Document:

Second Amendment to Note and Equity Purchase Agreement Dated March 12th 2003

 EXHIBIT 10.25 
  
 SECOND AMENDMENT TO 
 NOTE AND EQUITY PURCHASE AGREEMENT 
  
 THIS SECOND AMENDMENT TO NOTE AND EQUITY PURCHASE AGREEMENT (the “Amendment”), dated as of March 12, 2003 to be effective as of December 30, 2002 (the “Effective Date”), is
entered into by and between CAPITALSOURCE FINANCE LLC, a Delaware limited liability company, in its capacity as administrative agent and collateral agent for the Purchasers under the Agreement referenced below and as the sole Purchaser under
the Agreement referenced below (“Agent”), and each of ENCORE MEDICAL CORPORATION, ENCORE MEDICAL GP, INC., ENCORE MEDICAL ASSET CORPORATION, and ENCORE MEDICAL, L.P., (together, the “Loan Parties”).
Capitalized terms used and not otherwise defined herein are used as defined in the Agreement (as defined below). 
  
 WHEREAS, the Agent, Purchasers and Loan Parties have entered into that certain Note and Equity Purchase Agreement dated as of February 8, 2002 (as
amended, supplemented, modified or restated from time to time, the “Agreement”) pursuant to which Purchasers purchased certain Notes from the Loan Parties; 
  
 WHEREAS, the Loan Parties have requested that Agent and Purchasers amend certain provisions of the Agreement, all as
provided herein; and 
  
 WHEREAS, subject to satisfaction of the
conditions set forth herein, Agent and the Purchasers are willing to amend the Agreement as provided herein; 
  
 NOW, THEREFORE, in consideration of the premises and the other mutual covenants contained herein, the receipt and sufficiency are hereby acknowledged, the
parties hereto agree as follows: 
  
 SECTION
1.    Amendments. The following sections of the Agreement shall be and hereby are amended as follows: 
  
 A)  Section 7.3(a). Section 7.3(a) of the Agreement shall be and hereby is amended and restated and replaced in its entirety to read in
full as follows: 
  
 “(a)  Minimum EBITDA.
As measured on each Measurement Date for the Measurement Period ending on such Measurement Date, EBITDA shall not be less than: 
  

	 Measurement Date

	  	Minimum
EBITDA

	 December 31, 2002
	  	$	12,100,000
	 The last day of the 1st Fiscal Quarter of Fiscal Year 2003
	  	$	12,400,000
	 The last day of the 2nd Fiscal Quarter of Fiscal Year 2003
	  	$	12,700,000
	 The last day of the 3rd Fiscal Quarter of Fiscal Year 2003
	  	$	13,100,000
	 December 31, 2003
	  	$	13,700,000
	 The last day of the 1st Fiscal Quarter of Fiscal Year 2004
	  	$	14,500,000
	 The last day of the 2nd Fiscal Quarter of Fiscal Year 2004
	  	$	15,100,000
	 The last day of the 3rd Fiscal Quarter of Fiscal Year 2004
	  	$	15,800,000
	 December 31, 2004
	  	$	16,500,000
	 The last day of the 1st Fiscal Quarter of Fiscal Year 2005
	  	$	20,694,000
	 The last day of the 2nd Fiscal Quarter of Fiscal Year 2005
	  	$	21,289,000
	 The last day of the 3rd Fiscal Quarter of Fiscal Year 2005
	  	$	21,736,000

	 December 31, 2005
	  	$	22,220,000
	 The last day of the 1st Fiscal Quarter of Fiscal Year 2006
	  	$	22,753,000
	 The last day of the 2nd Fiscal Quarter of Fiscal Year 2006
	  	$	23,309,000
	 The last day of the 3rd Fiscal Quarter of Fiscal Year 2006
	  	$	23,865,000
	 December 31, 2006
	  	$	24,443,000

  
 B) Section
7.3(b). Section 7.3(b) of the Agreement shall be and hereby is amended and restated and replaced in its entirety to read in full as follows: 
  
 “(b) Debt to EBITDA Ratio (Total Debt/EBITDA). As measured on each Measurement Date for the Measurement Period ending on such Measurement
Date, the Debt to EBITDA Ratio shall not exceed: 
  

	 Measurement Date

	  	Ratio

	 December 31, 2002
	  	3.50 to 1.00
	 The last day of the 1st Fiscal Quarter of Fiscal Year 2003
	  	3.50 to 1.00
	 The last day of the 2nd Fiscal Quarter of Fiscal Year 2003
	  	3.50 to 1.00
	 The last day of the 3rd Fiscal Quarter of Fiscal Year 2003
	  	3.25 to 1.00
	 December 31, 2003
	  	3.25 to 1.00
	 The last day of the 1st Fiscal Quarter of Fiscal Year 2004
	  	3.25 to 1.00
	 The last day of the 2nd Fiscal Quarter of Fiscal Year 2004
	  	3.25 to 1.00
	 The last day of each Fiscal Quarter thereafter
	  	3.25 to 1.00

  
 C) Section
7.3(c). Section 7.3(c) of the Agreement shall be and hereby is amended and restated and replaced in its entirety to read in full as follows: 
  
 “(c) Fixed Charge Coverage Ratio. As measured on each Measurement Date for the Measurement Period ending on such Measurement Date, the Fixed
Charge Coverage Ratio shall not be less than: 
  

	 Measurement Date

	  	Ratio

	 December 31, 2002
	  	1.00 to 1.00
	 The last day of the 1st Fiscal Quarter of Fiscal Year 2003
	  	1.02 to 1.00
	 The last day of the 2nd Fiscal Quarter of Fiscal Year 2003
	  	1.02 to 1.00
	 The last day of the 3rd Fiscal Quarter of Fiscal Year 2003
	  	1.02 to 1.00
	 December 31, 2003
	  	1.05 to 1.00
	 The last day of each Fiscal Quarter thereafter
	  	1.05 to 1.00

  
 D) Section
7.3(d). Section 7.3(d) of the Agreement shall be and hereby is amended and restated and replaced in its entirety to read in full as follows: 
  
 “(d) Minimum EBITDA to Interest Ratio. As measured on each Measurement Date for the Measurement Period ending on such Measurement Date, the
EBITDA to Interest Ratio shall not be less than: 
  

	 Measurement Date

	  	Ratio

	 The last day of each Fiscal Quarter of Fiscal Year 2002
	  	2.50 to 1.00
	 The last day of each Fiscal Quarter of Fiscal Year 2003
	  	2.50 to 1.00
	 The last day of each Fiscal Quarter thereafter
	  	2.50 to 1.00

  
 SECTION
2.    [Intentionally Omitted.] 
  

 2 

 SECTION 3.    Conditions.    This Amendment, and
the amendments and waivers contained herein, shall be effective only upon and subject to satisfaction of the following conditions precedent: (a) the representations and warranties contained herein and in all other Purchase Documents shall be true
and correct in all material respects as of the date hereof and as of the Effective Date as if then made, except for such representations and warranties limited by their terms to a specific date; (b) no Default or Event of Default shall be in
existence after giving effect to this Amendment; (c) the Loan Parties shall have delivered to the Agent an executed original copy of this Amendment and each other agreement, document or instrument reasonably requested by the Agent in connection with
this Amendment; (d) the Senior Agent and all Senior Lenders shall have consented in writing to all of the provisions, amendments and waivers contained in this Amendment, in form and substance satisfactory to Agent, and none of the provisions of this
Amendment shall be a default or event of default under the Senior Credit Agreement or with respect to the Senior Financing; (e) the Loan Parties shall have paid to Agent all fees, costs and expenses owed to and/or incurred by the Agent and
Purchasers arising in connection with the Agreement and/or this Amendment, including, without limitation, a $25,000 amendment fee; and (f) all proceedings taken in connection with the transactions contemplated by this Amendment and all documentation
and other legal matters incident thereto shall be satisfactory to the Agent. 
  
 SECTION 4.    Agreement in Full Force and Effect as Amended.    Except as specifically amended and waived hereby, the Agreement and other Purchase Documents shall
remain in full force and effect and are hereby ratified and confirmed as so amended. Except as expressly set forth herein, this Amendment shall not be deemed to be a waiver, amendment or modification of any provisions of the Agreement or any other
Purchase Document or any right, power or remedy of Agent or Purchasers, nor constitute a waiver of any provision of the Agreement or any other Purchase Document, or any other document, instrument and/or agreement executed or delivered in connection
therewith or of any Default or Event of Default under any of the foregoing, in each case whether arising before or after the date hereof or as a result of performance hereunder or thereunder. This Amendment also shall not preclude the future
exercise of any right, remedy, power, or privilege available to Agent and/or Purchasers whether under the Agreement, the other Purchase Documents, at law or otherwise. All references to the Agreement shall be deemed to mean the Agreement as modified
hereby. This Amendment shall not constitute a novation or satisfaction and accord of the Agreement and/or other Purchase Documents, but shall constitute an amendment thereof. The parties hereto agree to be bound by the terms and conditions of the
Agreement and Purchase Documents as amended by this Amendment, as though such terms and conditions were set forth herein. Each reference in the Agreement to “this Agreement,” “hereunder,” “hereof,” “herein” or
words of similar import shall mean and be a reference to the Agreement as amended by this Amendment, and each reference herein or in any other Purchase Document to the “Loan Agreement” or “Credit Agreement” or “Purchase
Agreement” shall mean and be a reference to the Agreement as amended and modified by this Amendment. 
  
 SECTION 5.    Representations.    Each Loan Party hereby represents and warrants to Agent and
Purchasers as of the date of this Amendment and as of the Effective Date as follows: (i) it is duly incorporated or organized, validly existing and in good standing under the laws of its jurisdiction of organization; (ii) the execution, delivery and
performance by it of this Amendment and all other Purchase Documents executed and/or delivered in connection herewith are within its powers, have been duly authorized, and do not contravene (A) its articles of organization, operating agreement, or
other organizational documents, or (B) any applicable law; (iii) no consent, license, permit, approval or authorization of, or registration, filing or declaration with 
  

 3 

 any Governmental Authority or other Person, is required in connection with the execution, delivery, performance, validity
or enforceability of this Amendment or any other Purchase Documents executed and/or delivered in connection herewith by or against it; (iv) this Amendment and all other Purchase Documents executed and/or delivered in connection herewith has been
duly executed and delivered by it; (v) this Amendment and all other Purchase Documents executed and/or delivered in connection herewith constitute its legal, valid and binding obligation enforceable against it in accordance with its terms, except as
enforceability may be limited by applicable bankruptcy, insolvency, reorganization, moratorium or similar laws affecting the enforcement of creditors’ rights generally or by general principles of equity; (vi) after giving effect to this
Amendment, it is not in default under the Purchase Documents and no Default or Event of Default exists, has occurred and is continuing or would result by the execution, delivery or performance of this Amendment; and (vii) the representations and
warranties contained in the Purchase Documents are true and correct in all material respects as of the date hereof as if then made, except for such representations and warranties limited by their terms to a specific date. 
  
 SECTION 6.    Miscellaneous. 
  
 (a)    This Amendment may be executed in any number of
counterparts (including by facsimile), and by the different parties hereto on the same or separate counterparts, each of which shall be deemed to be an original instrument but all of which together shall constitute one and the same agreement. Each
party agrees that it will be bound by its own facsimile signature and that it accepts the facsimile signature of each other party. The descriptive headings of the various sections of this Amendment are inserted for convenience of reference only and
shall not be deemed to affect the meaning or construction of any of the provisions hereof or thereof. Whenever the context and construction so require, all words herein in the singular number herein shall be deemed to have been used in the plural,
and vice versa, and the masculine gender shall include the feminine and neuter and the neuter shall include the masculine and feminine. 
  
 (b)    This Amendment may not be changed, amended, restated, waived, supplemented, discharged, canceled, terminated or otherwise
modified orally or by any course of dealing or in any manner other than as provided in the Agreement. This Amendment shall be considered part of the Agreement and shall be a Purchase Document for all purposes under the Agreement and other Purchase
Documents. 
  
 (c)    This Amendment, the
Agreement and the Purchase Documents constitute the final, entire agreement and understanding between the parties with respect to the subject matter hereof and thereof and may not be contradicted by evidence of prior, contemporaneous or subsequent
oral agreements between the parties, and shall be binding upon and inure to the benefit of the successors and assigns of the parties hereto and thereto. There are no unwritten oral agreements between the parties with respect to the subject matter
hereof and thereof. 
  
 (d)    THIS AMENDMENT
AND THE RIGHTS AND OBLIGATIONS OF THE PARTIES UNDER THIS AMENDMENT SHALL BE GOVERNED BY AND CONSTRUED AND INTERPRETED IN ACCORDANCE WITH THE CHOICE OF LAW PROVISIONS SET FORTH IN THE AGREEMENT AND SHALL BE SUBJECT TO THE WAIVER OF JURY TRIAL AND
NOTICE PROVISIONS OF THE AGREEMENT. 
  
 (e)    No Loan Party may assign, delegate or transfer this Amendment or any of its rights or obligations hereunder. No rights are intended to be created under this Amendment for the benefit of any third party donee,
creditor or incidental beneficiary of any Loan Party or any 
  

 4 

 Guarantor. Nothing contained in this Amendment shall be construed as a delegation to Agent or Purchasers of Loan
Parties’ or any Guarantor’s duty of performance, including, without limitation, any duties under any account or contract in which Agent or Purchasers have has a security interest or Lien. This Amendment shall be binding upon the Loan
Parties and their respective successors and assigns. 
  
 (f)    The Loan Parties shall pay all costs and expenses incurred by Agent and Purchasers or any of their affiliates, including, without limitation, documentation and diligence fees and expenses, all search, audit,
appraisal, recording, professional and filing fees and expenses and all other out-of-pocket charges and expenses (including, without limitation, UCC and judgment and tax lien searches and UCC filings and fees for post-Closing UCC and judgment and
tax lien searches) and reasonable attorneys’ fees and expenses, in connection with (i) entering into, negotiating, preparing, reviewing and executing this Amendment and the documents, agreements and instruments contemplated hereby and all
related agreements, documents and instruments, and (ii) any actions, audits and/or examination taken pursuant to Section 6(i) below and/or as a result therefrom, and all of the same shall be part of the Obligations. If Agent, any Purchaser or
any of their affiliates uses in-house counsel for any of the purposes set forth above the Loan Parties expressly agrees that their Obligations include reasonable charges for such work commensurate with the fees that would otherwise be charged by
outside legal counsel selected by such Person in its sole discretion for the work performed. 
  
 (g)    Each Loan Party hereby (i) consents to the execution and delivery of this Amendment by the other Loan Parties, (ii) agrees that this Amendment shall not limit or diminish the obligations of
the subject Loan Party under the Purchase Documents, (iii) reaffirms its obligations under each of the Purchase Documents to which it is a party, and (iv) agrees that each of such Purchase Documents remains in full force and effect and is hereby
ratified and confirmed. 
  
 (h)    All
representations and warranties made in this Amendment shall survive the execution and delivery of this Amendment and no investigation by Agent or Purchasers shall affect such representations or warranties or the right of Agent or Purchasers to rely
upon them. 
  
 (i)    Notwithstanding and
without limiting any provision of any Purchase Document or of this Amendment, including, without limitation, Section 7.1(i) of the Agreement, the Loan Parties agree and acknowledge that, at the expense of Loan Parties, Agent shall have the right at
any time within 120 Business Days after the date of this Amendment as Agent deems necessary or appropriate in its sole discretion, during normal business hours, to (i) make one visit and inspection of any of Loan Parties’ offices or properties
or any other place where Collateral is located to inspect the Collateral and/or to examine or audit all of Loan Parties’ books of account, records, reports and other papers, in particular with respect to the financial covenants and compliance
therewith, (ii) make copies and extracts therefrom, and (iii) discuss Loan Parties’ business, operations, prospects, properties, assets, liabilities, condition and/or accounts with its officers and independent public accountants (and by this
provision such officers and accountants are authorized to discuss the foregoing). 
  
 [SIGNATURES APPEAR ON FOLLOWING PAGE] 
  

 5 

 IN WITNESS WHEREOF, the parties have caused this Second Amendment to the Note and Equity Purchase
Agreement to be executed by their respective officers thereunto duly authorized, as of the date first above written to be effective as of the Effective Date. 
  
 PURCHASER/AGENT: 
  
 CAPITALSOURCE FINANCE LLC 
  

		
	By:	 	 /S/  Joseph Turitz

	Name:	 	Joseph Turitz
	Title:	 	 

  
 LOAN PARTIES: 
  

	ENCORE MEDICAL CORPORATION	 	 	 	ENCORE MEDICAL ASSET CORPORATION
					
	By:	 	 /S/  Harry Zimmerman

	 	 	 	By:	 	 /S/  Harry Zimmerman

	Name:	 	Harry Zimmerman	 	 	 	Name:	 	Harry Zimmerman
	Title:	 	Executive Vice President—General Counsel	 	 	 	Title:	 	Executive Vice President—General Counsel
			
	ENCORE MEDICAL GP, INC.	 	 	 	ENCORE MEDICAL, L.P.
	 	 	 	 	 	 	By:	 	Encore Medical GP, Inc., its sole General Partner
					
	By:	 	 /S/  Harry Zimmerman

	 	 	 	By:	 	 /S/  Harry Zimmerman

	Name:	 	Harry Zimmerman	 	 	 	Name:	 	Harry Zimmerman
	Title:	 	Executive Vice President—General Counsel	 	 	 	Title:	 	Executive Vice President—General Counsel

  
 THE TERMS AND PROVISIONS OF THE
FOREGOING SECOND AMENDMENT TO THE NOTE AND EQUITY PURCHASE AGREEMENT ARE HEREBY CONSENTED TO AS OF THE EFFECTIVE DATE BY THE SENIOR AGENT AND ALL SENIOR LENDERS: 
  

	SENIOR AGENT AND SENIOR LENDERS:
	
	BANK OF AMERICA, NATIONAL ASSOCIATION
		
	By:	 	 /S/  Stephen King

	Name:	 	Stephen King
	Title:	 	Vice President

  

 6Fourth Amendment to Credit Agreement Dated March 12th 2003

 EXHIBIT 10.26 
  
 FOURTH AMENDMENT TO CREDIT AGREEMENT 
  
 THIS FOURTH AMENDMENT TO CREDIT AGREEMENT (“Amendment”), dated as of March 12, 2003 (the “Amendment
Date”), is among ENCORE MEDICAL CORPORATION, ENCORE MEDICAL GP, INC., ENCORE MEDICAL ASSET CORPORATION, ENCORE MEDICAL, L.P., and BANK OF AMERICA, NATIONAL ASSOCIATION (in its capacity as administrative agent under the Credit Agreement
referenced below and as the sole Lender under the Credit Agreement referenced below). 
  
 RECITALS: 
  
 A.    The Borrowers, the Agent, and the Lenders have entered into that certain Credit Agreement dated as of February 8, 2002 (as amended by that certain Waiver and First Amendment to Credit Agreement dated as of May 7,
2002, that certain Second Amendment to Credit Agreement dated as of May 30, 2002, that certain Third Amendment to Credit Agreement dated as of August 9, 2002, and that certain Waiver Letter dated November 7, 2002, the “Credit
Agreement”). 
  
 B.    The Borrowers
have requested that the Lenders amend certain provisions of the Credit Agreement as provided hereinbelow. 
  
 C.    Subject to satisfaction of the conditions set forth herein, the Lenders are willing to amend the Credit Agreement as
specifically provided herein. 
  
 NOW THEREFORE, in consideration
of the premises herein contained and other good and valuable consideration, the receipt and sufficiency of which are hereby acknowledged, the parties hereto hereby agree as follows: 
  
 ARTICLE 1 
  
 Definitions 
  
 Section 1.1    Definitions.    Capitalized terms used in this Amendment, to the extent not otherwise
defined herein, shall have the same meanings as in the Credit Agreement, as amended hereby. 
  
 ARTICLE 2 
  
 Amendments

  
 Section 2.1    Amendment to Section
7.23 of the Credit Agreement.    Effective as of December 30, 2002, Section 7.23 of the Credit Agreement is hereby amended and restated in its entirety to read as follows: 
  
 Section 7.23    Minimum
EBITDA.    The Borrowers shall not permit EBITDA, determined for the Parent and its Subsidiaries on a consolidated basis, 
  

 FOURTH AMENDMENT TO CREDIT AGREEMENT – Page 1 

 for the preceding twelve (12) Fiscal Periods, to be less than the amounts specified for the applicable
dates as follows: 
  

	 Fiscal Quarter End

	  	Minimum
EBITDA

	 December 31, 2002
	  	$	12,200,000
	 The last day of the first Fiscal Quarter of the Fiscal Year ending December 31, 2003
	  	$	12,500,000
	 The last day of the second Fiscal Quarter of the Fiscal Year ending December 31, 2003
	  	$	12,800,000
	 The last day of the third Fiscal Quarter of the Fiscal Year ending December 31, 2003
	  	$	13,200,000
	 December 31, 2003
	  	$	13,800,000
	 The last day of the first Fiscal Quarter of the Fiscal Year ending December 31, 2004
	  	$	14,600,000
	 The last day of the second Fiscal Quarter of the Fiscal Year ending December 31, 2004
	  	$	15,200,000
	 The last day of the third Fiscal Quarter of the Fiscal Year ending December 31, 2004
	  	$	15,900,000
	 December 31, 2004 and the last day of each Fiscal Quarter ending thereafter
	  	$	16,600,000

  
 Section
2.2    Amendment to Section 7.24 of the Credit Agreement.    Effective as of the Amendment Date, Section 7.24 of the Credit Agreement is hereby amended and restated in its entirety to read as
follows: 
  
 Section
7.24    Fixed Charge Coverage Ratio.    The Borrowers shall not permit the Fixed Charge Coverage Ratio, determined for the Parent and its Subsidiaries on a consolidated basis, as of the last day of any
Fiscal Quarter, to be less than the amounts specified for the applicable dates as follows: 
  

	 Fiscal Quarter End

	  	 Minimum
Fixed Charge
Coverage Ratio

	 The last day of the first, second, and third Fiscal Quarters of the Fiscal Year ending December 31, 2003
	  	1.02 to 1.00
	 The last day of the fourth Fiscal Quarter of the Fiscal Year ending December 31, 2003, and the last day of each Fiscal Quarter
ending thereafter
	  	1.05 to 1.00

  

 FOURTH AMENDMENT TO CREDIT AGREEMENT – Page 2 

 Section 2.3    Amendment to Section 7.25 of the Credit
Agreement.    Effective as of the Amendment Date, Section 7.25 of the Credit Agreement is hereby amended and restated in its entirety to read as follows: 
  
 Section 7.25    Total Debt to EBITDA Ratio.    The Borrowers
shall not permit the ratio of Total Debt to EBITDA, determined for the Parent and its Subsidiaries on a consolidated basis, as of the last day of any Fiscal Quarter, to be greater than the amounts specified for the applicable dates as follows:

  

	 Fiscal Quarter End

	  	 Ratio

	 The last day of the first and second Fiscal Quarters of the Fiscal Year ending December 31, 2003
	  	3.50 to 1.00
	 The last day of the third Fiscal Quarter of the Fiscal Year ending December 31, 2003, and the last day of each Fiscal Quarter
ending thereafter
	  	3.25 to 1.00

  
 Section
2.4    Amendment to Section 7.26 of the Credit Agreement.    Effective as of the Amendment Date, Section 7.26 of the Credit Agreement is hereby amended and restated in its entirety to read as follows:

  
 Section
7.26    Minimum EBITDA to Interest Ratio.    The Borrowers shall not permit the EBITDA to Interest Ratio, determined for the Parent and its Subsidiaries on a consolidated basis, as of the last day of
any Fiscal Quarter, to be less than 2.50 to 1.00. 
  
 Section
2.5    Amendment to Definition of Applicable Margin in Annex A of the Credit Agreement.     Effective as of the Amendment Date, the table set forth in the definition of “Applicable Margin” set
forth in Annex A of the Credit Agreement is hereby amended and restated to read in its entirety as follows: 
  

	 Total Debt to EBITDA

	  	Base Rate
Revolving
Loans

	 	 	LIBOR
Rate
Revolving
Loans

	 	 	Base
Rate
Term A
Loans

	 	 	LIBOR
Rate
Term A
Loans

	 	 	Base
Rate
Term B
Loans

	 	 	LIBOR
Rate
Term B
Loans

	 	 	Unused
Line Fee
Percentage

	 
	 Greater than or equal to 3.00 to 1.00
	  	1.50	%	 	3.00	%	 	2.00	%	 	3.50	%	 	2.25	%	 	3.75	%	 	0.75	%
	 Less than 3.00 to 1.00 but greater than or equal to 2.75 to 1.00
	  	1.25	%	 	2.75	%	 	2.00	%	 	3.50	%	 	2.25	%	 	3.75	%	 	0.75	%
	 Less than 2.75 to 1.00 but greater than or equal to 2.50 to 1.00
	  	1.00	%	 	2.50	%	 	2.00	%	 	3.50	%	 	2.25	%	 	3.75	%	 	0.75	%
	 Less than 2.50 to 1.00
	  	0.75	%	 	2.25	%	 	2.00	%	 	3.50	%	 	2.25	%	 	3.75	%	 	0.75	%

  

 FOURTH AMENDMENT TO CREDIT AGREEMENT – Page 3 

 Section 2.6    Amendment to Definition of Restricted Investments in Annex A of the
Credit Agreement. Effective as of the Amendment Date, clause (j) of the definition of “Restricted Investments” set forth in Annex A of the Credit Agreement is hereby amended by replacing the dollar amount “$1,250,000” set
forth therein with the dollar amount “$2,250,000”. 
  
 ARTICLE 3 
  
 Conditions 
  
 Section 3.1    Conditions Precedent. The
effectiveness of Article 2 of this Amendment is subject to the satisfaction of the following conditions precedent: 
  
 (a)    the representations and warranties contained herein and in all other Loan Documents, as amended hereby, shall
be true and correct in all material respects as of the date hereof as if made on the date hereof, except for such representations and warranties limited by their terms to a specific date; 
  
 (b)    evidence that CapitalSource
Finance LLC has amended the terms of the Capital Source Subordinated Debt Agreement in form and substance satisfactory to the Agent; 
  
 (c)    no Default or Event of Default shall be in existence; 
  
 (d)    the Borrowers and the Lenders
shall have delivered to the Agent an executed original copy of this Amendment and each other agreement, document, or instrument reasonably requested by the Agent in connection with this Amendment; 
  
 (e)    the Borrowers shall have paid to
the Agent all fees, costs, and expenses owed to and/or incurred by the Agent arising in connection with the Credit Agreement or this Amendment, including, without limitation, the reasonable fees, costs, and expenses of the Agent’s legal
counsel, Jenkens & Gilchrist, a Professional Corporation; 
  
 (f)    in consideration of the amendments contained herein, the Borrowers shall have paid to the Agent on the Amendment Date, for the ratable benefit of the Lenders, a fee in an amount equal to
$70,000; and 
  
 (g)    all
proceedings taken in connection with the transactions contemplated by this Amendment and all documentation and other legal matters incident thereto shall be satisfactory to (i) the Agent, (ii) the Lenders, and (iii) the Agent’s legal counsel,
Jenkens & Gilchrist, a Professional Corporation. 
  
 ARTICLE 4

  
 Ratifications, Representations and Warranties

  
 Section 4.1    Ratifications. The
terms and provisions set forth in this Amendment shall modify and supersede all inconsistent terms and provisions set forth in the Credit Agreement 
  

 FOURTH AMENDMENT TO CREDIT AGREEMENT – Page 4 

 and, except as expressly modified and superseded by this Amendment, the terms and provisions of the Credit Agreement and
the other Loan Documents are ratified and confirmed and shall continue in full force and effect. The Borrowers, the Agent, and the Lenders agree that the Credit Agreement as amended hereby and the other Loan Documents shall continue to be legal,
valid, binding, and enforceable in accordance with their respective terms. 
  
 Section 4.2    Representations and Warranties.    Each of the Borrowers hereby represents and warrants to the Agent and the Lenders that (a) the execution, delivery, and
performance of this Amendment and any and all other Loan Documents executed and/or delivered in connection herewith have been authorized by all requisite action on the part of each Borrower and will not violate the articles of incorporation or
bylaws of any Borrower, (b) the representations and warranties contained in the Credit Agreement, as amended hereby, and any other Loan Document are true and correct on and as of the date hereof as though made on and as of the date hereof (except to
the extent that such representations and warranties were expressly, in the Credit Agreement, made only in reference to a specific date), (c) no Default or Event of Default has occurred and is continuing, and (d) each Borrower is in full compliance
with all covenants and agreements contained in the Credit Agreement, as amended hereby, and the other Loan Documents. 
  
 ARTICLE 5 
  
 Miscellaneous 
  
 Section 5.1    Survival of Representations and Warranties.    All representations and warranties made in this Amendment or any other Loan Document including any Loan
Document furnished in connection with this Amendment shall survive the execution and delivery of this Amendment and the other Loan Documents, and no investigation by the Agent or any Lender shall affect the representations and warranties or the
right of the Agent or any Lender to rely upon them. 
  
 Section
5.2    Reference to Credit Agreement.    Each of the Loan Documents, including the Credit Agreement and any and all other agreements, documents, or instruments now or hereafter executed and delivered
pursuant to the terms hereof or pursuant to the terms of the Credit Agreement as amended hereby, are hereby amended so that any reference in such Loan Documents to the Credit Agreement shall mean a reference to the Credit Agreement as amended
hereby. 
  
 Section
5.3    Severability.    Any provision of this Amendment held by a court of competent jurisdiction to be invalid or unenforceable shall not impair or invalidate the remainder of this Amendment and the
effect thereof shall be confined to the provision so held to be invalid or unenforceable. 
  
 Section 5.4    Applicable Law.    THIS AMENDMENT SHALL BE GOVERNED BY AND CONSTRUED IN ACCORDANCE WITH THE LAWS OF THE STATE OF TEXAS AND THE APPLICABLE LAWS OF THE
UNITED STATES OF AMERICA. 
  

 FOURTH AMENDMENT TO CREDIT AGREEMENT – Page 5 

 Section 5.5    Successors and Assigns.    This Amendment
is binding upon and shall inure to the benefit of the Borrowers, the Agent, and the Lenders and their respective successors and assigns, except no Borrower may assign or transfer any of its respective rights or obligations hereunder without the
prior written consent of the Lenders. 
  
 Section
5.6    Counterparts.    This Amendment may be executed in one or more counterparts, and on telecopy counterparts each of which when so executed shall be deemed to be an original, but all of which when
taken together shall constitute one and the same agreement. 
  
 Section 5.7    Effect of Amendment.    No consent or waiver, express or implied, by the Agent or any Lender to or for any breach of or deviation from any covenant, condition, or duty by any
Borrower shall be deemed a consent or waiver to or of any other breach of the same or any other covenant, condition, or duty. Each of the Borrowers (individually, a “subject Borrower”) hereby (a) consents to the execution and delivery of
this Amendment by the other Borrowers, (b) agrees that this Amendment shall not limit or diminish the obligations of the subject Borrower under its certain Loan Documents delivered in connection with the Credit Agreement, executed or joined in by
the subject Borrower and delivered to the Agent, (c) reaffirms the subject Borrower’s obligations under each of such Loan Documents, and (d) agrees that each of such Loan Documents remains in full force and effect and is hereby ratified and
confirmed. 
  
 Section
5.8    Headings.    The headings, captions, and arrangements used in this Amendment are for convenience only and shall not affect the interpretation of this Amendment. 
  
 Section 5.9    Entire Agreement. THIS AMENDMENT
AND ALL OTHER INSTRUMENTS, DOCUMENTS, AND AGREEMENTS EXECUTED AND DELIVERED IN CONNECTION WITH THIS AMENDMENT EMBODY THE FINAL, ENTIRE AGREEMENT AMONG THE PARTIES HERETO AND SUPERSEDE ANY AND ALL PRIOR COMMITMENTS, AGREEMENTS, REPRESENTATIONS, AND
UNDERSTANDINGS, WHETHER WRITTEN OR ORAL, RELATING TO THIS AMENDMENT, AND MAY NOT BE CONTRADICTED OR VARIED BY EVIDENCE OF PRIOR, CONTEMPORANEOUS, OR SUBSEQUENT ORAL AGREEMENTS OR DISCUSSIONS OF THE PARTIES HERETO. THERE ARE NO ORAL AGREEMENTS AMONG
THE PARTIES HERETO. 
  

 FOURTH AMENDMENT TO CREDIT AGREEMENT – Page 6 

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

	BORROWERS:
	
	ENCORE MEDICAL CORPORATION
		
	By:	 	 /S/ Harry Zimmerman

	 	 	 Name: Harry Zimmerman
 Title: Executive Vice
President—General Counsel

  
  

	ENCORE MEDICAL GP, INC.
		
	By:	 	 /S/ Harry Zimmerman

	 	 	 Name: Harry Zimmerman
 Title: Executive Vice
President—General Counsel

  
  

	ENCORE MEDICAL ASSET CORPORATION
		
	By:	 	 /S/ Harry Zimmerman

	 	 	 Name: Harry Zimmerman
 Title: Executive Vice
President—General Counsel

  
  

	ENCORE MEDICAL, L.P.
		
	By:	 	Encore Medical GP, Inc., its sole General Partner
		
	By:	 	 /S/ Harry Zimmerman

	 	 	 Name: Harry Zimmerman
 Title:
Executive Vice President—General Counsel

  

 FOURTH AMENDMENT TO CREDIT AGREEMENT – Page 7 

	AGENT:
	
	BANK OF AMERICA, NATIONAL ASSOCIATION
		
	By:	 	 /S/ Stephen King

	 	 	 Name:  Stephen King    
 Title:    Vice President    

  

 FOURTH AMENDMENT TO CREDIT AGREEMENT – Page 8 

	LENDERS:
	
	BANK OF AMERICA, NATIONAL ASSOCIATION
		
	By:	 	 /S/ Stephen King

	 	 	 Name:  Stephen King
 Title:    Vice President 

  

 FOURTH AMENDMENT TO CREDIT AGREEMENT – Page 9

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