Document:

EXHIBIT
10.4

 

MEDICAL
TRANSCRIPTION BILLING, CORP.

EXECUTIVE
EMPLOYMENT AGREEMENT

 

EMPLOYMENT
AGREEMENT, dated as of the 1st day of May, 2018 between Medical Transcription Billing, Corp., a Delaware Company (the
“Company”) and Bill Korn (the “Executive”).

 

WHEREAS,
the Executive has been employed by the Company or one of its subsidiaries prior to the date hereof as Chief Financial Officer;

 

WHEREAS,
the Executive possesses unique knowledge of the business and affairs of the Company, including its policies, methods, personnel
and operations; and

 

WHEREAS,
the Board of Directors of the Company (the “Board of Directors”) believes it to be in the best interests of the Company
to ensure the Executive’s continued employment by the Company in the capacity and under the terms and conditions set forth
herein;

 

NOW,
THEREFORE, in consideration of the foregoing and the mutual promises and agreements hereinafter set forth, the Company and Executive
agree as follows:

 

1.                  
Effective Date. This Employment Agreement shall become effective on May 1, 2018. (the “Effective Date”).

 

2.                  
Employment. The Company hereby employs the Executive and the Executive hereby accepts employment all upon the terms and
conditions herein set forth.

 

3.                  
Duties. The Executive shall perform such management duties for the Company and its affiliates as may from time to time
be assigned and which are consistent with his title of Chief Financial Officer. The Executive hereby promises to perform and discharge,
well and faithfully, all duties of his position. If Executive is elected as a director or officer of any affiliate of the Company,
the Executive shall serve in such capacity or capacities without further compensation.

 

4.                  
Extent of Services. 

 

(a)                
The Executive shall devote his entire time, attention and energies to the business of the Company and shall not during the term
of this Employment Agreement be engaged in any other business activity whether or not such business activity is pursued for gain,
profit or other pecuniary advantage; but this shall not be construed as preventing the Executive from investing his personal assets
in businesses which do not compete with the Company in such form or manner as will not require any services on the part of the
Executive in the operation of the affairs of the companies in which such investments are made and in which his participation is
solely that of an investor, nor shall this be construed as preventing the Executive from purchasing securities in any Company
whose securities are regularly traded provided that such purchases shall not result in his collectively owning beneficially at
any time one percent (1%) or more of the equity securities of any Company engaged in a business competitive to that of the Company,
without the express prior written consent of the Company. 

 

    	 

     

    

 

(b)               
It shall not be a violation of this Agreement for the Executive to serve on corporate, civic or charitable boards or committees;
or deliver lectures, fulfill speaking engagements or teach at educational institutions, so long as such activities, separately
or in the aggregate, do not materially interfere with the performance of the Executive’s responsibilities as an employee
of the Company in accordance with this Agreement. 

 

5.                  
Compensation.

 

(a)                
For services rendered under this Employment Agreement, the Company shall pay the Executive a salary determined annually by the
Board of Directors (the “Base Salary”), payable (after deduction of applicable payroll taxes) in the same manner and
on the same payroll schedule in which Company employees receive payment. Executive’s Base Salary as of the Effective Date
shall be $250,000. The Executive shall also be eligible for and participate in such fringe benefits as shall be generally provided
to executives of the Company, including those under the Medical Transcription Billing, Corp. Amended and Restated Equity Incentive
Plan which may be adopted from time to time during the term hereof by the Company.

 

(b)               
The Board of Directors shall review the Executive’s compensation at least once a year and effect such increases in the Base
Salary as the Board of Directors, in its sole discretion, determines are merited, based upon the Executive’s performance
and consistent with the Company’s compensation policies. At the conclusion of each Fiscal Year, the Executive shall be eligible
for, and the Board of Directors in its sole discretion may award, an executive bonus based on the achievement of objectives established
by the Board of Directors in line with the rules of the Company’s bonus plan. Executive’s Target Bonus is equal to
100% of Base Salary.

 

6.                  
Paid Time Off. During the term of this Employment Agreement, the Executive shall be entitled to the same number of paid
days off pursuant to the Company’s customary paid time off policy as he has on the date of this Employment Agreement.

 

7.                  
Expenses. During the term of this Employment Agreement, the Company shall reimburse the Executive for all reasonable out-of-pocket
expenses incurred by the Executive in connection with the business of the Company and in performance of his duties under this
Employment Agreement upon the Executive’s presentation to the Company of an itemized accounting of such expenses with reasonable
supporting data.

 

8.                  
Term. The Executive’s employment under this Employment Agreement shall commence on the Effective Date and shall expire
on the second year anniversary date thereof. The term of employment shall automatically be extended for consecutive periods of
one (1) year each unless notice of termination of employment is given by either party hereto at least ninety (90) days prior to
the expiration of the initial or any renewal term, in which case, this Agreement shall terminate at the end of such initial or
renewal term, as the case may be. In the case of a renewal and unless otherwise agreed to in writing by parties, the terms and
conditions of this Employment Agreement shall apply to any renewals or extensions thereto. Notwithstanding the foregoing, the
Company may, at its election, terminate the Executive’s employment hereunder as follows:

 

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(i)                 
Upon thirty (30) days’ notice if the Executive becomes physically or mentally incapacitated or is injured so that he is
unable to perform the services required of him hereunder and such inability to perform continues for a period in excess of twenty-six
(26) weeks and is continuing at the time of such notice; or

 

(ii)               
For “Cause” upon notice of such termination to the Executive. For purposes of this Employment Agreement, the Company
shall have “Cause” to terminate its obligations hereunder upon (A) the reasonable determination by the Board of Directors
that the Executive has repeatedly failed to substantially to perform his duties hereunder (other than as a result of his incapacity
due to physical or mental illness or injury), which failure amounts to a repeated and consistent neglect of his duties hereunder,
(B) the reasonable determination by the Board of Directors that the Executive materially fails or refuses to comply with any lawful
regulation or policy of the Company, and fails to correct the non-compliance following written notice from the Company, (C) the
reasonable determination by the Board of Directors that the Executive has engaged or is about to engage in conduct materially
injurious to the Company, (D) the Executive’s having been convicted of a felony or a misdemeanor involving moral turpitude,
(E) a material breach by the Executive of any of the other covenants or representations herein or any other agreement between
Executive and the Company, or (F) fraud, theft, embezzlement or misappropriation of Company property or funds; or

 

(iii)             
Without Cause at any time upon notice of such termination to the Executive; or

 

(iv)              
Without Cause within twelve months after a Change in Control. Change in Control for purposes of this Agreement, unless the Board
determines otherwise, shall be deemed to have occurred at such time as: (A) any person (as the term is used in Sections 13(d)
and 14(d) of the Securities Exchange Act of 1934, as amended (the Exchange Act)) is or becomes the beneficial owner (as defined
in Rule 13d-3 under the Exchange Act), directly or indirectly, of voting securities of the Company representing more than 50%
of the Company s outstanding voting securities or rights to acquire such securities except for any voting securities issued or
purchased under any employee benefit plan of the Company or its subsidiaries, (B) Any sale, lease, exchange or other transfer
(in one transaction or a series of transactions) of all or substantially all of the assets of the Company, (C) a plan of liquidation
of the Company or an agreement for the sale or liquidation of the Company is approved and completed, or (D) The Board determines
in its sole discretion that a Change in Control has occurred, whether or not any event described above has occurred or is contemplated;
or

 

(v)               
Upon the death of the Executive.

 

In
addition, the Executive shall have the right to terminate this Employment Agreement upon notice to the Company if, without his
consent, his responsibilities and duties on the date hereof are materially reduced (a “Material Demotion”) and such
Material Demotion continues for ten (10) business days after the date of notice to the Company. A Material Demotion shall be treated
as a termination by the Company without Cause and the Executive shall be entitled to receive salary continuation pay as provided
by, and subject to the terms and conditions of, subparagraph 9(c) below.

 

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9.                  
Payment Upon Termination.

 

(a)                
If this Employment Agreement is terminated pursuant to paragraph 8(i) above, the Executive shall receive disability pay from the
date of such termination until the second anniversary of the Effective Date at the rate of 50% of the Base Salary, reduced by
applicable payroll taxes and further reduced by the amount received by the Executive during such period under any Company-maintained
disability insurance policy or plan or under Social Security or similar laws. Such disability payments shall be paid periodically
to the Executive as provided in paragraph 5(a) for the payment of salary.

 

(b)               
If the Employment Agreement is terminated pursuant to paragraph 8(ii) or 8(v) above, the Executive shall receive no salary continuation
pay or severance pay.

 

(c)                
If this Employment Agreement is terminated pursuant to paragraph 8(iii) or 8(iv) above, or as a result of the Executive having
terminated this Employment Agreement following a Material Demotion, the Executive shall receive salary continuation pay for the
remainder of the contractual term, but not in any event for less than twenty-four months from the date of such termination (“Salary
Continuation Period”), equal to the Executive’s most recent annual salary plus his target bonus (as determined under
the bonus plan last in effect for the Executive). In addition, the Company shall pay the premiums necessary to continue Executive’s
group health coverage for the Salary Continuation Period under the applicable provisions of the Consolidated Omnibus Budget Reconciliation
Act (“COBRA”), provided Executive elects to continue and remains eligible for those benefits under COBRA, and does
not become eligible for health coverage through another employer during this period; provided, however, that the salary continuation
payments, bonus and other benefits described in this paragraph 9(c) shall cease if the Executive shall, directly or indirectly,
be in breach of his obligations under paragraph 13 hereof. Such salary continuation payments (less applicable payroll taxes) shall
be paid periodically to the Executive as provided in paragraph 5(a) for the payment of the Base Salary.

 

(d)               
If the Company shall decide not to renew this Employment Agreement, the Executive shall receive severance pay, for a period of
twenty-four months following the date of expiration of the then current term (“Severance Pay”), equal to the Executive’s
most recent annual salary (excluding any and all executive bonus plan amounts). Such severance payments (less applicable payroll
taxes) shall be paid periodically to the Executive as provided in paragraph 5(a) for the payment of the Base Salary. The Executive
hereby agrees to make a smooth transition of responsibilities during that ninety (90) day period and the Executive further agrees
not to take any legal action against the Company related to said non-renewal and termination of employment.

 

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(e)                
During the Salary Continuation Period or Severance Period, the Executive shall be under no obligation to mitigate the costs to
the Company of the salary continuation or severance payments, and, no compensation that the Executive may receive from another
employer during the salary continuation or severance period shall be offset against amounts owed to Executive hereunder. Notwithstanding
the foregoing, in order to be entitled to the payments under paragraphs 9(c) and (d), Executive shall be required to execute and
deliver (and not revoke) a release of all employment related claims against the Company in a form attached hereto as Exhibit A.

 

10.               
Representations. The Executive hereby represents to the Company that (a) he is legally entitled to enter into this Employment
Agreement and to perform the services contemplated herein and is not bound under any employment or consulting agreement to render
services to any third party, (b) he has the full right, power and authority, subject to no rights of third parties, to grant to
the Company the rights contemplated by paragraph 11 hereof, and (c) he does not now have, nor within the last three years has
had, any ownership interest in any business enterprise (other than interest in publicly traded Companys where his ownership does
not exceed one percent (1%) or more of the equity capital) which is a customer of the Company, any of its subsidiaries, or from
which the Company or any of its subsidiaries purchases any goods or services or to whom such Companys owe any financial obligations
or are required or directed to make any payments.

 

11.               
Inventions. The Executive hereby sells, transfers and assigns to the Company or to any person or entity designated by the
Company all of the entire right, title and interest of the Executive in and to all inventions, ideas, disclosures and improvements,
whether patented or unpatented, and copyrightable material, made or conceived by the Executive, solely or jointly, during the
term hereof which relate to methods, apparatus, designs, products, processes or devices, sold, leased, used or under consideration
or development by the Company or any of its affiliates or which otherwise relate to or pertain to the business, functions or operations
of the Company or any of its affiliates or which arise from the efforts of the Executive during the course of his employment for
the Company or any of its affiliates. The Executive shall communicate promptly and disclose to the Company, in such form as the
Company requests, all information, details and data pertaining to the aforementioned inventions, ideas, disclosures and improvements;
and the Executive shall execute and deliver to the Company such formal transfers and assignments and such other papers and documents
as may be necessary or required of the Executive to permit the Company or any person or entity designated by the Company to file
and prosecute the patent applications and, as to copyrightable material, to obtain copyright thereof. Any invention relating to
the business of the Company and its affiliates and disclosed by the Executive within one year following the termination of this
Employment Agreement shall be deemed to fall within the provisions of this paragraph unless proved to have been first conceived
and made following such termination.

 

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12.               
Disclosure of Information. The Executive recognizes and acknowledges that the trade secrets, know-how and proprietary processes
of the Company and its affiliates as they may exist from time to time are valuable, special and unique assets of the business
of the Company and its affiliates, access to and knowledge of which are essential to the performance of the Executive’s
duties hereunder. The Executive will not, during or after the term of his employment by the Company or any of its affiliates,
in whole or in part, disclose such secrets, know-how or processes to any person, firm, Company, association or other entity for
any reason or purpose whatsoever, nor shall the Executive make use of any such property for his own purposes or for the benefit
of any person, firm, Company or other entity (except the Company and its affiliates) under any circumstances during or after the
term of his employment, provided that after the term of his employment these restrictions shall not apply to such secrets, know-how
and processes which are then in the public domain (provided that the Executive was not responsible, directly or indirectly, for
such secrets, know-how or processes entering the public domain without the Company’s consent).

 

13.               
Non-Competition. During the term of Executive’s employment hereunder and for a period beginning on the date of termination
of Executive’s employment hereunder for any reason and ending on the later of one (1) year after the date of this Agreement
or one (1) year after any such termination of employment (“Non-Competition Period”) Executive shall not: 

 

a)                  
without the prior written consent of the Company, directly or indirectly, as an Executive, employer, agent, principal, proprietor,
partner, stockholder, consultant, employee, director, or corporate officer, engage in any business or render any services to any
business that is in competition with the business of the Company; and

 

b)                  
(i) solicit any employee of the Company to engage in a competitive business or (ii) solicit customers of the Company on behalf
of any company or entity whose business is competitive with the Company.

 

If
the scope of any restrictions contained in Subsections (a) or (b) of this Section 13 are too broad to permit enforcement
of such restrictions to their full extent, then such restrictions shall be enforced to the maximum extent permitted by law, and
Executive hereby consents and agrees that such scope may be judicially modified accordingly in any proceeding brought to enforce
such restrictions.

 

14.               
Injunctive Relief. If there is a breach or threatened breach of the provisions of paragraph 11, 12 or 13 of this Employment
Agreement, the Company shall be entitled to an injunction restraining the Executive from such breach. Nothing herein shall be
construed as prohibiting the Company from pursuing any other remedies for such breach or threatened breach.

 

15.               
Insurance. The Company may, at its election and for its benefit, insure the Executive against accidental loss or death,
and the Executive shall submit to such physical examination and supply such information as may be required in connection therewith.

 

16.               
Notices. Any notice required or permitted to be given under this Employment Agreement shall be sufficient if in writing
and if sent by registered mail to the Executive at his home address as reflected on the records of the Company, in the case of
the Executive, or Medical Transcription Billing Company Inc., 7 Clyde Road, Somerset New Jersey 08873, in the case of the Company.

 

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17.               
Waiver of Breach. A waiver by the Company or the Executive of a breach of any provision of this Employment Agreement by
the other party shall not operate or be construed as a waiver of any subsequent breach by the other party.

 

18.               
Governing Law. This Employment Agreement shall be governed by and construed and enforce in accordance with the laws of
the State of New Jersey without giving effect to the choice of law or conflict of laws provisions thereof.

 

19.               
Assignment. This Employment Agreement may be assigned, without the consent of the Executive, by the Company to any of its
affiliates, or to any other person, partnership, Company, or other entity which has purchased substantially all the assets of
the Company, provided such assignee assumes all the liabilities of the Company hereunder.

 

20.               
Severability. If any provision of any part of this Agreement is determined to be invalid or unenforceable, such invalidity
or unenforceability shall not invalidate or render unenforceable any other portion of this Agreement. The entire Agreement shall
be construed as if it did not contain the particular invalid or unenforceable provision(s) and the rights and obligations of the
Parties shall be construed and enforced accordingly.

 

21.               
Entire Agreement. This Employment Agreement contains the entire agreement of the parties and supersedes any and all agreements,
letter of intent or understandings between the Executive and (a) the Company, (b) any of the Company’s principle shareholders,
affiliates or subsidiaries regarding employment. This Employment Agreement may be changed only by an agreement in writing signed
by a party against whom enforcement of any waiver, change, modification, extension or discharge is sought.

 

[Signature
page follows]

 

    	Page 7 of 10

    	 

    

 

IN
WITNESS WHEREOF, the parties have executed this Employment Agreement as of the day first herein above written.

 

	EXECUTIVE	 
	 	 	 
	By:	/s/
    Bill Korn	 
	 	Bill Korn	 
	 	 	 
	MEDICAL
    TRANSCRIPTION BILLING, CORP., INC.	 
	 	 	 
	By:	/s/
    Shruti Patel	 
	 	Shruti Patel	 
	 	General
    Counsel 	 

 

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EXHIBIT
A

SEPARATION
AGREEMENT AND RELEASE

 

I,
______________________________, hereby acknowledge that Medical Transcription Billing, Corp. (“the Company”)
has advised me by letter dated _____________________(“the Letter”) of the pay and benefits to which I am entitled
in connection with the separation of my employment with the Company, and the separation pay which it has agreed to pay to me in
exchange for my signing this Separation Agreement and Release (“Release”). I further hereby acknowledge that the Company
has advised me that I have a period of forty-five (45) days from the date of such Letter to sign the Release. I also understand
that I have a period of seven (7) days following the date of my signature on the Release to change my mind and cancel this Release
by sending a written revocation notice to the attention of General Counsel, Medical Transcription Billing, Corp, 7 Clyde Road,
Somerset, NJ 08873. I understand that this Release is not enforceable until after the end of the seven (7) day period. I understand
and agree that, should I revoke my Release, I will return any severance pay paid to me by the Company in exchange for signing
the Release.

 

In
consideration of such separation pay as set forth above and in the Letter, to which I acknowledge I am not otherwise entitled,
I hereby voluntarily release the Company, the Company’s respective associates, affiliates, predecessors, successors, subsidiaries,
parents, or agents of any of them, and the directors, officers, employees and agents of any of them, and shareholders (all the
parties mentioned immediately before shall be referred to as the “Released Parties”) from, and waive any right to
personal benefit arising from any proceedings or lawsuits, in connection with any and all claims relating to my employment, or
the separation of my employment which I have or may have or acquire up to the date of my signature on this Release, including,
but not limited to, claims of discrimination whether arising under Title VII of the Civil Rights Act of 1964, the Age Discrimination
in Employment Act of 1967 as amended, the Older Workers Benefit Protection Act, the Rehabilitation Act of 1973, the Americans
with Disabilities Act, the Civil Rights Act of 1991 or any other federal, state or local law. Moreover, I release all claims and
waive all rights to file a judicial action and to receive personal benefit in connection with any other proceeding against the
Released Parties arising from claims of breach of contract, claims for benefits other than those required by applicable law, claims
for additional compensation and/or commissions, claims that the separation of my employment was wrongful, unjust or a violation
of public policy or any other claim arising out of any matter concerning the Company or Released Parties in any form which may
have occurred prior to the date of my signature on this Release.

 

I
agree that I will not, directly or indirectly, engage in any conduct or make any statement disparaging or criticizing in any way
the Company or any of its subsidiaries or affiliates or any of their respective officers, directors or employees nor shall you,
directly or indirectly, engage in any conduct or make any statement that could be reasonably expected to impair the goodwill or
reputation of the Company or any of its subsidiaries or affiliates, in each case, except to the extent required by law, and then
only after consultation with the Company to the extent possible. The Company agrees it will use its reasonable efforts to ensure
that the Company does not, directly or indirectly, engage in any conduct or make any statement disparaging or criticizing you
in any way, or engage in any other conduct or make any other statement that could be reasonably expected to impair your business
reputation, except to the extent required by law, and then only after consultation with Executive to the extent possible; provided,
that any refusal by the Company to give a reference shall not be a breach of this provision.

 

I
recognize that this Release shall be binding upon and apply to all of my heirs, executors, administrators, successors and assigns.
In the event that state law restricts general releases and provides me with statutory rights, I also waive my right to such statutory
protection to the full extent lawfully possible. This Release shall run to and benefit the Company and its respective associates,
affiliates, predecessors, successors, subsidiaries, parents, or agents of any of them, assigns and the past and present directors,
officers, agents, and employees.

 

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I
agree that the Company has advised me in writing of my right to consult with an attorney prior to signing this Release and has
provided me with sufficient time to review and sign the Release. I have carefully read and fully understand the contents of the
Release and my voluntary signature is evidence of my intent to be legally bound by its terms.

 

	________________________________________	 	______________________________
	(Print or Type Name)	 	(Witness Name - Printed or Typed)
	 	 	 
	________________________________________	 	_______________________________
	Signature	 	Witness Signature
	 	 	 
	Date ______________________________	 	Date___________________________

 

    	Page 10 of 10EX-10.1

 Exhibit 10.1 

EXECUTION VERSION 

AMENDMENT NO. 1 

AMENDMENT NO. 1 (this “Agreement”), dated as of May 4, 2018, among SYNEOS HEALTH, INC. (f/k/a INC Research Holdings,
Inc.), a Delaware corporation (the “Administrative Borrower”), the other Borrowers from time to time party hereto (together with the Administrative Borrower, the “Borrowers”), the Subsidiaries of the
Administrative Borrower party hereto, CREDIT SUISSE AG, CAYMAN ISLANDS BRANCH, as administrative agent and collateral agent for the Lenders (in such capacities, the “Agent”) and the other parties hereto from time to time, relating
to the Credit Agreement, dated as of August 1, 2017 (as amended, restated, amended and restated, supplemented or otherwise modified from time to time, the “Credit Agreement”), among the Borrowers, the Lenders from time to time
party thereto and the Agent. 
 RECITALS: 

WHEREAS, pursuant to Section 9.02(c) of the Credit Agreement, the Administrative Borrower wishes to obtain Replacement Term Loans (the
“Replacement Term A Loans”) to refinance all Initial Term A Loans outstanding immediately prior to the effectiveness of this Agreement pursuant to a Refinancing Amendment under the Credit Agreement, and the Replacement Term A
Lenders are willing to provide the Replacement Term A Loans on and subject to the terms and conditions set forth herein. 
 WHEREAS,
pursuant to Section 9.02(c) of the Credit Agreement, the Administrative Borrower wishes to obtain Replacement Term Loans (the “Replacement Term B Loans”) to refinance all Initial Term B Loans outstanding immediately prior to
the effectiveness of this Agreement pursuant to a Refinancing Amendment under the Credit Agreement, and the Replacement Term B Lenders are willing to provide the Replacement Term B Loans on and subject to the terms and conditions set forth herein.

 WHEREAS, ING Capital LLC (“ING”) is acting as “left” lead arranger for the Replacement Term A Loans and Credit
Suisse Loan Funding LLC (“CSLF”) is acting as “left” lead arranger for the Replacement Term B Loans. 
 WHEREAS,
CSLF, JPMorgan Chase Bank, N.A., Wells Fargo Bank N.A., Goldman Sachs Bank USA, Regions Bank, SunTrust Robinson Humphrey, Inc., PNC Bank, National Association, KeyBank National Association, Bank of America, N.A., Barclays Bank PLC, Morgan Stanley
Senior Funding, Inc., The Bank of Nova Scotia, Fifth Third Bank, The Huntington National Bank, MUFG Bank, Ltd. and Mizuho Bank Ltd. (the “Right Term A Loan Arrangers” and, together with ING, the “2018 Replacement Term A Loan
Arrangers”) are acting as joint lead arrangers and joint bookrunners for the Replacement Term A Loans and ING, JPMorgan Chase Bank, N.A., Wells Fargo Bank N.A., Goldman Sachs Bank USA, Regions Bank, SunTrust Robinson Humphrey, Inc., PNC
Bank, National Association, KeyBank National Association, Bank of America, N.A., Barclays Bank PLC, Morgan Stanley Senior Funding, Inc., The Bank of Nova Scotia, Fifth Third Bank, The Huntington National Bank, MUFG Bank, Ltd. and Mizuho Bank Ltd.
are acting as joint lead arrangers and joint bookrunners for the Replacement Term B Loans (the “Right Term B Loan Arrangers” and, together with CSLF, the “2018 Replacement Term B Loan Arrangers” and, together with
the 2018 Replacement Term A Loan Arrangers, the “2018 Arrangers”). 
 WHEREAS, (x) the financial institution listed on
Schedule 1-A hereto (each, a “Replacement Term A Lender”) is willing to provide the Replacement Term A Loans the proceeds of which will be used by the Borrowers to repay the Initial Term A
Lenders, other than the Initial Term A Lenders who agree to convert, exchange or “cashless roll” all of their Initial Term A Loans to or for Replacement Term A Loans and (y) the financial institution listed on Schedule 1-B hereto (each, a “Replacement Term B Lender”) is willing to provide the Replacement Term B Loans the proceeds of which will be used by the Borrowers to repay the Initial Term B Lenders, other
than the Initial Term B Lenders who agree to convert, exchange or “cashless roll” all of their Initial Term B Loans to or for Replacement Term B Loans. 

 WHEREAS, pursuant to Section 9.02(c) of the Credit Agreement, the Credit Agreement may be amended
through a Refinancing Amendment executed by the Administrative Borrower, each of the Replacement Term A Lenders and Replacement Term B Lenders. 

NOW THEREFORE, the parties hereto hereby agree as follows: 

SECTION 1. Defined Terms. Unless otherwise specifically defined herein, each term used herein that is defined in
the Credit Agreement has the meaning assigned to such term in the Credit Agreement. Each reference in the Credit Agreement to “this Agreement”, “hereof”, “hereunder”, “herein” and “hereby” and each
other similar reference, and each reference in any other Loan Document to “the Credit Agreement”, “thereof”, “thereunder”, “therein” or “thereby” or any other similar reference to the Credit
Agreement shall, from the earlier of the Replacement Term A Closing Date and the Replacement Term B Closing Date (such earlier date, the “Amendment No. 1 Closing Date”), refer to the Credit Agreement as amended hereby.

 SECTION 2 Replacement Term A Loans. 

(a)    Subject to and upon the terms and conditions set forth herein, each Replacement Term A Lender severally agrees to
make, on the Replacement Term A Closing Date, a Replacement Term A Loan in Dollars to the Borrowers in an amount equal to the commitment amount set forth next to such Replacement Term A Lender’s name in Schedule 1-A hereto under the caption
“Replacement Term A Commitment.” The commitment set forth in this clause (a) will terminate in full upon the making of the related Replacement Term A Loan. Replacement Term A Loans borrowed under this Section 2 and subsequently repaid or
prepaid may not be reborrowed. 
 (b)    Substantially simultaneously with the borrowing of Replacement Term A Loans,
subject to Section 2.16 of the Credit Agreement, the Borrowers shall fully prepay any outstanding Initial Term A Loans, together with accrued and unpaid interest thereon to the Replacement Term A Closing Date. 

SECTION 3 Replacement Term B Loans. 

(a)    Subject to and upon the terms and conditions set forth herein, each Replacement Term B Lender severally agrees to
make, on the Replacement Term B Closing Date, a Replacement Term B Loan in Dollars to the Borrowers in an amount equal to the commitment amount set forth next to such Replacement Term B Lender’s name in Schedule
1-B hereto under the caption “Replacement Term B Commitment.” The commitment set forth in this clause (a) will terminate in full upon the making of the related Replacement Term B Loan. Replacement
Term B Loans borrowed under this Section 3 and subsequently repaid or prepaid may not be reborrowed. 

(b)    Substantially simultaneously with the borrowing of Replacement Term B Loans, subject to Section 2.16 of the Credit
Agreement, the Borrowers shall fully prepay any outstanding Initial Term B Loans, together with accrued and unpaid interest thereon to the Replacement Term B Closing Date. 

SECTION 4. Amendments to Credit Agreement. The following
amendments are made to the Credit Agreement to effect the foregoing: 
 (a)    Section 1.01 of the Credit Agreement is
amended as of the Replacement Term A Closing Date to add the following new defined term in the appropriate alphabetical order: 

“2018 Replacement Term A Closing Date” means the
Replacement Term A Closing Date (as defined in Amendment No. 1), which occurred on May 4, 2018. 

  
 2 

	 	(b)	Section 1.01 of the Credit Agreement is amended as of the Replacement Term B Closing Date to add the following new defined term in the appropriate alphabetical order: 

“2018 Replacement Term B Closing Date” means the
Replacement Term B Closing Date (as defined in Amendment No. 1), which occurred on May 4, 2018. 
  

	 	(c)	Section 1.01 of the Credit Agreement is amended as of the Amendment No. 1 Closing Date to add the following new defined term in the appropriate alphabetical order: 

“Amendment No. 1” means the Amendment No. 1, dated as of May 4, 2018, to this
Agreement. 
  

	 	(d)	(1) The table setting forth the ABR Spread and Adjusted Eurocurrency Rate Spread for the Initial Term B Loans in the definition of “Applicable Rate” is hereby amended and restated as of
the Replacement Term B Closing Date to read in its entirety as follows: 

  

									
	 Secured Leverage Ratio
	  	ABR Spread for Initial
Term B Loans	 	 	Adjusted Eurocurrency
Rate Spread for Initial
Term B Loans	 
	 Category 1
	  				 			
	 Greater than 2.75 to 1.00
	  	 	1.00	% 	 	 	2.00	% 
			
	 Category 2
	  				 			
	 Less than or equal to 2.75 to 1.00
	  	 	0.75	% 	 	 	1.75	% 

 (2) The table setting forth the ABR Spread and Adjusted Eurocurrency Rate Spread for the
Initial Term A Loans in the definition of “Applicable Rate” is hereby amended and restated as of the Replacement Term A Closing Date to read in its entirety as follows: 

 

									
	 First Lien Leverage Ratio
	  	ABR Spread for Initial
Term A Loans	 	 	Adjusted Eurocurrency
Rate Spread for Initial
Term A Loans	 
	 Category 1
	  				 			
	 Greater than 2.50 to 1.00
	  	 	0.50	% 	 	 	1.50	% 
			
	 Category 2
	  				 			
	 Less than or equal to 2.50 to 1.00
	  	 	0.25	% 	 	 	1.25	% 

 (e)    The defined term “Arrangers” is hereby amended as of the Amendment
No. 1 Closing Date by adding the following proviso to the end of the definition: “; provided that as this term relates to (x) arranging the Amendment No. 1 and/or syndicating the Replacement Term A Loans (as defined in Amendment No. 1),
“Arrangers” shall mean the 2018 Replacement Term A Loan Arrangers (as defined in Amendment No. 1) and (y) arranging the Amendment No. 1 and/or syndicating the Replacement Term B Loans (as defined in Amendment No. 1), “Arrangers”
shall mean the 2018 Replacement Term B Loan Arrangers (as defined in Amendment No. 1). 

  
 3 

 (f)    The defined term “Initial Term A Loans” is hereby
amended and restated in its entirety as of the Replacement Term A Closing Date as follows: 
 “Initial Term A Loans” means
the term loans made by the Initial Term A Lenders to the Borrowers pursuant to Section 2.01(a)(i) and the Replacement Term A Loans (as defined in Amendment No. 1). 

(g)    The defined term “Initial Term B Loans” is hereby amended and restated in its entirety as of the
Replacement Term B Closing Date as follows: 
 “Initial Term B Loans” means the term loans made by the Initial Term B
Lenders to the Borrowers pursuant to Section 2.01(a)(ii) and the Replacement Term B Loans (as defined in Amendment No. 1). 

(h)    Section 2.12(e) of the Credit Agreement is hereby amended and restated in its entirety as of the Replacement Term B
Closing Date as follows: 
 (e)    In the event that, prior to the date that is six months after the 2018 Replacement
Term B Closing Date, any Borrower (A) prepays, repays, refinances, substitutes or replaces any Initial Term B Loans in connection with a Repricing Transaction (including, for the avoidance of doubt, any prepayment made pursuant to
Section 2.11(b)(iii) that constitutes a Repricing Transaction), or (B) effects any amendment, modification or waiver of, or consent under, this Agreement resulting in a Repricing Transaction, the Borrowers shall pay to the Administrative
Agent, for the ratable account of each applicable Initial Term B Lender, (I) in the case of clause (A), a premium of 1.00% of the aggregate principal amount of the Initial Term B Loans so prepaid, repaid, refinanced, substituted or replaced and
(II) in the case of clause (B), a fee equal to 1.00% of the aggregate principal amount of the Initial Term B Loans that are the subject of such Repricing Transaction outstanding immediately prior to such amendment. If, prior to the date that is
six months after the 2018 Replacement Term B Closing Date, all or any portion of the Initial Term B Loans held by any Initial Term B Lender are prepaid, repaid, refinanced, substituted or replaced pursuant to Section 2.19(b)(iv) as a result of,
or in connection with, such Initial Term B Lender not agreeing or otherwise consenting to any waiver, consent, modification or amendment referred to in clause (B) above (or otherwise in connection with a Repricing Transaction), such prepayment,
repayment, refinancing, substitution or replacement will be made at 101% of the principal amount so prepaid, repaid, refinanced, substituted or replaced. All such amounts shall be due and payable on the date of effectiveness of such Repricing
Transaction in Dollars and in immediately available funds. 
 (i)    Section 2.22(a)(v) of the Credit Agreement is
hereby amended and restated in its entirety as of the Replacement Term B Closing Date as follows: 
 (v)    the Effective
Yield (and the components thereof) applicable to any Incremental Facility shall be determined by the Administrative Borrower and the lender or lenders providing such Incremental Facility; provided that (i) in the case of any Incremental
Term Facility that consists of term B loans (other than Customary Bridge Loans) incurred prior to the date that is six months after the 2018 Replacement Term B Closing Date that are (A) incurred in reliance on clause (e) of the
definition of “Incremental Cap” (without giving effect to the reclassification mechanic described in clause (iii) of the proviso to the definition of Incremental Cap), (B) pari passu with the Initial Term B Loans in
right of payment and with respect to security and (C) scheduled to mature prior to the date that is two years after the Initial Term B Loan Maturity Date, the Effective Yield applicable thereto may not be more than 0.75% higher than the
Effective Yield 

  
 4 

 
applicable to the Initial Term B Loans denominated in the same currency as such Incremental Term Facility unless the Applicable Rate (and/or, as provided in the proviso below, the Alternate Base
Rate floor or Adjusted Eurocurrency Rate floor) with respect to the Initial Term B Loans in such currency is adjusted such that the Effective Yield in respect of such Initial Term Loans is not more than 0.75% per annum less than the Effective Yield
with respect to such Incremental Term Facility, (ii) any increase in Effective Yield applicable to any Initial Term B Loan due to the application or imposition of an Alternate Base Rate floor or Adjusted Eurocurrency Rate floor on any
Incremental Term Loan may, at the election of the Administrative Borrower, be effected solely through an increase in (or implementation of, as applicable) any Alternate Base Rate floor or Adjusted Eurocurrency Rate floor applicable to such Initial
Term B Loan and (iii) the adjustment described in this proviso shall not apply to (A) the De Minimis Incremental Amount or (B) any Incremental Facility the proceeds of which will be applied to finance a Permitted Acquisition or other
Investment, 
 (j)    Section 5.11 of the Credit Agreement is hereby amended as of the Amendment No. 1 Closing Date
by changing the second sentence of Section 5.11 to: 
 The Borrowers shall use the proceeds of the (x) Initial Term Loans made on
the Closing Date, solely to finance a portion of the Transactions (including working capital and/or purchase price adjustments under the Merger Agreement (including with respect to the amount of any Cash, Cash Equivalents, marketable securities and
working capital to be acquired) and the payment of Transaction Costs) and (y)(1) Replacement Term A Loans (as defined in Amendment No. 1), made on the 2018 Replacement Term A Closing Date, solely to refinance the Initial Term A Loans and
(2) Replacement Term B Loans (as defined in Amendment No.1), made on the 2018 Replacement Term B Closing Date, solely to refinance the Initial Term B Loans. 

(k)    On (1) the Replacement Term A Closing Date, Schedule 1.01(a) (with respect to the Initial Term A Loan
Commitments) to the Credit Agreement is amended and restated in its entirety by Schedule 1-A hereto, and (2) the Replacement Term B Closing Date, Schedule 1.01(a) (with respect to the Initial Term
B Loan Commitments) to the Credit Agreement is amended and restated in its entirety by Schedule 1-B hereto. 

SECTION 5. Terms of the Replacement Term A Loans Generally. On the Replacement Term A Closing Date,
giving effect to the Replacement Term A Loans hereunder, (a) each Replacement Term A Lender shall become an “Initial Term A Lender” for all purposes of the Credit Agreement and the other Loan Documents and (b) each Replacement
Term A Loan shall constitute a “Loan” and shall be deemed to be an “Initial Term A Loan” for all purposes of the Credit Agreement and the other Loan Documents. The parties hereto hereby consent to the incurrence of the
Replacement Term A Loans on the terms set forth herein. Upon the effectiveness of this Agreement, all conditions and requirements set forth in the Credit Agreement or the other Loan Documents relating to the incurrence of the Replacement Term A
Loans shall be deemed satisfied and the incurrence of the Replacement Term A Loans shall be deemed arranged and consummated in accordance with the terms of the Credit Agreement and the other Loan Documents. 

SECTION 6. Terms of the Replacement Term B Loans Generally. On the Replacement Term B Closing Date, giving effect
to the Replacement Term B Loans hereunder, (a) each Replacement Term B Lender shall become an “Initial Term B Lender” for all purposes of the Credit Agreement and the other Loan Documents and (b) each Replacement Term B Loan
shall constitute a “Loan” and shall be deemed to be an “Initial Term B Loan” for all purposes of the 

  
 5 

 
Credit Agreement and the other Loan Documents. The parties hereto hereby consent to the incurrence of the Replacement Term B Loans on the terms set forth herein. Upon the effectiveness of this
Agreement, all conditions and requirements set forth in the Credit Agreement or the other Loan Documents relating to the incurrence of the Replacement Term B Loans shall be deemed satisfied and the incurrence of the Replacement Term B Loans shall be
deemed arranged and consummated in accordance with the terms of the Credit Agreement and the other Loan Documents. 

SECTION 7. Representations of the Administrative Borrower. After giving effect to this Agreement,
the Administrative Borrower represents and warrants that (i) the representations and warranties of the Administrative Borrower set forth in Article 3 of the Credit Agreement will be true in all material respects on and as of the Replacement
Term A Closing Date and the Replacement Term B Closing Date; provided that (A) to the extent that any such representation or warranty expressly relates to an earlier date such representation or warranty will be true as of such earlier
date (other than any representation or warranty made pursuant to Section 3.11 of the Credit Agreement (Disclosure) and Section 3.12 of the Credit Agreement (Solvency), which shall be deemed to be made as of the date hereof,
in each case as if each reference therein to the Closing Date were a reference to the Replacement Term A Closing Date or Replacement Term B Closing Date (as applicable) and each reference therein to the Transactions included a reference to the
transactions contemplated hereby) and (B) if such representation or warranty is qualified by or subject to a “material respects”, “material adverse effect”, “material adverse change” or similar term or
qualification, such representation and warranty will be true in all respects and (ii) no Default or Event of Default will have occurred and be continuing on such date. 

SECTION 8. Conditions. The obligation of (x) the Replacement Term A Lenders to make the Replacement Term A
Loans and the effectiveness of the amendments set forth in Section 4(a), Section 4(d)(2), Section 4(f) and Section 4(k)(1) above shall be subject to the applicable conditions precedent set forth below (the date of satisfaction or
waiver of such applicable conditions, the “Replacement Term A Closing Date”), (y) the Replacement Term B Lender to make the Replacement Term B Loans and the effectiveness of the amendments set forth in Section 4(b),
Section 4(d)(1), Section 4(g), Section 4(h), Section 4(i) and Section 4(k)(2) above shall be subject to the applicable conditions precedent set forth below (the date of satisfaction or waiver of such applicable conditions,
the “Replacement Term B Closing Date”) and (z) the effectiveness of the amendment set forth in Section 4(c), Section 4(e) and Section 4(j) above shall be subject to the earlier to occur of the Replacement Term A
Closing Date and the Replacement Term B Closing Date: 
 (a)    With respect to the Replacement Term A Closing Date, the
Agent shall have received from the Administrative Borrower, each other Loan Party, each Replacement Term A Lender (which Replacement Term A Lenders shall, taken together, constitute the Required Lenders) and the Agent an executed counterpart hereof
or other written confirmation (in form satisfactory to the Agent) that such party has signed a counterpart hereof ; 

(b)    With respect to the Replacement Term B Closing Date, the Agent shall have received from the Administrative
Borrower, each other Loan Party, each Replacement Term B Lender (which Replacement Term B Lenders shall, taken together, constitute the Required Lenders) and the Agent an executed counterpart hereof or other written confirmation (in form
satisfactory to the Agent) that such party has signed a counterpart hereof; 
 (c)    The Agent shall have received a
Borrowing Request with respect to the Replacement Term A Loans or the Replacement Term B Loans, as applicable, not later than 2:00 p.m. (New York Time) three Business Days prior to the Replacement Term A Closing Date or the Replacement Term B
Closing Date, respectively (or such later time as is reasonably acceptable to the Administrative Agent); 

  
 6 

 (d)    The Agent shall have received a customary legal opinion of
(i) Wyrick Robbins Yates & Ponton LLP, in its capacity as special counsel to the Administrative Borrower, (ii) Kegler Brown, in its capacity as special Ohio counsel to the Ohio Loan Parties, and (iii) Norris
McLaughlin & Marcus, in its capacity as special New Jersey and New York counsel to the New Jersey Loan Parties and New York Loan Parties, in each case, dated the Amendment No. 1 Closing Date, and addressed to the Administrative Agent
and the Lenders. 
 (e)    The Agent shall have received (i) a certificate of each Loan Party, dated the Amendment
No. 1 Closing Date, and executed by a secretary, assistant secretary or other Responsible Officer thereof, which shall (A) certify that (x) either (I) attached thereto are a true and complete copy of the certificate or articles of
incorporation, formation or organization of such Loan Party certified by the relevant authority of its jurisdiction of organization, which certificate or articles of incorporation, formation or organization have not been amended (except as attached
thereto) since the date reflected thereon or (II) there have been no changes to the certificate or articles of incorporation, formation or organization of such Loan Party since the Closing Date (or date of joinder with respect to any Loan Party
joined to Loan Documents after the Closing Date), (y) either (I) attached thereto are a true and correct copy of the bylaws or operating, management, partnership or similar agreement of such Loan Party, together with all amendments thereto as
of the Amendment No. 1 Closing Date, which by-laws or operating, management, partnership or similar agreement are in full force and effect or (II) there have been no changes to the by-laws or operating, management, partnership or similar agreement of such Loan Party since the Closing Date (or date of joinder with respect to any Loan Party joined to Loan Documents after the Closing Date), and
(z) attached thereto are a true and complete copy of the resolutions or written consent, as applicable, of its board of directors, board of managers, sole member or other applicable governing body authorizing the execution and delivery of this
Agreement, which resolutions or consent have not been modified, rescinded or amended (other than as attached thereto) and are in full force and effect, and (B) either (I) identify by name and title and bear the signatures of the officers,
managers, directors or other authorized signatories of such Loan Party authorized to sign this Agreement or (II) certify that there have been no changes to the officers, managers, directors or other authorized signatories of such Loan Party
since the Closing Date (or date of joinder with respect to any Loan Party joined to Loan Documents after the Closing Date) and (ii) a good standing (or equivalent) certificate for such Loan Party from the relevant authority of its jurisdiction
of organization, dated as of a recent date. 
 (f)    With respect to the Replacement Term A Closing Date, all fees due
to the Replacement Term A Lender on the Replacement Term A Closing Date pursuant to the Engagement Letter, dated as of April 25, 2018 between the Administrative Borrower and ING shall have been paid, and all reasonable and documented out-of-pocket expenses to be paid or reimbursed to ING on the Replacement Term A Closing Date pursuant to such Engagement Letter that have been invoiced at least three
business days prior to the Replacement Term A Closing Date shall have been paid; 
 (g)    With respect to the
Replacement Term B Closing Date, all fees due to the Agent on the Replacement Term B Closing Date pursuant to the Engagement Letter, dated as of April 18, 2018 between the Administrative Borrower and CSLF shall have been paid, and all
reasonable and documented out-of-pocket expenses to be paid or reimbursed to the Agent on the Replacement Term B Closing Date pursuant to such Engagement Letter that
have been invoiced at least three business days prior to the Replacement Term B Closing Date shall have been paid; 

(h)    All accrued interest (subject (x) with respect to the Initial Term A Loans, to Section 2(b) hereof and
(y) with respect to the Initial Term B Loans, to Section 3(b) hereof) and any fees pursuant to 

  
 7 

 
Section 2.12 of the Credit Agreement owing by the Borrowers as a result of the consummation of the transactions contemplated by this Agreement shall have been paid in full on the Replacement
Term A Closing Date or Replacement Term B Closing Date, as applicable; 
 (i)    The representations and warranties made
pursuant to Section 7 hereof are true and correct on and as of the Replacement Term A Closing Date or Replacement Term B Closing Date, as applicable; and 

(j)    The Agent shall have received a certificate, duly executed by a Responsible Officer of the Administrative Borrower,
certifying this to the satisfaction of the conditions referred to in Section 8(i) above on the Replacement Term A Closing Date or the Replacement Term B Closing Date, as applicable. 

SECTION 9. Governing Law. This Agreement shall be governed by and construed and interpreted in accordance
with the laws of the State of New York. 
 SECTION 10. Confirmation of Guarantees and Security Interests. By
signing this Agreement, each Loan Party hereby confirms that (a) the obligations of the Loan Parties under the Credit Agreement as modified or supplemented hereby (including with respect to the Replacement Term A Loans and Replacement Term B
Loans contemplated by this Agreement) and the other Loan Documents (i) are entitled to the benefits of the guarantees and the security interests set forth or created in the Credit Agreement, the Collateral Documents and the other Loan
Documents, (ii) constitute “Obligations” as such term is defined in the Credit Agreement, subject to the qualifications and exceptions described therein, (iii) notwithstanding the effectiveness of the terms hereof, the Collateral
Documents and the other Loan Documents, are, and shall continue to be, in full force and effect and are hereby ratified and confirmed in all respects and (b) each Replacement Term A Lender and Replacement Term B Lender shall be a “Secured
Party” and a “Lender” (including without limitation for purposes of the definition of “Required Lenders” contained in Section 1.01 of the Credit Agreement) for all purposes of the Credit Agreement and the other Loan
Documents. Each Loan Party ratifies and confirms that all Liens granted, conveyed, or assigned to the Agent by such Person pursuant to any Loan Document to which it is a party remain in full force and effect, are not released or reduced, and
continue to secure full payment and performance of the Secured Obligations as increased hereby, as contemplated by this Agreement. 

SECTION 11. Credit Agreement Governs. Except as expressly set forth herein, this Agreement shall not by
implication or otherwise limit, impair, constitute a waiver of or otherwise affect the rights and remedies of any Lender or the Agent under the Credit Agreement or any other Loan Document, and shall not alter, modify, amend, novate or in any way
affect any of the terms, conditions, obligations, covenants or agreements contained in the Credit Agreement or any other Loan Document, all of which are ratified and affirmed in all respects and shall continue in full force and effect. Nothing
herein shall be deemed to entitle any Loan Party to a future consent to, or a waiver, amendment, modification or other change of, any of the terms, conditions, obligations, covenants or agreements contained in the Credit Agreement or any other Loan
Document in similar or different circumstances. 
 SECTION 12. Waiver. Neither the Agent nor any of its
Affiliates shall be liable to the Borrowers, any other Loan Party, any Replacement Term A Lender, any Replacement Term B Lender or any of their respective Affiliates, equity holders or debt holders for any losses, costs, damages or liabilities
incurred, directly or indirectly, as a result of the Agent, or any of their respective Affiliates, taking any action in accordance with any election form executed by any (x) Replacement Term A Lender to convert its Replacement Term A Loans or
(y) Replacement Term B Lender to convert its Replacement Term B Loans as set forth herein. 

  
 8 

 SECTION 13. Counterparts. This Agreement may be signed in any
number of counterparts, each of which shall be an original, with the same effect as if the signatures thereto and hereto were upon the same instrument. Delivery of an executed counterpart of a signature page to this Agreement by facsimile or
electronic (i.e., “pdf” or “tif”) transmission shall be effective as delivery of a manually executed counterpart of this Agreement. 

SECTION 14. Miscellaneous. This Agreement shall constitute a “Refinancing Amendment” and a “Loan
Document” for all purposes of the Credit Agreement and the other Loan Documents. The provisions of this Agreement are deemed incorporated into the Credit Agreement as if fully set forth therein. To the extent required by the Credit Agreement,
each of the Administrative Borrower and the Agent hereby consent to each Replacement Term A Lender and/or Replacement Term B Lender that is not a Lender as of the date hereof becoming a Lender under the Credit Agreement. For only the purpose of
Section 9.05(b)(i)(A) of the Credit Agreement, the Administrative Borrower hereby consents to the assignments by (x) ING, in its capacity as Lender under the Credit Agreement, in a manner otherwise in accordance with the Credit Agreement,
as amended by this Agreement, of its Replacement Term A Loans made by it on the Replacement Term A Closing Date and (y) Credit Suisse AG, Cayman Islands Branch, in its capacity as a Lender under the Credit Agreement, in a manner otherwise in
accordance with the Credit Agreement, as amended by this Agreement, of its Replacement Term B Loans made by it on the Replacement Term B Closing Date, in each case, solely to the institutions and solely in the amounts previously agreed upon by the
Agent and the Administrative Borrower. 
 [Remainder of page intentionally left blank] 

  
 9 

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

					
	SYNEOS HEALTH, INC., as the Administrative Borrower
		
	By:	 	 /s/ Jason Meggs

		 	Name:	 	Jason Meggs
		 	Title:	 	Executive Vice President and Interim Chief Financial Officer
	
	INVENTIV HEALTH, INC., as a Borrower
		
	By:	 	 /s/ Jason Meggs

		 	Name:	 	Jason Meggs
		 	Title:	 	Chief Financial Officer
	
	INVENTIV HEALTH CLINICAL, INC., as a Borrower
		
	By:	 	 /s/ Thomas E. Zajkowski

		 	Name:	 	Thomas E. Zajkowski
		 	Title:	 	Treasurer
	
	INVENTIV HEALTH COMMUNICATIONS, INC., as a Borrower
		
	By:	 	 /s/ Thomas E. Zajkowski

		 	Name:	 	Thomas E. Zajkowski
		 	Title:	 	Treasurer
	
	INC RESEARCH, LLC, as Borrower
		
	By:	 	 /s/ Jason Meggs

		 	Name:	 	Jason Meggs
		 	Title:	 	Interim Chief Financial Officer

  
 [Signature Page –
Amendment No. 1 to Credit Agreement] 

 
			
	ADDISON WHITNEY LLC
	ADHERIS, LLC
	ALLIDURA COMMUNICATIONS, LLC
	BIOSECTOR 2 LLC
	BLUE DIESEL, LLC
	CADENT MEDICAL COMMUNICATIONS, LLC
	CHAMBERLAIN COMMUNICATIONS GROUP LLC
	CHANDLER CHICCO AGENCY, L.L.C.
	GERBIG, SNELL/WEISHEIMER ADVERTISING, LLC
	INCHORD HOLDING CORPORATION
	INVENTIV CLINICAL, LLC
	INVENTIV COMMERCIAL SERVICES, LLC
	INVENTIV HEALTH CLINICAL, LLC
	INVENTIV HEALTH CLINICAL LAB, INC.
	INVENTIV HEALTH CLINICAL RESEARCH SERVICES, LLC
	INVENTIV HEALTH CLINICAL SRE, LLC
	INVENTIV HEALTH CONSULTING, INC.
	INVENTIV HEALTH PUBLIC RELATIONS, LLC
	INVENTIV HEALTH RESEARCH & INSIGHTS, LLC
	INVENTIV MEDICAL COMMUNICATIONS, LLC
	LITMUS MEDICAL MARKETING SERVICES LLC
	NAVICOR GROUP, LLC
	PALIO + IGNITE, LLC
	PATIENT MARKETING GROUP, LLC
	PHARMA HOLDINGS, INC.
	PHARMACEUTICAL INSTITUTE, LLC
	TAYLOR STRATEGY PARTNERS, LLC
	THE SELVA GROUP, LLC
		
	By:	 	 /s/ Thomas E. Zajkowski

	Name:	 	Thomas E. Zajkowski
	Title:	 	Treasurer

  
 [Signature Page –
Amendment No. 1 to Credit Agreement] 

 
			
	KENDLE AMERICAS INVESTMENT INC.
	KENDLE AMERICAS MANAGEMENT INC.
		
	By:	 	 /s/ Alistair Macdonald

	Name:	 	Alistair Macdonald
	Title:	 	President and Chief Executive Officer

  
 [Signature Page –
Amendment No. 1 to Credit Agreement] 

 
					
	CREDIT SUISSE AG, CAYMAN ISLANDS     BRANCH,
	    as Agent and a Replacement Term B Lender
		
	By:	 	   /s/ Vipul Dhadda

		 	Name:	  	Vipul Dhadda
		 	Title:	  	Authorized Signatory
		
	By:	 	   /s/ Joan Park

		 	Name:	  	Joan Park
		 	Title:	  	Authorized Signatory

  
 [Signature Page –
Amendment No. 1 to Credit Agreement] 

 
					
	ING CAPITAL LLC,
	    as Replacement Term A Lender
		
	By:	 	   /s/ Laetitia Thate

		 	Name:	  	Laetitia Thate
		 	Title:	  	Managing Director
		
	By:	 	   /s/ Nancy Spiteri

		 	Name:	  	Nancy Spiteri
		 	Title:	  	Managing Director

  
 [Signature Page –
Amendment No. 1 to Credit Agreement] 

 SCHEDULE 1-A 

Replacement Term A Loan Commitments 
  

					
	 Name of Replacement Term A
Lender
	  	Replacement Term A Loan
Commitment	 
	 ING Capital LLC
	  	$	987,500,000	 

 SCHEDULE 1-B 

Replacement Term B Loan Commitments 
  

					
	 Name of Replacement Term B
Lender
	  	Replacement Term B Loan
Commitment	 
	 Credit Suisse AG, Cayman Islands Branch
	  	$	1,525,000,000.00

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