Document:

EXHIBIT
10.1

    

    EUROSITE
POWER INC.

    FORM
OF COMMON STOCK PURCHASE AGREEMENT

    

    
      	
              TO:

            	
              EuroSite
      Power Inc.

            

    

    45 First Avenue

    Waltham, Massachusetts
02451

    

    Ladies
and Gentlemen:

    

    The
undersigned (the “Investor”) desires to purchase from EuroSite Power Inc., a
Delaware corporation (the “Company”), ____________ shares of its Common Stock,
par value $.001 per share (the “Common Stock”). The purchase price for each
share of Common Stock is $1.00.

    

    1.          Subscription

    

    a.           Subject
to the terms and conditions of this Agreement (this “Agreement”), the Investor
agrees to subscribe for and purchase from the Company and tenders this
subscription for _____________ shares of Common Stock (the “Shares”) together
with payment of the subscription price for the Shares in the amount of
$_______________ . The subscription price is referred to in this Agreement as
the “Funds.”

    

    b.           Tender
of the Funds shall be made by delivery of a personal or bank check payable to
the Company or by wire transfer to the Company’s designated bank account,
together with executed copies of this Agreement. The Investor should deliver the
executed subscription documents and payment for the Shares to the Company,
Attention: Chief Financial Officer, 45 First Avenue, Waltham, MA
02451.

    

    
      2.           Acceptance
of Agreement

    

    

    It is understood and agreed that this
Subscription is made subject to the following terms and conditions:

    

    a.           The
Company shall have the right to accept or reject this Subscription, in whole or
in part, for any reason, the ineligibility of a subscriber under applicable
state or foreign securities laws, for any other reason or for no reason. If this
Subscription is rejected, the Funds previously delivered to the Company will be
returned to the Investor.

     

    b.           Two
complete copies of this Agreement will be executed by the Investor. If this
Subscription is accepted, one copy of this Common Stock Purchase Agreement as
accepted by the Company shall be delivered to the Investor.

     

    c.           If
this Subscription is accepted in part and rejected in part, the Investor will be
so notified, at which time the excess Funds previously delivered to the Company
will be returned to the Investor.

    

    3.           Representations
and Warranties of the Investor

    

    In order to induce the Company to
accept this Agreement, the Investor hereby represents and warrants to the
Company as follows:

    

    a.           THE INVESTOR HAS READ CAREFULLY AND
UNDERSTANDS THIS AGREEMENT AND HAS CONSULTED THE INVESTOR'S OWN ATTORNEY,
ACCOUNTANT OR INVESTMENT ADVISER WITH RESPECT TO THE INVESTMENT CONTEMPLATED
HEREBY AND ITS SUITABILITY FOR THE INVESTOR. THE INVESTOR HAS HAD AN OPPORTUNITY
TO ASK QUESTIONS OF AND RECEIVED ANSWERS FROM THE COMPANY, OR A PERSON OR
PERSONS ACTING ON THE COMPANY'S BEHALF, CONCERNING THE TERMS AND CONDITIONS OF
THIS INVESTMENT AND THE BUSINESS OF THE COMPANY, AND HAS RECEIVED AND REVIEWED
ALL ADDITIONAL DOCUMENTATION REGARDING THE BUSINESS AND OPERATIONS OF THE
COMPANY THAT HE OR SHE HAS REASONABLY REQUESTED.

    
      
         

      

      
         

        
          

        

      

      
         

      

    

    b.           The
Investor (i) has no need for liquidity in the investment in the Shares, (ii) is
able to bear the substantial economic risks of an investment in the Shares for
an indefinite period, and (iii) at the present time, could afford the complete
loss of such investment in the Shares.

     

    c.           The
address set forth at the end of this Agreement is the Investor's true and
correct residence, and the Investor has no present intention of changing such
residence to any other state or jurisdiction.

    

    d.           The
Investor confirms that all documents, records and books pertaining to the
investment in the Company reasonably requested by the Investor have been made
available to the Investor. The undersigned has relied only on such documents and
that no written or oral representation or information inconsistent with such
information has been made or furnished to the Investor in connection with the
Shares and if so made, has not been relied upon.

    

    e.           The
Investor understands that the Shares have not been registered under the
Securities Act, nor pursuant to the provisions of the securities laws or other
laws of any other applicable jurisdictions, in reliance on exemptions for
private offerings contained in the Securities Act and in the laws of such
jurisdictions. The Investor represents to the Company that he is an “accredited
investor”, as such term is defined in Rule 501(a) of Regulation D under the
Securities Act of 1933, as amended. The Investor is fully aware that the Shares
to which he or she is subscribing are to be sold in reliance upon such
exemptions based upon his or her representations, warranties and agreements set
forth in this Agreement. The Investor is fully aware that he or she must bear
the economic risk of his or her investment in the Company for an indefinite
period of time because the Shares have not been registered under the Securities
Act, and, therefore, cannot be offered or sold unless they are subsequently
registered under the Securities Act or an exemption from such registration is
available. The Investor further understands that the Company has no intention
and is under no obligation to register its Shares under the Securities Act or to
comply with the requirements for any exemption that might otherwise be
available, or to supply the Investor with any information necessary to enable
the Investor to make routine sales of the Shares under Rule 144 under the Securities Act
(which it understands is not now, and will not likely be, available) or any rule
of the Securities and Exchange Commission or any successor thereto.

     

    f.
           The Investor
understands that the certificate(s) representing the Shares will bear the
following legend restricting its transfer and that a notation restricting such
transfer will be made on the stock transfer books of the Company:

    

    “THE
SHARES OF STOCK REPRESENTED BY THIS CERTIFICATE HAVE NOT BEEN REGISTERED UNDER
THE SECURITIES ACT OF 1933, AS AMENDED (THE "SECURITIES ACT") OR THE APPLICABLE
SECURITIES LAWS OF ANY STATE OR OTHER JURISDICTION. THESE SHARES HAVE BEEN
ACQUIRED FOR INVESTMENT AND NOT WITH A VIEW TO THEIR DISTRIBUTION OR RESALE.
SUCH SHARES MAY NOT BE SOLD, PLEDGED OR OTHERWISE TRANSFERRED WITHOUT AN
EFFECTIVE REGISTRATION STATEMENT FOR SUCH SHARES UNDER THE ACT, OR AN OPINION OF
COUNSEL SATISFACTORY IN FORM AND SUBSTANCE TO THE COMPANY TO THE EFFECT THAT
SUCH REGISTRATION IS NOT REQUIRED.”

     

    g.           The
Shares are being acquired solely for the Investor's own account, for investment
and are not being purchased with a view to or for the resale or other
distribution of the Shares; and the Investor has no present plans to enter into
any contract, undertaking, agreement or arrangement relating to any resale or
other distribution of the Shares.

    

    h.           The
Investor understands that this Subscription may be accepted or rejected in whole
or in part in the sole and absolute discretion of the Company, and this
Agreement, unless properly revoked before the completion of the sale of the
Shares to the Investor, shall survive the Investor’s death, disability or
insolvency, except that the Investor shall have no obligations in the event that
this Subscription is rejected by the Company.

    
      
         

      

      
         

        
          

        

      

      
         

      

    

    i.     
      The Investor understands that even if the
Company becomes a “reporting company” under the Securities Exchange Act of 1934,
as amended, the provisions of Rule 144 promulgated under the Securities Act
permitting resales of the Shares will not be available for at least one (1)
year, and there can be no assurance that the conditions necessary to permit
routine sales of the Shares under Rule 144 will ever be satisfied, and, if Rule
144 should become available, routine sales made in reliance on its provisions
could be made only in limited amounts and in accordance with the terms and
conditions of the Rule. The Investor further understands that in connection with
sales of securities for which Rule 144 is not available, compliance with some
other exemption from registration will be required. The Investor understands
that the Company is under no obligation to the undersigned to register the
Shares or to comply with the conditions of Rule 144 or take any other action
necessary in order to make available any exemption for the sale of the Shares
without registration.

     

    j. 
          The Investor has
been advised to consult with the Investor’s own attorney regarding legal, tax,
and other matters concerning an investment in the Company and has done so, to
the extent the undersigned considers necessary.

     

    k.          
The
Investor acknowledges and is aware of the following:

    

    (i)           that
the Shares are a speculative investment and involve a high degree of risk of
loss by the Investor of the Investor's entire investment in the
Company;

     

    (ii)          that
there is no guarantee that the Investor will realize any gain from his or her
investment in the Company and that the Investor may lose his or her entire
investment;

     

    (iii)         that
the Company has no
current plan or intention to issue dividends with respect to the
Shares;

     

    (iv)        that
there has never been any representation, guarantee or warranty made to the
Investor by any broker, the Company, its agents or employees or any other
person, expressly or by implication, as to:

    

    (A)           the
approximate or exact length of time that the Investor will be required to remain
as owner of the Shares; or

    

    (B)           the
past performance or experience on the part of the officers or directors of the
Company, or of any other person, that will in any way indicate the predictable
results of the ownership of the Shares or any such other securities, or of the
overall business of the Company;

    

    (v)         that
the Company may in the future issue additional shares of capital stock in the
Company, and that the Investor's interest in the Company may thereby become
diluted.

    

    The
Investor acknowledges that he or she understands the meaning and legal
consequences of the representations, warranties and acknowledgments contained in
this Agreement. The Investor confirms that such representations, warranties and
acknowledgments are true and accurate as of the date of this Agreement and shall
be true and accurate as of the date of delivery of the Funds to the Company and
shall survive such delivery. If in any respect such representations and
warranties shall not be true and accurate prior to acceptance of this Agreement
pursuant to Section 2 of this Agreement, the Investor shall give written notice
of such fact to the Company, specifying which representations and warranties are
not true and accurate and the reasons therefor.

    

    4.           Indemnification. The Investor acknowledges
that he or she understands the meaning and legal consequences of the
representations and warranties contained in Section 3 of this Agreement, and the
Investor agrees to
indemnify, defend and hold harmless the Company and each officer, director,
representative and agent of the Company and any person or entity controlling the
Company from and against any and all loss, cost, damage or liability (including
reasonable attorneys' fees) due to or arising out of a breach of any
representation or warranty of the Investor contained in this
Agreement.

     

    5.           No
Waiver.
Notwithstanding any of the representations, warranties, acknowledgments or
agreements made in this Agreement by the Investor, the
Investor does not thereby or in any other manner waive any rights granted to the
Investor under federal and state securities law.

    
      
         

      

      
         

        
          

        

      

      
         

      

    

    6.           Transferability. The Investor agrees not to
transfer or assign this Agreement, or any of the Investor's interest in this
Agreement, and further agrees that any assignment or transfer of the Shares
shall be made only in accordance with applicable securities laws and that an
appropriate legend with respect thereto may be placed by the Company on any
certificate evidencing such Shares.

    

    7.           Revocation. The Investor agrees that he
or she shall not cancel, terminate or revoke this Agreement.

    

    8.           Termination
of Agreement. If
any representation or warranty of the Investor contained in Section 3 of this
Agreement shall not be true prior to acceptance of this Agreement, and written
notice of such fact has been given by the Investor to the Company, then and in
any such event this Agreement shall be null and void and of no further force and
effect, and no party shall have any rights against any other party under this
Agreement or otherwise, and the Company shall promptly return to the Investor
the Funds together with all agreements executed by the Investor.

    

    9.           Dispute
Resolution

    

    a.           All
disputes, claims, or controversies arising out of or relating to this Agreement
or any other agreement executed and delivered pursuant to this Agreement or the
negotiation, validity or performance hereof and thereof or the transactions
contemplated hereby and thereby that are not resolved by mutual agreement shall
be resolved solely and exclusively by binding arbitration to be conducted before
the American Arbitration Association (“AAA”). If AAA ceases operation, then the
parties shall select a comparable organization that provides qualified
arbitration services. The arbitration shall be held in Boston, Massachusetts
before a single arbitrator and shall be conducted in accordance with the rules
and regulations promulgated by AAA unless specifically modified
herein.

    

    b.           The
parties covenant and agree that the arbitration hearing shall commence within
ninety (90) days of the date on which a written demand for arbitration is filed
by any party hereto. In connection with the arbitration proceeding, the
arbitrator shall have the power to order the production of documents by each
party and any third-party witnesses. In addition, each party may take up to
three depositions as of right, and the arbitrator may in his or her discretion
allow additional depositions upon good cause shown by the moving party. However,
the arbitrator shall not have the power to order the answering of
interrogatories or the response to requests for admission. In connection with
any arbitration, each party shall provide to the other, no later than seven (7)
business days before the date of the arbitration hearing, the identity of all
persons that may testify at the arbitration and a copy of all documents that may
be introduced at the arbitration hearing or considered or used by a party’s
witness or expert. The arbitrator’s decision and award shall be made and
delivered within three (3) months of the selection of the arbitrator. The
arbitrator’s decision shall set forth a reasoned basis for any finding of
liability or award of damages. The arbitrator shall not have power to award
damages in excess of actual compensatory damages and shall not multiply actual
damages or award punitive damages or any other damages that are specifically
excluded under this Agreement, and each party hereby irrevocably waives any
claim to such damages.

    

    c.           The
parties covenant and agree that they will participate in the arbitration in good
faith and that they will share equally its costs, except as otherwise provided
herein. The arbitrator may in his or her discretion assess costs and expenses
(including the reasonable legal fees and expenses of the prevailing party
whether claimant or respondent) against any party to a proceeding. Any party
failing or refusing to comply with an order of the arbitrators shall be liable
for costs and expenses, including attorneys’ fees, incurred by the other party
in enforcing the award. Nothing in this Section 9 shall prohibit any party from
proceeding in court without prior arbitration for the limited purpose of seeking
a temporary or permanent injunction to avoid immediate and irreparable harm. The
provisions of this Section 9 shall be enforceable in any court of competent
jurisdiction.

     

    d.           Unless
otherwise ordered, the parties shall bear their own attorneys’ fees, costs and
expenses in connection with the arbitration. The parties will share equally in
the fees and expenses charged by AAA.

    
      
         

      

      
         

        
          

        

      

      
         

      

    

    e.           Each
of the parties hereto irrevocably and unconditionally consents to the exclusive
use of AAA to resolve all disputes, claims or controversies arising out of or
relating to this Agreement or any other agreement executed and delivered
pursuant to this Agreement or the negotiation, validity or performance hereof
and thereof or the transactions contemplated hereby and thereby and further
consents to the jurisdiction of the federal or state courts of the Commonwealth
of Massachusetts for the purposes of enforcing the arbitration provisions of
Section 9a of this Agreement. Each party further irrevocably waives any
objection to proceeding before AAA based upon lack of personal jurisdiction or
to the laying of venue and further irrevocably and unconditionally waives and
agrees not to make a claim in any court that arbitration before AAA has been
brought in an inconvenient forum. Each of the parties hereto hereby consents to
service of process by registered mail at the address to which notices are to be
given. Each of the parties hereto agrees that its or his submission to
jurisdiction and its or his consent to service of process by mail is made for
the express benefit of the other parties hereto.

    

    
      10.           
Miscellaneous

    

    

    a.           All
notices or other communications given or made under this Agreement shall be in
writing and shall be delivered or mailed by (a) registered or certified mail,
return receipt requested, postage prepaid, or (b) overnight air courier, fees
prepaid, to the Investor at his or her address set forth below and to the
Company at its address set forth at the outset of this Agreement.

     

    b.           Failure
of the Company to exercise any right or remedy under this Agreement or any other
agreement between the Company and the Investor, or delay by the Company in
exercising the same, will not operate as a waiver of such right or remedy. No
waiver by the Company will be effective unless and until it is in writing and
signed on behalf of the Company.

     

    c.           Notwithstanding
the place where this Agreement may be executed by any of the parties hereto, all
the terms and provisions hereof shall be construed in accordance with and
governed by the laws of the Commonwealth of Massachusetts, without giving effect
to its conflict of law principles.

     

    d.           This
Agreement is binding upon and inures to the benefit of the parties hereto and
their respective heirs, successors and permitted assigns. This Agreement cannot
be assigned, amended or modified by the parties hereto, except by written
agreement executed by the parties hereto.

     

    e.           This
Agreement may be executed in one or more counterparts, each of which shall be
deemed an original, but all of which together shall constitute one and the same
instrument.

     

    f.  
         If any provision of this
Agreement shall for any reason be held invalid or unenforceable, such invalidity
or unenforceability shall not affect any other provision hereof and this
Agreement shall be construed as if such invalid or unenforceable provision had
never been contained herein.
 

    g.           This
Agreement constitutes the entire agreement between the parties with respect to
the subject matter of this Agreement and may be amended only by a writing executed by
all parties.

    

    [The
balance of this page has been intentionally left blank.]

    
      
         

      

      
         

        
          

        

      

      
         

      

    

     

    IN WITNESS WHEREOF, the undersigned has
executed this Agreement on this ____ day of _____________ 2010.

    

    Manner in which Title is to be held
(Please Check One):

    

    1.         ___         
Individual

    

    2.          ___         Joint
Tenants With Right of Survivorship

    

    3.          ___         Community
Property

    

    4.          ___         Tenants
in Common

    

    5.          ___         Married
with Separate Property

     

      

      
        

      

    

    Exact
Name(s) in Which Title is to be Held

    
      (If Joint
Tenant or Tenants in Common, both persons must

    

    sign and
this page must contain all information for both persons).

    

    
      
        
          
            
              
                
                  
                    
                      
                        
                          
                            
                              	 
      	 
      	 
      
	
                                      Signature

                                    	 
      	
                                      Signature

                                    
	 
      	 
      	 
      
	 
      	 
      	 
      
	
                                      Name
      (Please Print)

                                    	 
      	
                                      Name
      (Please Print)

                                    
	 
      	 
      	 
      
	 
      	 
      	 
      
	
                                      Residence:
      Number and Street

                                    	 
      	
                                      Residence:
      Number and Street

                                    
	 
      	 
      	 
      
	 
      	 
      	 
      
	
                                      City,
      State, Zip Code

                                    	 
      	
                                      City,
      State, Zip Code

                                    
	 
      	 
      	 
      
	 
      	 
      	 
      
	
                                      Social
      Security Number

                                    	 
      	
                                      Social
      Security Number

                                    
	 
      	 
      	 
      
	 
      	 
      	 
      
	
                                      Telephone
      Number:

                                    	 
      	 
      

                            

                          

                        

                      

                    

                  

                

              

            

          

        

      

    

    

    Accepted
this _____ day of _______________ 2010, on behalf of the Company

    

    
      EUROSITE
POWER INC.

    

    

    
      
        
          	
                  By:

                	 
      	 
      
	 
      	 
      	 
      
	
                  Name: 

                	
                  Anthony
      S. Loumidis

                	 
      
	
                  Title:

                	
                  Chief
      Financial Officer

                	 
      

        

      

    

    
      
         

      

      
         

        
          

        

      

      
         

      

    

    EXECUTION BY SUBSCRIBER THAT
IS AN ENTITY

    

    (Corporation,
Limited Liability Company, Partnership, Trust, Etc.)

    

    ________________________________________________________

    Name of
Entity (Please Print)

    

    Date of
Incorporation or
Organization:  ______________________________________________

    

    State of
Principal
Offices:  ________________________________________________________

    

    Federal
Taxpayer Identification
Number:  _____________________________________________

    

    
      
        
          
            	 
      	
                    By:

                  	 
      
	 
      	 
      	 
      
	 
      	
                    Title: 

                  	 
      

          

        

      

    

    

    
      
        
          
            
              
                
                  
                    
                      	
                              Attest:

                            	 
      	 
      	
                              Address: 

                            	 
      
	 
      	 
      	 
      
	
                              (If
      Entity is a Corporation)

                            	 
      	 
      

                    

                  

                

              

            

          

        

      

    

    
      
        
          
            	 
      	 
      
	 
      	 
      
	 
      	 
      
	 
      	 
      
	 
      	 
      
	 
      	
                    Taxpayer
      Identification
Number

                  

          

        

      

    

    

    Accepted
this _____ day of _______________ 2010, on behalf of the Company

    

    
      EUROSITE
POWER INC.

    

    

    
      
        
          	
                  By:

                	 
      	 
      
	 
      	 
      	 
      
	
                  Name: 

                	
                  Anthony
      S. Loumidis

                	 
      
	
                  Title:

                	
                  Chief
      Financial Officer

                	 
      

        

      

    

     

    
      
         

      

      
         

        
          

        

      

      
         

      

    

    
      ACCREDITED INVESTOR
QUESTIONNAIRE

    

    

    Please
check the box below that best characterizes the person or entity subscribing for
the Shares under the terms of the foregoing Subscription Agreement.

     

    
      	
            	
               ̈

            	
              Any
      natural person whose individual net worth, or joint net worth with that
      person’s spouse, at the time of his purchase exceeds US $1,000,000
      exclusive of the value of his or her primary
  residence;

            

    

     

    
      	
            	
               ̈

            	
              Any
      natural person who had an individual income in excess of $200,000 in each
      of the two most recent years or joint income with that person’s spouse in
      excess of $300,000 in each of those years and has a reasonable expectation
      of reaching the same income level in the current
  year;

            

    

     

    
      	
            	
               ̈

            	
              Any
      organization described in Section 501(c)(3) of the Internal Revenue Code,
      a corporation, a Massachusetts or similar business trust or a partnership,
      in each case, not formed for the purpose of this investment, with total
      assets in excess of US $5,000,000;

            

    

     

    
      	
            	
               ̈

            	
              Any
      director, executive officer, or general partner of the issuer of the
      securities being offered or sold, or any director, executive officer, or
      general partner of a general partner of that
  issuer;

            

    

     

    
      	
            	
               ̈

            	
              Any
      trust with total assets in excess of US $5,000,000, not formed for the
      specific purpose of acquiring the securities offered, whose purchase is
      directed by a sophisticated person as described in Rule 506(b)(2)(ii) of
      the Securities Act of 1933;

            

    

     

    
      	
            	
               ̈

            	
              Any
      entity in which all of the equity owners are accredited
      investors;

            

    

     

    
      	
            	
               ̈

            	
              Any
      private business development company as defined in Section 202(a)(22) of
      the Investment Advisers Act of
1940;

            

    

     

    
      	
            	
               ̈

            	
              Any
      Small Business Investment Company licensed by the U.S. Small Business
      Administration under Section 301(c) or (d) of the Small Business
      Investment Act of 1958;

            

    

     

    
      	
            	
               ̈

            	
              Any
      investment company registered under the Investment Company Act of 1940 or
      a business development company as defined in Section 2(a)(48) of that
      Act;

            

    

     

    
      	
            	
               ̈

            	
              Any
      bank as defined in Section 3(a)(2) or a savings and loan association or
      other institution defined in Section 3(a)(5)(A) of the Securities Act of
      1933 acting in either an individual or fiduciary
  capacity;

            

    

     

    
      	
            	
               ̈

            	
              Any
      insurance company as defined in Section 2(13) of the Securities Act of
      1933;

            

    

     

    
      	
            	
               ̈

            	
              Any
      employee benefit plan within the meaning of Title I of the Employee
      Retirement Income Security Act of 1974 whose investment decision is made
      by a fiduciary which is either a bank, savings and loan association,
      insurance company, or registered investment advisor, or whose total assets
      exceed US $5,000,000, or, if a self-directed plan, a plan whose investment
      decisions are made solely by persons who are accredited
      investors;

            

    

     

    
      	
            	
               ̈

            	
              Any
      broker or dealer registered pursuant to Section 15 of the Securities
      Exchange Act of 1934; or

            

    

     

    
      	
            	
               ̈

            	
              Any
      plan established and maintained by a state, its political subdivisions, or
      any agency or instrumentality of a state or its political subdivisions for
      the benefit of its employees, if such plan has total assets in excess of
      $5,000,000.

            

    

     

    
      	
            	
               ̈

            	
              None
      of the above.

            

    

    

    
      
        
          
            
              
                
                  	
                          Name
      of Subscriber:

                        	 
      	 
      
	 
      	 
      	 
      
	
                          Social Security Number: 

                        	 
      	 
      
	 
      	 
      	 
      
	
                          Signature:Exhibit
10.19c

    

    Confidential
material appearing in this document has been omitted and filed separately with
the Securities and Exchange Commission in accordance with Rule 24b-2,
promulgated under the Securities and Exchange Act of 1934, as
amended.  Omitted information has been replaced with
asterisks.

     

    SECOND AMENDMENT
TO

     

    LEASE AGREEMENT FOR A GAMMA
KNIFE UNIT

     

    (PERFEXION
UPGRADE)

     

    This
SECOND AMENDMENT TO LEASE AGREEMENT FOR A GAMMA KNIFE UNIT (this “Second
Amendment”) is dated effective as of May 15, 2009 (the “Effective
Date”)  and is entered into by and between Yale-New Haven Hospital, Inc. a/k/a
Yale-New Haven Hospital, a Connecticut corporation (“YNHH”) and GK Financing, LLC, a
California limited liability company (“GKF”).

    

    Recitals:

    

    A.           On
April 10, 1997 GKF and Yale-New Haven Ambulatory Services Corporation, a
Connecticut corporation (“ASC”), entered into a Lease Agreement For A Gamma
Knife Unit, which was amended pursuant to (i) a certain Addendum dated as of
October 25, 2005 (the “Addendum”); and (ii) a certain Assignment, Assumption And
Amendment of Lease Agreement For A Gamma Knife Unit dated effective as of June
30, 2006 (the “First Amendment”).  The original Lease Agreement, as
amended by the Addendum and the First Amendment, is referred to herein as the
“Lease.”

     

    B.           
Pursuant to the First Amendment, ASC transferred and assigned its interest in
the Lease to its affiliate, YNHH, and YNHH assumed all of ASC’s rights and
obligations thereunder.

     

    C.           YNHH
and GKF desire to further amend the Lease to provide for the replacement and
upgrade of the existing Leksell Gamma Knife, Model 4C (the “Model 4C”) that is
currently being leased by GKF to YNHH pursuant to the Lease, with a Leksell
Gamma Knife Perfexion unit (such Perfexion unit leased hereunder is referred to
as the “Perfexion”), which will be installed at the new Yale-New Haven Cancer
Center to be known as The Smilow Cancer Hospital, located at Park Street and
South Frontage Road (the “New Site”) contemporaneously with the de-installation
of the Model 4C.

     

    Agreement:

    

    NOW, THEREFORE, in
consideration of the mutual covenants and agreements set forth herein, and for
other good and valuable consideration, the receipt and sufficiency of which are
hereby acknowledged, the parties agree as follows:

    

    1.           Defined
Terms.  Unless otherwise defined herein, the capitalized terms
used herein shall have the same meanings set forth in the Lease.

     

    2.           Upgrade
of the Model 4C to the Perfexion.

     

    a.      Subject
to the terms and conditions set forth herein, GKF shall acquire and hold title
to, and install the Perfexion with new cobalt-60 source, at the New Site (the
“Perfexion Upgrade”).  GKF shall use its commercially reasonable
efforts to perform the Perfexion Upgrade either during the fourth quarter of
2009 or the first quarter of 2010, subject to availability of the Perfexion from
the equipment manufacturer, issuance of all regulatory approvals, permits and/or
waivers, and completion of construction of the New Site.  The parties
acknowledge that YNHH may not be able to perform procedures for several weeks
during the Perfexion Upgrade and the deinstallation of the Model
4C.

    
      
         

      

      
        - 1
-

        
          

        

      

      
         

      

    

    

    Exhibit
10.19c

     

    b.      Subject
to Section 2.c below, YNHH shall be solely responsible for the construction and
preparation of the New Site, which construction and preparation shall be
performed by YNHH in the same manner as was performed with respect to the
original Site.  Prior to the Perfexion Upgrade, YNHH shall enter into
a mutually acceptable LGK Agreement with Elekta for the Perfexion.

     

    c.      GKF
shall be responsible for installation costs related to the Perfexion Upgrade,
consisting primarily of rigging costs.

     

    d.      GKF
shall be solely responsible for maintenance and service, personal property
taxes, and the cost of insurance coverage for the Perfexion to the same extent
and at the same levels as required under the Lease, provided that YNHH shall
have no obligation to pay for such costs.

     

    e.      In
connection with the Perfexion Upgrade, YNHH, at YNHH’s sole cost and expense,
shall provide GKF with YNHH personnel (including YNHH physicists) and services
upon reasonable request and as reasonably required by GKF, among other things,
to oversee, supervise and assist with construction and compliance with local,
state and federal regulatory requirements and with nuclear regulatory compliance
issues and the calibration of the Perfexion.

     

    f.      Notwithstanding
the foregoing, the Perfexion Upgrade shall be performed by GKF only after all
necessary and appropriate licenses, permits, approvals, waivers, consents and
authorizations, including, without limitation, the CON or its waiver, and the
proper handling of the cobalt-60 (collectively, the “Permits”), have been
obtained by YNHH at YNHH’s sole cost and expense.  The timing and
procedure for the Perfexion Upgrade shall be as mutually agreed upon between the
parties.

     

    3.           De-Installation
of the Model 4C.  Promptly
following the Perfexion Upgrade, GKF shall de-install, remove and retain all
ownership rights and title to the existing Model 4C.  Notwithstanding
anything to the contrary set forth in the Lease or herein, neither YNHH nor any
of its affiliates shall have any ownership interest in the Model 4C, and YNHH on
behalf of itself and its affiliates hereby waives any ownership interest (or
option to purchase any ownership interest) in the Model 4C.  With
respect to the Deposit * previously deposited with GKF pursuant to Section 6.c
of the Addendum, YNHH hereby grants, assigns and transfers unto GKF all of
YNHH’s right, title and interest in and to the Deposit for the purpose of
reducing the Per Procedure Payments to be paid to GKF by YNHH following the
Perfexion Upgrade pursuant to this Second Amendment.

     

    4.           Extension
of Lease Term.  In consideration of the Perfexion Upgrade, the
Term is hereby extended to the date that is seven (7) years following the First Perfexion Procedure Date (as hereinafter
defined); provided that the
Term may be further extended as set forth in Section 7(a) below.

     

    5.           Compensation.

     

    a.      The parties acknowledge that the compensation payable to
GKF for the Perfexion as set forth in this Second Amendment has been negotiated
by the parties at arm’s length based upon reasonable and jointly derived
assumptions regarding the capacity for clinical services available from the
Perfexion, YNHH’s capabilities in providing high quality radiation oncology
services, market dynamics, GKF’s risk in providing the Equipment, and the
provision to GKF of a reasonable rate of return on its investment in support of
the Equipment.  Based thereon, the Parties believe that the Per
Procedure Payments and Additional Payments, if any, represent fair market value
for the use of the Perfexion, the de-installation and removal of the Model 4C,
the Perfexion Upgrade, marketing support, maintenance and service, personal
property taxes, cost of insurance coverage for the Perfexion, and the other
additional services and costs to be provided or paid for by GKF pursuant to this
Second Amendment, and the transfer of the Deposit to GKF.  YNHH
undertakes no obligation to perform any minimum number of procedures on the
Equipment, and the use of the Equipment for the performance of procedures is
wholly based upon the independent judgment of physicians who order such
procedures to meet the medical needs of their patients.

     

    
      
         

      

      
        - 2
-

        
          

        

      

      
         

      

    

    

    Exhibit
10.19c

     

    b.      Commencing from the first procedure performed using the
Perfexion at the New Site (the “First Perfexion Procedure Date”) and continuing
through the duration of the Term (as extended hereby), YNHH shall pay to GKF on
a monthly basis, the applicable “Per Procedure Payments” (as set forth on
Exhibit “A” attached hereto) multiplied by each and every procedure performed
during the subject month using the Perfexion, irrespective of (i) whether the
procedure is performed by YNHH, ASC, or their respective representatives or
“Affiliates” (as defined in the First Amendment), or any other person or entity;
or (ii) the actual amounts billed or collected, if any, pertaining to such
procedures.  As used herein, a “procedure” shall mean any treatment of
a patient, whether performed on an inpatient or outpatient basis, that involves
stereotactic, external, single fraction, conformal radiation, commonly called
radiosurgery, that may include one or more isocenters during the patient
treatment session, delivered to any site(s) superior to the foramen
magnum.

     

    c.      The Per Procedure Payments shall be payable within
thirty (30) days after the conclusion of each calendar month in which the
applicable procedures were performed.  Throughout the Term and
thereafter until final settlement of all amounts owed to either party under the
Lease, each party shall have the right at reasonable times and upon reasonable
advance notice to inspect, audit and copy the other party’s books and records
which relate to scheduling and billing of, and reimbursement for, Gamma Knife
procedures, the Per Procedure Payments and Additional Payments, and the service,
insurance and property tax expenses associated with the
Perfexion.

     

    d.      In addition to the Per Procedure Payments, YNHH shall
continue to remain obligated to pay GKF any Additional Payments that may become
due from and after the Perfexion Upgrade, which Additional Payments shall be
calculated and paid as set forth in the First Amendment, except
that:

     

    (i)           The incremental Additional Payment of * (as set forth in
the First Amendment) for each procedure performed using the Additional Unit(s)
shall be replaced with the applicable Per Procedure Payment then being paid by
YNHH under this Second Amendment.  For example, if the Per Procedure
Payment then being paid by YNHH is *, then, the incremental Additional Payment
shall be equal to * multiplied by each procedure performed using the Additional
Unit(s) during the corresponding Contract Year (or Shortfall Contract Year, if
applicable), up to an aggregate of * procedures (prorated if the subject
Contract Year is less than 365 days) combined between procedures performed using
the Perfexion and procedures performed using the Additional Unit(s),
irrespective of (1) whether such procedures are performed by YNHH, its
representatives or Affiliates (as defined in the First Amendment), or any other
person or entity; or (2) the actual amounts billed or collected, if any,
pertaining to any such procedures; and

     

    (ii)           “Contract Year” shall mean each successive twelve (12)
month period commencing from the First Perfexion Procedure
Date.

     

    e.      Notwithstanding the foregoing, the compensation payable
to GKF pertaining to procedures performed prior to the First Perfexion Procedure
Date shall continue to be calculated and paid by YNHH in accordance with the
First Amendment.

    
      
         

      

      
        - 3
-

        
          

        

      

      
         

      

    

    

    Exhibit
10.19c

     

    6.           Marketing
Support. The parties obligations with
respect to marketing the Perfexion shall continue in the same manner and with
the same amounts as set forth in Section 2.d of the First
Amendment.

     

    7.           Cobalt
Reload.  Notwithstanding anything
to the contrary contained in the Lease, YNHH shall be solely responsible
for all costs related to any future reloading (but not the initial
loading)  of the Cobalt-60 source for the
Perfexion.  However, if GKF and YNHH mutually agree that GKF will be
solely responsible for the costs of such Cobalt-60 reloading, then, (a) the Term
(as extended by this Second Amendment) shall be further extended for an
additional three (3) years, plus the period of time during which the Perfexion
is not in use due to the Cobalt-60 reloading; and (b) the Per Procedure Payment
during years eight (8), nine (9) and ten (10) of the Term (as extended by this
Second Amendment) shall be at a rate to be mutually negotiated between the
parties, provided that if the
parties cannot reach agreement as to such rates, then, (i) YNHH (and not GKF) shall be solely responsible
for all costs related to any such future reloading, and (ii) the Term (as
extended by this Second Amendment) shall not be further extended.

     

    8.           Purchase
Option Upon Expiration.

     

    a.      Upon the expiration of the Term (as extended hereby),
YNHH shall have the option to purchase GKF’s ownership interest in the Perfexion
(the “Purchase Option”) for a purchase price of * (the “Option Purchase
Price”).  The Option Purchase Price shall be paid in full in cash to
GKF upon the expiration of the Term of the Lease (as extended), upon which GKF
shall transfer, convey and assign to YNHH, free and clear of all encumbrances,
all of GKF’s right, title and interest in and to the Perfexion, on an “as is,
where is” basis with all faults, and without representation or warranty (other
than as to clear title).  If the Purchase Option is exercised, upon
the expiration or termination of the Lease (as extended), it is understood that
GKF shall have no obligation with respect to the removal, relocation,
reinstallation and/or repair of the Perfexion, except as to any obligations to
insure and/or repair the Equipment that arose under the Lease prior to such
expiration or termination.

     

    b.      On or before the date that is twelve (12) months prior
to the expiration of the Term of the Lease (as extended), GKF will provide YNHH
with written notice of such expiration (the “Twelve Month
Notice”).  The Purchase Option may be exercised by YNHH by giving GKF
written notice of such exercise (the “Exercise Notice”), which Exercise Notice
shall be received by GKF not more than sixty (60) days following YNHH’s receipt
of the Twelve Month Notice.  The Twelve Month Notice and the Exercise
Notice may be delivered by hand or sent by certified mail, return receipt
requested to YNHH or GKF, as the case may be, at their respective addresses set
forth below:

     

    
      
        
          
            
              
                
                  	
                          If to
      GKF:

                        	 
      	
                          If to
      YNHH:

                        
	 
      	 
      	 
      
	
                          GK Financing, LLC

                        	 
      	
                          Yale-New
      Haven Hospital, Inc.

                        
	
                          Four Embarcadero Center, Suite
      3700

                        	 
      	
                          20 York Street MSC 2006

                        
	
                          San Francisco,
      CA  94111

                        	 
      	
                          New Haven CT 06504

                        
	
                          Attn:    Mr. Craig K. Tagawa,

                        	 
      	
                          _______________________

                        
	
                           Chief Executive
    Officer.

                        	
                            

                        	
                          Attn:     John
      Skelly

                        

                

              

            

          

        

      

    

     

    9.           Other
provisions.

     

    a.      Upon request by GKF and at GKF’s reasonable expense,
YNHH shall execute and deliver a commercially reasonable form of consent to
sublease, to be attached as Exhibit “B” hereto, if such a document is reasonably
requested by the third party financing company which holds a security interest
in the Perfexion.

    
      
         

      

      
        - 4
-

        
          

        

      

      
         

      

    

     

    Exhibit 10.19c

     

    b.      In each of Section 20(e) (Events of Default by Yale and
Remedies) and Section 21(e) (Events of Default by GKF and Remedies) of the
Lease, the words, “under any present or future statute, law or regulation,”
shall be deleted and replaced with the words, “under any then-current statute,
law or regulation.”

     

    c.      GKF, at its cost and expense, shall cover the tuition
costs for up to ten (10) Perfexion training slots for physicians and physicists
who will be using the Perfexion.  Travel and entertainment associated
with training shall not be the responsibility of GKF.

     

    d.      YNHH and GKF each, on its own behalf, represents and
warrants to the other that neither it nor any of its respective owners has ever
been (a) convicted of a criminal offense related to health care and/or related
to the provision of services paid for by Medicare, Medicaid or another federal
health care program; (b) excluded or debarred from participation in any federal
health care program, including Medicare and Medicaid; or (c) otherwise
sanctioned by the federal government in connection with health care and/or the
provision of services paid for by Medicare, Medicaid or another federal health
care program, including being listed on the General Services Administration’s
Excluded Party Listing System.  YNHH and GKF shall each notify the
other party immediately in the event that the representation contained in the
preceding sentence is or becomes untrue at any time during the Term (as
extended).  The parties shall use best efforts to preserve to
the greatest extent possible their economic arrangement represented by the Lease and this Second
Amendment (as the same may be further amended, the “Amended Lease”) such that
patient access to Gamma Knife treatments will be maintained in the event either party is excluded from Medicare, Medicaid
and/or any other Federal health care programs (an “Exclusion”).  In
furtherance of the foregoing and notwithstanding anything in the Amended Lease
to the contrary, in order to achieve the foregoing objective with minimal
disruption, prior to the effective date of any Exclusion and during the pendency
of any investigation, audit or proceeding with respect to either YNHH or GKF
which could result in an Exclusion of either party, both parties shall
diligently work together in good faith to implement the following, as
applicable, which will become effective upon the effective date of the
Exclusion:

     

    (i)           If
GKF is the subject of the Exclusion, then, GKF’s interests under the Amended
Lease may be assigned to a non-excluded assignee with an equal or greater credit
or financial condition as that of GKF, which assignee shall be approved by YNHH
(whose approval shall not be unreasonably withheld or
delayed).  Without limiting GKF’s selection of an assignee, it is
acknowledged that either American Shared Hospital Services or Elekta
Instruments, Inc. shall be an acceptable assignee provided that the applicable
assignee is not then subject to an Exclusion.  Upon the expiration or
termination of the Exclusion, the Amended Lease may be assigned back to GKF, and
GKF shall provide YNHH with a copy of GKF’s notice of reinstatement, as
applicable.

     

    (ii)           If
YNHH is the subject of the Exclusion, then, the parties shall negotiate in good
faith an increase to the Per Procedure Payments to offset the lost revenues to
GKF resulting from the Exclusion.

     

    10.         Governing
Law.  This Second Amendment shall be governed by and construed
under the laws of the State of Connecticut, without reference to its principles
of conflicts of law.

     

    11.         Counterparts.  This
Second Amendment may be executed in separate counterparts, each of which when so
executed and delivered shall be an original, but all of which counterparts shall
together constitute the same instrument.

     

    12.         Captions.  The
captions and paragraph headings used herein are for convenience only and shall
not be used in construing or interpreting this Second
Amendment.

    
      
         

      

      
        - 5
-

        
          

        

      

      
         

      

    

     

    Exhibit
10.19c

     

    13.         Full
Force and Effect.  Except as amended by this Second Amendment,
all of the terms and provisions of the Lease shall remain unchanged and in full
force and effect and, together with this Second Amendment, represent the entire
agreement of the parties with respect to the Equipment and its use by
YNHH.  Unless the context requires otherwise, with respect to the
Perfexion, all references in the Lease to (i) the “Equipment” shall be deemed to
mean the Perfexion; (ii) “Installation” shall be deemed to refer to the
Perfexion Upgrade; (iii) the “LGK Agreement” shall be deemed to refer to the new
LGK Agreement to be executed by YNHH relating to the Perfexion; (iv) the “Site”
shall be deemed to refer to the New Site; (v) the “Term” shall be deemed to
refer to the Term, as extended pursuant to this Second Amendment.  To
the extent any of the terms of the Lease conflict with the terms of this Second
Amendment, the terms and provisions of this Second Amendment shall prevail and
control.  Where not different or in conflict with the terms and
provisions of this Second Amendment, all applicable terms and provisions set
forth in the Lease are incorporated within this Second Amendment as is if set
forth herein and shall apply with equal force and effect to the
Perfexion.  Nothing set forth in this Second Amendment shall relieve
either party from any or all of its obligations under the Lease with respect to
the Model 4C, including, without limitation, the obligation to pay Lease
Payments, Additional Payments, and the service, insurance and property tax
expenses associated with the Model 4C.

     

    IN WITNESS WHEREOF, the undersigned
have executed this Second Amendment as of the day first written
above.

    

    
      
        
          
            	YALE-NEW
      HAVEN HOSPITAL, INC.	 
      	GK
      FINANCING, LLC
	 
      	 
      	 
      	 
      	 
      
	
                    By:

                  	
                    /s/ John Skelly

                  	 
      	
                    By:

                  	
                    Ernest A. Bates, M.D.

                  
	 
      	 
      	 
      	 
      	 
      
	
                    Its:

                  	
                    VP, Finance

                  	 
      	
                    Its:

                  	
                    CEO, ASHS

                  
	 
      	 
      	 
      	 
      	 
      
	
                    Dated:  

                  	
                    5/15/09

                  	 
      	
                    Dated:  

                  	
                    5/28/09

                  

          

        

      

    

     

    
      
         

      

      
        - 6
-

        
          

        

      

      
         

      

    

     

    Exhibit
10.19c

     

    Exhibit
“A”

    

    PER PROCEDURE
PAYMENTS

    

    
      
        
          	
                  Cumulative Procedures Performed Using the

                  Perfexion

                	 
      	
                  Per Procedure Payment

                
	 
      	 
      	 
      
	
                  *

                	 
      	
                  *

                
	 
      	 
      	 
      
	
                  *

                	 
      	
                  *

                
	 
      	 
      	 
      
	
                  *

                	
                    

                	
                  *

                

        

      

    

    

    Notwithstanding
anything to the contrary set forth herein, (a) for purposes of determining the
applicable Per Procedure Payment, the number of procedures performed using the
Perfexion shall be counted and cumulated from and after the First Perfexion
Procedure Date through the expiration of the Term (as extended hereby); (b)
procedures previously performed using prior models of the Equipment (including
the Model 4C) shall not be counted towards the cumulative total; and (c) there
shall be no retroactive adjustment of the Per Procedure Payment irrespective of
whether the number of procedures performed reaches a lower Per Procedure Payment
level.  For example, if the cumulative number of procedures totals *,
then, the Per Procedure Payment for the first * procedures would remain at * per
procedure while the Per Procedure Payment for the next * procedures (i.e., for procedures
* through *) would be * per procedure.  There are no minimum volume
requirements.

    
      
         

      

      
        - 7
-

        
          

        

      

      
         

      

    

     

    Exhibit 10.19c

     

    Exhibit
“B”

    

    CONSENT TO
SUBLEASE

     

    
      
        
        

      

      
        - 8
-

Source: [{"source": "alea-institute/alea-institute/kl3m-data-edgar-agreements/train-00180-of-00352.parquet"}, [{"source": "alea-institute/alea-institute/kl3m-data-edgar-agreements/train-00180-of-00352.parquet"}]]