Document:

Third Amendment to Loan Agreement

 Exhibit 4.4 

 

 

 2525 Ridgmar Blvd., Suite 237 
 Fort Worth, Texas 76116 
 August 12, 2010 

UROLOGY ASSOCIATES OF NORTH TEXAS, L.L.P. 

UANT VENTURES, L.L.P. 
 Attention:
John M. House, M.D. 
 612 East Lamar Blvd., Suite 700 
 Arlington, Texas 76011 
 Re:    Third Amendment to Loan
Agreement 
 Ladies and Gentlemen: 
 This letter (this “Amendment”) amends the Loan Agreement dated November 7, 2008, among UROLOGY ASSOCIATES OF NORTH
TEXAS, L.L.P. (“UANT”), a Texas registered limited liability partnership, and UANT VENTURES, L.L.P. (“UANT VENTURES”), a Texas registered limited liability
partnership (collectively “Borrowers”); the Guarantors listed on Schedule 1 attached (collectively “Guarantors”); and COMPASS BANK (“Lender”), an Alabama state
banking association, as amended by the First Amendment dated March 31, 2009, and the Second Amendment dated January 31, 2010 (the “Loan Agreement”). Capitalized terms below have the meanings assigned in the Loan Agreement.

 1. New Loans. Borrowers haves requested that Lender make a new advance loan and a new term loan, and Lender has agreed
on the terms set forth in this Amendment. Section 1 of the Loan Agreement is amended to read as follows: 

“(a) Subject to the terms and conditions set forth in the Loan Agreement and the other agreements, instruments, and
documents executed and delivered in connection with the Loan Agreement (collectively the “Loan Documents”), Lender agrees to make the following advance loans: 

(1) Lender has agreed to make a multiple advance loan to UANT in the aggregate original amount of the lesser of
(i) $5,000,000.00, or (ii) the aggregate cost of the equipment acquired (the “First Advance Loan”) on the terms set forth in the Advance Promissory Note attached as Exhibit D to the Loan Agreement (the

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“First Advance Note”) for the purpose of acquiring equipment, hardware, software, and other related equipment for Borrower’s new cancer care facility located at 801 West
Interstate 20, Arlington, Texas 76017, as specified in Part 1 of the Approved Budget (the “Center”). The period for advances on the First Advance Loan has expired, and Borrower has no right to request any further advances on the
First Advance Loan. The First Advance Loan is payable as set forth in the First Advance Note. As used herein, “Approved Budget” means the budget or cost itemization prepared by UANT, attached as Schedule 2 to the Loan
Agreement, itemizing and specifying the anticipated soft costs to be paid using proceeds of the First Advance Note in Part 1 and the Second Advance Note in Part 2. The Approved Budget may not be materially modified without the approval of Borrower
and the prior written consent of Lender. 
 (2) Lender has agreed to make a multiple advance loan to UANT in the
maximum aggregate original amount of the of $5,000,000.00 (the “Second Advance Loan”) on the terms set forth in the Advance Promissory Note attached as Exhibit E to the Loan Agreement (the “Second Advance
Note”), for the purpose of funding soft costs specified in Part 2 of the Approved Budget to be utilized at the Center. The period for advances on the Second Advance Loan has expired, and Borrower has no right to request any further advances
on the Second Advance Loan. The Second Advance Loan is payable as set forth in the Second Advance Note. 
 (3)
Lender has agreed to make an advance loan in the aggregate original amount of $1,000,000.00 to UANT (the “Third Advance Loan”) on the terms set forth in the Advance Promissory Note attached as Exhibit H to the Second
Amendment (the “Third Advance Note”). Subject to the terms and conditions of the Loan Agreement, UANT may request multiple advances on the Third Advance Loan from time to time during the period commencing on the date of this
Amendment and continuing through 11:00 a.m. (Arlington, Texas time) on January 31, 2011 (the “Termination Date”), in an aggregate amount not to exceed $1,000,000.00, solely for the purpose of financing capital expenditures. The
Third Advance Loan is not a revolving line of credit, and UANT may not borrow, repay, and reborrow on a revolving basis under the Third Advance Loan. The Third Advance Loan is payable as set forth in the Third Advance Note. 

(4) Lender agrees to make a new advance loan in the aggregate amount of $4,400,000.00 to UANT (the “Fourth
Advance Loan”) on the terms set forth in the Advance Promissory Note attached as Exhibit J to this Amendment (the “Fourth Advance Note”). Subject to the terms and conditions of the Loan Agreement, UANT may request
multiple advances on the Fourth Advance Loan from time to time during the period commencing on the date of this Amendment and continuing through 11:00 a.m. 

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(Arlington, Texas time) on January 12, 2011 (the “Advance Termination Date”), in an aggregate amount not to exceed $4,400,000.00, solely for the purpose of financing
expansion of a second cancer treatment vault and equipment for UANT’s operations at USMD Hospital at Arlington. The Fourth Advance Loan is not a revolving line of credit, and UANT may not borrow, repay, and reborrow on a revolving basis under
the Fourth Advance Loan. Initially, accrued, unpaid interest on the Fourth Advance Note shall be due and payable monthly. Commencing thirty (30) days after the Advance Termination Date, unless otherwise provided below, the Fourth Advance Loan
shall be payable in equal monthly installments, plus accrued but unpaid interest thereon, in an amount sufficient to fully amortize the balance over the remaining five-year term of the Fourth Advance Note. All sums advanced under the Fourth Advance
Loan, together with all accrued but unpaid interest thereon, shall be due and payable in full on January 12, 2016; provided, however, that notwithstanding any provision of the Fourth Advance Note to the contrary, if Borrower has not caused each
of the Guarantors to provide Lender with current personal financial statements on or before the Advance Termination Date, then the Fourth Advance Loan shall be payable in full on the Advance Termination Date. 

(b) Subject to the terms and conditions set forth in the Loan Agreement and the Loan Documents, Lender agrees to make the
following term loans: 
 (1) Lender has agreed to make a term loan to UANT in the original amount of the lesser
of (i) $3,476,000.00, or (ii) the aggregate amount of the outstanding indebtedness refinanced (the “First Term Loan”) on the terms set forth in the Term Promissory Note attached as Exhibit B to the Loan Agreement
(the “First Term Note”) for the following purposes: (i) approximately $623,000.00 to refinance existing equipment debt from JPMorgan Chase Bank, N.A., (ii) approximately $1,458,000.00 to refinance existing revolving line
of credit from JPMorgan Chase Bank, N.A., and (iii) approximately $1,395,000.00 to refinance two capital leases with JPMorgan Chase Bank, N.A. The advance period on the First Term Loan has expired, and Borrower has no right to request any
further advances on the First Term Loan. The First Term Loan is payable as set forth in the First Term Note. 

(2) Lender has agreed to make a term loan to UANT in the original amount of the lesser of (i) $2,600,000.00, or
(ii) the aggregate amount of the outstanding indebtedness refinanced (the “Second Term Loan”) on the terms set forth in the Term Promissory Note attached as Exhibit C to the Loan Agreement (the “Second Term
Note”), for the purpose of refinancing approximately $2,600,000.00 in existing debt from JPMorgan Chase Bank, N.A. The advance period on the Second Term Loan has expired, and Borrower has no right to request any further advances on the
Second Term Loan. The Second Term Loan is payable as set forth in the Second Term Note. 

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 (3) Lender has agreed to make a term loan to UANT Ventures in the
original amount of the lesser of (i) $3,260,000.00, or (ii) the aggregate amount of the outstanding indebtedness refinanced (the “Third Term Loan”) on the terms set forth in the Term Promissory Note attached as Exhibit
F to the Loan Agreement (the “Third Term Note”), for the purpose of refinancing approximately $3,260,000.00 in existing term debt from JPMorgan Chase Bank, N.A. The advance period on the Third Term Loan has expired, and Borrower
has no right to request any further advances on the Third Term Loan. The Third Term Loan is payable as set forth in the Third Term Note. 
 (4) Lender has agreed to make a term loan to UANT in the original amount of the lesser of (i) $700,000.00, or (ii) the aggregate amount of the outstanding indebtedness under the Revolving Loan
(the “Fourth Term Loan”) on the terms set forth in the Term Promissory Note attached as Exhibit I the Second Amendment (the “Fourth Term Note”), for the purpose of refinancing the outstanding principal
balance of the Revolving Loan. The advance period on the Fourth Term Loan has expired, and Borrower has no right to request any further advances on the Fourth Term Loan. The Fourth Term Loan is payable as set forth in the Fourth Term Note.

 (5) Lender agrees to make a new term loan to UANT Ventures in the amount of $430,000.00 (the “Fifth
Term Loan”) on the terms set forth in the Term Promissory Note attached as Exhibit K to this Amendment (the “Fifth Term Note”). UANT Ventures may request a single advance on the Fifth Term Loan for the purpose of
purchasing 8,082 shares in USMD HOSPITAL AT ARLINGTON, L.P., a Texas limited partnership. The Fifth Term Loan is payable in equal monthly installments, plus accrued but unpaid interest thereon, in an
amount sufficient to fully amortize the balance over the four-year term of the Fifth Term Note. 
 (c)
[Reserved for Revolving Loan.] 
 (d) At the request of Borrowers, Lender may from time to time issue one
or more letters of credit for the account of Borrowers, or either of them, or any affiliates (the “Letters of Credit”). Borrower’s availability on the Revolving Loan will be reduced by the face amount of all unexpired Letters
of Credit. Any fundings under any Letters of Credit will be treated as an advance on the Revolving Loan and will be secured by the Security Documents (as defined below). At no time may the aggregate face amount of all outstanding Letters of Credit
exceed $1,000,000.00. All Letters of Credit 

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shall be for a term of up to one year and shall expire not later than the Termination Date. Borrowers will sign and deliver Lender’s customary forms for the issuance of Letters of Credit.
Borrowers agree to pay to Lender a Letter of Credit fee equal to one percent (1.0%) per annum, calculated on the aggregated stated amount of each Letter of Credit for the stated duration thereof (computed on the basis of actual days elapsed as
if each year consisted of 360 days), due upon issuance. Any renewal or extension of a Letter of Credit will be treated as a new issuance for the purpose of the Letter of Credit fees. 

(e) [Reserved for Fees.] 
 (f) The First Term Loan, the Second Term Loan, the Third Term Loan, the Fourth Term Loan, the Fifth Term Loan, the First Advance Loan, the Second Advance Loan, the Third Advance Loan, the Fourth Advance
Loan, all other loans now or hereafter made by Lender to Borrowers, or either of them, and any renewals or extensions of or substitutions for those loans, will be referred to collectively as the “Loans.” The First Term Note, the
Second Term Note, the Third Term Note, the Fourth Term Note, the Fifth Term Note, the First Advance Note, the Second Advance Note, the Third Advance Note, the Fourth Advance Note, all other promissory notes now or hereafter payable by Borrowers, or
either of them, to Lender, and any renewals or extensions of or substitutions for those notes, will be referred to collectively as the “Notes.” “ 

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 2. Guarantors and Guaranty Limits. (a) In connection with the new loans,
Borrower and Lender have agreed to modify the liability limits under the Guaranties. Subsection (b) of Section 2 of the Loan Agreement is amended to read as follows: 

“(b) Payment of the Notes owed by each of the Borrowers will be guaranteed by the other Borrower pursuant to
Unlimited Guaranties dated November 7, 2008, executed by Borrowers, respectively, in favor of Lender; and payment of the Notes will also be contingently guaranteed by each of the Guarantors pursuant to Contingent Guaranties dated
November 7, 2008, and March 31, 2009, executed by each of the Guarantors in favor of Lender. The Guaranties now or hereafter signed by Borrowers and Guarantors, and all replacements for those Guaranties, as amended, shall be collectively
called the “Guaranties.” The liability of the Guarantors under the Guaranties shall only be triggered if there is an Event of Default, which is not cured on or before the end of any notice, cure, or grace period required
under the Loan Agreement. Once triggered, the liability of each of the Guarantors shall be limited to the amounts stated in Schedule 1 to this Amendment, and the Guaranties shall remain valid and subsisting, even if the Event of Default is
later cured, until otherwise agreed in writing by Lender. So long as there is no existing Event of Default, Lender will consider Borrowers’ written request to release one or more of the Guarantors, who have transferred their ownership interest
in Borrower, so long as (1) Borrowers propose a replacement guarantor reasonably acceptable to Lender, and that replacement guarantor signs and delivers a limited guaranty in Proper Form, or (2) Borrowers propose the increase of the
liability limits of one or more of the Guarantors to replace the released Guarantors, and the affected Guarantors sign and deliver an amendment in Proper Form evidencing such increase. Any release of a Guarantor, replacement of a Guarantor, or
increase of the Guarantors’ liability limits is subject to appropriate credit approval by Lender.” 
 (b) Within
thirty (30) days of the date of this Amendment, Borrowers shall cause each of the Guarantors to sign and deliver to Lender a Third Ratification and Modification of Contingent Guaranties in Proper Form. 

3. Reporting Requirements. (a) Subsection (a) of Section 8 of the Loan Agreement is hereby amended to read as
follows: 
 “(a) As soon as available, and on or before October 15 of each year, annual financial
statements for Borrowers on a consolidated and consolidating basis, consisting of at least a balance sheet, an income statement, a statement of cash flows, and a statement of changes in owners’ equity, including footnotes thereto, and with
contingent liabilities described in the footnotes, audited by an independent certified public accountant acceptable to Lender and certified by an authorized officer of Borrowers (i) as being true and correct in all material aspects to the best
of his knowledge, (ii) as fairly reporting the financial condition of Borrowers as of the close of the fiscal year and the results of their operations for the year, and (iii) as having been prepared in accordance with Accounting
Principles;” 

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 (b) Subsection (b) of Section 8 of the Loan Agreement is hereby deleted.

 4. Conditions Precedent. The obligation of Lender to enter into this Amendment is subject to Borrowers’
satisfaction, in Lender’s sole discretion, of the following conditions precedent: 
 (a) Borrowers shall be in material
compliance with the conditions set forth in Subsection (a) of Section 4 of the Loan Agreement as of the date of this Amendment, and all representations and warranties set forth in Section 5 of the Loan Agreement must be true as of the
date of this Amendment. 
 (b) the negotiation, execution, and delivery of Loan Documents in Proper Form, including, but not
limited to, the following: 
  

	 	(i)	this Amendment; 

  

	 	(ii)	the Fourth Advance Note; 

  

	 	(iii)	the Fifth Term Note; and 

  

	 	(iv)	Borrowing Resolutions. 

 (c)
there shall not have occurred a material adverse change in the business, assets, liabilities (actual and contingent), operations, or financial condition of Borrowers or in the facts and information regarding such entities as represented to date.

 5. Confirmations. (a) As security for the Notes, Borrowers previously executed the Security Documents. Borrowers
ratify and confirm the Security Documents, acknowledge that they are valid, subsisting, and binding, and agree that the Security Documents secure payment of the Notes and the Loans. 

(b) Borrowers hereby represent to Lender that all representations and warranties set forth in Section 5 of the Loan Agreement are
true and correct as of the date of execution of this Amendment; and that Borrowers are in compliance as of the date of execution of this Amendment with all covenants set forth in Section 6 of the Loan Agreement, all financial covenants set
forth in Section 7 of the Loan Agreement, and all reporting requirements set forth in Section 8 of the Loan Agreement. 

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 6. Validity and Defaults. The Loan Agreement, as amended, remains in full force
and effect. Borrowers acknowledge that the Loan Agreement, the Notes, the Security Documents, the Guaranties, and the other Loan Documents are valid, subsisting, and binding upon Borrowers and Guarantors; no uncured breaches or defaults exist under
the Loan Agreement, as amended; and no event has occurred or circumstance exists which, with the passing of time or giving of notice, will constitute a default or breach under the Loan Agreement, as amended. Borrowers and Guarantors ratify the Loan
Agreement, as amended. 
 7. Counterparts. This Amendment and the related Loan Documents may be executed in counterparts,
and Lender is authorized to attach the signature pages from the counterparts to copies for Lender and Borrowers and filing counterparts. At Lender’s option, this Amendment and the related Loan Documents may also be executed by Borrowers and
Guarantors in remote locations with signature pages faxed or scanned and e-mailed to Lender. Borrowers agree that the faxed and scanned signatures are binding upon Borrowers and Guarantors, and Borrowers further agree to promptly deliver the
original signatures for this Amendment and the related Loan Documents by overnight mail or expedited delivery. It will be an Event of Default if Borrowers or Guarantors fail to promptly deliver all required original signatures. 

8. Captions. Captions are for convenience only and should not be used in interpreting this Amendment. 

9. Final Agreement. (a) In connection with the Loans, Borrowers and Lender have executed and delivered this Amendment, the
Loan Agreement, and the Loan Documents (collectively the “Written Loan Agreement”). 
 (b) It is the intention
of Borrowers and Lender that this paragraph be incorporated by reference into each of the Loan Documents. Borrowers and Lender each warrant and represent that their entire agreement with respect to the Loans is contained within the Written Loan
Agreement, and that no agreements or promises have been made by, or exist by or among, Borrowers and Lender that are not reflected in the Written Loan Agreement. 

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 (c) THE LOAN AGREEMENT, AS AMENDED, REPRESENTS 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 UNWRITTEN AGREEMENTS BETWEEN THE PARTIES. 
 If the foregoing correctly sets forth your understanding of our agreement, please sign and return one copy of this letter. 

 

			
	Yours very truly,
	
	COMPASS BANK
		
	By:	 	  

		 	 Lisa Gunter,

		 	 Senior Vice President

  

			
	Accepted and agreed to
	this      day of August, 2010:
	
	BORROWERS:
	
	UROLOGY ASSOCIATES OF NORTH TEXAS, L.L.P.
		
	By:	 	  

		 	 John M. House, M.D.,

		 	 Authorized Partner

	
	UANT VENTURES, L.L.P.
		
	By:	 	  

		 	 John M. House, M.D.,

		 	 Authorized Partner

 UROLOGY ASSOCIATES OF NORTH
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 Exhibits and Schedules 
 Exhibit J - Fourth Advance Note 
 Exhibit K - Fifth Term Note 

Schedule 1 - Guarantors 

 Schedule 1 to 
 Third Amendment to Loan Agreement 
 Guarantors and Limits 

GUARANTORS:  
  

									
	 	  	Ownership	 	 	Liability Amount*	 
	 Aaron M. Amos MD
	  	 	2.44	% 	 	$	243,506.00	  
	 Ali R. Shirvani MD
	  	 	2.44	% 	 	$	243,506.00	  
	 Andrew Craig Sambell MD
	  	 	2.44	% 	 	$	243,506.00	  
	 Barney T. Maddox MD
	  	 	2.44	% 	 	$	243,506.00	  
	 Christopher M. Pace MD
	  	 	2.44	% 	 	$	243,506.00	  
	 David L. Shepherd MD
	  	 	2.44	% 	 	$	243,506.00	  
	 Delbert C. Rudy MD
	  	 	2.44	% 	 	$	243,506.00	  
	 Diane C. West MD
	  	 	2.44	% 	 	$	243,506.00	  
	 Edward Paul Kaplan MD
	  	 	2.44	% 	 	$	243,506.00	  
	 Frank H. Moore III MD
	  	 	2.44	% 	 	$	243,506.00	  
	 Gordon Stewart Brody MD
	  	 	2.44	% 	 	$	243,506.00	  
	 Harrison Mitchell Abrahams MD
	  	 	2.44	% 	 	$	243,506.00	  
	 Ira N. Hollander MD
	  	 	2.44	% 	 	$	243,506.00	  
	 James C. Vestal MD
	  	 	2.44	% 	 	$	243,506.00	  
	 James Daniel Johnson MD
	  	 	2.44	% 	 	$	243,506.00	  
	 James G. Saalfield MD
	  	 	2.44	% 	 	$	243,506.00	  
	 Jeff L. Pugach MD
	  	 	2.44	% 	 	$	243,506.00	  
	 Jeffrey Charles Applewhite MD
	  	 	2.44	% 	 	$	243,506.00	  
	 John M. House MD
	  	 	2.44	% 	 	$	243,506.00	  
	 John W. Jaderlund MD
	  	 	2.44	% 	 	$	243,506.00	  
	 Justin T. Lee MD
	  	 	2.44	% 	 	$	243,506.00	  
	 Keith A. Waguespack MD
	  	 	2.11	% 	 	$	211,040.00	  
	 Kenneth I. Licker MD
	  	 	2.44	% 	 	$	243,506.00	  
	 Kevin D. Diamond MD
	  	 	2.44	% 	 	$	243,506.00	  
	 Kirk J. Pinto MD
	  	 	2.44	% 	 	$	243,506.00	  
	 Lawrence J. Alter MD
	  	 	2.44	% 	 	$	243,506.00	  
	 Marie-Blanche N. Tchetgen MD
	  	 	2.44	% 	 	$	243,506.00	  
	 Mark A. McCurdy MD
	  	 	2.44	% 	 	$	243,506.00	  
	 Mark A. Norris MD
	  	 	2.44	% 	 	$	243,506.00	  
	 Michael B. Gruber MD
	  	 	2.44	% 	 	$	243,506.00	  
	 Michael Patrick Collini MD
	  	 	2.44	% 	 	$	243,506.00	  
	 Patrick R. Frey MD, FACS
	  	 	2.44	% 	 	$	243,506.00	  
	 Paul C. Chan MD
	  	 	2.44	% 	 	$	243,506.00	  
	 Richard R. Scriven MD
	  	 	2.44	% 	 	$	243,506.00	  
	 Robert A. Dowling MD
	  	 	2.44	% 	 	$	243,506.00	  

									
	 Scott A. Thurman MD
	  	 	2.11	% 	 	$	211,040.00	  
	 Sherry Alexis Gordon
	  	 	1.79	% 	 	$	178,571.00	  
	 Thomas C. Truelson MD
	  	 	2.44	% 	 	$	243,506.00	  
	 Tracy L. Cannon Smith
	  	 	1.79	% 	 	$	178,571.00	  
	 Vernon Gary Price MD
	  	 	2.44	% 	 	$	243,506.00	  
	 Wade L. Lowry MD
	  	 	2.44	% 	 	$	243,506.00	  
	 Weber W. Chuang MD
	  	 	2.11	% 	 	$	211,040.00	  

  

	*	LIMITS: 

 The liability of the
Guarantors under the Guaranties shall only be triggered if there is an Event of Default, which is not cured on or before the end of any notice, cure, or grace period required under the Loan Agreement. Once triggered, the liability of each of the
Guarantors shall be limited to the Liability Amount stated above, plus all attorneys fees and collection costs for enforcement of the Guaranty against the respective Guarantor; and the Guaranties shall remain valid and subsisting, even if the Event
of Default is later cured, until otherwise agreed in writing by Lender.Unlimited Guaranty

 Exhibit 4.5 

 

 

 UNLIMITED GUARANTY 
 This Unlimited Guaranty (this “Guaranty”) is entered into effective November 7, 2008, by UANT VENTURES, L.L.P. (“Guarantor”), a Texas registered
limited liability partnership, for the benefit of COMPASS BANK (“Lender”), an Alabama state banking association. For valuable consideration, Guarantor absolutely and unconditionally guarantees and
promises to pay to Lender or its order, in legal tender of the United States of America, the Indebtedness (as defined below) of UROLOGY ASSOCIATES OF NORTH TEXAS, L.L.P.
(“Borrower”), a Texas registered limited liability partnership, to Lender on the terms and conditions set forth in this Guaranty. Under this Guaranty, the liability of Guarantor is unlimited and the obligations of Guarantor are
continuing. 
 1. DEFINITIONS. The following words have the meanings assigned below when used in this Guaranty: 

(a) “Indebtedness” means any and all of Borrower’s liabilities, obligations, debts, and indebtedness to Lender, now
existing or hereinafter incurred or created, together with all other liabilities, costs, and expenses for which Borrower is responsible under the Loan Agreement, under any Loan Documents, including, without limitation, the obligations evidenced by
the Notes, and all other loans, advances, interest, costs, attorneys fees, debts, overdraft indebtedness, credit card indebtedness, lease obligations, other obligations, and liabilities of Borrower, any present or future judgments against Borrower,
and all renewals, extensions, modifications, substitutions, and rearrangements of the foregoing; and whether any such Indebtedness is voluntarily or involuntarily incurred, due or not due, absolute or contingent, direct or indirect, liquidated or
unliquidated, determined or undetermined; whether Borrower may be liable individually or jointly with others, or primarily or secondarily, or as debtor, maker, comaker, drawer, endorser, guarantor, or surety; whether such Indebtedness arises by
note, draft, acceptance, guaranty, endorsement, letter of credit, assignment, overdraft, indemnity agreement, or otherwise; whether recovery on the Indebtedness may be or may become barred or unenforceable against Borrower for any reason whatsoever;
and whether the Indebtedness arises from transactions which may be voidable on account of infancy, insanity, ultra vires, or otherwise. 
 (b) “Loan Agreement” means the Loan Agreement of even date, executed by Borrower and Guarantor, as co-borrowers, and Lender, as amended. 

(c) “Loan Documents” means the Loan Agreement, the Notes, and all Loan Documents (as defined in the Loan Agreement), and
includes, without limitation, all promissory notes, credit agreements, loan agreements, guaranties, security agreements, mortgages, deeds of trust, and all other instruments, agreements, and documents, whether now or hereafter existing, executed in
connection with the Indebtedness. 
 (d) “Notes” has the meaning assigned in the Loan Agreement and includes
all renewals, extensions, or substitutions for any of those notes. 

 2. NATURE OF GUARANTY. This is a guaranty of payment and not of collection. Guarantor’s
liability under this Guaranty shall be open and continuous for so long as this Guaranty remains in force. Guarantor intends to guarantee at all times the performance and prompt payment when due, whether at maturity or earlier by reason of
acceleration or otherwise, of all Indebtedness. Accordingly, no payments made upon the Indebtedness will discharge or diminish the continuing liability of Guarantor in connection with any remaining portions of the Indebtedness or any of the
Indebtedness which subsequently arises or is thereafter incurred or contracted. 
 3. DURATION OF GUARANTY. This Guaranty will
take effect when received by Lender without the necessity of any acceptance by Lender, or any notice to Guarantor or to Borrower, and will continue in full force until all Indebtedness incurred, committed, or contracted before receipt by Lender of
any notice of revocation shall have been fully and finally paid and satisfied and all other obligations of Guarantor under this Guaranty shall have been performed in full. If Guarantor elects to revoke this Guaranty, Guarantor may only do so in
writing. Guarantor’s written notice of revocation must be delivered to Lender at the address of Lender listed below or such other place as Lender may designate in writing. This Guaranty may be revoked only with respect to Indebtedness incurred
or contracted by Borrower, or acquired or committed to by Lender after the date on which written notice of revocation is actually received by Lender. No notice of revocation hereof shall be effective as to any Indebtedness: (a) existing at the
date of receipt of such notice; (b) incurred or contracted by Borrower, or acquired or committed to by Lender, prior to receipt of such notice; (c) now existing or hereafter created pursuant to or evidenced by the Loan Agreement or a
commitment in existence prior to receipt of such notice under which Borrower is or may become obligated to Lender; or (d) renewals, extensions, consolidations, substitutions, and refinancings of the foregoing. Guarantor waives notice of
revocation given by any other guarantor of the Indebtedness. If Guarantor is an individual, this Guaranty shall bind the estate of Guarantor as to Indebtedness created both before and after the death or incapacity of Guarantor, regardless of
Lender’s actual notice of Guarantor’s death or incapacity. Release of any other guarantor of the Indebtedness, or termination or revocation of any other guaranty of the Indebtedness, shall not affect the liability of Guarantor under this
Guaranty. Notwithstanding any provision to the contrary, it shall be an Event of Default under the Loan Agreement if Guarantor revokes or disputes the validity of or liability under this Guaranty or any of the Loan Documents. It is anticipated that
fluctuations may occur in the aggregate amount of Indebtedness covered by this Guaranty, and it is specifically acknowledged and agreed by Guarantor that reductions in the amount of Indebtedness, even to zero dollars shall not constitute a
termination of this Guaranty, unless and until all Indebtedness has been fully and finally paid and satisfied, Lender has no further commitment to loan funds to Borrower, and all other obligations of Guarantor under this Guaranty have been performed
in full. 
 4. AUTHORIZATION TO LENDER. Guarantor authorizes Lender, either before or after any revocation hereof, without
notice or demand and without lessening or otherwise affecting Guarantor’s liability under this Guaranty, from time to time: (a) prior to revocation as set forth above, to make one or more additional secured or unsecured loans to Borrower,
to lease equipment or other goods to Borrower, or otherwise to extend additional credit to Borrower; (b) to alter, compromise, renew, extend, accelerate, or otherwise change one or more times the time for payment or other terms of the
Indebtedness or any part of the Indebtedness, including increases and decreases of the rate of interest on the Indebtedness; extensions may be repeated and may be for longer than the original loan term; (c) to take and hold security for the
payment of this Guaranty or the Indebtedness, and exchange, enforce, waive, fail or decide not to perfect, and release any such security, with or without the substitution of new collateral; (d) to release, substitute, agree not to sue, or deal
with any one or more of Borrower’s sureties, endorsers, or other guarantors on any terms or in any manner Lender may choose; (e) to determine how, when, and what application of payments

  
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and credits shall be made on the Indebtedness; (f) to apply such security and direct the order or manner of sale thereof, including without limitation, any non-judicial sale permitted by the
terms of the controlling security agreement or deed of trust, as Lender in its discretion may determine; (g) to sell, transfer, assign, or grant participations in all or any part of the Indebtedness; and (h) to assign or transfer this
Guaranty in whole or in part. 
 5. REPRESENTATIONS, WARRANTIES, AND COVENANTS. Guarantor represents, warrants, and covenants to
Lender that (a) no representations or agreements of any kind have been made to Guarantor which would limit or qualify in any way the terms of this Guaranty; (b) this Guaranty is executed at Borrower’s request and not at the request of
Lender; (c) Guarantor has not and will not, without the prior written consent of Lender, sell, lease, assign, encumber, hypothecate, transfer, or otherwise dispose of all or substantially all of Guarantor’s assets; (d) Lender has made
no representation to Guarantor as to the creditworthiness of Borrower; (e) Guarantor will provide to Lender financial statements and other financial information regarding Guarantor as Lender may request from time to time, in form and detail
acceptable to Lender, and all such financial information heretofore and hereafter provided to Lender is and shall be true and correct in all material respects and fairly presents the financial condition of Guarantor as of the dates thereof, and no
material adverse change has occurred in the financial condition of Guarantor since the date of the most current financial statements provided to Lender; (f) Guarantor is familiar with the current financial condition of Borrower and has
established adequate means of obtaining from Borrower on a continuing basis information regarding Borrower’s future financial condition and is not relying on Lender to provide such information to Guarantor; (g) as of the date hereof, and
after giving effect to this Guaranty, (i) Guarantor is and will be solvent, (ii) the fair saleable value of Guarantor’s assets exceeds and will continue to exceed Guarantor’s liabilities (both fixed and contingent),
(iii) Guarantor is and will continue to be able to pay Guarantor’s debts as they mature, and (iv) if Guarantor is not an individual, Guarantor has and will continue to have sufficient capital to carry on its business and all
businesses in which it is about to engage; and (h) Guarantor has the power and authority to execute, deliver, and perform this Guaranty and the other Loan Documents executed by Guarantor. Guarantor agrees to keep adequately informed from such
means of any facts, events, or circumstances which might in any way affect Guarantor’s risks under this Guaranty, and Guarantor further agrees that Lender shall have no obligation to disclose to Guarantor any information or documents acquired
by Lender in the course of its relationship with Borrower. 
 6. WAIVERS. (a) General Waivers. Guarantor waives any
right to require Lender (i) to continue lending money or to extend other credit to Borrower; (ii) to make any presentment, protest, demand, or notice of any kind, including notice of any nonpayment of the Indebtedness or of any nonpayment
related to any collateral, or notice of any action or non-action on the part of Borrower, Lender, any surety, endorser, or other guarantor in connection with the Indebtedness or in connection with the creation of new or additional loans or
obligations; (iii) to notify Guarantor of any change in the manner, place, time, or terms of payment of any of the Indebtedness (including, without limitation, any renewal, extension, or other modification of any of the Indebtedness); or
(iv) to notify Guarantor of any change in the interest rate accruing on any of the Indebtedness (including, without limitation, any periodic change in such interest rate that occurs because such Indebtedness accrues interest at a variable rate
which may fluctuate from time to time). Should Lender seek to enforce the obligations of Guarantor hereunder, Guarantor waives any right to require Lender to first (i) resort for payment or to proceed directly or at once against any person,
including Borrower or any other guarantor of the Indebtedness; (ii) to proceed directly against, marshal, enforce, or exhaust any collateral held by Lender from Borrower, Guarantor, any other guarantor, or any other person; or (iii) to
pursue any other remedy within Lender’s power. 

  
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 (b) Waiver of Defenses. Guarantor waives all rights of Guarantor under, or the
requirements imposed by, Chapter 34 of the Texas Business and Commerce Code. Guarantor also waives any and all rights or defenses arising by reason of (i) any election of remedies by Lender which destroys or otherwise adversely affects
Guarantor’s subrogation rights or Guarantor’s rights to proceed against Borrower for reimbursement, including without limitation, any loss of rights Guarantor may suffer by reason of any law limiting, qualifying, or discharging the
Indebtedness; (ii) any disability or other defense of Borrower, of any other guarantor, or of any other person, or by reason of the cessation of Borrower’s liability from any cause whatsoever, other than payment in full in legal tender of
the Indebtedness; (iii) any right to claim discharge of the Indebtedness on the basis of unjustified impairment of any collateral for the Indebtedness; or (iv) any defenses given to guarantors at law or in equity other than actual payment
and performance of the Indebtedness. This Guaranty shall continue to be effective or be reinstated, as the case may be, if at any time any payment of all or any part of the Indebtedness is rescinded or must otherwise be returned by Lender upon the
insolvency, bankruptcy, or reorganization of Borrower, Guarantor, any other guarantor of all or any part of the Indebtedness, or otherwise, all as though such payment had not been made. 

(c) Waiver of Claims. Guarantor further waives and agrees not to assert or claim at any time any deductions to the amount
guaranteed under this Guaranty for any claim of set off, counterclaim, counter demand, recoupment, or similar right, whether such claim, demand, or right may be asserted by Borrower, Guarantor, or both. In addition to any other waivers, agreements,
and covenants of Guarantor set forth herein, Guarantor hereby further waives and releases all claims, causes of action, defenses, and offsets for any act or omission of Lender, its directors, officers, employees, representatives, or agents in
connection with Lender’s administration of the Indebtedness, except for Lender’s willful misconduct and gross negligence. 
 (d) Waiver of Subrogation. Notwithstanding any provision in this Guaranty to the contrary, Guarantor hereby waives and releases (i) any and all rights of subrogation, reimbursement,
indemnification, or contribution which it may have after payment in full or in part of the Indebtedness against others liable on any of the Indebtedness, (ii) any and all rights to be subrogated to the rights of Lender in any collateral or
security for any of the Indebtedness after payment in full or in part of the Indebtedness, and (iii) any and all other rights and claims of Guarantor against Borrower or any third party as a result of Guarantor’s payment of any
Indebtedness. 
 (e) Waivers Binding. Guarantor warrants and agrees that each of the waivers set forth above is made with
Guarantor’s full knowledge of its significance and consequences and that, under the circumstances, the waivers are reasonable and not contrary to public policy or law. If any such waiver is determined to be contrary to any applicable law or
public policy, such waiver shall be effective only to the extent permitted by law or public policy. 
 7. PAYMENT BY GUARANTOR.
In the event of a default in the payment or performance of all or any part of the Indebtedness when such Indebtedness becomes due, whether by its terms, by acceleration, or otherwise, Guarantor shall, without notice or demand, promptly pay the
amount due thereon to Lender, in lawful money of the United States. The exercise by Lender of any right or remedy under this Guaranty or under any other agreement or instrument, at law, in equity or otherwise, shall not preclude concurrent or
subsequent exercise of any other right or remedy. Whenever Guarantor pays any sum which is or may become due under this Guaranty, written notice must be delivered to Lender contemporaneously with such payment. In the absence of such notice to Lender
by Guarantor, any sum received by Lender on account of the Indebtedness shall be conclusively deemed paid by Borrower. 

  
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 8. MISCELLANEOUS PROVISIONS. (a) Amendments. This Guaranty, together with any
Loan Documents, constitutes the entire understanding and agreement of the parties as to the matters set forth in this Guaranty and supersedes all prior written and oral agreements and understandings, if any, regarding same. No alteration of or
amendment to this Guaranty shall be effective unless given in writing and signed by the party or parties sought to be charged or bound by the alteration or amendment. 
 (b) Applicable Law. This Guaranty has been delivered to Lender and is performable in Tarrant County, Texas. Courts within the State of Texas have jurisdiction over any dispute arising under or
pertaining to this Guaranty, and venue for such dispute shall be in Tarrant County, Texas. THIS GUARANTY SHALL BE GOVERNED BY AND CONSTRUED IN ACCORDANCE WITH THE LAWS OF THE STATE OF TEXAS AND APPLICABLE FEDERAL LAWS. 

(c) Costs and Expenses. Guarantor shall also pay on demand by Lender all costs and expenses, including, without limitation, all
reasonable attorneys fees, incurred by Lender in connection with the enforcement or collection of this Guaranty and with the collection or sale of any collateral securing this Guaranty. This covenant shall survive the payment of the Indebtedness.

 (d) Notice. All notices required to be given by either party to the other under this Guaranty shall be in writing and,
except for revocation notices by Guarantor, shall be effective when actually delivered or when deposited with a nationally recognized overnight courier, or when deposited in the United States mail, first class postage prepaid, addressed to the party
to whom the notice is to be given at the address shown below or to such other addresses as either party may designate to the other in writing. All revocation notices by Guarantor shall be in writing and shall be effective only upon delivery to
Lender as provided above in the section titled “DURATION OF GUARANTY.” For notice purposes, Guarantor agrees to keep Lender informed at all times of Guarantor’s current address. In the event that Guarantor is entitled to receive any
notice under the Uniform Commercial Code, as it exists in the state governing any such notice, of the sale or other disposition of any collateral securing all or any part of the Indebtedness or this Guaranty, reasonable notice shall be deemed given
when such notice is given pursuant to the terms of this Subsection ten (10) days prior to the date any public sale, or after which any private sale, of any such collateral is to be held. 

(e) Interpretation. In all cases where there is more than one Borrower, then all words used in this Guaranty in the
singular shall be deemed to have been used in the plural where the context and construction so require; and where there is more than one Borrower named in this Guaranty, the word “Borrower” shall mean all and any one or more of them. This
Guaranty is for the benefit of Lender, its successors and assigns. This Guaranty is binding upon Guarantor and Guarantors’s heirs, executors, administrators, personal representatives, and successors. Caption headings in this Guaranty are for
convenience purposes only and are not to be used to interpret or define the provisions of this Guaranty. If a court of competent jurisdiction finds any provision of this Guaranty to be invalid or unenforceable as to any person or circumstance, such
finding shall not render that provision invalid or unenforceable as to any other persons or circumstances, and all provisions of this Guaranty in all other respects shall remain valid and enforceable. If any one or more of Borrower or Guarantor are
corporations, limited liability companies, or partnerships, it is not necessary for Lender to inquire into the powers of Borrower or Guarantor or of the officers, directors, managers, members, partners, or agents acting or purporting to act on their
behalf, and any Indebtedness made or created in reliance upon the professed exercise of such powers shall be guaranteed under this Guaranty. 

  
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 (f) Waiver. Lender shall not be deemed to have waived any rights under this Guaranty
unless such waiver is given in writing and signed by Lender, and then only in the specific instance and for the purpose given. No delay or omission on the part of Lender in exercising any right shall operate as a waiver of such right or any other
right. A waiver by Lender of a provision of this Guaranty shall not prejudice or constitute a waiver of Lender’s right to thereafter demand strict compliance with that provision or any other provision of this Guaranty. No prior waiver by
Lender, nor any course of dealing between Lender and Guarantor, shall constitute a waiver of any of Lender’s rights or of any of Guarantor’s obligations as to any future transactions. Whenever the consent of Lender is required under this
Guaranty, the granting of such consent by Lender in any instance shall not constitute continuing consent to subsequent instances where such consent is required, and in all cases such consent may be granted or withheld in the sole discretion of
Lender. 
 9. NOTICE OF FINAL AGREEMENT. (a) In connection with the Indebtedness, Borrower, Guarantor, and Lender have
executed and delivered the Loan Agreement and the Loan Documents (collectively the “Written Loan Agreement”). 

(b) It is the intention of Borrower, Guarantor, and Lender that this paragraph be incorporated by reference into each of the Loan
Documents. Guarantor and Lender each warrant and represent that their entire agreement with respect to the Indebtedness is contained within the Written Loan Agreement, and that no agreements or promises have been made by, or exist by or among,
Borrower, Guarantor, and Lender that are not reflected in the Written Loan Agreement. 
 (c) THE WRITTEN LOAN AGREEMENT
REPRESENTS 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 UNWRITTEN AGREEMENTS BETWEEN THE PARTIES. 

  
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 GUARANTOR ACKNOWLEDGES HAVING READ ALL THE PROVISIONS OF THIS GUARANTY AND AGREES TO ITS TERMS. IN ADDITION,
GUARANTOR UNDERSTANDS THAT THIS GUARANTY IS EFFECTIVE UPON GUARANTOR’S EXECUTION AND DELIVERY OF THIS GUARANTY TO LENDER AND THAT THE GUARANTY WILL CONTINUE UNTIL TERMINATED IN THE MANNER SET FORTH IN THE SECTION TITLED “DURATION OF
GUARANTY”. NO FORMAL ACCEPTANCE BY LENDER IS NECESSARY TO MAKE THIS GUARANTY EFFECTIVE. 
 Signed effective the date stated
above. 
  

							
		 		 	GUARANTOR:
			
	Guarantor’s address:	 		 	UANT VENTURES, L.L.P.
	612 East Lamar Blvd., Suite 700	 		 		 	
	Arlington, Texas 76011	 		 		 	
				
		 		 	By:	 	  

		 		 		 	 John M. House, M.D.,

		 		 		 	 Authorized Partner

Lender’s address: 
 COMPASS
BANK 
 Attn: Josh Burleson 
 701 Highlander Blvd., Suite 520 
 Arlington, Texas 76015 

  
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