Document:

Exhibit 10.3.1

 

AMENDMENT NO. 1 TO

AMENDED AND RESTATED

REVOLVING CREDIT AGREEMENT

 

                This AMENDMENT NO.
1 (“Amendment”), dated as of March 29, 2005 is by and among (i) WACHOVIA BANK, NATIONAL ASSOCIATION, as an
individual Lender and as Sole Lead Arranger and Administrative Agent (“Wachovia”),
Wachovia in its capacity as the Lead Arranger and Administrative Agent is
hereinafter referred to as the “Agent”, MERRILL
LYNCH BUSINESS FINANCIAL SERVICES INC., as an individual Lender (“Merrill”),
BANKNORTH, N.A., as an individual
Lender (“Banknorth”) and UNION BANK OF CALIFORNIA, N.A., an
individual Lender (“UBOC”) and (ii) TRC
COMPANIES, INC., a Delaware corporation (“TRC”) and the subsidiaries
of TRC listed herein, (each a “Borrower” and collectively the “Borrowers”).

W I  T  N  E  S
S  E  T  H:

 

                WHEREAS, the Borrowers (except
for the Additional Borrowers, as defined below), Agent and Lenders are parties
to a certain Amended and Restated Revolving Credit Agreement, dated as of March
31, 2004 (the “Credit Agreement”) and certain other Credit Documents executed
and delivered in connection therewith;

 

                WHEREAS, the Borrowers, the
Agent and the Lenders desire to amend the Credit Agreement for the purpose of
increasing the Commitments to an aggregate amount not to exceed $80,000,000,
said increase to be accomplished by the increase of the Commitments of
Wachovia, MLBFS and Banknorth to $30,000,000, $15,000,000 and $25,000,000,
respectively;

 

                WHEREAS, the Borrowers, the
Agent and the Lenders further desire to amend the Credit Agreement to (i)
extend the Revolving Credit Expiration Date to March 31, 2008, (ii) modify
and/or supplement certain of the financial covenants set forth therein and
(iii) make certain other changes as set forth herein;

 

                WHEREAS, the Borrowers have also
requested that the following companies be joined to the Credit Agreement and
the Security Agreement as additional Borrowers and Grantors: Environomics,
Inc., Environomics Southwest, LLC, Environomics TX, LLC, Environomics West,
LLC, Pacific Land Design, Inc., Pacific Land Design-Roseville, Inc., Vpoint,
and Willis Engineering, Inc., Centurion Solutions, LLC and Site-Blauvelt
Engineers International, LLC (together, the “Additional Borrowers”); and

 

                NOW, THEREFORE, in consideration
of the premises and other good and valuable consideration (the receipt and
sufficiency of which are hereby acknowledged), the parties hereto hereby agree
as follows:

 

* Based on
currently proposed allocations/subject to change

 

1

 

 

                1.             Defined Terms; Effect of Amendment.

 

                (a)           Unless otherwise modified hereby, all capitalized terms
used herein which are defined in the Credit Agreement, and not otherwise
defined herein, are used herein as defined in the Credit Agreement.  All capitalized terms used herein which are
defined in the Credit Agreement and modified herein shall have the meaning
assigned to such terms in the Credit Agreement as so modified.

 

                (b)           This Amendment is an amendment to the Credit
Agreement.  Unless the context of this
Amendment otherwise requires, the Credit Agreement and this Amendment shall be
read together and shall have effect as if the provisions of the Credit
Agreement and this Amendment were contained in one agreement.  After the effective date of this Amendment,
all references in the Credit Agreement to the “Credit Agreement”, “this
Agreement”, “hereto”, “hereof”, “hereunder” or words of like import referring
to the Credit Agreement shall mean the Credit Agreement as amended by this
Amendment, and all references in the Notes and the other Credit Documents to
the Credit Agreement shall mean the Credit Agreement as amended by this
Amendment.

 

                2.             Amendment to Credit Agreement.

 

                (a)           For
the purpose of establishing the increased commitments of Wachovia, Merrill and
Banknorth under the Credit Agreement and increasing the aggregate Commitments
of all of the Lenders to $80,000,000, SCHEDULE
“A” to the Credit Agreement is hereby deleted in its entirety
and SCHEDULE “A” attached
hereto is hereby substituted into, and made a part of, the Credit Agreement, in
its place.

 

                (b)           The
definition of “Applicable Margin” set forth in Section 1.01 of the Credit
Agreement is hereby amended and restated in its entirety to read as follows:

 

““Applicable Margin”
shall mean (A) with respect to Base Rate Loans, 0 basis points (0.00%),
(B) with respect to LIBOR Loans, 170 basis points (1.70%) and (C) as
used to determine the unused fee pursuant to Section 3.01 hereof, 25 basis
points (0.25%); subject, however, to adjustment in accordance with
the following pricing schedule determined by reference to the Leverage Ratio of
the Borrowers based on the results reported on the then most recently received
financial statements delivered by the Borrowers pursuant to Section 7.02(a) and
(b) hereof, as the case may be, for the Test Period ending as of the last day
of the fiscal period reported in said statements:

 

	
  Level

  	
   

  	
  If Such Ratio Is:

  	
   

  	
  Applicable Margin for

  Base Rate Loans

  	
   

  	
  Applicable Margin for

  LIBOR Loans

  	
   

  	
  Applicable Margin for

  Unused Fees

  	
   

  
	
  I

  	
   

  	
  Less than 1.00 to 1.00

  	
   

  	
  minus 50 basis points

  (-0.50%)

  	
   

  	
  plus 145 basis points (1.45%)

  	
   

  	
  plus 25 basis points (.25%)

  	
   

  
	
  II

  	
   

  	
  Greater than or equal to 1.00 to 1.00; but less than
  2.00 to 1.00

  	
   

  	
  0 basis points (.00%)

  	
   

  	
  plus 170 basis points (1.70%)

  	
   

  	
  plus 25 basis points (.25%)

  	
   

  
	
  III

  	
   

  	
  Greater than or equal to 2.00 to 1.00

  	
   

  	
  plus 25 basis points (0.25%)

  	
   

  	
  plus 195 basis points (1.95%)

  	
   

  	
  plus 25 basis points (.25%)

  	
   

  

 

Adjustments, if any, to the Applicable Margin shall be
made by the Agent effective as of the tenth (10th) Business Day
after receipt by the Agent and the Lenders of the compliance certificate
required pursuant to Section 7.03 hereof.

 

Notwithstanding the foregoing, at all times during
which there exists a Default or Event of Default, the Applicable Margin (A) with
respect to Base Rate Loans and LIBOR Loans, shall be determined by reference to
2.07(a), and (B) as used to determine the unused fee pursuant to Section
3.01 hereof, shall be plus 50
basis points (.50%).”

 

                (c)           The
definition of “Consolidated EBITDA” set forth in Section 1.01 of the Credit
Agreement is hereby amended and restated in its entirety to read as follows:

 

 ““Consolidated EBITDA” shall mean, for any
period, the consolidated net income (or deficit) of the Borrowers, determined
in accordance with GAAP, plus to the extent deducted in computing
consolidated net income (or deficit) for such period (a) interest expense, (b)
income taxes, (c) non-cash stock option compensation expense, and (d)
depreciation and amortization.”

 

                (d)           The
definition of “Revolving Credit Expiration Date” set forth in Section 1.01 of
the Credit Agreement is hereby amended and restated in its entirety to read as
follows:

 

““Revolving
Credit Expiration Date” shall mean March 31, 2008, as the same may
be extended for an additional one (1) year period in accordance with Section
2.02 hereof.”

 

(e)           Section 5.02 of the Credit Agreement shall be amended and
restated as follows:

 

“5.02       Requirements for Any Advance and Issuance of Letter of
Credit.  The obligation of
the Lenders to make any Revolving Credit Loans or Swingline Loans and the obligation of the Agent to issue
any Letter of Credit, in each case subsequent to the Closing Date, is subject
to satisfaction of the following conditions:

 

                                                                                                                                                (i)            the
representations and warranties contained in Section 6 hereof are true and
correct on and as of the date of funding of each such Loan or date of issuance
of such Letter of Credit, as the case may be;

 

2

 

                                                                                                                                                (ii)           no
Default or Event of Default has occurred and is continuing;

 

                                                                                                                                                (iii)          there
has been no material adverse change in the Borrower’s or any other Obligor’s
condition, financial or otherwise, since the Closing Date;

 

(iv)          all of the Credit Documents remain in
full force and effect; and

 

(v)           after
recalculating the Leverage Ratio for the Test Period immediately preceding the
date a Notice of Borrowing is delivered to the Agent in connection with a
requested Loan or Letter of Credit in accordance with the immediately preceding
Section, the Borrowers shall be in compliance with the Leverage Ratio in effect
at the end of such Test Period pursuant to Section 8.08 hereof.  For purposes of recalculating the Leverage
Ratio in connection with this condition only, the amount of the Loan or Letter
of Credit requested by the Borrower shall be added to the amount of Borrower’s
Consolidated Funded Debt as if it were incurred in the applicable Test Period.”

 

                (f)            Section
8.08 of the Credit Agreement shall be amended and restated to read as follows:

 

“8.08       Leverage Ratio.  The Borrowers will not permit the Leverage
Ratio to be greater than (i) 2.50 to 1.00 for the Test Periods ended March 31,
2005 and June 30, 2005, (ii) 2.25 to 1.00 for the Test Periods ended September
30, 2005, December 31, 2005, March 31, 2006 and June 30, 2006 and (iii) 2.00 to
1.00 for any Test Period thereafter.”

 

                (g)           Section
8.10 of the Credit Agreement shall be amended and restated to read as follows:

 

“8.10       Net Worth.   The Borrowers will not permit Consolidated
Net Worth at any time to be less than (a) $160,000,000 plus  (b) the sum of (i) 75%
of quarterly positive net income on a cumulative basis commencing with results
reported with respect to the fiscal quarter ending March 31, 2005 and
(ii) 100% of the value of all property received by the Borrowers in
exchange for the issuance of new equity securities (or the sale of treasury
shares) of any of the Borrowers issued subsequent to December 31, 2004,
measured quarterly.”

 

                (h)           Section
8.13 of the Credit Agreement shall be amended and restated to read as follows:

 

“8.13       Exit Strategy Projects. 
The Borrowers will not undertake, or commit to undertake, any Exit
Strategy Project with a value of over $10,000,000 unless (a) the Borrowers
have provided to the Agent and each Lender a written summary of the scope of
such Exit Strategy Project in form and substance satisfactory to the Required
Lenders, including a summary of the reimbursement mechanics and

 

3

 

insurance for such project, (b) the Borrowers
have provided evidence satisfactory to the Required Lenders that the risks to
the Borrowers associated with such Exit Strategy project are similar to and in
any event do not exceed the risks associated with the Wells Project,
(c) the Borrowers have provided the Agent and each Lender with a schedule
of all reserves taken against all Exit Strategy Project contracts and agreement
and an explanation for such reserves as well as the Borrowers’ expected
resolution thereof, and (d) upon execution of such Exit Strategy Project
contract or agreement, the Borrowers will furnish to the Agent and each Lender
a copy of such Exit Strategy contract or agreement and the associated insurance
policies.”

 

 

                4.             Adjustment to Exposures; New Notes.  (a) Upon satisfaction of the conditions
precedent set forth in Section 10 hereof, the Lenders shall be deemed to have
effected the necessary assignments and purchases among themselves, without
recourse, representation or warranty, of interests in the Revolving Credit
Loans and L/C Participations (but excluding accrued interest and fees to and
including the Effective Date) such that, as of the Effective Date (as defined
in Section 10 below), each Lender’s interest in the Revolving Credit Loans and
L/C Participations shall be equal to its Pro Rata Share of said outstanding
obligations.  In connection with said
assignments and purchases, on the Effective Date the Lenders shall make payments
among themselves in such amounts as may be necessary such that after giving
effect to such payments, each of the Lenders shall be owed from the Borrowers
outstanding Revolving Credit Obligations equal to their respective Pro Rata
Shares therein as of the Effective Date.

 

                (b)           To evidence the obligations of the Borrowers (including,
without limitation, the Additional Borrowers) owing to the Lenders, the
Borrowers shall (i) issue to each Lender new Revolving Credit Notes
substantially in the form of EXHIBIT A
hereto and (ii) issue to Wachovia, a new Swingline Note substantially in
the form of EXHIBIT B
hereto.  Each such note shall be dated
the Effective Date and shall be in an original principal amount of up to the
Commitment of the Lender to which such note is being issued.

 

                5.             Joinder of Additional Borrowers.  (a) In accordance with Section 7.17 of
the Credit Agreement, each of Additional Borrower shall become a Borrower under
the Credit Agreement and a Grantor under the Security Agreement, in each case
as of the Effective Date.  In connection
with said joinder, the Borrowers shall cause to be delivered to the Agent and
the Lenders the following items within ten (10) days of the Effective Date, in
each case in form and substance satisfactory to the Agent and the Lenders and
disclosing no unacceptable circumstances as determined by the Agent or any
Lender in their reasonable discretion: (i) a new SCHEDULE I to the Credit Agreement
reflecting the addition of the Additional Borrowers, and (ii) any supplements,
modifications or amendments to ANNEX I
to the Credit Agreement as may be required to provide any and all necessary
disclosure pertaining to the Additional Borrower so as to make said disclosure
true and complete as to all of the Borrowers after giving effect to the joinder
of the Additional Borrowers to the Credit Agreement.

 

                (b)           In connection with the joinder contemplated in clause (a)
of this Section 5, the Borrowers shall have caused to be delivered to the Agent
and the Lenders with respect to the

 

4

 

Additional
Borrowers documentation substantially in the form required by clauses
(iii) (lien searches), (iv) (incumbency certificate),
(v) (opinion of counsel), (vi) (secretary’s certificate)
and (vii) (good standing certificates) of Section 5.01 of the
Credit Agreement, dated March 25, 2002, among the parties hereto, in each case
in form and substance satisfactory to the Agent and the Lenders and showing no
unacceptable Liens, qualifications or circumstances as determined by the Agent
or any Lender in their reasonable discretion.

 

                6.             Full Force and Effect.  Except as expressly modified by this
Amendment, all of the terms and conditions of the Credit Agreement shall
continue in full force and effect, and all parties hereto shall be entitled to
the benefits thereof.  This Amendment is
limited as written and shall not be deemed (i) to be an amendment of or a
consent under or waiver of any other term or condition of the Credit Agreement
or (ii) to prejudice any right or rights which the Lenders now have or may
have in the future under or in connection with the Credit Agreement or such
other agreements.

 

                7.             Representations and Warranties.  In order to induce the Lenders to enter into
this Amendment, each Borrower makes the following representations and
warranties to the Lenders, which shall survive the execution and delivery
hereof:

 

(i)                                     The execution and delivery of this
Amendment has been authorized by all necessary corporate action on its part,
this Amendment has been duly executed and delivered by it, and this Amendment
and the Credit Agreement, as amended hereby, constitutes the legal, valid and
binding obligations of it enforceable against it in accordance with its terms
subject to applicable bankruptcy, insolvency, reorganization and other laws
affecting creditors’ rights generally, moratorium laws from time to time in
effect and general principles of equity (regardless of whether such
enforceability is considered in a proceeding in equity or at law);

 

(ii)                                  No Event of Default has occurred and is
continuing under the Credit Agreement, and no event has occurred which, with
notice, lapse of time or both, would constitute such an Event of Default; and

 

(iii)                               The representations and warranties set
forth in the Credit Agreement and the other Credit Documents are true and
correct as of the date hereof in all material respects.

 

                8.             Counterparts. 
This Amendment may be executed in any number of counterparts, each of
which when so executed shall be deemed to be an original, and all which when
taken together shall constitute one and the same agreement.

 

                9.             Governing Law. 
This Amendment, including the validity thereof and the rights and
obligations of the parties hereunder, shall be construed in accordance with and
governed by the laws of the State of New Jersey.

 

5

 

                10.           Conditions Precedent.  This Amendment shall not be effective until
(i) the Agent shall have received counterparts of this Amendment, duly
executed by each of the parties hereto, (ii) each Lender shall have
received a Revolving Credit Note reflecting its Commitment as of the Effective
Date duly executed by the Borrowers and delivered to each Lender,
(iii) Wachovia shall have received a Swingline Note reflecting its
Swingline Commitment as of the Effective Date duly executed by the Borrowers
and delivered to Wachovia, (iv) the relevant Lenders shall have received
the payments required pursuant to Section 4(a) hereof, (v) the Agent shall
have received a joinder to Credit Agreement and Security Agreement in the form
of EXHIBIT C hereto duly
executed by each Additional Borrower, together with a duly completed SCHEDULE I thereto for each
Additional Borrower (vi) the Borrowers shall have caused to be delivered to Agent
and the Lenders the materials required by Section 5(b) hereof, (vii) the
Borrowers shall have paid to the Agent (for distribution to the Lenders) an
upfront/amendment fee in accordance with a separate letter agreement dated
March 29, 2005 and (viii) Borrowers shall have paid all reasonable fees and
expenses of the Agent’s counsel incurred in connection with the preparation,
negotiation, execution and delivery and review of this Amendment.  The date on which all of the foregoing
conditions are satisfied as determined by the Lenders is referred to herein as
the “Effective Date”.

 

                11.           Execution Certification.  The Borrowers hereto certified that this
Amendment and each of the notes referenced in Section 10 above were executed by
the Borrowers in the State of Connecticut and delivered to the Agent in the
State of New Jersey.

 

[SIGNATURE
PAGES TO FOLLOW]

 

6

 

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

 

THE
BORROWERS:

 

	
  TRC COMPANIES, INC.

  	
   

  	
  TRC ENVIRONMENTAL CORPORATION

  
	
   

  	
   

  	
   

  	
   

  	
   

  
	
  By:

  	
  /s/ Harold C. Elston, Jr.

  	
   

  	
  By: 

  	
  /s/ Harold C. Elston, Jr.

  
	
   

  	
  Harold C. Elston, Jr., Senior Vice

  President & Chief Financial Officer

  	
   

  	
   

  	
  Harold C. Elston, Jr.,

  Vice President & Treasurer

  
	
   

  	
   

  	
   

  	
   

  	
   

  
	
   

  	
   

  	
   

  	
   

  	
   

  
	
  TRC ENGINEERS, INC. 

  	
   

  	
  TRC GARROW ASSOCIATES, INC. 

  
	
   

  	
   

  	
   

  	
   

  	
   

  
	
  By: 

  	
  /s/ Harold C. Elston, Jr.

  	
   

  	
  By:

  	
  /s/ Harold C. Elston, Jr. 

  
	
   

  	
  Harold C. Elston, Jr., Senior Vice
  President

  & Chief Financial Officer

  	
   

  	
   

  	
  Harold C. Elston, Jr., Treasurer

  
	
   

  	
   

  	
   

  	
   

  	
   

  
	
   

  	
   

  	
   

  	
   

  	
   

  
	
  TRC MARIAH ASSOCIATES, INC. 

  	
   

  	
  VECTRE CORPORATION

  
	
   

  	
   

  	
   

  	
   

  	
   

  
	
  By:

  	
  /s/ Harold C. Elston, Jr.

  	
   

  	
  By: 

  	
  /s/ Harold C. Elston, Jr.

  
	
   

  	
  Harold C. Elston, Jr., Vice President &
  Treasurer

  	
   

  	
   

  	
  Harold C. Elston, Jr., Treasurer

  
	
   

  	
   

  	
   

  	
   

  	
   

  
	
   

  	
   

  	
   

  	
   

  	
   

  
	
  TRC SOLUTIONS, INC. 

  	
   

  	
  LOWNEY ASSOCIATES 

  
	
   

  	
   

  	
   

  	
   

  	
   

  
	
  By: 

  	
  /s/ Harold C. Elston, Jr.

  	
   

  	
  By: 

  	
  /s/ Harold C. Elston, Jr.

  
	
   

  	
  Harold C. Elston, Jr.,
  Assistant Treasurer

  	
   

  	
   

  	
  Harold C. Elston, Jr.,
  Treasurer

  

 

7

 

	
  HUNTER ASSOCIATES TEXAS, LTD. 

  	
   

  	
  IMBSEN & ASSOCIATES

  
	
  By 

  	
  Hunter Associates, Inc., its General
  Partner

  	
   

  	
   

  	
   

  
	
   

  	
   

  	
   

  	
   

  	
   

  
	
  By:

  	
  /s/ Harold C. Elston, Jr.

  	
   

  	
  By:

  	
  /s/ Harold C. Elston, Jr.

  
	
   

  	
  Harold C. Elston, Jr., Treasurer

  	
   

  	
   

  	
  Harold C. Elston, Jr., Assistant
  Treasurer

  
	
   

  	
   

  	
   

  	
   

  	
   

  
	
   

  	
   

  	
   

  	
   

  	
   

  
	
  TRC OMNI ENVIRONMENTAL CORPORATION 

  	
   

  	
  ECON CAPITAL, LP

  TRC Companies,
  Inc., its General Partner 

  
	
   

  	
   

  	
   

  	
   

  	
   

  
	
  By: 

  	
  /s/ Harold C. Elston, Jr.

  	
   

  	
  By:

  	
  /s/ Harold C. Elston, Jr.

  
	
   

  	
  Harold C. Elston, Jr., Treasurer

  	
   

  	
   

  	
  Harold C. Elston, Jr., Treasurer

  
	
   

  	
   

  	
   

  	
   

  	
   

  
	
   

  	
   

  	
   

  	
   

  	
   

  
	
  ENGINEERED AUTOMATION SYSTEMS, INCORPORATED

  	
   

  	
  GBF HOLDINGS LLC

  
	
   

  	
   

  	
   

  	
  By

  	
  TRC Companies, Inc., its Managing Member

  
	
   

  	
   

  	
   

  	
   

  	
   

  
	
  By:

  	
  /s/ Harold C. Elston, Jr.

  	
   

  	
  By:

  	
  /s/ Harold C. Elston, Jr.

  
	
   

  	
  Harold C. Elston, Jr., Treasurer

  	
   

  	
   

  	
  Harold C. Elston, Jr., Senior Vice
  President

  & Chief Financial Officer

  
	
   

  	
   

  	
   

  	
   

  	
   

  
	
   

  	
   

  	
   

  	
   

  	
   

  
	
  PBWO HOLDINGS, LLC

  	
   

  	
  SITE-BLAUVELT ENGINEERS, INC.

  
	
  By

  	
  TRC Companies, Inc., its Managing Member 

  	
   

  	
  (New Jersey) 

  
	
   

  	
   

  	
   

  	
   

  	
   

  
	
   

  	
   

  	
   

  	
   

  	
   

  
	
  By:

  	
  /s/ Harold C. Elston, Jr.

  	
   

  	
  By:

  	
  /s/ Harold C. Elston, Jr.

  
	
   

  	
  Harold C. Elston, Jr., Senior Vice
  President

  & Chief Financial Officer

  	
   

  	
   

  	
  Harold C. Elston, Jr., Treasurer

  
	
   

  	
   

  	
   

  	
   

  	
   

  
	
   

  	
   

  	
   

  	
   

  	
   

  
	
  HUNTER ASSOCIATES, INC. 

  	
   

  	
  SITE-BLAUVELT ENGINEERS, INC.

  
	
   

  	
   

  	
  (New York)

  
	
   

  	
   

  	
   

  	
   

  	
   

  
	
  By:

  	
  /s/ Harold C. Elston, Jr.

  	
   

  	
  By:

  	
  /s/ Harold C. Elston, Jr.

  
	
   

  	
  Harold C. Elston, Jr.,
  Treasurer

  	
   

  	
   

  	
  Harold C. Elston, Jr., Treasurer

  

 

8

 

	
  E/PRO ENGINEERING AND

  ENVIRONMENTAL CONSULTING LLC 

  	
   

  	
  ESSEX ENVIRONMENTAL, INC. 

  
	
   

  	
   

  	
   

  	
   

  	
   

  
	
  By: 

  	
  /s/ Harold C. Elston, Jr.

  	
   

  	
  By: 

  	
  /s/ Harold C. Elston, Jr.

  
	
   

  	
  Harold C. Elston, Jr., Treasurer

  	
   

  	
   

  	
  Harold C. Elston, Jr., Assistant
  Treasurer

  
	
   

  	
   

  	
   

  	
   

  	
   

  
	
   

  	
   

  	
   

  	
   

  	
   

  
	
  NEW CENTURY ENGINEERING SUPPORT SERVICES, LLC 

  	
   

  	
  NOVAK ENGINEERING, INC. 

  
	
   

  	
   

  	
   

  	
   

  	
   

  
	
  By 

  	
  /s/ Harold C. Elston, Jr.

  	
   

  	
  By 

  	
  /s/ Harold C. Elston, Jr.

  
	
   

  	
  Harold C. Elston, Jr., Treasurer

  	
   

  	
   

  	
  Harold C. Elston, Jr., Treasurer

  
	
   

  	
   

  	
   

  	
   

  	
   

  
	
   

  	
   

  	
   

  	
   

  	
   

  
	
  SITE CONSTRUCTION SERVICES INC. 

  	
   

  	
  BV ENGINEERING 

  
	
   

  	
   

  	
   

  	
   

  	
   

  
	
  By:

  	
  /s/ Harold C. Elston, Jr.

  	
   

  	
  By:

  	
  /s/ Harold C. Elston, Jr.

  
	
   

  	
  Harold C. Elston, Jr., Treasurer

  	
   

  	
   

  	
  Harold C. Elston, Jr., Treasurer

  
	
   

  	
   

  	
   

  	
   

  	
   

  
	
   

  	
   

  	
   

  	
   

  	
   

  
	
  SITE-BLAUVELT ENGINEERS, INC.

  	
   

  	
  TRC RAVIV ASSOCIATES, INC.

  
	
  (Virginia)

  	
   

  	
   

  	
   

  
	
   

  	
   

  	
   

  	
   

  	
   

  
	
  By: 

  	
  /s/ Harold C. Elston, Jr.

  	
   

  	
  By:

  	
  /s/ Harold C. Elston, Jr.

  
	
   

  	
  Harold C. Elston, Jr., Treasurer

  	
   

  	
   

  	
  Harold C. Elston, Jr., Treasurer

  
	
   

  	
   

  	
   

  	
   

  	
   

  
	
   

  	
   

  	
   

  	
   

  	
   

  
	
  CUBIX CORPORATION 

  	
   

  	
  EAST CANYON HOLDINGS LLC 

  
	
   

  	
   

  	
   

  	
   

  	
   

  
	
   

  	
   

  	
   

  	
  By 

  	
  TRC Companies, Inc., its Managing Member

  
	
   

  	
   

  	
   

  	
   

  	
   

  
	
  By: 

  	
  /s/ Harold C. Elston, Jr.

  	
   

  	
  By:

  	
  /s/ Harold C. Elston, Jr.

  
	
   

  	
  Harold C. Elston, Jr., Assistant
  Treasurer

  	
   

  	
   

  	
  Harold C. Elston, Jr., Senior Vice
  President

  & Chief Financial Officer

  
	
   

  	
   

  	
   

  	
   

  	
   

  
	
   

  	
   

  	
   

  	
   

  	
   

  
	
  SGS WITTER, INC. 

  	
   

  	
   

  	
   

  
	
   

  	
   

  	
   

  	
   

  	
   

  
	
  By:

  	
  /s/ Harold C. Elston, Jr.

  	
   

  	
   

  	
   

  
	
   

  	
  Harold C. Elston,
  Jr., Assistant Treasurer

  	
   

  	
   

  	
   

  

 

9

 

THE ADDITIONAL BORROWERS

 

	
  ENVIRONOMICS,
  INC.

  	
   

  	
  ENVIRONOMICS TX, LLC 

  
	
   

  	
   

  	
   

  	
  By: 

  	
  TRC Companies, Inc., its Managing Member

  
	
   

  	
   

  	
   

  	
   

  	
   

  
	
  By:

  	
  /s/ Harold C. Elston, Jr.

  	
   

  	
  By:

  	
  /s/ Harold C. Elston, Jr.

  
	
   

  	
  Harold C. Elston, Jr., Treasurer

  	
   

  	
   

  	
  Harold C. Elston, Jr., Treasurer

  
	
   

  	
   

  	
   

  	
   

  	
   

  
	
   

  	
   

  	
   

  	
   

  	
   

  
	
  PACIFIC LAND DESIGN, INC. 

  	
   

  	
  VPOINT 

  
	
   

  	
   

  	
   

  	
   

  	
   

  
	
  By:

  	
  /s/ Harold C. Elston, Jr.

  	
   

  	
  By: 

  	
  /s/ Harold C. Elston, Jr.

  
	
   

  	
  Harold C. Elston, Jr., Treasurer

  	
   

  	
   

  	
  Harold C. Elston, Jr., Treasurer

  
	
   

  	
   

  	
   

  	
   

  	
   

  
	
   

  	
   

  	
   

  	
   

  	
   

  
	
  ENVIRONOMICS SOUTHWEST, LLC 

  	
   

  	
  ENVIRONOMICS WEST, LLC 

  
	
   

  	
   

  	
   

  	
   

  	
   

  
	
  By:

  	
  TRC Companies, Inc., its Managing Member 

  	
   

  	
  By: 

  	
  TRC Companies, Inc., its Managing Member

  
	
   

  	
   

  	
   

  	
   

  	
   

  
	
  By:

  	
  /s/ Harold C. Elston, Jr.

  	
   

  	
  By:

  	
  /s/ Harold C. Elston, Jr.

  
	
   

  	
  Harold C. Elston, Jr., Treasurer

  	
   

  	
   

  	
  Harold C. Elston, Jr., Treasurer

  
	
   

  	
   

  	
   

  	
   

  	
   

  
	
   

  	
   

  	
   

  	
   

  	
   

  
	
  PACIFIC LAND DESIGN-ROSEVILLE, INC. 

  	
   

  	
  WILLIS ENGINEERING, INC. 

  
	
   

  	
   

  	
   

  	
   

  	
   

  
	
  By:

  	
  /s/ Harold C. Elston, Jr.

  	
   

  	
  By: 

  	
  /s/ Harold C. Elston, Jr.

  
	
   

  	
  Harold C. Elston, Jr., Treasurer

  	
   

  	
   

  	
  Harold C. Elston, Jr., Treasurer

  
	
   

  	
   

  	
   

  	
   

  	
   

  
	
   

  	
   

  	
   

  	
   

  	
   

  
	
  CENTURION SOLUTIONS, LLC 

  	
   

  	
  SITE-BLAUVELT ENGINEERS

  INTERNATIONAL, LLC

  
	
   

  	
   

  	
   

  	
   

  	
   

  
	
  By:

  	
  /s/ Harold C. Elston, Jr.

  	
   

  	
  By:

  	
  /s/ Harold C. Elston, Jr.

  
	
   

  	
  Harold C. Elston, Jr., Treasurer

  	
   

  	
   

  	
  Harold C. Elston, Jr., Treasurer

  

 

10

 

	
   

  	
   

  	
   

  	
  THE AGENT:

  
	
   

  	
   

  	
   

  	
  WACHOVIA
  BANK, NATIONAL ASSOCIATION, 

  
	
   

  	
   

  	
   

  	
  (formerly known as
  First Union National Bank),

  
	
   

  	
   

  	
   

  	
  as
  Agent

  
	
   

  	
   

  	
   

  	
   

  	
   

  
	
   

  	
   

  	
   

  	
  By: 

  	
  /s/ Paul J. Bakey

  
	
   

  	
   

  	
   

  	
   

  	
  Paul J. Bakey, Vice President

  
	
   

  	
   

  	
   

  	
   

  	
   

  
	
   

  	
   

  	
   

  	
   

  	
   

  
	
   

  	
   

  	
   

  	
  THE LENDERS:

  
	
   

  	
   

  	
   

  	
  WACHOVIA
  BANK, NATIONAL ASSOCIATION,

  
	
   

  	
   

  	
   

  	
  (formerly known as
  First Union National Bank),

  
	
   

  	
   

  	
   

  	
  individually

  
	
   

  	
   

  	
   

  	
   

  	
   

  
	
   

  	
   

  	
   

  	
  By: 

  	
  /s/ Paul J. Bakey

  
	
   

  	
   

  	
   

  	
   

  	
  Paul J. Bakey, Vice President

  
	
   

  	
   

  	
   

  	
   

  	
   

  
	
   

  	
   

  	
   

  	
   

  	
   

  
	
   

  	
   

  	
   

  	
  MERRILL
  LYNCH BUSINESS FINANCIAL SERVICES INC.

  
	
   

  	
   

  	
   

  	
   

  	
   

  
	
   

  	
   

  	
   

  	
  By: 

  	
  /s/ Steven Rubenstein

  
	
   

  	
   

  	
   

  	
   

  	
  Steven Rubenstein, Credit Manager

  
	
   

  	
   

  	
   

  	
   

  	
   

  
	
   

  	
   

  	
   

  	
   

  	
   

  
	
   

  	
   

  	
   

  	
  BANKNORTH,
  N.A.

  
	
   

  	
   

  	
   

  	
   

  	
   

  
	
   

  	
   

  	
   

  	
  By:

  	
  /s/ Jeffrey R. Westling

  
	
   

  	
   

  	
   

  	
   

  	
  Jeffrey R. Westling, Senior Vice President

  
	
   

  	
   

  	
   

  	
   

  	
   

  
	
   

  	
   

  	
   

  	
   

  	
   

  
	
   

  	
   

  	
   

  	
  UNION
  BANK OF CALIFORNIA, N.A.

  
	
   

  	
   

  	
   

  	
   

  	
   

  
	
   

  	
   

  	
   

  	
  By: 

  	
  /s/ James Heim

  
	
   

  	
   

  	
   

  	
   

  	
  James Heim, Vice President

  

 

11

 

SCHEDULE
“A”

 

LENDERS
AND COMMITMENTS

 

 

 

 

	
  Lender

  	
   

  	
  Commitment

  	
   

  
	
   

  	
   

  	
   

  	
   

  
	
  Wachovia Bank,
  National Association

  	
   

  	
  $30,000,000*

  (includes $5,000,000 Swingline Commitment)

  	
   

  
	
   

  	
   

  	
   

  	
   

  
	
  Merrill Lynch
  Business Financial Services Inc.

  	
   

  	
  $15,000,000*

  	
   

  
	
   

  	
   

  	
   

  	
   

  
	
  Banknorth, N.A.

  	
   

  	
  $25,000,000*

  	
   

  
	
   

  	
   

  	
   

  	
   

  
	
  Union Bank of
  California, N.A.

  	
   

  	
  $10,000,000*

  	
   

  
	
   

  	
   

  	
   

  	
   

  
	
  AGGREGATE
  COMMITMENTS:

  	
   

  	
  $80,000,000

  	
   

  
					

 

* Based on
currently proposed allocations/subject to change

 

12Exhibit 10.60

CONFIDENTIAL
TREATMENT REQUESTED

COMPREHENSIVE iVOW CENTER PROGRAM

BARIATRIC
ADMINISTRATIVE SERVICES AGREEMENT

This
Bariatric Administrative Services Agreement
(“hereafter Agreement”) is entered into as of April 20, 2005 by and between iVOW,  INC. (“iVOW”),
a Delaware corporation qualified to do business in California, with its
principal offices at 2101 Faraday, Carlsbad, California 92008, LENOX HILL HOSPITAL, an acute care hospital located at 100 East 77th Street, New York, New York 10021
(“LHH”) and MANHATTAN MINIMALLY INVASIVE & BARIATRIC
SURGERY, P.C., a professional corporation  located at 100 East 77th Street,
New York, NY 10021 (“MIBSPC”) to engage iVOW to provide operational assistance
in the ongoing administration and development of an iVOW branded bariatric
surgical and medical center and Program (“hereafter Program”).

WHEREAS, iVOW is a
consulting firm with an array of products developed to help LHH, MIBSPC and
other entities address the disease of chronic and morbid obesity.

WHEREAS, LHH and
MIBSPC desire to expand the available outpatient and inpatient bariatric
services (“Bariatric Services”) to their patients and to engage iVOW to provide
ongoing collaborative administrative services to MIBSPC and LHH’s bariatric
surgical and medical patients.

WHEREAS, LHH and
MIBSPC desire to retain iVOW’s expertise to help stage the evolution of their
bariatric program and its benefits to correspond with vehicles for programmatic
growth and revenue enhancement via adoption of a more comprehensive program
model, e.g. medical weight loss, psychological readiness, and exercise
physiology.

NOW, THEREFORE, in
consideration of the mutual promises, covenants and obligations of the parties
set forth herein, iVOW, LHH and MIBSPC hereby agree as follows:

AGREEMENT

SECTION 1:  DEFINITIONS

Whenever used in this
Agreement with initial letters capitalized, the following terms will have the
specified meanings:

“Affiliate” means, with
respect to a party, any person that, directly or indirectly, Controls or is
Controlled, or is under common Control with such party.

“Blueprint”
means the analysis by iVOW of the financial feasibility, market potential and
program readiness for continuing its Program.

 “Control” means the possession, directly or
indirectly, of the power to direct or cause the direction of the administration
and policies of a person, whether by contract or otherwise.

“Clients” means LHH and
MIBSPC.

“Contractor” means iVOW.

“Clinicians” means any and
all of the medical, surgical, clinical and ancillary clinical personnel
involved in direct patient care provided to patients receiving care under the
auspices of the Clients’ Program.

***Certain confidential portions of this Exhibit were omitted and
replaced with “***” (the “Mark”).  This
Exhibit has been filed separately with the Secretary of the Securities and
Exchange Commission without the Mark pursuant to the Company’s application
requesting confidential treatment under Rule 24b-2 under the 1934 Act.

“Credentialing”
means the policies and procedures used by LHH to gather, evaluate and
re-evaluate on an ongoing basis information pertaining to the education,
training, licensure, experience, reputation, ethical standards, utilization,
quality administration and the history of the Clinicians participating in its
Program. This includes but is not limited to information on Clinician’s office
practice, referrals, resource administration, practice patterns, complication
rates and other indices of quality in both the acute setting and otherwise,
staff privileges, professional liability insurance and claim status, patient
and payor complaints, health and other matters concerning Clinician’s clinical
performance and professional competence.

“Party(ies)”
means any person(s) or entity(ies) covered by this Agreement.

“Third
party” means any person that is not a party hereto or an Affiliate of a Party
hereto.

“Quality Administration
Program” means a program that is established by LHH and/or MIBSPC and
administered by LHH and/or MIBSPC designed to review and manage the utilization
and quality of medical services and to assure that the services are provided at
the most appropriate level and quality of care consistent with medical and
surgical practices and standards prevailing in the community at the time of
treatment.

“iVOW Center Program” or
“Program” means a fully developed and implemented operating plan for the
ongoing implementation and administration of the current MIBSPC program in
conjunction with LHH and subsequently developed conjoint medical programs named
as either the iVOW Center at Lenox Hill Hospital or the Lenox Hill iVOW Center
and Programs or some other derivative acceptable to all the Parties (referred
to hereafter as the “Program”).   The
Program shall be administered by iVOW with personnel on site at the 59th
and Park Avenue location of MIBSPC and Lenox Hill Hospital.  The iVOW Center Program provides the skills
and market-driven standardized practices applicable to the key areas of
marketing, finance and operations jointly elaborated with MIBSPC and LHH and
under the day to day administrative control of MIBSPC and LHH with
collaborative consultation and support from the iVOW corporate office. The
supervision and practice of any and all Clinicians of MIBSPC and LHH and how
they practice medicine or their respective clinical disciplines shall be the
sole and exclusive purvey of MIBSPC and LHH respectively. iVOW does not
practice medicine and accepts and desires no role explicit or implicit in the
clinical practice of medicine per se performed by the Clinicians.

SECTION 2:  TERMS OF THE AGREEMENT

2.1
          Term.  The term of this Agreement shall be for three
(3) years and shall commence on April 25, 2005 and end on April 24, 2008,
unless terminated earlier pursuant to this Agreement.

SECTION 3: 
OBLIGATIONS OF
iVOW

3.1           Compliance with Law and MIBSPC and
LHH Policies and Procedures.  iVOW
shall assist MIBSPC and LHH to establish and administer the day-to-day
operations of the Program. iVOW shall administer and provide operational
assistance to the Program in accordance with (a) all applicable federal, state
and local laws, rules and regulations, regarding the licensing and operation of
LHH and MIBSPC facilities, and the Program, (b) the terms and conditions of
this Agreement, (c) the rules, regulations, policies, procedures and standards
of  MIBSPC, LHH and its Medical Staff,
(d) LHH’s compliance program, and (e) the standards of the Joint Commission for
the Accreditation of Health Care Organizations (JCAHO), provided that LHH and MIBSPC
cooperate with iVOW to ensure that LHH, MIBSPC and the Program meet all
requirements imposed by law, rule, regulation, ordinance, or certificate
of  accreditation requirements, including
but not limited to the Program pertaining to federal, 

2

 

state or local agencies,
departments, commissions, associations or other governing or advisory bodies
having authority to set standards governing the operation of  LHH, MIBSPC and the Program.

3.2           Medical Recordkeeping.  iVOW shall comply with MIBSPC and LHH’s
rules, regulations, policies, procedures and standards for medical
recordkeeping, including making timely and appropriate documentation of
services provided to their patients in the Program and maintaining
confidentiality in accordance with Section 10.4 of this Agreement.

3.3           Quality Administration and
Utilization Review.  iVOW shall
assist MIBSPC and LHH by supporting their activities, policies and procedures
related to their ongoing Quality Administration Program and the operation of
the Program, including but not limited to in-service education to LHH and
MIBSPC personnel and if requested to LHH’s Medical Staff.

3.4           Reports. iVOW shall make
quarterly reports to appropriate MIBSPC and/or LHH administrative and
supervisory personnel.  iVOW will cooperate
in its administrative communication and reporting in a manner consistent with
the Clients’ requirements for compliance from accreditation bodies and
government sponsorship.  iVOW will
collect, analyze and provide quarterly reports pertaining to its Program
administration. The form and content of the report(s) shall be agreed upon in
advance in writing by all parties.

Administrative Services Personnel

3.4.1          iVOW
Personnel.  iVOW shall provide
administration and operational assistance for the Program in accordance with
the terms and conditions of this Agreement. 
iVOW will support the Program with personnel who are onsite and who are
regionally and centrally-based at iVOW offices. 
In addition, iVOW will provide corporate support services.

iVOW
    ***   
 a Program Director (hereinafter
referred to as “PD”) with the salary and benefits and direct overhead of the PD
    ***   
.. LHH, MIBSPC and iVOW will agree upon this salary, benefits and direct
overhead The PD shall coordinate and administer
the Program on behalf of MIBSPC and LHH including marketing, financial and
operational components, based on iVOW expertise and LHH and MIBSPC
direction.  The PD will be the
administrative director of both the MIBSPC and the LHH components of the
Program.

 

iVOW
is solely responsible for employing such PD, and in no event is the PD to be
considered an employee of MIBSPC or LHH.

 

iVOW
retains full authority to discipline and to terminate iVOW personnel, provided
that, at MIBSPC’s or LHH’s reasonable request, iVOW will review the performance
of any iVOW employee and will remove and replace at iVOW’s own expense such
individual from the Program should such individual fail to meet the obligations
of the Program.

iVOW
shall not be required to employ as personnel, individuals who are now or have
previously been employed by MIBSPC or LHH. 
iVOW shall not be bound by any agree­ment entered into by LHH with
respect to its own employees.

The
PD will be responsible for advising MIBSPC and LHH regarding Program employees
and contractors, scheduling Program services, monitoring the day-to-day
operations of the Program, maintaining Program compliance with all LHH and
Medical Staff rules and regula­tions, and all other required laws, rules and
regulations.  iVOW will supply timely and
accurate reporting to designated and appropriate MIBSPC and LHH administrative
personnel on the 

 

***Portions of this page have been omitted pursuant to a request for
Confidential Treatment filed separately with the Commission.

 

3

 

progress
of the Program and any potential or actual problems with its operations.  The PD shall track Program performance,
design applicable reports and collaborate with MIBSPC and LHH’s staff to
produce a compilation of data elements useful to all Parties.

 

iVOW
will establish the    ***    with the Program and
subsequent care, and supply operational direction using effective templates
that complement and facilitate the required processes. iVOW will provide
Program training, training manuals and materials to MIBSPC and LHH staff to
integrate the    ***    into a bona fide conjoint
Program.

 

3.4.2        Professional
Expertise.  During the term of the
Agreement, the Program Director must at all times be qualified by training or
experience to fulfill the responsibilities set forth herein.

3.4.3        Consultation.  If requested, iVOW shall assist LHH and its
Medical Staff in developing appropriate criteria for credentialing physicians
to perform Bariatric Services at the iVOW Center.  iVOW shall be available initially and from
time to time thereafter to advise LHH on the billing requirements of insurers
and other third party payors with respect to Bariatric Services, including
coding standards and clinical documentation requirements.  iVOW shall cooperate with and assist LHH and
MIBSPC as may be reasonably required to file appeals on claims or resolve other
billing disputes with respect to Bariatric Services provided in the
Program.  In addition, iVOW may provide,
as needed intensive on-site or remote “a la carte” iVOW consulting services,
e.g. process redesign and new product elaboration from the iVOW corporate
office staff.  MIBSPC and/or LHH will
reimburse iVOW for all attendant travel expenses incurred in providing any such
approved or requested regional or corporate support on site.

 

                3.5           Administrative
Assistance.  iVOW will assist LHH in
administering the Bariatric Service(s) via an iVOW Center Program.

                3.6           Personnel.  iVOW will assure that its personnel are
timely available and diligently pursue its commitments in performing its duties
in the start up and ongoing operation of the Program as well as in providing
training and inservice education.

SECTION
4:  OBLIGATIONS OF LHH AND MIBSPC

4.1
          Compliance with Law and LHH
and MIBSPC Policies and Procedures. 
LHH warrants and represents that it is now, and will be at all times
during the term of this Agreement, remain fully licensed, certified and
accredited as an acute care hospital, as required by the laws of the State of
New York, by JCAHO or equivalent accreditation organization, and by Medicare
and Medicaid, or any successor 
thereto.  LHH and MIBSPC will
notify iVOW in writing of the revocation, cancellation, non-renewal,
limitation, or suspension of any or all of either’s license(s), certification(s),
accreditation(s) or LHH’s JCAHO accreditation status as well as either’s status
as a Medicare or Medicaid Provider.

4.2           Medical
Recordkeeping.  LHH and MIBSPC will
provide iVOW access to the medical records of Program patients for the purposes
of evaluating, monitoring the performance and effectiveness of the Program
subject to any legal restriction or other restrictions necessary to maintain
their confidentiality.  MIBSPC and LHH
will take appropriate steps to obtain consents from Program patients to release
pertinent information to iVOW in compliance with any applicable laws and
regulations.  iVOW, MIBSPC and LHH will
not disclose the contents of any Program patients’ medical records to any 

***Portions of this page have been omitted pursuant to a request for
Confidential Treatment filed separately with the Commission.

 

4

third
party without the patient’s prior written consent unless required to do so
pursuant to law, regulation or legally permissible contractual requirement and
in accordance with Section 10.4 of this Agreement.

4.3           Quality
Administration and Utilization Review. LHH’s Quality Administration Program
shall ensure LHH’s continuing compliance with applicable requirements of JCAHO
and any other state and federal regulations and/or mandates with respect to the
Program.  If and as requested by LHH,
iVOW shall participate in utilization review and peer review programs
established by LHH and/or MIBSPC.

 4.4 LHH and MIBSPC Personnel.  With the exception of the aforementioned iVOW
employee (the PD), MIBSPC and/or LHH shall, at their appropriately respective
expense, provide all clinical, ancillary and other staff necessary for the
Program, including but not limited to a full time, dedicated receptionist(s),
customer service representative(s) and licensed personnel.  Ancillary personnel such as a registered
dietician, social service/behavioral services personnel and physical/
physiotherapist(s) are strongly recommended as described in Exhibit A.  iVOW shall assist LHH and MIBSPC in
determining the staffing level needed to support the Program.  LHH and MIBSPC shall ensure that all such
licensed personnel (i) are qualified to perform Bariatric Services, (ii) are
duly licensed, certified or registered under applicable state, federal and
local laws to perform the services for which they are employed, (iii) perform
only those services that are within the scope of their licenses, (iv) perform
such services in compliance with all applicable laws, rules and regulations,
and (v) perform such services under the supervision of a physician when so
required by applicable law.  LHH and
MIBSPC shall be responsible for maintaining the licensing and credentialing
required of their respective employees assigned to the Program.

 LHH and MIBSPC personnel hired specifically to
work at the Program or assigned to work with and/or at the Program will be
subject to the prior consent of iVOW, such consent shall not be unreasonably
withheld.  iVOW may request the removal
of any non-physician employee from Program services, but LHH and/or MIBSPC
shall make decisions about the employees’ status and possible placement in
other areas within their respective domains. 
LHH and MIBSPC will be solely responsible for employing the clinical,
ancillary and other essential staff, and in no event shall  LHH’s or MIBSPC’s employees be considered
employee(s) of iVOW. LHH and MIBSPC personnel hired specifically to work at the
Program or assigned to work with and/or at the Program will undergo the same
background evaluation and check as all of their other employees.

 

                    4.4.1          Medical
Director.   MIBSPC, LHH and iVOW
concur with the selection of *** as the inaugural Medical Director of the
Program.  The Medical Director of the
Program will be responsible for working with LHH administration, the LHH’s
Medical Staff, MIBSPC and iVOW.  The
Medical Director shall be accountable to LHH and MIBSPC and shall consult with
the President of iVOW as to matters provided by iVOW.  The Medical Director must be available on a
regular, part-time basis to assure the clinical appropriateness of care
provided to all Program participants, to participate in any LHH and/or MIBSPC
designated or payor/regulator required peer review and quality assurance
activities of the Program, e.g. required to satisfy its accrediting/regulatory
agencies and payors, discuss case specific issues with attending physicians and
provide support for MIBSPC’s, LHH’s and its Medical Staff’s ongoing Quality
Assurance Program as it directly relates to services rendered to iVOW Center
Program or  MIBSPC or LHH patients.

 

4.4.2          Bariatric
Steering Committee.  LHH and MIBSPC
shall form a Bariatric Steering committee which shall include, but not be
limited to, LHH’s vice president of medical affairs, the Program Medical
Director and the PD.  The Program Medical
Director shall chair the committee.  Its
composition shall be determined by iVOW, MIBSPC and LHH, and shall represent
key departments 

 

***Portions of this page have been omitted pursuant to a request for
Confidential Treatment filed separately with the Commission.

 

5

 

which will support the Program’s progress.  Departments may include but are not limited
to marketing, admissions, operating room, utilization administration, quality
assurance, discharge planning, medical surgical unit, dietary, physical
therapy, printing and production, facilities, and medical records.  Every appropriate and reasonable effort will
be made to develop a clinical subcommittee of this committee in such a manner
as is appropriate for bestowing upon this subcommittee peer review protection.

 

4.5         Retention of
Professional and Administrative Control.  
MIBSPC and LHH will retain professional and administrative responsibility
for the services rendered as outlined in this Agreement.   LHH and MIBSPC retain ultimate control over
all activities performed at the iVOW Center and under the auspices of the iVOW
Program on behalf of MIBSPC and LHH in their respective domains.  Notwithstanding any other provision contained
in this Agreement, LHH remains responsible for ensuring that any service
provided pursuant to this Agreement at LHH complies with all pertinent
provisions of federal, state and local statutes, rules and regulations.

 

4.6           Facility
and Equipment.  MIBSPC and LHH will
maintain a site for the Program that is convenient for both patients and
physicians with convenient access from mass transit and/or convenient
parking.  The site must ensure adequate
space and shall accommodate a reception area, space for the on site iVOW
employee(s) and any co-located LHH and MIBSPC employees.  The site must also include, at a minimum, a
private area to provide privacy for patient intake and financial counseling.

 

 LHH shall provide use of such operating rooms
and patient rooms for the Program and the provision of Bariatric Services as
are required for the inpatient treat­ment and care of bariatric patients at its
own cost and expense.

4.7           Equipment.  LHH shall, at its own cost and expense,
provide and maintain for use in the Program, operating rooms in which Bariatric
Services procedures (both open and laparoscopic) are performed, inpatient
rooms, and all equipment as is reasonable and necessary for the proper
operation of the Program and the provision of Bariatric Services.  Decisions regarding the acquisition,
selection, replacement and upgrade of medical and non-medical equipment for the
Program component at LHH shall be made by LHH after consultation with MIBSPC
and iVOW.  Decisions regarding the
acquisition, selection, replacement and upgrade of medical and non-medical
equipment for the Program component at MIBSPC shall be made by MIBSPC after
consultation with LHH and iVOW.

All
additions and improvements made to such equipment during the term of this
Agreement shall belong to and become the property of either LHH or MIBSPC
dependent upon whichever is the purchaser. 
In addition, LHH and/or MIBSPC will provide and replenish all supplies
and inventory which LHH and MIBSPC determine are reasonable and necessary for
the proper operation of the Program and the provision of Bariatric
Services.  LHH and MIBSPC also shall be
responsible for all equipment repair, maintenance, and training, the purchase
and maintenance of all office related supplies, inventory and services,
including telephones and all customary utilities including gas, electric,
heating and air conditioning.

 MIBSPC or LHH shall, at its cost and expense,
provide the customary provisions for computer configuration, which includes but
is not limited to computer hardware, hardwiring, desktop software and high
speed internet connection capabilities.

Subject
to Section 10.4 of this Agreement, LHH and MIBSPC will permit and provide
access that links to patient registration, billing and diagnostic testing to
iVOW such that iVOW is able to interface with LHH and MIBSPC in order to
monitor patient activity and support the revenue cycle.

6

4.8           Safety.  iVOW shall assist MIBSPC and LHH in providing
Program-related safety presentations to MIBSPC and LHH staff.  MIBSPC and LHH will extend its existing and
future security precautions and protocols, such as well lighted areas and
security guards, if needed.

4.9           Environment.   LHH and MIBSPC will be responsible for
infection control surveillance, adherence to OSHA standards, routine
maintenance including housekeeping, reduction of pathogens and providing a
clean, safe workplace and care setting consistent with other patient care areas
of  LHH and MIBSPC.

4.10         Diagnostic Health Screening.  LHH will provide all personnel, including the
Program Director, at its expense, with pre-employment and periodic diagnostic
and health screening procedures, immunizations and any other health screening
to the same extent as customarily required by LHH for its employees and staff
members.

4.11         Third Party Payor Agreements.  LHH and MIBSPC will use commercially
reasonable efforts to offer Bariatric Services to beneficiaries under existing
and new agreements with third party payors.

4.12         Personnel.

4.12.1      LHH and MIBSPC will assure that their
personnel will timely and diligently assist iVOW in the performance of its
duties in the start up and ongoing operation of the Program.

4.12.2      LHH and MIBSPC will assure that their personnel
will timely undergo the requisite training and inservice education necessary to
facilitate the start up and ongoing operation of the Program.

 

4.13         MIBSPC
Physicians. LHH attests that MIBSPC’s physicians are members in good
standing of LHH’s Medical Staff.  LHH
will facilitate any requisite credentialing and privileging required by its
Medical Staff in order for any new MIBSPC’s physicians to be admitted to its
Medical Staff in accordance with LHH policies. 
LHH will facilitate any requisite re-credentialing and re-privileging
required by its Medical Staff in order for MIBSPC’s physicians to retain their
Medical Staff credentialing and privileges.

 

4.14         Resources.
LHH will provide the resources articulated in the LHH Blueprint (a copy of
which is annexed to this Agreement and incorporated herein by reference) as
Exhibit B presented to LHH on or before March 29, 2005 to facilitate the launch
and ongoing operation of the Program.

 

SECTION 5:  OBLIGATIONS OF BOTH PARTIES

5.1           Regulatory
Permits and Approvals.  MIBSPC, LHH
and iVOW will obtain, if applicable, permits, licenses and regulatory approvals
required in the operation of the Program under this Agreement.  Each entity shall cooperate with the other to
the extent required to obtain such permits, licenses and approvals and meet any
other requirements for regulatory mandates.

 

5.2           No Violation.  To the best of each Party’s knowledge, the
Parties hereby represent and warrant that neither the provisions of this
Agreement nor the Parties execution hereof does now or shall hereafter
constitute or result in a breach, default or violation of any contract,
agreement (including any collective bargaining agreement), judgment, order or
decree to which the Parties are bound.

7

5.3           No Discrimination.  In the operation of the Program, Parties
shall not differentiate in the treatment of any patient because of race, color,
national origin, ancestry, religion, sex, marital status, sexual orientation or
age. During the performance of this Agreement, Parties and their subcontractors
shall not unlawfully discriminate, harass or allow harassment, against any
employee or applicant for employment because of sex, race, color, ancestry,
religious creed, national origin, 
physical disability, mental disability, medical condition (cancer), age
(over 40), and marital status. Parties and their subcontractors shall ensure
that the evaluation and treatment of their employees and applicants for
employment are free from such discrimination and harassment.  Parties and their subcontractors will give
written notice of their obligations under this clause to labor organizations
with which they have a collective bargaining or other agreement. iVOW, MIBSPC
and LHH will include the nondiscrimination and compliance provisions of this
Agreement in all subcontracts to perform work under this Agreement.

5.4           Access to Determine Compliance.
Parties shall permit access by representatives of any federal, state or local
agencies, departments, commissions, associations or other governing or advisory
bodies having authority governing the operation of the Program upon reasonable
notice at any time during normal business hours to such of its books, records,
accounts, other sources of information and its facilities as such agencies
shall require to ascertain compliance of the Program within the scope of their
jurisdiction, regulatory or statutory authority.

5.5           Representation
and Warranty.  Each Party represents
and warrants to the other that each Party is not currently excluded, debarred,
or otherwise ineligible to participate in the Federal health care programs as
defined in 42 U.S.C. Section 1320a-7b(f) (the “Federal health care
programs”).  Each Party represents that
it has not been convicted of a criminal offense related to the provisions of
health care items or services.  Each
Party represents that it is not under investigation or otherwise aware of any
circumstances which may result in them being excluded from participation in the
Federal healthcare programs.  The
statements set forth in this Section 5.5 shall be an ongoing representation and
warranty during the term of this Agreement and each party shall notify one
another of any change in the status of the representation and warranty set
forth in this section.  Any breach of
this section shall give each Party the right to terminate this Agreement with
cause.

5.6             Nonsolicitation.  
iVOW, for the term of this Agreement and for   ***   after
its termination or expiration, shall not directly or indirectly, on iVOW’s own
behalf or on behalf of any other person, organization or entity, individually
or collectively, in any fashion, form or manner, employ, engage, contract in
any manner for the services of, induce or solicit the services of employees of
MIBSPC or LHH to work for iVOW or any person, corporation, partnership, sole
proprietorship, governmental agency, organization, joint venture or other
entity with whom or which iVOW is associated, or otherwise interfere with any
contractual relationship of  MIBSPC or
LHH, unless mutually agreed upon by iVOW and MIBSPC or LHH.  Without limiting any other remedies available
to MIBSPC or LHH to enforce this covenant, iVOW agrees that an injunction or
other equitable relief shall be available, without the necessity of  MIBSPC or LHH posting a bond.  The provisions of this Section 6.6 shall
survive the termination or expiration of this Agreement.

5.7           Nonsolicitation.  MIBSPC or LHH, for the term of this Agreement
and for    ***         after its termination or expiration,
shall not directly or indirectly, on 
MIBSPC or LHH’s own behalf or on behalf of any other person,
organization or entity, individually or collectively, in any fashion, form or
manner, employ, engage, contract in any manner for the services of, induce or
solicit the services of employees of iVOW to work for MIBSPC or LHH or any
person, corporation, partnership, sole 

***Portions of this page have been omitted pursuant to a request for
Confidential Treatment filed separately with the Commission.

8

 

proprietorship, governmental
agency, organization, joint venture or other entity with whom or which LHH or
MIBSPC is associated, or otherwise interfere with any contractual relationship
of iVOW, unless mutually agreed upon by iVOW and MIBSPC or LHH.  Without limiting any other remedies available
to iVOW to enforce this covenant, MIBSPC or LHH agrees that an injunction or
other equitable relief shall be available, without the necessity of iVOW
posting a bond.  The provisions of this
Section 5.7 shall survive the termination or expiration of this Agreement.

5.8             Non-Competition. 
During the term of this Agreement and for           ***          after termination of the
Agreement,  iVOW shall not, without the prior written consent of LHH
and/or MIBSPC, directly or indirectly, including by or through any corporation
or any entity that is an affiliate of iVOW (for purposes of this
provision, a corporation or entity is an affiliate of iVOW if iVOW owns
more than a    ***    in such corporation or
entity), invest in, manage, operate, market, finance or provide administrative
services to any entity within the     
***             that is performing
or will perform bariatric services or services related thereto.  Should LHH and/or MIBSPC elect to terminate
iVOW’s services other than for material breach then iVOW is released from this
non compete provision.

 

5.9           Non-Competition 
During the term of this Agreement and for      ***     
after termination of the Agreement, LHH and MIBSPC shall not,
without the prior written consent of iVOW, directly or indirectly, including by
or through any corporation or any entity that is an affiliate of either or
both (for purposes of this provision, a corporation or entity is an affiliate
of either if either owns more than a    ***   
in such corporation or entity) engage, hire, contract with or otherwise have
services provided to either or both by a bariatric management or consulting
company that is performing or will perform bariatric administrative, marketing,
financial, operational or consulting services related thereto. Should iVOW
elect to terminate this relationship with LHH and/or MIBSPC other than for
material breach then LHH and/or MIBSPC is released from this non compete
provision.

 

SECTION 6:  PROMOTION/MARKETING AND PATIENT EDUCATION

6.1           iVOW shall develop and make available
to LHH and MIBSPC for Program use patient education, marketing and outreach
materials tailored to MIBSPC and LHH’s mission and culture that are designed to
inform and educate the general public, physicians and other health care
clinicians, patients and payors about MIBSPC and LHH’s Bariatric Services and
the Program.  Such marketing and outreach
shall include, by way of example and not limitation, rights to use
iVOW-licensed promotional partners, rights to use iVOW-prepared presentation
materials, including    ***   materials.

6.2           iVOW
shall be responsible for the material development costs for the initial LHH
and/or MIBSPC specific customization of its templates for    ***   
materials as well as their subsequent placement according to a mutually agreed
upon schedule and venue at a year-one cost of $*** to be expended during the    ***   of
the engagement.  iVOW shall provide LHH
and MIBSPC with documentation evidencing that $*** has been spent during the    ***   .

 

6.3           MIBSPC
and LHH will be responsible for the linking of iVOW to their websites and
intranet sites (as appropriate), reproduction of Program materials and postage
for mailing such Program 

 

***Portions of this page have been omitted pursuant to a request for
Confidential Treatment filed separately with the Commission.

9

 

materials. 
MIBSPC and LHH will promote the Program and provide a link to the
Program from their internet sites.  The
placement of such links shall be mutually agreed upon by the Parties.

 

iVOW shall be responsible for the linking of MIBSPC
and LHH to iVOW’s websites and intranet site (as appropriate). iVOW shall
promote the Program and provide a link to the Program from its Internet
site.  The placement of such links shall
be mutually agreed upon by MIBSPC, LHH and iVOW.

 

6.4           Any subsequent or additional
marketing and outreach expense and materials, including    ***   
disbursed    ***   materials, shall be the
responsibility of    ***    inclusive of all
production and distribution cost.  No
such cost shall be incurred without the prior approval of the financially
responsible party.

6.5           During the term of this Agreement,
iVOW hereby grants to MIBSPC and LHH a non-exclusive and non-assignable right
entitling MIBSPC and LHH to use one or more of iVOW’s trade names or trade
marks as designated by iVOW in connection with MIBSPC and LHH’s marketing and
advertising activities under this Agreement and in the routine course of their
businesses, which right(s) shall immediately terminate upon termination of this
Agreement.   MIBSPC and LHH consent to
the use of their names by iVOW in connection with its marketing and advertising
activities undertaken on behalf of 
MIBSPC and LHH and in the routine course of its business, such right(s)
shall immediately terminate upon termination of this Agreement.

6.6           MIBSPC and LHH agrees to participate
in the unique marketing of iVOW Center Programs’ brand names and obtain the pre-approval
from iVOW for all marketing materials developed, reproduced and distributed
under the iVOW Center Program brand such approval not to be unreasonably
withheld.

6.7           To complement the $***    ***   has
committed to outreach, marketing and advertising, MIBSPC and LHH agree to spend
      ***      during the    ***   
of the term of this Agreement for advertising and public relations activities
of the Program and in subsequent years to ultimate assumption of all marketing
and advertising costs.

6.8           In cooperation with MIBSPC and LHH,
iVOW shall develop or refine and implement a Community Relations and Education
Program to aggressively and effectively communicate to interested candidates
about the Program.  iVOW shall provide
templates for MIBSPC and LHH’s use with MIBSPC and LHH being responsible for
all expenses incurred for production and distribution.  Components of an education plan shall include
some or all of the activities listed in Exhibit C.

6.9           iVOW will provide Program training
manuals and materials (any updates or revisions thereto), as illustrated in
Exhibit D during the term of this Agreement.

6.10         If
requested and    ***   shall develop and    ***   and
   ***   distribution center for the
Program.  Client(s) materials and
collaterals for the    ***   , their reproduction
and distribution of said materials inclusive of postage for mailing shall be
borne at cost by    ***    as appropriate.  It is presumed that the iVOW collateral
templates will be utilized to avoid any additional developmental cost for such
collaterals by the client(s).  Should the
client(s) prefer unique, significantly customized collaterals, such collaterals
will be utilized per the client(s) directions but their prima facie production
cost will be borne by    ***    as appropriate.

 

***Portions of this page have been omitted pursuant to
a request for Confidential Treatment filed separately with the Commission.

 

10

 

 

The
cost of the provision of *** and disbursement services are not a component of
the $*** iVOW outreach, marketing and advertising *** commitment but will be ***
under a separate arrangement.

 

SECTION 7:  COMPENSATION AND PAYMENT

                7.1
Fees and Compensation.  MIBSPC
and/or LHH shall compensate iVOW for its services hereunder as follows:

 

                                7.1.1  A flat monthly Administrative Services Fee of
$*** (the “Fee”) commences and applies during the preparatory/ramp up
implementation of the Program, defined as a ninety (90) day preparation window
and continues for one (1) year. This fee will be $*** a month for year two (2)
and $*** a month in year three (3) of 
this Agreement. By the end of the first year of this Agreement, iVOW
agrees to have successfully implemented *** of the *** Models (defined in
Section 7.1.6(a)) identified under the Milestones set forth in Section 7.1.6 of
this Agreement. If LHH and MIBSPC have utilize their best efforts to
successfully implement the Models defined in Sec 7.1.6(a) and iVOW fails to
have successfully implemented at least *** of the *** Models by the end of the    ***   
year, at LHH and MIBSPC’s sole discretion, LHH and MIBSPC may either (i)
terminate this Agreement effective    ***    or
(ii) renegotiate a new Fee for year    ***    of
this Agreement taking into account the number of Models that have been
successfully implemented and the remaining number of Models to be
implemented.  In addition, the Fee for
year *** of this
Agreement is based upon    ***    of the Models
having been successfully implemented.  If
LHH and MIBSPC have utilized their best efforts to successfully implement the
Models defined in Sec.7.1.6(a) and all of the Models have not been successfully
implemented by the end of    ***    of the
Agreement, the Fee in year    ***    of this
Agreement shall be renegotiated taking into account the number of Models that
have been successfully implemented and the remaining number of Models to be
implemented.  Additionally, iVOW    ***   
for the salary, bonus, benefits and direct overhead of the on site PD at
cost.  Any    ***   
to be paid will be mutually agreed upon by the client(s) and iVOW.  Should MIBSPC and/or LHH desire other iVOW
personnel be hired for on-site support to the Bariatric Services Program their
wages, salaries, bonuses etc.   ***    by MIBSPC
and/or LHH consistent with their FTE equivalency.  Any    ***    to
be paid will be mutually agreed upon by the client(s) and iVOW.

 

                                7.1.2
During the ramp up period when the iVOW interim PD is commuting to set up the
program and before the local PD is hired (his/her selection being with the
concurrence of the client) the PD’s travel and living expenses shall be    ***   
by the    ***   . Air travel is booked at regular
coach fare and accommodations in 3-4 star hotel facilities.  The expense reimbursement for the interim
PD’s travel and living expense shall be    ***   
to the Client(s) by iVOW at ***/week. It is understood that Client(s) will
attempt to limit such expense via a    ***   
provided accommodation, probably a    ***   .

 

                                7.1.3
Should there be hiring issues beyond the ramp up period (for example to retain
the iVOW local PD suitable to all parties consequent to clients’ preference)
then the Client(s) will bear the cost of the attendant travel and living
expenses for the continued commuting of the iVOW interim PD in accordance with
Section 7.1.2 of this Agreement.

 

***Portions of this page have been omitted pursuant to
a request for Confidential Treatment filed separately with the Commission.

 

11

 

                                7.1.4
iVOW corporate and regional consultants time and work required to execute the
Agreement is covered under the monthly management and milestone fees e.g.
intensive on-site or remote iVOW a la carte consulting e.g. contracting,
marketing, process redesign and new product elaboration provided by the
regional or corporate iVOW personnel. Additionally, iVOW shall bill LHH and
MIBSPC on a monthly basis for the reimbursement of reasonable travel related
expenses actually incurred by iVOW staff and Consultants providing services to
MIBSPC and LHH under the terms of this Agreement whenever such personnel are
not the full time on site employees of iVOW providing services at MIBSPC and
LHH but personnel who travel to New York to assist iVOW’s full time onsite
personnel in fulfilling iVOW’s obligations and Client(s)’ request under the
terms of this Agreement.

 

                                7.1.5
       Nothing in this Agreement is to be
construed to directly or indirectly be interpreted or construed to mean that
iVOW is expected or required to provide services to LHH and MIBSPC beyond the
professional competency of its personnel. Should LHH and MIBSPC request any
such assistance, iVOW will facilitate its acquisition at LHH and/or MIBSPC’s
expense.

 

                        7.1.6    The following
developmental accomplishments set forth in 7.1.6(a) through (c) are considered MILESTONES

 

                                        (a)  The following five (5) models shall be
referred to as “Models” and iVOW is expected to successfully implement these
Models in accordance with the timeframes set forth in Section 7.1.1.

 

***

***

***

 

 

(b)  A truly integrated
surgical/medical group practice model.  Four (4) months after all the desired
services of 1-5 above are instituted  and
with the iVOW Program Director integrating and supervising agreed upon MIBSPC
office personnel,  iVOW will be paid an
additional incentive fee of $***/month. 
Should there be a change of interest or new direction from the Client(s)
which results in any of    ***    above being
foregone or cancelled as service lines then this integration incentive will be
paid four (4) months after  iVOW has
implemented the remaining services lines.

(c)           Successful achievement of grants or
research contracts. LHH and/or MIBSPC will pay to iVOW a fee equal to
$*** per grant or contract for each grant or contract received by LHH or MIBSPC
for which iVOW has participated in the acquisition of such grant or award
and/or provides administrative or operational assistance in the fulfillment of
the awards operating and/or deliverable requirements. Such fee will be paid
upon the receipt of award of such grant or contract from the funder.

 

                7.2           The aforementioned Fees represent the
fair market value for the Services provided by iVOW through its Program
Director and its corporate administrative consulting team.

 

(a) The amounts provided represent
the    ***    for the development and
implementation of the iVOW Center, the    ***   
to monies exchanged for the ongoing administrative onsite and the off-site
consulting services provided by iVOW to assist with the Center’s operation.

 

***Portions of this page have been omitted pursuant to
a request for Confidential Treatment filed separately with the Commission.

 

12

 

7.3            Clients are responsible for an expense in addition to
iVOW’s onsite placement personnel reimbursement expense(s), equivalent to ***
days wind-down fee i.e., *** months of the then current Fee (Sec. 7.1.1) upon
the termination of the iVOW Center Administrative Program Services Agreement,
in accordance with the termination provisions of this Agreement.

 

7.4             The Fee shall be paid to iVOW by the             ***         of
the month for current month of service. Payments not received by the   ***       
of the month shall bear interest at a rate equal to the lesser of one
and one-half percent per month compounded or the highest rate permitted under
law, accruing from the due date until paid in full.

7.5             Travel expense reimbursement payments shall be due to
iVOW upon presentation following receipt by Clients of iVOW’s reimbursement
request accompanied by appropriate supporting documentation including paid
receipts.  Payments not received
within     ***     days shall bear interest at a rate equal
to the lesser of      ***     percent per month compounded or the
highest rate permitted under law, accruing from the due date until paid in
full.

7.6             Governmental and Private Payors.  LHH and MIBSPC shall have sole right to and
responsibility for their respective revenue and expenses and shall respectively
bill and collect from all payors (both governmental and private) for all their
respective Bariatric Services provided to patients.

7.7  Books and Records.  Each party shall make its books, records and
accounts related to the provision of services under this Agreement available
for inspection and examination by the other party or its authorized
representative, at all times during normal business hours, upon seven days
advance notice to such party for the purpose of verifying the amounts billed or
charged under this Section 7.

SECTION 8:  INSURANCE AND INDEMNIFICATION

8.1  Insurance.

8.1.1        iVOW Liability Insurance.  iVOW shall maintain at all times during the
term of this Agreement and for a period of three (3) years following its
termination (the “Required Insurance Period”), commercial and professional
liability insurance by a New York licensed carrier inclusive of D&O as well
as E&O coverage or a comparable program of self insurance covering all
risks and exposures arising out of the performance of services pursuant to this
Agreement in the amount of ***           ***         per occurrence and        ***     
in the annual aggregate.  Coverage
shall be for claims made during the Required Insurance Period for services
rendered during the term of this Agreement. 
Upon request by LHH and/or MIBSPC, iVOW shall provide either with an
insurance certificate or other applicable document evidencing coverage.

8.1.2          LHH and MIBSPC Liability Insurance.   LHH and MIBSPC shall maintain at all times
during the term of this Agreement and for a period of three (3) years following
its termination (the “Required Insurance Period”), commercial and professional
liability insurance inclusive of D&O as well as E&O coverage or a self
insured or pooled program that complies with Medicare or any successor program,
covering all risks and exposures arising out of the performance of services
pursuant to this Agreement in the amount                        ***     
per occurrence and        ***      in the annual aggregate.  Coverage shall be for claims for services
rendered during the term of this Agreement. 
Upon request by iVOW,  and/or
MIBSPC provide 

***Portions of this page have been omitted pursuant to
a request for Confidential Treatment filed separately with the Commission.

 

13

iVOW with an insurance
certificate or other applicable document evidencing such coverage. Consequent
to the bone fide clinical roles of their personnel, LHH and MIBSPC will also
provide iVOW upon request with evidence documenting similar coverage levels
of  malpractice insurance for all of
their respective physicians, clinical employees or Clinicians rendering
services under the auspices of or in conjunction with the Program.

8.2.  Indemnification.

8.2.1        iVOW shall indemnify, hold harmless and
defend  LHH, MIBSPC, their agents and
employees and affiliates from and against any claim, loss, damage, cost,
expense or liability, including reasonable attorneys’ fees, arising out of or
related to the performance or nonperformance of iVOW, its agents and employees
of any services to be performed or provided by iVOW under this Agreement.  However, iVOW shall not be liable to LHH or
MIBSPC hereunder for any claim covered by insurance, except to the extent the
liability of iVOW exceeds the amount of such insurance coverage.

8.2.2        LHH and MIBSPC shall indemnify, hold
harmless and defend iVOW, its agents and employees from and against any claim,
loss, damage, cost, expense or liability, including reasonable attorneys’ fees,
arising out of or related to the performance or nonperformance of LHH and/or
MIBSPC, their agents or employees of any duty or obligation of  LHH and/or MIBSPC under this Agreement.  However, LHH and MIBSPC will not be liable to
iVOW hereunder for any claim covered by insurance, except to the extent the
liability of LHH and/or MIBSPC exceeds the amount of such insurance coverage.

8.3           The obligations of the parties under
Section 8.2 shall survive the expiration or termination of this Agreement.

SECTION 9:  TERMINATION

9.1           Termination upon Certain Events.  This Agreement may be terminated by either
party hereto upon   ***          prior written notice to the other
party, upon occurrence of any of the following:

9.1.1        Such other party shall: (i) commence
voluntary proceedings under any applicable bankruptcy, insolvency or other
similar law now or hereafter in effect; (ii) consent to the entry of an order
for relief in any voluntary proceedings under any such law; (iii) consent to
the appointment of a receiver, liquidator, assignee, trustee, custodian,
sequestrator or similar official for itself or any substantial part of its
property; (iv) make a general assignment for the benefit of its creditors; or
(v) take any corporate action in furtherance of any of the foregoing; or

9.1.2        Such other party shall fail to perform
in any material respect any of its obligations hereunder if such failure has
continued for a period of    ***     days after written notice of such
non-performance has been given to such non-performing party by the party electing
to terminate this Agreement.

9.1.3
       Notwithstanding anything to the
contrary contained in this Agreement, if the performance of any Party of any
term, covenant, condition or provision of this Agreement should (i) jeopardize
the tax-exempt status of the bonds of LHH or (ii) violate any statute,
ordinance, or otherwise be deemed illegal by any governmental body or agency
(collectively “Jeopardy Event”), then the Parties shall use their best efforts
to meet forthwith to attempt to renegotiate 
this Agreement to remove or negate the effect of the Jeopardy
Event;  however, LHH shall have the right
to terminate this agreement if a reasonably and mutually satisfactory
resolution to mitigate or remove said Jeopardy Event cannot be reached by  the Parties.

 

14

SECTION 9:  TERMINATION

9.2             Additional Rights of Termination.

                  9.2.1        This
Agreement may be terminated by either party, (a) upon written notice to the
other and without further obligation hereunder (except to the extent accrued to
the date of termination), in the event that the other party fails to obtain or
main­tain the insurance required by Section 9.1 above.

                  9.2.2        This
Agreement may be terminated by LHH and MIBSPC in accordance with Section 7.1.1
of this Agreement.

                  9.2.3        This
Agreement may be terminated by iVOW on the same terms as afforded LHH and
MIBSPC in 7.1.1(i) if LHH and MIBSPC do not utilize their best efforts to
successfully implement the Models in Section 7.1.6(a)

9.3           Effect of Termination.  Termination of this Agreement shall not
relieve either party of any obligation to the other party under this Agreement
with respect to services rendered prior to termination.  Under no circumstances shall iVOW having
performed in good faith, have any obligations to satisfy any outstanding terms
of an agreement beyond the    ***    year anniversary
date of the Agreement’s termination effective date.

9.4           Post Termination.  Upon termination, iVOW, MIBSPC and LHH will
cooperate to develop and implement a pragmatic process for the dissolution  of the Agreement, and  LHH, MIBSPC and iVOW will return to each
other Party’s Confidential Information in whatever form or format provided to
the other, including but not limited to, templates, forms, community and
professional education materials, scripts, manuals, computer hardware and
software, or at the other company’s option, destroy all of such other party’s
Confidential Information, with exception of any computer hardware or software.

9.5           Responsibility for Patients at
Termination.  LHH and MIBSPC will
continue to provide services to the patient who is currently receiving services
from either on the effective termination date of this Agreement until such time
as the services being rendered are completed, under its obligation.  LHH and MIBSPC agree to make reasonable and
medically appropriate provisions for the continued care of any such affected
patient(s).

SECTION 10:  CONFIDENTIALITY AND PROTECTION OF PROPRIETARY
INFORMATION

10.1         iVOW Proprietary Information.  LHH and MIBSPC acknowledge and agree that
iVOW has a proprietary interest in its business systems for operating a
Bariatric Services program, including all trade secrets, policies, procedures,
operating manuals, specifications, software, forms, signs, notices, displays,
marketing techniques, outreach materials, financial information, employee information,
and other information developed and/or used by iVOW in the furtherance of
Program operations and in performance of iVOW’s obligations under this
Agreement (collectively the “iVOW Proprietary Information”).  LHH and MIBSPC will maintain the confidentiality
of all such iVOW Proprietary Information and shall not divulge such information
to any third parties both during the term of this Agreement and after its  termination except as may be necessary (a)
for the dis­charge of its obligations under this Agreement and (b) under law.
LHH and MIBSPC will retain the iVOW Proprietary Information at its premises at
the address designated below and shall take reasonable precautions against
disclosure of any iVOW Proprietary Information to unauthorized persons by any
of its officers, directors, employees or agents.   LHH and MIBSPC will not directly or
indirectly, without the express prior written permission of iVOW, use the iVOW
Proprietary Information for any purpose except as provided herein 

***Portions of this page have been omitted pursuant to a request for
Confidential Treatment filed separately with the Commission.

15

and,
upon termination of this Agreement for any reason, LHH and MIBSPC shall cease
all use of any of the Proprietary Information and shall return to iVOW any
copies thereof.

  10.2      
LHH and MIBSPC Proprietary Information. 
iVOW acknowledges and agrees that in the course of performance under
this Agreement, iVOW may have access to certain information proprietary to LHH
and/or MIBSPC, including but not be limited to trade secrets, policies,
procedures, operating manuals, specifications, software, business or strategic
plans, budgets, salary information, contractual arrangements or negotiations, patient
names, patient lists, price lists, pricing policies, financial information, and
employee information (collectively, the “LHH and/or MIBSPC Proprietary
Information”). iVOW shall maintain the confidentiality of all such LHH and/or
MIBSPC Proprietary Informa­tion and shall not divulge such information to any
third parties, except as may be necessary for the discharge of its obligations
under this Agreement and under law.  iVOW
shall take reasonable precautions against disclosure of any LHH and/or MIBSPC Proprietary
Information to unauthorized persons by any of its officers, directors,
employees or agents.  Upon termination of
this Agreement for any reason, iVOW shall cease all use of any of LHH and/or
MIBSPC Proprietary Information and shall return to LHH and/or MIBSPC any copies
thereof.

10.3         General Confidentiality.  Other than as provided in the marketing
provisions of this Agreement both parties shall acknowledge and treat the
business relationship created by and under this agreement as confidential, including
its terms and conditions, unless a duty to disclose is otherwise mandated or
created by a court of law or by either entity’s license or official obligation
set forth by federal or state statutes or otherwise required by the public
domain inherit for each entity.

10.4         Confidentiality of Patient Records
and Information.  All Parties shall
comply with any and all federal and state privacy laws and regulations that
apply to the protection of individually identifiable health information.  Patient medical records and other privileged
patient information shall not be disclosed or utilized by MIBSPC or LHH  or iVOW or their agents or employees except
as required or permitted by applicable laws and regulations.  iVOW, MIBSPC and LHH will comply with all
applicable requirements of the Health Insurance Portability and Accountability
Act of 1996, Public Law 104-191 (“HIPAA”), regulations promulgated thereunder
by the U.S. Department of Health and Human Services (the “HIPAA Regulations”)
and other applicable laws relating to data security and privacy in performing
its and his respective obligations under this Agreement.  iVOW acknowledges that it has entered into a Business
Associate Agreement (the “Business Associate Agreement”) with LHH and MIBSPC
substantially in the form attached hereto as Exhibit E.

10.5         Trademarks & Service Marks.
LHH and MIBSPC acknowledge that iVOW is the sole and exclusive owner of
certain trademarks, including iVOW. Inc., iVOW Obesity to Wellness Solutions,
and such other marks as may be designated by iVOW for time to time (“the
Marks”).  LHH  and MIBSPC are granted a non-exclusive,
non-transferable, limited right during the term of this Agreement to use the
Marks solely to identify iVOW or the Program. 
LHH and MIBSPC will adhere to iVOW’s protocols for use of its Marks and
will submit to iVOW for prior approval any written materials not developed by
iVOW that use the Marks.  LHH and MIBSPC
will not at any time do or suffer to be done any act or thing that would impair
the rights of iVOW in and to the Marks. 
The terms of this Section shall survive the termination of this
Agreement.

10.6         Copyright & Proprietary
Materials.  iVOW will make available
to LHH and MIBSPC certain copyrighted and/or proprietary materials owned by
iVOW, including but is not limited to, manuals, forms, commercial scripts,
marketing plans, software and data.  iVOW
grants to LHH and MIBSPC a non-exclusive, non-transferable, limited right for
the term of this Agreement to use copyrighted and/or proprietary materials solely
for use in connection with the Program. 
LHH and 

 

16

MIBSPC understand and
acknowledge that such copyrighted and proprietary materials shall remain the
exclusive property of iVOW.  The terms of
this Section shall survive the termination of this Agreement.

10.7         Program Name.  The name of the of the Program will be The
iVOW Center at  LHH or the LHH iVOW
Center and Program.  The Program name may
be used in publications, advertisements and periodicals.  LHH’s or MIBSPC’s use of the Program name
will comply with protocols for font, logo, design, and layout as specified and
approved by iVOW.

10.8         Equitable Relief and
Indemnification.  Each of the Parties
acknowledges and agrees that due to the unique nature of its Proprietary
Information there can be no adequate remedy of law for any breach of its
obligations hereunder, that any such breach may allow the breaching Party or
third parties to unfairly compete with the non-breaching Party resulting in
irreparable harm to the non-breaching Party that cannot be adequately
compensated.  Therefore, upon any such
breach or any threat thereof, the non-breaching Party shall be entitled to
appropriate equitable relief in addition to whatever remedies it might have at
law and to be indemnified by the breaching Party from any loss or harm,
including without limitation, attorney’s fees, in connection with any breach or
enforcement of the breaching Party’s obliga­tions hereunder or the unauthorized
use or release of any such Proprietary Information.  Each Party will notify the other Party in
writing immediately upon the occurrence of any unauthorized release or other
breach of which it is aware.

SECTION 11:  GENERAL PROVISIONS

 11.1        Patient
Records.  Any and all patient records
and charts produced as a result of either party’s performance under this
Agreement shall be and remain the property of 
MIBSPC and/or LHH.

 11.2        Government
Access to Books and Records.  For the
purpose of implementing Section 1861(v)(1)(I) of the Social Security Act
(42 U.S.C. § 1395x(v)(1)(I)), iVOW shall, until the expiration of four (4)
years after the furnishing of services pursuant to this Agreement, upon written
request, make available to the Secretary of the U.S. Department of Health and
Human Services (HHS) or to the Comptroller General of the United States, or to
their duly authorized representatives, this Agreement and such books, documents
and records that are necessary to certify the nature and extent of services and
costs under this Agreement and, if iVOW carries out any of its duties under
this Agreement through a subcontract with a related organization with a value
of or cost of $10,000 or more over a twelve-month period, such subcontract
shall require the related organization to provide the HHS Secretary or the
Comptroller General or their duly authorized representatives, the subcontract,
and such books, documents and records that are necessary to certify the nature
and extent of such costs.

11.3           Patient Care. 
Nothing in this Agreement shall dictate how MIBSPC or LHH or any
physician or any clinician shall practice medicine, deliver patient care, or
exercise clinical or medical judgment. 
LHH, MIBSPC and the patient’s physicians shall have complete control over
the diagnosis and treatment of all Program Patients.  iVOW does not practice medicine and accepts
and desires no role explicit or implicit in the clinical practice of medicine
per se performed by any of the Physicians, Clinicians, or other  the clinical practitioners.

11.4         Relationship of the Parties.  This Agreement does not constitute either
Party hereto as the agent, legal representative, partner or joint venture of
the other Party and neither Party hereto is granted any right or authority to
assume or create any obligation for or on behalf of, or in the name of, or in
any way to bind the other without the specific written consent of the other.

11.5         Dispute Resolution.  If any dispute, controversy or claim arises
out of this Agreement, the parties shall first use their good faith efforts to
resolve the dispute.  In the event of
such a dispute, either 

 

17

party may notify the other
that a dispute exists and, within ten (10) days, the parties shall meet and use
best efforts to resolve the dispute.  If
the parties are unable to resolve the dispute, the matter shall be submitted the American Health Lawyers Association
(“AHLA”) Dispute Resolution Service utilizing three (3) arbitrator(s) who shall
be chosen from a list of arbitrators maintained by the AHLA and are mutually
acceptable to both parties.  In the event
mutually acceptable arbitrators cannot be selected, the Parties will utilize
the standard AHLA procedures for the selection of arbitrators.  Arbitration shall commence within thirty (30)
days of notice and shall take place at a mutually convenient setting in the
County of New York, New York, unless otherwise agreed by the parties.  The costs of arbitration, excluding each
party’s attorney, experts and witness fees, shall be shared equally by each
party to the arbitration.  Each party
shall be responsible for paying the costs of its own attorneys, experts, and
witnesses.  A decision of the arbitrators
shall be final and binding upon the parties and may be reduced to judgment and
filed and enforced in any court of appropriate jurisdiction.  The parties agree that the arbitrators shall
not be authorized to award punitive changes.

11.6         Successors and Assigns.  This Agreement shall inure to the benefit of,
and be binding upon, the respective successors and assigns of the Parties
hereto.

11.6.1  This agreement is not assignable without
prior written consent of the other Party, with the exception of an assignment
by iVOW to an entity directly owned or controlled by, or which owns or
controls, or which is under the common ownership or control of iVOW.  Additionally, there is an exception of an
assignment by LHH or MIBSPC to an entity directly owned or controlled by, or
which owns or controls, or which is under the common ownership or control of
LHH or MIBSPC.  Notice shall be provided
to the other Party with regard to such permitted assignments.

11.7           Notices.  All
notices and other communications under this Agreement shall be given in writing
and shall be deemed duly given when delivered, if delivered in person, upon
receipt if receipted overnight mail,  or
four (4) days after being deposited, with first class postage thereon prepaid,
in the U.S. mail if mailed by certified mail, return receipt requested,
addressed as follows:

 

	
  If to iVOW:

  	
   

  	
  iVOW, Inc.

  	
   

  	
   

  	
   

  	
   

  
	
   

  	
   

  	
  2101 Faraday Avenue

  	
   

  	
   

  	
   

  	
   

  
	
   

  	
   

  	
  Carlsbad, California 92008

  	
   

  	
   

  	
   

  
	
   

  	
   

  	
  Attention:

  	
  Michael H. Owens, M.D.,
  MPH, FACPE, CPE

  	
   

  	
   

  
	
   

  	
   

  	
   

  	
  President and CEO

  	
   

  	
   

  	
   

  
	
   

  	
   

  	
   

  	
   

  	
   

  	
   

  	
   

  
	
  If to LHH:

  	
   

  	
  Lenox Hill Hospital

  	
   

  	
   

  	
   

  
	
   

  	
   

  	
  100
  East 77th Street

  	
   

  	
   

  	
   

  
	
   

  	
   

  	
  New
  York, New York 10021

  	
   

  	
   

  
	
   

  	
   

  	
  Attention:

  	
  Mr.
  Philip P. Rosenthal

  	
   

  	
   

  	
   

  
	
   

  	
   

  	
   

  	
  Vice
  President, Operations

  	
   

  	
   

  
	
   

  	
   

  	
   

  	
   

  	
   

  	
   

  	
   

  
	
  If to
  MIBSPC

  	
  Manhattan
  Minimally Invasive & Bariatric Surgery, P.C.

  	
   

  	
   

  
	
   

  	
   

  	
  100
  East 77th Street

  	
   

  	
   

  	
   

  	
   

  
	
   

  	
   

  	
  New
  York, New York 10021

  	
   

  	
   

  	
   

  
	
   

  	
   

  	
  Attention:

  	
  Mitchell
  Roslin, M.D.

  	
   

  	
   

  	
   

  
	
   

  	
   

  	
   

  	
  President
  MIBSPC

  	
   

  	
   

  	
   

  
	
   

  	
   

  	
   

  	
  Chief
  Obesity Program at LHH

  	
   

  	
   

  
								

 

 

18

 

The Parties acknowledge and agree that proof of such
mailing shall constitute proof of receipt. 
The Parties shall be responsible for notifying each other promptly in
writing of any change of address.

11.8         Entire Agreement.  This Agreement contains the entire agreement
between the Parties hereto with regard to the subjects hereof and supersedes
all prior agreements and understandings both written and oral.  Each Party to this Agreement acknowledges
that no representations, inducements, promises, or agreements, oral or
otherwise, have been made by either Party, or anyone acting on behalf of either
Party, which are not embodied herein, and that no other agreement, statement,
or promise not contained in this Agreement shall be valid or binding. This
Agreement may not be modified orally or in any other manner except by an
agreement in writing signed by all Parties or their respective successors in
interest.

11.9         Counterparts.  This Agreement may be executed in several
counterparts, each of which shall be an original, but all of which shall
constitute but one and the same instrument.

11.10       Severability.  Nothing contained in this Agreement shall be
construed to require the commission of an act contrary to law, and whenever
there is any conflict between any provision of this Agreement and any statute,
law, ordinance or regulation, the latter shall prevail.  In such event, and in any case in which any
provision of this Agreement is determined to be in violation of a statute, law,
ordinance or regulation, the affected provision(s) shall be limited only to the
extent necessary to bring it within the requirements of the law and, insofar as
possible under the circumstances, to carry out the purposes of this
Agreement.  The other provisions of this
Agreement shall remain in full force and effect, and the invalidity or
unenforceability of any provision hereof shall not affect the validity and
enforceability of the other provisions of this Agreement, nor the availability
of all remedies in law or equity to the Parties with respect to such other
provisions.

11.11       Contract Modifications for Prospective
Legal Events.  In the event
(a) any state or federal laws or regulations, now existing or enacted or
promulgated after the effective date of this Agreement, are interpreted by
judicial decision, a regulatory agency or legal counsel of all Parties in such
a manner as to indicate that the structure of this Agreement may be in
violation of such laws or regulations, or (b) a material change in
circumstances occurs which requires a change in the relationship between LHH,
MIBSPC and iVOW, then LHH, MIBSPC and iVOW shall negotiate with each other in
good faith to amend this Agreement, to the maximum extent possible, to preserve
the underlying economic and financial arrangements between LHH, MIBSPC and
iVOW.  Until the earlier to occur of one
year following such change of law or circumstances or the Parties’ reasonable
determination that they are unable to restructure their relationship in a
manner that complies with applicable law, no Party shall negotiate with any
other person with respect to entering or creating any arrangements involving
the subject matter hereof unless the Party first obtains the approval of the
other Parties hereto.  If an amendment is
not possible, any Party shall have the right to terminate this Agreement upon
thirty (30) days’ written notice to the other Parties.

11.12       Force Majeure.  If any Party fails to perform any such obligations
under this Agreement due to any cause beyond the reasonable control of such
Party, including, but not limited to, an act of God, act or omission of civil
or military authorities of the state in which LHH is located or the United
States of America, fire, strike, flood, riot, delay of transportation, or the
inability due to the aforementioned causes to obtain necessary labor, material
or facilities, such Party will not be deemed liable under this Agreement for
failing to fulfill such obligations.

11.13       Governing Law.  This Agreement shall be governed by and
construed in accordance with the laws of the State of New York (without
reference to conflicts of law principles).

 

19

 

11.14       Headings.  Headings or titles of the sections hereof are
for convenience only and shall not be construed to modify or otherwise affect
the terms hereof.

11.15       Interpretation. Each Party to this
Agreement acknowledges that it has been represented by counsel in connection
with this Agreement and the transactions contemplated by this Agreement.

11.16       Jurisdiction and Venue.  The proper venue for any suit, action or
legal proceeding arising out of or relating to this Agreement shall be brought
in New York, New York.

11.17       Independent Contractor.  Neither LHH, MIBSPC or any of the physicians
or Clinicians providing services at the Program are or shall be an employee,
agent or servant of iVOW; instead LHH, MIBSPC and such physicians/Clinicians
are independent contractors who are providing services on a fee for service
basis to Program patients or employees of LHH or MIBSPC.  Furthermore, iVOW is not and shall not be an
employee, agent, servant of LHH or MIBSPC or such physicians or clinicians; instead
it is an independent contractor providing administrative services to LHH and
MIBSPC on a fee for service basis.

11.18       Ethics.  iVOW agrees not to advertise, disclose, or
otherwise discuss this Agreement and its business relationship with LHH, MIBSPC
and/or their affiliates except as otherwise herein specified without prior
written consent of LHH’s Chief Operating Officer or VP of Operations and/or the
President of MIBSPC.  Any violation of
this provision shall be considered a material breach of the Agreement,
conferring on LHH and MIBSPC the right to cancel this Agreement immediately
without further obligation to iVOW and to seek any other legal recourse
available to them.

11.18.1   LHH and MIBSPC agree not to advertise,
disclose, or otherwise discuss this Agreement and its business relationship
with iVOW and/or its affiliates except as otherwise herein specified without
prior written consent of iVOW’s President and/or Chief Executive Officer.  Any violation of this provision shall be
considered a material breach of the Agreement, conferring on iVOW the right to
cancel this Agreement immediately without further obligation to  LHH and/or MIBSPC  and to seek any other legal recourse
available to it.

 

20

 

IN WITNESS WHEREOF, the parties
have executed this Bariatric Administrative Services Agreement as of the first
date referenced above.

 

	
  For CLIENTS:

  	
   

  	
  For CONTRACTOR:

  	
   

  
	
   

  	
   

  	
   

  	
   

  
	
   

  	
   

  	
   

  	
   

  
	
  By:

  	
  /s/ Mitchell Roslin

  	
   

  	
  By: 

  	
  /s/ Michael H. Owens 

  	
   

  
	
  Mitchell Roslin, MD

  	
   

  	
  Michael. H. Owens, MD,
  MPH, FACPE, CPE 

  	
   

  
	
  Title: President MIBSPC 
  

  	
   

  	
  Title: President and CEO
  IVOW, Inc.

  	
   

  
	
  Chief Obesity Program

  	
   

  	
   

  	
   

  
	
  at Lenox Hill Hospital

  	
   

  	
   

  	
   

  
	
   

  	
   

  	
   

  	
   

  
						

 

 

21

 

 

EXHIBIT A:

LHH—EMPLOYED
PERSONNEL AND DESIGNATED MEDICAL DIRECTOR APPOINTEE

LHH and MIBSPC will ensure
the employ of the following staff consistent with Section 4, and its respective
subsection 4.4.  Consistent with
subsection 4.4.1, LHH and MIBSPC shall also appoint a Medical Director, who may
not be an employee, but for whom LHH and/or MIBSPC will bear all expenses to
retain.  The FTEs described at start up
and the incremental increases thereafter are consistent with the “Blueprint”
submitted to  LHH and MIBSPC.  Not incorporated herein is the inclusion of
acute care nursing hours attributed to incremental increases in caseload.

 

Advanced Practice Clinician
-    ***    at Program start

Receptionist —    ***   
at Program start, then increases based on an incremental caseload

Customer Service
Representative -    ***    at start-up, then increases
based on incremental caseload

Registered Dietician -    ***   
at Program start, then increases based on an incremental caseload

Patient Educator -    ***   
at Program start

Medical Director - A Medical
Director shall be so named, consistent with Section 4 the Bariatric
Administrative Services Agreement.

**Registered Nurse -    ***   
at Program start

 

**Placement
of a Registered Nurse employed by LHH or MIBSPC should be negotiated based on
Program features.  If, for example,
clinical services are rendered at the MIBSPC Program site, then MIBSPC would
likely employ an appropriate clinician to render such services.

***Portions of this page have been omitted pursuant to a request for
Confidential Treatment filed separately with the Commission.

 

1

EXHIBIT B:

LHH BLUEPRINT delivered to
Clients on March 28,2005 by Fed Ex

 

 

[Diagram]

 

 

2

EXHIBIT C:

COMMUNITY
RELATIONS AND EDUCATIONAL PLAN ACTIVITIES:

MIBSPC and LHH and iVOW
shall agree on a number of marketing initiatives as outlined under Subsection
6.1 of Section 6 of the Bariatric Administrative Services Agreement. Provided
below are a listing of endeavors for discussion:

The community relations and
education plan shall include some or all of the following activities:

   ***   

   ***   

   ***   

   ***   

   ***   

   ***   

   ***   

   ***   

***Portions of this page have been omitted pursuant to a request for
Confidential Treatment filed separately with the Commission.

 

3

 

EXHIBIT D:

TRAINING
MATERIALS

MIBSPC, LHH and iVOW will
agree on a number of training initiatives as outlined under Subsection 6.9 of
Section 6.0 of the Bariatric Administrative Services Agreement, with further
and specific mutual agreement by iVOW and MIBSPC and LHH.  Provided below are a listing of training
materials which iVOW shall provide MIBSPC and LHH’s staff for their training:

•             ***   

•             ***   

•             ***   

•                  ***   

 

***Portions of this page have been omitted pursuant to a request for
Confidential Treatment filed separately with the Commission.

 

4

EXHIBIT E:

LHH BUSINESS
ASSOCIATE AGREEMENT

 

5

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