Document:

Exhibit 4.1

Exhibit 4.1

AMENDMENT NO. 1 TO RIGHTS AGREEMENT

This Amendment No. 1 to Rights Agreement (this “Amendment”), dated as of March 10, 2010, is entered into
by Allied Healthcare International Inc., a New York corporation (the “Company”), and Computershare Trust
Company, N.A., a federally-charted trust company, as rights agent (the “Rights Agent”), and amends the Rights
Agreement, dated as of April 2, 2009, between the Company and the Rights Agent (the “Rights Agreement”).

W I T N E S S E T H:

WHEREAS, on April 2, 2009, the Company and the Rights Agent entered into the Rights Agreement.

WHEREAS, the Company and the Rights Agent wish to amend the Rights Agreement in the manner hereinafter specified.

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

1. Amendments.

(a) Section 1(w) of the Rights Agreement is hereby amended by substituting “April 1, 2012” for “April 1,
2019” in the one place in Section 1(w) in which April 1, 2019 appears.

(b) Section 21 of the Rights Agreement is hereby amended by adding the words “, in the event that the
Rights Agent or one of its Affiliates is not also the transfer agent for the Company,” immediately before the
word “to” and after the word “and” in the first sentence thereof.

(c) Section 34 of the Rights Agreement is hereby amended by adding the following sentence at the end of
such section: “A signature to this Agreement transmitted electronically shall have the same authority, effect
and enforceability as an original signature.”

2. No Other Changes. All other provisions of the Rights Agreement shall remain unchanged.

3. Governing Law. The validity, enforceability, interpretation and performance of this Amendment shall be
governed by and construed in accordance with the laws of the State of New York applicable to contracts made and to be
performed entirely within such state.

4. Counterparts. This Amendment may be executed in any number of counterparts, each of such counterparts
shall for all purposes be deemed to be an original, and all such counterparts shall together constitute one and the
same instrument. A signature to this Amendment transmitted electronically shall have the same authority, effect and
enforceability as an original signature.

 

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IN WITNESS WHEREOF, the parties hereto have executed this Amendment as of the date first written above.

ALLIED HEALTHCARE

INTERNATIONAL INC.

By: /s/Sandy Young     
                   
  

Name: Alexander S Young

Title: CEO

COMPUTERSHARE TRUST COMPANY,

N.A., as Rights Agent

By: /s/ Dennis V. Maccia     
                   
  

Name: Dennis V. Maccia

Title: Manager

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2exv10w33

Exhibit 10.33

FIRST AMENDMENT TO EMPLOYMENT AGREEMENT

(Non CEO)

     This First Amendment to Employment Agreement is executed as of the 1st day of July, 2009, by
and between TomoTherapy Incorporated, a Wisconsin corporation (the “Company”), and
                    , an individual (“Employee”), and amends that certain Employment Agreement
between the Employee and Company entered into effective November 5, 2008.

RECITALS

     The Company wishes to revise the provision concerning termination pursuant to a change of
control, and the Employee agrees to such revised provisions as set forth herein.

     NOW, THEREFORE, in consideration of the premises and the mutual agreements and covenants
contained herein, and for other good and valuable consideration, the receipt and sufficiency of
which is hereby acknowledged by the Company and Employee,

     IT IS HEREBY AGREED AS FOLLOWS:

     1. Article 3.2(d) is deleted in its entirety and replaced by the following:

          (d) Termination Pursuant to a Change of Control. If, within three (3) months before or
twenty four (24) months following a Change of Control, the Company terminates Employee’s employment
without Cause pursuant to Section 3.1(a), Employee terminates his employment for Good Reason
pursuant to Section 3.1(b), or upon expiration of this Agreement following the company’s notice of
its intention not to renew pursuant to Section 1.1, Employee shall have no further rights against
the Company hereunder, except the Company will, subject to 

Section 3.2(g):

          (i) pay the Employee the Accrued Obligations;

          (ii) subject to Section 3.2(f), pay Employee a lump-sum severance payment (the
“Severance Payment”) 53 days following the termination of employment, in an amount equal to
the sum of: (a) 2.0 times Employee’s annual base salary as in effect on the date of
termination; and (b) 2.0 times the greater of (x) the average of the two annual bonuses paid
to Employee for the two years preceding the year in which such termination occurs, provided
that if the Employee was not employed for the period required to be eligible for two prior
annual bonuses, then the amount in this subparagraph (b)(x) shall be the amount of the annual
bonus, if any, received for the year prior to the year in which termination of the employment
occurred, or (y) the target bonus for the year in which such termination occurs; provided
such lump sum shall be reduced by the amount of any lump sum payable under Section
3.2(a)(ii).

          (iii) subject to Section 3.2(f), pay the COBRA premium (and up to the
equivalent in cost to the Company for premiums under an individual plan after COBRA rights
expire) for health care coverage for Employee and Employee’s eligible dependents, as
applicable and to the extent eligible, for the 24 month period immediately following the date
of such termination of Employee’s employment, provided that Employee properly elects COBRA
continuation coverage for the initial 18 months after the date of Employee’s termination and
is able to convert to an individual plan for the remaining 6 months, except that payment of
such premiums shall cease if and when the Employee (and Employee’s eligible dependents)
become eligible for medical, hospital and health coverage under a plan of a subsequent
employer; and

          (iv) subject to Section 3.2(f), pay up to $10,000 for outplacement services,
provided such payment shall be reduced by the amount of any payment under Section 3.2(a)(iv),
and provided further that such services are used within two years of termination of
employment.

     2. All other provisions of the Employment Agreement are not altered by this First Amendment
and remain in full force and effect.

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

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	EMPLOYEE:	 	 	 	COMPANY:	 	 
	 
	 	 	 	 	 	 	 	 
	 	 	 	 	TomoTherapy Incorporated	 	 
	 	 	 	 	 	 	 
	 
	 	 	 	 	 	 	 	 
	 

	 	 	 	By:	 	 	 	 
	 

	 	 
	 	 	 	 

	 	 

2exv10w38

Exhibit 10.38

FIRST AMENDMENT TO EMPLOYMENT AGREEMENT

(Non CEO)

     This First Amendment to Employment Agreement is executed as of the 1st day of July, 2009, by
and between TomoTherapy Incorporated, a Wisconsin corporation (the “Company”), and Rafael
L. Vaello, an individual (“Employee”), and amends that certain Employment Agreement between
the Employee and Company entered into effective November 5, 2008.

RECITALS

     The Company wishes to revise the provision concerning termination pursuant to a change of
control, and the Employee agrees to such revised provisions as set forth herein.

     NOW, THEREFORE, in consideration of the premises and the mutual agreements and covenants
contained herein, and for other good and valuable consideration, the receipt and sufficiency of
which is hereby acknowledged by the Company and Employee,

     IT IS HEREBY AGREED AS FOLLOWS:

     1. The first sentence of Article 1.1 is deleted in its entirety and replaced by the following:

     The Company employs Employee, and Employee accepts employment by the Company, for the
period commencing on the date hereof and ending on March 31, 2010, subject to earlier
termination as hereinafter set forth in Article III (the “Employment Term”).

     2. Article 3.2(d) is deleted in its entirety and replaced by the following:

          (d) Termination Pursuant to a Change of Control. If, within three (3) months before or
twenty four (24) months following a Change of Control, the Company terminates Employee’s employment
without Cause pursuant to Section 3.1(a), Employee terminates his employment for Good Reason
pursuant to Section 3.1(b), or upon expiration of this Agreement following the company’s notice of
its intention not to renew pursuant to Section 1.1, Employee shall have no further rights against
the Company hereunder, except the Company will, subject to 

Section 3.2(g):

          (v) pay the Employee the Accrued Obligations;

          (vi) subject to Section 3.2(f), pay Employee a lump-sum severance payment (the
“Severance Payment”) 53 days following the termination of employment, in an amount equal to
the sum of: (a) 2.0 times Employee’s annual base salary as in effect on the date of
termination; and (b) 2.0 times the greater of (x) the average of the two annual bonuses paid
to Employee for the two years preceding the year in which such termination occurs, provided
that if the Employee was not employed for the period required to be eligible for two prior
annual bonuses, then the amount in this subparagraph (b)(x) shall be the amount of the annual
bonus, if any, received for the year prior to the year in which termination of the employment
occurred, or (y) the target bonus for the year in which such termination occurs; provided
such lump sum shall be reduced by the amount of any lump sum payable under Section
3.2(a)(ii).

          (vii) subject to Section 3.2(f), pay the COBRA premium (and up to the
equivalent in cost to the Company for premiums under an individual plan after COBRA rights
expire) for health care coverage for Employee and Employee’s eligible dependents, as
applicable and to the extent eligible, for the 24 month period immediately following the date
of such termination of Employee’s employment, provided that Employee properly elects COBRA
continuation coverage for the initial 18 months after the date of Employee’s termination and
is able to convert to an individual plan for the remaining 6 months, except that payment of
such premiums shall cease if and when the Employee (and Employee’s eligible dependents)
become eligible for medical, hospital and health coverage under a plan of a subsequent
employer; and

          (viii) subject to Section 3.2(f), pay up to $10,000 for outplacement services,
provided such payment shall be reduced by the amount of any payment under Section 3.2(a)(iv),
and provided further that such services are used within two years of termination of
employment.

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     3. All other provisions of the Employment Agreement are not altered by this First Amendment
and remain in full force and effect.

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

	 	 	 	 	 	 	 	 	 
	EMPLOYEE:	 	 	 	COMPANY:	 	 
	 
	 	 	 	 	 	 	 	 
	Rafael L. Vaello	 	 	 	TomoTherapy Incorporated	 	 
	 
	 	 	 	 	 	 	 	 
	 

	 	 	 	By:	 	 	 	 
	 

	 	 
	 	 	 	 

	 	 

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