preceding
such Exercise Date.

 

“Fully
Diluted” means, with respect to any determination of the number of shares of Company Common Stock outstanding or held
by one or more Persons, the number of shares of Company Common Stock outstanding or held by such Person or Persons (excluding any
unvested shares of restricted stock issued under any Company Stock Plan) assuming the conversion, exercise or exchange of all other
Options or Convertible Securities for Company Common Stock (excluding any unvested stock options issued under any Company Stock
Plan).

 

“Initial
Public Offering” means the sale of shares of Company Common Stock to the public for the first time pursuant to an effective
registration statement (other than a registration statement on Form S-4, Form S-8 or any similar or successor form) filed
under the Securities Act.

 

“Market
Disruption Event” means any suspension of, or limitation imposed on, trading of the Company Common Stock by any
exchange or quotation system on which the Closing Price is determined pursuant to the definition of the term “Closing
Price” (the “Relevant Exchange”) during the one-hour period prior to the close of trading for the
regular trading session on the Relevant Exchange (or for purposes of determining the VWAP per share of Company Common Stock,
any period or periods aggregating one half-hour or longer during the regular trading session on the relevant day) and whether
by reason of movements in price exceeding limits permitted by the Relevant Exchange as to securities generally, or otherwise
relating to the Company Common Stock or options contracts relating to the Company Common Stock on the Relevant Exchange.

 

    -3-

     

    

 

“Options
or Convertible Securities” means any securities directly or indirectly convertible into or exercisable or exchangeable
for Company Capital Stock.

 

“Person”
means any natural person, corporation, limited liability company, partnership, trust, joint stock company, business trust, unincorporated
association, joint venture, governmental authority or other legal entity of any nature whatsoever.

 

“Trading
Day” means a Business Day on which (A) trading in the Company Common Stock generally occurs on the principal U.S.
national or regional securities exchange on which the Company Common Stock is then listed or, if the Company Common Stock is not
then listed on a U.S. national or regional securities exchange, on the principal other market on which the Company Common Stock
is then traded and (B) on which there has not occurred a Market Disruption Event.

 

(d)         Section 6
of the Warrant Agreement is further amended by deleting the following defined terms: “Change of Control,” “Consolidated
EBITDA” (including Exhibit B), “Last Fiscal Quarter,” “TCO,” “TTM Consolidated EBITDA,”
and “Valuation Firm.”

 

(e)         Section 18
of the Warrant Agreement is deleted in its entirety and replaced with the following:

 

(a)          Adjustment
to Exercise Price and Warrant Shares Upon Dividend, Subdivision or Combination of Common Stock. If the Company shall, at any
time or from time to time after the date hereof, (i) pay a dividend or make any other distribution upon the Company Common
Stock or any other capital stock of the Company payable in shares of Company Common Stock or in Options or Convertible Securities,
or (ii) subdivide (by any stock split, recapitalization or otherwise) its outstanding shares of Company Common Stock into
a greater number of shares, the Exercise Price in effect immediately prior to any such dividend, distribution or subdivision shall
be proportionately reduced and the number of shares of Warrant Common Stock issuable upon exercise of this Warrant shall be proportionately
increased. If the Company at any time combines (by combination, reverse stock split or otherwise) its outstanding shares of Company
Common Stock into a smaller number of shares, the Exercise Price in effect immediately prior to such combination shall be proportionately
increased and the number of shares of Warrant Common Stock issuable upon exercise of this Warrant shall be proportionately decreased.
Any adjustment under this Section 18(a) shall become effective at the close of business on the date the dividend, subdivision
or combination becomes effective.

 

(b)          Notice
of any Reorganization, Reclassification, Consolidation or Merger.

 

(i)          At
least 30 Business Days prior to the record date used for any (i) capital reorganization of the Company,
(ii) reclassification of the stock of the Company (other than a change in par value or from par value to no par value or
from no par value to par value or as a result of a stock dividend or subdivision, split-up or combination of shares),
(iii) consolidation or merger of the Company with or into another Person, (iv) sale of all or substantially all of
the Company’s assets to another Person or (v) other similar transaction (other than any such transaction covered
by Section 18(a)), in each case which entitles the holders of Company Common Stock to receive (either directly or upon
subsequent liquidation) stock, securities or assets with respect to or in exchange for Company Common Stock (any such
occurrence in items (i) through (v), a “Reorganization Event”), the Company shall provide the Holder
with advanced written notice of such event or transaction and the Holder shall have the right to elect prior to the
consummation of such Reorganization Event, to give effect to the exercise rights contained in Section 2.

 

    -4-

     

    

 

(ii)         In
the event of any Reorganization Event, the Holder shall thereafter have the right to purchase from the Company the number, kind
and amount of securities, cash and other property (the “Exchange Property”) (without any interest on such Exchange
Property and without any right to dividends or distributions on such Exchange Property which have a record date that is prior to
the applicable Exercise Date) that the Holder would have received in such Reorganization Event had such Holder given effect to
the exercise rights contained in Section 2 immediately prior to the effective date of the Reorganization Event. If the kind
or amount of securities, cash and other property receivable upon such Reorganization Event is not the same for each share of Common
Stock held immediately prior to such Reorganization Event by a Person, then for the purpose of this Section 18(b)(ii),
the kind and amount of securities, cash and other property receivable upon conversion following such Reorganization Event will
be deemed to be the weighted average of the types and amounts of consideration received by the holders of Company Common Stock.

 

Section 3              Effectiveness.
This Amendment shall be effective upon the consummation of the Company’s Initial Public Offering. In the event the Company
does not consummate its Initial Public Offering on or before April 30, 2021, this Amendment shall be terminated automatically
and be of no further force or effect, and the terms of the Warrant Agreement, as originally provided for, shall remain unchanged.

 

Section 4.              Miscellaneous.

 

(a)          Each
party hereto hereby represents and warrants that (i) it has all organizational power and authority to execute, deliver and
perform this Amendment, (ii) the execution, delivery and performance of this Amendment by such party has been duly and validly
authorized and approved by all necessary organizational action by it, (iii) this Amendment has been duly and validly executed
and delivered by it and constitutes a valid and legally binding obligation of it, enforceable against it in accordance with the
term of this Amendment, except to the extent that enforceability may be limited by applicable bankruptcy, insolvency, reorganization,
arrangement, moratorium or other similar laws relating to or affecting creditors’ rights and subject to general principles
of equity and (iv) all consents, approvals, authorizations, permits of, filings with and notifications to, any person or party
necessary for the due execution, delivery and performance of this Amendment by such party have been obtained or made.

 

(b)           This
Amendment and the Warrant Agreement constitute the complete agreement and understanding among the parties hereto regarding the
subject matter of this Amendment and supersede any prior understandings, agreement or representations regarding the subject matter
of this Amendment or the Warrant Agreement. No party hereto shall be bound by any amendment, modification, waiver, discharge or
termination of this Amendment unless the each party has agreed in writing to such amendment, modification, waiver, discharge or
termination. This Amendment may be executed in multiple counterparts, all of which taken together shall constitute one instrument.
Delivery of an executed signature page of this Amendment by electronic transmission shall be effective delivery as delivery
of a manually executed counterpart hereof. This Amendment is governed by the laws of the State of Delaware, without regard to conflict
of laws principles. After giving effect to this Amendment, each reference in the Warrant Agreement to “this Warrant”,
this “Warrant Agreement”, “hereof”, “hereunder” or words of like import referring to the Warrant
Agreement or the Warrant shall refer to the Warrant Agreement or the Warrant, as applicable, as amended by this Amendment.

 

    -5-

     

    

 

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

 

	 	THE HOLDER
	 	 
	 	ADVENTIST HEALTH SYSTEM/WEST
	 	 	 
	 	By:	/s/
    Brian Wing 
	 	Its: 	President
	 	 
	 	THE COMPANY
	 
	 	INNOVAGE HOLDING CORP.
	 	(F.K.A. TCO GROUP HOLDINGS, INC.)
	 	 
	 	By:	/s/ Maureen Hewitt
	 	Name: 	Maureen Hewitt   
	 	Its:	Chief Executive Officer and President

 

    

     

    

 

Execution Version

 

THIS STOCK PURCHASE WARRANT AGREEMENT AND THE WARRANT COMMON
STOCK THAT MAY BE PURCHASED HEREUNDER HAVE NOT BEEN REGISTERED UNDER THE SECURITIES ACT OF 1933 OR UNDER THE SECURITIES LAWS
OF ANY STATE. THIS STOCK PURCHASE WARRANT AGREEMENT HAS BEEN ACQUIRED FOR INVESTMENT PURPOSES AND NOT WITH A VIEW TO DISTRIBUTION,
AND THIS STOCK PURCHASE WARRANT AGREEMENT AND THE WARRANT COMMON STOCK THAT MAY BE PURCHASED HEREUNDER MAY NOT BE SOLD
OR OFFERED FOR SALE IN THE ABSENCE OF AN EFFECTIVE REGISTRATION STATEMENT UNDER THE SECURITIES ACT OF 1933, AND REGISTRATION OR
QUALIFICATION UNDER APPLICABLE STATE SECURITIES LAWS OR AN OPINION OF COUNSEL THAT THE PROPOSED TRANSACTION DOES NOT VIOLATE THE
SECURITIES ACT OF 1933, AND APPLICABLE STATE SECURITIES LAWS. THIS STOCK PURCHASE WARRANT AGREEMENT AND THE WARRANT COMMON STOCK
THAT MAY BE PURCHASED HEREUNDER ARE SUBJECT TO RESTRICTIONS ON VOTING AND TRANSFER AND REQUIREMENTS OF SALE AND OTHER PROVISIONS
AS SET FORTH IN THE STOCKHOLDERS AGREEMENT.

 

TCO GROUP HOLDINGS, INC.

STOCK PURCHASE WARRANT AGREEMENT

 

Date
of Issuance: March 18, 2019        Certificate No. W-1

 

THIS
IS TO CERTIFY that ADVENTIST HEALTH SYSTEM/WEST, a California nonprofit religious corporation, d/b/a ADVENTIST
HEALTH, and its permitted transferees, successors and assigns (the “Holder”), for good and valuable consideration,
the receipt and sufficiency of which are hereby acknowledged, is entitled to purchase from TCO GROUP HOLDINGS, INC.,
a Delaware corporation (the “Company”), shares of Company Common Stock, par value $0.001 per share, of the Company
representing an aggregate number of Company Common Stock equal to five percent (5%) of the issued and outstanding equity interests
of the Company on a Fully Diluted basis determined at the time of and after giving effect to the exercise of this Warrant in full
at an exercise price equal to the Fair Market Value Per Share of such Company Common Stock at the time of the exercise of this
Warrant (the “Exercise Price”), at any time on or after the Exercise Date and expiring on the Expiration Date.
The number of Warrant Common Stock which may be purchased pursuant to this Stock Purchase Warrant Agreement (as amended, modified
or supplemented from time to time, this “Warrant Agreement” or this “Warrant”) are referred
to herein as the “Aggregate Number.” Capitalized terms used but not defined herein shall have the meanings ascribed
to such terms in that certain Stockholders Agreement dated as May 13, 2016, as amended from time to time, by and among the
Company and the other parties named therein (the “Stockholders Agreement”).

 

SECTION 1

THE WARRANT AGREEMENT; TRANSFER AND EXCHANGE;
VESTING

 

(a)           The
Warrant Agreement. This Warrant Agreement and the rights and privileges of the Holder hereunder may be exercised by the Holder
in whole or in part as provided herein.

 

    

     

    

 

(b)          Transfer
and Exchanges. The Company shall initially record this Warrant Agreement on a register to be maintained by the Company with
its other books and records and subject to Stockholders Agreement, from time to time thereafter shall reflect the transfer of this
Warrant Agreement on such register when surrendered for transfer in accordance with the terms of this Warrant and the Stockholders
Agreement and properly endorsed, accompanied by appropriate instructions. Upon any such transfer, a new warrant agreement on the
same terms and conditions as set forth herein shall be issued to the transferee and the Holder (in the event the Warrant is only
partially transferred) and the surrendered warrant shall be canceled.

 

(c)           Vesting.
This Warrant shall be fully vested on the Exercise Date.

 

SECTION 2

EXERCISE; PAYMENT; ISSUANCE

 

(a)           Right
to Exercise.

 

(i)          At
any time on or after the Exercise Date and on or before the Expiration Date, and subject to any applicable regulatory requirements
(in which the Company shall comply with such regulatory requirements on a timely basis), but only once per six-month period, the
Holder, in accordance with the terms hereof, may provide a written request to the Company for the most current TTM Consolidated
EBITDA (the “Exercise TTM Consolidated EBITDA”), and, within 10 Business Days of such request, the Company will
provide in writing to the Holder (x) the most current TTM Consolidated EBITDA, (y) the Company’s calculation of
the Fair Market Value Per Share, and (z) the back-up information supporting such calculation. Within 30 days of receipt of
the Company’s calculation of the Fair Market Value Per Share and such supporting information, the Holder may elect to have
the Fair Market Value Per Share be determined by the Valuation Firm. The Holder and the Company shall work in good faith to select
the Valuation Firm within 15 Business Days of the Holder’s election. The determination by such firm shall be final and conclusive,
and the fees and expense of such firm shall be borne solely by the Holder.

 

(ii)         Within
30 days of receipt of the later of (x) the Exercise TTM Consolidated EBITDA and Fair Market Value Per Share from the Company
or (y) the determination of the Fair Market Value Per Share by the Valuation Firm, subject to Section 2(a)(iii),
the Holder may exercise this Warrant Agreement, in whole or in part, by delivering the Notice of Exercise, in the form of Exhibit A
attached hereto and made a part hereof (the “Notice of Exercise”), duly executed. The aggregate Exercise Price
(the “Aggregate Exercise Price”) to be paid for the Warrant Common Stock to be purchased (the “Exercise
Amount”) shall be equal to the product of (A) the Exercise Amount multiplied by (B) the Exercise Price. If
the Expiration Date is not a Business Day, then this Warrant Agreement may be exercised on the next succeeding Business Day.

 

(iii)        Subject
to all other terms and conditions hereof, the Holder only may exercise this Warrant Agreement and deliver a Notice of Exercise
(A) once per twelve-month period and (B) if the Aggregate Exercise Price in respect of such exercise is more than Five
Million Dollars ($5,000,000), unless, in the case of clause (B), such exercise is for all of the, or the remainder of any, outstanding,
unexercised Warrant Common Stock.

 

    - 2 -

     

    

 

(b)          Payment
of the Aggregate Exercise Price. Payment of the Aggregate Exercise Price shall be made to the Company in cash or other immediately
available funds or as provided in Section 2(c) or a combination thereof. In the case of payment of all or a portion
of the Aggregate Exercise Price pursuant to Section 2(c), the direction by the Holder to make a “Cashless Exercise”
shall serve as accompanying payment for that portion of the Exercise Price.

 

(c)          Cashless
Exercise. The Holder shall have the right to pay all or a portion of the Aggregate Exercise Price by making a “Cashless
Exercise” in connection with a Change of Control, in which case the proceeds to be received by the Holder in respect of the
Aggregate Number of shares of Warrant Common Stock that are being acquired upon the exercise of this Warrant in connection with
the Change of Control will be reduced by the portion of the Aggregate Exercise Price that is to be paid through the “Cashless
Exercise” (which will be retained by the Company).

 

(d)          Issuance
of Company Common Stock. Upon receipt by the Company of the Notice of Exercise and payment of the Aggregate Exercise Price,
the Holder shall be deemed to be the holder of record of the Company Common Stock issuable upon such exercise, notwithstanding
that certificates representing such Company Common Stock may not then be actually delivered. Within three (3) Business Days
after such delivery of the Notice of Exercise and payment of the Aggregate Exercise Price, the Company shall issue and cause to
be delivered to the Holder a certificate or certificates (in the name of the Holder) for the Exercise Amount.

 

(e)          Fractional
Shares. The Company may, but shall not be required to, deliver fractions of Company Common Stock upon exercise of this Warrant
Agreement. If any fraction of a share of Company Common Stock would be deliverable upon an exercise of this Warrant Agreement,
the Company may, in lieu of receiving such fraction of a share of Company Common Stock, require the Holder to accept a cash payment
in an amount equal to the same fraction of the Fair Market Value Per Share.

 

SECTION 3

PAYMENT OF TAXES; REPLACEMENT WARRANT

 

The Company shall pay all stamp taxes attributable
to the initial issuance of Warrant Common Stock or other securities issuable upon the exercise of this Warrant Agreement, excluding
any tax or taxes which may be payable because of the transfer involved in the issuance or delivery of any certificates for Warrant
Common Stock or other securities in a name other than that of the Holder in respect of which such Warrant Common Stock or securities
are issued.

 

IN CASE THIS WARRANT AGREEMENT IS MUTILATED, LOST, STOLEN OR
DESTROYED, THE COMPANY SHALL ISSUE AND DELIVER IN EXCHANGE AND SUBSTITUTION FOR AND UPON CANCELLATION OF THE MUTILATED WARRANT
AGREEMENT, OR IN LIEU OF AND IN SUBSTITUTION FOR THE WARRANT AGREEMENT LOST, STOLEN OR DESTROYED, A NEW WARRANT AGREEMENT WITH
THE SAME TERMS AND CONDITIONS AS SET FORTH HEREIN AND REPRESENTING AN EQUIVALENT RIGHT OR INTEREST, BUT ONLY UPON RECEIPT OF EVIDENCE
REASONABLY SATISFACTORY TO THE COMPANY OF SUCH LOSS, THEFT OR DESTRUCTION OF SUCH WARRANT AGREEMENT.

 

    - 3 -

     

    

 

SECTION 4

ISSUANCE OF STOCK

 

(a)            Regulatory
Requirements and Restrictions. In the event of any reasonable determination by the Holder that, by reason of any existing or
future federal or state law, statute, rule, regulation, guideline, order, court or administrative ruling, request or directive
(whether or not having the force of law and whether or not failure to comply therewith would be unlawful) (collectively, a “Regulatory
Requirement”), the Holder is effectively restricted or prohibited from holding this Warrant Agreement or the Warrant
Common Stock (including any Company Common Stock or other securities distributable to the Holder in any merger, reorganization,
readjustment or other reclassification), or otherwise realizing upon or receiving the benefits intended under this Warrant Agreement,
the Company shall, and shall use its commercially reasonable efforts to have its Stockholders take such action as the Holder and
the Company shall jointly agree in good faith to be necessary to permit the Holder to comply with such Regulatory Requirement.
The reasonable costs of taking such action, whether by the Company, the Holder or otherwise, shall be borne by the Company if such
Regulatory Requirement is applicable to the Company, and the Holder if such Regulatory Requirement is applicable to the Holder.

 

(b)            Validly
Issued Company Common Stock. The Company covenants that all Company Common Stock that may be issued pursuant to this Warrant
Agreement, assuming full payment of the Aggregate Exercise Price shall, upon delivery by the Company, be duly authorized and validly
issued, fully paid and nonassessable, free and clear from all taxes, liens and charges with respect to the issue or delivery thereof
and otherwise free and clear of all other security interests, encumbrances and claims of any nature whatsoever (other than restrictions
under applicable federal and/or state securities laws). The Company shall at all times during the term of the Warrant (i) have
authorized and reserved shares of Company Common Stock as will be sufficient to satisfy the requirements of this Warrant Agreement
and (ii) take all such actions as may be necessary or appropriate in order that the Company Common Stock that may be issued
upon exercise of this Warrant pursuant to the terms hereof be validly issued, fully paid and nonassessable, issued without violation
of any preemptive or similar rights of any equityholder of the Company, and free and clear from all taxes, liens and charges with
respect to the issue or delivery thereof, and otherwise free and clear of all other security interests, encumbrances and claims
of any nature whatsoever (other than restrictions under applicable federal and/or state securities laws).

 

(c)            Rights
as Stockholders. No holder of this Warrant, as such, shall be entitled to vote or receive dividends or be deemed the holder
of shares of Company Common Stock, nor shall anything contained herein be construed to confer upon the holder of this Warrant,
as such, any of the rights of a stockholder of the Company or any right to vote for the election of directors or upon any matter
submitted to stockholders at any meeting thereof, or to receive notice of meetings, or to receive dividends or subscription rights
or otherwise until this Warrant shall have been exercised as provided herein.

 

    - 4 -

     

    

 

SECTION 5 

TRANSFERS OF THE WARRANT AGREEMENT OR
WARRANT COMMON STOCK

 

(a)            Acknowledgment
of the Holder. This Warrant Agreement has not been, and the Warrant Common Stock at the time of their issuance may not be,
registered under the Securities Act and except as provided in this Warrant Agreement, the Company shall not be required to so register
this Warrant Agreement and the Warrant Common Stock. This Warrant Agreement and the Warrant Common Stock are issued or issuable
subject to the provisions and conditions contained herein, and every Holder hereof by accepting the same (i) agrees with the
Company to such provisions and conditions, and (ii) represents to the Company that this Warrant Agreement has been acquired
and the Warrant Common Stock will be acquired for the account of the Holder for investment and not with a view to or for sale in
connection with any distribution thereof.

 

(b)            Compliance
with Securities Laws. The Holder agrees that this Warrant Agreement and the Warrant Common Stock may not be sold or otherwise
disposed of except pursuant to an effective registration statement under the Securities Act and applicable state securities laws
or pursuant to an applicable exemption from the registration requirements of the Securities Act and applicable state securities
laws. In the event that the Holder transfers this Warrant Agreement or the Warrant Common Stock pursuant to an applicable exemption
from registration, the Company may request, at its expense, that the Holder deliver an opinion of counsel reasonably acceptable
to the Company that the proposed transfer does not violate the Securities Act and applicable state securities laws.

 

(c)            Restrictive
Securities Legend. Shares of Company Common Stock issued upon exercise of this Warrant or otherwise delivered in satisfaction
of this Warrant will bear such legends as may be required or provided for under the terms of the Stockholders Agreement.

 

SECTION 6 

DEFINITIONS

 

As used herein, the following terms shall
have the following meanings.

 

“Aggregate
Exercise Price” has the meaning set forth in Section 2(a)(ii).

 

“Aggregate
Number” has the meaning set forth in the Preamble.

 

“Board”
means the Board of Directors of the Company.

 

“Change
of Control” means any of (i) a consolidation, merger, or similar transaction or series of related transactions involving
the Company, including a sale or other disposition of equity securities of the Company, as a result of which, the Company (or the
surviving entity of such transaction) is controlled by a Third Party or Third Parties acting in concert, or which results in the
acquisition of all or substantially all of the Company’s then outstanding equity by a Third Party or by a group of Third
Parties acting in concert or (ii) a sale or transfer of all or substantially all of the Company’s assets to a Third
Party or a group of Third Parties acting in concert. For the avoidance of doubt, if an event or condition constitutes a Change
of Control, then no other event or condition shall thereafter constitute a Change of Control hereunder.

 

    - 5 -

     

    

 

“Company”
has the meaning set forth in the Preamble.

 

“Consolidated
EBITDA” has the meaning set forth in the then-current credit agreement between TCO and TCO’s senior secured lender.
The definition of “Consolidated EBITDA” as of the date hereof is attached hereto at Exhibit B.

 

“Exercise
Amount” has the meaning set forth in Section 2(a)(ii).

 

“Exercise
Date” means the date on which the Holder or its Affiliate has made aggregate capital contributions in an amount greater
than Twenty-Five Million U.S. Dollars ($25,000,000) to one or more joint venture entities in which the Holder or its Affiliate,
on the one hand, and the Company or one of its Affiliates, on the other hand, hold equity.

 

“Exercise
Price” has the meaning set forth in the Preamble.

 

“Exercise
TTM Consolidated EBITDA” has the meaning set forth in Section 2(a)(i).

 

“Expiration
Date” means the earlier of earlier of (i) the liquidation, dissolution or winding up of the Company or (ii) a
Change of Control, provided that if the Change of Control occurs after the Exercise Date, the Holder has the opportunity
to exercise this Warrant Agreement, in whole or in part, in connection with a Change of Control.

 

“Fair
Market Value Per Share” means (a) an amount equal to (i) (A) 10.5 multiplied by (B) the Exercise
TTM Consolidated EBITDA minus (C) the Company’s and its Subsidiaries’ aggregate debt as of the last day
of the Last Fiscal Quarter that is used for calculating the Exercise TTM Consolidated EBITDA plus (D) the Company’s
and its Subsidiaries’ aggregate cash as of the last day of the Last Fiscal Quarter that is used for calculating the Exercise
TTM Consolidated EBITDA minus (E) all cash reserved by the Company and its Subsidiaries as required by Program of All-Inclusive
Care for the Elderly law as of the last day of the Last Fiscal Quarter that is used for calculating the Exercise TTM Consolidated
EBITDA plus (F) the cash proceeds received by the Company assuming all issued and outstanding in-the-money Options
or Convertible Securities (other than warrants) are exercised as of the last day of the Last Fiscal Quarter that is used for calculating
the Exercise TTM Consolidated EBITDA divided by (ii) the then-current number of issued and outstanding Company Common
Stock assuming all issued and outstanding in-the- money Options or Convertible Securities (other than warrants) are exercised as
of the last day of the Last Fiscal Quarter that is used for calculating the Exercise TTM Consolidated EBITDA without giving effect
to the exercise of this Warrant, or (b) in the event the Holder elects to have the Fair Market Value Per Share determined
by the Valuation, then the value per share of the Company Common Stock as determined by the Valuation Firm.

 

“Holder”
has the meaning set forth in the Preamble.

 

“Last
Fiscal Quarter” means the most recently completed quarterly accounting period of the Company for which unaudited financial
statements have been completed.

 

“Notice
of Exercise” has the meaning set forth in Section 2(a)(ii).

 

    - 6 -

     

    

 

“TCO”
means Total Community Options, Inc., a Colorado corporation and indirect Subsidiary of the Company.

 

“TTM
Consolidated EBITDA” means the trailing twelve-month Consolidated EBITDA as of the last day of the Last Fiscal Quarter.

 

“Valuation
Firm” means a nationally recognized investment banking, accounting or valuation firm jointly selected by the Board and
the Holder and engaged by the Company.

 

“Warrant”
has the meaning set forth in the Preamble.

 

“Warrant
Agreement” has the meaning set forth in the Preamble.

 

“Warrant
Common Stock” means the Company Common Stock issued or issuable upon exercise of this Warrant Agreement in accordance
with its terms.

 

“Warrant
Securities” means the Warrant Agreement and the Warrant Common Stock, collectively.

 

SECTION 7 

SURVIVAL OF PROVISIONS

 

ALL OF THE PROVISIONS OF THIS WARRANT AGREEMENT SHALL EXPRESSLY
SURVIVE ANY EXERCISE OF THIS WARRANT AGREEMENT UNTIL THE DATE ON WHICH THE HOLDER NO LONGER HOLDS ANY WARRANT SECURITIES.

 

SECTION 8 

CAPTIONS

 

The titles and captions of the Sections
and other provisions of this Warrant Agreement are for convenience of reference only and are not to be considered in construing
this Warrant Agreement.

 

SECTION 9 

NOTICES

 

Any notice, request, demand, claim or
other communication required or permitted to be delivered, given or otherwise provided under this Warrant Agreement must be
in writing and must be delivered personally, delivered by nationally recognized overnight courier service, sent by certified
or registered mail, postage prepaid, or (if a facsimile number is provided below) sent by facsimile (subject to electronic
confirmation of good facsimile transmission). Any such notice, request, demand, claim or other communication will be deemed
to have been delivered and given (a) when delivered, if delivered personally, (b) the Business Day after it is
deposited with such nationally recognized overnight courier service, if sent for overnight delivery by a nationally
recognized overnight courier service, (c) the day of sending, if sent by facsimile prior to 5:00 p.m. (Eastern
time) on any Business Day or the next succeeding Business Day if sent by facsimile after 5:00 p.m. (Eastern time) on any
Business Day or on any day other than a Business Day or (d) five Business Days after the date of mailing, if mailed by
certified or registered mail, postage prepaid, in each case, to the following address or, if applicable, facsimile number, or
to such other address or addresses or facsimile number or numbers as such party may subsequently designate to the other
parties by notice given hereunder:

 

    - 7 -

     

    

 

If to the Company:

 

c/o Welsh, Carson, Anderson & Stowe 

320 Park Avenue Suite 2500 

New York, New York 10022-6815 

Facsimile number: (212) 893-9575 

Attention: Thomas A. Scully and Sean M. Traynor

 

with a copy to:

 

McDermott Will & Emery LLP 

444 West Lake Street 

Chicago, Illinois 60606 

Facsimile number: (312) 277-2813 

Attention: John Callahan and Patrick Martinez

 

If to Holder:

 

Adventist Health 

2100 Douglas Blvd. 

Roseville, CA 95661 

Facsimile number: (916) 774-3326 

Attn: President

 

with a copy (not constituting notice) to:

 

Meredith Jobe 

Vice President, General Counsel 

Adventist Health 

2100 Douglas Blvd. 

Roseville, CA 95661 

Facsimile number: (916) 406-2324

 

Latham & Watkins LLP 

355 South Grand Ave., Suite 100 

Los Angeles, CA 90071-1560 

Attn: Daniel K. Settelmayer 

Facsimile number: (213) 891-8763

 

Each of the parties to this Warrant Agreement may specify a
different address or addresses or facsimile number or facsimile numbers by giving notice in accordance with this Section 9
to each of the other parties hereto.

 

    - 8 -

     

    

 

SECTION 10 

ASSIGNMENT, SUCCESSORS AND ASSIGNS

 

This Warrant and all of the provisions hereof
shall be binding upon and inure to the benefit of the parties hereto and their respective successors and permitted assigns, but
neither this Warrant nor any of the rights, interests or obligations hereunder shall be assigned by any of the parties hereto without
the prior written consent of the other parties.

 

SECTION 11 

AMENDMENTS

 

Neither this Warrant Agreement nor any term
hereof may be amended, changed, waived, discharged or terminated without the prior written consent of the Holder and the Company
to such action.

 

SECTION 12 

SEVERABILITY

 

If any one or more of the provisions contained
herein, or the application thereof in any circumstance, is held invalid, illegal or unenforceable in any respect for any reason,
the validity, legality and enforceability of any such provision in every other respect and of the remaining provisions hereof shall
not be in any way impaired, unless the provisions held invalid, illegal or unenforceable shall substantially impair the benefits
of the remaining provisions hereof.

 

SECTION 13 

GOVERNING LAW

 

This Warrant Agreement is to be construed
and enforced in accordance with and governed by the laws of the State of Delaware and without regard to the principles of conflicts
of law of such state.

 

SECTION 14 

ENTIRE AGREEMENT

 

This Warrant Agreement, the Stockholders
Agreement and the agreements, documents and instruments entered hereby are intended by the parties as a final expression of their
agreement and are intended to be a complete and exclusive statement of the agreement and understanding of the parties hereto in
respect of the subject matter contained herein and therein.

 

SECTION 15

RULES OF CONSTRUCTION

 

Unless the context otherwise requires, “or”
is not exclusive, and references to sections or subsections refer to sections or subsections of this Warrant Agreement. All pronouns
and any variations thereof refer to the masculine, feminine or neuter, singular or plural, as the context may require. The use
in this Warrant of the term “including” means “including, without limitation”.

 

    - 9 -

     

    

 

SECTION 16 

COUNTERPARTS

 

This Warrant Agreement may be executed in
any number of counterparts, and each such counterpart hereof shall be deemed to be an original instrument, but all such counterparts
together shall constitute but one agreement. The parties hereto may deliver executed signature pages to this Warrant Agreement
by facsimile or email transmission. No party hereto may raise as a defense to the formation or enforceability of this Warrant Agreement,
and each party hereto forever waives any such defense, either (i) the use of a facsimile or email transmission to deliver
a signature or (ii) the fact that any signature was signed and subsequently transmitted by facsimile or email transmission.

 

SECTION 17 

EXPENSES

 

Each party will pay their own respective
financial advisory, legal, accounting and other expenses incurred by them or for their benefit in connection with the preparation
and execution of this Warrant Agreement, the compliance herewith and the consummation of the transactions contemplated hereby.

 

SECTION 18 

JOINDER TO STOCKHOLDERS AGREEMENT

 

By acceptance of the Warrant Common Stock,
the undersigned agrees hereby to become a party to, and be bound by the terms of, the Stockholders Agreement, as a Stockholder.

 

[Remainder of Page Intentionally
omitted]

 

    - 10 -

     

    

 

IN
WITNESS WHEREOF, the Company has caused this Warrant Agreement to be issued and executed in its corporate name by its
duly authorized officer as of the date of issuance set forth above.

 

	 	TCO GROUP HOLDINGS, INC.
	 	 	 
	 	By:	/s/ Maureen Hewitt
	 	Name:	Maureen Hewitt
	 	Title:	Chief Executive Officer and President

 

ACKNOWLEDGED AND ACCEPTED this 6 day of
March, 2019.

 

	 	ADVENTIST HEALTH SYSTEM/WEST
	 	 	 
	 	By:	/s/ Illegible
	 	Name:	                         
	 	Title:	 

 

     

     

    

 

EXHIBIT A

 

NOTICE OF EXERCISE

 

	To:	 	 
	 	 	 
	 	 	 
	 	 	 
	 	 	 

 

1.            Capitalized
terms used but not otherwise defined herein have the meanings ascribed thereto in the Warrant Agreement. The undersigned, pursuant
to the provisions of the Warrant Agreement, hereby elects to exercise the Warrant Agreement with respect to shares of Warrant Common
Stock representing  ___ % of the issued and outstanding equity interest of the Company on a Fully Diluted, as of the date hereof
after giving effect to the exercise of the Warrant Agreement. Subject to adjustment after confirmation with the Company, the Holder
has calculated the number of shares of Warrant Common Stock to be   _______shares.

 

2.            Subject
to adjustment after confirmation with the Company, the undersigned herewith tenders payment for such Company Common Stock, together
with any applicable transfer taxes, in the following manner (please check type, or types, of payment and indicate the portion of
the Exercise Price to be paid by each type of payment):

 

________ Exercise for Cash

 

________ Cashless Exercise

 

3.            Please
issue a certificate or certificates representing the Company Common Stock issuable in respect hereof under the terms of the attached
Warrant Agreement, as follows:

 

	 	 
	 	(Name of Record Holder/Transferee)

 

and deliver such certificate or certificates to the following
address:

 

	 	 
	 	(Address of Record Holder/Transferee)

 

4.            The
undersigned represents that the aforesaid Company Common Stock are being acquired for the account of the undersigned for investment
and not with a view to, or for resale in connection with, the distribution thereof and that the undersigned has no present intention
of distributing or reselling such Company Common Stock.

 

	 	 
	 	(Signature)
	 	 
	 	(Date)

 

     

     

    

 

EXHIBIT
B

 

DEFINITION OF
 “ CONSOLIDATED EBITDA”

 

[Intentionally Omitted]

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