Document:

exv4w6

Exhibit 4.6

EXECUTION VERSION

 

FOURTH SUPPLEMENTAL INDENTURE

Dated as of December 1, 2009

Supplementing that Certain

INDENTURE

Dated as of June 9, 2009

 

Among

EXPRESS SCRIPTS, INC.,

THE GUARANTORS PARTIES HERETO

and

UNION BANK, N.A.,

as Trustee

 

 

 

 

FOURTH SUPPLEMENTAL INDENTURE

The Fourth Supplemental Indenture (this “Fourth Supplemental Indenture”), dated as of December 1,
2009, among Express Scripts, Inc., a corporation duly organized and existing under the laws of the
State of Delaware (the “Company”), the Guarantors listed as signatories hereto (each, an “Existing
Guarantor”; and collectively, the “Existing Guarantors”), NextRx, Inc., a Delaware corporation,
NextRx Services, Inc., a New York corporation, and NextRx, LLC, an Ohio limited liability company
(each, a “Successor Guarantor”; and collectively, the “Successor Guarantors”) and Union Bank, N.A.,
a national association, as trustee under the indenture referred to below (the “Trustee”).

W I T N E S S E T H

WHEREAS, the Company, the Existing Guarantors and the Trustee are parties to the indenture, dated
as of June 9, 2009, as supplemented by the First Supplemental Indenture thereto, dated as of June
9, 2009 (the “First Supplemental Indenture”), relating to the 5.250% Notes due 2012 (the “2012
Notes”), the Second Supplemental Indenture thereto, dated as of June 9, 2009 (the “Second
Supplemental Indenture”), relating to the 6.250% Notes due 2014 (the “2014 Notes”) and the Third
Supplemental Indenture thereto, dated as of June 9, 2009 (the “Third Supplemental Indenture” and
together with the First Supplemental Indenture and the Second Supplemental Indenture, the
“Supplemental Indentures”), relating to the 7.250% Notes due 2019 (the “2019 Notes” and together
with the 2012 Notes and the 2014 Notes, the “Notes”) (so supplemented, the “Indenture”);

WHEREAS, each of NextRx Sub I, LLC, NextRx Sub II, LLC and NextRx Sub III, LLC (collectively, the
“NextRx Subs”) has merged with and into the Successor Guarantors (the “NextRx Mergers”), with each
of the Successor Guarantors as the surviving entity in the NextRx Mergers;

WHEREAS, the Supplemental Indentures provide that upon any consolidation or merger by any Existing
Guarantor with or into any Person, the successor Person formed by such consolidation or merger
shall sign a supplemental indenture and guarantee and succeed to, and be substituted for, an
exercise every right and power of, the Existing Guarantor;

WHEREAS, pursuant to Section 7.1 of each Supplemental Indenture, the Company and the Trustee are
authorized to execute this Fourth Supplemental Indenture without consent of Holders of the Notes.

NOW, THEREFORE, for good and valuable consideration, the receipt of which is acknowledged, each
Successor Guarantor hereby succeeds to the guarantee of the Company’s obligations under the Notes
as follows:

          1. Capitalized Terms. Capitalized terms used herein without definition shall have the
meanings assigned to them in the Indenture.

          2. Guarantee, Etc. Each Successor Guarantor hereby agrees that from and after the
date hereof it shall be a Guarantor under the Indenture and be bound by its terms thereof
applicable to Guarantors and shall be entitled to all of the rights and subject to all of the
obligations of a Guarantor thereunder.

          3. Ratification of Indenture; Supplemental Indenture Part of Indenture. The Indenture
is in all respects ratified and confirmed, and all terms, conditions and provisions thereof shall
remain in full force and effect. This Fourth Supplemental Indenture shall form a part of the
Indenture for all purposes, and every Holder of Notes heretofore or hereafter authenticated and
delivered shall be bound hereby.

          4. Representations and Warranties. Each Successor Guarantor hereby represents that
(a) it is duly organized, validly existing and in good standing under the laws of the jurisdiction
of its organization, (b) it has full power, authority and legal rights to execute and deliver this
Fourth Supplemental Indenture and to perform its obligations hereunder and under the Indenture, (c)
the execution, delivery and performance by it of this Fourth Supplemental Indenture has been duly
authorized by all necessary corporate action, and no other proceedings or actions on the part of
such Successor Guarantor are necessary therefor and (d) this Fourth Supplemental Indenture has been
duly and validly executed and delivered by such Successor Guarantor and constitutes a legal, valid
and binding obligation of such Successor Guarantor, enforceable against such Successor Guarantor in
accordance with its terms (subject to applicable bankruptcy, insolvency, receivership,
reorganization, moratorium and other similar laws of general applicability relating to or
affecting creditors’ rights and to general equity principles).

 

 

          5. No Personal Liability of Directors, Officers, Employees or Stockholders. No
director, officer, employee, member or stockholder of each of the Successor Guarantors, as such,
will have any liability for any obligations of the Company, any Existing Guarantor or any Successor
Guarantor under the Notes, the Indenture or the Guarantees, or for any claim based on, in respect
of, or by reason of, such obligations or their creation. Each Holder of Notes, by accepting a
Note, waives and releases the Company, each Existing Guarantor and each Successor Guarantor from
all such liability. The waiver and release are part of the consideration for issuance of the
Guarantee by each Successor Guarantor.

          6. GOVERNING LAW. THIS FOURTH SUPPLEMENTAL INDENTURE AND THE GUARANTEES HEREUNDER
SHALL BE GOVERNED BY, AND CONSTRUED IN ACCORDANCE WITH, THE LAWS OF THE STATE OF NEW YORK WITHOUT
GIVING EFFECT TO THE CONFLICTS OF LAWS PRINCIPLES THEREOF.

          7. Counterparts. This Fourth Supplemental Indenture may be executed in any number of
counterparts, each of which shall be deemed an original; but all such counterparts shall together
constitute but one and the same instrument.

          8. Effect of Headings. The Section headings herein are for convenience only and shall
not affect the construction hereof.

          9. Trustee. The Trustee shall not be responsible in any manner whatsoever for or in
respect of the validity or sufficiency of this Fourth Supplemental Indenture or for or in respect
of the recitals contained herein, all of which recitals are made solely by the Successor
Guarantors, the Existing Guarantors and the Company.

2

 

IN WITNESS WHEREOF, the parties hereto have caused this Fourth Supplemental Indenture to be duly
executed, all as of the day and year first above written.

	 	 	 	 	 
	 	EXPRESS SCRIPTS, INC.

 	 
	 	By:  	/s/ Martin P. Akins
 	 
	 	 	Name:  	Martin P. Akins 	 
	 	 	Title:  	Associate General Counsel 	 
	 

AIRPORT HOLDINGS, LLC

ESI REALTY, LLC

By: Express Scripts, Inc., as sole Member

	 	 	 	 	 
	 	By:  	            /s/ Martin P. Akins
 	 
	 	 	Name:  	Martin P. Akins 	 
	 	 	Title:  	Secretary 	 
	 

 

 

BYFIELD DRUG, INC.

CHESAPEAKE INFUSION, INC.

CURASCRIPT, INC.

CURASCRIPT PBM SERVICES, INC.

ESI MAIL PHARMACY SERVICE, INC.

EXPRESS SCRIPTS SPECIALTY

DISTRIBUTION SERVICES, INC.

EXPRESS SCRIPTS UTILIZATION

MANAGEMENT CO.

FRECO, INC.

FREEDOM SERVICE COMPANY, LLC

HEALTHBRIDGE REIMBURSEMENT AND

PRODUCT SUPPORT, INC.

IBIOLOGIC, INC.

LYNNFIELD DRUG, INC.

MATRIX GPO LLC

MOORESVILLE ON-SITE PHARMACY, LLC

PRIORITYHEALTHCARE.COM, INC.

PRIORITY HEALTHCARE CORPORATION

PRIORITY HEALTHCARE CORPORATION
WEST

PRIORITY HEALTHCARE PHARMACY, INC.

SINUSPHARMACY, INC.

SPECIALTY INFUSION PHARMACY, INC.

SPECTRACARE, INC.

SPECTRACARE HEALTH CARE

VENTURES, INC.

SPECTRACARE INFUSION PHARMACY, INC.

	 	 	 	 	 
	 	 	 
	 	By:  	               /s/ Patrick McNamee
 	 
	 	 	Name:  	Patrick McNamee 	 
	 	 	Title:  	President 	 
	 

CARE CONTINUUM, INC.

HEALTHBRIDGE, INC.

LYNNFIELD COMPOUNDING CENTER, INC.

PHOENIX MARKETING GROUP, LLC

PRIORITY HEALTHCARE DISTRIBUTION, INC.

	 	 	 	 	 
	 	 	 
	 	By:  	                    /s/ Michael Holmes
 	 
	 	 	Name:  	Michael Holmes 	 
	 	 	Title:  	President 	 
	 

 

 

CFI OF NEW JERSEY, INC.

DIVERSIFIED PHARMACEUTICAL SERVICES, INC.

ESI CLAIMS, INC.

ESI ENTERPRISES, LLC

EXPRESS SCRIPTS PHARMACEUTICAL

PROCUREMENT, LLC

EXPRESS SCRIPTS SALES DEVELOPMENT CO.

EXPRESS SCRIPTS SENIOR CARE, INC.

EXPRESS SCRIPTS SENIOR CARE

HOLDINGS, INC.

IVTX, INC.

NATIONAL PRESCRIPTION

ADMINISTRATORS, INC.

VALUE HEALTH, INC.

YOURPHARMACY.COM, INC.

	 	 	 	 	 
	 	 	 
	 	By:  	                    /s/ George Paz
 	 
	 	 	Name:  	George Paz 	 
	 	 	Title:  	President 	 
	 

	 	 	 	 	 
	 	CONNECTYOURCARE, LLC

CONNECTYOURCARE COMPANY, LLC

 	 
	 	By:  	/s/ Marc Palmer
 	 
	 	 	Name:  	Marc Palmer 	 
	 	 	Title:  	President 	 
	 

ESI PARTNERSHIP

By: Express Scripts, Inc., as Partner

	 	 	 	 	 
	 	 	 
	 	By:  	                  ./s/ George Paz
 	 
	 	 	Name:  	George Paz 	 
	 	 	Title:  	Chairman, Chief Executive Officer and President 	 
	 

By: ESI-GP Holdings, Inc., as Partner

	 	 	 	 	 
	 	 	 
	 	By:  	                  /s/ Tom Rocheford
 	 
	 	 	Name:  	Tom Rocheford 	 
	 	 	Title:  	President 	 
	 

 

 

	 	 	 	 	 
	 	ESI-GP HOLDINGS, INC.

ESI RESOURCES, INC.

 	 
	 	By:  	/s/ Tom Rocheford
 	 
	 	 	Name:  	Tom Rocheford 	 
	 	 	Title:  	President 	 
	 
	 	EXPRESS SCRIPTS CANADA HOLDING, CO.

 	 
	 	By:  	/s/ Michael Biskey
 	 
	 	 	Name:  	Michael Biskey 	 
	 	 	Title:  	President 	 
	 
	 	MSC — MEDICAL SERVICES COMPANY

SPEEDY RE-EMPLOYMENT, LLC

 	 
	 	By:  	/s/ Edward Ignaczak
 	 
	 	 	Name:  	Edward Ignaczak 	 
	 	 	Title:  	President 	 
	 

SPECTRACARE OF INDIANA

By: Spectracare, Inc., as Partner

	 	 	 	 	 
	 	 	 
	 	By:  	                    /s/ Patrick McNamee
 	 
	 	 	Name:  	Patrick McNamee 	 
	 	 	Title:  	President 	 
	 

By: Care Continuum, Inc., as Partner

	 	 	 	 	 
	 	 	 
	 	By:  	                   /s/ Michael Holmes
 	 
	 	 	Name:  	Michael Holmes 	 
	 	 	Title:  	President 	 
	 

 

 

	 	 	 	 	 	 	 	 	 

	 	 	NEXTRX LLC,	 	 
	 
	 	 	 	 	 	 	 	 
	 

	 	 	 	by	 	 	 	 
	 

	 	 	 	 	 	/s/ Martin P. Akins
 

	 	 
	 

	 	 	 	 	 	Name: Martin P.
Akins	 	 
	 

	 	 	 	 	 	Title: Secretary	 	 
	 
	 	 	 	 	 	 	 	 
	 	 	NEXTRX, INC.	 	 
	 
	 	 	 	 	 	 	 	 
	 

	 	 	 	by	 	 	 	 
	 

	 	 	 	 	 	/s/ Martin P. Akins
 

	 	 
	 

	 	 	 	 	 	Name: Martin P.
Akins	 	 
	 

	 	 	 	 	 	Title: Secretary	 	 
	 
	 	 	 	 	 	 	 	 
	 	 	NEXTRX SERVICES, INC.	 	 
	 
	 	 	 	 	 	 	 	 
	 

	 	 	 	by	 	 	 	 
	 

	 	 	 	 	 	/s/ Martin P. Akins
 

	 	 
	 

	 	 	 	 	 	Name: Martin P. Akins	 	 
	 

	 	 	 	 	 	Title: Secretary	 	 

 

 

	 	 	 	 	 	 	 	 	 

	 	 	UNION BANK, N.A., AS TRUSTEE	 	 
	 
	 	 	 	 	 	 	 	 
	 

	 	 	 	By	 	 	 	 
	 

	 	 	 	 	 	/s/ Hugo Gindraux
 

	 	 
	 

	 	 	 	 	 	Name: Hugo Gindraux	 	 
	 

	 	 	 	 	 	Title: Vice Presidentexv4w7

Exhibit 4.7

EXECUTION VERSION

FIFTH SUPPLEMENTAL INDENTURE

The Fifth Supplemental Indenture (this “Fifth Supplemental Indenture”), dated as of April 26, 2011,
among Express Scripts, Inc., a corporation duly organized and existing under the laws of the State
of Delaware (the “Company”), the Guarantors listed as signatories hereto (each, an “Existing
Guarantor”; and collectively, the “Existing Guarantors”), Express Scripts Canada Holding, LLC, a
Delaware limited liability company (the “Additional Guarantor”) and Union Bank, N.A., a national
association, as trustee under the indenture referred to below (the “Trustee”).

W I T N E S S E T H

     WHEREAS, the Company, the Existing Guarantors and the Trustee are parties to the
indenture, dated as of June 9, 2009, as supplemented by the First Supplemental Indenture thereto,
dated as of June 9, 2009 (the “First Supplemental Indenture”), relating to the 5.250% Notes due
2012 (the “2012 Notes”), the Second Supplemental Indenture thereto, dated as of June 9, 2009 (the
“Second Supplemental Indenture”), relating to the 6.250% Notes due 2014 (the “2014 Notes”), the
Third Supplemental Indenture thereto, dated as of June 9, 2009 (the “Third Supplemental
Indenture”), relating to the 7.250% Notes due 2019 (the “2019 Notes” and together with the 2012
Notes and the 2014 Notes, the “Notes”) and the Fourth Supplemental Indenture thereto, dated as of
December 1, 2009 (the “Fourth Supplemental Indenture”, and together with the First Supplemental
Indenture, the Second Supplemental Indenture and the Third Supplemental Indenture, the
“Supplemental Indentures”) (so supplemented, the “Indenture”);

     WHEREAS, the Additional Guarantor desires to provide a full and unconditional guarantee (the
“Guarantee”) of the obligations of the Company under the Notes, the Securities (as defined
in the Indenture) and the Indenture on the terms and conditions set forth herein;

     WHEREAS, the Company has complied with all conditions precedent provided for in the Indenture
and each Supplemental Indenture relating to this Fifth Supplemental Indenture; and

     WHEREAS, pursuant to Section 901 of the Indenture and Section 7.1 of each of the First
Supplemental Indenture, the Second Supplemental Indenture and the Third Supplemental Indenture, the
Company, the Trustee and the Additional Guarantor are authorized to execute and deliver this Fifth
Supplemental Indenture.

     NOW, THEREFORE, for good and valuable consideration, the receipt of which is acknowledged, the
Additional Guarantor hereby succeeds to the guarantee of the Company’s obligations under the Notes
as follows:

          1. Capitalized Terms. Capitalized terms used herein without definition shall have the
meanings assigned to them in the Indenture.

          2. Guarantee, Etc. The Additional Guarantor hereby agrees that from and after the
date hereof it shall be a Guarantor under the Indenture and be bound by its terms thereof
applicable to Guarantors and shall be entitled to all of the rights and subject to all of the
obligations of a Guarantor thereunder.

          3. Ratification of Indenture; Supplemental Indenture Part of Indenture. The Indenture
is in all respects ratified and confirmed, and all terms, conditions and provisions thereof shall
remain in full force and effect. This Fifth Supplemental Indenture shall form a part of the
Indenture for all purposes, and every Holder of Notes heretofore or hereafter authenticated and
delivered shall be bound hereby.

          4. Representations and Warranties. The Additional Guarantor hereby represents that
(a) it is duly organized, validly existing and in good standing under the laws of the jurisdiction
of its organization, (b) it has full power, authority and legal rights to execute and deliver this
Fifth Supplemental Indenture and to perform its obligations hereunder and under the Indenture, (c)
the execution, delivery and performance by it of this Fifth Supplemental Indenture has been duly
authorized by all necessary corporate action, and no other proceedings or actions on the part of
the Additional Guarantor are necessary therefor and (d) this Fifth Supplemental Indenture has been
duly and validly executed and delivered by the Additional Guarantor and constitutes a legal, valid
and binding obligation of the Additional Guarantor, enforceable against the Additional Guarantor in
accordance with its terms (subject to applicable bankruptcy, insolvency, receivership,
reorganization, moratorium and other similar laws of general applicability relating to or
affecting creditors’ rights and to general equity principles)

 

 

          5. No Personal Liability of Directors, Officers, Employees or Stockholders. No
director, officer, employee, member or stockholder of the Additional Guarantor, as such, will have
any liability for any obligations of the Company, any Existing Guarantor or the Additional
Guarantor under the Notes, the Indenture or the Guarantees, or for any claim based on, in respect
of, or by reason of, such obligations or their creation. Each Holder of Notes, by accepting a
Note, waives and releases the Company, each Existing Guarantor and the Additional Guarantor from
all such liability. The waiver and release are part of the consideration for issuance of the
Guarantee by the Additional Guarantor.

          6. GOVERNING LAW. THIS FIFTH SUPPLEMENTAL INDENTURE AND THE GUARANTEES HEREUNDER
SHALL BE GOVERNED BY, AND CONSTRUED IN ACCORDANCE WITH, THE LAWS OF THE STATE OF NEW YORK WITHOUT
GIVING EFFECT TO THE CONFLICTS OF LAWS PRINCIPLES THEREOF.

          7. Counterparts. This Fifth Supplemental Indenture may be executed in any number of
counterparts, each of which shall be deemed an original; but all such counterparts shall together
constitute but one and the same instrument.

          8. Effect of Headings. The Section headings herein are for convenience only and shall
not affect the construction hereof.

          9. Trustee. The Trustee shall not be responsible in any manner whatsoever for or in
respect of the validity or sufficiency of this Fifth Supplemental Indenture or for or in respect of
the recitals contained herein, all of which recitals are made solely by the Additional Guarantor,
the Existing Guarantors and the Company.

 

 

IN WITNESS WHEREOF, the parties hereto have caused this Fifth Supplemental Indenture to be duly
executed, all as of the day and year first above written.

	 	 	 	 	 

	 
	 	EXPRESS SCRIPTS, INC.
	 
	 

	 	By:
	 	/s/ Keith J. Ebling
 
 Name:
Keith J. Ebling
	 

	 	 	 	Title: Executive Vice President, General Counsel, and Secretary
	 
	 	 	 	 
	 	 	AIRPORT HOLDINGS, LLC
	 	 	ESI REALTY, LLC
	 
	 	 	 	 
	 	 	By: Express Scripts, Inc., as sole Member
	 
	 	 	 	 
	 

	 	By:
	 	/s Keith J. Ebling
 
 Name:
Keith J. Ebling
	 

	 	 	 	Title: Executive Vice President, General Counsel, and Secretary

(Signature Page to Fifth Supplemental Indenture)

 

 

	 	 	 

	 

	 	BYFIELD DRUG, INC.
	 

	 	CARE CONTINUUM, INC.
	 

	 	CFI OF NEW JERSEY, INC.
	 

	 	CHESAPEAKE INFUSION, INC.
	 

	 	CONNECTYOURCARE COMPANY LLC
	 

	 	CONNECTYOURCARE LLC
	 

	 	CURASCRIPT PBM SERVICES, INC.
	 

	 	DIVERSIFIED PHARMACEUTICAL SERVICES, INC.
	 

	 	ESI ACQUISITION, INC.
	 

	 	ESI CLAIMS, INC.
	 

	 	ESI ENTERPRISES, LLC
	 

	 	ESI MAIL ORDER PROCESSING, INC.
	 

	 	EXPRESS SCRIPTS CANADA HOLDING CO.
	 

	 	EXPRESS SCRIPTS PHARMACEUTICAL PROCUREMENT, LLC
	 

	 	EXPRESS SCRIPTS SALES DEVELOPMENT CO.
	 

	 	FRECO, INC.
	 

	 	FREEDOM SERVICE COMPANY, LLC
	 

	 	HEALTHBRIDGE, INC.
	 

	 	HEALTHBRIDGE REIMBURSEMENT AND PRODUCT SUPPORT, INC.
	 

	 	iBIOLOGIC, INC.
	 

	 	IVTX, INC.
	 

	 	LYNNFIELD COMPUNDING CENTER, INC.
	 

	 	LYNNFIELD DRUG, INC.
	 

	 	MATRIX GPO LLC
	 

	 	NATIONAL PRESCRIPTION ADMINISTRATORS, INC.
	 

	 	PRIORITY HEALTHCARE CORPORATION
	 

	 	PRIORITY HEALTHCARE CORPORATION WEST
	 

	 	PRIORITY HEALTHCARE DISTRIBUTION, INC.
	 

	 	PRIORITY HEALTHCARE PHARMACY, INC.
	 

	 	PRIORITYHEALTHCARE.COM, INC.
	 

	 	SINUSPHARMACY, INC.
	 

	 	SPECIALTY INFUSION PHARMACY, INC.
	 

	 	SPECTRACARE, INC.
	 

	 	SPECTRACARE HEALTH CARE VENTURES, INC.
	 

	 	SPECTRACARE INFUSION PHARMACY, INC.
	 

	 	VALUE HEALTH, INC.
	 

	 	YOURPHARMACY.COM, INC.

	 	 	 	 	 
	 	 	 
	 	By:  	                   /s/ Keith J. Ebling
 	 
	 	 	Name:  	Keith J. Ebling 	 
	 	 	Title:  	Vice President 	 
	 

	 	 	 

	 

	 	CURASCRIPT, INC.
	 

	 	ESI MAIL PHARMACY SERVICE, INC.
	 

	 	EXPRESS SCRIPTS SPECIALTY DISTRIBUTION SERVICES, INC.
	 

	 	EXPRESS SCRIPTS UTILIZATION MANAGEMENT CO.
	 

	 	MOORESVILLE ON-SITE PHARMACY, LLC

	 	 	 	 	 
	 	 	 
	 	By:  	                                       /s/ Patrick McNamee
 	 
	 	 	Name:  	Patrick McNamee 	 
	 	 	Title:  	President 	 
	 

(Signature Page to Fifth Supplemental Indenture)

 

 

ESI-GP HOLDINGS, INC.

ESI RESOURCES, INC.

	 	 	 	 	 
	 	 	 
	 	By:  	                            /s/ Tom Rocheford
 	 
	 	 	Name:  	Tom Rocheford 	 
	 	 	Title:  	President 	 
	 

ESI PARTNERSHIP

By: Express Scripts, Inc., as Partner

	 	 	 	 	 
	 	 	 
	 	By:  	                 /s/ Martin P. Akins
 	 
	 	 	Name:  	Martin P. Akins 	 
	 	 	Title:  	Vice President and Deputy General Counsel 	 
	 

By: ESI-GP Holdings, Inc., as Partner

	 	 	 	 	 
	 	 	 
	 	By:  	                            /s/ Tom Rocheford
 	 
	 	 	Name:  	Tom Rocheford 	 
	 	 	Title:  	President 	 
	 

SPECTRACARE OF INDIANA

By: Spectracare, Inc., as Partner

	 	 	 	 	 
	 	 	 
	 	By:  	                            /s/ Keith J. Ebling
 	 
	 	 	Name:  	Keith J. Ebling 	 
	 	 	Title:  	Vice President 	 
	 

By: Care Continuum, Inc., as Partner

	 	 	 	 	 
	 	 	 
	 	By:  	                             /s/ Keith J. Ebling
 	 
	 	 	Name:  	Keith J. Ebling 	 
	 	 	Title:  	Vice President 	 
	 

EXPRESS SCRIPTS MSA, LLC

EXPRESS SCRIPTS WC, INC.

	 	 	 	 	 
	 	 	 
	 	By:  	                            /s/ Edward Ignaczak
 	 
	 	 	Name:  	Edward Ignaczak 	 
	 	 	Title:  	President 	 
	 

EXPRESS SCRIPTS SENIOR CARE, INC.

EXPRESS SCRIPTS SENIOR CARE HOLDINGS, INC.

	 	 	 	 	 
	 	 	 
	 	By:  	                            /s/ George Paz
 	 
	 	 	Name:  	George Paz 	 
	 	 	Title:  	President 	 
	 

(Signature Page to Fifth Supplemental Indenture)

 

 

EXPRESS SCRIPTS CANADA HOLDING, LLC

	 	 	 	 	 
	 	 	 
	 	By:  	                            /s/ Keith J. Ebling
 	 
	 	 	Name:  	Keith J. Ebling 	 
	 	 	Title:  	Vice President 	 
	 

(Signature Page to Fifth Supplemental Indenture)

 

 

	 	 	 	 	 

	 	 	UNION BANK, N.A., AS TRUSTEE
	 
	 	 	 	 
	 

	 	By
	 	/s/ Hugo Gindraux
 
 Name:
Hugo Gindraux
	 

	 	 	 	Title: Vice President

(Signature Page to Fifth Supplemental Indenture)

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