Document:

EX-10.4

FIRST AMENDMENT TO PURCHASE AND SALE AGREEMENT 

AND ESCROW INSTRUCTIONS

THIS FIRST AMENDMENT TO PURCHASE AND SALE AGREEMENT AND ESCROW INSTRUCTIONS (“First
Amendment”) is made and entered into as of this 29th day of April, 2011 by and
between MEDICAL PARK PLACE MEDICAL COMPLEX, LLC, a Delaware limited liability company
(“Seller”); and G&E HC REIT II BENTON MEDICAL PLAZA I & II MOB, LLC, a Delaware limited
liability company, its successors and assigns (“Buyer”).

Recitals

WHEREAS, Seller and Buyer are parties to that certain Purchase and Sale Agreement and Escrow
Instructions, dated as of April 20, 2011 (the “Purchase Agreement”); and

WHEREAS, Seller and Buyer seek to amend the Purchase Agreement as set forth below;

Agreement

NOW, THEREFORE, in consideration of the mutual covenants contained herein, and for other good
and valuable consideration, the receipt and sufficiency of which is hereby acknowledged, Seller and
Buyer hereby agree as follows:

1. Recitals. The recitals set forth above are true and correct and are hereby
incorporated in their entirety. Capitalized terms not otherwise defined herein shall have the
meanings attributed to them in the Purchase Agreement.

2. Due Diligence Period. Notwithstanding anything to the contrary contained in the
Purchase Agreement, the parties hereby acknowledge and agree that the definition of “Due
Diligence Period” set forth in Section 3.2 of the Original Purchase Agreement as “from
the Effective Date until April 29, 2011 (such period being the “Due Diligence Period”)” is
hereby deleted and replaced with “from the Effective Date until May 2, 2011 (such period being the
“Due Diligence Period”)”.

3. Ratifications. Except as specifically herein amended, all terms, provisions,
conditions and exhibits contained in the Purchase Agreement are hereby confirmed, ratified and
restated and shall remain unmodified and in full force and effect. In the event that any provision
of this First Amendment shall conflict with the terms, provisions, conditions, and exhibits of the
Purchase Agreement, the terms of this First Amendment shall govern and control.

4. Counterparts; Signatures. This First Amendment may be executed in any number of
counterparts and by each of the undersigned on separate counterparts, and each such counterpart
shall be deemed to be an original, but all such counterparts put together shall constitute but one
and the same First Amendment. Signatures to this First Amendment transmitted by .pdf, electronic
mail or other electronic means shall be treated as originals in all respects for purposes of this
First Amendment.

5. Successors and Assigns. This First Amendment shall be binding upon and shall inure
to the benefit of the parties hereto and their respective successors and assigns.

[Remainder of Page Intentionally Left Blank; Signatures Follow on Next Page]

1

IN WITNESS WHEREOF, the parties have executed this First Amendment as of the date indicated in
the preamble above.

BUYER:

G&E HC REIT II BENTON MEDICAL PLAZA I & II MOB, LLC,

a Delaware limited liability company

By: /s/ Danny Prosky

Name: Danny Prosky

Its: Authorized Signatory

SELLER:

	 
	MEDICAL PARK PLACE MEDICAL COMPLEX, LLC,

a Delaware limited liability company

	By its Manager:

	Landmark Healthcare Properties Fund, LLC, a Delaware series limited liability

company, on behalf of its Medical Park Place Series

	By its sole Member:

	Landmark Healthcare Companies LLC, a Delaware limited liability company

	By: /s/ Nicholas F. Checota

	Nicholas F. Checota

President

[Signature page to First Amendment to Purchase and Sale Agreement and Escrow Instructions]

2EX-10.5

THIS AMENDED AND RESTATED PROMISSORY NOTE AMENDS AND RESTATES IN THEIR ENTIRETY THE FOLLOWING:
(I) THAT CERTAIN PROMISSORY NOTE DATED JULY 19, 2010 IN THE ORIGINAL PRINCIPAL AMOUNT OF
$25,000,000.00 MADE BY GRUBB & ELLIS HEALTHCARE REIT II HOLDINGS, L.P., G&E HC REIT II LACOMBE MOB,
LLC AND G&E REIT II PARKWAY MEDICAL CENTER, LLC, COLLECTIVELY AS BORROWER, TO THE ORDER OF BANK OF
AMERICA, N.A., AS LENDER (“LENDER”); (II) THAT CERTAIN JOINDER TO PROMISSORY NOTE DATED SEPTEMBER
9, 2010 MADE BY G&E REIT II ST. VINCENT CLEVELAND MOB, LLC AND G&E HC REIT II LIVINGSTON MOB, LLC,
COLLECTIVELY AS BORROWER, TO THE ORDER OF LENDER; (III) THAT CERTAIN JOINDER TO PROMISSORY NOTE
DATED NOVEMBER 15, 2010 MADE BY G&E REIT II SYLVA MOB, LLC, AS BORROWER, TO THE ORDER OF LENDER;
AND (IV) THAT CERTAIN JOINDER TO PROMISSORY NOTE DATED JANUARY 28, 2011 MADE BY G&E REIT II ENNIS
MOB, LLC, AS BORROWER, TO THE ORDER OF LENDER. THIS AMENDED AND RESTATED PROMISSORY NOTE DOES NOT
CONSTITUTE A NOVATION OF THE ORIGINAL INDEBTEDNESS EVIDENCED HEREBY.

AMENDED AND RESTATED PROMISSORY NOTE

$45,000,000.00 May 4, 2011

FOR VALUE RECEIVED, GRUBB & ELLIS HEALTHCARE REIT II HOLDINGS, LP, a Delaware limited
partnership (“REIT LP”), G&E HC REIT II LACOMBE MOB, LLC, a Delaware limited liability
company (“Lacombe”), G&E HC REIT II PARKWAY MEDICAL CENTER, LLC, a Delaware limited
liability company (“Parkway”), G&E HC REIT II ST. VINCENT CLEVELAND MOB, LLC, a Delaware
limited liability company (“St. Vincent”), G&E HC REIT II LIVINGSTON MOB, LLC, a Delaware
limited liability company (“Livingston”), G&E HC REIT II SYLVA MOB, LLC, a Delaware limited
liability company (“Sylva”), and G&E HC REIT II ENNIS MOB, LLC, a Delaware limited
liability company (“Ennis”) (all of the aforementioned, together with each other party
which becomes a borrower under the Credit Agreement [as defined below], individually and
collectively, jointly and severally, “Borrower”), hereby promises to pay to the order of
BANK OF AMERICA, N.A., a national banking association (“Lender”) under the Credit Agreement
among REIT LP, Lacombe and Parkway, Bank of America, N.A., a national banking association and
administrative agent (together with any and all of its successors and assigns, the
"Administrative Agent”) for the benefit of itself and the other Lenders from time to time a
party thereto (the “Original Credit Agreement”) dated July 19, 2010, as amended by that
certain Joinder to Credit Agreement and Other Loan Documents dated September 9, 2010 among St.
Vincent, Livingston and Administrative Agent, as consented to by REIT LP, Lacombe, Parkway,
Guarantor and Pledgor (the “First Joinder Agreement”), as further amended by that certain
Joinder to Credit Agreement and Other Loan Documents dated November 15, 2010 between Sylva and
Administrative Agent, as consented to by REIT LP, Lacombe, Parkway, St. Vincent, Livingston,
Guarantor and Pledgor (the “Second Joinder Agreement”), as further amended by that certain
Joinder to Credit Agreement and Other Loan Documents dated January 28, 2011 between Ennis and
Administrative Agent, as consented to by REIT LP, Lacombe, Parkway, St. Vincent, Livingston, Sylva,
Guarantor and Pledgor (the “Third Joinder Agreement”), and as further amended by that
certain First Amendment to Credit Agreement and Related Loan Documents dated May 4, 2011 between
the Borrower and the Administrative Agent (the “First Amendment to Credit Agreement”; the
Original Credit Agreement as amended by the First Joinder Agreement, the Second Joinder Agreement,
the Third Joinder Agreement and the First Amendment to Credit Agreement is referred to herein as
the “Credit Agreement”), without offset, in immediately available funds in lawful money of
the United States of America, at Administrative Agent’s Office, the principal sum of FORTY FIVE
MILLION AND NO/100 DOLLARS ($45,000,000.00) (or the unpaid balance of all principal advanced
against this Note, if that amount is less), together with interest on the unpaid principal balance
of this Note from day to day outstanding as hereinafter provided. All capitalized terms used
herein and not defined shall have the meaning ascribed to such terms in the Credit Agreement.

1. Note; Interest; Payment Schedule and Maturity Date. This Note is one of the Notes
referred to in the Credit Agreement and is entitled to the benefits thereof and subject to
prepayment in whole or part as provided therein. The entire principal balance of this Note then
unpaid shall be due and payable at the times as set forth in the Credit Agreement. Accrued unpaid
interest shall be due and payable at the times and at the interest rate as set forth in the Credit
Agreement until all principal and accrued interest owing on this Note shall have been fully paid
and satisfied. Any amount not paid when due and payable hereunder shall, to the extent permitted
by applicable Law, bear interest and if applicable a late charge as set forth in the Credit
Agreement.

2. Security; Loan Documents. The security for this Note includes the Mortgages
encumbering the Borrowing Base Properties. This Note, the Mortgage, the Credit Agreement and all
other documents now or hereafter securing, guaranteeing or executed in connection with the loan
evidenced by this Note (the “Loan”), are, as the same have been or may be amended,
restated, modified or supplemented from time to time, herein sometimes called individually a
"Loan Document” and together the “Loan Documents”.

3. Defaults.

(a) It shall be a Default (an “Event of Default”) under this Note and each of
the other Loan Documents if (i) any amount of interest on or principal of any Loan or fee
due under this Note or any other Loan Document is not paid in full within five (5) days of
when due, regardless of how such amount may have become due (provided, however, there shall
be no five (5) day grace period for amounts due at maturity or upon acceleration of the
Loan); (ii) within five (5) days after the same becomes due, any other amount payable under
this Note or any other Loan Document is not paid in full; (iii) any covenant, agreement,
condition, representation or warranty herein or in any other Loan Documents is not fully and
timely performed, observed or kept in all material respects; or (iv) there shall occur any
default or event of default under the Credit Agreement, the Mortgages or any other Loan
Document. Upon the occurrence of an Event of Default, the Administrative Agent on behalf of
the Lenders shall have the rights to declare the unpaid principal balance and accrued but
unpaid interest on this Note, and all other amounts due hereunder and under the other Loan
Documents, at once due and payable (and upon such declaration, the same shall be at once due
and payable), to foreclose any liens and security interests securing payment hereof and to
exercise any of its other rights, powers and remedies under this Note, under any other Loan
Document, or at Law or in equity.

(b) All of the rights, remedies, powers and privileges (together, “Rights”) of
the Administrative Agent on behalf of the Lenders provided for in this Note and in any other
Loan Document are cumulative of each other and of any and all other Rights at Law or in
equity. The resort to any Right shall not prevent the concurrent or subsequent employment
of any other appropriate Right. No single or partial exercise of any Right shall exhaust
it, or preclude any other or further exercise thereof, and every Right may be exercised at
any time and from time to time. No failure by the Administrative Agent or the Lenders to
exercise, nor delay in exercising any Right, including but not limited to the right to
accelerate the maturity of this Note, shall be construed as a waiver of any Event of Default
or as a waiver of any Right. Without limiting the generality of the foregoing provisions,
the acceptance by the Lender from time to time of any payment under this Note which is past
due or which is less than the payment in full of all amounts due and payable at the time of
such payment, shall not (i) constitute a waiver of or impair or extinguish the right of the
Administrative Agent or the Lenders to accelerate the maturity of this Note or to exercise
any other Right at the time or at any subsequent time, or nullify any prior exercise of any
such Right, or (ii) constitute a waiver of the requirement of punctual payment and
performance or a novation in any respect.

(c) If any holder of this Note retains an attorney in connection with any Event of
Default or at maturity or to collect, enforce or defend this Note or any other Loan Document
in any lawsuit or in any probate, reorganization, bankruptcy, arbitration or other
proceeding, or if the Borrower sues any holder in connection with this Note or any other
Loan Document and does not prevail, then the Borrower agrees to pay to each such holder, in
addition to principal, interest and any other sums owing to the Lenders hereunder and under
the other Loan Documents, all costs and expenses incurred by such holder in trying to
collect this Note or in any such suit or proceeding, including, without limitation,
reasonable attorneys’ fees actually incurred and expenses, investigation costs and all court
costs, whether or not suit is filed hereon, whether before or after the Maturity Date, or
whether in connection with bankruptcy, insolvency or appeal, or whether collection is made
against the Borrower or any guarantor or endorser or any other person primarily or
secondarily liable hereunder. Any judgment on this Note shall bear interest at the highest
rate allowed by applicable law.

4. Heirs, Successors and Assigns. The terms of this Note and of the other Loan
Documents shall bind and inure to the benefit of the representatives, successors and assigns of the
parties. The foregoing sentence shall not be construed to permit the Borrower to assign the Loan
except as otherwise permitted under the Loan Documents. As further provided in the Credit
Agreement, a Lender may, at any time, sell, transfer or assign all or a portion of its interest in
this Note, the Mortgage and the other Loan Documents, as set forth in the Credit Agreement.

5. General Provisions. Time is of the essence with respect to the Borrower’s
obligations under this Note. If more than one person or entity executes this Note as the Borrower,
all of said parties shall be jointly and severally liable for payment of the indebtedness evidenced
hereby. The Borrower and all sureties, endorsers, guarantors and any other party now or hereafter
liable for the payment of this Note in whole or in part, hereby severally (a) waive demand,
presentment for payment, notice of dishonor and of nonpayment, protest, notice of protest, notice
of intent to accelerate, notice of acceleration and all other notices (except any notices which are
specifically required by this Note or any other Loan Document), filing of suit and diligence in
collecting this Note or enforcing any of the security herefor; (b) agree to any substitution,
subordination, exchange or release of any such security or the release of any party primarily or
secondarily liable hereon; (c) agree that neither the Administrative Agent nor any Lender shall be
required first to institute suit or exhaust its remedies hereon against the Borrower or others
liable or to become liable hereon or to perfect or enforce its rights against them or any security
herefor; (d) consent to any extensions or postponements of time of payment of this Note for any
period or periods of time and to any partial payments, before or after maturity, and to any other
indulgences with respect hereto, without notice thereof to any of them; and (e) submit (and waive
all rights to object) to non-exclusive personal jurisdiction of any state or federal court sitting
in the city and county, and venue in the city or county, in which payment is to be made as
specified in the Preamble to this Note, for the enforcement of any and all obligations under this
Note and the Loan Documents; (f) waive the benefit of all homestead and similar exemptions as to
this Note; (g) agree that their liability under this Note shall not be affected or impaired by any
determination that any security interest or lien taken by the Lender to secure this Note is invalid
or unperfected; and (h) hereby subordinate any and all rights against the Borrower and any of the
security for the payment of this Note, whether by subrogation, agreement or otherwise, until this
Note is paid in full. A determination that any provision of this Note is unenforceable or invalid
shall not affect the enforceability or validity of any other provision and the determination that
the application of any provision of this Note to any person or circumstance is illegal or
unenforceable shall not affect the enforceability or validity of such provision as it may apply to
other persons or circumstances. This Note may not be amended except in a writing specifically
intended for such purpose and executed by the party against whom enforcement of the amendment is
sought. Captions and headings in this Note are for convenience only and shall be disregarded in
construing it. THIS NOTE SHALL TAKE EFFECT AS A SEALED INSTRUMENT AND ITS VALIDITY, ENFORCEMENT
AND INTERPRETATION, SHALL BE GOVERNED BY ILLINOIS LAW (WITHOUT REGARD TO ANY CONFLICT OF LAWS
PRINCIPLES) AND APPLICABLE UNITED STATES FEDERAL LAW.

6. Notices. Any notice, request, or demand to or upon the Borrower or the Lender
shall be deemed to have been properly given or made when delivered in accordance with the Credit
Agreement.

7. No Usury. It is expressly stipulated and agreed to be the intent of the Borrower,
the Administrative Agent and all the Lenders at all times to comply with applicable state Law or
applicable United States federal Law (to the extent that it permits a Lender to contract for,
charge, take, reserve, or receive a greater amount of interest than under state Law) and that this
Section 7 shall control every other covenant and agreement in this Note and the other Loan
Documents. If applicable state or federal Law should at any time be judicially interpreted so as
to render usurious any amount called for under this Note or under any of the other Loan Documents,
or contracted for, charged, taken, reserved, or received with respect to the Loan, or if the
Administrative Agent’s exercise of the option to accelerate the Maturity Date, or if any prepayment
by the Borrower results in the Borrower having paid any interest in excess of that permitted by
applicable Law, then it is the Administrative Agent’s and each Lender’s express intent that all
excess amounts theretofore collected by the Administrative Agent or any Lender shall be credited on
the principal balance of this Note and all other indebtedness and the provisions of this Note and
the other Loan Documents shall immediately be deemed reformed and the amounts thereafter
collectible hereunder and thereunder reduced, without the necessity of the execution of any new
documents, so as to comply with the applicable Law, but so as to permit the recovery of the fullest
amount otherwise called for hereunder or thereunder. All sums paid or agreed to be paid to the
Lenders for the use, forbearance, or detention of the Loan shall, to the extent permitted by
applicable Law, be amortized, prorated, allocated, and spread throughout the full stated term of
the Loan until payment in full so that the rate or amount of interest on account of the Loan does
not exceed the maximum lawful rate from time to time in effect and applicable to the Loan (the
"Maximum Rate”) for so long as the Loan is outstanding. The Lender may, in determining the
Maximum Rate, take advantage of: (i) the rate of interest permitted by applicable Illinois law and
12 United States Code, Sections 85 and 86, and (ii) any other law, rule, or regulation on effect
from time to time, available to the Lender which exempts the Lender from any limit upon the rate of
interest it may charge or grants to the Lender the right to charge a higher rate of interest than
that allowed otherwise.

THE LOAN DOCUMENTS REPRESENT THE FINAL AGREEMENT BETWEEN THE PARTIES AND MAY NOT BE
CONTRADICTED BY EVIDENCE OF PRIOR, CONTEMPORANEOUS OR SUBSEQUENT ORAL AGREEMENTS OF THE PARTIES.

THERE ARE NO ORAL AGREEMENTS BETWEEN THE PARTIES.

This Note is issued in replacement of (i) that certain Promissory Note dated July 19, 2010 in
the original principal amount of $25,000,000.00 made by Grubb & Ellis Healthcare REIT II Holdings,
L.P., G&E HC REIT II Lacombe MOB, LLC and G&E REIT II Parkway Medical Center, LLC, collectively as
Borrower, to the order of Bank of America, N.A., as Lender (“Lender”); (ii) that certain Joinder to
Promissory Note dated September 9, 2010 made by G&E REIT II St. Vincent Cleveland MOB, LLC and G&E
HC REIT II Livingston MOB, LLC, collectively as Borrower, to the order of Lender; (iii) that
certain Joinder to Promissory Note dated November 15, 2010 made by G&E REIT II Sylva MOB, LLC, as
Borrower, to the order of Lender; and (iv) that certain Joinder to Promissory Note dated January
28, 2011 made by G&E REIT II Ennis MOB, LLC, as Borrower, to the order of Lender (collectively, the
"Original Note”). The indebtedness evidenced by the Original Note has not been paid;
instead, this Note is issued in substitution for the Original Note and upon execution and delivery
of this Note, the Original Note shall be deemed “cancelled” and superseded by this Note, however,
the unpaid indebtedness evidenced thereby continues to be outstanding and is intended to be
evidenced hereby. This Note is in no way intended to constitute a novation of the Original Note.

[REMAINDER OF PAGE INTENTIONALLY LEFT BLANK]

[SIGNATURE PAGES FOLLOW]IN WITNESS WHEREOF, Borrower has duly executed this Note under
seal as of the date first above written.

BORROWER:

GRUBB & ELLIS HEALTHCARE REIT II HOLDINGS, LP,

a Delaware limited partnership

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

a Maryland corporation, its general partner

By: /s/ Danny Prosky

Name: Danny Prosky

Title: President and Chief Operating Officer

G&E HC REIT II LACOMBE MOB, LLC,

a Delaware limited liability company

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

a Delaware limited partnership, its sole Member

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

a Maryland corporation, its general partner

By: /s/ Danny Prosky

Name: Danny Prosky

Title: President and Chief Operating Officer

G&E HC REIT II PARKWAY MEDICAL CENTER, LLC,

a Delaware limited liability company

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

a Delaware limited partnership, its sole Member

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

a Maryland corporation, its general partner

By: /s/ Danny Prosky

Name: Danny Prosky

Title: President and Chief Operating Officer

G&E HC REIT II ST. VINCENT CLEVELAND MOB, LLC,

a Delaware limited liability company

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

a Delaware limited partnership, its sole Member

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

a Maryland corporation, its general partner

By: /s/ Danny Prosky

Name: Danny Prosky

Title: President and Chief Operating Officer

G&E HC REIT II LIVINGSTON MOB, LLC,

a Delaware limited liability company

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

a Delaware limited partnership, its sole Member

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

a Maryland corporation, its general partner

By: /s/ Danny Prosky

Name: Danny Prosky

Title: President and Chief Operating Officer

G&E HC REIT II SYLVA MOB, LLC,

a Delaware limited liability company

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

a Delaware limited partnership, its sole Member

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

a Maryland corporation, its general partner

By: /s/ Danny Prosky

Name: Danny Prosky

Title: President and Chief Operating Officer

G&E HC REIT II ENNIS MOB, LLC,

a Delaware limited liability company

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

a Delaware limited partnership, its sole Member

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

a Maryland corporation, its general partner

By: /s/ Danny Prosky

Name: Danny Prosky

Title: President and Chief Operating Officer

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