Document:

Ex-10.5

 Exhibit 10.5 
 NOTE: Portions of this Exhibit are the subject of a Confidential Treatment Request by the Registrant to the Securities and Exchange Commission (the “Commission”). Such portions have been
redacted and are marked with a “[***]” in the place of the redacted language. The redacted information has been filed separately with the Commission. 
 Execution Copy 
 Confidential 

FIFTH AMENDMENT TO THE LICENSE AGREEMENT 
 This FIFTH AMENDMENT TO THE LICENSE AGREEMENT (the “Fifth Amendment”) is made and entered into as of April 1, 2013 (the “Fifth Amendment Effective Date”), by and
between SANGAMO BIOSCIENCES, INC., a Delaware corporation having its principal place of business at Point Richmond Tech Center, 501 Canal Boulevard, Suite A100, Richmond, California 94804 (“Sangamo”), and SIGMA-ALDRICH
CO., LLC, a Delaware limited liability company having its principal place of business at 3050 Spruce Street, St. Louis, MO 63103 (“Sigma”). Sigma and Sangamo are individually referred to herein as a “Party” or
collectively as the “Parties.” 
 RECITALS 

A. Sigma and Sangamo are parties to a License Agreement effective as of July 10, 2007 as previously amended (the
“Agreement”), under which Sangamo granted to Sigma a certain license to use Sangamo’s proprietary zinc finger protein technology in the fields as defined therein. 

B. Sigma and Sangamo desire to amend the Agreement in accordance with the amendments below, in order to allow Sigma to execute the
license agreement attached hereto as Appendix A, which license agreement includes the grant by Sigma of a sublicense of certain rights licensed to Sigma pursuant to the Agreement. 

Now, Therefore, for good and valuable consideration, the receipt and sufficiency of which are hereby acknowledged, the Parties hereto
agree as follows: 
 The Parties hereby agree to amend the terms of the Agreement as provided below, effective as of the Fifth
Amendment Effective Date. Where the Agreement is not explicitly amended, the terms of the Agreement and any prior amendments will remain in force. Capitalized terms used in this Fifth Amendment that are not otherwise defined herein shall have the
same meanings as such terms are given in the Agreement or prior amendments. 
  

	 	1.	The following new Section 1.107 shall be added to read in its entirety as follows: 

“1.107 “SAGE” shall mean (a) the entity that enters into the SAGE Sublicense together with Sigma and to whom
Sigma sells its ZFN -modified research animal business, (b) any affiliate of such entity, or (c) any assignee of, or successor-in-interest to, any of such entity’s rights or obligations under the SAGE Sublicense.” 

	 	2.	The following new Section 1.108 shall be added to read in its entirety as follows: 

“1.108 “SAGE Improvement” shall mean any Improvement that is assigned or licensed to Sigma pursuant to the SAGE
Sublicense or a Sub-sublicense Agreement. All SAGE Improvements are deemed to be Sigma Improvements, and Sigma is obligated to disclose them to Sangamo pursuant to Section 8.1(a) and to license them to Sangamo pursuant to
Section 2.3(b).” 
  

	 	3.	The following new Section 1.109 shall be added to read in its entirety as follows: 

“1.109 “SAGE Sublicense” shall mean the license agreement attached hereto as Appendix A.” 

 

	 	4.	The following new Section 1.110 shall be added to read in its entirety as follows: 

“1.110 “Sub-sublicense Agreement” means any agreement, other than a Use License (as defined in the SAGE
Sublicense), under which SAGE grants a Third Party a sublicense under SAGE’s rights to the Sangamo Technology pursuant to the SAGE Sublicense.” 
  

	 	5.	The following new Section 1.111 shall be added to read in its entirety as follows: 

“1.111 “Sub-sublicensee” means any Third Party to which SAGE grants a sublicense under SAGE’s rights to the
Sangamo Technology pursuant to the SAGE Sublicense.” 
  

	 	6.	Section 1.45 shall be amended to read in its entirety as follows: 

 “1.45 “Net Sales” means the amount invoiced or otherwise billed by Sigma or SAGE for sales or other commercial disposition of a Licensed Product in the Field to a Third Party
purchaser, less the following to the extent included in such billing or otherwise actually allowed or incurred with respect to such sales: (a) discounts, including cash, trade and quantity discounts, price reduction programs, retroactive price
adjustments with respect to sales of a product, charge-back payments and rebates granted to trade customers; (b) credits or allowances actually granted upon rejections or returns of Licensed Products, including for recalls or damaged goods;
(c) freight, postage, shipping and insurance charges actually allowed or paid for delivery of Licensed Products, to the extent billed; (d) customs duties, surcharges and other governmental charges incurred in connection with the
exportation or importation of a Licensed Product; (e) taxes, duties or other governmental charges levied on, absorbed or otherwise imposed on sale of Licensed Products, including without limitation value-added taxes, or other governmental
charges otherwise measured by the billing amount, when included in billing, as adjusted for rebates and refunds, but specifically excluding taxes based on net income of the seller; and (f) a reasonable allowance for bad debts (such allowance
not to exceed 2% of gross sales) provided that all of the foregoing deductions are calculated in accordance with generally accepted accounting principles consistently applied throughout the selling party’s organization.” 

  
 2 

	 	7.	Section 1.73 shall be amended to read in its entirety as follows: 

 “1.73 “Sigma Improvements” means (a) Improvements (other than Joint Improvements) that are made by one or more employees, consultants, or independent contractors of Sigma or of
any entity while it is a Sigma Affiliate; and (b) Improvements made by Sublicensees or Sub-sublicensees, to the extent Controlled by Sigma or any Sigma Affiliate. Notwithstanding the foregoing, an Improvement that satisfies the foregoing
definition solely because it was made by one or more employees, consultants, or independent contractors of an entity while it is a Sigma Affiliate shall be deemed not to be a Sigma Improvement if Sigma can demonstrate by competent evidence that such
entity had no access to the Sangamo Technology or to any other Improvements that are Sigma Improvements.” 
  

	 	8.	Section 1.78 shall be amended to read in its entirety as follows: 

 “1.78 “Sublicensing Revenues” means any consideration that Sigma or SAGE receives in return for the granting or practice of a sublicense under the Sangamo Technology pursuant to a
Sublicense Agreement or Sub-sublicense Agreement, respectively, in which the sublicense under the Sangamo Technology includes rights in the Field, which may include (without limitation) royalties on sales, upfront license fees, annual license or
maintenance payments, milestone payments, credits against Sigma’s or SAGE’s future expenses, or reductions in royalties or other payments otherwise owed to the Sublicensee or Sub-sublicensee. In the event that Sigma or SAGE receives
non-cash consideration from a Sublicensee or Sub-sublicensee for the granting or practice of a sublicense under the Sangamo Technology in the Field, the Parties shall determine in good faith the fair market value of such consideration, and such fair
market value shall be included in Sublicensing Revenues; provided, however, that the term “Sublicensing Revenues” shall in no event include all or any portion of the Business Sale Payment (as defined in Section 21 of the Fifth
Amendment) or any Earn Out Payment (as defined in Section 23 of the Fifth Amendment).” 
  

	 	9.	The last sentence of Section 2.1 (a) shall be amended to read in its entirety as follows: 

“No Sigma sublicensee shall be permitted to grant further sublicenses without Sangamo’s prior written approval; provided,
however, that SAGE may grant sublicenses in accordance with Section 2.9.” 
  

	 	10.	Section 2.2 (b) shall be amended to read in its entirety as follows: 

 “2.2 (b) Each Sublicense Agreement shall require the relevant Sublicensee to: 

  
 3 

 (i) Disclose in a timely fashion to Sigma any Improvement(s) made, conceived or reduced to
practice by the such Sublicensee in its activities under the Sublicense Agreement; and 
 (ii) Grant to Sangamo a fully-paid,
world-wide, royalty-free, irrevocable (subject to Section 10.3(f)) license under any such Improvements (other than SAGE Improvements) that is exclusive for uses outside the Field and is fully sublicensable.” 

 

	 	11.	The following new Section 2.9 shall be added in its entirety to read as follows: 

“2.9 Sub-sublicense Agreement. SAGE shall provide Sigma with a copy of each executed Sub-sublicense Agreement within thirty
(30) days after execution, and Sigma shall provide Sangamo with a copy of each such Sub-sublicense Agreement within sixty (60) days after execution. Each such Sub-sublicense Agreement so provided to Sangamo shall be treated as Sigma
“Confidential Information.” With respect to any Sub-sublicense Agreement that includes a sublicense under a Third Party License that requires Sangamo to provide to the applicable Third Party licensor a copy of any Sub-sublicense Agreement
or a summary of the terms of such Sub-sublicense Agreement, Sangamo shall be permitted to provide such Third Party licensor with such copy or summary and Sigma shall provide such copy or other necessary information a reasonable amount of time in
advance of the relevant deadline for Sangamo’s provision of such copy or summary to such Third Party licensor. SAGE shall ensure that all Sub-sublicense Agreements comply with the following requirements: 

(a) No Sub-sublicense Agreement shall obligate (or purport to obligate) Sangamo, without Sangamo’s express prior written consent.

 (b) Each Sub-sublicense Agreement shall require the relevant Sub-sublicensee to: 

(i) disclose in a timely fashion to SAGE any Improvement(s) made, conceived, or reduced to practice by the such Sub-sublicensee in its
activities under the Sub-sublicense Agreement; 
 (ii) acknowledge that SAGE is obligated to disclose such Improvements to Sigma
and that Sigma is obligated to disclose such Improvements to Sangamo; 
 (iii) assign to Sigma all such Improvements that are
SAGE Developed IP (as defined in the SAGE Sublicense); 
 (iv) grant to Sigma a fully paid, world-wide, royalty-free,
irrevocable license under any such Improvement that is not SAGE Developed IP (and all patents and patent applications claiming the same) that is (1) exclusive for uses outside SAGE’s Commercial Field (as defined in the SAGE Sublicense) and
is fully sublicensable and (2) non-exclusive for uses in SAGE’s Commercial Field and is fully sublicensable; 

  
 4 

 (v) acknowledge that Sigma is obligated to grant Sangamo certain fully paid, world-wide,
royalty-free, irrevocable, exclusive and non-exclusive (1) licenses under the SAGE Developed IP and (2) sublicenses of the license set forth in Section 2.9(b)(iv). 

(c) Each Sub-sublicense Agreement shall identify Sigma and Sangamo as third party beneficiaries with respect to the assignment set forth
in Section 2.9(b)(iii) and the license set forth in Section 2.9(b)(iv). 
 (d) Each Sub-sublicense Agreement shall
require that the relevant Sub-sublicensee (i) comply with the relevant terms of Sections 5.3(a) and 5.4 (as if such Sub-sublicensee were Sigma), (ii) assume the obligations set forth in Exhibit C (as if such Sub-sublicensee were Sigma)
with respect to each Third Party License sublicensed thereunder, and (iii) acknowledge that the Sub-sublicense Agreement is subject to the terms and conditions of each such Third Party License.” 

 

	 	12.	The last sentence of Section 5.1 shall be amended to read in its entirety as follows: 

“Except as expressly set out in this Agreement, Sangamo shall have no responsibility for any costs or expenses incurred by Sigma or
any Sublicensees or Sub-sublicensees in undertaking development or commercialization of Licensed Products.” 
  

	 	13.	Section 5.3(a) shall be amended to read in its entirety as follows: 

 “(a) Sigma shall keep the JSC informed regarding the overall progress and results of the development and commercialization of any Licensed Products in the Field and Commercial Products in the
Commercial Field, in each case by Sigma, its Affiliates, its Sublicensees or Sub-sublicensees, including any written reports requested by the JSC. After the JSC ceases to exist pursuant to Section 3.1, Sigma shall thereafter provide directly to
Sangamo summaries of the development and commercialization activities performed or anticipated to be performed by Sigma, its Affiliates, its Sublicensees or Sub-sublicensees with respect to Licensed Products in the Field and Commercial Products in
the Commercial Field, which summaries shall be in a format and at a frequency decided by the JSC (i.e., prior to the time it ceases to exist) or mutually agreed by the Parties.” 

 

	 	14.	The second and third sentences of Section 7.6 shall be amended to read in their entirety as follows: 

“Within sixty (60) days after the end of each calendar quarter thereafter, Sigma shall pay Sangamo an amount equal [***] of the
Sublicensing 
 *** CONFIDENTIAL PORTIONS OMITTED AND FILED SEPARATELY WITH THE COMMISSION

  
 5 

 
Revenues received by Sigma during such calendar quarter and [***] of the Sublicensing Revenues received by SAGE during such calendar quarter; provided that solely with respect to Sublicensing
Revenues received by SAGE which are subsequently received by Sigma, Sigma shall be obligated to pay Sangamo [***] of the amount received by Sigma from SAGE but shall not be obligated to pay to Sangamo an additional [***] of such amount received.
Each Sublicensing Revenue payment shall be accompanied by a statement itemizing the amount and type (e.g., license fee, milestone payment, etc.) of each payment received by Sigma from each Sublicensee or SAGE during the relevant calendar
quarter.” 
  

	 	15.	The first sentence of Section 7.10(b) shall be amended to read in its entirety as follows: 

“Sigma shall be responsible for paying (i) any sublicense issuance and sublicense maintenance fees owed to Third Parties
pursuant to Third Party Licenses on account of the grant of a sublicense by Sigma or its sublicensees (including SAGE) and (ii) all milestones, royalties and other compensation owed to Third Parties pursuant to post-Effective Date Third Party
Licenses on account of (A) the grant to Sigma of the licenses set forth in Section 2.1(a) or (B) the generation, development and/or commercialization of Licensed Products by Sigma, its Affiliates, Sublicensees and Sub-sublicensees
within the Field. Sigma shall be responsible for paying (i) any sublicense issuance and sublicense maintenance fees owed to Third Parties pursuant to Third Party Licenses on account of the grant of a sublicense by Sigma or its sublicensees and
(ii) all milestones, royalties and other compensation owed to Third Parties pursuant to post-Third Amendment Effective Date Third Party Licenses on account of (A) the grant to Sigma of the licenses set forth in Section 2.1(c) or
(B) the generation, development and/or commercialization of Commercial Products by Sigma, its Affiliates, and Sublicensees within the Commercial Field.” 
  

	 	16.	Add the following to the end of Section 9.4: 

 “If SAGE provides Sigma with a marked copy of the SAGE Sublicense pursuant to Section 6.3 of the SAGE Sublicense, then Sigma shall request that SAGE attempt to obtain confidential treatment for
those portions of the SAGE Sublicense that correspond portions of this Agreement for which Sangamo has obtained confidential treatment.” 
  

	 	17.	Section 10.2(d) shall be amended to read in its entirety as follows: 

 “(d) Sigma shall provide Sangamo with a complete and accurate list of (i) all projects in which Sigma, a Sigma Affiliate, a Sublicensee (to the extent of Sigma’s knowledge) or a
Sub-sublicensee (to the extent of Sigma’s knowledge) practiced the Sangamo Technology in the Field or the Commercial Field prior to the termination effective date and (ii) all Licensed Products in existence as of the effective date of
termination.” 
 *** CONFIDENTIAL PORTIONS OMITTED AND FILED SEPARATELY WITH THE COMMISSION 

  
 6 

	 	18.	The first sentence of Section 12.2 (a) shall be amended to read in its entirety as follows: 

“Subject to Section 12.3, Sigma hereby agrees to indemnify, defend and hold the Sangamo Indemnitees harmless from and against
any and all Damages resulting from Claims brought by a Third Party to the extent resulting from the manufacture, use, handling, storage, marketing, sale or other disposition of Licensed Products by Sigma, its Affiliates, agents or sublicensees
(including Sublicensees and Sub-sublicensees).” 
  

	 	19.	The following new Section 13.19 shall be added to read in its entirety as follows: 

“13.19 [***]. In the event that the license set forth in Section 2.1(a) should terminate for any reason and such
termination did not arise directly or indirectly from any acts or omissions of SAGE or its Sub-sublicensees, and Sangamo receives a written request for [***] (as defined in this Section 13.19) from SAGE within thirty (30) days of such
termination, Sangamo agrees, without demanding additional consideration from SAGE (other than reimbursement of Sangamo’s reasonable out-of-pocket legal fees incurred in connection therewith) or Sigma, to enter into an agreement with SAGE
whereby: (a) SAGE would receive [***], which [***] would be [***] and would be subject to the same [***], and (b) such [***] would be subject to the same [***], except [***] would owe all such obligations [***], and [***] would not have
any obligations [***].” 
  

	 	20.	Sigma shall obtain Sangamo’s prior written consent before approving any proposed label license that, with Sigma’s approval would be a Use License under the
SAGE Sublicense or any Sub-sublicense Agreement. Notwithstanding Section 3.2(c)(iv) and the first sentence of Section 5.4, Sigma or its sublicensee SAGE may sell Licensed Products pursuant to the label license set forth in Exhibit A,
provided that the Customer purchasing the applicable Licensed Product is non-profit organization or governmental entity or agency. Such label license shall be deemed to be a Use License for the purposes of the Agreement. 

 

	 	21.	Sigma shall pay to Sangamo, within fifteen (15) days following the date of execution of the SAGE Sublicense by both Sigma and SAGE (such execution date, the
“SAGE Sublicense Date”), an amount in immediately available funds equal to the greater of (a) [***] and (b) [***] of the fair market value of all consideration received by Sigma and its Affiliates on or before the SAGE Sublicense
Date in connection with Sigma’s sale of its animal research business to SAGE and the granting of the SAGE Sublicense to SAGE (such consideration received by Sigma and its Affiliates, the “Business Sale Payment”). Such payment shall be
nonrefundable and noncreditable. The Parties acknowledge and agree that the payment set forth in this Section 21 of the Fifth Amendment is [***]. 

 *** CONFIDENTIAL PORTIONS OMITTED AND FILED SEPARATELY WITH THE COMMISSION 

  
 7 

	 	22.	Sigma shall pay to Sangamo[***] of all amounts received by Sigma pursuant to the SAGE Sublicense. All amounts received by Sigma pursuant to the [***] shall be deemed to
be [***] to the extent such amounts [***] with respect to the [***], and Sigma shall make the payments set forth in Sections 7.4 and 7.7 with respect thereto. 

 

	 	23.	If Sigma or its Affiliates receive consideration, in addition to the amounts described in Section 22 of this Fifth Amendment, after the SAGE Sublicense Date in
connection with Sigma’s sale of its animal research business to SAGE and the granting of the SAGE Sublicense (each such consideration, an “Earn Out Payment”), then Sigma shall pay to Sangamo, within thirty (30) days of such
receipt, an amount equal to [***] of the fair market value of such Earn Out Payment; each such payment shall be nonrefundable and noncreditable and shall be in lieu of the payment that Sigma would otherwise owe to Sangamo pursuant to
Section 7.6 on account of such Earn Out Payment. 

  

	 	24.	Sigma hereby represents and warrants to Sangamo that: (a) the only consideration that Sigma or any of its Affiliates will receive on or before the SAGE Sublicense
Date in connection with Sigma’s sale of its animal research business to SAGE and the granting of the SAGE Sublicense to SAGE is [***] cash payment for the purchase of one hundred percent of the stock of S-A Ace, Inc.; (b) Sigma will not
own any equity or other interest in [***] Sublicense Date; (c) Sigma is not making any sales of Licensed Products or Licensed Services, on or before the SAGE Sublicense Date, to SAGE or otherwise in connection with the sale of its animal
research business to SAGE, for which Sigma will receive any consideration in addition to the cash payment described in (a); (d) all sales of Licensed Products to SAGE after the SAGE Sublicense Date [***] and Sigma shall make payments to Sangamo
in connection therewith as set forth in Section 22 of this Fifth Amendment. 

 [The remainder of this page
was left blank intentionally.] 
 *** CONFIDENTIAL PORTIONS OMITTED AND FILED SEPARATELY WITH THE COMMISSION 

  
 8 

 In witness whereof, the Parties have executed this Fifth Amendment in duplicate originals by
their proper officers as of the Fifth Amendment Effective Date. 
  

									
	 SIGMA-ALDRICH CO., LLC
	 		 	SANGAMO BIOSCIENCES, INC.
					
	 By:
	 	 /s/ George L. Miller
      
	 		 	By:	 	 /s/ Edward Lanphier
      

	 Name:
	 	 George L. Miller
      
	 		 	Name:	 	 Edward Lanphier
      

	 Title:
	 	 General Counsel and Secretary
      
	 		 	Title:	 	 President and CEO
      

  
 9EX-10.1

 EXHIBIT 10.1 
 

 
  

					
	 Ventas Realty, Limited Partnership
	 		  	10350 Ormsby Park Place
		 		  	Suite 300
		 		  	Louisville, KY 40223
		 		  	T 502.357-9000
		 		  	F 502.357-9029

 March 1, 2013 
 Kindred Healthcare, Inc. 
 Kindred Healthcare Operating, Inc. 

680 South Fourth Street 
 Louisville, KY
40202-2612 
  

	 	Re:	Second Amended and Restated Master Lease Agreement No. 1, dated April 27, 2007 and by and among Ventas Realty, Limited Partnership, as lessor, and Kindred
Healthcare, Inc. and Kindred Healthcare Operating, Inc., as tenant (as heretofore amended by that certain letter agreement dated May 23, 2012, and that certain letter agreement dated January 29, 2013 (the “January 2013 Letter
Agreement”) or otherwise amended or modified, the “Master Lease”) 

 Dear Ladies and Gentlemen:

 Reference is made to the Master Lease. Capitalized terms that are used herein and not otherwise defined shall have the same
meanings herein as in the Master Lease. Contemporaneously herewith, (a) Bay View Rehabilitation Hospital LLC (“Bay View”) and Kindred Nursing Centers West, LLC (“KNCW”) are entering into that certain Interim
Sublease (the “Sublease”) dated as of March 1, 2013 (the “Closing Date”) and Bay View, Meridian Management Services, LLC and KNCW are entering into that certain Interim Management Agreement dated as of the
Closing Date (the “Management Agreement”), each relating to the property commonly known as Kindred Transitional Care and Rehabilitation – Bay View and located at 516 Willow Street, Alameda, California 94501 (the
“Affected Facility”), and (b) Lessor is entering into an Owner Consent relating to each of the Sublease and the Management Agreement. Bay View, Lessor and certain other entities have heretofore entered into a master lease with
respect to the Affected Facility and other property (the “New Lease”). 
 Pursuant to this letter and
notwithstanding anything to the contrary in the Master Lease, Lessor and Tenant hereby agree as follows: 
  

	 	1.	 With respect to the Affected Facility, Lessor and Tenant agree that (i) during the period from the Closing Date until either the termination of
the Management Agreement, as it relates to operations under the “Kindred License” (as defined in 

 March 1, 2013 
 Kindred Healthcare, Inc. 
 Kindred Healthcare Operating, Inc. 

 Page
 2
 
  

	 	
the Management Agreement), pursuant to clause (ii) below or the occurrence of the Reinstatement Date (defined below) pursuant to clause (iii) below (either such period, the
“Interim Period”), the Master Lease shall be held in abeyance, and not apply or be of any force or effect (and no rent, liability or obligations shall accrue thereunder), with respect to the Affected Facility, (ii) if the
Management Agreement terminates, as it relates to operations under the Kindred License, because the Bay View License (as defined in the Management Agreement) has been obtained by Bay View prior to the earliest to occur of the applicable dates set
forth in Section 1.3(a) of the Management Agreement (the “Outside Licensure Date”), the Master Lease shall terminate as it relates to the Affected Facility, effective as of the Closing Date, subject to the terms of the Master
Lease that expressly survive the termination thereof, and (iii) if the Management Agreement terminates, as it relates to operations under the Kindred License, because the Bay View License is not obtained by Bay View prior to the Outside
Licensure Date or for any other reason (other than Bay View’s obtaining of the Bay View License prior to the Outside Licensure Date), the Master Lease shall cease to be held in abeyance, and again apply (i.e., to effectuate the transfer or wind
down of operations, as applicable), effective as of the Reinstatement Date (defined below), to the Affected Facility on the same terms set forth in the Master Lease, except as amended by this letter agreement. 

 

	 	2.	For the purposes hereof, the “Reinstatement Date” shall be the date on which Bay View fully vacates and surrenders possession of the Affected Facility and the
New Lease is terminated as it relates to the Affected Facility. If the Bay View License is not obtained by Bay View prior to the Outside Licensure Date, Lessor agrees that it will terminate the New Lease, as it relates to the Affected Facility, on
the Outside Licensure Date and use commercially reasonable efforts to cause Bay View to fully vacate and surrender possession of the Affected Facility to Tenant on the Outside Licensure Date. 

 

	 	3.	Notwithstanding anything contained herein, in the Master Lease, New Lease, Sublease or Management Agreement to the contrary: 

(a) neither Tenant nor any of its affiliates shall have any liability to Lessor for any matters occurring with respect to the Affected
Facility during the Interim Period, including, without limitation, (i) any accident, injury to or death of persons or loss of or damage to property occurring on or about the Affected Facility or adjoining sidewalks, including, without
limitation, any claims of malpractice, (ii) any use, misuse, non-use, condition, maintenance or repair by Bay View or anyone claiming under Bay View, including agents, contractors, invitees or visitors of the Affected Facility or the personal
property thereon, (iii) any Impositions, (iv) any failure on the part of Bay View or anyone claiming under Bay View to perform or comply with any of the terms of the New Lease, (v) any failure by Bay View to observe, perform and
comply with the terms of any Existing Ground Lease or 

 March 1, 2013 
 Kindred Healthcare, Inc. 
 Kindred Healthcare Operating, Inc. 

 Page
 3
 
  
 
other Permitted Encumbrance applicable to or binding upon Lessor or the Affected Facility or any breach of, default under or termination of any such Existing Ground Lease or other Permitted
Encumbrance caused, whether by act or omission, by Bay View or its agents, employees, contractors, invitees, subtenants, licensees, concessionaires or assigns (whether or not permitted hereunder), and (vi) the non-performance of any of the
terms and provisions of any and all existing and future subleases of the Affected Facility to be performed by the subtenant thereunder; and 
 (b) no event, condition or other state of facts arising (other than due to the gross negligence or willful misconduct of Tenant) during the Interim Period and relating to the Affected Facility shall give
rise to a Facility Default or Event of Default under the Master Lease. 
  

	 	4.	If the Master Lease shall cease to be held in abeyance in accordance with Paragraph 1(iii) above, then effective as of the Reinstatement Date, the applicable
provisions of Paragraph 2 of the January 2013 Letter Agreement shall be deemed amended, solely with respect to the Affected Facility, as set forth on Exhibit A hereto (with deletions in strikethrough and additions in
underlining). 

  

	 	5.	Except as set forth herein, the Master Lease shall remain in full force and effect. In order to induce Lessor to enter into this letter, Tenant hereby represents and
warrants to Lessor that Tenant’s entry into this letter does not require that any consent or approval first be obtained from any lender or other third party. In order to induce Tenant to enter into this letter, Lessor hereby represents and
warrants to Tenant that Lessor’s entry into this letter does not require that any consent or approval first be obtained from any lender or other third party. 

 [SIGNATURE PAGES FOLLOW] 

 March 1, 2013 
 Kindred Healthcare, Inc. 
 Kindred Healthcare Operating, Inc. 

 Page
 4
 
  
 If
you are in agreement with the foregoing matters, please execute and return to the undersigned the enclosed copy of this letter. 
  

					
	Very truly yours,
	
	VENTAS REALTY, LIMITED PARTNERSHIP, a Delaware limited partnership
		
	By:	 	Ventas, Inc., a Delaware corporation,
		 	its general partner
			
		 	By:	 	 /s/ T. Richard Riney

		 		 	T. Richard Riney,
		 		 	Executive Vice President, Chief Administrative Officer, General Counsel and Secretary

  

			
	AGREED AND ACCEPTED:
	
	 KINDRED HEALTHCARE, INC.,
 a Delaware corporation

		
	By: 	 	 /s/ Douglas L. Curnutte

	Name:	 	Douglas L. Curnutte
	Its: 	 	Vice President - Facilities and Real Estate Development
	
	KINDRED HEALTHCARE OPERATING, INC., a Delaware corporation
		
	By: 	 	 /s/ Douglas L. Curnutte

	Name:	 	Douglas L. Curnutte
	Its: 	 	Vice President - Facilities and Real Estate Development

 March 1, 2013 
 Kindred Healthcare, Inc. 
 Kindred Healthcare Operating, Inc. 

 Page
 5
 
  

JOINDER 
 For the avoidance of doubt and although it is not required to do so, the undersigned, as the joint and several Lessor with Ventas Realty, Limited Partnership under the Master Lease (with respect to
Facility 4619), hereby joins in this letter for the purpose of evidencing its consent thereto, joinder therein and agreement to be bound thereby. 
  

			
	VENTAS, INC., a Delaware corporation
		
	By:	 	 /s/ T. Richard Riney

		 	T. Richard Riney, Executive Vice President, Chief Administrative Officer, General Counsel and Secretary

 March 1, 2013 
 Kindred Healthcare, Inc. 
 Kindred Healthcare Operating, Inc. 

 Page
 6
 
  

Exhibit A 
 Deemed
amendments to applicable provisions of Paragraph 2 of the January 2013 Letter Agreement (for the avoidance of doubt, such amendments shall not apply to the Transfer Notice previously delivered on December [    ], 2012, with
respect to the Affected Facility). 
 (b) From time to time from and after the date of this letter, but in no event later than
June 15, 2013 the date that is eighteen weeks following the Reinstatement Date (the “Transfer Notice Deadline”), Lessor may notify Tenant of its election to require that the Affected
Facility, asa Terminating Leased Property or Terminating Leased Properties identified by Lessor in its notice (each, a “Transfer Notice”) be transferred and transitioned as provided in this letter;

 (c) Each Transfer Notice shall specify the date (subject to extension as described below, the applicable
“Transfer Date”) on which such transfer and transition is to occur with respect to the Affected Facilityidentified Terminating Leased Property(ies), which Transfer Date shall be not less than
forty-five (45) days after Tenant’s receipt of the applicable Transfer Notice (provided, however, that (i) if the Transfer Date specified by Lessor in its Transfer Notice is less than ninety (90) days after Tenant’s receipt
of such Transfer Notice, then, if Tenant shall reasonably and in good faith determine (which determination shall be made as soon as practicable) that an extension of the specified Transfer Date is required due to the requirements of the Worker
Adjustment and Retraining Notification Act, then, as soon as practicable, but in any event within fifteen (15) days of such determination by Tenant, Tenant shall so notify Lessor in writing, and the Transfer Date that was specified in
Lessor’s Transfer Notice shall be extended to such later date set forth in such notice by Tenant by which the requirements of the Worker Adjustment and Retraining Notification Act shall be satisfied (which date shall not, in any event, be later
than the ninetieth (90th) day after Tenant’s
receipt of such Transfer Notice) and (ii) Lessor shall have the right, at its option by written notice (the “Extension Notice”) to Tenant from time to time after delivery of the applicable Transfer Notice, to extend the
Transfer Date; provided that the Transfer Date specified by Lessor, exclusive of any extension pursuant to subsection (i) above, may not be extended by Lessor beyond August 1, 2013 the date that is six months
following the Reinstatement Date (the Transfer Date, as it may be extended by Lessor pursuant to subsection (ii) above or by Tenant pursuant to subsection (i) above (including, in the case of an extension by Tenant, beyond
August 1, 2013 the date that is six months following the Reinstatement Date) “Lessor’s Outside Closing Date”); 
 (d) The expiration date of the Term for the Affected Facility Terminating Leased Property(ies) shall be: (i) with respect to a Terminating Leased
Property as to which the closing of a transfer, or the completion of a Facility Termination, has occurred with respect thereto, in accordance with the terms of the Master Leases and this letter, prior to April 30, 2013, the date of such closing
or the date of completion of such Facility Termination, as applicable, and (ii) in all other cases, April 30, 2013 the Reinstatement Date (for the avoidance of doubt, notwithstanding the expiration of the Term of
the Affected Facility any Terminating Leased Property(ies), ,Tenant shall continue to have the right as tenant to use and occupy such Affected Facility Terminating Leased
Property(ies) in accordance with the Master Leases and this letter (i.e., to effectuate the transfer or wind down of operations, as applicable). , and No holdover tenancy shall be deemed to occur thereby,
so long as Tenant vacates such Affected Facility Terminating Leased Property(ies) and redelivers possession thereof to Lessor, in accordance with the requirements of the Master Leases and this letter, on or
prior to the expiration of the applicable Reimbursement Period, as further described below (and if Tenant fails to so vacate, a holdover tenancy would be deemed to commence only after the expiration of such Reimbursement Period);

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 (e) Each of Lessor
and Tenant shall comply with the provisions of Section 40.3 of the Master Leases, and any other applicable provisions of the Master Leases relating to transfer of operations, in connection with any such early transition and
transfer of the Affected Facility any Terminating Leased Property(ies) identified from time to time by Lessor (and, in addition, prior to the applicable Transfer Date with respect to the Affected Facility
each Terminating Leased Property, Tenant and the applicable replacement operator identified by Lessor shall enter into an Operations Transfer Agreement that is usual and customary for facilities comparable to the Affected
Facility Terminating Leased Property(ies) and otherwise in a form mutually and reasonably agreed upon by Tenant and such replacement operator); 
 (f) Unless Lessor otherwise notifies Tenant in writing that Tenant may commence a Facility Termination with respect to the Affected Facility a Terminating Leased Property
(or Lessor is deemed to have delivered such notice pursuant to subsection (g) below) (such notice or deemed notice, a “Facility Termination Notice”), Tenant shall continue to operate the Affected Facility such
Terminating Leased Property until the earlier to occur of the following dates: (i) if Lessor delivers a Transfer Notice and the applicable closing occurs, the closing date of such transfer, and (ii) if Lessor delivers a
Transfer Notice by the Transfer Notice Deadline but fails, on or after the Transfer Notice Deadline, to close such transfer on or before the applicable Lessor’s Outside Closing Date, such Lessor’s Outside Closing Date. Commencing on
May 1, 2013, Lessor shall have obligations relating to reimbursement of operating deficits (the “Reimbursement Obligation”) or, if Tenant elects to forego its rights to reimbursement of operating deficits, Lessor shall be
obligated to allow Tenant to pay reduced Base Rent (the “Reduced Base Rent Obligation”) with respect to the Affected Facility such Terminating Leased Property as provided in Section 40.3 (and the
parties hereby agree that Tenant may make such an election with respect to the Affected Facility a Terminating Leased Property by written notice to Lessor delivered at any time within fifteen (15) days following
the termination of the applicable Master Lease with respect to the Affected Facility such Terminating Leased Property), as if Lessor had procured a “Qualified Successor” and issued a
timely Section 40.3 Notice with respect thereto (it being agreed that, if Lessor has issued a Transfer Notice with respect to the Affected Facility a particular Terminating Leased Property but, as of the Transfer
Date specified therein (as such Transfer Date may be extended as provided in subsection (c) above), Lessor is not prepared to complete a transfer and transition of the Affected Facility such Terminating Leased
Property to a replacement operator, from and after such Transfer Date, Lessor and Tenant shall continue to have the post expiration and other obligations referenced in Section 40.3 of the applicable Master
Lease, as amended by this subsection (f) and the other provisions of this letter, relating to the Affected Facility such Terminating Leased Property, including, as and when applicable with respect to the
Affected Facility such Terminating Leased Property, the right of Tenant to commence a Facility Termination upon receipt of a Facility Termination Notice or as the result of a deemed Facility Termination Notice as described
in subsection (g) below, and Lessor shall comply with the Reimbursement Obligation or Reduced Base Rent Obligation, as applicable; 
 (g)
If, with respect to the Affected Facility a particular Terminating Leased Property, (i) Lessor has not delivered a Transfer Notice on or prior to the Transfer Notice Deadline, (ii) Lessor has not delivered a
Facility Termination Notice on or prior to August 1, 2013 the date that is six months following the Reinstatement Date (except that this subsection (ii), and subsection (iii) below, shall not apply to
the Affected Facility if a Terminating Leased Property as to which Lessor has delivered a Transfer Notice but the closing has not occurred on or prior to August 1, 2013 the date that is six
months following the Reinstatement Date due to an extension of the Transfer Date by Tenant beyond August 1, 2013 the date that is six months following the Reinstatement Date pursuant to subsection (c)(i)
above), (iii) subject to subsection (ii) above, Lessor has delivered a Transfer Notice but the closing has not occurred with respect thereto on or prior to August 1, 2013 the date that is six months following
the Reinstatement Date or (iv) subsection (iii) above is applicable and the closing with respect thereto does not occur on the extended Transfer Date, then Lessor shall be deemed to have irrevocably delivered a Facility Termination

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Notice as of (x) the day after the Transfer Notice Deadline (if subsection (i) above is applicable), (y) August 1, 2013 the date that is six months
following the Reinstatement Date (if subsection (ii) or (iii) above is applicable) or (z) the day after the extended Transfer Date referenced in subsection (iv) above (if subsection (iv) above is applicable), and
Tenant shall thereafter have the right to commence a Facility Termination. Provided that Tenant diligently proceeds toward the completion of a Facility Termination (whether pursuant to a Facility Termination Notice issued by Lessor or a deemed
Facility Termination Notice), Tenant shall have such period of time to complete such Facility Termination as Tenant reasonably, in good faith and with due diligence requires to complete such Facility Termination (and the Reimbursement Period shall
continue during such period), and Tenant shall not be a holdover tenant as long as it is proceeding in such manner to complete such Facility Termination; and 
 (h) In the case of the Affected Facility each Terminating Leased Property, the Reimbursement Period, if any, that is applicable thereto shall commence on May 1, 2013,
and, instead of ending on the earliest of the dates referenced in subsections (i), (ii) and (iii) of Section 40.3 of each the Master Lease, shall end on the earliest to occur of: (X) the date that
the closing occurs under an Operations Transfer Agreement between Tenant and a replacement operator identified by Lessor with respect to the Affected Facility such Terminating Leased Property; and (Y) the date
that Tenant completes a Facility Termination (or reasonably should have completed such Facility Termination acting reasonably, in good faith and with due diligence) with respect to the Affected Facility such Terminating Leased
Property in accordance with the applicable Master Lease (as amended by this letter); provided, however, that, if subsection (Y) is applicable, the Reimbursement Obligation, if applicable to the
Affected Facility such Terminating Leased Property, shall terminate ninety (90) days after the date of delivery or deemed delivery of the Facility Termination Notice relative to the Affected Facility
such Terminating Leased Property and thereafter Base Rent allocable to the Affected Facility such Terminating Leased Property shall be reduced to zero, and Tenant, not Lessor, shall be
responsible for any operating deficits with respect to the Affected Facility such Terminating Leased Property, until the end of the applicable Reimbursement Period.

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