Document:

exv10w33

Exhibit
10.33

FIRST LOAN MODIFICATION AGREEMENT

     This First Loan Modification Agreement (this “Loan Modification Agreement”) is entered into as
of March 29, 2011, by and between (i) SILICON VALLEY BANK, a California corporation with a loan
production office located at 275 Grove Street, Suite 2-200, Newton, Massachusetts 02466 (“Bank”),
and (ii) NXSTAGE MEDICAL, INC., a Delaware corporation (“NxStage”), EIR MEDICAL, INC., a
Massachusetts corporation (“EIR”), MEDISYSTEMS CORPORATION, a Washington corporation
(“Medisystems”), each with offices located at 439 South Union Street, 5th Floor,
Lawrence, Massachusetts 01843, and MEDISYSTEMS SERVICES CORPORATION, a Nevada corporation,
(“Services”), with offices located at 101 Convention Center Drive, Suite 850, Las Vegas, Nevada
89101 (NxStage, EIR, Medisystems and Services are individually and collectively, jointly and
severally, the “Borrower”).

1. DESCRIPTION OF EXISTING INDEBTEDNESS AND OBLIGATIONS. Among other indebtedness and
obligations which may be owing by Borrower to Bank, Borrower is indebted to Bank pursuant to a loan
arrangement dated as of March 10, 2010, evidenced by, among other documents, a certain Loan and
Security Agreement dated as of March 10, 2010, between Borrower and Bank (as amended, the “Loan
Agreement”). Capitalized terms used but not otherwise defined herein shall have the same meaning
as in the Loan Agreement.

2. DESCRIPTION OF COLLATERAL. Repayment of the Obligations is secured by the Collateral as
described in the Loan Agreement and in certain Intellectual Property Security Agreements, each
dated as of March 10, 2010 executed by each Borrower in favor of Bank (collectively, the “IP
Agreements”, and together with any other collateral security granted to Bank, the “Security
Documents”).

Hereinafter, the Security Documents, together with all other documents evidencing or securing the
Obligations shall be referred to as the “Existing Loan Documents”.

3. DESCRIPTION OF CHANGE IN TERMS.

	 	A.	 	Modifications to Loan Agreement.

	 	1	 	The Loan Agreement shall be amended by deleting the following
text appearing as Section 2.3(a)(i) thereof:

“(i) Advances. Subject to Section 2.3(b), the principal amount
outstanding under the Revolving Line shall accrue interest at floating per
annum rate equal to two percentage points (2.00%) above the Prime Rate,
which interest shall be payable monthly, in arrears, in accordance with
Section 2.3(f) below.”

and inserting in lieu thereof the following:

“(i) Advances. Subject to Section 2.3(b), effective as of January
1, 2011 and thereafter, the principal amount outstanding under the Revolving
Line shall accrue interest at floating per annum rate equal to one-half of
one percentage point (0.50%) above the Prime Rate, which interest shall be
payable monthly, in arrears, in accordance with Section 2.3(f) below.”

	 	2	 	The Loan Agreement shall be amended by deleting the following
text appearing as Section 2.4(d) thereof:

“(d) Unused Revolving Line Facility Fee. A fee (the “Unused
Revolving Line Facility Fee”), payable monthly, in arrears, on a calendar
year basis, in an amount equal to one-half of one percent (0.50%) per annum
of the average unused portion of the Revolving Line, as determined by Bank.
The unused portion of the Revolving Line, for the purposes of this
calculation, shall not include amounts reserved for products provided in
connection with Cash Management Services, FX Forward Contracts or Letters of
Credit. Borrower shall not be entitled to any credit, rebate or repayment
of any Unused Revolving Line Facility Fee previously earned by Bank pursuant
to this Section

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notwithstanding any termination of the Agreement or the suspension or
termination of Bank’s obligation to make loans and advances hereunder,
including during any Streamline Period; and”

and inserting in lieu thereof the following:

“(d) Unused Revolving Line Facility Fee. A fee (the “Unused
Revolving Line Facility Fee”), payable monthly, in arrears, commencing with
the monthly period ended January 1, 2011, and each monthly period ending
thereafter, on a calendar year basis, in an amount equal to one-quarter of
one percent (0.25%) per annum of the average unused portion of the Revolving
Line, as determined by Bank. The unused portion of the Revolving Line, for
the purposes of this calculation, shall not include amounts reserved for
products provided in connection with Cash Management Services, FX Forward
Contracts or Letters of Credit. Borrower shall not be entitled to any
credit, rebate or repayment of any Unused Revolving Line Facility Fee
previously earned by Bank pursuant to this Section notwithstanding any
termination of the Agreement or the suspension or termination of Bank’s
obligation to make loans and advances hereunder, including during any
Streamline Period; and”

	 	3	 	The Loan Agreement shall be amended by deleting the following
text appearing as Section 6.2(a)(iii) thereof:

“(iii) as soon as available, and in any event within thirty (30) days after
the end of each month, monthly unaudited consolidated and consolidating
financial statements;”

and inserting in lieu thereof the following:

“(iii) for any month in which, as of any date of measurement in such month,
Borrower’s unrestricted cash at Bank plus the unused Availability
Amount (as determined by Bank with reference to the most recent Borrowing
Base Certificate of Borrower) is less than or equal to $20,000,000, then as
soon as available, and in any event within thirty (30) days after the end of
each such month, monthly unaudited consolidated and consolidating financial
statements;”

	 	4	 	The Loan Agreement shall be amended by deleting the following
text from Section 10 thereof:

	 	 	 	 	 	 	 

	 

	 	“If to Bank:
	 	 	 	Silicon Valley Bank
	 

	 	 	 	 	 	One Newton Executive Park,
	 

	 	 	 	 	 	Suite 200
	 

	 	 	 	 	 	2221 Washington Street
	 

	 	 	 	 	 	Newton, Massachusetts 02462
	 

	 	 	 	 	 	Attn: Mr. Ryan Ravenscroft
	 

	 	 	 	 	 	Fax: (617) 527-0177
	 

	 	 	 	 	 	Email: rravenscroft@svb.com”
	 
	 	 	 	 	 	 
	 	 	and inserting in lieu thereof the following:
	 
	 	 	 	 	 	 
	 

	 	“If to Bank:
	 	 	 	Silicon Valley Bank
	 

	 	 	 	 	 	275 Grove Street, Suite 2-200
	 

	 	 	 	 	 	Newton, Massachusetts 02466
	 

	 	 	 	 	 	Attn: Mr. Michael Quinn
	 

	 	 	 	 	 	Fax: (617) 527-0177
	 

	 	 	 	 	 	Email: mquinn@svb.com”

4. FEES. Borrower shall pay to Bank the “Anniversary Fee” described in Section 2.4 of the
Loan Agreement, as and when due and payable in accordance therewith. Borrower shall also reimburse
Bank for all legal fees and expenses incurred in connection with this amendment to the Existing
Loan Documents.

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5. CONSISTENT CHANGES. The Existing Loan Documents are hereby amended wherever necessary
to reflect the changes described above.

6. RATIFICATION OF LOAN DOCUMENTS. Borrower hereby ratifies, confirms, and reaffirms all
terms and conditions of the Loan Agreement (as modified hereby), each other Existing Loan Document
and all security or other collateral granted to the Bank, and confirms that the indebtedness
secured thereby includes, without limitation, the Obligations. Nothing in this Loan Modification
Agreement shall constitute a satisfaction of the Obligations. It is the intention of Bank and
Borrower to retain as liable parties all makers of Existing Loan Documents, unless the party is
expressly released by Bank in writing. No maker will be released by virtue of this Loan
Modification Agreement.

7. JURISDICTION/VENUE. Section 11 of the Loan Agreement is hereby incorporated by
reference in its entirety.

8. COUNTERSIGNATURE. This Loan Modification Agreement shall become effective only when it
shall have been executed by Borrower and Bank.

[The remainder of this page is intentionally left blank]

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     IN WITNESS WHEREOF, the parties hereto have caused this Loan Modification Agreement to be
executed as a sealed instrument under the laws of the Commonwealth of Massachusetts as of the date
first above written.

BORROWER:

	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 

	NXSTAGE MEDICAL, INC.	 	 	 	EIR MEDICAL, INC.	 	 
	 
	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	By
	 	 	 	/s/ Robert S. Brown 	 	 	 	By	 	 	 	/s/ Robert S. Brown  	 	 
	 	 	 	 	 	 	 	 	 	 	 
	Name:	 	Robert S. Brown  	 	 	 	Name:	 	Robert S. Brown  	 	 
	Title:	 	Treasurer,
SVP & CFO	 	 	 	Title:	 	Treasurer 	 	 

	 
	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	MEDISYSTEMS CORPORATION	 	 	 	MEDISYSTEMS SERVICES CORPORATION	 	 
	 
	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	By
	 	 	 	/s/ Robert S. Brown 	 	 	 	By	 	 	 	/s/ Robert S. Brown 	 	 
	 	 	 	 	 	 	 	 	 	 	 
	Name:	 	Robert S. Brown 	 	 	 	Name:	 	Robert S. Brown 	 	 
	Title:	 	Treasurer 	 	 	 	Title:	 	Treasurer 	 	 
	 
	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	BANK:	 	 	 	 	 	 	 	 	 	 	 	 
	 
	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	SILICON VALLEY BANK	 	 	 	 	 	 	 	 	 	 
	 
	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	By
	 	 	 	/s/ Michael Quinn 	 	 	 	 	 	 	 	 	 	 
	 	 	 	 	 	 	 	 	 	 	 	 	 
	Name:	 	Michael Quinn 	 	 	 	 	 	 	 	 	 	 
	Title:	 	VP 	 	 	 	 	 	 	 	 	 	 

4exv10w1

Exhibit 10.1

CONFIDENTIAL TREATMENT REQUESTED UNDER

17 C.F.R. SECTIONS 200.80(b)(4), 200.83 AND 230.24b-2.

[*****] INDICATES OMITTED MATERIAL THAT IS THE

SUBJECT OF A CONFIDENTIAL TREATMENT REQUEST

FILED SEPARATELY WITH THE COMMISSION.

THE OMITTED MATERIAL HAS BEEN FILED

SEPARATELY WITH THE COMMISSION.

Amendment Two to Customer Care and Billing Services Agreement Between

Clearwire US LLC

and

Amdocs Software Systems Limited

This amendment two to Customer Care and Billing Systems Agreement (“Amendment Two”) is entered into
this seventh (7th) day of March, 2011 (“Amendment Two Effective Date”) by and between
Clearwire US LLC (“Clearwire”) and Amdocs Software Systems Limited (“Amdocs”), each of whom is
referred to as a “Party” and collectively as the “Parties”. Capitalized terms that are not defined
in this Amendment Two shall have the same definition as used in the CCBS Agreement (defined below)
or Amendment One (defined below) as applicable.

RECITALS

Whereas, Clearwire and Amdocs entered into a Customer Care and Billing Systems Agreement dated
March 31, 2009 (as amended from time to time through the date hereof, the “CCBS Agreement”); and

Whereas, the Parties entered into that certain Letter Agreement for the Payment of Amounts Due and
the Amendment of Agreements, dated December 21, 2010 (“Amendment One”) which modified and amended
certain terms and conditions of the CCBS Agreement, including without limitation certain schedules
to the CCBS Agreement; and

Whereas, pursuant to Amendment One, on December 30, 2010, Clearwire paid to Amdocs the [*****]
Initial Payment which amount, together with the [*****] Subsequent Payment due on March 15, 2011,
represents complete, full, final payment and satisfaction of certain outstanding invoices attached
as Annex A to Amendment One; and

Whereas, the parties hereto desire to further amend and/or modify the CCBS Agreement;

Now, wherefore, for good and valuable consideration, the receipt and sufficiency of which is hereby
acknowledged, the Parties agree to the following provisions of this Amendment Two which provisions
amend and modify the CCBS Agreement, including without limitation, certain schedules to the CCBS
Agreement:

1. The opening paragraph under Chapter B.1 “Clearwire BSS Managed Services Fees” contained in
Schedule D of the CCBS Agreement is deleted in its entirety, and is hereby replaced by a new
opening paragraph of Chapter B.1 which provides as follows

Amdocs will charge Clearwire for Amdocs’ services as described in Chapter C to
Schedule A of the Agreement and in Schedule B to the Agreement (as amended by
Additional Service Orders “Order #2 (Additional Services)” dated November 9,
2009; “Order #10 (Additional Services)” dated November 17, 2009; and “Order #12
(Additional Services)” dated November 9, 2009) (the “Managed Services”) , except
for the services where a separate charge has been expressly stated by the Parties
in this Schedule D (e.g., Chapters B.2 and C) and Additional Services (for which
the charges shall be set forth in the applicable Additional Services Order) as
described in this Chapter B.1 or as otherwise provided in this Chapter B to
Schedule D.

2. Section 8.1 of Chapter B.1 “Clearwire BSS Managed Services Fees” contained in Schedule D of the
CCBS Agreement is deleted in its entirety, and is hereby replaced by new Section 8.1 of Chapter B.1
which provides as follows:

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8.1 Subject to the cap described in Section 9 below, starting January 1, 2011 the
total monthly managed services fee for the Manage Services under the Agreement
(including, without limitation, the reference table management services described
in Schedule B and the Additional Service Orders amending Schedule B, i.e.,
Additional Service Orders “Order #2 (Additional Services)” dated November 9,
2009; “Order #10 (Additional Services)” dated November 17, 2009; “Order #12
(Additional Services)” dated November 9, 2009) will be the greater of (a) a flat
fee of [*****] per month (the “Reduced Managed Service Fee”) or (b) the
combination of Monthly Subscriber Fees as specified in the following tables
(Table 8.1(a) through Table 8.1(d) inclusive), provided however that Table 8.1(a)
and Table 8.1(b) shall only be applicable to retail subscribers that Clearwire
activates and manages on the CCBS-based “CES 7.5” retail billing and customer
care system, and not to any retail subscribers activated and managed on any other
retail billing and customer care system.

3. Section 3 of Additional Services Order #2 dated November 9, 2009 under the CCBS Agreement is
deleted in its entirety and is hereby replaced by new Section 3 which provides as follows:

3. Cost: No additional fees or charges shall be assessed for the Additional
Services described in Section 2 above (to be considered an amendment to Schedule
D of the Agreement for the period up to and through December 31, 2011). If
Clearwire is no longer using the services stated in Additional Services Order #2
as of January 1, 2012, then Clearwire shall promptly notify Amdocs in writing
that it is, in its sole discretion, either (a) terminating this ASO #2 at no cost
or penalty to Clearwire, or (b) electing to proceed with this ASO #2 in which
case the parties shall modify this ASO #2 to reflect any newly defined terms, as
applicable. The costs for Additional Services under this Additional Services
Order are included in the Reduced Managed Services Fee described in Section 8.1
of Chapter B.1 contained in Schedule D of the Agreement.

4. Section 5 of Additional Services Order #10 dated November 17, 2009 under the CCBS Agreement is
deleted in its entirety and is hereby replaced by new Section 5 which provides as follows:

5. Cost: No additional fees or charges shall be assessed for the Additional
Services described in Section 2 and Section 3 above (to be considered an
amendment to Schedule D of the Agreement for the duration of this Additional
Services Order). The costs for Additional Services under this Additional
Services Order are included in the Reduced Managed Services Fee described in
Section 8.1 of Chapter B.1 contained in Schedule D of the Agreement.

5. Section 3 of Additional Services Order #12 dated November 9, 2009 under the CCBS Agreement is
deleted in its entirety and is hereby replaced by new Section 3 which provides as follows:

3. Cost: No additional fees or charges shall be assessed for the Additional
Services described in Section 2 above (to be considered an amendment to Schedule
D of the Agreement for the period up to and through December 31, 2011). ). If
Clearwire is no longer using the services stated in Additional Services Order #12
as of January 1, 2012, then Clearwire shall promptly notify Amdocs in writing
that it is, in its sole discretion, either (a) terminating this ASO #12 at no
cost or penalty to Clearwire, or (b) electing to proceed with this ASO #12 in
which case the parties shall modify this ASO #12 to reflect any newly defined
terms, as applicable. The costs for Additional Services under this Additional
Services Order are included in the Reduced Managed Services Fee described in
Section 8.1 of Chapter B.1 contained in Schedule D of the Agreement.

6. Section 6.2 of Schedule D of the CCBS Agreement is deleted in its entirety, and is hereby
replaced by new Section 6.2 set forth below, provided, however ,notwithstanding anything contained
herein, the CCBS Agreement or any other applicable agreement this new Section 6.2 shall be deemed
null and void to the extent that Clearwire does not make the Subsequent Payment in accordance with
Amendment One:

2

 

6.2. Clearwire shall earn a credit of up to [*****] each calendar year during the
Term of the Agreement (including any extension of the Term) in the form of
development credits (the “Restructured Development Credits”) which may be applied
toward Services, provided or performed by Amdocs under the Agreement. The amount
of Restructured Development Credits earned each calendar year shall be (i) based
on, an hour by hour basis, the aggregate number of development hours and testing
hours paid for by Clearwire during the applicable calendar year, subject to
achieving the minimum thresholds as set forth below in Table 6.2 and (ii) to the
extent earned, apportioned between development credits earned (which may only be
used for development services), and testing credits earned (which may only be
used for testing services), based on the proportion of development hours and
testing hours paid for by Clearwire during such calendar year to the total
development and testing credits available during such calendar year as set forth
in Table 6.2 (e.g., [*****] development hours and [*****] testing hours paid for
by Clearwire during a calendar year will earn Clearwire [*****] development
credits and [*****] testing credits for such calendar year ) . For the purposes
of this Section 6.2, a “development hour” means any activity performed in the
scoping, analysis, design, coding, or project management of a development
delivery into production and “testing hour” means any activity performed in
testing a project. Any Restructured Development Credits earned by Clearwire
during a respective calendar year may be used by Clearwire through, and
including, the end of the second quarter of the immediately succeeding calendar
year during which such Restructured Development Credits were earned by Clearwire
(such period, the “Restructured Development Credit Use Period”). Any Restructured
Development Credits not used by Clearwire during the applicable Restructured
Development Credit Use Period shall permanently expire and may not be used by
Clearwire in any way under the Agreement or any other applicable agreement.

TABLE 6.2

	 	 	 
	Annual Development And Testing	 	Annual Development And Testing
	Hours Paid	 	Hours Credited
	[*****]

	 	[*****]
	[*****]

	 	[*****]

7. For the avoidance of doubt, the Parties acknowledge and agree that fees from Schedule D, Chapter
B.2, sections 15-18 only apply if those systems or services are in production. Unless and until
Clearwire places those modules or services (e.g. APRM, APS, ASMM, etc.) described in sections 15-18
in production, the fees do not apply and Amdocs cannot invoice Clearwire for such modules or
services. If Clearwire places those modules or services in production, then the fees will apply,
and such fees would not be subject to the [*****] Reduced Managed Service Fee cap.

8. Additional Services Order #14 dated January 4, 2010 under the CCBS Agreement is hereby cancelled
in its entirety effective December 31, 2010, including without limitation any ongoing maintenance
or service fees of any kind. Clearwire shall not be charged, and shall not pay, any cancellation
fees or other charges in connection with the cancellation of Additional Services Order #14, and
Amdocs waives any and all rights to invoice or collect any such fees or charges from Clearwire.
Clearwire is relieved from any obligation to pay any maintenance or other services and Amdocs
waives any and all rights to invoice or collect any such fees or charges from Clearwire.

9. Additional Services Order #16 dated November 1, 2009 under the CCBS Agreement is hereby
cancelled in its entirety effective December 31, 2010, including without limitation any ongoing
maintenance or service fees of any kind. Clearwire shall not be charged, and shall not pay, any
cancellation fees or other charges in connection with the cancellation of Additional Services Order
#16, and Amdocs waives any and all rights to invoice or collect any such fees or charges from
Clearwire. Clearwire is relieved from any obligation to pay any maintenance or other services and
Amdocs waives any and all rights to invoice or collect any such fees

3

 

or charges from Clearwire. Notwithstanding the foregoing, Clearwire may continue to use any and
all deliverables under Additional Services Order #16 subsequent to such cancellation.

10. All other terms and conditions in the CCBS Agreement not amended or modified herein, will
remain in effect and are not affected by this Amendment Two. In the event of a conflict between
the provisions of this Amendment Two and the provisions of the CCBS Agreement prior to the date
hereof , the provisions of this Amendment Two shall govern. Except as expressly provided in this
Amendment Two, nothing herein shall operate as, or be deemed to constitute, a waiver of any rights
or benefits by any Party, and each Party retains all of its rights under the CCBS Agreement as
amended.

Each Party has caused this Amendment Two to be executed by its authorized representative as of the
Amendment Two Effective Date.

	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 

	CLEARWIRE US LLC	 	 	 	AMDOCS SOFTWARE SYSTEMS LIMITED
	 
	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	By:

	 	/s/ William Morrow	 	 	 	By:	 	/s/ Philip Butter	 	 	 	 	 	 
	 

	 	 
	 	 	 	 	 	 	 	 	 	 	 	 
	Name:

	 	William Morrow	 	 	 	Name:	 	Philip Butter	 	 	 	 	 	 
	 

	 	 
	 	 	 	 	 	 	 	 	 	 	 	 
	Title:

	 	CEO	 	 	 	Title:	 	Assistant Secretary	 	 	 	 	 	 
	 

	 	 
	 	 	 	 	 	 	 	 	 	 	 	 

4

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