Document:

Exhibit 10.9

 

VOTING
AND REGISTRATION RIGHTS AGREEMENT

 

THIS VOTING AND
REGISTRATION RIGHTS AGREEMENT (this “Agreement”) is made and entered into as of September 11, 2019,
by and among Apollo Medical Holdings, Inc., a Delaware corporation (the “Company”), and Allied Physicians of
California, A Professional Medical Corporation (“Purchaser”).

 

BACKGROUND STATEMENT

 

This Agreement is made
pursuant to that certain Stock Purchase Agreement, dated as of May 10, 2019 between Company and Purchaser (the “Stock
Purchase Agreement”).

 

AGREEMENT

 

NOW, THEREFORE,
in consideration of the mutual covenants contained in this Agreement, and for other good and valuable consideration, the receipt
and adequacy of which are hereby acknowledged, and in order to induce Purchaser to enter into the Stock Purchase Agreement, the
parties hereto hereby agree as follows:

 

1.                 
Defined Terms. Capitalized terms used and not otherwise defined herein shall have the meanings given such terms in
the Stock Purchase Agreement. As used in this Agreement, the following terms shall have the following respective meanings:

 

“Advice”
shall have the meaning set forth in Section 7(b).

 

“Affiliate”
means, as to any Person, (i) any other Person which directly, or indirectly through one or more intermediaries, controls such Person
or is consolidated with such Person in accordance with generally accepted accounting principles, (ii) any other Person which directly,
or indirectly through one or more intermediaries, is controlled by or is under common control with such Person, or (iii) any other
Person of which such Person owns, directly or indirectly, ten percent (10%) or more of the common stock or equivalent equity interests.
As used herein, the term “control” means possession, directly or indirectly, of the power to direct or cause the direction
of the management or policies of a Person, whether through the ownership of voting securities or otherwise.

 

“Agreement”
shall have the meaning set forth in the Preamble.

 

“Allowable
Grace Period” shall have the meaning set forth in Section 2(d).

 

“Business
Day” means any day of the year on which banks are open for business in Los Angeles, California.

 

“Commission”
means the Securities and Exchange Commission.

 

“Company”
shall have the meaning set forth in the Preamble.

 

“Effective
Date” means the date that the Registration Statement filed pursuant to Section 2(a) is first declared effective
by the Commission.

 

     

     

    

 

“Effectiveness
Period” shall have the meaning set forth in Section 2(b).

 

“FINRA”
shall have the meaning set forth in Section 3(g).

 

“Grace Period”
shall have the meaning set forth in Section 2(d).

 

“Holder”
or “Holders” means the holder or holders, as the case may be, from time to time of Registrable Securities.

 

“Indemnified
Party” shall have the meaning set forth in Section 5(c).

 

“Indemnifying
Party” shall have the meaning set forth in Section 5(c).

 

“Initial Registration
Statement” means the initial Registration Statement filed pursuant to Section 2(a) of this Agreement.

 

“Losses”
shall have the meaning set forth in Section 5(a).

 

“New Registration
Statement” shall have the meaning set forth in Section 2(a).

 

“Proceeding”
means an action, claim, suit, investigation or proceeding (including, without limitation, an investigation or partial proceeding,
such as a deposition), whether commenced or threatened.

 

“Prospectus”
means the prospectus included in a Registration Statement (including, without limitation, a prospectus that includes any information
previously omitted from a prospectus filed as part of an effective registration statement in reliance upon Rule 430A promulgated
under the Securities Act), as amended or supplemented by any prospectus supplement, with respect to the terms of the offering of
any portion of the Registrable Securities covered by a Registration Statement, and all other amendments and supplements to the
Prospectus, including post-effective amendments, and all material incorporated by reference or deemed to be incorporated by reference
in such Prospectus.

 

“Registrable
Securities” means any shares of Common Stock issued by the Company pursuant to the Stock Purchase Agreement and any additional
shares of Common Stock or other equity securities of the Company issued by the Company in connection with a stock dividend, stock
split, combination, exchange, reorganization, recapitalization or similar reclassification of the Company’s securities; provided,
that, as to any particular Registrable Securities, such securities shall cease to constitute Registrable Securities when: (x) a
registration statement with respect to the sale of such securities shall have become effective under the Securities Act and such
securities shall have been disposed of thereunder; (y) such securities shall be able to be sold in satisfaction of all applicable
conditions to the resale provisions of Rule 144 under the Securities Act (or any similar provision then in force); or (z) such
securities shall have ceased to be issued and outstanding.

 

“Registration
Statements” means any one or more registration statements of the Company filed under the Securities Act that covers the
resale of any of the Registrable Securities pursuant to the provisions of this Agreement (including without limitation the Initial
Registration Statement, the New Registration Statement and any Remainder Registration Statements), amendments and supplements to
such Registration Statements, including post-effective amendments.

 

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“Remainder
Registration Statement” shall have the meaning set forth in Section 2(a).

 

“Rule 144”
means Rule 144 promulgated by the Commission pursuant to the Securities Act, as such Rule may be amended from time to time, or
any similar rule or regulation hereafter adopted by the Commission having substantially the same effect as such Rule.

 

“Rule 415”
means Rule 415 promulgated by the Commission pursuant to the Securities Act, as such Rule may be amended from time to time, or
any similar rule or regulation hereafter adopted by the Commission having substantially the same effect as such Rule.

 

“Rule 424”
means Rule 424 promulgated by the Commission pursuant to the Securities Act, as such Rule may be amended from time to time, or
any similar rule or regulation hereafter adopted by the Commission having substantially the same effect as such Rule.

 

“SEC Guidance”
means (i) any publicly-available guidance, comments or requirements of the Commission staff and (ii) the Securities Act.

 

“Selling Shareholder
Questionnaire” means a questionnaire in the form adopted by the Company from time to time.

 

“Stock Purchase
Agreement” shall have the meaning set forth in the Recitals.

 

“Trading Market”
means the NASDAQ Capital Market or other exchange, trading market or quotation system on which the Common Stock is listed or quoted
for trading on the date in question.

 

2.             Registration.

 

(a)              
If at any time after the six (6) month anniversary of the date of this Agreement the Company receives a request from Holders
of at least twenty-five percent (25%) of the Registrable Securities then outstanding, the Company shall prepare and file with the
Commission a Registration Statement covering the resale of all of the Registrable Securities not already covered by an existing
and effective Registration Statement for an offering to be made on a continuous basis pursuant to Rule 415 or, if Rule 415 is not
available for offers and sales of the Registrable Securities, by such other means of distribution of Registrable Securities as
the Company may reasonably determine (the “Initial Registration Statement”). The Initial Registration Statement
shall be on Form S-3 (except if the Company is then ineligible to register for resale of the Registrable Securities on Form S-3,
then the Initial Registration Statement shall be on Form S-1). Subject to such other limitations as specified in this Agreement,
the Company shall have the right to include its equity securities that are not Registrable Securities, including a primary offering
of equity securities by the Company for its own account or a secondary offering of equity securities owned by the Company’s
directors and officers, in any such Registration Statement. Notwithstanding the registration obligations set forth in this Section
2, in the event the Commission informs the Company that all of the Registrable Securities cannot, as a result of the application
of Rule 415, be registered for resale as a secondary offering on a single registration statement, the Company agrees to promptly
(i) inform each of the Holders thereof and use its commercially reasonable efforts to file amendments to the Initial Registration
Statement as required by the Commission, (ii) remove any and all securities that are not Registrable Securities from such Initial
Registration Statement and/or (iii) withdraw the Initial Registration Statement and file a new registration statement (a “New
Registration Statement”), in either case covering the maximum number of Registrable Securities permitted to be registered
by the Commission, on Form S-3 or such other form available to the Company to register for resale the Registrable Securities as
a secondary offering; provided, that prior to filing such amendment or New Registration Statement, the Company shall be
obligated to use its commercially reasonable efforts to advocate with the Commission for the registration of all of the Registrable
Securities in accordance with the SEC Guidance. In the event the Company amends the Initial Registration Statement or files a New
Registration Statement, as the case may be, under clauses (i) or (ii) above, the Company will use its commercially reasonable efforts
to file with the Commission, as promptly as allowed by Commission or SEC Guidance provided to the Company or to registrants of
securities in general, one or more registration statements on Form S-3 or such other form available to the Company to register
for resale those Registrable Securities that were not registered for resale on the Initial Registration Statement, as amended,
or the New Registration Statement (the “Remainder Registration Statements”).

 

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(b)              
The Company shall use its commercially reasonable efforts to cause each Registration Statement to be declared effective
by the Commission as soon as practicable (and will continue to use commercially reasonable efforts thereafter if the applicable
Registration Statement is not effective by such date), and shall use its commercially reasonable efforts to keep each Registration
Statement continuously effective under the Securities Act until the earlier of (i) such time as all of the Registrable Securities
covered by such Registration Statement have been publicly sold by the Holders or (ii) the date that all Registrable Securities
covered by such Registration Statement may be sold by Holders under Rule 144, and without the requirement for the Company to be
in compliance with the current public information requirements under Rule 144(c)(1) (or Rule 144(i)(2), if applicable), as
determined by counsel to the Company pursuant to a written opinion letter to such effect, addressed and reasonably acceptable to
the Company’s transfer agent and the affected Holders (the “Effectiveness Period”).

 

(c)              
Each Holder agrees to furnish to the Company a completed Selling Shareholder Questionnaire not more than seven (7) Trading
Days following the date of the Company’s written request therefor. At least five (5) Trading Days prior to the first anticipated
filing date of a Registration Statement for any registration under this Agreement, the Company will notify each Holder of the information
the Company requires from that Holder other than the information contained in the Selling Shareholder Questionnaire, if any, which
shall be completed and delivered to the Company promptly upon request and, in any event, within three (3) Trading Days prior to
the applicable anticipated filing date. Each Holder further agrees that it shall not be entitled to be named as a selling security
holder in the Registration Statement or use the Prospectus for offers and resales of Registrable Securities at any time, unless
such Holder has returned to the Company a completed and signed Selling Shareholder Questionnaire and a response to any requests
for further information as described in the previous sentence. If a Holder of Registrable Securities returns a Selling Shareholder
Questionnaire or a request for further information, in either case, after its respective deadline, the Company shall use its commercially
reasonable efforts at the expense of the Holder who failed to return the Selling Shareholder Questionnaire or to respond for further
information to take such actions as are required to name such Holder as a selling security holder in the Registration Statement
or any pre-effective or post-effective amendment thereto and to include (to the extent not theretofore included) in the Registration
Statement the Registrable Securities identified in such late Selling Shareholder Questionnaire or request for further information.
Each Holder acknowledges and agrees that the information in the Selling Shareholder Questionnaire or request for further information
as described in this Section 2(c) will be used by the Company in the preparation of the Registration Statement and hereby
consents to the inclusion of such information in the Registration Statement.

 

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(d)              
Notwithstanding anything to the contrary herein, at any time after the Registration Statement has been declared effective
by the Commission, the Company may delay the disclosure of material non-public information concerning the Company if the disclosure
of such information at the time is not, in the good faith judgment of the Company, in the best interests of the Company (such delay,
a “Grace Period”); provided, the Company shall promptly (i) notify the Holders in writing of the existence
of material non-public information giving rise to a Grace Period (provided that the Company shall not disclose the content of such
material non-public information to the Holders) or the need to file a post-effective amendment, as applicable, and the date on
which such Grace Period will begin, (ii) use commercially reasonable efforts to terminate a Grace Period as promptly as reasonably
practicable, unless doing so would reasonably be expected to have a material adverse effect on the Company with respect to any
proposal or plan of the Company to effect a merger, acquisition, disposition, financing, reorganization, recapitalization or similar
transaction or any negotiations, discussions or pending proposals with respect thereto, and (iii) notify the Holders in writing
of the date on which the Grace Period ends; provided, further, that no single Grace Period shall exceed ninety (90)
consecutive days, and during any three hundred sixty-five (365) day period, the aggregate of all Grace Periods shall not exceed
an aggregate of one hundred eighty (180) days (each Grace Period complying with this provision being an “Allowable Grace
Period”). For purposes of determining the length of a Grace Period, the Grace Period shall be deemed to begin on and
include the date the Holders receive the notice referred to in clause (i) above and shall end on and include the later of the date
the Holders receive the notice referred to in clause (iii) above and the date referred to in such notice; provided, that
no Grace Period shall be longer than an Allowable Grace Period.

 

3.             Registration Procedures

 

In connection with the
Company’s registration obligations hereunder:

 

(a)              
(i) the Company shall prepare and file with the Commission such amendments, including post-effective amendments and supplements,
to each Registration Statement and the Prospectus used in connection therewith as may be necessary to keep such Registration Statement
continuously effective as to the applicable Registrable Securities for its Effectiveness Period (except during an Allowable Grace
Period); (ii) the Company shall cause the related Prospectus to be amended or supplemented by any required Prospectus supplement
(subject to the terms of this Agreement), and, as so supplemented or amended, to be filed pursuant to Rule 424 (except during an
Allowable Grace Period); (iii) the Company shall respond as promptly as reasonably practicable to any comments received from the
Commission with respect to each Registration Statement or any amendment thereto; and (iv) the Company shall comply with the provisions
of the Securities Act and the Exchange Act with respect to the disposition of all Registrable Securities covered by a Registration
Statement until such time as all of such Registrable Securities shall have been disposed of (subject to the terms of this Agreement)
in accordance with the intended methods of disposition by the Holders thereof as set forth in such Registration Statement as so
amended or in such Prospectus as so supplemented; provided, that Purchaser shall be responsible for the delivery of the
Prospectus to the Persons to whom such Purchaser sells any of the Registrable Securities (including in accordance with Rule 172
under the Securities Act), and Purchaser agrees (and shall cause each other Holder) to dispose of Registrable Securities in compliance
with the plan of distribution described in the Registration Statement and otherwise in compliance with applicable federal and state
securities laws. In the case of amendments and supplements to a Registration Statement which are required to be filed pursuant
to this Agreement (including pursuant to this Section 3(a)) by reason of the Company filing a report on Form 10-K, Form
10-Q or Form 8-K or any analogous report under the Exchange Act, the Company shall have incorporated such report by reference into
such Registration Statement, if applicable, or shall file such amendments or supplements with the Commission as soon as reasonably
practicable after the Exchange Act report which created the requirement for the Company to amend or supplement such Registration
Statement was filed.

 

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(b)              
the Company shall use commercially reasonable efforts to avoid the issuance of, or, if issued, obtain the withdrawal of
(i) any order suspending the effectiveness of a Registration Statement, or (ii) any suspension of the qualification (or exemption
from qualification) of any of the Registrable Securities for sale in any jurisdiction, as soon as practicable.

 

(c)              
the Company shall, if requested by a Holder, furnish to such Holder, without charge, at least one conformed copy of each
Registration Statement and each amendment thereto and all exhibits to the extent requested by such Holder promptly after the filing
of such documents with the Commission; provided, that the Company may provide a link to, and shall have no obligation to
provide a physical copy of, any such document that is available on the Commission’s EDGAR or successor system.

 

(d)              
the Company shall, prior to any resale of Registrable Securities by a Holder, use its commercially reasonable efforts to
register or qualify or cooperate with the selling Holders in connection with the registration or qualification (or exemption from
the registration or qualification) of such Registrable Securities for the resale by the Holder under the securities or Blue Sky
laws of such jurisdictions within the United States as any Holder reasonably requests in writing, to keep each registration or
qualification (or exemption therefrom) effective during the Effectiveness Period and to do any and all other acts or things reasonably
necessary to enable the disposition in such jurisdictions of the Registrable Securities covered by each Registration Statement;
provided, that the Company shall not be required to qualify generally to do business in any jurisdiction where it is not
then so qualified, subject the Company to any material tax in any such jurisdiction where it is not then so subject or file a general
consent to service of process in any such jurisdiction.

 

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(e)              
the Company shall, reasonably cooperate with the Holders to facilitate the timely preparation and delivery of certificates
representing Registrable Securities to be delivered to a transferee pursuant to the Registration Statement, which certificates
shall be free, to the extent permitted by the Stock Purchase Agreement and under law, of all restrictive legends, and to enable
such Registrable Securities to be in such denominations and registered in such names as any such Holders may reasonably request.
Certificates for Registrable Securities free from all restrictive legends may be transmitted by the transfer agent to a Holder
by crediting the account of such Holder’s prime broker with DTC as directed by such Holder.

 

(f)               
subject to Section 2(c), the Company shall, following the occurrence of any event that the Company determines requires
it to file a supplement or amendment to any Registration Statement, as promptly as reasonably practicable (taking into account
the Company’s good faith assessment of any adverse consequences to the Company and its shareholders of the premature disclosure
of such event), prepare and file a supplement or amendment, including a post-effective amendment, to the affected Registration
Statements or a supplement to the related Prospectus or any document incorporated or deemed to be incorporated therein by reference,
and file any other required document so that, as thereafter delivered, no Registration Statement nor any Prospectus will contain
an untrue statement of a material fact or omit to state a material fact required to be stated therein or necessary to make the
statements therein (in the case of any Prospectus, form of prospectus or supplement thereto, in light of the circumstances under
which they were made), not misleading.

 

(g)              
the Company may require each selling Holder to furnish to the Company a certified statement as to (i) the number of Securities
beneficially owned by such Holder and any Affiliate thereof, (ii) any Financial Industry Regulatory Authority (“FINRA”)
affiliations, (iii) any natural persons who have the power to vote or dispose of the Common Stock and (iv) any other
information as may be requested by the Commission, FINRA, any state securities commission or any other government or regulatory
body with jurisdiction over the Company or its activities.

 

(h)              
the Company shall cooperate with any registered broker through which a Holder proposes to resell its Registrable Securities
in effecting a filing with FINRA pursuant to FINRA Rule 5110 as requested by any such Holder and the Company shall pay the filing
fee required for the first such filing (but not additional filings) within two (2) Business Days of the request therefore.

 

(i)                
as and when Form S-3 is available to the Company, the Company shall use its commercially reasonable efforts to maintain
or achieve eligibility for use of Form S-3 (or any successor form thereto) for the registration of the resale of Registrable Securities.

 

(j)                
if, at any time after the six (6) month anniversary of the date of this Agreement, at least 85% in interest of the Holders
so request by notice to the Company to sell Registrable Securities pursuant to an underwritten offering, the Company shall enter
into a written underwriting agreement in customary form and substance with the managing underwriter(s) selected by such requesting
Holders, provided that such managing underwriter(s), shall be reasonably acceptable to the Company, and shall take any and all
such actions and furnish and provide all such information, documents and undertakings to such managing underwriter(s) in connection
with such underwritten offering as is customary in connection with such underwritten offerings, and provided further, that the
Company and Holders agree to be bound by such agreements and provisions as are customary in underwriting agreements of the type
to be entered in connection with the sale of Registrable Securities contemplated by such underwritten offering.

 

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(k)              
if the managing underwriter(s) of a proposed underwritten offering of Registrable Securities effected pursuant to Section
2 advise the Holders requesting to sell Registrable Securities in such underwritten offering in writing that, in their opinion,
the number of securities requested to be included in such offering exceeds the number which can be sold in such offering without
being likely to have a significant adverse effect on the price, timing or distribution of the securities offered or the market
for the securities offered, the securities to be included in such Registration Statement (i) first, shall be allocated, pro rata
if necessary, among the Holders that have requested to sell Registrable Securities in such underwritten offering, (ii) second,
and only if all the securities referred to in clause (i) have been included in such Registration Statement, shall be allocated
to any shares that the Company has requested to sell in such underwritten offering; and (iii) third, and only if all the securities
referred to in clauses (i) and (ii) have been included in such Registration Statement, shall be allocated pro rata among the officers
and directors of the Company that have requested to sell in such underwritten offering.

 

(l)                
if the managing underwriter(s) of a proposed underwritten offering of securities effected pursuant to Section 7(c)
advise the Company in writing that, in their opinion, the number of securities requested to be included in such offering exceeds
the number which can be sold in such offering without being likely to have a significant adverse effect on the price, timing or
distribution of the securities offered or the market for the securities offered, the securities to be included in such Registration
Statement (i) first, shall be allocated to any shares that the Company has requested to sell in such underwritten offering, (ii)
second, and only if all the securities referred to in clause (i) have been included in such Registration Statement, shall be allocated,
pro rata if necessary, among Holders of Registrable Securities that have requested to sell in such underwritten offering, and (iii)
third, and only if all the securities referred to in clauses (i) and (ii) have been included in such Registration Statement, shall
be allocated pro rata among the holders of all other securities that have requested to sell in such underwritten offering.

 

4.             Registration Expenses. All fees and expenses incident to the Company’s performance of or compliance with its
obligations under this Agreement shall be borne by the Company whether or not any Registrable Securities are sold pursuant to a
Registration Statement. The fees and expenses referred to in the foregoing sentence shall include, without limitation, (i) all
registration and filing fees (including, without limitation, fees and expenses (A) with respect to filings required to be
made with the Commission and any Trading Market on which the Common Stock is then listed for trading, (B) with respect to compliance
with applicable state securities or Blue Sky laws (including, without limitation, fees and disbursements of counsel for the Company
in connection with Blue Sky qualifications or exemptions of the Registrable Securities and determination of the eligibility of
the Registrable Securities for investment under the laws of such jurisdictions as requested by the Holders) and (C) if not previously
paid by the Company in connection with an issuer filing, with respect to any filing that may be required to be made by any broker
through which a Holder intends to make sales of Registrable Securities with FINRA pursuant to FINRA Rule 5110, so long as the broker
is receiving no more than a customary brokerage commission in connection with such sale, (ii) printing expenses (including,
without limitation, expenses of printing certificates for Registrable Securities and of printing prospectuses if the printing of
prospectuses is reasonably requested by the Holders of a majority of the Registrable Securities included in the Registration Statement),
(iii) messenger, telephone and delivery expenses of the Company, (iv) fees and disbursements of counsel for the Company, (v) Securities
Act liability insurance, if the Company so desires such insurance, and (vi) fees and expenses of all other Persons retained by
the Company in connection with the consummation of the transactions contemplated by this Agreement. In addition, the Company shall
be responsible for all of its internal expenses incurred in connection with the consummation of the transactions contemplated by
this Agreement (including, without limitation, all salaries and expenses of its officers and employees performing legal or accounting
duties), the expense of any annual audit and the fees and expenses incurred in connection with the listing of the Registrable Securities
on any securities exchange as required hereunder. In no event shall the Company be responsible for any underwriting, broker or
similar fees, discounts or commissions or stock transfer taxes applicable to any Registered Securities registered by any Holder
or any legal fees or other costs of the Holders. Within ten (10) Trading Days of written notice from the Company, the Holders shall
reimburse the Company for all fees and expenses it incurs hereunder that are otherwise the responsibility of the Holders.

 

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5.             Indemnification.

 

(a)              
Indemnification by the Company. The Company shall, notwithstanding any termination of this Agreement, indemnify,
defend and hold harmless each Holder, the officers, directors, agents, brokers, general partners, managing members, managers, Affiliates,
employees and investment advisers of each of them, each Person who controls any such Holder (within the meaning of Section 15 of
the Securities Act or Section 20 of the Exchange Act) and the officers, directors, general partners, managing members, managers,
agents, employees and investment advisers of each such controlling Person, to the fullest extent permitted by applicable law, from
and against any and all losses, claims, damages, liabilities, costs (including, without limitation, reasonable costs of preparation
and investigation and reasonable and documented attorneys’ fees) and expenses (collectively, “Losses”),
as incurred, that arise out of or are based upon (i) any untrue or alleged untrue statement of a material fact contained in any
Registration Statement, any Prospectus or any form of prospectus or in any amendment or supplement thereto or in any preliminary
prospectus, or arising out of or relating to any omission or alleged omission to state a material fact required to be stated therein
or necessary to make the statements therein (in the case of any Prospectus or form of prospectus or supplement thereto, in light
of the circumstances under which they were made) not misleading, or (ii) any violation or alleged violation by the Company of the
Securities Act, the Exchange Act or any state securities law, or any rule or regulation thereunder, in connection with the performance
of its obligations under this Agreement, except to the extent that such untrue statements, alleged untrue statements, omissions
or alleged omissions are based solely upon information regarding such Holder furnished in writing to the Company by such Holder
expressly for use therein, or to the extent that such information relates to such Holder or such Holder’s proposed method
of distribution of Registrable Securities, such Prospectus or such form of Prospectus or in any amendment or supplement thereto,
related to the use by a Holder of an outdated or defective Prospectus after the Company has notified such Holder in writing or
electronic mail that the Prospectus is outdated or defective and prior to the receipt by such Holder of the Advice contemplated
and defined in Section 7(b) below, but only if and to the extent that following the receipt of the Advice the misstatement
or omission giving rise to such Loss would have been corrected. The Company shall notify the Holders promptly of the institution,
threat or assertion of any Proceeding arising from or in connection with the transactions contemplated by this Agreement of which
the Company is aware. Such indemnity shall remain in full force and effect regardless of any investigation made by or on behalf
of an Indemnified Party (as defined in Section 5(c)) and shall survive the transfer of the Registrable Securities by the
Holders.

 

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(b)              
Indemnification by Holders. Each Holder shall, severally and not jointly, indemnify and hold harmless the Company,
its directors, officers, agents and employees, each Person who controls the Company (within the meaning of Section 15 of the Securities
Act and Section 20 of the Exchange Act), and the directors, officers, agents or employees of such controlling Persons, to the fullest
extent permitted by applicable law, from and against all Losses, as incurred, arising out of or are based upon any untrue or alleged
untrue statement of a material fact contained in any Registration Statement, any Prospectus, or any form of prospectus, or in any
amendment or supplement thereto or in any preliminary prospectus, or arising out of or relating to any omission or alleged omission
of a material fact required to be stated therein or necessary to make the statements therein (in the case of any Prospectus, or
any form of prospectus or supplement thereto, in light of the circumstances under which they were made) not misleading (i) to the
extent that such untrue statements or omissions are based solely upon information regarding such Holder furnished in writing to
the Company by such Holder expressly for use therein or (ii) to the extent that such information relates to such Holder or
such Holder’s proposed method of distribution of Registrable Securities, such Prospectus or such form of Prospectus or in
any amendment or supplement thereto, to the extent related to the use by such Holder of an outdated or defective Prospectus after
the Company has notified such Holder in writing that the Prospectus is outdated or defective and prior to the receipt by such Holder
of the Advice contemplated in Section 7(b), but only if and to the extent that following the receipt of the Advice the misstatement
or omission giving rise to such Loss would have been corrected. In no event shall the liability of any selling Holder hereunder
be greater in amount than the dollar amount of the net proceeds received by such Holder upon the sale of the Registrable Securities
giving rise to such indemnification obligation.

 

(c)              
Conduct of Indemnification Proceedings. If any Proceeding shall be brought or asserted against any Person entitled
to indemnity hereunder (an “Indemnified Party”), such Indemnified Party shall promptly notify the Person from
whom indemnity is sought (the “Indemnifying Party”) in writing, and the Indemnifying Party shall have the right
to assume the defense thereof, including the employment of one counsel reasonably satisfactory to the Indemnified Party and the
payment of all reasonable and documented fees and expenses incurred in connection with defense thereof; provided, that the
failure of any Indemnified Party to give such written notice within a reasonable time of commencement of any such Proceeding shall
not relieve the Indemnifying Party of its obligations or liabilities pursuant to this Agreement, except to the extent that it shall
be finally determined by a court of competent jurisdiction (which determination is not subject to appeal or further review) that
such failure shall have materially and adversely prejudiced the Indemnifying Party in its ability to defend such Proceeding.

 

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An Indemnified Party
shall have the right to employ separate counsel in any such Proceeding and to participate in the defense thereof, but the fees
and expenses of such counsel shall be at the expense of such Indemnified Party or Parties unless: (1) the Indemnifying Party has
agreed in writing to pay such fees and expenses; (2) the Indemnifying Party shall have failed promptly to assume the defense of
such Proceeding and to employ counsel reasonably satisfactory to such Indemnified Party in any such Proceeding; or (3) the named
parties to any such Proceeding (including any impleaded parties) include both such Indemnified Party and the Indemnifying Party,
and such Indemnified Party shall have been advised by counsel that a conflict of interest exists if the same counsel were to represent
such Indemnified Party and the Indemnifying Party; provided, that the Indemnifying Party shall not be liable for the fees
and expenses of more than one separate firm of attorneys at any time for all Indemnified Parties. The Indemnifying Party shall
not be liable for any settlement of any such Proceeding effected without its written consent, which consent shall not be unreasonably
withheld, delayed or unreasonably conditioned. No Indemnifying Party shall, without the prior written consent of the Indemnified
Party, effect any settlement of any pending Proceeding in respect of which any Indemnified Party is a party, unless such settlement
includes an unconditional release of such Indemnified Party from all liability on claims that are the subject matter of such Proceeding.

 

Subject to the terms
of this Agreement, all documented fees and expenses of the Indemnified Party (including reasonable fees and expenses to the extent
incurred in connection with investigating or preparing to defend such Proceeding in a manner not inconsistent with this Section
5(c)) shall be paid to the Indemnified Party, as incurred, within twenty (20) Trading Days of written notice thereof to the
Indemnifying Party; provided, that the Indemnified Party shall promptly reimburse the Indemnifying Party for that portion
of such fees and expenses applicable to such actions for which such Indemnified Party is finally judicially determined to not be
entitled to indemnification hereunder.

 

(d)              
Contribution. If a claim for indemnification under Section 5(a) or 5(b) is unavailable to an Indemnified
Party or insufficient to hold an Indemnified Party harmless for any Losses, then each Indemnifying Party, in lieu of indemnifying
such Indemnified Party, shall contribute to the amount paid or payable by such Indemnified Party as a result of such Losses, in
such proportion as is appropriate to reflect the relative fault of the Indemnifying Party and Indemnified Party in connection with
the actions, statements or omissions that resulted in such Losses as well as any other relevant equitable considerations. The relative
fault of such Indemnifying Party and Indemnified Party shall be determined by reference to, among other things, whether any action
in question, including any untrue or alleged untrue statement of a material fact or omission or alleged omission of a material
fact, has been taken or made by, or relates to information supplied by, such Indemnifying Party or Indemnified Party, and the parties’
relative intent, knowledge, access to information and opportunity to correct or prevent such action, statement or omission. The
amount paid or payable by a party as a result of any Losses shall be deemed to include, subject to the limitations set forth in
this Agreement, any reasonable attorneys’ or other reasonable fees or expenses incurred by such party in connection with
any Proceeding to the extent such party would have been indemnified for such fees or expenses if the indemnification provided for
in this Section 5(d) was available to such party in accordance with its terms.

 

    	 	11	 

     

    

 

The parties hereto agree
that it would not be just and equitable if contribution pursuant to this Section 5(d) were determined by pro rata allocation
or by any other method of allocation that does not take into account the equitable considerations referred to in the immediately
preceding paragraph. Notwithstanding the provisions of this Section 5(d), no Holder shall be required to contribute, in
the aggregate, any amount in excess of the amount by which the net proceeds actually received by such Holder from the sale of the
Registrable Securities subject to the Proceeding exceeds the amount of any damages that such Holder has otherwise been required
to pay by reason of such untrue or alleged untrue statement or omission or alleged omission. No person guilty of fraudulent misrepresentation
(within the meaning of Section 11(f) of the Securities Act) shall be entitled to contribution from any Person who was not guilty
of such fraudulent misrepresentation.

 

6.              Restrictions on Voting. Notwithstanding anything to the contrary in the Certificate of Incorporation of the Company
or under applicable law, to the extent that Purchaser holds Registrable Securities that, together with any other voting securities
of the Company, result in Purchaser having voting power in excess of nine and 99/100 percent (9.99%) of all voting securities of
the Company, Purchaser shall appoint one or more individuals designated by the Company as its proxy and authorize and instruct
such proxy holders to vote such voting securities with such excess voting power in the same proportion as all other votes cast
on any specific proposal coming before the Company’s stockholders.

 

7.              Miscellaneous.

 

(a)              
Compliance. Each Holder covenants and agrees that it will comply with the prospectus delivery requirements of the
Securities Act as applicable to it (unless an exemption therefrom is available) in connection with sales of Registrable Securities
pursuant to the Registration Statement and shall sell the Registrable Securities only in accordance with a method of distribution
described in the Registration Statement.

 

(b)              
Discontinued Disposition. By its acquisition of Registrable Securities, each Holder agrees that, during any Grace
Period and upon receipt of a notice from the Company, such Holder will forthwith discontinue disposition of such Registrable Securities
under a Registration Statement until it is advised in writing (the “Advice”) by the Company that the use of
the applicable Prospectus (as it may have been supplemented or amended) may be resumed. The Company may provide appropriate stop
orders to enforce the provisions of this paragraph.

 

(c)              
Holder Piggyback Rights. If, at any time during the Effectiveness Period but in no event earlier than the six (6)
month anniversary of the date of this Agreement, there is not an effective Registration Statement covering all of the Registrable
Securities and the Company shall determine to prepare and file with the Commission a registration statement relating to an offering
for its own account or the account of others under the Securities Act of any of its equity securities, other than on Form S-4 or
Form S-8 (each as promulgated under the Securities Act) or their then equivalents relating to equity securities to be issued solely
in connection with any acquisition of any entity or business or equity securities issuable in connection with the Company’s
stock option or other employee benefit plans, then the Company shall deliver to each Holder a written notice of such determination
and, if within fifteen (15) days after the date of the delivery of such notice, at least 85% in interest of the Holders so request
in writing, the Company shall include in such registration statement all or any part of such Registrable Securities such Holders
request to be registered; provided, however, that the Company shall not be required to register any Registrable Securities pursuant
to this Section 7(c) that are eligible for resale pursuant to Rule 144 (without volume restrictions or current public
information requirements) promulgated by the Commission pursuant to the Securities Act or that are the subject of a then effective
Registration Statement.

 

    	 	12	 

     

    

 

(d)              
Amendments and Waivers. The provisions of this Agreement, including the provisions of this sentence, may not be amended,
modified or supplemented, or waived unless the same shall be in writing and signed by the Company and Holders holding at least
two-thirds of the then outstanding Registrable Securities, provided that any party may give a waiver as to itself. Notwithstanding
the foregoing, a waiver or consent to depart from the provisions hereof with respect to a matter that relates exclusively to the
rights of Holders and that does not directly or indirectly affect the rights of other Holders may be given by Holders of all of
the Registrable Securities to which such waiver or consent relates; provided, that the provisions of this sentence may not
be amended, modified, or supplemented except in accordance with the provisions of the immediately preceding sentence. Notwithstanding
the foregoing, if any such amendment, modification or waiver would adversely affect in any material respect any Holder or group
of Holders who have comparable rights under this Agreement disproportionately to the other Holders having such comparable rights,
such amendment, modification, or waiver shall also require the written consent of the Holder(s) so adversely affected.

 

(e)              
Notices. Any and all notices or other communications or deliveries required or permitted to be provided hereunder
shall be delivered as set forth in the Stock Purchase Agreement.

 

(f)               
Successors and Assigns. This Agreement shall inure to the benefit of and be binding upon the successors and permitted
assigns of each of the parties and shall inure to the benefit of each Holder. Nothing in this Agreement, express or implied, is
intended to confer upon any party other than the parties hereto or their respective successors and assigns any rights, remedies,
obligations, or liabilities under or by reason of this Agreement, except as expressly provided in this Agreement. The Company may
not assign its rights (except by merger or in connection with another entity acquiring all or substantially all of the Company’s
assets) or obligations hereunder without the prior written consent of all the Holders of the then outstanding Registrable Securities.
Notwithstanding anything in this Agreement to the contrary, Purchaser shall not transfer or assign any of the Registrable Securities,
nor any of its rights hereunder, for a period of six (6) months following the date of this Agreement.  Thereafter, Purchaser
may (i) distribute any of the Registrable Securities to its shareholders, (ii) transfer or assign any of the Registrable Securities
in any sale through underwriters, dealers or agents who sell such Registrable Securities on a national securities exchange, (iii)
transfer or assign any of the Registrable Securities so long as (x) no transferee, after giving effect to such transfer or assignment,
holds voting securities of the Company, including Registrable Securities, having voting power in excess of nine and 99/100 percent
(9.99%) of all voting securities of the Company, or (y) a transferee otherwise enters into an agreement with the Company as a condition
to any such transfer or assignment limiting the voting power of all voting securities of the Company, including Registrable Securities,
held by such transferee, after giving effect to such transfer or assignment, to not more than nine and 99/100 percent (9.99%) of
all voting securities of the Company, and (iv) assign its rights hereunder with respect to the Registrable Securities only to its
shareholders who hold Registrable Securities.

 

    	 	13	 

     

    

 

(g)              Execution and Counterparts. This Agreement may be executed in two or more counterparts, each of which when so executed
shall be deemed to be an original and, all of which taken together shall constitute one and the same Agreement and shall become
effective when counterparts have been signed by each party and delivered to the other party, it being understood that both parties
need not sign the same counterpart. In the event that any signature is delivered by facsimile transmission or in electronic form,
such signature shall create a valid and binding obligation of the party executing (or on whose behalf such signature is executed)
with the same force and effect as if such facsimile or electronic form were the original thereof.

 

(h)              Governing Law. All questions concerning the construction, validity, enforcement and interpretation of this Agreement
shall be determined in accordance with the provisions of the Stock Purchase Agreement.

 

(i)               
Severability. If any term, provision, covenant or restriction of this Agreement is held by a court of competent jurisdiction
to be invalid, illegal, void or unenforceable, the remainder of the terms, provisions, covenants and restrictions set forth herein
shall remain in full force and effect and shall in no way be affected, impaired or invalidated, and the parties hereto shall use
their good faith reasonable efforts to find and employ an alternative means to achieve the same or substantially the same result
as that contemplated by such term, provision, covenant or restriction. It is hereby stipulated and declared to be the intention
of the parties that they would have executed the remaining terms, provisions, covenants and restrictions without including any
of such that may be hereafter declared invalid, illegal, void or unenforceable.

 

(j)               
Headings. The headings in this Agreement are for convenience only and shall not limit or otherwise affect the meaning
hereof.

 

(k)              
Independent Nature of Holders’ Obligations and Rights. If and to the extent there is more than one Holder under
this Agreement, the obligations of each Holder hereunder shall be several and not joint with the obligations of any other Holder
hereunder, and no Holder shall be responsible in any way for the performance of the obligations of any other Holder hereunder.
Nothing contained herein or in any other agreement or document delivered at any closing, and no action taken by any Holder pursuant
hereto or thereto, shall be deemed to constitute the Holders as a partnership, an association, a joint venture or any other kind
of group or entity, or create a presumption that the Holders are in any way acting in concert or as a group or entity with respect
to such obligations or the transactions contemplated by this Agreement or any other matters, and the Company acknowledges that
the Holders are not acting in concert or as a group, and the Company shall not asset any such claim, with respect to such obligations
or transactions. Each Holder shall be entitled to protect and enforce its rights, including without limitation the rights arising
out of this Agreement, and it shall not be necessary for any other Holder to be joined as an additional party in any proceeding
for such purpose. It is expressly understood and agreed that each provision contained in this Agreement is between the Company
and a Holder, solely, and not between the Company and the Holders collectively and not between and among Holders.

 

    	 	14	 

     

    

 

(l)            Legend. Each certificate, instrument, or book entry representing any Registrable Securities shall be notated by the
Company with a legend reading substantially as follows:

 

“THE SHARES REPRESENTED
HEREBY ARE SUBJECT TO A VOTING AND REGISTRATION RIGHTS AGREEMENT, AS MAY BE AMENDED FROM TIME TO TIME, (A COPY OF WHICH MAY BE
OBTAINED UPON WRITTEN REQUEST FROM THE COMPANY), AND BY ACCEPTING ANY INTEREST IN SUCH SHARES THE PERSON ACCEPTING SUCH INTEREST
SHALL BE DEEMED TO AGREE TO AND SHALL BECOME BOUND BY ALL THE PROVISIONS OF THAT VOTING AND REGISTRATION RIGHTS AGREEMENT, INCLUDING
CERTAIN RESTRICTIONS ON VOTING AND OWNERSHIP SET FORTH THEREIN.”

 

The Company, by its execution
of this Agreement, agrees that it will cause the certificates instruments, or book entry evidencing the Registrable Securities
to be notated with the legend required by this Section 7(l). The parties to this Agreement do hereby agree that the failure
to cause the certificates, instruments, or book entry evidencing the Registrable Securities to be notated with the legend required
by this Section 7(l) shall not affect the validity or enforcement of this Agreement.

 

 

 

    	 	15	 

     

    

 

IN WITNESS WHEREOF,
the parties hereto have caused this Agreement to be duly executed and delivered by their respective duly authorized officers as
of the date first above written.

 

	 	APOLLO MEDICAL HOLDINGS, INC.	 
	 	 	 
	 	 	 
	 	By:	/s/ Mitchell Kitayama	 
	 	 	Mitchell Kitayama	 
	 	 	Independent Committee Director	 
	 	 	 	 
	 	 	 	 
	 	By: 	/s/ Eric Chin	 
	 	 	Eric Chin	 
	 	 	Chief Financial Officer	 

 

 

[REMAINDER OF PAGE INTENTIONALLY LEFT BLANK,

SIGNATURE PAGES OF ALLIED PHYSICIANS OF CALIFORNIA, A PROFESSIONAL MEDICAL CORPORATION TO FOLLOW]

 

    Voting and Registration Rights Agreement Signature Page (1 of 2)

     

    

 

	 	ALLIED PHYSICIANS OF CALIFORNIA,
	 	A PROFESSIONAL MEDICAL CORPORATION
	 	 
	 	 	 
	 	By: 	/s/ Thomas Lam
	 	 	Name: 	Thomas Lam, M. D.
	 	 	Title:	Chief Executive Officer

 

	 	ADDRESS FOR NOTICE
	 	 	 	 
	 	1668 S. Garfield Ave., 2nd Floor	 	 
	 	Alhambra, CA 91801	 	 

 

	 	Attention:	CEO	 

 

    
Voting and Registration Rights Agreement Signature Page (2 of 2)Exhibit 10.10

 

SECOND AMENDMENT TO

LOAN AGREEMENT

 

This SECOND AMENDMENT
TO LOAN AGREEMENT (the “Amendment”) is made and entered into as of September 11, 2019, by and between Apollo
Medical Holdings, Inc., a Delaware corporation (“Lender”), and AP-AMH Medical Corporation, a California professional
medical corporation (“Borrower”).

 

A.       Lender
and Borrower have previously entered into that certain Loan Agreement dated as of May 10, 2019, as amended by that certain First
Amendment to Loan Agreement dated as of August 26, 2019 (together, the “Loan Agreement”). 

 

B.       Lender
and Borrower desire to further amend the Loan Agreement as set forth herein. 

 

NOW, THEREFORE, in
consideration of the premises and of the mutual agreements, representations, warranties, provisions and covenants herein contained,
the parties hereto, each intending to be bound hereby, agree as follows:

 

1.       Definitions.
Capitalized terms used but not defined in this Amendment shall have the meanings given to such terms in the Loan Agreement.

 

2.       Definition
of Excluded Assets. Exhibit B to the Loan Agreement is hereby amended by amending and restating the definition of “Excluded
Assets” in Section 1 thereof to read in full as follows:

 

“Excluded
Assets” means (i) assets received from the sale of shares of the Series A Preferred equal to the Series A Purchase Price,
(ii) the assets of the Company that are not Healthcare Services Assets, including the Company’s equity interests in
Universal Care, Inc., Apollo Medical Holdings, Inc., and any entity that is primarily engaged in the business of owning, leasing,
developing or otherwise operating real estate, (iii) any assets acquired with the proceeds of the sale, assignment or other
disposition of any of the assets described in clauses (i) or (ii), and (iv) any proceeds of the assets described in clauses
(i), (ii) and (iii).

 

3.       Effect
of Amendment. Except as expressly amended by this Amendment, all of the terms of the Loan Agreement shall remain unchanged
and in full force and effect. The provisions of Sections 6 through 15 of the Loan Agreement are incorporated in this Amendment
by this reference, mutatis mutandis.

 

 

 

[Signatures appear on the following page.]

 

    1

     

    

 

IN WITNESS WHEREOF,
this Amendment has been executed as of the date first above written.

 

	Borrower:	 	Lender:	 
	 	 	 	 	 	 
	AP-AMH MEDICAL CORPORATION	 	APOLLO MEDICAL HOLDINGS, INC.	 
	 	 	 	 	 	 
	 	 	 	 	 	 
	By: 	/s/ Thomas Lam	 	By:	/s/ Eric Chin	 
	 	Thomas S. Lam, M.D., 	 	 	Eric Chin,	 
	 	Chief Executive Officer  	 	 	Chief Financial Officer	 
	 	 	 	 	 	 
	Address:	 	 	 	 
	1668 S. Garfield Ave., 2nd Floor	 	By:	/s/ Mitchell Kitayama	 
	Alhambra, CA 91801	 	 	Mitchell Kitayama,	 
	 	 	 	 	Independent Committee Director	 
	 	 	 	 	 	 
	 	 	 	Address:	 
	 	 	 	1668 S. Garfield Avenue, 2nd Floor	 
	 	 	 	Alhambra, CA 91801	 

 

    S-1

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