Document:

exv4w19

Exhibit 4.19

AMENDMENT NO. 2 TO AMENDED AND RESTATED SHAREHOLDERS’ AGREEMENT

     AMENDMENT NO. 2 TO AMENDED AND RESTATED SHAREHOLDERS’ AGREEMENT (this “Amendment”) dated as
of December 7, 2009 (the “Amendment Date”) by and among (1) CICC Sun Company Limited, a company
incorporated under the laws of the British Virgin Islands (“CICC”), (2) Carlyle Asia Growth
Partners III, L.P., a limited partnership formed under the laws of the Cayman Islands (“CAGP”), (3)
CAGP III Co-Investment III, L.P. (“CAGP Co-Invest”, together with CAGP, “Carlyle”), (4) Starr
Investments Cayman II, Inc., a company incorporated under the laws of the Cayman Islands (“Starr”,
together with CICC and Carlyle, the “Investors”), (5) Concord Medical Services Holdings Limited, an
exempted company with limited liability organized and existing under the laws of the Cayman Islands
(the “Company”), and (6) the other parties set forth in the signature pages hereof.

W I T N E S S E T H :

     WHEREAS, the parties hereto entered into an Amended and Restated Shareholders’ Agreement dated
as of October 20, 2008 in relation to the issuance by the Company to each of the Investors of
certain Series B convertible redeemable preferred shares, par value $0.01 per share, of the
Company, which was amended on Novmeber 17, 2009 (the “Agreement”);

     WHEREAS, the parties hereto and thereto desire to amend the Agreement to reflect the changes
set forth herein.

     NOW, THEREFORE, the parties hereto agree as follows:

     Section 1 . Amendment. The Agreement is amended by adding the following Section 7.03(c):

     “Section 7.03. Waiver; Amendment; Termination.

     (c) This
Agreement (except for Article 5, Section 6.01, this Article 7, and any applicable definitions in Article 1) shall terminate and
be of no further force or effect immediately prior to the closing of a QPO.”

     Section 2 . Effect of Amendment. Except as amended by this Amendment, the Agreement shall
remain unchanged and in full force and effect. From and after the Amendment Date, each reference
to “this Agreement,” “hereof,” “hereunder” or words of like import, and all references to the
Agreement in any and all agreements, instruments, documents, notes, certificates and other writings
of every kind and nature shall be deemed to mean the Agreement as amended by this Amendment, except
as is otherwise expressly stated.

 

 

     Section 3 . General. (a) This Amendment shall be binding on the successors and permitted
assigns of the parties hereto; (b) this Amendment shall be governed by and construed in accordance
with the laws of the State of New York, without regard to conflicts of law principles thereunder
and shall be subject to the jurisdiction of the courts in the State of New York; (c) this Amendment
may be executed in more than one counterpart, each of which shall be deemed an original and any
counterpart so executed shall be deemed to be one and the same instrument; (d) each party hereto
acknowledges that the parties hereto have participated jointly in the negotiation and drafting of
this Amendment, and in the event an ambiguity or question of intent or interpretation arises, this
Amendment shall be construed as if drafted jointly by the parties hereto and no presumption or
burden of proof shall arise favoring or disfavoring any party hereto by virtue of the authorship of
any of the provisions of this Amendment; (e) if any part of any provision of this Amendment shall
be invalid or unenforceable under applicable law, such part shall be ineffective to the extent of
such invalidity only, without in any way affecting the remaining parts of such provision or the
remaining provisions of this Amendment; and (f) each party hereto acknowledges that the remedies at
law of the other parties hereto for a breach or threatened breach of this Amendment would be
inadequate and, in recognition of this fact, any party hereto, without posting any bond, and in
addition to all other remedies that may be available, shall be entitled to obtain equitable relief
in the form of specific performance, a temporary restraining order, a temporary or permanent
injunction or any other equitable remedy that may then be available.

[The remainder of this page has been intentionally left blank]

 

 

     IN WITNESS WHEREOF, the undersigned shareholders have executed this Agreement, in one or more counterparts, each of which
shall constitute an original and all of which when taken together shall constitute one instrument,
on December 7, 2009.

	 	 	 	 	 
	 	 	 	 
	/s/ Jianyu Yang
 	 	 	 	 
	For and on behalf of 	 	 	 	 
	Concord Medical Services Holdings Limited 	 	 	 	 
	 

	 	 	 	 	 
	 	 	 
	/s/ Bo Tao Shi
 	 	 	 	 
	For and on behalf of 	 	 	 	 
	Grand Best Group Limited 	 	 	 	 
	 

	 	 	 	 	 
	 	 	 
	/s/ Steve Sun
 	 	 	 	 
	For and on behalf of 	 	 	 	 
	Dragon Image Investment Ltd. 	 	 	 	 
	 

	 	 	 	 	 
	 	 	 
	/s/ Jianyu Yang
 	 	 	 	 
	For and on behalf of 	 	 	 	 
	Daketala International Investment Holdings Ltd. 	 	 	 	 
	 

	 	 	 	 	 
	 	 	 
	/s/ Sirong Tian
 	 	 	 	 
	For and on behalf of 	 	 	 	 
	Sino Prime Investments Limited 	 	 	 	 
	 

	 	 	 	 	 
	 	 	 
	/s/ Xiaogang Wang
 	 	 	 	 
	For and on behalf of 	 	 	 	 
	Latek Corporation 	 	 	 	 
	 

	 	 	 	 	 
	 	 	 
	/s/ Peipei Zhang
 	 	 	 	 
	For and on behalf of 	 	 	 	 
	Genius Aspect Investment Ltd. 	 	 	 	 

 

 

	 	 	 	 	 

	 	 	 	 	 
	 	 	 
	/s/ Wenqing Tan
 	 	 	 	 
	For and on behalf of 	 	 	 	 
	Star Rising Ltd. 	 	 	 	 
	 

	 	 	 	 	 
	 	 	 
	 	 	 	 	 
	For and on behalf of 	 	 	 	 
	Homerun Technology Ltd. 	 	 	 	 
	 

	 	 	 	 	 
	 	 	 
	/s/ Wenqing Tan
 	 	 	 	 
	For and on behalf of 	 	 	 	 
	Sino First Holdings Ltd. 	 	 	 	 
	 

	 	 	 	 	 
	 	 	 
	/s/ Bona Lau
 	 	 	 	 
	For and on behalf of 	 	 	 	 
	Notable Enterprise Limited 	 	 	 	 
	 

	 	 	 	 	 
	 	 	 
	/s/ Zheng Cheng
 	 	 	 	 
	For and on behalf of 	 	 	 	 
	CZY Investment Limited 	 	 	 	 
	 

	 	 	 	 	 
	 	 	 	 	 
	/s/ Jing Zhang
 	 	 	 	 
	For and on behalf of 	 	 	 	 
	Thousand Ocean Group Limited 	 	 	 	 
	 

	 	 	 	 	 
	 	 	 	 	 
	/s/ Yap Yaw Kong
 	 	 	 	 
	For and on behalf of 	 	 	 	 
	Top Mount Group Limited 	 	 	 	 

 

 

	 	 	 	 	 

	 	 	 	 	 
	 	 	 	 	 
	/s/ Boxun Zhang
 	 	 	 
	For and on behalf of 	 	 	 	 
	Triumph Concept Investment Limited 	 	 	 	 
	 

	 	 	 	 	 
	 	 	 	 	 
	
 	 	 	 	 
	For and on behalf of 	 	 	 	 
	ATL International Group Limited 	 	 	 	 
	 

	 	 	 	 	 
	 	 	 	 	 
	
 	 	 	 	 
	Huang Jen-Fu, in his individual capacity 	 	 	 	 
	 	 	 	 	 
	 

	 	 	 	 	 
	 	 	 	 	 
	
 	 	 	 	 
	Wang Jen-Wen, in his individual capacity 	 	 	 	 
	 	 	 	 	 
	 

	 	 	 	 	 
	 	 	 	 	 
	
 	 	 	 	 
	Ni Shiao-Jane, in her individual capacity 	 	 	 	 
	 	 	 	 	 
	 

	 	 	 	 	 
	 	 	 	 	 
	/s/ Daniel A. D’Aniello
 	 	 	 	 
	For and on behalf of 	 	 	 	 
	Carlyle Asia Growth Partners III, L.P. 	 	 	 	 
	 

	 	 	 	 	 
	 	 	 	 	 
	/s/ Daniel A. D’Aniello
 	 	 	 	 
	For and on behalf of 	 	 	 	 
	CAGP III Co-Investment, L.P. 	 	 	 	 
	 

	 	 	 	 	 
	 	 	 	 	 
	/s/ Michael J. Horvath
 	 	 	 	 
	For and on behalf of 	 	 	 	 
	Starr Investments Cayman II, Inc. 	 	 	 	 

 

 

	 	 	 	 	 

	 	 	 	 	 
	 	 	 	 	 
	/s/ Shirley Chen
 	 	 	 	 
	For and on behalf of 	 	 	 	 
	CICC Sun Company Limited 	 	 	 	 
	 

	 	 	 	 	 
	 	 	 	 	 
	/s/ Shirley Chen
 	 	 	 	 
	For and on behalf of 	 	 	 	 
	Perfect Key Holdings Limited 	 	 	 	 
	 

BEING ALL OF THE SHAREHOLDERS OF THE COMPANYexv10w21

Exhibit 10.21

English Translation

Strategic Cooperative Agreement

between

China Construction Bank Corporation

Shenzhen Branch

and

China Medical Services Holdings Limited

16 November, 2009

 

 

Party A: China Medical Services Holdings Limited

Address: No. 3702, Rongchao Trade Center, Jintian Road, Futian District, Shenzhen

Legal Representative: YANG Jianyu

Party B: China Construction Bank Corporation, Shenzhen Branch

Address: East Tower, Financial Center, Hongling South Road, Shenzhen

Person in Charge: TIAN Huiyu

Party A is Asia’s largest, most professionally competent and longest-operating medical equipment
investment service provider and operator of relevant medical centers.

Party B is a major state-owned commercial bank with a nationwide branch network, a comprehensive
service system as well as a presence (through branches or representative offices) in the world’s
major financial centers, which enjoys extensive experiences in servicing key engineering and
construction projects and large enterprise groups and possesses competitive edges in terms of
products, technology, talents, service philosophy, etc.

In order to establish a sound bank-enterprise cooperative relationship and promote the mutual
development and long term partnership of the Parties, in keeping with the principle of “equality
and mutual benefit, mutual support, honesty and creditworthiness” , Party A and Party B, on the
basis of their existing successful cooperation, reach the following agreement upon full discussions
and covenant to strictly abide by each provision set out herein and duly fulfill their respective
obligations hereunder.

Article I The Parties mutually agree to establish between them a long-term strategic partnership.

Party B will treat Party A as one of its most important clients, will fully support the development
of Party A, and will, to the extent permitted by the laws, regulations and financial policies of
the state and relevant rules of Party B, provide, on a priority basis, Party A and all of its
controlled subsidiaries with full financial services and full financial support.

Party A will treat Party B as one of its most important long-term partners and will, where the
conditions are equal, retain, on a priority basis, Party B as its primary cooperation bank for its
financial operations.

Article II Subject to compliance with the Guarantee Law, the General Provisions on Lending and
other relevant laws, regulations and financial policies of the state as well as relevant lending
rules of Party B, Party B will actively support the business growth of Party A and will in the
forthcoming three years grant to Party A an indicative credit line of RMB1.5 billion (subject to
business review and approval by Party B and satisfaction of relevant approval conditions of Party
B, with the specific rights and obligations to be

 

 

governed by relevant definitive agreements entered into by the Parties upon mutual discussions and mutual agreement), which may be disbursed
towards working capital loans, fixed-asset project loans, RMB bridge loans, onshore
guarantor-backed offshore affiliate loans, export buyer credit, pooled guarantees-backed loans, M&A
loans, factoring, receivables pledge arrangements and other areas of business cooperation. The
Parties will equally strengthen their cooperation in the areas of import and export business, trade
finance, etc.

Article III Party B will actively design a best possible management solution for the funds of Party
A, will ensure the security and timely transfer and disbursement of the funds of Party A, and will,
subject to compliance with the relevant laws, regulations and financial policies of the state and
relevant lending rules of Party B, procure the funds deposited by Party A with Party B to achieve
highest possible returns.

Article III1 Party B’s Undertakings on Financial Service

	(1)	 	Credit Financing Service

	(a)	 	Conditions for Grant of Credit Facility

In respect of RMB and foreign currency-denominated financing services under the aforesaid credit
facility, Party B undertakes to offer, where the conditions are equal, Party A and its subordinated
enterprises preferential conditions and rates within the pricing range stipulated by applicable
regulators.

	(b)	 	Approval procedures for grant of credit facility

When Party A and its subordinated enterprises apply to Party B to draw on the credit facility
granted by Party B, Party B shall to the extent possible simplify its approval procedures and offer
the most convenient services.

	(2)	 	Innovative financial service

To the extent permitted by applicable rules and regulations, Party B will carry out product
innovation and provide corresponding financial products in respect of its overall financial
services to the various projects of Party A and its controlled subsidiaries.

	(3)	 	Fund settlement service

To the extent permitted by applicable rules and regulations, Party B will, in line with the
financial and fund settlement patterns of Party A, consider and develop, on a priority basis,
corresponding settlement methods and provide relevant financial settlement services to Party A so
as to meet Party A’s needs for the management of its funds, finances, etc.

Article IV Party A’s Undertakings on Business Cooperation

	(1)	 	Undertakings on grant of credit facility

	(a)	 	Party A shall maintain reasonable financial conditions and shall have sound operating
conditions and development prospects.

 

			
	1	 	Article III was used twice in the original Chinese
version.

 

 

	(b)	 	Upon accepting a credit facility from Party B, Party A shall act in accordance with the
principle of “fairness and reasonableness” in accepting any credit facility from another bank so as
not to prejudice the rights of Party B.
	 
	(c)	 	Party A shall promptly provide Party B or its branches with material information as well as
basic information reflecting the changes in its operations and management.

	(2)	 	Party A shall on a priority basis choose to open with Party B its sweeping accounts for IPO
proceeds, follow-on offerings and rights issues.
	 
	(3)	 	Party A shall use its best efforts to perform the obligations required to be performed by it in
the course of its existing and future business cooperation with Party B.
	 
	(4)	 	Where the conditions are equal, Party A and its subordinated enterprises and controlled
enterprises shall on a priority basis choose to open their accounts with Party B and shall utilize,
on a priority basis, the financial products and services of Party B, including:

	(a)	 	To select Party B as one of their major RMB and foreign currency financing banks;
	 
	(b)	 	To select party B as one of their major RMB and foreign currency account-opening banks
(including the basic account, the capital funds account, the foreign debt account, the rent payment
account, the escrow account and the general settlement account) and settlement banks;
	 
	(c)	 	To select Party B as the “main bank” for their international settlement business (including
but not limited to L/C, remittance, profit repatriation, letter of guarantee and other non-trade
settlement businesses), as well as the major RMB settlement reporting bank for their cross-border
trading businesses;
	 
	(d)	 	To select Party B as one of the “main banks” for their co-branding card, credit card and
personal wealth management businesses;
	 
	(e)	 	To select Party B as one of the main handling banks for their cash management and drafts
operations as well as for the NRA accounts of Party B’s 2offshore affiliates;
	 
	(f)	 	To select, in line with their business growth needs, Party B as the provider of financial
advisory service, public housing fund service, personal residential mortgage loans, corporate
annuity service, and other financial services and products provided by Party B; and
	 
	(g)	 	To utilize other financial products not specified herein.

Article V Cooperation on Other Businesses

	(1)	 	Cooperation on Cash Management

Party B will support the centralized management of the multi-level funds of Party A and enhance the
operating efficiency of such funds by utilizing its online banking services and other electronic
banking platforms and by providing entrusted loan facilities, legal person account overdraft
facilities and other services to Party A, all in accordance with the needs of Party A. Party B
will, by means of its own money products, provide corresponding services in respect of the RMB and
foreign currency receipts and

 

			
	2	 	As shown in the original Chinese version.

 

 

	 	 	disbursements of Party A and thereby procure the value maintenance
and appreciation of the relevant funds.

	(2)	 	Consultancy and Advisory Service

Party B will provide Party A with financial advisory and foreign exchange management policy
consulting services.

	(3)	 	Party B will fully tap into its strengths in the Bank-Customs-Connection system and the online
trade settlement system (E-TRADE) so as to satisfy Party A’s business needs for fast customs
clearance, fast remittance, etc.

	(4)	 	Other Services

Party B will design individualized financial products or a combination of such products based on
the needs of Party A.

Article VI Coordination and Communication

So long as the Parties shall maintain each other’s trade secrets in confidence, Party A and Party B
shall strengthen their mutual communication and thereby facilitate the implementation of this
Strategic Cooperative Agreement. The Parties agree to timely circulate this Strategic Cooperative
Agreement to their respective subordinated entities, to each designate business cooperation contact
persons at different levels and to establish a regular coordination meeting system so as to resolve
issues arising during the course of implementation hereof.

Party A shall designate its Finance Department as the agreement implementation coordination
department which shall be responsible for the full implementation of this Agreement. Party B shall
designate the Corporate Business Department of its branch as the agreement implementation
coordination department which shall be responsible for the full implementation of this Agreement;
and the business office of such branch of Party B shall act as the main entity to provide the
specific services while other relevant sub-branches of Party B shall act as the auxiliary entity to
assist with the provision of such services.

Article VII Dispute Settlement

Any dispute arising out of the implementation of this Agreement upon its effectiveness shall be
resolved by Party A and Party B through friendly consultations based on the principle of “equality,
mutual benefit, mutual understanding and mutual accommodation”.

Article VIII Effectiveness of Agreement

This Agreement shall become effective when it shall have been signed by the legal representatives
(or persons in charge) of the Parties or their authorized representatives and affixed with the
corporate seals of the Parties and shall remain valid for 2 years. Upon expiry of such term, this
Agreement shall continue to be effective if so confirmed in writing by the Parties.

Article IX This Agreement shall be made in four originals and Party A and Party B shall each hold
two copies thereof.

 

 

(No operative text on this page)

	 	 	 
	China Medical Services Holdings Limited

	 	China Construction Bank Corporation Shenzhen Branch
	 
	 	 
	(Corporate Seal)

	 	(Corporate Seal)
	 
	 	 
	Legal Representative (or Authorized Representative)

	 	Legal Representative (or Authorized Representative)
	 
	 	 
	(Signature)

	 	(Signature)
	 
	 	 
	17 November, 2009

	 	17 November, 2009

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