Document:

Exhibit 4.24

FIFTEENTH
SUPPLEMENTAL INDENTURE

                    SUPPLEMENTAL
INDENTURE dated as of November 30, 2011 (this “Fifteenth Supplemental
Indenture”), among ADI HOLDING COMPANY, INC., ATHENA DIAGNOSTICS, INC., AXYS
PHARMACEUTICALS, INC. and CELERA CORPORATION, each a Delaware corporation,
CELERA DIAGNOSTICS, LLC, a Delaware limited liability company, and BERKELEY
HEARTLAB, INC., a California corporation (the “Additional Subsidiary
Guarantors”), QUEST DIAGNOSTICS INCORPORATED, a Delaware corporation (the “Company”),
and THE BANK OF NEW YORK MELLON, a New York banking corporation, as Trustee
(the “Trustee”). 

RECITALS
OF THE COMPANY

                    WHEREAS,
the Company, the Trustee and the Initial Subsidiary Guarantors (as hereinafter
defined) executed and delivered an Indenture, dated as of June 27, 2001
(the “Base Indenture”), as supplemented by the first supplemental indenture,
dated as of June 27, 2001, among the Company, the Initial Subsidiary
Guarantors (as defined therein) party thereto, and the Trustee, as further
supplemented by a second supplemental indenture, dated as of November 26,
2001, among the Company, the Subsidiary Guarantors (as defined therein) party
thereto and the Trustee, as further supplemented by a third supplemental
indenture, dated as of April 4, 2002, among the Company, the Subsidiary
Guarantors (as defined therein) party thereto and the Trustee, as further
supplemented by a fourth supplemental indenture, dated as of March 19,
2003, among the Company, the Subsidiary Guarantors (as defined therein) party
thereto and the Trustee, as further supplemented by a fifth supplemental
indenture, dated as of April 16, 2004, among the Company, the Subsidiary
Guarantors (as defined therein) party thereto and the Trustee, as further
supplemented by a sixth supplemental indenture dated October 31, 2005,
among the Company, the Subsidiary Guarantors (as defined therein) party
thereto, as further supplemented by a seventh supplemental indenture dated
November 21, 2005, among the Company, the Subsidiary Guarantors (as
defined therein) party thereto and the Trustee, as further supplemented by an
eighth supplemental indenture dated July 31, 2006, among the Company, the
Subsidiary Guarantors (as defined therein) party thereto and the Trustee, as
further supplemented by a ninth supplemental indenture, dated as of
September 30, 2006, among the Company, the Subsidiary Guarantors (as
defined therein) party thereto and the Trustee, as further supplemented by a
tenth supplemental indenture, dated as of June 22, 2007, among the
Company, the Subsidiary Guarantors (as defined therein) party thereto and the
Trustee and the Trustee, as further supplemented by an eleventh supplemental
indenture, dated as of June 22, 2007, among the Company, the Subsidiary
Guarantors (as defined therein) party thereto and the Trustee, as further
supplemented by a twelfth supplemental indenture, dated as of June 25, 2007,
among the Company, the Subsidiary Guarantors (as defined therein) party thereto
and the Trustee, as further supplemented by a thirteenth supplemental
indenture, dated as of November 17, 2009, among the Company, the Subsidiary
Guarantors (as defined therein) party thereto and the Trustee, as further
supplemented by a fourteenth supplemental indenture, dated as of March 24, 2011,
among the Company, the Subsidiary Guarantors (as defined therein) party thereto
and the Trustee, and to be further supplemented by this Fifteenth Supplemental
Indenture (collectively, the “Indenture”), to provide for the issuance by the
Company from time to time of Securities to be issued in one or mores series as
provided in the Indenture;

                    WHEREAS,
the Additional Subsidiary Guarantors intend to guarantee the Floating Rate
Senior Notes due 2014, the 5.45% Senior Notes due 2015, the 3.200% Senior Notes
due 2016, the 6.40% Senior Notes due 2017, the 4.750% Senior Notes due 2020,
the 4.700% Senior Notes due 2021, the 6.95% Senior Notes due 2037, and the
5.750% Senior Notes due 2040 under the Indenture and the issuance of guarantees
has been authorized by resolutions adopted by the Boards of Directors or Board
of Members, as the case may be, of such Additional Subsidiary Guarantors;

                    WHEREAS,
Sections 901(1) and 901(11) of the Indenture provide that without the
consent of Holders of the Securities of any series issued under the Indenture,
the Company and the Subsidiary Guarantors, when authorized by a Board
Resolution, and the Trustee may enter into one or more indentures supplemental
to the Indenture to (a) evidence the successor of another Person to any
Subsidiary Guarantor and the assumption by such successor of the covenants of
such Subsidiary Guarantor in the Indenture and in the Securities and
(b) add a guarantor or guarantors for any series or all series of the Securities;

                    WHEREAS,
pursuant to Sections 904, 1601, 1602 and 1604 of the Indenture, by
delivery of a Supplemental Indenture to the Trustee in accordance with the
terms of the Indenture, each Person that becomes a Subsidiary Guarantor after
the date of the Base Indenture will be deemed to have executed and delivered
the Subsidiary Guarantee for the benefit of the Holder of the Security upon
which the Subsidiary Guarantee is endorsed, with the same effect as if such
Subsidiary Guarantor had been named thereon and had executed and delivered the
Subsidiary Guarantee; and

                    WHEREAS,
all acts and requirements necessary to make this Fifteenth Supplemental
Indenture a valid supplement to the Indenture according to its terms and the
terms of the Indenture have been done;

                    NOW,
THEREFORE, for and in consideration of the foregoing, the parties hereto hereby
enter into this Fifteenth Supplemental Indenture, for the equal and
proportionate benefit of all Holders of the Securities, as follows:

                    SECTION 1 Certain Terms Defined in the Indenture. 

                    All
capitalized terms used but not defined herein shall have the meanings assigned
to them in the Indenture.

                    SECTION 2 Agreement to Guarantee. 

                    The
Additional Subsidiary Guarantors, by their signature below, agree to become
Additional Subsidiary Guarantors under the Indenture with the same force and
effect as if originally named therein as Subsidiary Guarantors. The Additional
Subsidiary Guarantors agree to guarantee the Floating Rate Senior Notes due
2014, the 5.45% Senior Notes due 2015, the 3.200% Senior Notes due 2016, the
6.40% Senior Notes due 2017, the 4.750% Senior Notes due 2020, the 4.700% Senior
Notes due 2021, the 6.95% Senior Notes due 2037, and the 5.750% Senior Notes
due 2040. The Additional Subsidiary Guarantors hereby agree to all the terms
and provisions of the Indenture applicable to them as Additional Subsidiary
Guarantors thereunder

2

and each reference to a “Subsidiary Guarantor” in the
Indenture shall be deemed to include the Additional Subsidiary Guarantors.

                    SECTION 3 Indenture remains in Full Force and Effect. 

                    Except
as expressly supplemented by this Fifteenth Supplemental Indenture, the
Indenture shall remain in full force and effect in accordance with its terms.

                    SECTION 4 New York Law to Govern. 

                    THIS
FIFTEENTH SUPPLEMENTAL INDENTURE SHALL BE GOVERNED BY AND CONSTRUED IN
ACCORDANCE WITH THE LAWS OF THE STATE OF NEW YORK, WITHOUT REGARD TO PRINCIPLES
OF CONFLICT OF LAWS.

                    SECTION 5 Separability. 

                    In case any one or more of the provisions contained in
this Fifteenth Supplemental Indenture should be held invalid, illegal or
unenforceable in any respect, the validity, legality and enforceability of the
remaining provisions contained herein and in the Indenture shall not in any way
be affected or impaired. The parties hereto shall endeavor in good faith
negotiations to replace any invalid, illegal or enforceable provisions herein
with valid provisions, the economic effect of which comes as close as possible
to that of the invalid, illegal or unenforceable provisions.

                    SECTION 6 May be Executed in Counterparts. 

                    This
Fifteenth Supplemental Indenture may be executed in counterparts, each of which
when taken together shall constitute one and the same instrument. This
Fifteenth Supplemental Indenture shall become effective when the Trustee shall
have received a counterpart thereof that bears the signatures of the Additional
Subsidiary Guarantors.

                    SECTION 7 Trustee. 

                    The
Trustee makes no representations as to the validity or sufficiency of this
Fifteenth Supplemental Indenture. The recitals and statements herein are deemed
to be those of the Company and the Additional Subsidiary Guarantors and not of
the Trustee.

[Remainder of Page Intentionally
Left Blank]

3

                    IN WITNESS WHEREOF, the Company, the Additional
Subsidiary Guarantors, and the Trustee have duly executed this Fifteenth
Supplemental Indenture as of the day and year first above written.

	
   
  	
   
  	
   
  	
   
  
	
   
  	
  QUEST DIAGNOSTICS INCORPORATED
  
	
   
  	
   
  	
   
  	
   
  
	
   
  	
  By:  
  	

  /s/ Robert O’Keef

	
   
  	
   
  	
  
  
	
   
  	
   
  	
  Name:
  	
  Robert O’Keef
  
	
   
  	
   
  	
  Title:
  	
  Vice President and Treasurer
  
	
   
  	
   
  	
   
  	
   
  
	
   
  	
  ADI HOLDING COMPANY, INC.

  ATHENA DIAGNOSTICS, INC.

  AXYS PHARMACEUTICALS, INC. 

  CELERA CORPORATION 

  BERKELEY HEARTLAB, INC.
  
	
   
  	
   
  
	
   
  	
  By:
  	
  /s/ Robert O’Keef
  
	
   
  	
   
  	
  
  
	
   
  	
   
  	
  Name:
  	
  Robert O’Keef
  
	
   
  	
   
  	
  Title:
  	
  Vice President and Treasurer
  
	
   
  	
   
  	
   
  	
   
  
	
   
  	
  CELERA DIAGNOSTICS, LLC
  
	
   
  	
   
  	
   
  	
   
  
	
   
  	
  By. CELERA CORPORATION, its
  sole member
  
	
   
  	
   
  
	
   
  	
   
  	
  /s/ Robert O’Keef
  
	
   
  	
   
  	
  
  
	
   
  	
   
  	
  Name:
  	
  Robert O’Keef
  
	
   
  	
   
  	
  Title:
  	
  Vice President and Treasurer
  

Signature
Page to Fifteenth Supplemental Indenture

	
   
  	
   
  	
   
  	
   
  
	
   
  	
  THE BANK OF NEW YORK
  MELLON, as trustee
  
	
   
  	
   
  	
   
  	
   
  
	
   
  	
  By:  
  	

  /s/ J. Christopher Howe

	
   
  	
   
  	
  
  
	
   
  	
   
  	
  Name:
  	
  J. Christopher Howe
  
	
   
  	
   
  	
  Title:
  	
  Senior Associate
  

Signature
Page to Fifteenth Supplemental IndentureExhibit
10.5

EXECUTION
VERSION

AMENDMENT NO. 4 TO FOURTH AMENDED AND RESTATED
CREDIT AND SECURITY AGREEMENT

                    THIS
AMENDMENT NO. 4 TO FOURTH AMENDED AND RESTATED CREDIT AND SECURITY AGREEMENT (this
“Amendment”) is
entered into as of December 9, 2011, by and among (a) QUEST DIAGNOSTICS
RECEIVABLES INC., a Delaware corporation (together with its successors and
permitted assigns, the “Borrower”), (b) QUEST DIAGNOSTICS
INCORPORATED, a Delaware corporation (together with its successors, “Quest
Diagnostics”), as initial servicer (in such
capacity, together with any successor servicer or sub-servicer, the “Servicer”),
(c) MARKET STREET FUNDING LLC, a Delaware limited liability company, as assignee
of Atlantic Asset Securitization LLC (“Market Street”),
and PNC BANK, NATIONAL ASSOCIATION, in its capacity as a Liquidity Bank to Market
Street and assignee of Crédit
Agricole Corporate and Investment Bank (together with its successors, “PNC” and
together with Market Street, the “Market Street Group”),
(d) GOTHAM FUNDING CORPORATION, a Delaware corporation (together with its successors, “Gotham” and
together with Market Street, the
“Conduits”),
and THE BANK OF TOKYO-MITSUBISHI UFJ, LTD., NEW YORK BRANCH, in its capacity
as a Liquidity Bank to Gotham (together with its successors, “BTMU” and,
together with Gotham, the “Gotham Group”), (e)
PNC BANK, NATIONAL ASSOCIATION, in its capacity as agent for the Market Street
Group (together with its successors in such capacity, the “Market
Street Agent” or a “Co-Agent”), and THE
BANK OF TOKYO-MITSUBISHI UFJ, LTD., NEW YORK BRANCH, in its capacity as agent
for the Gotham Group (together with its successors in such capacity, the “Gotham
Agent” or a “Co-Agent”), and (f)
THE BANK OF TOKYO-MITSUBISHI UFJ, LTD., NEW YORK BRANCH, as administrative
agent for the Market Street Group, the Gotham Group and the Co-Agents (in such
capacity, together with any successors thereto in such capacity, the “Administrative
Agent” and
together with each of the Co-Agents, the “Agents”), with
respect to that certain Fourth Amended and Restated Credit and Security Agreement,
dated as of June 11, 2008, by and among the parties hereto as heretofore amended
from time to time (the “Existing Agreement,”
which, as amended hereby, is hereinafter referred to as the “Agreement”). Unless
otherwise indicated, capitalized terms used in this Amendment are used with the
meanings attributed thereto in the Existing Agreement.

W I T N E S S E T H :

	
  

 	
  

 	
  

 
	
  

 	
           WHEREAS, the
 parties hereto desire to amend the Existing Agreement on the terms and
 subject to the conditions hereinafter set forth.

 	
  

 
	
  

 	
  

 	
  

 
	
                     NOW, THEREFORE, in
 consideration of the premises and the mutual agreements herein contained, the
 parties hereto hereby agree as follows:

 
	
  

 	
  

 	
  

 
	
  

 	
           1. Amendments
 to Existing Agreement.

 	
  

 
	
  

 	
  

 	
  

 
	
                     1.1.
 The preamble to the Existing Agreement is hereby amended and restated in its
 entirety to read as follows:

 
	
  

 	
  

 	
  

 
	
  

 	
           THIS
 FOURTH AMENDED AND RESTATED CREDIT AND SECURITY AGREEMENT
 is entered into as of June 11, 2008, by and among:

 	
  

 
	
  

 	
  

 	
  

 
	
  

 	
           (1) QUEST
 DIAGNOSTICS RECEIVABLES INC., a Delaware corporation (together with its
 successors and permitted assigns, the “Borrower”),

 	
  

 
	
  

 	
  

 	
  

 
	
  

 	
           (2) QUEST
 DIAGNOSTICS INCORPORATED, a Delaware corporation (together with its
 successors, “Quest Diagnostics”),
 as initial servicer hereunder (in such capacity, 

 	
  

 

	
  

 	
  

 
	
 1

 
	
  

 	
 Quest
 Diagnostics Receivables Inc.

 Amendment No. 4 to

 Fourth Amended and Restated Credit and Security Agreement

 

	
  

 	
  

 	
  

 
	
  

 	
 together with any
 successor servicer or sub-servicer appointed pursuant to Section 8.1, the “Servicer”),

 	
  

 
	
  

 	
  

 	
  

 
	
  

 	
           (3) MARKET
 STREET FUNDING LLC, a Delaware limited liability company, as assignee of
 Atlantic Asset Securitization LLC (“Market Street”), and PNC BANK, NATIONAL ASSOCIATION,
 in its capacity as a Liquidity Bank to Market Street and assignee of Crédit
 Agricole Corporate and Investment Bank (together with its successors, “PNC” and together
 with Market Street, the “Market Street Group”),

 	
  

 
	
  

 	
  

 	
  

 
	
  

 	
           (4) GOTHAM
 FUNDING CORPORATION, a Delaware corporation (together with its successors, “Gotham”), and THE
 BANK OF TOKYO-MITSUBISHI UFJ, LTD., NEW YORK BRANCH, in its capacity as a
 Liquidity Bank to Gotham (together with its successors, “BTMU” and, together with Gotham, the “Gotham Group”),

 	
  

 
	
  

 	
  

 	
  

 
	
  

 	
           (5) PNC
 BANK, NATIONAL ASSOCIATION, in its capacity as agent for the Market Street
 Group (together with its successors in such capacity, the “Market Street Agent” or
 a “Co-Agent”), and
 THE BANK OF TOKYO-MITSUBISHI UFJ, LTD., NEW YORK BRANCH, in its capacity as
 agent for the Gotham Group (together with its successors in such capacity,
 the “Gotham Agent” or
 a “Co-Agent”), and

 	
  

 
	
  

 	
  

 	
  

 
	
  

 	
           (6) THE
 BANK OF TOKYO-MITSUBISHI UFJ, LTD., NEW YORK BRANCH, as administrative agent
 for the Market Street Group, the Gotham Group and the Co-Agents (in such
 capacity, together with any successors thereto in such capacity, the “Administrative Agent” and
 together with each of the Co-Agents, the “Agents”),

 	
  

 
	
  

 	
  

 	
  

 
	
  

 	
 and amends and restates
 in its entirety that certain Third Amended and Restated Credit and Security
 Agreement dated as of April 20, 2004 originally by and among the Borrower,
 the Servicer, Atlantic Asset Securitization LLC, Calyon New York Branch, individually
 and as a co-agent, Variable Funding Capital Company LLC, and Wachovia Bank,
 National Association, individually, as a co-agent and as administrative
 agent, as amended from time to time prior to the date hereof (the “Existing Agreement”).

 	
  

 

                    1.2.
Annex A to the Existing Agreement is hereby amended to delete in their entirety
the definitions of the following terms:

	
  

 	
  

 
	
  

 	
  “Atlantic”

 
	
  

 	
  “Atlantic Agent”

 
	
  

 	
  “Atlantic
 Allocation Limit”

 
	
  

 	
  “Atlantic Fee
 Letter”

 
	
  

 	
  “Atlantic Group”

 
	
  

 	
  “Atlantic Group
 Termination Date”

 
	
  

 	
  “Atlantic
 Liquidity Agreement”

 
	
  

 	
  “Atlantic
 Liquidity Bank”

 
	
  

 	
  “Calyon”

 
	
  

 	
  “Calyon Roles”

 
	
  

 	
  “Crédit Agricole”

 

                    1.3.
Annex A to the Existing Agreement is hereby amended to insert the following new
definitions in their appropriate alphabetical order:

	
  

 	
  

 
	
 2

 
	
  

 	
 Quest
 Diagnostics Receivables Inc.

 Amendment No. 4 to

 Fourth Amended and Restated Credit and Security Agreement

 

	
  

 	
  

 	
  

 
	
  

 	
           “Market
 Street” has the meaning provided in the preamble of
 this Agreement.

 	
  

 
	
  

 	
  

 	
  

 
	
  

 	
           “Market
 Street Agent” has the meaning provided in the preamble
 of this Agreement.

 	
  

 
	
  

 	
  

 	
  

 
	
  

 	
           “Market
 Street Allocation Limit” has the meaning set forth in
 Section 1.1(a).

 	
  

 
	
  

 	
  

 	
  

 
	
  

 	
           “Market
 Street Fee Letter” means that certain Market Street Fee
 Letter dated as of December 9, 2011 by and among Quest Diagnostics, the
 Borrower, Market Street, PNC Capital Markets LLC and the Market Street Agent,
 as the same may be amended, restated, supplemented, replaced or otherwise
 modified from time to time.

 	
  

 
	
  

 	
  

 	
  

 
	
  

 	
           “Market
 Street Group” has the meaning provided in the preamble
 of this Agreement.

 	
  

 
	
  

 	
  

 	
  

 
	
  

 	
           “Market
 Street Group Termination Date” means December 7, 2012.

 	
  

 
	
  

 	
  

 	
  

 
	
  

 	
           “Market
 Street Liquidity Agreement” means the Liquidity Asset
 Purchase Agreement dated as of December 9, 2011 among Market Street, the
 Market Street Agent, and the Liquidity Banks from time to time party thereto,
 as the same may be amended, restated, supplemented, replaced or otherwise
 modified from time to time.

 	
  

 
	
  

 	
  

 	
  

 
	
  

 	
           “Market
 Street Liquidity Bank” means any Liquidity Bank that
 enters into this Agreement and the Market Street Liquidity Agreement.

 	
  

 
	
  

 	
  

 	
  

 
	
  

 	
           “Market
 Street Roles” has the meaning set forth in Section
 11.10(a).

 	
  

 
	
  

 	
  

 	
  

 
	
  

 	
           “PNC”
 has the meaning provided in the preamble of this Agreement.

 	
  

 
	
  

 	
  

 	
  

 
	
  

 	
           “Specified
 Government Ineligible” means a Specified Government
 Receivable that does not meet each of the criteria in clauses (a)-(p) of the
 definition of “Eligible Participation
 Interest.”

 	
  

 
	
  

 	
  

 	
  

 
	
                     1.4.
 The definitions of the following defined terms that are currently included in
 Annex A to the Existing Agreement are hereby amended and restated in their
 entirety to read, respectively, as follows:

 
	
  

 	
  

 	
  

 
	
  

 	
           “Gotham Group Termination Date”
 means December 7, 2012.

 	
  

 
	
  

 	
  

 	
  

 
	
  

 	
           “Scheduled Termination Date” means as to each Liquidity Bank,
 the earlier to occur of December 7, 2012 and the date on which its Liquidity
 Commitment(s) terminate(s) in accordance with the Liquidity Agreement to
 which it is a party.

 	
  

 
	
  

 	
  

 	
  

 
	
                     1.5.
 All remaining references in the Existing Agreement (including, without
 limitation, Annex A thereto) to any term in column A of the table below are
 hereby replaced with references to the adjacent term in column B of the table
 below:

 

	
  

 	
  

 
	
 3

 
	
  

 	
 Quest
 Diagnostics Receivables Inc.

 Amendment No. 4 to

 Fourth Amended and Restated Credit and Security Agreement

 

	
  

 	
  

 	
  

 
	
 A

 	
  

 	
 B

 
	
 

 	
  

 	
 

 
	
 “Atlantic”

 	
  

 	
 “Market Street”

 
	
  

 	
  

 	
  

 
	
 “Atlantic Agent”

 	
  

 	
 “Market Street Agent”

 
	
  

 	
  

 	
  

 
	
 “Atlantic Allocation Limit”

 	
  

 	
 “Market Street Allocation Limit”

 
	
  

 	
  

 	
  

 
	
 “Atlantic Fee Letter”

 	
  

 	
 “Market Street Fee Letter”

 
	
  

 	
  

 	
  

 
	
 “Atlantic Group”

 	
  

 	
 “Market Street Group”

 
	
  

 	
  

 	
  

 
	
 “Atlantic Group Termination Date”

 	
  

 	
 “Market Street Group Termination Date”

 
	
  

 	
  

 	
  

 
	
 “Atlantic Liquidity Agreement”

 	
  

 	
 “Market Street Liquidity Agreement”

 
	
  

 	
  

 	
  

 
	
 “Atlantic Liquidity Bank”

 	
  

 	
 “Market Street Liquidity Bank”

 
	
  

 	
  

 	
  

 
	
 “Calyon,” “Crédit Agricole” or “Credit Agricole”

 	
  

 	
 “PNC”

 
	
  

 	
  

 	
  

 
	
 “Calyon New York Branch,” “Crédit Agricole Corporate
 and Investment Bank New York Branch” or “Credit Agricole Corporate and
 Investment Bank New York Branch”

 	
  

 	
 “PNC Bank, National Association”

 
	
  

 	
  

 	
  

 
	
 “Calyon Role” or “Calyon Roles”

 	
  

 	
 “PNC Role” or “PNC Roles”

 

                    1.6.
Section 5.1 of the Existing Agreement is hereby deleted in its entirety and
replaced with “[Intentionally deleted].”

                    2. Representations.

                    2.1.
Each of the Loan Parties represents and warrants to the Lenders and the Agents
that it has duly authorized, executed and delivered this Amendment and that the
Agreement constitutes, a legal, valid and binding obligation of such Loan
Party, enforceable in accordance with its terms (except as enforceability may
be limited by applicable bankruptcy, insolvency, or similar laws affecting the
enforcement of creditors’ rights generally or by equitable principles relating
to enforceability).

                    2.2.
Each of the Loan Parties further represents and warrants to the Lenders and the
Agents that each of its representations and warranties set forth in Section 6.1
of the Agreement is true and correct as of the date hereof and that no Event of
Default or Unmatured Default exists as of the date hereof and is continuing.

	
  

 	
  

 
	
 4

 
	
  

 	
 Quest
 Diagnostics Receivables Inc.

 Amendment No. 4 to

 Fourth Amended and Restated Credit and Security Agreement

 

                    3. Conditions
Precedent. This Amendment shall become effective as of the date
first above written upon satisfaction of the following conditions precedent:

	
  

 	
  

 	
  

 
	
  

 	
           (a)
 receipt by the Administrative Agent of counterparts of that certain
 Assignment and Assumption Agreement, dated as of December 9, 2011 (the “Assignment and Assumption”),
 by and among Atlantic Asset Securitization LLC, Crédit Agricole Corporate and
 Investment Bank, individually and as a Co-Agent, Market Street Funding LLC,
 and PNC Bank, National Association, individually and as a Co-Agent, duly
 executed by the parties thereto, and payment in full of all amounts required
 to be paid thereunder;

 	
  

 
	
  

 	
  

 	
  

 
	
  

 	
           (b)
 receipt by the Administrative Agent of a Notice of Effectiveness, dated as of
 December 9, 2011 executed by the Administrative Agent and the Borrower with
 respect to the Assignment and Assumption; 

 	
  

 
	
  

 	
  

 	
  

 
	
  

 	
           (c)
 receipt by the Administrative Agent of counterparts of this Amendment, duly
 executed by each of the parties hereto;

 	
  

 
	
  

 	
  

 	
  

 
	
  

 	
           (d)
 receipt by the Gotham Agent of an amended and restated version of the Gotham
 Fee Letter, duly executed by the parties thereto, together with payment the
 upfront fee specified therein;

 	
  

 
	
  

 	
  

 	
  

 
	
  

 	
           (e)
 receipt by the Market Street Agent of the Market Street Fee Letter, duly
 executed by the parties thereto, together with payment the upfront fee
 specified therein;

 	
  

 
	
  

 	
  

 	
  

 
	
  

 	
           (f)
 receipt by the Market Street Agent of the Market Street Liquidity Agreement,
 duly executed by each of the parties thereto;

 	
  

 
	
  

 	
  

 	
  

 
	
  

 	
           (g)
 receipt by the Market Street Agent of opinion reliance letters from Shearman
 & Sterling LLP and William J. O’Shaughnessy in favor of PNC Bank,
 National Association, individually and as a Co-Agent, and Market Street
 Funding LLC, in respect of the opinions delivered in connection with the
 Existing Agreement and the Sale Agreement;

 	
  

 
	
  

 	
  

 	
  

 
	
  

 	
           (h)
 receipt by the Administrative Agent of a certificate of an assistant
 secretary of the Borrower, certifying that (i) the attached copy of the
 resolutions of its Board of Directors authorizing the execution, delivery and
 performance of the Transaction Documents remain in full force and effect,
 (ii) the attached copies of its certificate of incorporation and by-laws
 remain in full force and effect, (iii) the Borrower remains in good standing
 in the State of Delaware, and (iv) the names, title and specimen signatures
 of the Borrower’s officers who are authorized to execute this Amendment and
 any other Transaction Document; 

 	
  

 
	
  

 	
  

 	
  

 
	
  

 	
           (i)
 receipt by the Administrative Agent of amendments to the Collection Account
 Agreements with Bank of America, N.A. and PNC, adding additional Collection
 Accounts thereto, duly executed by each of the parties to such Collection
 Account Agreements; 

 	
  

 
	
  

 	
  

 	
  

 
	
  

 	
           (j)
 receipt by the Gotham Agent of payment of $1,077,000 of Gotham’s Capital in
 immediately available funds, and by the Borrower of the proceeds of a Loan
 from Market Street in the amount of $1,077,000; and

 	
  

 

	
  

 	
  

 
	
 5

 
	
  

 	
 Quest
 Diagnostics Receivables Inc.

 Amendment No. 4 to

 Fourth Amended and Restated Credit and Security Agreement

 

	
  

 	
  

 	
  

 
	
  

 	
           (k)
 receipt by the Agents of payment of the reasonable fees and disbursements of
 their respective counsel.

 	
  

 

                    By
their respective signatures on counterparts of this Amendment, each of the
parties hereto hereby consents to the payment and Loan described in clause (j)
above, provided that
after giving effect thereto, each Group’s share of the outstanding principal
balance of the Advances will be pro rata with its share of the Aggregate
Commitment.

                    4. Miscellaneous.

                    4.1.
Except as expressly amended hereby, the Existing Agreement shall remain
unaltered and in full force and effect, and each of the parties hereby ratifies
and confirms the Agreement and each of the other Transaction Documents to which
it is a party.

                    4.2.
THIS AMENDMENT SHALL BE GOVERNED BY, AND CONSTRUED IN ACCORDANCE WITH, THE
INTERNAL LAWS OF THE STATE OF NEW YORK WITHOUT REFERENCE TO PRINCIPLES OF
CONFLICTS OF LAW.

                    4.3.
EACH LOAN PARTY HEREBY ACKNOWLEDGES AND AGREES THAT:

	
  

 	
  

 
	
                     4.3.1.
 IT IRREVOCABLY (i) SUBMITS TO THE NON-EXCLUSIVE JURISDICTION, FIRST, OF ANY
 UNITED STATES FEDERAL COURT, AND SECOND, IF FEDERAL JURISDICTION IS NOT
 AVAILABLE, OF ANY NEW YORK STATE COURT, IN EITHER CASE SITTING IN NEW YORK
 COUNTY, NEW YORK, IN ANY ACTION OR PROCEEDING ARISING OUT OF OR RELATING TO
 THE AGREEMENT, AND (ii) WAIVES, TO THE FULLEST EXTENT IT MAY EFFECTIVELY DO
 SO, THE DEFENSE OF AN INCONVENIENT FORUM TO THE MAINTENANCE OF AN ACTION OR
 PROCEEDING IN SUCH COURTS.

 	
  

 
	
  

 	
  

 
	
                     4.3.2.
 TO THE EXTENT THAT IT HAS OR HEREAFTER MAY ACQUIRE ANY IMMUNITY FROM THE
 JURISDICTION OF ANY COURT OR FROM ANY LEGAL PROCESS (WHETHER THROUGH SERVICE
 OR NOTICE, ATTACHMENT PRIOR TO JUDGMENT, ATTACHMENT IN AID TO EXECUTION,
 EXECUTION OR OTHERWISE) WITH RESPECT TO ITSELF OR ITS PROPERTY, IT HEREBY
 IRREVOCABLY WAIVES SUCH IMMUNITY IN RESPECT OF ITS OBLIGATIONS UNDER OR IN
 CONNECTION WITH THE AGREEMENT.

 	
  

 

                    4.4.
This Amendment may be executed in any number of counterparts and by the different
parties hereto in separate counterparts, each of which when so executed shall
be deemed to be an original and all of which when taken together shall
constitute one and the same Amendment.

<Signature pages follow>

	
  

 	
  

 
	
 6

 
	
  

 	
 Quest
 Diagnostics Receivables Inc.

 Amendment No. 4 to

 Fourth Amended and Restated Credit and Security Agreement

 

                    IN WITNESS
WHEREOF, the parties hereto have executed this Amendment
as of the date first above written.

	
  

 	
  

 	
  

 
	
 QUEST DIAGNOSTICS RECEIVABLES INC.

 
	
  

 	
  

 	
  

 
	
 By:

 	
 /s/ Robert F. O’Keef

 
	
  

 	

 

 
	
  

 	
     Name:
 

 	
 Robert F. O’Keef

 
	
  

 	
     Title:
 

 	
 Vice President and
 Treasurer

 
	
  

 	
  

 	
  

 
	
 QUEST DIAGNOSTICS INCORPORATED

 
	
  

 	
  

 	
  

 
	
 By:

 	
 /s/ Robert F. O’Keef

 
	
  

 	

 

 
	
  

 	
     Name:
 

 	
 Robert F. O’Keef

 
	
  

 	
     Title:
 

 	
 Vice President and
 Treasurer

 

	
  

 	
  

 
	
 7

 
	
  

 	
 Quest
 Diagnostics Receivables Inc.

 Amendment No. 4 to

 Fourth Amended and Restated Credit and Security Agreement

 

	
  

 	
  

 	
  

 	
  

 
	
 THE BANK OF
 TOKYO-MITSUBISHI UFJ, LTD., NEW YORK BRANCH, INDIVIDUALLY

 
	
  

 	
  

 	
  

 	
  

 
	
 By:

 	
 /s/ T. Kobayashi

 	
  

 
	
  

 	

 

 	
  

 
	
  

 	
     Name:

 	
 T. Kobayashi

 	
  

 
	
  

 	
     Title:

 	
 Authorized Signatory

 	
  

 
	
  

 	
  

 	
  

 	
  

 
	
 THE BANK OF
 TOKYO-MITSUBISHI UFJ, LTD., NEW YORK BRANCH, AS GOTHAM AGENT

 
	
  

 	
  

 	
  

 	
  

 
	
 By:

 	
 /s/ Aditya Reddy 

 	
  

 
	
  

 	

 

 	
  

 
	
  

 	
     Name:

 	
 Aditya Reddy 

 	
  

 
	
  

 	
     Title:

 	
 Managing Director 

 	
  

 
	
  

 	
  

 	
  

 	
  

 
	
 THE BANK OF TOKYO-MITSUBISHI UFJ, LTD., NEW YORK
 BRANCH, AS ADMINISTRATIVE AGENT

 
	
  

 	
  

 	
  

 	
  

 
	
 By:

 	
 /s/ Aditya Reddy 

 	
  

 
	
  

 	

 

 	
  

 
	
  

 	
     Name:

 	
 Aditya Reddy 

 	
  

 
	
  

 	
     Title:

 	
 Managing Director 

 	
  

 

	
  

 	
  

 
	
 8

 
	
  

 	
 Quest
 Diagnostics Receivables Inc.

 Amendment No. 4 to

 Fourth Amended and Restated Credit and Security Agreement

 

	
  

 	
  

 	
  

 	
  

 
	
 GOTHAM FUNDING CORPORATION

 
	
  

 	
  

 	
  

 	
  

 
	
 By:

 	
 /s/ David V. DeAngelis

 	
  

 
	
  

 	

 

 	
  

 
	
  

 	
     Name:

 	
 David V. DeAngelis

 	
  

 
	
  

 	
     Title:

 	
 Vice President

 	
  

 

	
  

 	
  

 
	
 9

 
	
  

 	
 Quest
 Diagnostics Receivables Inc.

 Amendment No. 4 to

 Fourth Amended and Restated Credit and Security Agreement

 

	
  

 	
  

 	
  

 	
  

 
	
 PNC BANK, NATIONAL ASSOCIATION, INDIVIDUALLY AND AS MARKET STREET AGENT

 
	
  

 	
  

 	
  

 	
  

 
	
 By:

 	
 /s/ Michael A. Richards

 	
  

 
	
  

 	

 

 	
  

 
	
  

 	
     Name:

 	
 Michael A. Richards

 	
  

 
	
  

 	
     Title: 

 	
 SeniorVice President

 	
  

 
	
  

 	
  

 	
 PNC Bank, National Association

 

	
  

 	
  

 
	
 10

 
	
  

 	
 Quest
 Diagnostics Receivables Inc.

 Amendment No. 4 to

 Fourth Amended and Restated Credit and Security Agreement

 

	
  

 	
  

 	
  

 	
  

 
	
 MARKET STREET FUNDING LLC

 
	
  

 	
  

 	
  

 	
  

 
	
 By:

 	
 /s/ Doris J. Hearn

 	
  

 
	
  

 	

 

 	
  

 
	
  

 	
     Name:

 	
 Doris J. Hearn

 	
  

 
	
  

 	
     Title:

 	
 Vice President

 	
  

 

	
  

 	
  

 
	
 11

 
	
  

 	
 Quest
 Diagnostics Receivables Inc.

 Amendment No. 4 to

 Fourth Amended and Restated Credit and Security Agreement

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