Document:

EX-10.13

THIS DOCUMENT PREPARED BY

AFTER RECORDING RETURN TO:

Beth S. Rubin

Riemer & Braunstein LLP

71 South Wacker Drive, Suite 3515

Chicago, Illinois 60606

Property Address:

220 Physicians Boulevard

Ennis, Texas

FIRST AMENDMENT TO DEED OF TRUST,

ASSIGNMENT OF LEASES AND RENTS, SECURITY AGREEMENT,

FIXTURE FILING AND FINANCING STATEMENT

THIS FIRST AMENDMENT TO DEED OF TRUST, ASSIGNMENT OF LEASES AND RENTS, SECURITY AGREEMENT,
FIXTURE FILING AND FINANCING STATEMENT (this “Amendment”), is made as of this
4th day of May, 2011, by and between G&E HC REIT II ENNIS MOB, LLC, a Delaware limited
liability company (“Grantor”), and BANK OF AMERICA, N.A., a national banking association,
as agent (“Administrative Agent”), under a Credit Agreement dated as of July 19, 2010 (as
amended from time to time, the “Credit Agreement”) among Grantor, each other party which is
or becomes a borrower under the Credit Agreement each of whom with Mortgagor are referred to herein
individually and collectively as “Borrower”, Administrative Agent and the other lending
institutions which become parties to the Credit Agreement (Bank of America, N.A. and the other
lending institutions which become parties to the Credit Agreement are collectively referred to as
"Lenders” and individually as “Lender”; and Administrative Agent, in such capacity
as agent for Lenders, together with its successors and assigns, “Beneficiary”).

WITNESSETH:

WHEREAS, Grantor, by that certain Deed of Trust, Assignment of Leases and Rents, Security
Agreement, Fixture Filing and Financing Statement dated as of January 28, 2011 in favor of
Administrative Agent, which was filed January 31, 2011, recorded in Volume 2553, Page 2124, Real
Property Records of Ellis County, Texas (the “Deed of Trust”), granted, bargained, sold,
conveyed, transferred, assigned and set over, with general warranty, to Trustee for the benefit of
Beneficiary, certain real property located in Ennis, Ellis County, Texas, as more particularly
described on Exhibit A attached hereto and made a part hereof (the “Land”), to
secure certain indebtedness (the “Loan”); and

WHEREAS, the Loan is evidenced by those certain Promissory Notes made by Borrower payable to
the order of the applicable Lender in the aggregate original principal amount of Twenty Five
Million and No/100 Dollars ($25,000,000.00) (as amended from time to time, collectively, the
"Note”); and

WHEREAS, Grantor has requested certain modifications to the Credit Agreement, the Note and
certain other Loan Documents (as defined in the Deed of Trust), all as set forth in that certain
First Amendment to Credit Agreement and Related Loan Documents dated as of the date hereof by and
between Borrower and Administrative Agent (the “First Amendment to Credit Agreement”), and
in that certain Amended and Restated Promissory Note dated as of the date hereof made by Borrower
to the order of the applicable Lender (the “Amended and Restated Note”); and

WHEREAS, Grantor and Beneficiary desire to execute and deliver this Amendment to reflect such
modifications to the Deed of Trust all as set forth in the First Amendment to Credit Agreement, and
as more particularly described herein.

NOW THEREFORE, for and in consideration of the recitals set forth above and made a part
hereof, and other good and valuable consideration, the receipt and sufficiency of which is hereby
acknowledged, the undersigned do hereby agree as follows:

1. Capitalized terms used herein and not defined shall have the meaning ascribed to such terms
in the Deed of Trust.

2. The definition of “Note” is hereby amended and restated in its entirety as follows:

""Note” means, singly and collectively, those certain
Promissory Notes, each dated July 19, 2010 made by Borrower and
payable, respectively, to the order of each Lender in the principal
face amount of that Lender’s Commitment, such Note being in the
aggregate original principal amount of Twenty Five Million and
No/100 Dollars ($25,000,000.00), as amended and restated pursuant to
that certain Amended and Restated Promissory Note dated May 4, 2011
made by Borrower and payable, respectively, to the order of
Administrative Agent as a Lender in the principal amount of that
Lender’s Commitment, as such amount is increased pursuant to those
certain Amended and Restated Promissory Note and the First Amendment
to Credit Agreement, such Note being in the aggregate original
principal amount of Forty Five Million and No/100 Dollars
($45,000,000.00), bearing interest as provided in the Credit
Agreement, as the same may from time to time be extended, amended,
restated, supplemented or otherwise modified.”

3. The reference in Section 19.6 of the Deed of Trust to the total indebtedness secured by the
Deed of Trust as “Fifty Million and No/100 Dollars ($50,000,000.00)” is hereby deleted and replaced
with “Ninety Million and No/100 Dollars ($90,000,000.00)”.

4. The parties hereto agree that the terms “Credit Agreement”, “Note” and “Loan Documents”,
each as used in the Deed of Trust and the other Loan Documents, shall mean the Credit Agreement,
the Note and the Loan Documents, respectively, each as amended by this Amendment, the First
Amendment to Credit Agreement and the Amended and Restated Promissory Note.

5. Except as expressly modified and amended hereby, the Deed of Trust shall continue in full
force and effect and, as thus modified and amended, is hereby ratified, confirmed and approved.
This Amendment applies to, inures to the benefit of and is binding on the parties hereto, and their
respective successors and assigns.

6. This Amendment may be executed in multiple counterparts all of which taken together shall
constitute one executed original.

7. TO THE MAXIMUM EXTENT PERMITTED BY LAW, GRANTOR HEREBY AGREES THAT ALL ACTIONS OR
PROCEEDINGS ARISING IN CONNECTION WITH THIS AMEDNMENT OR THE DEED OF TRUST MAY BE TRIED AND
DETERMINED IN THE STATE AND FEDERAL COURT LOCATED IN THE COUNTY OF COOK, STATE OF ILLINOIS OR, AT
THE SOLE OPTION OF BENEFICIARY, IN ANY OTHER COURT IN WHICH BENEFICIARY SHALL INITIATE LEGAL OR
EQUITABLE PROCEEDINGS AND WHICH HAS SUBJECT MATTER JURISDICTION OVER THE MATTER IN CONTROVERSY,
EXCEPT THAT ANY ACTION TO FORECLOSE THE DEED OF TRUST, TO OBTAIN POSSESSION OF THE PROPERTY, TO
HAVE A RECEIVER OR KEEPER APPOINTED FOR THE PROPERTY OR TO ENFORCE ANY OTHER REMEDY HEREIN
AFFECTING THE PROPERTY, INCLUDING, BUT NOT LIMITED TO, INJUNCTIVE RELIEF, MAY BE BROUGHT, AT THE
SOLE OPTION OF BENEFICIARY, IN THE STATE AND FEDERAL COURTS LOCATED IN THE STATE OF TEXAS. TO THE
MAXIMUM EXTENT PERMITTED BY LAW, GRANTOR HEREBY EXPRESSLY WAIVES ANY RIGHT IT MAY HAVE TO ASSERT
THE DOCTRINE OF FORUM NON CONVENIENS OR TO OBJECT TO VENUE TO THE EXTENT ANY PROCEEDING IS
BROUGHT IN ACCORDANCE WITH THIS PARAGRAPH. TO THE MAXIMUM EXTENT PERMITTED BY LAW, GRANTOR HEREBY
WAIVES PERSONAL SERVICE OF PROCESS UPON GRANTOR, AND AGREES THAT ALL SUCH SERVICE OF PROCESS MAY BE
MADE BY REGISTERED MAIL DIRECTED TO GRANTOR AT THE ADDRESS STATED IN THE DEED OF TRUST AND SERVICE
SO MADE WILL BE DEEMED TO BE COMPLETED UPON ACTUAL RECEIPT.

8. EACH PARTY HERETO HEREBY IRREVOCABLY WAIVES, TO THE FULLEST EXTENT PERMITTED BY APPLICABLE
LAW, ANY RIGHT IT MAY HAVE TO A TRIAL BY JURY IN ANY LEGAL PROCEEDING DIRECTLY OR INDIRECTLY
ARISING OUT OF OR RELATING TO THIS AMENDMENT, THE DEED OF TRUST OR ANY OTHER LOAN DOCUMENT OR THE
TRANSACTIONS CONTEMPLATED HEREBY OR THEREBY (WHETHER BASED ON CONTRACT, TORT OR ANY OTHER THEORY).
EACH PARTY HERETO (A) CERTIFIES THAT NO REPRESENTATIVE, AGENT OR ATTORNEY OF ANY OTHER PERSON HAS
REPRESENTED, EXPRESSLY OR OTHERWISE, THAT SUCH OTHER PERSON WOULD NOT, IN THE EVENT OF LITIGATION,
SEEK TO ENFORCE THE FOREGOING WAIVER AND (B) ACKNOWLEDGES THAT IT AND THE OTHER PARTIES HERETO HAVE
BEEN INDUCED TO ENTER INTO THIS AMENDMENT, THE DEED OF TRUST AND THE OTHER LOAN DOCUMENTS BY, AMONG
OTHER THINGS, THE MUTUAL WAIVERS AND CERTIFICATIONS IN THIS PARAGRAPH.

9. THIS AMENDMENT REPRESENTS THE FINAL AGREEMENT BETWEEN THE PARTIES AND MAY NOT BE
CONTRADICTED BY EVIDENCE OF PRIOR, CONTEMPORANEOUS OR SUBSEQUENT ORAL AGREEMENTS OF THE PARTIES.
THERE ARE NO UNWRITTEN ORAL AGREEMENTS BETWEEN THE PARTIES.

[REMAINDER OF PAGE INTENTIONALLY LEFT BLANK]

[SIGNATURE PAGES FOLLOW]

IN WITNESS WHEREOF, Grantor and Administrative Agent have caused this Amendment to be
executed under seal as of the day and year first written above.

GRANTOR:

G&E HC REIT II ENNIS MOB, LLC,

a Delaware limited liability company

By: Grubb & Ellis Healthcare REIT II Holdings, LP,

a Delaware limited partnership, its sole Member

By: Grubb & Ellis Healthcare REIT II, Inc.,

a Maryland corporation, its general partner

By: /s/ Danny Prosky

Name: Danny Prosky

Title: President and Chief Operating Officer

	 	 	 	 	 
	STATE OF CALIFORNIA

COUNTY OF ORANGE

	 	§

§

§
	 	

SS.

On April 28, 2011 before me, P.C. Han, Notary Public, personally appeared Danny Prosky, who
proved to me on the basis of satisfactory evidence to be the person whose name is subscribed to the
within instrument and acknowledged to me that he executed the same in his authorized capacity, and
that by his signature on the instrument the person, or the entity upon behalf of which person
acted, executed the instrument.

I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing
paragraph is true and correct.

WITNESS my hand and official seal.

Signature: /s/ P.C. Han (Seal)

IN WITNESS WHEREOF, Grantor and Administrative Agent have caused this Amendment to be executed
under seal as of the day and year first written above.

ADMINISTRATIVE AGENT:

BANK OF AMERICA, N.A.,

a national banking association

By: /s/ Christopher A. Thangaraj

Name: Christopher A. Thangaraj

Its: Vice President

	 	 	 
	State of Illinois

County of Cook

	 	§

§

§

This instrument was acknowledged before me on April 29, 2011, by Christopher A. Thangaraj, a
Vice President of Bank of America, N.A., a national banking association, on behalf of said entity.

/s/ Ckeotre A Roca-Dawson

Notary Public

My commission expires: June 17, 2014Exhibit 4.1

EXHIBIT 4.1(C)  Supplemental Indenture No. 2 

THIS SUPPLEMENTAL INDENTURE NO. 2, dated as of March 15, 2007 (the “Supplemental Indenture No. 2”), between CIGNA CORPORATION, a corporation duly organized and existing under the laws of the State of Delaware (the “Company”), and U.S. BANK NATIONAL ASSOCIATION, a national banking association duly organized and existing under the laws of the United States of America, as trustee (the “Trustee”). 

Recitals: 

WHEREAS, the Company and the Trustee are parties to a Senior Indenture, dated as of August 16, 2006 (the “Base Indenture” and as amended by this Supplemental Indenture No. 2, the “Indenture”), relating to the issuance from time to time by the Company of its Securities on terms to be specified at the time of issuance; 

WHEREAS, Section 901(7) of the Base Indenture provides that the Company may enter into a supplemental indenture to establish the terms and provisions of a series of Securities issued pursuant to the Indenture; 

WHEREAS, the Company desires to issue a series of Securities, and has duly authorized the creation and issuance of such Securities and the execution and delivery of this Supplemental Indenture No. 2 to modify the Base Indenture and provide certain additional provisions as hereinafter described; 

WHEREAS, the parties hereto deem it advisable to enter into this Supplemental Indenture No. 2 for the purpose of establishing the terms of such Securities, providing for the rights, obligations and duties of the Trustee with respect to such Securities and amending certain provisions of the Base Indenture; and 

WHEREAS, all conditions and requirements of the Base Indenture necessary to make this Supplemental Indenture No. 2 a valid, binding and legal instrument in accordance with its terms have been performed and fulfilled by the parties hereto. 

NOW, THEREFORE, for and in consideration of the premises and other good and valuable consideration, receipt of which is hereby acknowledged by the parties hereto, the parties hereto agree as follows: 

1

Article I	The Senior Notes 

Section 1.01	Title of Securities 

There shall be a series of Securities designated the “5.375% Senior Notes due 2017” of the Company (the “Senior Notes”). 

Section 1.02	Limitation of Aggregate Principal Amount 

The aggregate principal amount of the Senior Notes shall initially be limited to $250,000,000 (except for Securities authenticated and delivered upon registration of transfer of, or in exchange for, or in lieu of, Senior Notes pursuant to Sections 304, 305, 306, 906 or 1107 of the Indenture and except for any Securities which, pursuant to Section 303 of the Indenture, are deemed never to have been authenticated and delivered thereunder). The Company may, without the consent of the Holders of the Senior Notes, issue additional Senior Notes having the same interest rate, maturity date, CUSIP number and other terms (other than issue date and issue price) (“Additional Senior Notes”). Any Additional Senior Notes, together with the Senior Notes, will constitute a single series of Securities under the Indenture. No Additional Senior Notes may be issued if an Event of Default under the Indenture has occurred and is continuing with respect to the Senior Notes. 

Section 1.03	Principal Payment Date 

The principal amount of the Senior Notes outstanding (together with any accrued and unpaid interest) shall be payable in a single installment on March 15, 2017, which date shall be the Stated Maturity of the Senior Notes. 

Section 1.04	Interest and Interest Rates 

The rate of interest on each Senior Note shall be 5.375% per annum, accruing from March 15, 2007, or from the most recent Interest Payment Date to which interest has been paid or duly provided for, payable semiannually in arrears on March 15 and September 15 of each year, commencing September 15, 2007 until the principal thereof is paid or made available for payment. The amount of interest payable on any Interest Payment Date shall be computed on the basis of a 360-day year of twelve 30-day months. The amount of interest payable for any period shorter than a full monthly period shall be computed on the basis of the actual number of calendar days elapsed in such a period. In the event that any Interest Payment Date, Redemption Date, Maturity or Stated Maturity of any Senior Note is not a Business Day, then payment of interest or principal (and premium, if any) payable on such date will be made on the next succeeding day that is a Business Day (and without any interest or other payment in respect of any such delay). The interest so payable in respect of any Senior Note, and punctually paid or duly provided for, on any Interest Payment Date will be paid to the Person in whose name such Senior Note (or one or more Predecessor Securities) is registered at the close of business on the fifteenth calendar day (whether or not a Business Day) prior to such Interest Payment Date (the “Regular Record Date”). Any such interest not punctually paid or duly provided for in respect of any Senior Note shall forthwith cease to be payable to the registered Holder on such Regular Record Date and may either be paid to the Person in whose name such Senior Note (or one or more Predecessor Securities) is registered at the close of business on a Special Record Date to be fixed by the Trustee for the payment of such Defaulted Interest, notice whereof shall be given to the Holders of the Senior Notes not less than 10 calendar days prior to such Special Record Date, or be paid at any time in any other lawful manner not inconsistent with the requirements of any securities exchange on which the Senior Notes may be listed, and upon such notice as may be required by such exchange. 

Section 1.05	Place of Payment 

The place where the Senior Notes may be presented or surrendered for payment, where the Senior Notes may be surrendered for registration of transfer or exchange and where notices and demand to or upon the Company in respect of the Senior Notes and the Indenture may be served shall be the Corporate Trust Office of the Trustee or the Paying Agent’s office maintained for that purpose in the Borough of Manhattan, City of New York. 

Section 1.06	Optional Redemption 

(a)

	The Company may redeem the Senior Notes, at any time, and from time to time, in whole or in part, at a redemption price equal to the greater of (i) 100% of the principal amount of such Senior Notes to be redeemed and (ii) the sum of the present values of the remaining scheduled payments of principal and interest (excluding interest accrued to the Redemption Date) on the Senior Notes to be redeemed from the Redemption Date to the Stated Maturity date discounted to the Redemption Date on a semi-annual basis (assuming a 360-day year consisting of twelve 30-day months) at the Treasury Rate, plus 15 basis points, plus, in each case, accrued and unpaid interest on the Senior Notes to the Redemption Date (the “Redemption Price”). Unless the Company defaults in payment of the Redemption Price, interest will cease to accrue on the Senior Notes called for redemption on and after the Redemption Date. 

(b)

	The Treasury Rate shall be calculated on the third Business Day preceding the Redemption Date. 

(c)

	Notice of redemption shall be given in accordance with Section 1104 of the Indenture. If less than all of the Senior Notes then Outstanding are to be redeemed, the Trustee will select the particular Senior Notes or portions thereof in accordance with Section 1103 of the Indenture. 

2

(d)

	For the purposes of this Section 1.06 of Supplemental Indenture No. 2, the terms below are defined as follows: 

“Comparable Treasury Issue” means the United States Treasury Security selected by an Independent Investment Banker as having a maturity comparable to the remaining term of the Senior Notes to be redeemed that would be utilized, at the time of selection and in accordance with customary financial practice, in pricing new issues of corporate debt securities of comparable maturity to the remaining term of the Senior Notes to be redeemed. 

“Comparable Treasury Price” means, with respect to any Redemption Date for any Senior Notes, the average of all Reference Treasury Dealer Quotations obtained. 

“Independent Investment Banker” means one of the Reference Treasury Dealers appointed by the Trustee after consultation with the Company. 

“Primary Treasury Dealer” means a primary U.S. Government securities dealer in New York City. 

“Reference Treasury Dealer” means Banc of America Securities LLC, Citigroup Global Markets Inc., Deutsche Bank Securities, Goldman, Sachs & Co. and their successors; provided, however, that if any Reference Treasury Dealer ceases to be a Primary Treasury Dealer, the Company will substitute therefor another Primary Treasury Dealer. 

“Reference Treasury Dealer Quotations” means, with respect to each Reference Treasury Dealer and any Redemption Date, the average, as determined by the Trustee, of the bid and asked prices for the Comparable Treasury Issue (expressed in each case as a percentage of its principal amount) quoted in writing to the Trustee by that Reference Treasury Dealer at 5:00 p.m. (New York City time) on the third Business Day preceding such Redemption Date. 

“Treasury Rate” means, with respect to any Redemption Date, (1) the yield, under the heading which represents the average for the immediately preceding week, appearing in the most recently published statistical release designated “H.15(519)” or any successor publication which is published weekly by the Board of Governors of the Federal Reserve System and which establishes yields on actively traded United States Treasury securities adjusted to constant maturity under the caption “Treasury Constant Maturities,” for the maturity corresponding to the Comparable Treasury Issue (if no maturity is within three months before or after the maturity date for the Senior Notes, yields for the two published maturities most closely corresponding to the Comparable Treasury Issue will be determined and the Treasury Rate shall be interpolated or extrapolated from such yields on a straight line basis, rounding to the nearest month) or (2) if such release (or any successor release) is not published during the week preceding the calculation date or does not contain such yields, the rate per annum equal to the semi-annual equivalent yield-to-maturity of the Comparable Treasury Issue, calculated using a price for the Comparable Treasury Issue (expressed as a percentage of its principal amount) equal to the Comparable Treasury Price for such Redemption Date. 

Section 1.07	Sinking Fund Obligations 

The Company has no obligation to redeem or purchase any Senior Notes pursuant to any sinking fund or analogous requirement or upon the happening of a specified event or at the option of a Holder thereof. 

Section 1.08	Denomination 

The Senior Notes shall be issuable only in registered form without coupons and in denominations of $2,000 and multiples of $1,000 in excess thereof. 

Section 1.09	Currency 

Principal and interest on the Senior Notes shall be payable in such coin or currency of the United States of America that at the time of payment is legal tender for payment of public and private debts. 

Section 1.10	Senior Notes to be Issued in Global Form 

The Senior Notes will be permanently represented by one or more securities in global form (the “Global Note”). The Company hereby designates The Depository Trust Company as the initial Depositary for the Global Note. 

Section 1.11	Form of Senior Notes 

The Senior Notes shall be substantially in the form attached as Annex A hereto. 

Section 1.12	Security Registrar and Paying Agent for the Senior Notes 

The Trustee shall serve initially as the Security Registrar and the Paying Agent. 

Section 1.13	Defeasance 

The provisions of Section 1006 of the Indenture shall apply to the Senior Notes. 

3

Article II	Miscellaneous 

Section 2.01	Integral Part; Effect of Supplement on Indenture 

This Supplemental Indenture No. 2 constitutes an integral part of the Indenture. Except for the amendments and supplements made by this Supplemental Indenture No. 2, the Base Indenture shall remain in full force and effect as executed. 

Section 2.02	General Definitions 

For purposes of this Supplemental Indenture No. 2: 

(a)

	Capitalized terms used herein without definition shall have the meanings specified in the Base Indenture; 

(b)

	All references to Articles and Sections, unless otherwise specified, refer to the corresponding Articles and Sections of the Base Indenture; and 

(c)

	The terms “herein,” “hereof,” “hereunder” and other words of similar import refer to this Supplemental Indenture No. 2. 

Section 2.03	Adoption, Ratification and Confirmation 

The Indenture, as supplemented by this Supplemental Indenture No. 2, is in all respects hereby adopted, ratified and confirmed. 

Section 2.04	Trustee Not Responsible for Recitals 

The recitals in this Supplemental Indenture No. 2 are made by the Company, and the Trustee assumes no responsibility for the correctness of such recitals. The Trustee makes no representations as to the validity or sufficiency of this Supplemental Indenture No. 2. 

Section 2.05	Counterparts 

This Supplemental Indenture No. 2 may be executed in multiple counterparts, each of which shall be regarded for all purposes as an original and all of which shall constitute but one and the same instrument. 

Section 2.06	Governing Law 

This Supplemental Indenture No. 2 and the Senior Notes shall be governed by and construed in accordance with the laws of the State of New York applicable to agreements made or instruments entered into, in each case, performed in said state. 

(signature page follows) 

4

IN WITNESS WHEREOF, the Company and the Trustee have executed this Supplemental Indenture No. 2 as of the date first above written. 

		
CIGNA CORPORATION

		
By:

	
/s/ Mordecai Schwartz

		
Name:

	

Mordecai Schwartz

		
Title:

	

Senior Vice President and Treasurer

		
U.S. BANK NATIONAL ASSOCIATION

		
By:

	
/s/ Paul J. Schmalzel

		
Name:

	

Paul J. Schmalzel

		
Title:

	

Vice President

5

Annex A	Form of Global Note 

UNLESS THIS CERTIFICATE IS PRESENTED BY AN AUTHORIZED REPRESENTATIVE OF THE DEPOSITORY TRUST COMPANY, TO THE COMPANY OR ITS AGENT FOR REGISTRATION OF TRANSFER, EXCHANGE OR PAYMENT, AND ANY CERTIFICATE ISSUED IS REGISTERED IN THE NAME OF CEDE & CO. OR SUCH OTHER NAME AS IS REQUESTED BY AN AUTHORIZED REPRESENTATIVE OF THE DEPOSITORY TRUST COMPANY (AND ANY PAYMENT HEREON IS MADE TO CEDE & CO. OR TO SUCH OTHER ENTITY AS IS REQUESTED BY AN AUTHORIZED REPRESENTATIVE OF THE DEPOSITORY TRUST COMPANY), ANY TRANSFER, PLEDGE OR OTHER USE HEREOF FOR VALUE OR OTHERWISE BY OR TO ANY PERSON IS WRONGFUL SINCE THE REGISTERED OWNER HEREOF, CEDE & CO., HAS AN INTEREST HEREIN. 

THIS SECURITY IS A GLOBAL SECURITY WITHIN THE MEANING OF THE INDENTURE AND IS REGISTERED IN THE NAME OF CEDE & CO. THIS SECURITY MAY NOT BE EXCHANGED IN WHOLE OR IN PART FOR A SECURITY REGISTERED, AND NO TRANSFERS OF THIS GLOBAL SECURITY IN WHOLE OR IN PART MAY BE REGISTERED, IN THE NAME OF ANY PERSON OTHER THAN NOMINEES OF CEDE & CO. OR A SUCCESSOR THEREOF OR SUCH SUCCESSOR’S NOMINEE. 

CIGNA CORPORATION 

5.375% Senior Note Due 2017 

CUSIP: 125509BJ7 

No. 1 Principal Amount $250,000,000 

CIGNA CORPORATION, a Delaware corporation (herein called the “Company”), which term includes any successor Person under the Indenture hereinafter referred to, for value received, hereby promises to pay to CEDE & CO., or its registered assigns, the principal sum of Two Hundred Fifty Million Dollars ($250,000,000) upon presentation and surrender of this Security on March 15, 2017 and to pay interest thereon accruing from March 15, 2007 or from the most recent Interest Payment Date to which interest has been paid or duly provided for, semi-annually in arrears on March 15 and September 15 of each year, commencing September 15, 2007, at the rate of 5.375% per annum, until the principal hereof is paid or made available for payment. The interest so payable, and punctually paid or duly provided for, on any Interest Payment Date will, as provided in such Indenture, be paid to the Person in whose name this Security (or one or more Predecessor Securities) is registered at the close of business on the Regular Record Date for such interest payment, which shall be the close of business on the fifteenth calendar day (whether or not a Business Day) prior to such Interest Payment Date. Any such interest not punctually paid or duly provided for shall forthwith cease to be payable to the registered Holder on such Regular Record Date and may either be paid to the Person in whose name this Security (or one or more Predecessor Securities) is registered at the close of business on a Special Record Date for the payment of such Defaulted Interest to be fixed by the Trustee, notice whereof shall be given to Holders of Securities of this series not less than 10 calendar days prior to such Special Record Date, or be paid at any time in any other lawful manner not inconsistent with the requirements of any securities exchange on which the Securities of this series may be listed, and upon such notice as may be required by such exchange, all as more fully provided in said Indenture. 

Payment of the principal of (and premium, if any) and interest on this Security will be made at the office or agency of the Company maintained for that purpose in the Borough of Manhattan, City of New York, in such coin or currency of the United States of America as at the time of payment is legal tender for payment of public and private debts; provided, however, that at the option of the Company payment of interest may be made by check mailed to the address of the Person entitled thereto as such address shall appear in the Security Register. 

Reference is hereby made to the further provisions of this Security set forth on the reverse hereof, which further provisions shall for all purposes have the same effect as if set forth at this place. 

Unless the certificate of authentication hereon has been executed the Trustee referred to on the reverse hereof by manual signature, this Security shall not be entitled to any benefit under the Indenture or be valid or obligatory for any purpose. 

IN WITNESS WHEREOF, the Company has caused this instrument to be duly executed under its corporate seal. 

(SEAL) 

	
 

	
CIGNA CORPORATION

		
By:

		
		
Name:

	

Mordecai Schwartz

		
Title:

	

Senior Vice President and Treasurer

		
Attest:

		
		
Name:

	

Danthu Phan

		
Title:

	

Assistant Corporate Secretary

A-1

Trustee’s Certificate of Authentication 

This is one of the Securities of the series designated under, and referred to in, the within-mentioned Indenture. 

	
 

	
U.S. BANK NATIONAL ASSOCIATION, as Trustee

		
By:

	
		
Authorized Signatory

	

A-2

[REVERSE SIDE OF SECURITY] 

CIGNA CORPORATION 

5.375% Senior Notes due 2017 

This Security is one of a duly authorized issue of securities of the Company (herein called the “Securities”), issued and to be issued in one or more series under a Senior Indenture, dated as of August 16, 2006, as supplemented by a Supplemental Indenture No. 2, dated as of March 15, 2007 (as so supplemented, the “Indenture”), between the Company, as issuer, and U.S. Bank National Association, as trustee (herein called the “Trustee”, which term includes any successor trustee under the Indenture), to which Indenture and all indentures supplemental thereto reference is hereby made for a statement of the respective rights, limitations of rights, duties and immunities thereunder of the Company, the Trustee and the Holders of the Securities and of the terms upon which the Securities are, and are to be, authenticated and delivered. This Security is one of the series designated on the face hereof, initially limited in aggregate principal amount to $250,000,000, subject to future issuances of additional Securities pursuant to Section 301 of the Indenture. 

The Securities of this series are subject to redemption upon not less than 30 calendar days’ nor more than 60 calendar days’ notice by mail, at any time, and from time to time, in whole or in part, at a redemption price equal to the greater of (i) 100% of the principal amount of such Securities to be redeemed and (ii) the sum of the present values of the remaining scheduled payments of principal and interest (excluding interest accrued to the Redemption Date) on the Securities to be redeemed from the Redemption Date to the Stated Maturity date discounted to the Redemption Date on a semi-annual basis (assuming a 360-day year consisting of twelve 30-day months) at the Treasury Rate, plus 15 basis points, plus, in each case, accrued and unpaid interest on the Securities to the Redemption Date. 

“Treasury Rate” means, with respect to any Redemption Date, (1) the yield, under the heading which represents the average for the immediately preceding week, appearing in the most recently published statistical release designated “H.15(519)” or any successor publication which is published weekly by the Board of Governors of the Federal Reserve System and which establishes yields on actively traded United States Treasury securities adjusted to constant maturity under the caption “Treasury Constant Maturities,” for the maturity corresponding to the Comparable Treasury Issue (if no maturity is within three months before or after the maturity date for the Senior Notes, yields for the two published maturities most closely corresponding to the Comparable Treasury Issue will be determined and the Treasury Rate shall be interpolated or extrapolated from such yields on a straight line basis, rounding to the nearest month) or (2) if such release (or any successor release) is not published during the week preceding the calculation date or does not contain such yields, the rate per annum equal to the semi-annual equivalent yield-to-maturity of the Comparable Treasury Issue, calculated using a price for the Comparable Treasury Issue (expressed as a percentage of its principal amount) equal to the Comparable Treasury Price for such Redemption Date. 

The Treasury Rate shall be calculated on the third Business Day preceding the Redemption Date. 

“Comparable Treasury Issue” means the United States Treasury Security selected by an Independent Investment Banker as having a maturity comparable to the remaining term of the Senior Notes to be redeemed that would be utilized, at the time of selection and in accordance with customary financial practice, in pricing new issues of corporate debt securities of comparable maturity to the remaining term of the Senior Notes to be redeemed. 

“Comparable Treasury Price” means, with respect to any Redemption Date for any Senior Notes, the average of all Reference Treasury Dealer Quotations obtained. 

“Independent Investment Banker” means one of the Reference Treasury Dealers appointed by the Trustee after consultation with the Company. 

“Primary Treasury Dealer” means a primary U.S. Government securities dealer in New York City. 

“Reference Treasury Dealer” means Banc of America Securities LLC, Citigroup Global Markets Inc., Deutsche Bank Securities, Goldman, Sachs & Co. and their successors; provided, however, that if any Reference Treasury Dealer ceases to be a Primary Treasury Dealer, the Company will substitute therefor another Primary Treasury Dealer. 

“Reference Treasury Dealer Quotations” means, with respect to each Reference Treasury Dealer and any Redemption Date, the average, as determined by the Trustee, of the bid and asked prices for the Comparable Treasury Issue (expressed in each case as a percentage of its principal amount) quoted in writing to the Trustee by that Reference Treasury Dealer at 5:00 p.m. (New York City time) on the third Business Day preceding such Redemption Date. 

Unless the Company defaults in payment of the Redemption Price, interest will cease to accrue on the Securities of this series called for redemption on and after the Redemption Date. In the event of redemption of this Security in part only, a new Security or Securities of this series for the unredeemed portion hereof will be issued in the name of the Holder hereof upon the cancellation hereof. 

If an Event of Default with respect to Securities of this series shall occur and be continuing, the principal of the Securities of this series may be declared due and payable in the manner and with the effect provided in the Indenture. 

The Indenture permits, with certain exceptions as therein provided, the amendment thereof and the modification of the rights and obligations of the Company and the rights of the Holders of the Securities of each series to be affected under the Indenture at any time by the Company and the Trustee with the consent of the Holders of not less than a majority in aggregate principal amount of the Securities at the time Outstanding of each series to be affected. The Indenture also contains provisions permitting the Holders of specified percentages in aggregate principal amount of the Securities of each series at the time Outstanding, on behalf of the Holders of all Securities of such series, to waive compliance by the Company with certain provisions of the Indenture and certain past defaults under the Indenture and their consequences. Any such consent or waiver by the Holder of this Security shall be conclusive and binding upon such Holder and upon all future Holders of this Security and of any Security issued upon the registration of transfer hereof or in exchange herefor or in lieu hereof, whether or not notation of such consent or waiver is made upon this Security. 

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No reference herein to the Indenture and no provision of this Security or of the Indenture shall alter or impair the obligation of the Company, or the right of the Holder of this Security, which is absolute and unconditional, to pay, or, in the case of the Holder of this Security, to receive payment of, the principal of (and premium, if any) and interest on this Security at the times, place and rate, and in the coin or currency, herein prescribed. 

As provided in the Indenture and subject to certain limitations therein set forth, the transfer of this Security is registrable in the Security Register, upon surrender of this Security for registration of transfer at the office or agency of the Company in any place where the principal of (and premium, if any) and interest on this Security are payable, duly endorsed by, or accompanied by a written instrument of transfer in form satisfactory to the Company and the Security Registrar duly executed by, the Holder hereof or such Holder’s attorney duly authorized in writing; and thereupon one or more new Securities of this series and of like tenor, of authorized denominations and for the same aggregate principal amount, will be issued to the designated transferee or transferees. 

The Securities of this series are issuable only in registered form without coupons in denominations of $2,000 and multiples of $1,000 in excess thereof. As provided in the Indenture and subject to certain limitations therein set forth, Securities of this series are exchangeable for other Securities of this series, of a like tenor and aggregate principal amount but of a different authorized denomination, as requested by the Holder surrendering the same. 

No service charge shall be made for any such registration of transfer or exchange, but the Company or the Trustee may require payment of a sum sufficient to cover any tax or other governmental charge that may be imposed in connection with any registration of transfer or exchange of Securities, other than exchanges pursuant to Section 304, 906 or 1107 of the Indenture not involving any transfer. 

Prior to due presentment of this Security for registration of transfer, the Company, the Trustee and any agent of the Company or the Trustee may treat the Person in whose name this Security is registered as the owner hereof for all purposes, whether or not this Security be overdue, and neither the Company, the Trustee nor any such agent shall be affected by notice to the contrary. 

The Indenture provides that the Company, at the Company’s option, (a) will be discharged from any and all obligations in respect of the Securities (except for certain obligations to register the transfer or exchange of Securities, replace stolen, lost or mutilated Securities, maintain paying agencies and hold moneys for payment in trust) or (b) need not comply with certain restrictive covenants of the Indenture, in each case if the Company deposits, in trust, with the Trustee money, or U.S. Government Obligations (or Foreign Government Obligations if the Securities are denominated in a foreign currency or currencies) which through the payment of interest thereon and principal thereof in accordance with their terms will provide money, in an amount sufficient to pay all the principal (including any mandatory sinking fund payments) of, and (premium, if any) and interest on, the Securities on the dates such payments are due in accordance with the terms of such Securities, and certain other conditions are satisfied. 

No recourse shall be had for the payment of the principal of (and premium, if any) or interest on this Security, or for any claim based hereon, or otherwise in respect hereof, or based on or in respect of the Indenture or any indenture supplemental thereto, against any incorporator, stockholder, officer, employee, agent or director, as such, past, present or future, of the Company or of any successor corporation, whether by virtue of any constitution, statute or rule of law, or by the enforcement of any assessment or penalty or otherwise, all such liability being, by the acceptance hereof and as part of the consideration for the issue hereof, expressly waived and released. 

All terms used in this Security which are defined in the Indenture shall have the meanings assigned to them in the Indenture. 

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Assignment Form 

I or we assign and transfer this Security to:................................................................. 

Insert social security or other identifying number of assignee...................................... 

Print or type name, address and zip code of assignee................................................... 

and irrevocably appoint	,......................................, as agent, to transfer this Security on the books of the Company. 

The agent may substitute another to act for him. 

Date:................................................................ 

Signed.............................................................. 

(Sign exactly as name appears on the other side of this Security) 

Signature Guarantee*: 

*	The Holder’s signature must be guaranteed by a member firm of a registered national securities exchange or of the National Association of Securities Dealers, Inc., a commercial bank or trust company having an office or correspondent in the United States or an “eligible guarantor institution” as defined by Rule 17Ad-15 under the Exchange Act.

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