Document:

Agreement, dated December 29, 2006, to renew Advisory Agreement

 Exhibit 10.3 
  
 December 29, 2006 
  
 Mr. Alan B. Miller 
 President 
 UHS of Delaware, Inc. 
 367 South Gulph Road 
 King of Prussia, PA 19406 
  
 Dear Alan:

  
 The Board of Trustees of Universal Health Realty Income
Trust, at their December 1, 2006 meeting, authorized the renewal of the current Advisory Agreement between the Trust and UHS of Delaware, Inc. (“Agreement”) upon the same terms and conditions. 
  
 This letter constitutes the Trust’s offer to renew the Agreement, until
December 31, 2007, upon the same terms and conditions. Please acknowledge UHS of Delaware’s acceptance of this offer by signing in the space provided below and returning one copy of this letter to me. 
  

	
	 Sincerely,

	
	Charles F. Boyle
	Vice President and Chief Financial Officer

  

	cc:	Warren J. Nimetz, Esq. 

 Cheryl K. Ramagano 
  
 Agreed to and Accepted: 
  

			
	 UHS OF DELAWARE, INC.

		
	By:	 	 /s/ Alan B. Miller

		 	Alan B. Miller, PresidentAmendment No.1 to the Master Lease Document

 Exhibit 10.29 
  
 AMENDMENT NO. 1 TO MASTER LEASE 
  
 THIS AMENDMENT (the “Amendment”), dated as of the 24th day of April, 2006, between Universal Health
Realty Income Trust (“Lessor”), a Maryland real estate investment trust having an address at 367 South Gulph Road, King of Prussia, Pennsylvania 19406, and the certain wholly-owned subsidiaries of Universal Health Services, Inc.
(“ UHS “) set forth on Exhibit A hereto (each a “ Lessee, “ and together, the “ Lessees “), a Delaware corporation having an address at 367 South Gulph Road, King of Prussia, Pennsylvania 19406.

  
 WITNESSETH 
  
 WHEREAS, that certain Master Lease Document, General
Terms and Conditions, by and among Lessor and certain wholly-owned subsidiaries of UHS, dated December 24, 1986, as the same heretofore has been amended (said Lease, as amended, is hereinafter referred to as the “ Lease “),
governs certain leases between Lessor and Lessees; 
  
 WHEREAS, certain premises (each a “Leased Property” and together, the “Leased Properties”), as therein described, are now leased and demised by Lessor to the Lessees subject to the terms of
the Master Lease; 
  
 WHEREAS, UHS has requested
that Lessor modify certain provisions of the Master Lease and Lessor has agreed to do so subject to and in accordance with the terms and provisions of this Amendment; 
  
 WHEREAS, the parties hereto mutually desire to amend the Master Lease as herein set forth, and are
executing and delivering this Amendment for such purpose; 
  
 NOW, THEREFORE, the parties hereto, in consideration of the terms and conditions herein contained and other good and valuable consideration, the receipt and sufficiency of which are hereby acknowledged, hereby amend the
Master Lease as follows. 
  
 1. Amendment. Notwithstanding
anything to the contrary contained in the Master Lease, effective on and after April 24, 2006, Article XXXVIII of the Master Lease is hereby amended by adding the following sub-section: 
  
 “38.4 Change of Control. 
  
 a) A “Change of Control” shall occur in the event that, directly or
indirectly: 
  
 i. Lessor shall consolidate with, or merge with
and into, any individual, firm, corporation or other entity (each a “Person”) (other than a wholly-owned subsidiary of Lessor in a transaction the principal purpose of which is to change the state of organization of Lessor); 
  
 ii. any Person shall consolidate with Lessor, or merge with and into Lessor
and Lessor shall be the continuing or surviving entity of such consolidation or merger and, in connection with such merger, all or part of the shares of beneficial interest of Lessor be changed into or exchanged for stock or other securities of any
other Person (or Lessor); 
  
 iii. any Person or
“group” other than Lessor or an affiliate of Lessor becomes the “beneficial owner” (as defined in Rule 13d-3 under the Securities Exchange Act of 1934, as amended) directly or indirectly of securities of Lessor representing more
than 20% of the voting power of Lessor’s securities in one more transactions (including by way of merger, reorganization or consolidation); or 
  
 iv. there is a change in the composition of the Board of Trustees of Lessor as a result of which the majority of the Trustees are not Incumbent Trustees.
“Incumbent Trustees” shall mean Trustees who either (i) are Trustees of Lessor as of the date hereof, or (ii) are elected, or nominated for election, to the Board or Trustees of Lessor with the affirmative votes of at least a
majority of the Incumbent Trustees at the time of such election or nomination. 
  
 b) Lessor agrees to provide Notice to Lessee not less than 60 days prior to any proposed Change of Control. 
  
 c) In the event of a Change of Control, Lessee shall have the option exercisable at any time within 12 months of the Change of Control to purchase the
Leased Property, upon not less than one month’s Notice, at the Fair Market Value Purchase Price of the Leased Property as of the date Lessee exercises its option to purchase the Leased Property.” 
  
 2. Brokerage. Lessee and Lessor represent that neither has dealt with
a broker or finder in connection with this Amendment. Lessee or Lessor, as applicable, shall indemnify, defend (with legal counsel reasonably acceptable to the other) and save harmless the other from and against all liability, claims, suits,
demands, judgments, costs, interest and expenses (including, without limitation, reasonable counsel fees and disbursements incurred in the defense thereof) to which the other may be subject or suffer by reason of any claim made for any commission,
reimbursement or other compensation arising from or as a result of a claim by any broker or finder that it dealt with such party in connection with the consummation of this Amendment. 
  
 3. Full Force and Effect. The Lease, as hereby amended, shall remain in full force and effect according to its terms
and conditions. 

 4. Defined Terms. All capitalized terms used but not defined in this Amendment shall, for
the purposes hereof, have the respective meanings ascribed to such terms in the Lease. 
  
 5. Successors and Assigns. The covenants, agreements, terms and conditions contained in this Amendment shall bind and inure to the benefit of the parties hereto and their respective successors and assigns.

  
 6. Amendments in Writing. This Amendment may not be
changed orally, but only by a writing signed by the party against whom enforcement thereof is sought. 
  
 7. Effectiveness. This Amendment shall not be binding in any respect upon Lessor until a counterpart hereof is executed by Lessor and delivered to
Lessee. 
  
 IN WITNESS WHEREOF, the parties
hereto have duly executed this Amendment as of the day and year first above written. 
  

			
	UNIVERSAL HEALTH REALTY INCOME
TRUST
		
	By:	 	 /s/ Cheryl K. Ramagano

	Name:	 	Cheryl K. Ramagano
	Title:	 	Vice President

  

			
	UNIVERSAL HEALTH SERVICES OF RANCHO
SPRINGS, INC.
		
	By:	 	 /s/ Steve Filton

	Name:	 	Steve Filton
	Title:	 	Vice President

  

			
	THE BRIDGEWAY, INC.
		
	By:	 	 /s/ Steve Filton

	Name:	 	Steve Filton
	Title:	 	Vice President

  

			
	WELLINGTON REGIONAL MEDICAL CENTER
INCORPORATED
		
	By:	 	 /s/ Steve Filton

	Name:	 	Steve Filton
	Title:	 	Vice President

  

			
	MCALLEN HOSPITALS, L.P.
		
	By:	 	South Texas Heart, Inc., General Partner
		
	By:	 	 /s/ Steve Filton

	Name:	 	Steve Filton
	Title:	 	Vice President

 Exhibit A 
  
 Lessees 
  
 UNIVERSAL HEALTH SERVICES OF RANCHO SPRINGS, INC. 
  
 THE BRIDGEWAY, INC. 
  
 WELLINGTON REGIONAL MEDICAL CENTER INCORPORATED 
  
 MCALLEN HOSPITALS, L.PAmendment No. 3 to Receivables Purchase Agreement

 Exhibit 4.7(c) 
 AMENDMENT NO. 3 TO RECEIVABLES PURCHASE AGREEMENT 
 AMENDMENT dated as of August 3, 2006 to the
RECEIVABLES PURCHASE AGREEMENT dated as of December 17, 2003 (as amended, the “Agreement”) among EQUISTAR RECEIVABLES II, LLC, a Delaware limited liability company (the “Seller”), EQUISTAR CHEMICALS, LP, a
Delaware limited partnership (the “Servicer”), the PURCHASERS from time to time party thereto, CITICORP USA, INC., as co-asset agent and administrative agent for the Purchasers (the “Agent”), CREDIT SUISSE FIRST
BOSTON, and JPMORGAN CHASE BANK, N.A. and WACHOVIA BANK, NATIONAL ASSOCIATION as co-documentations agents, and BANK OF AMERICA, N.A., as co-asset agent. 
 The parties hereto agree as follows: 
 SECTION 1. Defined Terms. Unless otherwise specifically defined
herein, each term used herein which is defined in the Agreement has the meaning assigned to such term in the Agreement. 
 SECTION 2.
Amendments. (a) The following defined term in Section 1.1 of the Agreement is amended to read in its entirety as follows: 
 “Receivables Pool” means at any time the aggregation of all then outstanding Receivables sold or otherwise transferred by the Originators to the Seller. 
 (b) The reference to “Receivables” in the definition of Credit and Collection Policy is changed to “Pool Receivables”. 
 SECTION 3. Limited Waiver and Consent. The Purchasers hereby: 
 (a) waive the provisions of Section 5.3(o) of the Agreement to the extent necessary to permit execution and delivery of Amendment No. 1 to the Receivables Sale Agreement in substantially in the form of
Exhibit A hereto, and authorize and direct the Agent to consent thereto; 
 (b) authorize and consent to the Agent’s consent to
instruments tendered to it for its consent by the parties to the Receivables Sale Agreement as contemplated by said Amendment No. 1 so long as the Agent shall have received evidence satisfactory to it in its sole discretion that the Receivables
to be thereby excluded from “Seller Receivables” (as defined in the Receivables Sale Agreement) would not be Eligible Receivables at such time under the Agreement; and 

 (c) authorize and consent to Agent’s execution and delivery of such further documents and
instruments as may be requested of it and it may deem reasonably necessary or appropriate to confirm such exclusion of Receivables from Seller Receivables. 
 SECTION 4. Governing Law. This Amendment shall be governed by and construed in accordance with the laws of the State of New York. 
 SECTION 5. Counterparts. This Amendment may be signed in any number of counterparts, each of which shall be an original, with the same effect as if the signatures thereto and hereto were upon the same
instrument. 
 SECTION 6. Effectiveness. This Amendment shall become effective on the first date on which the Agent shall have
received counterparts hereof signed by each of the Required Purchasers, the Seller and the Servicer (or, in the case of any party as to which an executed counterpart shall not have been received, receipt by the Agent in form satisfactory to it of
telegraphic, telex or other written confirmation from such party of execution of a counterpart hereof by such party). 
  

 2 

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

					
	CITICORP USA, INC., as Agent
		
	By:	 	 /s/ David Jaffe

	Name:	 	 David Jaffe

	Title:	 	 Director Vice President

  

					
	 EQUISTAR RECEIVABLES II, LLC, as Seller

		
	By:	 	 /s/ Charles L. Hall

	Name:	 	 Charles L. Hall

	Title:	 	 Vice President and Controller

  

					
	 EQUISTAR CHEMICALS, LP, as Servicer

		
	By:	 	 /s/ Charles L. Hall

	Name:	 	 Charles L. Hall

	Title:	 	 Vice President, Controller and Chief Accounting Officer

  

					
	 ALLIED IRISH BANKS P.L.C.

		
	By:	 	 /s/ John F. Farrace

	 Name:
	 	 John F. Farrace

	Title:	 	 Co-Head Leverage Finance

		
	By:	 	 /s/ Derrick Lynch

	 Name:
	 	 Derrick Lynch

	Title:	 	 Vice President

  

					
	 Amsouth Bank

		
	By:	 	 /s/ Bruce Kasper

	Name:	 	 Bruce Kasper

	Title:	 	 Attorney in Fact

  

					
	 Bank of America, N.A.

		
	By:	 	 /s/ Stephen King

	Name:	 	 Stephen King

	Title:	 	 Vice President

  

					
	 Calyon New York Branch

		
	By:	 	 /s/ Page Dillehunt

	 Name:
	 	Page Dillehunt
	Title:	 	Managing Director
		
	By:	 	 /s/ Michael Willis

	 Name:
	 	Michael Willis
	Title:	 	Director

  

 F-1 

					
	 Commerzbank AG, New York and Grand Cayman Branches.

		
	By:	 	 /s/ Andrew Campbell

	Name:	 	Andrew Campbell
	Title:	 	Senior Vice President
		
	By:	 	 /s/Andrew Kjoller

	Name:	 	Andrew Kjoller
	Title:	 	Vice President

  

					
	 GENERAL ELECTRIC CAPITAL CORPORATION

		
	By:	 	 /s/ Dwayne L. Coker

	Name:	 	Dwayne L. Coker
	Title:	 	Duly Authorized Signatory

  

					
	 GMAC COMMERCIAL FINANCE LLC

		
	By:	 	 /s/ Robert F. McIntyre

	Name:	 	Robert F. McIntyre
	Title:	 	Director

  

					
	 JPMorgan Chase Bank, N.A..

		
	By:	 	 /s/ Stacey Haimes

	Name:	 	Stacey L. Haimes
	Title:	 	Vice President

  

 F-2 

					
	 LASALLE BUSINESS CREDIT, LLC

		
	By:	 	 /s/ Jason T. Sylvester

	Name:	 	Jason T. Sylvester
	Title:	 	Vice President

  

					
	 NATIONAL CITY BUSINESS CREDIT, INC. (formerly known as National City Commercial Finance, Inc.)

		
	By:	 	 /s/ Anthony Alexander

	Name:	 	Anthony Alexander
	Title:	 	Vice President

  

					
	 RZB Finance LLC

		
	By:	 	 /s/ John A. Valiska

	Name:	 	John A. Valiska
	Title:	 	First Vice President
		
	By:	 	 /s/ Christoph Hoedl

	Name:	 	Christoph Hoedl
	Title:	 	Group Vice President

  

					
	 UBS LOAN FINANCE LLC

		
	By:	 	 /s/ Richard L. Tavrow

	Name:	 	Richard L. Tavrow
	Title:	 	Director
		
	By:	 	 /s/ Irja R. Otsa

	Name:	 	Irja R. Otsa
	Title:	 	Associate Director

  

 F-3 

					
	 UPS CAPITAL CORPORATION

		
	By:	 	 /s/ John P. Holloway

	Name:	 	John P. Holloway
	Title:	 	Director of Portfolio Management

  

					
	 WACHOVIA CAPITAL FINANCE

		
	By:	 	 /s/ M. Galovic Jr.

	Name:	 	M. Galovic, Jr.
	Title:	 	Vice President

  

					
	 WELLS FARGO FOOTHILL LLC

		
	By:	 	 /s/ Patrick McCormack

	Name:	 	Patrick McCormack
	Title:	 	Assistant Vice President

  

 F-4

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