Document:

Exhibit 4.3

 

EIGHTH SUPPLEMENTAL INDENTURE, dated as of August 22, 2013 (this “Supplemental Indenture”), among  Radiation Therapy Services, Inc., a Florida corporation (the “Company,” which term includes its successors and assigns), each other then existing Guarantor under the Indenture referred to below (the “Guarantors”), and Wells Fargo Bank, National Association, as trustee (“the Trustee”) under the Indenture referred to below.

 

WITNESSETH:

 

WHEREAS, the Company, any Guarantors and the Trustee have heretofore become parties to an Indenture, dated as of April 20, 2010, as supplemented by the First Supplemental Indenture, dated as of June 24, 2010, as further supplemented by the Second Supplemental Indenture, dated as of September 29, 2010, as further supplemented by the Third Supplemental Indenture, dated as of March 1, 2011, as further supplemented by the Fourth Supplemental Indenture, dated as of March 30, 2011, as further supplemented by the Fifth Supplemental Indenture, dated as of September 30, 2011, as further supplemented by the Sixth Supplemental Indenture dated as of January 25, 2012, as further supplemented by the Seventh Supplemental Indenture dated as of May 10, 2012 and as otherwise amended, supplemented, waived or modified from time to time in accordance with the terms thereof, the “Indenture”), providing for the issuance of 97/8% Senior Subordinated Notes due 2017 of the Company (the “Notes”);

 

WHEREAS, Section 9.01 of the Indenture provides that the Company, the Guarantors and the Trustee may supplement the Indenture to provide for the issuance of Additional Notes; and

 

WHEREAS, the Company wishes to issue $3,800,000 in aggregate principal amount of 97/8% Senior Subordinated Notes due 2017.

 

NOW, THEREFORE, in consideration of the foregoing and for other good and valuable consideration, the receipt of which is hereby acknowledged,  the Company, the Guarantors and the Trustee mutually covenant and agree for their benefit and the benefit of the Holders of the Notes as follows:

 

1.     Defined Terms.  As used in this Supplemental Indenture, terms defined in the Indenture or in the preamble or recital hereto are used herein as therein defined.  The words “herein,” “hereof’ and “hereby” and other words of similar import used in this Supplemental Indenture refer to this Supplemental Indenture as a whole and not to any particular Section hereof.

 

2.     Additional Notes.  The $3,800,000 in aggregate principal amount of 97/8% Senior Subordinated Notes due 2017 as Additional Notes are hereby issued under the Indenture.

 

3.     Governing Law.  THIS SUPPLEMENTAL INDENTURE SHALL BE GOVERNED BY AND CONSTRUED IN ACCORDANCE WITH THE LAWS OF THE STATE OF NEW YORK.  THE TRUSTEE, THE COMPANY, ANY OTHER OBLIGOR IN RESPECT OF THE NOTES AND (BY THEIR ACCEPTANCE OF THE NOTES) THE HOLDERS AGREE TO SUBMIT TO THE JURISDICTION OF ANY UNITED STATES FEDERAL OR STATE COURT LOCATED IN THE BOROUGH OF MANHATTAN, IN THE

 

 

CITY OF NEW YORK IN ANY ACTION OR PROCEEDING ARISING OUT OF OR RELATING TO THIS SUPPLEMENTAL INDENTURE.

 

4.     Ratification of Indenture; Supplemental Indentures Part of Indenture.  Except as expressly amended hereby, the Indenture is in all respects ratified and confirmed and all the terms, conditions and provisions thereof shall remain in full force and effect.  This Supplemental Indenture shall form a part of the Indenture for all purposes, and every Holder of Notes heretofore or hereafter authenticated and delivered shall be bound hereby.  The Trustee makes no representation or warranty as to the validity or sufficiency of this Supplemental Indenture or as to the accuracy of the recitals to this Supplemental Indenture.

 

5.     Counterparts.  The parties hereto may sign one or more copies of this Supplemental Indenture in counterparts, all of which together shall constitute one and the same agreement.

 

6.     Headings.  The Section headings herein are for convenience of reference only and shall not be deemed to alter or affect the meaning or interpretation of any provisions hereof.

 

 

IN WITNESS WHEREOF, the parties hereto have caused this Supplemental Indenture to be duly executed as of the date first above written.

 

	
 
    	
RADIATION THERAPY SERVICES, INC.
    
	
 
    	
 
    
	
 
    	
 
    
	
 
    	
By:
    	
/s/ Bryan J. Carey
    
	
 
    	
Name: Bryan J. Carey
    
	
 
    	
Title: Chief Financial Officer
    

 

Signature Page to Supplemental Indenture

 

 

	
 
    	
RADIATION THERAPY SERVICES   HOLDINGS, INC.
    
	
 
    	
 
    
	
 
    	
 
    
	
 
    	
By:
    	
/s/ Bryan J. Carey
    
	
 
    	
Name: Brian J. Carey
    
	
 
    	
Title: Chief Financial Officer
    

 

Signature Page to Supplemental Indenture

 

 

	
 
    	
21ST CENTURY ONCOLOGY OF ALABAMA, LLC
    
	
 
    	
ARIZONA RADIATION THERAPY MANAGEMENT SERVICES,   INC.
    
	
 
    	
CALIFORNIA RADIATION THERAPY MANAGEMENT   SERVICES, INC.
    
	
 
    	
21ST CENTURY ONCOLOGY OF JACKSONVILLE, LLC
    
	
 
    	
DEVOTO CONSTRUCTION OF SOUTHWEST FLORIDA, INC.
    
	
 
    	
RADIATION THERAPY SERVICES INTERNATIONAL, INC.
    
	
 
    	
21ST CENTURY ONCOLOGY MANAGEMENT SERVICES, INC.
    
	
 
    	
JACKSONVILLE RADIATION THERAPY SERVICES, LLC
    
	
 
    	
FINANCIAL SERVICES OF SOUTHWEST FLORIDA, LLC
    
	
 
    	
21ST CENTURY ONCOLOGY, LLC
    
	
 
    	
21ST CENTURY ONCOLOGY OF HARFORD COUNTY,   MARYLAND L L C
    
	
 
    	
BERLIN RADIATION THERAPY TREATMENT CENTER,   LLC
    
	
 
    	
21ST CENTURY ONCOLOGY OF PRINCE GEORGES   COUNTY, MARYLAND, LLC
    
	
 
    	
MARYLAND RADIATION THERAPY MANAGEMENT   SERVICES, LLC
    
	
 
    	
AMERICAN CONSOLIDATED TECHNOLOGIES, L.L.C.
    
	
 
    	
MICHIGAN RADIATION THERAPY MANAGEMENT   SERVICES, INC.
    
	
 
    	
NEVADA RADIATION THERAPY MANAGEMENT   SERVICES, INCORPORATED
    
	
 
    	
21ST CENTURY ONCOLOGY OF NEW JERSEY, INC.
    
	
 
    	
NEW YORK RADIATION THERAPY MANAGEMENT   SERVICES, LLC
    
	
 
    	
NORTH CAROLINA RADIATION THERAPY MANAGEMENT   SERVICES, LLC
    
	
 
    	
21ST CENTURY ONCOLOGY OF SOUTH CAROLINA, LLC
    
	
 
    	
WEST VIRGINIA RADIATION THERAPY SERVICES, INC.
    
	
 
    	
PHOENIX MANAGEMENT COMPANY, LLC
    

 

Signature Page to Supplemental Indenture

 

 

	
 
    	
CAROLINA REGIONAL CANCER CENTER, LLC
    
	
 
    	
ATLANTIC UROLOGY CLINICS, LLC
    
	
 
    	
DERM-RAD INVESTMENT COMPANY, LLC
    
	
 
    	
21ST CENTURY ONCOLOGY OF PENNSYLVANIA, INC.
    
	
 
    	
GETTYSBURG RADIATION, LLC
    
	
 
    	
CAROLINA RADIATION AND CANCER TREATMENT   CENTER, LLC
    
	
 
    	
21ST CENTURY ONCOLOGY OF KENTUCKY, LLC
    
	
 
    	
NEW ENGLAND RADIATION THERAPY MANAGEMENT   SERVICES, INC.
    
	
 
    	
RADIATION THERAPY SCHOOL FOR RADIATION   THERAPY TECHNOLOGY, INC.
    
	
 
    	
AURORA TECHNOLOGY DEVELOPMENT, LLC
    
	
 
    	
21ST CENTURY ONCOLOGY SERVICES, INC.
    
	
 
    	
GOLDSBORO RADIATION THERAPY SERVICES, INC.
    
	
 
    	
AHLC, LLC
    
	
 
    	
ASHEVILLE CC, LLC
    
	
 
    	
SAMPSON ACCELERATOR, LLC
    
	
 
    	
SAMPSON SIMULATOR, LLC
    
	
 
    	
 
    
	
 
    	
 
    
	
 
    	
By:
    	
/s/ Bryan J. Carey
    
	
 
    	
 
    
	
 
    	
Name: Bryan J. Carey
    
	
 
    	
Title: Chief Financial Officer
    

 

Signature Page to Supplemental Indenture

 

 

	
 
    	
WELLS FARGO BANK, NATIONAL ASSOCIATION, as   Trustee
    
	
 
    	
 
    
	
 
    	
 
    
	
 
    	
By:
    	
/s/ Stefan Victory
    
	
 
    	
Name:
    	
Stefan Victory
    
	
 
    	
Title:
    	
Vice President
    

 

Signature Page to Supplemental IndentureExhibit 4.4

 

NINTH SUPPLEMENTAL INDENTURE

 

This Ninth Supplemental Indenture, dated as of October 30, 2013 (this “Ninth Supplemental Indenture”), is by and among OnCure Holdings, Inc., a Delaware corporation (“OnCure”), the subsidiaries of OnCure listed on the signature pages hereto (the “OnCure Guarantors”), Southern New England Regional Cancer Center, LLC, a Rhode Island limited liability company (the “Rhode Island Guarantor”) and Palms West Radiation Therapy, L.L.C., a Florida limited liability company  (the “Florida Guarantor” and, tougher with the Rhode Island Guarantor, the OnCure Guarantors and OnCure, the “New Guarantors”), Radiation Therapy Services, Inc., a Florida corporation (the “Company,” which term includes its successors and assigns), each other then existing Guarantor under the Indenture referred to below (the “Guarantors”), and Wells Fargo Bank, National Association, as trustee (“Trustee”) under the Indenture referred to below.  Capitalized terms used and not defined herein shall have the same meanings given in the Indenture unless otherwise indicated.

 

W I T N E S S E T H:

 

WHEREAS, the Company, the Guarantors and the Trustee have heretofore executed and delivered an Indenture, dated as of April 20, 2010 (as supplemented by the First Supplemental Indenture, dated as of June 24, 2010, as further supplemented by the Second Supplemental Indenture, dated as of September 29, 2010, as further supplemented by the Third Supplemental Indenture, dated as of March 1, 2011, as further supplemented by the Fourth Supplemental Indenture, dated as of March 30, 2011, as further supplemented by the Fifth Supplemental Indenture, dated as of September 30, 2011, as further supplemented by the Sixth Supplemental Indenture, dated as of January 26, 2012, as further supplemented by the Seventh Supplemental Indenture, dated as of May 10, 2012, as further supplemented by the Eight Supplemental Indenture, dated as of August 22, 2013 and as otherwise amended, supplemented, waived or modified, the “Indenture”), providing for the issuance of 9 7/8% Senior Subordinated Notes due 2017 of the Company (the “Notes”);

 

WHEREAS, pursuant to Section 10.03 of the Indenture, each Person that becomes obligated to provide a Guarantee pursuant to Section 4.16 of the Indenture must execute and deliver to the Trustee a supplemental indenture making such Person a party to the Indenture, along with a notation of such Guarantee in the form included as Exhibit E to the Indenture;

 

WHEREAS, pursuant to Section 4.16 of the Indenture, the Company will not permit any of its Restricted Subsidiaries (other than Foreign Subsidiaries) to guarantee Indebtedness under the Credit Agreement, unless such Restricted Subsidiary executes and delivers to the Trustee a supplemental indenture, providing a guarantee of payment of the Notes by such Restricted Subsidiary;

 

WHEREAS, the New Guarantors are Restricted Subsidiaries of the Company and have guaranteed or will guarantee Indebtedness under the Credit Agreement;

 

 

WHEREAS, pursuant to Section 9.01 of the Indenture, the Trustee, the Company and the Guarantors are authorized to execute and deliver this Ninth Supplemental Indenture to amend the Indenture, without the consent of any Holder; and

 

WHEREAS, by entering into this Ninth Supplemental Indenture, the Company, the Guarantors and the Trustee have consented to amend the Indenture in accordance with the terms and conditions herein.

 

NOW, THEREFORE, in consideration of the foregoing and for other good and valuable consideration, the receipt of which is hereby acknowledged, the New Guarantors, the Guarantors, the Company and the Trustee mutually covenant and agree for the equal and ratable benefit of the Holders of the Notes as follows:

 

Section 1.                                           Agreement to be Bound.  Each of the New Guarantors hereby becomes a party to the Indenture as a Guarantor and as such will have all of the rights and be subject to all of the obligations and agreements of a Guarantor under the Indenture.  Each of the New Guarantors agrees to be bound by all of the provisions of the Indenture applicable to a Guarantor and to perform all of the obligations and agreements of a Guarantor under the Indenture.

 

Section 2.                                           Compliance with and Fulfillment of Condition of Sections 4.16 and 10.03.  The execution and delivery of this Ninth Supplemental Indenture and the Guarantee by each New Guarantor (along with such documentation relating thereto as the Trustee shall require) fulfills the obligations of the Company under Sections 4.16 and 10.03 of the Indenture.

 

Section 3.                                           Ratification of Indenture; Supplemental Indenture Part of Indenture; Trustee’s Disclaimer.  Except as expressly amended hereby, the Indenture is in all respects ratified and confirmed and all the terms, conditions and provisions thereof shall remain in full force and effect.  This Ninth Supplemental Indenture shall form a part of the Indenture for all purposes, and every Holder of Notes heretofore or hereafter authenticated and delivered shall be bound hereby.  The Trustee makes no representation or warranty as to the validity or sufficiency of this Ninth Supplemental Indenture.

 

Section 4.                                           Governing Law.  This Ninth Supplemental Indenture and the Notes shall be governed by and construed in accordance with the laws of the State of New York, as applied to contracts made and performed within the State of New York.

 

Section 5.                                           No Adverse Interpretation of Other Agreements.  This Ninth Supplemental Indenture may not be used to interpret any other indenture, loan or debt agreement of the Company or its Subsidiaries (other than the Indenture).  No such indenture, loan or debt agreement may be used to interpret this Ninth Supplemental Indenture or the Indenture.

 

Section 6.                                           Successors.  This Ninth Supplemental Indenture shall be binding upon and inure to the benefit of the parties hereto and their respective successors and assigns.

 

Section 7.                                           Separability.  Each provision of this Ninth Supplemental Indenture shall be considered separable and if for any reason any provision which is not essential to the effectuation of the basic purpose of this Ninth Supplemental Indenture or the Notes shall be

 

 

invalid, illegal or unenforceable, the validity, legality and enforceability of the remaining provisions shall not in any way be affected or impaired thereby.

 

Section 8.                                           Counterpart Originals.  The parties may sign multiple counterparts of this Ninth Supplemental Indenture.  Each signed counterpart shall be deemed an original, but all of them together represent one and the same agreement.

 

Section 9.                                           Headings, etc.  The headings of the Sections of this Ninth Supplemental Indenture have been inserted for convenience of reference only, are not to be considered a part of this Ninth Supplemental Indenture and shall in no way modify or restrict any of the terms or provisions hereof.

 

* * * * *

 

 

IN WITNESS WHEREOF, the parties hereto have caused this Ninth Supplemental Indenture to be duly executed as of the date first above written.

 

 

	
 
    	
RADIATION   THERAPY SERVICES, INC.
    
	
 
    	
 
    
	
 
    	
 
    
	
 
    	
By:
    	
/s/   Bryan J. Carey
    
	
 
    	
Name:
    	
Bryan   J. Carey
    
	
 
    	
Title:
    	
Chief   Financial Officer
    
	
 
    	
 
    
	
 
    	
 
    
	
 
    	
RADIATION   THERAPY SERVICES HOLDINGS, INC.
    
	
 
    	
 
    
	
 
    	
 
    
	
 
    	
By:
    	
/s/   Bryan J. Carey
    
	
 
    	
Name:
    	
Bryan   J. Carey
    
	
 
    	
Title:
    	
Chief   Financial Officer
    

 

 

	
 
    	
GUARANTORS
    
	
 
    	
 
    
	
 
    	
21ST CENTURY   ONCOLOGY MANAGEMENT SERVICES, INC.
    
	
 
    	
21ST CENTURY   ONCOLOGY OF ALABAMA, LLC
    
	
 
    	
21ST CENTURY   ONCOLOGY OF HARFORD COUNTY MARYLAND, LLC
    
	
 
    	
21ST CENTURY   ONCOLOGY OF JACKSONVILLE, LLC
    
	
 
    	
21ST CENTURY   ONCOLOGY OF KENTUCKY, LLC
    
	
 
    	
21ST CENTURY   ONCOLOGY OF NEW JERSEY, INC.
    
	
 
    	
21ST CENTURY   ONCOLOGY OF PENNSYLVANIA, INC.
    
	
 
    	
21ST CENTURY   ONCOLOGY OF PRINCE GEORGES COUNTY, MARYLAND, LLC
    
	
 
    	
21ST CENTURY   ONCOLOGY OF SOUTH CAROLINA, LLC
    
	
 
    	
21ST CENTURY   ONCOLOGY SERVICES, INC
    
	
 
    	
21ST CENTURY   ONCOLOGY, LLC
    
	
 
    	
AHLC,   LLC
    
	
 
    	
AMERICAN   CONSOLIDATED TECHNOLOGIES, LLC
    
	
 
    	
ARIZONA   RADIATION THERAPY MANAGEMENT SERVICES, INC.
    
	
 
    	
ASHEVILLE   CC, LLC
    
	
 
    	
ATLANTIC   UROLOGY CLINICS, LLC
    
	
 
    	
AURORA   TECHNOLOGY DEVELOPMENT, LLC
    
	
 
    	
BERLIN   RADIATION THERAPY TREATMENT CENTER, LLC
    
	
 
    	
CALIFORNIA   RADIATION THERAPY MANAGEMENT SERVICES, INC.
    
	
 
    	
CAROLINA   RADIATION AND CANCER TREATMENT CENTER, LLC
    
	
 
    	
CAROLINA   REGIONAL CANCER CENTER, LLC
    
	
 
    	
DERM-RAD   INVESTMENT COMPANY, LLC
    
	
 
    	
DEVOTO   CONSTRUCTION OF SOUTHWEST FLORIDA, INC.
    
	
 
    	
FINANCIAL   SERVICES OF SOUTHWEST FLORIDA, LLC
    
	
 
    	
GETTYSBURG   RADIATION, LLC
    

 

 

	
 
    	
GOLDSBORO   RADIATION THERAPY SERVICES, INC.
    
	
 
    	
JACKSONVILLE   RADIATION THERAPY SERVICES, LLC
    
	
 
    	
MARYLAND   RADIATION THERAPY MANAGEMENT SERVICES, LLC
    
	
 
    	
MICHIGAN   RADIATION THERAPY MANAGEMENT SERVICES, INC.
    
	
 
    	
NEVADA   RADIATION THERAPY MANAGEMENT SERVICES, INCORPORATED
    
	
 
    	
NEW   ENGLAND RADIATION THERAPY MANAGEMENT SERVICES, INC.
    
	
 
    	
NEW   YORK RADIATION THERAPY MANAGEMENT SERVICES, LLC
    
	
 
    	
NORTH   CAROLINA RADIATION THERAPY MANAGEMENT SERVICES, LLC
    
	
 
    	
PHOENIX   MANAGEMENT COMPANY, LLC
    
	
 
    	
RADIATION   THERAPY SCHOOL FOR RADIATION THERAPY TECHNOLOGY, INC.
    
	
 
    	
RADIATION   THERAPY SERVICES INTERNATIONAL, INC.
    
	
 
    	
SAMPSON   ACCELERATOR, LLC
    
	
 
    	
SAMPSON   SIMULATOR, LLC
    
	
 
    	
WEST   VIRGINIA RADIATION THERAPY SERVICES, INC.
    
	
 
    	
 
    
	
 
    	
By:
    	
/s/   Bryan J. Carey
    
	
 
    	
Name:
    	
Bryan   J. Carey
    
	
 
    	
Title:
    	
Vice   President
    

 

 

	
 
    	
SOUTHERN NEW ENGLAND   REGIONAL CANCER CENTER, LLC
    
	
 
    	
 
    
	
 
    	
 
    
	
 
    	
By:
    	
/s/   Bryan J. Carey
    
	
 
    	
 
    	
Name:
    	
Bryan   J. Carey
    
	
 
    	
 
    	
Title:
    	
Treasurer
    
	
 
    	
 
    
	
 
    	
 
    
	
 
    	
PALMS   WEST RADIATION THERAPY, L.L.C.
    
	
 
    	
 
    
	
 
    	
 
    
	
 
    	
By:
    	
21ST   CENTURY ONCOLOGY MANAGEMENT SERVICES, INC.
    
	
 
    	
 
    	
Its   Sole Member
    
	
 
    	
 
    	
 
    
	
 
    	
 
    	
 
    
	
 
    	
By:
    	
/s/   Bryan J. Carey
    
	
 
    	
 
    	
Name:
    	
Bryan   J. Carey
    
	
 
    	
 
    	
Title:
    	
Vice   President
    

 

 

	
 
    	
ONCURE   HOLDINGS, INC.
    
	
 
    	
 
    
	
 
    	
 
    
	
 
    	
By:
    	
/s/   Bryan J. Carey
    
	
 
    	
Name:
    	
Bryan   J. Carey
    
	
 
    	
Title:
    	
Chief   Financial Officer
    

 

 

	
 
    	
ONCURE   GUARANTORS
    
	
 
    	
 
    
	
 
    	
ONCURE   MEDICAL CORP.
    
	
 
    	
MANATEE   RADIATION ONCOLOGY, INC.
    
	
 
    	
MISSION   VIEJO RADIATION ONCOLOGY MEDICAL GROUP, INC.
    
	
 
    	
RADIATION   ONCOLOGY CENTER, LLC
    
	
 
    	
U.S.   CANCER CARE, INC.
    
	
 
    	
USCC   FLORIDA ACQUISITION CORP.
    
	
 
    	
USCC   ACQUISITION CORP.
    
	
 
    	
USCC   HEALTHCARE MANAGEMENT CORP.
    
	
 
    	
COASTAL   ONCOLOGY, INC.
    
	
 
    	
FOUNTAIN   VALLEY & ANAHEIM RADIATION ONCOLOGY CENTERS, INC.
    
	
 
    	
SANTA   CRUZ RADIATION ONCOLOGY MANAGEMENT CORP.
    
	
 
    	
MICA   FLO II, INC.
    
	
 
    	
POINTE   WEST ONCOLOGY, LLC
    
	
 
    	
JAXPET,   LLC
    
	
 
    	
JAXPET/POSITECH,   L.L.C.
    
	
 
    	
SARASOTA   COUNTY ONCOLOGY, INC.
    
	
 
    	
VENICE   ONCOLOGY CENTER, INC.
    
	
 
    	
ENGLEWOOD   ONCOLOGY, INC.
    
	
 
    	
CHARLOTTE   COMMUNITY RADIATION ONCOLOGY, INC.
    
	
 
    	
SARASOTA   RADIATION & MEDICAL ONCOLOGY CENTER, INC.
    
	
 
    	
INTERHEALTH   FACILITY TRANSPORT, INC.
    
	
 
    	
 
    
	
 
    	
By:
    	
/s/   Bryan J. Carey
    
	
 
    	
Name:
    	
Bryan   J. Carey
    
	
 
    	
Title:
    	
Vice   President
    

 

 

	
 
    	
WELLS   FARGO BANK, NATIONAL ASSOCIATION, as Trustee
    
	
 
    	
 
    
	
 
    	
 
    
	
 
    	
By:
    	
/s/   Stefan Victory
    
	
 
    	
Name:
    	
Stefan   Victory
    
	
 
    	
Title:
    	
Vice   President

Source: [{"source": "alea-institute/alea-institute/kl3m-data-edgar-agreements/train-00223-of-00352.parquet"}, [{"source": "alea-institute/alea-institute/kl3m-data-edgar-agreements/train-00223-of-00352.parquet"}]]