Document:

Exhibit 10.2b

 

ADDENDUM TWO TO

LEASE AGREEMENT FOR

A GAMMA KNIFE UNIT

 

This Addendum Two executed as of October
16, 1997, amends that certain Lease Agreement for a Gamma Knife Unit (“Agreement”) executed as of October 31, 1996
between Methodist Healthcare System of San Antonio, LTD. d.b.a. Southwest Texas Methodist Hospital (“Hospital”) and
GK Financing, LLC (“GKF”).

 

Whereas Paragraph 8(b) of the Agreement
stipulates that Hospital shall cause all neurosurgeons, radiation therapists and physicists that may use the Equipment as contemplated
in this Agreement to obtain and maintain at no expense to GKF, throughout the Gamma Knife Service Term, a policy or policies of
insurance insuring their respective risks of professional medical liability incurred in connection with providing professional
services utilizing the Equipment as contemplated in this Agreement, in amounts for such person which shall be not less than $500,000
per incident and $1,000,000 in the annual aggregate.

 

Now, therefore, GKF and Hospital agree that
the amounts stated in Paragraph 8(b) shall be amended to stipulate $200,000 per incident and $600,000 in the annual aggregate.

 

Except as otherwise set forth in this Addendum
Two, all of the provisions of the Agreement remain in full force and effect.

 

	GK Financing, LLC

A California Limited Liability Company

	Methodist Healthcare System of

San Antonio, LTD., d.b.a. Southwest

Texas Methodist Hospital

A Texas Limited Partnership

	By:	
        /s/ Craig K. Tagawa

        Craig K. Tagawa

        Chief Executive Officer
	By:	
        /s/ James C. Scoggin

        James C. Scoggin, Jr.

        Chief Executive Officer

	Dated: 10/9/97	Dated: 10/16/97Exhibit 10.2c

 

AMENDMENT
TO

LEASE AGREEMENT
FOR A GAMMA KNIFE UNIT

 

This
AMENDMENT TO LEASE AGREEMENT FOR
A GAMMA KNIFE UNIT (this “Amendment”) is made effective
December 13, 2003 (the “Effective Date”), by
and between Methodist
Healthcare System of San Antonio, Ltd., d/b/a
Southwest Texas Methodist Hospital, a Texas Corporation
(“Hospital”), and GK Financing, LLC, a California
limited liability company (“GKF”).

 

RECITALS

 

WHEREAS,
on October 29, 1996,
GKF and Hospital executed a Lease Agreement for
a Gamma Knife Unit, and an Addendum dated October 31, 1996
(collectively, the “Original
Lease”);

 

WHEREAS,
the parties desire to amend the
terms and provisions of
the Original Lease as set forth herein.

 

NOW,
THEREFORE, in consideration of the mutual covenants and
agreements set forth herein, and for other
good and valuable consideration, the receipt
and sufficiency of which are hereby
acknowledged, the parties agree
as follows:

 

AGREEMENT

 

1.          Defined
Terms. Unless otherwise defined herein, the capitalized
terms used herein shall have
the same meaning set
forth in the Original Lease.

 

2.          Lease
Extension. The
original ten (10)
year Gamma Knife Service Term set
forth in Paragraph 3
of the Original Lease
shall be extended for an additional two (2)
years plus the number of
days the Equipment is
not available for clinical use
during Cobalt reloading
(the “Cobalt Reloading
Period”). The Commencement Date
of the Gamma Knife Service Term was March 17,
1998, and the Cobalt
Reloading Period consisted
of twenty-two (22) days.
Accordingly, the date
on which the Gamma
Knife Service Term expires
shall be extended from March 16, 2008
to April 7, 2010, (which
includes the Cobalt
Reloading Period).

 

3.          Cobalt
Reload. The existing Cobalt-60 was removed
from, and new Cobalt-60
reloaded into, the Equipment
during the Cobalt Reloading
Period commencing on
or about December 13, 2003.
The costs to remove
and reload Cobalt-60
on the Equipment shall
be the sole responsibility
of GKF.

 

4.          Paragraph
5 of the Original Lease
shall be deleted in its
entirety.

 

5.          Marketing
Support. Paragraph 6 of
the Original Lease shall be deleted in its entirety
and replaced with the
following:

 

     

     

    

  

Per
Procedure Payments. As its sole
consideration for the lease of the Equipment and
the provision of administrative support, Hospital shall pay
GKF the per procedure payment of eight thousand five hundred
dollars ($8,500) for each procedure that is performed using
the Equipment during the first five (5) years
of this Agreement starting from
the Commencement Date (i.e.,
from March 17, 1998
through March 16, 2003).

 

“The
per procedure payments during the sixth (6th) year of this
Agreement as extended by the Cobalt
Reloading Period (i.e., from March 17, 2003 through April 7, 2004) shall
be determined as follows:

 

	“Annual Procedures	Per Procedure Payment
	1-100	$8,200
	101-125	$7,000
	126- 150	$6,000
	151+	$5,000

 

“The
per procedure payments during the seventh (7th) year of
this Agreement and during each subsequent year thereafter
through the expiration of this Agreement (i.e.,
from April 8, 2004 through April 7, 2010) shall
be determined as follows:

 

	“Annual Procedures	Per Procedure Payment
	1-150	$5,242 (or $5,800 if applicable pursuant to Section 8(e) below)
	151+	$4,000

  

“Notwithstanding
anything to the contrary
set forth herein, (a) for purposes of determining the per procedure payment, the number of
annual procedures performed shall be reset to zero (0)
on March 17, 2003, on April 8, 2004, and on each April
3th thereafter through the expiration of
this Agreement ; and
(b) there shall be
no retroactive adjustment of the per procedure payment
irrespective of whether the number of procedures performed reaches a lower
per procedure payment level.
For example, if 155
procedures are performed during the eighth year, Hospital
would pay $5,242 for each of the first 150 procedures,
and $4,000 for each of the next five procedures (i.e.,
for procedures 151 through
155).

 

“If
no procedures are performed utilizing the Equipment, no
charges shall be incurred
by Hospital.

 

“A
procedure shall be defined as
a single patient
treatment session that may include one or more isocenters
during that session. Hospital shall be
billed on the fifteenth (15th)
and the last day of each month
for the actual number
of procedures performed during the first and second half
of the month, respectively. Hospital shall pay the procedures
invoiced within thirty (30) days after being invoiced. Interest shall accrue at the rate of
1-1/2% per month on all invoices remaining unpaid after
45 days.”

 

     

     

    

  

		6.	Paragraph 8(e) of the
Original Lease shall be deleted in its entirety
and replaced with the following:

 

		(e)	Use best efforts to develop
and implement an ongoing marketing program that is specific to the Equipment (the “Marketing Program”), which shall
include, without limitation (i) providing reasonable
and customary marketing materials (i.e., brochures,
announcements, seminars for physicians by neurosurgeons
and radiation therapists, etc.) for the Gamma Knife service
to be operated by the Hospital; and (ii) employing an
individual, who shall be
employed only after consultation with GKF, whose primary
responsibility shall be to provide
marketing services for the Gamma Knife service to be operated
by the Hospital (the “Marketing Employee”).
All of the costs and expenses of the Marketing Program, including, without
limitation, all compensation paid to the Marketing Employee,
shall be borne solely by
Hospital.

 

The
Marketing Program including, without limitation, all advertisements,
brochures and other marketing materials, shall be subject to review by GKF prior to their use. Hospital and GKF shall discuss the
Marketing Program on a regular basis, which shall be
not less than once per month. In
the event Hospital materially
fails to provide marketing
efforts under the Marketing Program generally consistent with the level and scope of such efforts, as made by Hospital during its
2003 fiscal year, and such material failure continues for at least
thirty (30) calendar days, GKF at is option
may either (i) terminate
this Agreement upon providing
Hospital with thirty (30) calendar days written notice;
or (ii) upon providing fifteen
(15) calendar days written notice to Hospital, increase the per procedure payments owed
by Hospital from $5,242 per procedure to $5,800 per procedure
for each of the first
one hundred fifty (150)
procedures during the seventh (7th)
year of this Agreement
and during each subsequent year thereafter
through the expiration of this Agreement (i.e.,
from April 8, 2004 through April
7, 2010) subject to the procedures set forth in
Section 6 of this Agreement.

 

     

     

    

 

		6.	Paragraph 17
of the Original Lease shall be deleted in its entirety
and replaced with the following:

  

		“17.	Options.

 

“(a)          Hospital
shall have the option, exercisable as set forth below to:

 

“(i)
Renegotiate this Agreement
on terms mutually agreeable
to GKF for a specified renewal
term taking into account
the first twelve (12) years of activity of the
Equipment at the Site.
Pursuant to Paragraph 17(a)(ii), if
terms and conditions of an extension are not executed by both parties by the end
of the eleventh (11th) year of the
Gamma Knife Service Term (as extended by the Cobalt Reloading Period (i.e., April 7, 2009),
this Agreement shall terminate.
Both parties shall negotiate in
good faith on the terms and conditions of an extension
of this Agreement.

 

“(ii)
Terminate this Agreement. If Hospital fails to renew this
Agreement as provided in Paragraph 17(a)(i)
above, GKF shall, at its sole
expense remove the Gamma Knife within a reasonable period
of time after the expiration
of the Gamma Knife Service Term.
Hospital shall cooperate in good faith in such
removal.

 

“(iii)
Purchase the Equipment from GKF at the end of the Gamma
Knife Service Term, at a price equal to One Dollar
($1.00) if at least
one thousand seven
hundred (1,700) paid procedures have been performed
during the Gamma Knife Service Term.

 

“(iv)
Purchase the Equipment from GKF at the end of the
Gamma Knife Service Term at a price equal to 80%
of its Fair Market Value. Should Hospital pay for the cost
to reload the Cobalt
on the Equipment during the original Gamma Knife Service
Term, any increase in Equipment value attributed to Cobalt
reloading will be excluded from determining the Equipment's Fair Market Value.

 

“Hospital
shall exercise one (1) of the four (4)
options referred to above,
by mailing an irrevocable written notice
thereof to GKF at Four Embarcadero Center, Suite 3700, San Francisco, California, 94111,
by certified mail, return receipt requested, postmarked
on or before the end of the eleventh (11th) year of the
Gamma Knife Service Term (as extended by the Cobalt Reloading
Period (i.e., April 7, 2009). Any such notice shall
be sufficient if it
states in substance that Hospital elects to exercise its
option and states which of the four (4)
options referred to above Hospital is exercising.

 

7.          Full
Force and Effect. Except
as otherwise amended hereby or provided herein, all of the terms and provisions
of the Original Lease shall remain in full force and effect. Notwithstanding the foregoing, to the extent of any conflict or inconsistency
between the terms and provisions
of this Amendment and that of the Original Lease, the
terms and provisions
of this Amendment shall
prevail and control.

 

IN
WITNESS WHEREOF, the parties have executed this Amendment effective as of the Effective Date.

 

     

     

    

 

	“HOSPITAL”	 	“GKF”
	 	 	 
	Methodist Healthcare System of San

                    Antonio, Ltd, d/b/a Southwest Texas

                    Methodist Hospital
	 	GK Financing, LLC
	 	 	 	By:	/s/ Craig K. Tagawa
	By:	/s/ James C. Scoggin, Jr.	 	 	Craig K. Tagawa
	Name:	James C. Scoggin, Jr.	 	 	Chief Executive Officer
	Title:	Executive Vice President	 	 	 
	 	 	 
	Approved as to Form:	 	 
	 	 	 	 
	By:	/s/ Elizabeth Henry 	 	 
	 	Elizabeth Henry 	 	 
	 	General Counsel

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