Document:

EX-4.4

 Exhibit 4.4 

 
  

 
 (Real Estate Mortgage)

 PUGET SOUND ENERGY, INC. 
 TO 
 U.S. BANK NATIONAL ASSOCIATION, 

Trustee 
  

 
 Ninety-Second
Supplemental Indenture 
 Dated as of May 1, 2013 

 
  

Relating to First Mortgage Bonds 
  

 
 Supplemental
to Indenture dated as of 
 June 2, 1924, as supplemented and modified 

 
  

 
  

 
 (NOT PART OF INDENTURE)

  

 ANY WRITING, TEXT, INITIALS, REVISIONS OR NOTARY SEAL APPEARING OUTSIDE THESE MARGINS MAY
DISQUALIFY THIS DOCUMENT FOR RECORDING 
  
 THIS
NINETY-SECOND SUPPLEMENTAL INDENTURE, made as of the 1st day of May, 2013, by and between Puget Sound Energy, Inc., formerly Puget Sound Power & Light Company, a corporation duly organized and existing under and by virtue of the laws
of the State of Washington (hereinafter sometimes called the “Company”), party of the first part, and U.S. Bank National Association, a national banking association with a principal corporate trust office at 100 Wall Street, Suite 1600, in
the city of New York and State of New York 10005 (successor to Old Colony Trust Company) (hereinafter sometimes called the “Trustee”), as Trustee under the First Mortgage (originally, and before modification thereof by certain supplemental
indentures, called “First and Refunding Mortgage”) from Puget Sound Power & Light Company, a Massachusetts corporation (hereinafter sometimes called the “Predecessor Company”), dated as of June 2, 1924 (said
Mortgage being hereinafter sometimes called the “Original Mortgage”), as supplemented and modified by all indentures supplemental thereto heretofore executed and delivered, party of the second part; 

WITNESSETH: that 
 WHEREAS, the Predecessor Company did by the Original Mortgage, filed for record in the offices of the Auditors of the Counties of Chelan, Clallam, Cowlitz, Douglas, Grant, Grays Harbor, Island, Jefferson,
King, Kitsap, Kittitas, Lewis, Mason, Pacific, Pierce, Skagit, Snohomish, Thurston and Whatcom, all in the State of Washington, and left on file as a chattel mortgage in each of said counties, convey and pledge certain property therein described to
Old Colony Trust Company, as Trustee, to be held upon the trusts expressed in the Original Mortgage to equally secure an unlimited authorized amount of mortgage bonds (therein and herein called the “Bonds”) issued or to be issued in one or
more series, all as more fully provided in the Original Mortgage; and 
 WHEREAS, the Predecessor Company, prior to
September 1, 1954, had executed and delivered to the Trustee thirty-nine supplemental indentures, supplementing and in certain respects modifying the Original Mortgage and providing for the execution, certification and delivery of Bonds of
various series from time to time pursuant thereto (which Original Mortgage, as so supplemented and modified, is therein and herein sometimes called the “First Mortgage”); and 

WHEREAS, the Predecessor Company executed and delivered to the Trustee a Fortieth Supplemental Indenture, dated as of September 1,
1954, which Supplemental Indenture is divided into two parts, designated as Part I and Part II, and Part I thereof provided for the establishment and the execution, certification and delivery initially of Twenty-Five Million Dollars ($25,000,000)
principal amount of a series of Bonds, designated as First Mortgage Bonds, 3-1/2% Series due 1984, and contained certain 

  

			
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covenants, restrictions, conditions and provisions affecting, and provided for certain modifications of, the First Mortgage (the First Mortgage, as so supplemented and modified by said Part I,
being sometimes in said Fortieth Supplemental Indenture and herein called the “Revised First Mortgage”) and Part II thereof provided for modifications of the Revised First Mortgage as therein set forth, which modifications became effective
on October 20, 1955 (the Revised First Mortgage as so modified by Part II of the Fortieth Supplemental Indenture as heretofore, hereby, and hereafter supplemented and modified being sometimes in said Part II and herein called the
“Indenture” and references herein to Sections, Articles or other provisions of the Indenture being to the revised or modified provisions thereof as set forth in Part II of the Fortieth Supplemental Indenture); and 

WHEREAS, the Predecessor Company has heretofore executed and delivered to the Trustee a Forty-First Supplemental Indenture dated as of
December 1, 1954, a Forty-Second Supplemental Indenture dated as of July 1, 1957, a Forty-Third Supplemental Indenture dated as of May 1, 1958, a Forty-Fourth Supplemental Indenture dated as of November l, 1959, and a Forty-Fifth
Supplemental Indenture dated as of April 1, 1960, all of which mortgaged, pledged, assigned, conveyed and transferred to the Trustee and subjected to the lien of the Indenture additional property acquired or constructed, and betterments,
improvements and additions made to the mortgaged property, since the execution and delivery of the Fortieth Supplemental Indenture; and 
 WHEREAS, the Company has executed and delivered to the Trustee a Forty-Sixth Supplemental Indenture dated as of November 10, 1960, whereby the Company has succeeded to the Predecessor Company with
the same effect as if the Company had been named in the Indenture as the mortgagor company and in the Bonds and coupons as the obligor thereon or maker thereof, and the Predecessor Company merged into the Company on November 16, 1960, whereupon
the Company acquired all the property, real, personal or mixed, including all rights, privileges, easements, licenses and franchises, described in the Indenture and thereby conveyed and mortgaged or intended so to be, including also all such
property acquired by the Predecessor Company since the execution and delivery of the Original Mortgage, which by the terms of the Indenture is subjected or intended to be subjected to the lien thereof; and 

WHEREAS, the Company has executed and delivered to the Trustee the supplemental indentures set forth herein: 

 

			
	 Supplemental Indenture
	  	 Dated as of

	Forty-Seventh Supplemental Indenture	  	February 1, 1961
	Forty-Eighth Supplemental Indenture	  	November 1, 1963
	Forty-Ninth Supplemental Indenture	  	May 1, 1964

  

			
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	Fiftieth Supplemental Indenture	  	January 1, 1966
	Fifty-First Supplemental Indenture	  	June 1, 1967
	Fifty-Second Supplemental Indenture	  	February 1, 1969
	Fifty-Third Supplemental Indenture	  	July 1, 1970
	Fifty-Fourth Supplemental Indenture	  	October 1, 1972
	Fifty-Fifth Supplemental Indenture	  	March 1, 1974
	Fifty-Sixth Supplemental Indenture	  	November 1, 1974
	Fifty-Seventh Supplemental Indenture	  	August 1, 1975
	Fifty-Eighth Supplemental Indenture	  	October 1, 1976
	Fifty-Ninth Supplemental Indenture	  	July 1, 1978
	Sixtieth Supplemental Indenture	  	December 1, 1979
	Sixty-First Supplemental Indenture	  	December 1, 1981
	Sixty-Second Supplemental Indenture	  	July 1, 1984
	Sixty-Third Supplemental Indenture	  	January 1, 1986
	Sixty-Fourth Supplemental Indenture	  	April 1, 1986
	Sixty-Fifth Supplemental Indenture	  	April 1, 1986
	Sixty-Sixth Supplemental Indenture	  	August 1, 1986
	Sixty-Seventh Supplemental Indenture	  	November 1, 1986
	Sixty-Eighth Supplemental Indenture	  	September 1, 1987
	Sixty-Ninth Supplemental Indenture	  	February 1, 1990
	Seventieth Supplemental Indenture	  	October 1, 1990
	Seventy-First Supplemental Indenture	  	May 1, 1991
	Seventy-Second Supplemental Indenture	  	August 1, 1991
	Seventy-Third Supplemental Indenture	  	March 1, 1992
	Seventy-Fourth Supplemental Indenture	  	October 1, 1992
	Seventy-Fifth Supplemental Indenture	  	April 1, 1993
	Seventy-Sixth Supplemental Indenture	  	December 1, 1997
	Seventy-Seventh Supplemental Indenture	  	March 1, 1999
	Seventy-Eight Supplemental Indenture	  	October 1, 2000
	Seventy-Ninth Supplemental Indenture	  	May 1, 2003
	Eightieth Supplemental Indenture	  	April 30, 2004
	Eighty-First Supplemental Indenture	  	March 1, 2005
	Eighty-Second Supplemental Indenture	  	April 27, 2005
	Eighty-Third Supplemental Indenture	  	April 28, 2006
	Eighty-Fourth Supplemental Indenture	  	September 1, 2006
	Eighty-Fifth Supplemental Indenture	  	April 27, 2007
	Eighty-Sixth Supplemental Indenture	  	April 29, 2008
	Eighty-Seventh Supplemental Indenture	  	April 29, 2009
	Eighty-Eighth Supplemental Indenture	  	April 28, 2010

  

			
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	Eighty-Ninth Supplemental Indenture	  	April 26, 2011
	Ninetieth Supplemental Indenture	  	April 30, 2012
	Ninety-First Supplemental Indenture	  	April 30, 2013; and

 WHEREAS, all Bonds of any series heretofore executed, authenticated and delivered pursuant to the
Original Mortgage, as from time to time supplemented and modified, have been retired and canceled or payment duly and irrevocably provided for, except for the series set forth herein: 

 

			
	 Principal Amount of Bonds
	    	 Series

		
	 Three Hundred Million Dollars

($300,000,000)
	    	 First Mortgage
 Bonds, Pledged
Series A due December 1, 2027

		
	 Two Hundred Million Dollars

($200,000,000)
	    	 First Mortgage
 Bonds, Pledged
Series A due June 15, 2018

		
	 One Hundred Million Dollars

($100,000,000)
	    	 First Mortgage
 Bonds, Pledged
Series B due March 9, 2029

		
	 One Hundred Thirty-Eight Million Four Hundred Sixty Thousand Dollars

($138,460,000)
	    	 5% First Mortgage
 Bonds,
Pledged Series C due March 1, 2031

		
	 Twenty-Three Million Four Hundred Thousand Dollars

($23,400,000)
	    	 5.10% First Mortgage
 Bonds,
Pledged Series C due March 1, 2031

		
	 Two Hundred Fifty Million Dollars

($250,000,000)
	    	 5.483% Pledged First Mortgage

Bonds due June 1, 2035

		
	 One Hundred Fifty Million Dollars

($150,000,000)
	    	 5.197% Pledged First Mortgage

Bonds due October 1, 2015

		
	 Three Hundred Million Dollars

($300,000,000)
	    	 6.274% Pledged First Mortgage

Bonds due March 15, 2037

		
	 Two Hundred Fifty Million Dollars

($250,000,000)
	    	 6.750% Pledged First Mortgage

Bonds due January 15, 2016

  

			
	NINETY-SECOND SUPPLEMENTAL INDENTURE	  	PAGE 4

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	 Principal Amount of Bonds
	    	 Series

		
	 Three Hundred Fifty Million Dollars

($350,000,000)
	    	 5.757% Pledged First Mortgage

Bonds due October 1, 2039

		
	 Three Hundred Million Dollars

($300,000,000)
	    	 5.638% Pledged First Mortgage

Bonds due April 15, 2041

		
	 Two Hundred Fifty Million Dollars

($250,000,000)
	    	 4.434% Pledged First Mortgage

Bonds due November 15, 2041

		
	 Forty-Five Million Dollars

($45,000,000)
	    	 4.70% Pledged First Mortgage

Bonds due November 15, 2051

 which Bonds are now outstanding and constitute the only Bonds of the Company outstanding under the Indenture; and

 WHEREAS, effective as of the opening of business on January 4, 1971, The First National Bank of Boston succeeded Old
Colony Trust Company as Trustee under the Indenture by reason of the merger of Old Colony Trust Company into The First National Bank of Boston; and 
 WHEREAS, effective as of October 2, 1995, State Street Bank and Trust Company succeeded The First National Bank of Boston as Trustee under the Indenture; and 

WHEREAS, effective as of February 15, 2003, U.S. Bank National Association succeeded State Street Bank and Trust Company as Trustee
under the Indenture; and 
 WHEREAS, the Company has entered into an Indenture (the “Debenture Indenture”) dated as of
December 1, 1997 with U.S. Bank National Association (as successor to State Street Bank and Trust Company) as trustee (in such capacity, the “Debenture Indenture Trustee”) pursuant to which the Company proposes to issue from time to
time its Senior Notes (the “Senior Notes”) and the Company has agreed to make certain payments to the Debenture Indenture Trustee in respect of the principal of, premium, if any, and interest on such Senior Notes; and 

WHEREAS, in order to secure the payment and performance of its obligations under such Debenture Indenture, the Company has agreed to
create new Bonds from time to time with substantially the same terms as the Senior Notes; to issue and deliver such Bonds to the Debenture Indenture Trustee in trust for the benefit of the owners from time to time of the Senior Notes; and

  

			
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 WHEREAS, the Board of Directors of the Company has authorized the execution and delivery
of this Ninety-Second Supplemental Indenture, which establishes a new series of Bonds to be designated as “Pledged First Mortgage Bonds” due Nine Months or More From Date of Issue (hereinafter sometimes called “Bonds of the New
Series”), and the Company has complied or will comply with all provisions required to issue additional Bonds provided for in the Indenture; and 
 WHEREAS, the Company desires to execute and deliver this Ninety-Second Supplemental Indenture, in accordance with the provisions of the Indenture, for the purpose of providing for the creation of the
Bonds of the New Series, designating such series to be created and specifying the form and provisions of the Bonds of the New Series; and 
 WHEREAS, all things necessary have been done to authorize the execution, delivery and recording of these presents validly to secure the payment of the principal of and interest on the aggregate principal
amount of such Bonds of the New Series as may be issued pursuant to this Ninety-Second Supplemental Indenture, and to make such Bonds, when executed by the Company, authenticated and delivered by the Trustee and duly issued, the valid and binding
legal obligations of the Company, and to constitute the Indenture a valid and binding mortgage for the security of all the Bonds in accordance with its and their terms; 
 NOW, THEREFORE, this Ninety-Second Supplemental Indenture 
 WITNESSETH, that,
pursuant to and in execution of the powers, authorities and obligations conferred, imposed and reserved in the Indenture, and pursuant to and in execution of every other power, authority and obligation thereto appertaining and/or enabling, in order
to secure the payment of the principal of, and the premium, if any, and interest on, the Bonds of the New Series issued and to be issued under this Ninety-Second Supplemental Indenture, and secured thereby and hereby at any time outstanding
according to their tenor and effect, and the performance of all the covenants and conditions therein and herein and in said Bonds of the New Series contained, and for the purpose of confirming the lien of the Indenture, said Puget Sound Energy,
Inc., organized and existing under the laws of the State of Washington, in consideration of the premises and of One Dollar ($1.00) and other good and valuable consideration to it duly paid by the Trustee, at or before the execution and delivery of
these presents, the receipt whereof is hereby acknowledged, has granted, bargained, sold, conveyed, transferred, assigned, remised, released, mortgaged, set over and confirmed and by these presents does grant, bargain, sell, convey, transfer,
assign, remise, release, mortgage, set over and confirm unto U.S. Bank National Association, as Trustee, and to its successor or successors in the trust created by the Indenture, and to said Trustee and its assigns, for the uses and purposes created
by the Indenture, all property, real, personal or mixed, including all rights, privileges, easements, licenses and franchises, 

  

			
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described in the Indenture and thereby conveyed and mortgaged or intended so to be, including also all such property acquired by the Company since the execution and delivery of the Original
Mortgage, which by the terms of the Indenture is subjected or intended to be subjected to the lien thereof, and including also all such property as the Company may hereafter acquire which by the terms of the Indenture is subjected or intended to be
subjected to the lien thereof, excepting from the foregoing, however, all property included within the foregoing general description, whether now owned or hereafter acquired, which by the provisions of the Indenture is excepted or to be excepted
from the conveyance and lien of the Indenture, or which has heretofore been released from the lien of the Indenture or otherwise disposed of by the Company free from the lien of the Indenture in accordance with the provisions thereof; 

TO HAVE AND TO HOLD all and singular the said property, and also all other property and interest of any kind and of every nature that, by
virtue of any provision hereof or of the Indenture or otherwise, has or shall hereafter become subject to the Indenture, to the Trustee, its successor or successors and assigns; 

BUT IN TRUST NEVERTHELESS, for the equal and proportionate benefit and security (except as otherwise expressly provided) of all present
and future holders of the Bonds of the New Series issued and to be issued under and secured by this Ninety-Second Supplemental Indenture, and to secure the payment of such Bonds of the New Series and the interest thereon, prior to the Substitution
Date (as defined herein), in accordance with the provisions of said Bonds of the New Series and of this Ninety-Second Supplemental Indenture, without priority or distinction as to lien or otherwise of any Bonds of the New Series over any other Bonds
of the New Series so that, except as otherwise expressly provided, the principal of, and the premium, if any, and interest on, every such Bond shall be equally and proportionately secured by this Ninety-Second Supplemental Indenture, and to secure
the performance of and compliance with the covenants and conditions of this Ninety-Second Supplemental Indenture, pursuant to and under and subject to the provisions and conditions and for the uses hereinafter and in this Ninety-Second Supplemental
Indenture set forth; provided, however, that on the Substitution Date, the Bonds of the New Series will cease to secure the Senior Notes, and, at the option of the Company, the Senior Notes either (i) will become unsecured general obligations
of the Company or (ii) will be secured by first mortgage bonds issued under another mortgage indenture; it being hereby agreed as follows, to wit: 

  

			
	NINETY-SECOND SUPPLEMENTAL INDENTURE	  	PAGE 7

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 ARTICLE ONE 

BONDS OF THE NEW SERIES AND CERTAIN 
 PROVISIONS RELATING THERETO 
  

	 	SECTION 1.01	     

  

	 	A.	Terms of Bonds of the New Series 

 There shall be hereby established a series of bonds, known as and entitled “Series II Pledged First Mortgage Bonds” (herein referred to as the “Bonds of the New Series”). The aggregate
principal amount of the Bonds of the New Series shall not be limited (provided that for purposes of Montana law the maximum aggregate principal amount of the Bonds of the New Series shall be $1,500,000,000 and they shall be due no later than 2063)
and shall be initially authenticated and delivered from time to time upon delivery to the Trustee of the documents required by the Indenture, including a resolution of the Board of Directors, or a duly authorized committee of such Board of Directors
that has been designated an Executive Committee (the “Pricing Committee”), of the Company specifying the following with respect to each issue of the Bonds of the New Series: (i) any limitations on the aggregate principal amount of
such issue of Bonds of the New Series, (ii) the Original Issue Date (as defined below) or Dates for such issue of Bonds of the New Series, (iii) the stated maturity of such issue of Bonds of the New Series (provided that no Bond of the New
Series shall mature on a date less than nine months from its Original Issue Date), (iv) the interest rate or rates, or method of calculation of such rate or rates, for such issue of Bonds of the New Series, (v) the terms, if any, regarding
the optional or mandatory redemption of such issue of Bonds of the New Series, including the redemption date or dates, if any, and the price or prices applicable to such redemption (including any premium), (vi) whether or not such issue of
Bonds of the New Series shall be entitled to the benefit of any sinking fund, and the terms, if any, of such sinking fund, (vii) the designation of such issue of Bonds of the New Series, (viii) if the form of such Bonds of the New Series
is not as described herein, the form of such Bonds of the New Series, (ix) the maximum annual interest rate, if any, of the Bonds of the New Series permitted for such issue, (x) any other information necessary to complete the Bonds of the
New Series of such issue and (xi) any other terms of such issue not inconsistent with the Indenture or this Ninety-Second Supplemental Indenture. 
 The definitive Bonds of the New Series shall be issuable in registered form without coupons in denominations of $1,000 and integral multiples thereof or such other amount or amounts as may be authorized
by a resolution of the Board of Directors or the Pricing Committee. 

  

			
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 Both principal of and interest on the Bonds of the New Series (and premium, if any) are
to be paid in any coin or currency of the United States of America which at the time of payment is legal tender for the payment of public and private debts at a corporate trust office, in the City of New York, New York, or the City of Saint Paul,
Minnesota, of the Trustee. 
 The definitive Bonds of the New Series may, at the option of the Company, be fully engraved or
printed or lithographed on steel engraved borders. 
 Notwithstanding any provision in the Indenture to the contrary, each Bond
of the New Series shall be dated and issued as of the date of its authentication by the Trustee (the “Original Issue Date”). Each Bond of the New Series shall bear interest from the later of its Original Issue Date or the most recent date
to which interest has been paid or duly provided for with respect to such Bond of the New Series until the principal of such Bond of the New Series is paid or made available for payment, and interest on each Bond of the New Series shall be payable
on each interest payment date after the Original Issue Date. 
 Notwithstanding any provision in the Indenture to the contrary,
the person in whose name any Bond of the New Series is registered at the close of business on any record date (as determined by the Board of Directors or the Pricing Committee) with respect to any interest payment date for such Bond of the New
Series shall be entitled to receive the interest payable on such interest payment date notwithstanding the cancellation of such Bond of the New Series upon any registration of transfer, exchange or substitution thereof subsequent to such record date
and prior to such interest payment date, except that, if and to the extent that the Company shall default in the payment of the interest due on such interest payment date, then the registered holders of Bonds of the New Series on such record date
shall have no further right to or claim in respect of such defaulted interest as such registered holders on such record date, and the persons entitled to receive payment of any defaulted interest thereafter payable or paid on any Bonds of the New
Series shall be the registered holders of such Bonds of the New Series on the record date for payment of such defaulted interest. Unless otherwise determined by the Board of Directors or the Pricing Committee, the term “record date” as
used in this Section 1.01, and in the form of the Bonds of the New Series, with respect to any interest payment date applicable to any Bond of the New Series, shall mean the last day of the calendar month next preceding such interest payment
date unless such interest payment date is the date of maturity of such Bond of the New Series, in which event the record date shall be the date of maturity of such Bond of the New Series. 

In case of failure by the Company to pay any interest when due, the claim for such interest shall be deemed to have been transferred by
transfer of any Bond of the New Series registered on the books of the Company, and the Company, by not less than 10 days’ written notice to the bondholders, may fix a subsequent record date, not more than 15 days or less

  

			
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than 10 days prior to the date fixed for the payment of such interest, for determination of the holders entitled to payment of such interest. Such provision for establishment of a subsequent
record date, however, shall in no way affect the rights of the bondholders or of the Trustee consequent on any default. 
 The
Trustee hereunder shall, by virtue of its office as such Trustee, be the registrar and transfer agent of the Company for the purpose of registering and transferring Bonds of the New Series; however, the Company may also act as the registrar and
transfer agent in lieu of the Trustee. Notwithstanding any provision in the Indenture to the contrary, neither the Company nor the Trustee shall be required to make transfers or exchanges of Bonds of the New Series for a period of 15 days next
preceding any designation of Bonds of the New Series to be redeemed, and neither the Company nor the Trustee shall be required to make transfers or exchanges of any Bonds designated in whole for redemption or that part of any Bond designated in part
for redemption. 
 Notwithstanding any other provision of the Indenture to the contrary, the Company shall receive a credit
against its obligations to make any payment in respect of the principal of, or premium, if any, or interest on, any Bond of the New Series (whether at maturity, upon redemption or otherwise), and such obligations shall be fully or partially, as the
case may be, satisfied and discharged to the extent that, at the time that any such payment shall be due, the then due principal of, or premium, if any, or interest on, the Senior Notes initially issued contemporaneously with such Bond of the New
Series shall have been fully or partially paid or there shall have been deposited with the Debenture Indenture Trustee pursuant to the Debenture Indenture sufficient available funds to fully or partially pay the then due principal of, or premium, if
any, or interest on, such Senior Notes. The obligations of the Company hereunder to make such payment of principal of, premium, if any, or interest on, such Bond of the New Series shall be deemed to have been reduced by the amount of such credit.

 The Debenture Indenture requires that if any Senior Note in respect of which any Bond of the New Series was delivered to the
Debenture Indenture Trustee pursuant to the Debenture Indenture is deemed paid and discharged pursuant to Section 5.01 of the Debenture Indenture, the obligation of the Company to make payment with respect to the principal of and premium, if
any, and interest on such Bond of the New Series shall be satisfied and discharged and such Bond of the New Series shall cease to secure such Senior Note in any manner and, the Debenture Indenture Trustee shall surrender such Bond of the New Series,
subject to the limitations of the Debenture Indenture, to the Company for cancellation. 
 The Bonds of the New Series shall be
issued and delivered pursuant to the Debenture Indenture to, registered in the name of and held by the Debenture Indenture Trustee in trust 

  

			
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for the benefit of the owners from time to time of the Senior Notes. The Debenture Indenture Trustee shall not sell, assign or transfer any of the Bonds of the New Series except to a successor
trustee under the Debenture Indenture. The Company may take such actions as it shall deem desirable to effect compliance with such restrictions on transfer, including the placing of an appropriate legend on the Bonds of the New Series. 

 

	 	B.	Form of Bonds of the New Series 

 The Bonds of the New Series, and the Trustee’s authentication certificate to be executed on the Bonds of the New Series, shall be in substantially the following forms respectively: 

[FORM OF FACE OF BOND OF THE NEW SERIES] 
 REGISTERED 
 $          

No.              
 PUGET SOUND ENERGY, INC. 
 SERIES II PLEDGED FIRST MORTGAGE BOND

  

							
	Original Issue Date:	  	Interest Rate:	 	 	Maturity Date:
		  	 	            	% 	 	
			
	Initial Redemption Date:	  	 Initial Redemption

Percentage:
	 	 	 Annual Redemption
 Percentage
Reduction:

		  				 	

 PUGET SOUND ENERGY, INC., a corporation of the state of Washington (the “Company”), for value
received hereby promises to pay to 
 DOLLARS 
 or registered assigns, the principal sum of 

  

			
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 on the Maturity Date set forth above, and to pay interest thereon from the Original Issue Date set forth
above or from the most recent date to which interest has been paid or duly provided for, semiannually in arrears on              and
             in each year (each, an “Interest Payment Date”), commencing on the first such Interest Payment Date succeeding the Original Issue Date set forth above, at the per
annum Interest Rate set forth above, until the principal hereof is paid or made available for payment. No interest shall accrue on the Maturity Date, so long as the principal amount of this Bond is paid in full on the Maturity Date. The interest so
payable and punctually paid or duly provided for on any such Interest Payment Date will be paid to the person in whose name this Bond is registered (the “Holder”) at the close of business on the Regular Record Date for such interest, which
shall be the              or             , as the case may be, next preceding such Interest Payment Date; provided that the first
Interest Payment Date for any Bond, the Original Issue Date of which is after a Regular Record Date but prior to the applicable Interest Payment Date, shall be the Interest Payment Date following the next succeeding Regular Record Date; and
provided, further, that interest payable on the Maturity Date set forth above or, if applicable, upon redemption or acceleration, shall be payable to the person to whom principal shall be payable. Any such interest not so punctually paid or duly
provided for will forthwith cease to be payable to the Holder on such Regular Record Date and shall be paid to the person in whose name this Bond is registered at the close of business on a Special Record Date for the payment of such defaulted
interest to be fixed by the Trustee, notice whereof shall be given to the Holder not more than 15 days nor fewer than 10 days prior to such Special Record Date. 
 Both principal of and interest on this Bond (and premium, if any) are to be paid in any coin or currency of the United States of America which at the time of payment is legal tender for the payment of
public and private debts at a corporate trust office, in the City of New York, New York, or the City of Saint Paul, Minnesota, of the Trustee. 
 If any Interest Payment Date or the date on which the principal of this Bond is required to paid is not a Business Day, then payment of principal, premium or interest need not be made on such date but may
be made on the next succeeding Business Day with the same force and effect as if made on such Interest Payment Date or the date on which the principal of this Bond is required to be paid, and, in the case of timely payment thereof, no interest shall
accrue for the period from and after such Interest Payment Date or the date on which the principal of this Bond is required to be paid. 
 “Business Day” means each Monday, Tuesday, Wednesday, Thursday and Friday that is not a day on which banking institutions or trust companies in the Borough of Manhattan, The City of New York, or
in the city where the corporate trust office of the Debenture Indenture Trustee (as defined on the reverse hereof) is located, are obligated or authorized by law or executive order to close. 

  

			
	NINETY-SECOND SUPPLEMENTAL INDENTURE	  	PAGE 12

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 This Bond shall not become obligatory for any purpose or be entitled to any security or
benefit under said Indenture until the authentication certificate hereon shall have been signed by the Trustee. 
 The
provisions of this Bond are continued on the reverse hereof and such continued provisions shall for all purposes have the same effect as though fully set forth at this place. 
 IN WITNESS WHEREOF, PUGET SOUND ENERGY, INC. has caused these presents to be executed in its corporate name and behalf by the facsimile of the signature of its President or one of its Vice Presidents and
by the facsimile of the signature of its Treasurer or an Assistant Treasurer or its Secretary, thereunto duly authorized, and its corporate seal or a facsimile thereof to be hereto affixed. 

 

									
		 		 		 	PUGET SOUND ENERGY, INC.
					
	Dated:	 	  
	 		 		 	
					
		 		 		 	By	 	  

		 		 		 	Its	 	  

					
		 		 		 	And by	 	  

		 		 		 	Its	 	  

  

			
	NINETY-SECOND SUPPLEMENTAL INDENTURE	  	PAGE 13

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 [FORM OF REVERSE OF BOND OF THE NEW SERIES] 

PUGET SOUND ENERGY, INC. 
 Series II Pledged First Mortgage Bond 
 This Bond is one of the Bonds of the
above-designated series, of an unlimited authorized amount of Bonds of the Company known as First Mortgage Bonds, all issued or to be issued in one or more series under and secured by a First Mortgage dated as of June 2, 1924, executed and
delivered by the Company to Old Colony Trust Company (U.S. Bank National Association, successor) as Trustee, as supplemented and/or modified by indentures supplemental thereto, including particularly the Fortieth Supplemental Indenture, dated as of
September 1, 1954, in Part II of which are set forth the revised provisions of said First Mortgage as theretofore and then supplemented and modified, and the Ninety-Second Supplemental Indenture dated as of September 1, 2006,
relating, among other things, to the Bonds of the above-designated series, and by all other instruments supplemental thereto (herein sometimes called the “Indenture”), reference to each and all of which is hereby made for a description of
the property mortgaged and pledged as security for said Bonds, the rights and remedies of the Holder of this Bond in regard thereto, and the terms and conditions upon which Bonds may be issued. 

The Bonds of this series shall be issuable in registered form without coupons in denominations of $1,000 and integral multiples thereof
or such other amount or amounts as may be authorized by a resolution of the Board of Directors or a duly authorized committee of the Board of Directors that has been designated an Executive Committee (the “Pricing Committee”). 

This Bond is issued to secure the payment and performance of the Company’s obligations under the Indenture, dated as of
December 1, 1997 (the “Debenture Indenture”), with U.S. Bank National Association (successor to State Street Bank and Trust Company), as Trustee (the “Debenture Indenture Trustee”) to make payments in respect of the
principal of, premium, if any, and interest on Senior Notes of the Company (the “Senior Notes”) initially issued contemporaneously with this Bond. 
 Notwithstanding any other provision of the Indenture to the contrary, the Company shall receive a credit against its obligations to make any payment in respect of the principal of, or premium, if any, or
interest on, this Bond (whether at maturity, upon redemption or otherwise), and such obligations shall be fully or partially, as the case may be, satisfied and discharged to the extent that, at the time that any such payment shall be due, the then
due principal of, or premium, if any, or interest on, the Senior Notes of the Company initially 

  

			
	NINETY-SECOND SUPPLEMENTAL INDENTURE	  	PAGE 14

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issued contemporaneously with this Bond shall have been fully or partially paid or there shall have been deposited with the Debenture Indenture Trustee pursuant to the Debenture Indenture
sufficient available funds to fully or partially pay the then due principal of, or premium, if any, or interest on, such Senior Notes. The obligations of the Company to make such payment of principal of, premium, if any, or interest on, this Bond
shall be deemed to have been reduced by the amount of such credit. 
 This Bond is not transferable except as required to effect
transfer to any successor trustee under the Debenture Indenture. 
 As provided in the Ninety-Second Supplemental Indenture, the
Holder of this Bond, by his acceptance hereof, hereby consents, and all other holders of the Bonds of the above designated series, by their acceptance thereof, shall thereby consent, for the purpose and within the meaning of Section 18.02 of
the Indenture, to modifications of the Indenture that (a) redefine the term “minimum provision for depreciation” by deducting from operating revenues the cost of fuel used in the generation of electricity and (b) allow that any
corporation to which all or substantially all of the corporate trust business of the Trustee may have been transferred shall succeed as trustee without the performance of any other act. The modification in clause (a) has become effective and
the modification in clause (b) shall become effective without any further approval or consent of the holder of this Bond when a further supplemental indenture has been executed with the requisite consents of the holders of the Bonds of each
other series then outstanding or when all Bonds of all series issued prior to May 1, 2003 have ceased to be outstanding. 

This Bond is subject to redemption at the option of the Company on any date on and after the Initial Redemption Date, if any, specified
on the face hereof (any date fixed for redemption shall hereafter be referred to as a “Redemption Date”). If no Initial Redemption Date is set forth on the face hereof, this Bond may not be redeemed at the option of the Company prior to
the Maturity Date specified on the face hereof. On and after the Initial Redemption Date, if any, this Bond may be redeemed at any time in whole or from time to time in part at the option of the Company at the applicable Redemption Price (as defined
below) together with interest thereon payable to the Redemption Date, on notice given not less than 30 days nor more than 60 days prior to the Redemption Date. In the event of redemption of this Bond in part only, a new Bond of like tenor and series
for the unredeemed portion hereof shall be issued in the name of the Holder hereof upon the surrender hereof. 
 If this Bond is
redeemable in the foregoing manner at the option of the Company, the “Redemption Price” shall initially be the Initial Redemption Percentage, specified on the face hereof, of the principal amount of this Bond to be redeemed and shall
decline at each anniversary of the Initial Redemption Date by the Annual Redemption Percentage Reduction, if any, specified on the face hereof, of the principal amount to be redeemed until the Redemption Price is 100% of such principal amount.

  

			
	NINETY-SECOND SUPPLEMENTAL INDENTURE	  	PAGE 15

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 If this Bond or any portion hereof ($1,000 or any multiple thereof) is duly designated
for redemption, if payment of the principal hereof or of such portion, together with accrued interest and premium, if any, is irrevocably provided for, and if notice of such redemption shall have been duly given, this Bond shall cease to be entitled
to the lien of the Indenture from and after the date such payment is irrevocably so provided for and shall cease to bear interest from and after the date fixed for redemption. 
 The Indenture provides that (1) the Company and the Trustee, with the consent of the holders of not less than 66-2/3% in principal amount of the Bonds at the time outstanding (determined as provided
in the Indenture) including, if more than one series of Bonds shall be at the time outstanding, not less than 66-2/3% in principal amount of the Bonds at the time outstanding of each series affected, may effect, by an indenture supplemental to the
Indenture, further modifications or alterations of the Indenture and of the rights and obligations of the Company and of the holders of the Bonds; provided, however, that no such modification or alteration shall be made without the consent of the
registered owner hereof which will (a) extend the maturity of this Bond or reduce the rate or extend the time of payment of interest hereon or reduce the amount of the principal hereof or reduce any premium payable on the redemption hereof, or
(b) permit the creation of any lien, not otherwise permitted, prior to or on a parity with the lien of the Indenture, or alter the equal and proportionate security afforded by the lien of the Indenture for the Bonds issued thereunder, or
(c) reduce the number or percentage of the principal amount of the Bonds upon the consent of the holders of which modifications or alterations may be made as aforesaid or defaults may be waived; and (2) the holders of like percentages of
the principal amount of the Bonds outstanding and of each such series thereof may waive certain uncured past defaults and the consequences thereof. 
 In certain events of default, the principal of this Bond may be declared due and payable before maturity as provided in said Indenture. 

The registered owner of this Bond is the Debenture Indenture Trustee. The Debenture Indenture requires that if any Senior Note in respect
of which this Bond was delivered to the Debenture Indenture Trustee pursuant to the Debenture Indenture is deemed paid and discharged pursuant to Section 5.01 of the Debenture Indenture, the obligation of the Company to make payment with
respect to the principal of and premium, if any, and interest on this Bond shall be satisfied and discharged and this Bond shall cease to secure such Senior Note in any manner, and the Debenture Indenture Trustee shall surrender this Bond, subject
to the limitations of the Debenture Indenture, to the Company for cancellation. 

  

			
	NINETY-SECOND SUPPLEMENTAL INDENTURE	  	PAGE 16

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 The Ninety-Second Supplemental Indenture provides that in the event of any default of
the interest due on any interest payment date, such interest shall not be payable to the holder of the Bond on the original record date but shall be paid to the registered holder of such Bond on the subsequent record date established for payment of
such defaulted interest. 
 It is part of the contract herein contained that each holder hereof waives all right of recourse to
any personal, statutory or other liability of any promoter, shareholder, officer or director, past, present or future, of the Company or of any predecessor or successor corporation for the collection of any indebtedness hereunder as more fully
provided in said Indenture. 
 [FORM OF TRUSTEE’S AUTHENTICATION CERTIFICATE] 

This is one of the Bonds, of the series designated herein, described in the within-mentioned Indenture. 

 

			
	U.S. BANK NATIONAL ASSOCIATION, as Trustee
		
	By	 	  

		 	Authorized Officer

  

	 	SECTION 1.02	Redemption Provisions 

 As
designated by resolution of the Board of Directors or the Pricing Committee, the Bonds of the New Series may be subject to redemption prior to maturity, as a whole at any time or in part from time to time, at the option of the Company, upon payment
of the Redemption Price designated by the Board of Directors or the Pricing Committee, together with interest accrued thereon to the date fixed for redemption, upon not less than 30 days’ nor more than 60 days’ notice given by
first class mail, postage prepaid, to the holder of record at the date of such notice of each Bond of the New Series affected, at his address as shown on the Bond register. Such notice shall be sufficiently given if deposited in the United States
mail within such period. Neither the failure to mail such notice, nor any defect in any notice so mailed to any holder, shall affect the sufficiency of such notice. The foregoing provision with respect to notice shall be subject to all other
conditions and provisions of the Indenture not inconsistent herewith. 
  

	 	SECTION 1.03	Depreciation Fund 

Notwithstanding the provisions of Section Six of Article II Part I of the Fortieth Supplemental Indenture, the Company
hereby covenants that, so long as any of the Bonds of the New Series shall remain outstanding, (a) the covenants made by the Company in Section 

  

			
	NINETY-SECOND SUPPLEMENTAL INDENTURE	  	PAGE 17

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Four of Article II of Part I of the Fortieth Supplemental Indenture shall continue in full force and effect and (b) Bonds delivered, redeemed or purchased pursuant to said Section
Four and any amount of unfunded Bond credits used as a credit in Item 7 of any depreciation fund certificate shall be deemed to be funded, unless and until the same shall have been reinstated as provided in said Section Four or in
Section 2.03 of the Indenture. Cash deposited in the depreciation fund may not be applied to the redemption of the Bonds of the New Series. 
  

	 	SECTION 1.04	Duration of Effectiveness of Article One 

 This Article shall be in force and effect only so long as any of the Bonds of the New Series are outstanding. 
  

	 	SECTION 1.05	Execution and Delivery 

An unlimited aggregate principal amount of Bonds of the New Series may forthwith, upon execution and delivery of the Ninety-Second
Supplemental Indenture, or from time to time thereafter, and upon compliance by the Company with the provisions of Article Five of the Indenture, be executed by the Company and delivered to the Trustee and shall thereupon be authenticated and
delivered by the Trustee to or upon the written order of the Company. 
  

	 	SECTION 1.06	Substitution 

 On the
Substitution Date (as defined below), the Trustee will deliver to the Company for cancellation all Bonds of the New Series. The Company will cause the Trustee to provide notice to all holders of Bonds of the New Series prior to the occurrence of the
Substitution Date. “Substitution Date” shall mean the date that all Bonds issued and outstanding under the Indenture (“Electric Bonds”), other than the Bonds of the New Series or any other Bonds issued to secure the
Company’s obligations on its Senior Notes, and all first mortgage bonds of the Company issued and outstanding under the Indenture of First Mortgage, dated as of April 1, 1957 (the “Gas Utility Mortgage”), from the Company, as
successor to Washington Natural Gas Company, to The Bank of New York Mellon Trust Company, N.A., successor to Harris Trust and Savings Bank, as trustee, as supplemented and amended (“Gas Bonds” and, together with the Electric Bonds, the
“First Mortgage Bonds”), other than Gas Bonds issued to secure the Company’s obligations on its Senior Notes, have been retired (at, before or after the maturity thereof) through payment, redemption or otherwise (including those
Electric Bonds deemed to be paid within the meaning of the Indenture and those Gas Bonds deemed to be paid within the meaning of the Gas Utility Mortgage). 

  

			
	NINETY-SECOND SUPPLEMENTAL INDENTURE	  	PAGE 18

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	 	SECTION 1.08	Definitions 

 All other
terms used but not otherwise defined in this Ninety-Second Supplemental Indenture shall be taken to have the same meaning as in the Indenture, except in cases where the context herein clearly indicates otherwise. 

ARTICLE TWO 
 PRINCIPAL AMOUNT PRESENTLY TO BE OUTSTANDING 
  

	 	SECTION 2.01	     

The total aggregate principal amount of Bonds of the Company issued and outstanding as of the date hereof under the provisions of and
secured by the Indenture is Two Billion Six Hundred Fifty-Six Million Eight Hundred Sixty Thousand Dollars ($2,656,860,000); namely, the series of Bonds set forth herein: 

 

			
	 Principal Amount of Bonds
	    	 Series

		
	 Three Hundred Million Dollars

($300,000,000)
	    	 First Mortgage Bonds,
 Pledged
Series A due December 1, 2027

		
	 Two Hundred Million Dollars

($200,000,000)
	    	 First Mortgage Bonds,
 Pledged
Series A due June 15, 2018

		
	 One Hundred Million Dollars

($100,000,000)
	    	 First Mortgage Bonds,
 Pledged
Series B due March 9, 2029

		
	 One Hundred Thirty-Eight Million Four Hundred Sixty Thousand Dollars

($138,460,000)
	    	 5% First Mortgage Bonds,

Pledged Series C due March 1, 2031

		
	 Twenty-Three Million Four Hundred Thousand Dollars

($23,400,000)
	    	 5.10% First Mortgage Bonds,

Pledged Series C due March 1, 2031

		
	 Two Hundred Fifty Million Dollars

($250,000,000)
	    	 5.483% Pledged First Mortgage

Bonds due June 1, 2035

  

			
	NINETY-SECOND SUPPLEMENTAL INDENTURE	  	PAGE 19

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	 Principal Amount of Bonds
	    	 Series

		
	 One Hundred Fifty Million Dollars

($150,000,000)
	    	 5.197% Pledged First Mortgage

Bonds due October 1, 2015

		
	 Three Hundred Million Dollars

($300,000,000)
	    	 6.274% Pledged First Mortgage

Bonds due March 15, 2037

		
	 Two Hundred Fifty Million Dollars

($250,000,000)
	    	 6.750% Pledged First Mortgage

Bonds due January 15, 2016

		
	 Three Hundred Fifty Million Dollars

($350,000,000)
	    	 5.757% Pledged First Mortgage

Bonds due October 1, 2039

		
	 Three Hundred Million Dollars

($300,000,000)
	    	 5.638% Pledged First Mortgage

Bonds due April 15, 2041

		
	 Two Hundred Fifty Million Dollars

($250,000,000)
	    	 4.434% Pledged First Mortgage

Bonds due November 15, 2041

		
	 Forty-Five Million Dollars

($45,000,000)
	    	 4.70% Pledged First Mortgage

Bonds due November 15, 2051

 Additional Bonds of the New Series and of any other series established after the execution and delivery of this
Ninety-Second Supplemental Indenture may from time to time be authenticated, delivered and issued pursuant to the terms of the Indenture and indentures supplemental thereto. 

 

	 	SECTION 2.02	     

Without limitation as to aggregate principal amount, Bonds of the New Series may forthwith, upon execution and delivery of this
Ninety-Second Supplemental Indenture, or from time to time thereafter, and upon compliance by the Company with the provisions of Article Five of the Indenture, be executed by the Company and delivered to the Trustee and shall thereupon be
authenticated and delivered by the Trustee to or upon the written order of the Company. 

  

			
	NINETY-SECOND SUPPLEMENTAL INDENTURE	  	PAGE 20

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 ARTICLE THREE 

MISCELLANEOUS 
  

	 	SECTION 3.01	     

This Ninety-Second Supplemental Indenture is executed and shall be construed as an indenture supplemental to the Indenture, and shall form
a part thereof, and the Indenture, as hereby supplemented and modified, is hereby confirmed. Except to the extent inconsistent with the express terms hereof, all the provisions, terms, covenants, and conditions of the Indenture shall be applicable
to the Bonds of the New Series to the same extent as if specifically set forth herein. 
  

	 	SECTION 3.02	     

The Trustee has accepted the amendment of the Indenture effected by this Ninety-Second Supplemental Indenture and agrees to execute the
trust created by the Indenture as hereby amended, but only upon the terms and conditions set forth in the Indenture, including the terms and provisions defining and limiting the liabilities and responsibilities of the Trustee, and without limiting
the generality of the foregoing, the Trustee shall not be responsible in any manner whatsoever for or with respect of any of the recitals or statements contained herein, all of which recitals or statements are made solely by the Company, or for or
with respect to (a) the validity or sufficiency of this Ninety-Second Supplemental Indenture or any of the terms or provisions hereof, (b) the proper authorization hereof by the Company by corporate action or otherwise, and (c) the
due execution hereof by the Company. 
  

	 	SECTION 3.03	     

The Company covenants that it is lawfully seized and possessed of all the trust estate at the date of the execution of the Ninety-Second
Supplemental Indenture except as in the Indenture otherwise stated or permitted; that on said date the trust estate is free and clear from all liens and encumbrances other than permitted encumbrances, except as in the Indenture otherwise stated or
permitted; that the Company will warrant and forever defend the trust estate and the title thereto to the Trustee against the claims of all persons whomsoever except as in the Indenture otherwise stated or permitted; that it will maintain and
preserve the lien of the Indenture, as a first mortgage lien, except as in the Indenture otherwise stated or permitted so long as any of the Bonds issued under the Indenture are outstanding; and that it has good right and lawful authority to subject
said property to the lien of the Indenture, as provided in and by the Indenture. 

  

			
	NINETY-SECOND SUPPLEMENTAL INDENTURE	  	PAGE 21

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	 	SECTION 3.04	     

This Ninety-Second Supplemental Indenture may be executed in several counterparts, and each of such counterparts shall for all purposes be
deemed to be an original, and all such counterparts, or as many of them as the Company and the Trustee shall preserve undestroyed, shall together constitute but one and the same instrument. 

 

	 	SECTION 3.05	     

Although this Ninety-Second Supplemental Indenture is dated for convenience and for the purpose of reference as of May 1, 2013, the
actual date or dates of execution by the Company and by the Trustee are as indicated by their respective acknowledgments hereto annexed. 
 ARTICLE FOUR 
 MODIFICATION OF THE INDENTURE 

 

	 	SECTION 4.01	     

Each holder of any of the Bonds of the New Series, by his or its acceptance thereof, thereby acknowledges, agrees and consents that
Section 1.32 of the Indenture is modified to read as follows: 
 “So long as there are outstanding any Bonds of the
1984 Series or any Bonds of any other series subsequently authenticated and delivered hereunder as to which it is so provided in the supplemental indenture establishing said Bonds or modifying this Indenture, the term “minimum provision for
depreciation” for each calendar year (or monthly fractions thereof) in the period being computed shall mean an amount by which 15% of the gross operating revenues of the Company derived from the operation of its utility property subject to the
lien of the Indenture (after deducting from such operating revenues (a) an amount equal to the cost of electricity purchased, including any standby or service charges or similar charges for electricity and net cost of electricity interchanged,
(b) all rentals and lease payments, and (c) the cost of fuel used in the generation of electricity during such period to the extent such cost is included or reflected in operating expense accounts of the Company) exceeds the charges for
maintenance, repairs and renewals of such mortgaged utility property included or which should be included in operating expense pursuant to sound accounting practice.” 

  

			
	NINETY-SECOND SUPPLEMENTAL INDENTURE	  	PAGE 22

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	 	SECTION 4.02	     

Each holder of any of the Bonds of the New Series, by his or its acceptance thereof, shall thereby consent, for the purpose and within the
meaning and intent of Section 18.02 of the Indenture, that the first sentence of Section 15.20 of the Indenture shall be modified (effective at the time provided in Section 4.03 hereof) to read as follows: 

“Any corporation into which the Trustee may be merged or with which it may be consolidated or any corporation resulting from any
merger or consolidation to which the Trustee shall be a party or any corporation to which substantially all the business and assets of the Trustee or of the corporate trust business of the Trustee may be transferred, provided such corporation shall
be eligible under the provisions of Section 15.01 and qualified under Section 15.13, shall be successor Trustee under this Indenture, without the execution or filing of any paper or the performance of any further act on the part of any
other party hereto, anything herein to the contrary notwithstanding.” 
  

	 	SECTION 4.03	     

The modification of the Indenture set forth in Section 4.02 hereof shall become effective without any further approval or consent of
the holders of any Bonds of the New Series (a) when a further supplemental indenture making it effective shall have been executed with the consent of the holders of not less than 66-2/3% in principal amount of the Bonds of each other series at
the time outstanding or (b) when all Bonds of all series issued prior to the May 1, 2003 have ceased to be outstanding. 

  

			
	NINETY-SECOND SUPPLEMENTAL INDENTURE	  	PAGE 23

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 IN WITNESS WHEREOF, Puget Sound Energy, Inc. has caused this Ninety-Second Supplemental
Indenture to be signed in its corporate name and behalf by its President or one of its Vice Presidents or its Treasurer or Assistant Treasurer and its corporate seal to be hereunto affixed and attested by its Secretary or one of its Assistant
Secretaries, and U.S. Bank National Association in token of its acceptance of the trust hereby created has caused this Ninety-Second Supplemental Indenture to be signed in its corporate name and behalf by its Vice President or one of its Assistant
Vice Presidents, and its corporate seal to be hereunto affixed and attested by one of its Vice Presidents, Assistant Vice Presidents or one of its Assistant Secretaries, all as of the day and year first above written. 

 

			
	PUGET SOUND ENERGY, INC.
		
	By	 	 /s/ Brandon Lohse

		 	Brandon Lohse
		 	Corporate Treasurer

  

	
	Attest:
	
	 /s/ Samuel S. Osborne     

	Samuel S. Osborne
	Assistant Secretary

 

			
	U.S. BANK NATIONAL ASSOCIATION
	
	not in its individual capacity but solely as Trustee
		
	By	 	 /s/ K. Wendy Kumar

		 	Authorized Officer

  

	
	Attest:
	
	 /s/ Sirojui Dindial-Persaud

  

			
	NINETY-SECOND SUPPLEMENTAL INDENTURE	  	PAGE 24

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	STATE OF WASHINGTON	  	)
		  	) ss.
	COUNTY OF KING	  	)

 On this      day of
             2013, before me personally appeared Brandon Lohse and Samuel S. Osborne to me known to be the Corporate Treasurer and Assistant Secretary, respectively, of PUGET SOUND ENERGY,
INC., one of the corporations that executed the within and foregoing instrument and acknowledged the said instrument to be the free and voluntary act and deed of said corporation for the uses and purposes therein mentioned, and on oath stated that
they were authorized to execute and attest said instrument, and that the seal affixed is the corporate seal of said corporation. 
 IN WITNESS THEREOF I have hereunto set my hand and affixed my official seal the day and year first above written. 

 

					
	  

	Notary Name:
	Notary Public for the State of Washington
	Residing at	 	  

					
	My commission expires:	 	  

  

			
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	STATE OF NEW YORK	  	)
		  	) ss.
	COUNTY OF QUEENS	  	)

 On this      day of
             2013, before me personally appeared              and
             to me known to be a Vice President and Assistant Vice President, respectively, of U.S. BANK NATIONAL ASSOCIATION, one of the corporations that executed the within and foregoing
instrument and acknowledged the said instrument to be the free and voluntary act and deed of said corporation for the uses and purposes therein mentioned, and on oath stated that they were authorized to and did in the name and on behalf of said
corporation execute and attest said instrument. 
 IN WITNESS WHEREOF I have hereunto set my hand the day and year first above
written. 
  

			
	  

		 	[Signature of Notary]
	  

		 	[Printed Name of Notary]
	Notary Public for the State of New York
	Residing at	 	  

		 	[City of Residence]

 
			
	My commission expires:	 	  

		 	[Month    Day    Year]

  

			
	NINETY-SECOND SUPPLEMENTAL INDENTURE	  	PAGE 26EX-10.1

 EXHIBIT 10.1 
 LOAN AGREEMENT 
 THIS LOAN AGREEMENT, dated as of
October 5th, 2006 (this “Agreement”), is
between UNIVERSITY HOSPITAL SYSTEMS, LLP, a Delaware limited liability partnership (“Borrower”), and FELIX SPIEGEL, M.D., an individual (“Lender”). 

RECITALS: 

Borrower has requested that Lender extend credit to Borrower in the form of a revolving line of credit in the amount of $2,000,000.00.
Lender is willing to make such extensions of credit to Borrower upon the terms and conditions hereinafter set forth. 
 NOW
THEREFORE, in consideration of the premises and the mutual covenants herein contained, the parties hereto agree as follows: 

ARTICLE I. 

Definitions 

Section 1.1. Definitions. As used in this Agreement, the following terms have the following meanings: 

“Advance” means an advance of funds by Lender to Borrower pursuant to Article II. 

“Advance Request Form” means a certificate, in substantially the form of Exhibit “C”, properly
completed and signed by Borrower requesting an Advance. 
 “Advance Termination Date” means
September 30, 2007. 
 “Affiliate” means, with respect to any Person, any other Person
which, directly or indirectly, controls or is controlled by or is under common control with such Person, including , (a) any Person which beneficially owns or holds ten percent (10%) or more of any class of voting stock of such Person or
ten percent (10%) or more of the equity interest in such Person, (b) any Person of which such Person beneficially owns or holds ten percent (10%) or more of any class of voting shares or in which such Person beneficially owns or holds
ten percent (10%) or more of the equity interests in such Person, and (c) any officer or director of such Person. 
 “Authorized Representative” means any officer or employee of Borrower who has been designated in writing by Borrower to Lender to be an Authorized Representative. 

“Business Day” means any day on which commercial banks are not authorized or required to close in Houston,
Texas. 
 “Closing Date” means the date on which this Agreement has been executed and delivered by the
parties hereto and the conditions set forth in Section 6.1 have been satisfied. 

 EXHIBIT 10.1 

 

 “Commitment” means the obligation of Lender to make Advances
hereunder in an aggregate principal amount at any time outstanding up to but not exceeding $2,000,000.00, except as otherwise provided in Section 2.1. 
 “Debt” means for any Person (a) all indebtedness, whether or not represented by bonds, debentures, notes, securities or other evidences of indebtedness, for the repayment of money
borrowed, including, with respect to Borrower, the indebtedness evidenced by the Note and all other indebtedness of Borrower to Lender, (b) all indebtedness representing deferred payment of the purchase price of property or assets, (c) all
indebtedness under any lease which is required to be capitalized for balance sheet purposes, (d) all indebtedness under guaranties, endorsements, assumptions or other contingent obligations, in respect of, or to purchase or otherwise acquire,
indebtedness of others, (e) all indebtedness secured by a Lien existing on property owned, subject to such Lien, whether or not the indebtedness secured thereby shall have been assumed by the owner thereof, and (f) any obligation to redeem
or repurchase any of such Person’s capital stock, partnership or membership interests or other ownership interests as applicable. 
 “Default Rate” means the lesser of (a) the sum of the Prime Rate in effect from day to day plus five percent (5.0%) or (b) the Maximum Rate. 

“Distribution” means (a) any distribution, dividend or any other payment or distribution (in cash,
property or obligations) made by Borrower on account of its partnership interests, (b) any redemption, purchase, retirement or other acquisition by Borrower of any of its partnership interests, or (c) the establishment of any fund for any
such distribution, dividend, payment or acquisition. 
 “Environmental Laws” means any and all
laws, rules, regulations, codes, ordinances, orders, decrees, judgments, injunctions, notices or binding agreements issued, promulgated or entered into by any federal, state, county, municipal or other governmental unit, relating in any way to the
environment, preservation or reclamation of natural resources, the management, release or threatened release of Hazardous Substance or to health and safety matters. 

“ERISA” means the Employee Retirement Income Security Act of 1974, as amended from time to time, and the
regulations and published interpretations thereof. 
 “Event of Default” has the meaning
specified in Section 11.1. 
 “Field Audits” means audits, verifications and inspections of
the accounts receivable of Borrower, conducted by an independent third Person selected by Lender. 

“Funded Debt” means, at any time, for Borrower, the sum of (a) all indebtedness for borrowed money,
whether or not evidenced by bonds, debentures, notes or similar instruments, including the Note, (b) all obligations as lessee under capital leases, (c)all obligations to pay the deferred purchase price of property or services (but excluding
trade accounts payable or trade notes in the ordinary course of business that are not past due by more than 90 days), (d) all indebtedness secured by a Lien on the property of such Borrower. 

  
 2 

 EXHIBIT 10.1 

 

 “Guarantors” means Kamran Nezami, Hassan Chahadeh,
M.D., Octavio Calvillo, M.D. and Henry Small, M.D., and “Guarantor” means any one of them. 

“Guaranty Agreement” means a Guaranty Agreement executed by a Guarantor in favor of Lender in
substantially the form of Exhibit “B”, as the same may be amended, supplemented or modified. 

“Hazardous Substance” means any substance, product, waste, pollutant, material, chemical, contaminant,
constituent or other material which is or becomes listed, regulated or addressed under any Environmental Law. 

“Income Tax Expense” means for Borrower for any period, all state and federal income taxes paid or due to
be paid during such period. 
 “Lien” means any lien, mortgage, security interest, tax lien,
financing statement, pledge, charge, hypothecation, assignment, preference, priority or other encumbrance of any kind or nature whatsoever (including, without limitation, any conditional sale or title retention agreement), whether arising by
contract, operation of law or otherwise. 
 “Loan Documents” means this Agreement and all
promissory notes, security agreements, deeds of trust, assignments, letters of credit, guaranties, and other instruments, documents and agreements executed and delivered pursuant to or in connection with this Agreement, as such instruments,
documents and agreements maybe amended, modified, renewed, extended or supplemented. 
 “Material Adverse
Effect” means a material adverse effect on (a) the business, operations, property or condition (financial or otherwise) of Borrower and its Subsidiaries, taken as a whole, or the Obligated Parties, taken as a whole, (b) the
ability of Borrower to pay the Obligations or the ability of Borrower or the Obligated Parties, taken as a whole, to perform their respective obligations under this Agreement or any of the other Loan Documents or (c) the validity or
enforceability of this Agreement or any of the other Loan Documents, or the rights or remedies of Lender hereunder or there under. 
 “Maximum Rate” means the maximum rate of nonusurious interest permitted from day to day by applicable law, including Chapter 303 of the Texas Finance Code(the “Code”) (and as
the same may be incorporated by reference in other Texas statutes). To the extent that Chapter 303 of the Code is relevant to Lender for the purposes of determining the Maximum Rate, Lender may elect to determine such applicable legal rate pursuant
to the “weekly ceiling,” from time to time in effect, as referred to and defined in Chapter 303 of the Code; subject, however, to the limitations on such applicable ceiling referred to and defined in the Code, and further subject to any
right Lender may have subsequently 
 “Note” means the promissory note executed by Borrower
payable to the order of Lender, in substantially the form of Exhibit “A”, as the same may be renewed, extended or modified and all promissory notes executed in renewal, extension, modification or substitution thereof. 

  
 3 

 EXHIBIT 10.1 

 

 “Obligated Party” means each Guarantor and any other
Person who is or becomes a party to any agreement pursuant to which such Person guarantees or secures payment and performance of the Obligations or any part thereof. 

“Obligations” means all obligations, indebtedness and liabilities of Borrower to Lender, now existing or
hereafter arising, including, without limitation, the obligations, indebtedness and liabilities of Borrower under the Note, and all interest accruing thereon and all attorneys’ fees and other expenses incurred in the enforcement or collection
thereof. 
 “Organizational Documents” means, for any Person, (a) the articles of
incorporation and bylaws of such Person if such Person is a corporation, (b) the articles of organization and regulations of such Person if such Person is a limited liability company, (c) the limited partnership agreement of such Person if
such Person is a limited partnership, or (d) the documents under which such Person was created and is governed if such person is not a corporation, limited liability company or limited partnership. 

“Person” means any individual, corporation, limited liability company, partnership, joint venture,
company, trust, governmental authority or other entity. 
 “Plans and Specifications” means the plans
and specifications for the development, construction and renovation of the Project, approved by Borrower and Lender as required herein, and all amendments and modifications thereof. 

“Prime Rate” means that variable rate of interest per annum established by Lender from time to time as
its prime rate which shall vary from time to time. Such rate is set by Lender as a general reference rate of interest, taking into account such factors as Lender may deem appropriate, it being understood that many of Lender’s commercial or
other loans are priced in relation to such rate, that it is not necessarily the lowest or best rate charged to any customer and that Lender may make various commercial or other loans at rates of interest having no relationship to such rate.

 “Regulatory Change” means, with respect to Lender, any change after the date of this
Agreement in United States federal, state or foreign laws or regulations(including Regulation D of the Board of Governors of the Federal Reserve System), or the adoption or making after such date of any interpretations, directives or requests
applying to a class of banks including Lender of or under any United States federal, state or foreign laws or regulations (whether or not having the force of law) by any court or governmental or monetary authority charged with the interpretation or
administration thereof. 
 “Subsidiary” means any Person of which or in which Borrower or its
other Subsidiaries own or control, directly or indirectly, fifty percent (50%) or more of (a) the combined voting power of all classes having general voting power under ordinary circumstances to elect a majority of the directors, managers
or equivalent body of such Person, if it is a corporation, (b) the capital interest or profits interest of such Person, if it is a partnership, limited liability company, joint venture or similar entity, or (c) the beneficial interest of
such Person, if it is a trust, association or other unincorporated association or organization. 

  
 4 

 EXHIBIT 10.1 

 

 “Tax Distribution” means any Distribution made by
Borrower in amounts which are sufficient to permit the partners of Borrower to pay their federal income taxes which arise solely and directly as a result of their ownership interest in Borrower. 

“Termination Date” means 11:00 a.m., Houston, Texas time on September 30, 2007, or such earlier date
on which the Commitment terminates as provided in this Agreement. 
 “Unmatured Event of
Default” means the occurrence of an event or the existence of a condition which, with the giving of notice or the passage of time would constitute an Event of Default. 

Section 1.2. All definitions contained in this Agreement are equally applicable to the singular and plural forms of the terms
defined. The words “hereof’, “herein” and “hereunder” and words of similar import referring to this Agreement refer to this Agreement as a whole and not to any particular provision of this Agreement. Unless otherwise
specified, all Article and Section references pertain to this Agreement. All accounting terms not specifically defined herein shall be construed in accordance with GAAP. Terms used herein that are defined in the Uniform Commercial Code as adopted by
the State of Texas, unless otherwise defined herein, shall have the meanings specified in the Uniform Commercial Code as adopted by the State of Texas. In the event that, at any time, Borrower has no Subsidiaries, all references to the Subsidiaries
of Borrower and the consolidation of certain financial information shall be deemed to be inapplicable until such time as Borrower has a Subsidiary. 
 ARTICLE II. 
 Advances 

Section 2.1. Advances. Subject to the terms and conditions of this Agreement, Lender agrees to make one or more Advances to
Borrower from time to time from the date hereof to and including the Termination Date in an aggregate principal amount at any timeout standing up to but not exceeding the Commitment; provided that the aggregate amount of all Advances at any time
outstanding shall not exceed the Commitment. Lender shall have no obligation to make any Advance if an Event of Default or an Unmatured Event of Default has occurred and is continuing. Subject to the foregoing limitations, and the other terms and
provisions of this Agreement, Borrower may borrow, repay and reborrow hereunder. 
 Section 2.2. Note. The
obligation of Borrower to repay the Advances shall be evidenced by Note executed by Borrower, payable to the order of Lender, in the principal amount of the Commitment. 
 Section 2.3. Repayment of Advances. Borrower shall repay the unpaid principal amount of all Advances on the earlier of (a) the Termination Date or (b) such other dates on which the
Advances are or may be required to be paid pursuant to this Agreement. 

  
 5 

 EXHIBIT 10.1 

 

 Section 2.4. Interest. The unpaid principal amount of the Advances shall bear
interest prior to maturity at a varying rate per annum equal from day to day to the lesser of (a)the Maximum Rate or (b) the greater of (i) TEN percent (10%) per annum or (ii) the sum of the Prime Rate in effect from day to day
plus TWO percent (2.0%), and each change in the rate of interest charged on the Advances shall become effective, without notice to Borrower, on the effective date of each change in the Prime Rate or the Maximum Rate, as the case may be; provided,
however, if at any time the rate of interest specified in clause (b) preceding shall exceed the Maximum Rate, thereby causing the interest on the Advances to be limited to the Maximum Rate, then any subsequent reduction in the Prime Rate shall
not reduce the rate of interest on the Advances below the Maximum Rate until the aggregate amount of interest actually accrued on the Advances equals the amount of interest which would have accrued on the Advances if the interest rate specified in
clause (b) preceding had at all times been in effect. Accrued and unpaid interest on the Advances shall be payable on the last day of each month commencing on October 31, 2006, and on the Termination Date. If an Event of Default has
occurred and is continuing, all principal of the Advances shall bear interest at the Default Rate. 
 Section 2.5.
Requests for Advances. Borrower shall give Lender notice of each requested Advance by delivery to Lender of an Advance Request Form executed by an Authorized Representative, properly completed and containing the information required therein,
including the purpose for each Advance. Assuming that each Advance Request Form is in proper form, if Lender receives an Advance Request Form prior to 1:00 p.m. on any Business Day, Lender will make the requested Advance on the same Business Day,
and if Lender receives an Advance Request Form after 1:00 p.m., Lender will make the requested Advance on the next Business Day. 
 Section 2.6. Use of Proceeds. The proceeds of Advances shall be used for working capital purposes or operating expenses. 

ARTICLE III. 

Intentionally Omitted 
 ARTICLE IV. 
 Payments 

Section 4.1. Method of Payment. All payments of principal, interest and other amounts to be made by Borrower under this
Agreement, the Note or any other Loan Documents shall be made to Lender at its designated office, without setoff, deduction or counterclaim in immediately available funds. Whenever any payment under this Agreement, the Note or any other Loan
Document shall be stated to be due on a day that is not a Business Day, such payment may be made on the next Business Day, and interest shall continue to accrue until the payment is received. 

Section 4.2. Voluntary Prepayment. Borrower may prepay the Note in whole or in part at any time or from time to time without
premium or penalty but with accrued interest to the date of prepayment on the amount so prepaid. 

  
 6 

 EXHIBIT 10.1 

 

 Section 4.3. Computation of Interest. Interest on the indebtedness evidenced
by the Note shall be computed on the basis of a year of 360 days and the actual number of days elapsed (including the first day but excluding the last day) unless such calculation would result in a usurious rate, in which case interest shall be
calculated on the basis of a year of 365 or 366 days, as the case may be. 
 ARTICLE V. 

Guaranty 

Section 5.1. Guaranty. Guarantors shall unconditionally and irrevocably guarantee payment and performance of the Obligations as
provided in the Guaranty Agreement by execution and delivery of the Guaranty Agreement, respectively. 
 ARTICLE VI. 

Conditions Precedent 
 Section 6.1. Initial Extension of Credit. The obligation of Lender to make the initial Advance is subject to the condition precedent that prior thereto Lender shall have received all of the
documents set forth below in form and substance satisfactory to Lender. 
 (a) Certificate –
Borrower. A certificate of a Manager or another officer of Borrower acceptable to Lender certifying (i) resolutions of the partners of Borrower which authorize the execution, delivery and performance by Borrower of this Agreement and the other
Loan Documents to which Borrower is or is to be a party and (ii) the names of the officers of Borrower authorized to sign this Agreement and each of the other Loan Documents to which Borrower is or is to be a party together with specimen
signatures of such Persons. 
 (b) Organizational Documents – Borrower. The Partnership Agreement of
Borrower and the Certificate of Partnership of Borrower certified by an officer of Borrower acceptable to Lender. 
 (c) Governmental Certificates – Borrower. A certificate issued by the appropriate government official of the state of organization of Borrower as to the existence of Borrower. 

(d) Note. The Note executed by Borrower. 

(e) Guaranty Agreements. The Guaranty Agreements executed by each of the Guarantors, respectively. 

(f) Attorneys’ Fees and Expenses. Evidence that the costs and expenses (including reasonable attorneys’
fees) referred to in Section 12.1, to the extent incurred, have been paid in full by Borrower. 

  
 7 

 EXHIBIT 10.1 

 

 (g) Additional Documentation. Such additional approvals, opinions
or documents as Lender may reasonably request. 
 Section 6.2. Conditions to Advances. The obligation of Lender to
make any Advance (including the initial Advance) is subject to receipt by Lender of the items required by Section 2.5, as applicable, and such additional approvals or documents as Lender may reasonably request. 

ARTICLE VII. 

Representations and Warranties 
 To induce Lender to enter into this Agreement, Borrower represents and warrants to Lender that: 
 Section 7.1. Existence. Borrower and each Subsidiary (a) are duly organized, validly existing and in good standing under the laws of their respective jurisdictions of organization,(b)
have all requisite power and authority to own their assets and carry on their business as now being or as proposed to be conducted and (c) are qualified to do business in all jurisdictions necessary and where failure to so qualify would have a
Material Adverse Effect. Borrower has the power and authority to execute, deliver and perform its obligations under this Agreement and the other Loan Documents to which it is or may become a party. 

Section 7.2. Requisite Action; No Breach. The execution, delivery and performance by Borrower of this Agreement and the other
Loan Documents to which Borrower is or may become a party have been duly authorized by all requisite action on the part of Borrower and do not and will not violate or conflict with the Organizational Documents of Borrower or any law, rule or
regulation or any order, writ, injunction or decree of any court, governmental authority or arbitrator, and do not and will not conflict with, result in a breach of, or constitute a default under, or result in the imposition of any Lien (except as
provided in this Agreement) upon any of the revenues or assets of Borrower or any Subsidiary pursuant to the provisions of any indenture, mortgage, deed of trust, security agreement, franchise, permit, license or other instrument or agreement by
which Borrower or any Subsidiary or any of their respective properties is bound. 
 Section 7.3. Operation of Business.
Borrower and each Subsidiary possess all licenses, permits, franchises, patents, copyrights, trademarks and trade names, or rights thereto, to conduct their respective businesses substantially as now conducted and as presently proposed to be
conducted. 
 Section 7.4. Litigation and Judgments. There is no action, suit, investigation or proceeding before or
by any court, governmental authority or arbitrator pending, or to the knowledge of Borrower, threatened against or affecting Borrower or any Subsidiary, that could, if adversely determined, have a Material Adverse Effect. There are no outstanding
judgments against Borrower or any Subsidiary. 
 Section 7.5. Rights in Properties; Liens. Borrower and each Subsidiary
have good and marketable title to or valid leasehold interests in their respective properties and assets, real and personal, and none of the properties, assets or leasehold interests of Borrower or any Subsidiary is subject to any Lien, except as
permitted by this Agreement. 

  
 8 

 EXHIBIT 10.1 

 

 Section 7.6. Enforceability. This Agreement constitutes, and the other Loan
Documents to which Borrower is a party, when delivered, shall constitute the legal, valid and binding obligations of Borrower, enforceable against Borrower in accordance with their respective terms, except as enforceability thereof may be limited by
bankruptcy, insolvency or other laws of general application relating to the enforcement of creditor’s rights. 

Section 7.7. Approvals. No authorization, approval or consent of, and no filing or registration with, any court,
governmental authority or third party is or will be necessary for the execution, delivery or performance by Borrower of this Agreement and the other Loan Documents to which Borrower is or may become a party or the validity or enforceability thereof.

 Section 7.8. Use of Proceeds; Margin Securities. Neither Borrower nor any Subsidiary is engaged principally, or
as one of its important activities, in the business of extending credit for the purpose of purchasing or carrying margin stock (within the meaning of Regulations T, U or X of the Board of Governors of the Federal Reserve System), and no part of the
proceeds of any extension of credit under this Agreement will be used to purchase or carry any such margin stock or to extend credit to others for the purpose of purchasing or carrying margin stock. 

Section 7.9. ERISA. Borrower and each Subsidiary have complied with all applicable minimum funding requirements and all other
applicable and material requirements of ERISA, and there are no existing conditions that would give rise to liability thereunder. No Reportable Event (as defined in Section 4043 of ERISA) has occurred in connection with any employee benefit
plan that might constitute grounds for the termination thereof by the Pension Benefit Guaranty Corporation or for the appointment by the appropriate United States District Court of a trustee to administer such plan. 

Section 7.10. Taxes. Borrower and each Subsidiary have filed all tax returns (federal, state and local) required to be filed,
including all income, franchise, employment, property and sales taxes, and have paid all of their liabilities for taxes, assessments, governmental charges and other levies that are due and payable, and Borrower knows of no pending investigation of
Borrower or any Subsidiary by any taxing authority or of any pending but unassessed tax liability of Borrower or any Subsidiary. 
 Section 7.11. Disclosure. There is no fact known to Borrower which has a Material Adverse Effect on the Borrower or which might in the future have a Material Adverse Effect on the Borrower
that has not been disclosed in writing to Lender. 
 Section 7.12. Subsidiaries. Borrower has no Subsidiaries.

 Section 7.13. Compliance with Laws. Neither Borrower nor any Subsidiary is in violation in any material respect
of any law, rule, regulation, order or decree of any court, governmental authority or arbitrator. 

  
 9 

 EXHIBIT 10.1 

 

 Section 7.14. Compliance with Agreements. Neither Borrower nor any
Subsidiary is in violation in any material respect of any document, agreement, contract or instrument to which it is a party or by which it or its properties are bound. 
 Section 7.15. Environmental Matters. Borrower and each Subsidiary, and their respective properties, are in compliance with all applicable Environmental Laws and neither Borrower nor any
Subsidiary is subject to any liability or obligation for remedial action thereunder. There is no pending or threatened investigation or inquiry by any governmental authority of Borrower or any Subsidiary or any of their respective properties
pertaining to any Hazardous Substance. Except in the ordinary course of business and in compliance with all Environmental Laws, there are no Hazardous Substances located on or under any of the properties of Borrower or any Subsidiary. Except in the
ordinary course of business and incompliance with all Environmental Laws, neither Borrower nor any Subsidiary has caused or permitted any Hazardous Substance to be disposed of on or under or released from any of its properties. Borrower and each
Subsidiary have obtained or will obtain prior to the time required all permits, licenses and authorizations which are required under and by all Environmental Laws. 
 Section 7.16. Solvency. Borrower and its Subsidiaries, on an individual and a consolidated basis, are not insolvent, Borrower’s and its Subsidiaries’ assets, on an individual and a
consolidated basis, exceed their liabilities, and Borrower will not be rendered insolvent by the execution and performance of this Agreement and the Loan Documents. 
 Section 7.17. Investment Company Act. Neither Borrower nor any Subsidiary is an “investment company” within the meaning of the Investment Company Act of 1940, as amended. 

ARTICLE VIII.  
 Affirmative Covenants 
 Borrower covenants and agrees that, as long as the
Obligations or any part thereof are outstanding or Lender has any Commitment hereunder, Borrower will perform and observe the covenants set forth below, unless Lender shall otherwise consent in writing 

Section 8.1. Reporting Requirements. Borrower will deliver to Lender: 

(a) Tax Returns. Within fifteen (15) days following the filing thereof, copies of each federal income tax
return filed by Borrower. 
 (b) Notice of Litigation. Promptly after the commencement thereof, notice of all
actions, suits and proceedings before any court or governmental department, commission, board, agency or instrumentality, domestic or foreign, affecting Borrower, any Guarantor or any Subsidiary which could have a Material Adverse Effect.

 (c) Judgments. Within five (5) days of obtaining knowledge thereof, notice of any judgment against
Borrower, any Guarantor or any Subsidiary in an amount which is greater than $25,000.00. 

  
 10 

 EXHIBIT 10.1 

 

 (d) Notice of Default. As soon as possible and in any event within five
(5)days after the occurrence of each Event of Default and Unmatured Event of Default a written notice setting forth the details of such Event of Default or Unmatured Event of Default or event and the action which Borrower has taken and proposes to
take with respect thereto. 
 (e) Notice of Material Adverse Effect. As soon as possible, and in any event within
five (5) days after Borrower becomes aware thereof, notice of the occurrence of any event or the existence of any condition which could have a Material Adverse Effect. 

(f) General Information. Promptly, such other information concerning Borrower, any Guarantor or any Subsidiary as Lender
may from time to time reasonably request. 
 Section 8.2. Maintenance of Existence; Conduct of Business. Borrower
will preserve and maintain, and will cause each Subsidiary to preserve and maintain, its corporate existence and all of its leases, privileges, licenses, permits, franchises, qualifications and rights that are necessary in the ordinary conduct of
its business 
 Section 8.3. Maintenance of Properties. Borrower will maintain, and will cause each Subsidiary to maintain
its assets and properties in good condition and repair. 
 Section 8.4. Taxes and Claims. Borrower will pay or discharge,
and will cause each Subsidiary to pay or discharge, at or before maturity or before becoming delinquent (a) all taxes, levies, assessments and governmental charges imposed on it or its income or profits or any of its property and (b) all
lawful claims for labor, material and supplies, which, if unpaid, might become a Lien upon any of its property; provided, however, that neither Borrower nor any Subsidiary shall be required to pay or discharge any claim, tax, levy, assessment or
governmental charge with respect to which no Lien has been filed of record, which is being contested in good faith by appropriate proceedings diligently pursued and for which adequate reserves have been established. 

Section 8.5. Insurance. 
 (a) Borrower will maintain, and will cause each Subsidiary to maintain, with financially sound and reputable insurance companies workmen’s compensation insurance, liability insurance and insurance on
its property, assets and business, all at least in such amounts and against such risks as are usually insured against by Persons engaged in similar businesses. Each insurance policy covering Collateral shall name Lender as lender loss payee
and provide that such policy will not be cancelled without thirty (30) days prior written notice to Lender. 

(b) Borrower will cause its partners to maintain malpractice insurance in at least in such amounts and against such risks
as are usually insured against by physicians engaged in similar practices. 

  
 11 

 EXHIBIT 10.1 

 

 Section 8.6. Inspection; Field Audits. At any reasonable time and from time
to time, Borrower will permit, and will cause Guarantor and each Subsidiary to permit, representatives of Lender: 
 (a) To examine and make copies of the books and records of, and visit and inspect the properties or assets of Borrower, Guarantors and any Subsidiary and to discuss the business, operations and financial
condition of any such Persons with their respective officers and employees and with their independent certified public accountants; and 
 (b) To conduct Field Audits; provided, however, that (i) Lender intends to conduct at least one Field Audit during each fiscal year of Borrower, and (ii) the cost of one Field Audit during each
fiscal year shall be paid by Borrower. 
 Section 8.7. Keeping Books and Records. Borrower will maintain, and will
cause each Subsidiary to maintain, proper books of record and account in which full, true and correct entries in conformity with Borrower’s historical accounting methods and procedures and in compliance with good accounting principles
consistently applied shall be made of all dealings and transactions in relation to its business and activities. 

Section 8.8. Compliance with Laws. Borrower will comply, and will cause each Subsidiary to comply, in all material respects
with all applicable laws, rules, regulations and orders of any court, governmental authority or arbitrator. 
 Section 8.9.
Compliance with Agreements. Borrower will comply, and will cause each Subsidiary to comply, in all material respects with all agreements, contracts and instruments binding on it or affecting its properties or business. 

Section 8.10. Further Assurances. Borrower will execute and deliver, and will cause each Subsidiary to execute and deliver, such
further instruments as may be requested by Lender to carry out the provisions and purposes of this Agreement and the other Loan Documents and to preserve and perfect the Liens of Lender in the Collateral. 

Section 8.11. ERISA. Borrower will comply, and will cause each Subsidiary to comply, with all minimum funding requirements, and all
other material requirements, of ERJSA, if applicable, so as not to give rise to any liability thereunder. 
 Section 8.12.
Continuity of Operations. Borrower will continue to conduct, and will cause each Subsidiary to continue to conduct, its primary businesses as conducted as of the Closing Date and to continue its operations in such businesses. 

ARTICLE IX. 

Negative Covenants 
 Borrower covenants and agrees that, as long as the Obligations or any part thereof are outstanding or Lender has any Commitment hereunder, Borrower will perform and observe the covenants set forth
below, unless Lender shall otherwise consent in writing. 

  
 12 

 EXHIBIT 10.1 

 

 Section 9.1. Mergers. Acquisitions, Dissolutions and Disposition of Assets.
Borrower will not, and will not permit any Subsidiary to, (a) become a party to a merger, consolidation, partnership or joint venture or purchase or otherwise acquire all or a substantial part of the assets of any Person or any shares or other
evidence of beneficial ownership of any Person,(b) dissolve or liquidate, (c) amend its Organizational Documents, (d) sell, lease, assign, transfer or otherwise dispose of substantially all of its assets, except dispositions of inventory
in the ordinary course of business, (e) create any new Subsidiary or (f) enter into any agreement to do any of the foregoing. 
 Section 9.2. Restricted Payments. Borrower will not declare or pay any Distribution if (a) at the time of making such Distribution, an Event of Default or Unmatured Event of Default exists, or
(b) an Event of Default or Unmatured Event of Default would arise as a result of making such Distribution. 

Section 9.3. Loans and Advances. Other than advances for normal business expenses, Borrower will not make, and will not permit any
Subsidiary to make, any advance, loan or extension of credit to any Person, including any employee, officer or director of Borrower or any Subsidiary. 
 Section 9.4. Investments. Borrower will not make, and will not permit any Subsidiary to make, any capital contribution to or investment in, or purchase, or permit any Subsidiary to purchase, any
stock, bonds, notes, debentures, or other securities of any Person, except (a) readily marketable direct obligations of the United States of America, (b) fully insured certificates of deposit with maturities of one year or less from the
date of acquisition of Lender or any commercial bank operating in the United States having capital and surplus in excess of $100,000,000.00, (c) commercial paper of a domestic issuer if at the time of purchase such paper is rated in one of the
two highest rating categories of Standard and Poor’s Corporation or Moody’s Investors Service, Inc., and (d) investments made through Lender or its Affiliates and approved by Lender. 

Section 9.5. Compliance with Environmental Laws. Borrower will not, and will not permit any Subsidiary to, (a) use (or permit
any tenant to use) any of their respective properties or assets for the handling, processing, storage, transportation or disposal of any Hazardous Substance, except in the ordinary course of business and in compliance with all Environmental Laws,
(b) generate any Hazardous Substance, except in the ordinary course of business and in compliance with all Environmental Laws, (c) conduct any activity which is likely to cause a release or threatened release of any Hazardous Substance, or
(d) otherwise conduct any activity or use any of their respective properties or assets in any manner that is likely to violate any Environmental Law. 
 Section 9.6. Accounting. Borrower will not make, and will not permit any Subsidiary to make, any change in accounting methods unless Borrower shall have received the consent of Lender and
Borrower’s accounting treatments and reporting practices shall be in accordance Borrower’s historical accounting methods and procedures and in compliance with good accounting principles consistently applied. 

  
 13 

 EXHIBIT 10.1 

 

 Section 9.7. Change of Business. Borrower will not enter into, or permit any
Subsidiary to enter into, any type of business which is materially different from the business in which Borrower or such Subsidiary is presently engaged. 
 Section 9.8. Transactions With Affiliates. Borrower will not enter into, or permit to exist, and will not permit any Subsidiary to enter into or permit to exist, any transaction, arrangement
or contract (including any lease or other rental agreement) with any of its Affiliates which is on terms which are less favorable than are obtainable from any Person who is not an Affiliate of Borrower or such Subsidiary. 

ARTICLE X.  
 Intentionally Omitted 
 ARTICLE XI. 

Default 

Section 11.1. Events of Default. Each of the following shall be deemed an “Event of Default”: 

(a) Borrower shall fail to pay the Obligations or any part thereof within five (5) days of the date when due.

 (b) Any representation or warranty made or deemed made by Borrower or any Obligated Party (or any of their
respective officers) in any Loan Document or in any certificate, report, notice or financial statement furnished at any time in connection with this Agreement shall be false, misleading or erroneous in any material respect when made or deemed to
have been made. 
 (c) Borrower or any Obligated Party shall fail to perform, observe or comply with (i) any
covenant, agreement or term contained in Sections 8.1, 8.5, 8.13, or 8.15, or Article IX or Article X of this Agreement or (ii) any covenant, agreement or term contained in this Agreement (other than in Sections 8.1, 8.5, 8.13, or 8.15, or
Article IX or Article X of this Agreement) or any other Loan Document and such failure shall continue for fifteen (15) days following the date on which Lender gives Borrower notice of such failure. 

(d) Borrower, any Subsidiary, or any Obligated Party shall commence a voluntary proceeding seeking liquidation,
reorganization or other relief with res pect to itself or its debts under any bankruptcy, insolvency or other similar law now or hereafter in effect or seeking the appointment of a trustee, receiver, liquidator, custodian or other similar official
of it or a substantial part of its property or shall consent to any such relief or to the appointment of or taking possession by any such official in an involuntary case or other proceeding commenced against it or shall make a general assignment for
the benefit of creditors or shall generally fail to pay its debts as they become due or shall take any corporate action to authorize any of the foregoing. 

  
 14 

 EXHIBIT 10.1 

 

 (e) An involuntary proceeding shall be commenced against Borrower, any
Subsidiary or any Obligated Party seeking liquidation, reorganization or other relief with respect to it or its debts under any bankruptcy, insolvency or other similar law now or hereafter in effect or seeking the appointment of a trustee, receiver,
liquidator, custodian or other similar official for it or a substantial part of its property, and such involuntary proceeding shall remain undismissed and unstayed for a period of thirty (30) days. 

(f) Borrower, any Subsidiary or any Obligated Party shall fail to discharge within a period of thirty (30) days after
the commencement thereof any attachment, sequestration or similar proceeding or proceedings involving an aggregate amount m excess of $25,000.00 against any of its assets or properties. 

(g) Borrower, any Subsidiary or any Obligated Party shall fail to satisfy and discharge promptly any judgment or judgments
against it for the payment of money in an aggregate amount in excess of $25,000.00. 
 (h) Borrower, any
Subsidiary or any Obligated Party shall fail to pay when due any principal of or interest on any Debt (other than the Obligations), or the maturity of any such Debt shall have been accelerated, or any such Debt shall have been required to be prepaid
prior to the stated maturity thereof, or any event shall have occurred that permits (or, with the giving of notice or lapse of time or both, would permit) any holder or holders of such Debt or any Person acting on behalf of such holder or holders to
accelerate the maturity thereof or require any such prepayment. 
 (i) This Agreement or any other Loan Document
shall cease to be in full force and effect or shall be declared null and void or the validity or enforceability thereof shall be contested or challenged by Borrower, any Subsidiary, any Obligated Party or any of their respective owners, or Borrower
or any Obligated Party shall deny that it has any further liability or obligation under any of the Loan Documents, or any Lien or security interest created by the Loan Documents shall for any reason cease to be a valid, first priority perfected
security interest in and Lien upon any of the Collateral purported to be covered thereby. 
 (j) A Material
Adverse Effect shall have occurred. 
 (k) The ownership of more than twenty percent (20%) of the ownership
interests of either the limited partners or the General Partner of Borrower shall change, on a cumulative basis, during the term of this Agreement. 
 Section 11.2. Remedies Upon Default. If any Event of Default shall occur, Lender may do any one or more of the following: (a) declare the outstanding principal of and accrued and unpaid interest
on the Note and the Obligations or any part thereof to be immediately due and payable, and the san1e shall thereupon become immediately due and payable, without notice, demand, presentment, notice of dishonor, notice of acceleration, notice of
intent to accelerate, notice of intent to demand, protest or other formalities of any kind, all of which are hereby expressly waived by Borrower, (b) terminate the Commitment without notice to Borrower, (c) foreclose or otherwise enforce
any Lien granted to Lender to secure payment and 

  
 15 

 EXHIBIT 10.1 

 

 
performance of the Obligations and (d) exercise any and all rights and remedies afforded byte laws of the State of Texas or any other jurisdiction by any of the Loan Documents, by equity or
otherwise; provided, however, that upon the occurrence of an Event of Default under Section 11.1(d) or Section 11.1(e), the Commitment shall automatically terminate, and the outstanding principal of and accrued and unpaid interest on the
Note and the other Obligations shall become immediately due and payable without notice, demand, presentment, notice of dishonor, notice of acceleration, notice of intent to accelerate, notice of intent to demand, protest or other formalities of any
kind, all of which are hereby expressly waived by Borrower. 
 Section 11.3. Performance by Lender. If Borrower shall
fail to perform any covenant, duty or agreement contained in any of the Loan Documents, Lender may after five (5) days prior written notice to Borrower perform or attempt to perform such covenant, duty or agreement on behalf of
Borrower. In such event, Borrower shall, at the request of Lender, promptly pay any amount expended by Lender in such performance or attempted performance to Lender, together with interest thereon at the Default Rate from the date of such
expenditure until paid. Notwithstanding the foregoing, it is expressly agreed that Lender shall not have any liability or responsibility for the performance of any obligation of Borrower under this Agreement or any other Loan Document. 

ARTICLE XII. 

Miscellaneous 

Section 12.1. Expenses of Lender. Borrower hereby agrees to pay Lender on demand (a) all reasonable costs and expenses incurred by
Lender in connection with the preparation, negotiation and execution of this Agreement and the other Loan Documents and any and all amendments, modifications, renewals, extensions and supplements thereof and thereto, including, without limitation,
the reasonable fees and expenses of Lender’s legal counsel, (b) all reasonable costs and expenses incurred by Lender in connection with the enforcement of this Agreement or any other Loan Document, including, without limitation, the fees
and expenses of Lender’s legal counsel and (c) all other reasonable costs and expenses incurred by Lender in connection with this Agreement or any other Loan Document, including, without limitation, all costs, expenses, taxes, assessments,
filing fees and other charges levied by any governmental authority or otherwise payable in respect of this Agreement or any other Loan Document or in obtaining any insurance policy, audit or appraisal in respect of the Collateral. 

Section 12.2. INDEMNIFICATION. BORROWER HEREBY INDEMNIFIES LENDER AND EACH AFFILIATE THEREOF AND THEIR RESPECTIVE OFFICERS,
DIRECTORS, EMPLOYEES., ATTORNEYS AND AGENTS FROM, AND HOLDS EACH OF THEM HARMLESS AGAINST, ANY AND ALL LOSSES, LIABILITIES, CLAIMS, DAMAGES, PENALTIES, JUDGMENTS, DISBURSEMENTS, COSTS AND EXPENSES (INCLUDING ATTORNEYS’ FEES) (COLLECTIVELY,
“CLAIMS”) TO WHICH ANY OF THEM MAY BECOME SUBJECT WHICH · DIRECTLY OR INDIRECTLY ARISE FROM OR RELATE TO (A) THE NEGOTIATION, EXECUTION, DE LIVERY, PERFORMANCE, ADMINISTRATION OR ENFORCEMENT OF ANY OF THE LOAN DOCUMENTS,
(B) ANY OF THE TRANSACTIONS CONTEMPLATED BY THE LOAN DOCUMENTS, (C) ANY 

  
 16 

 EXHIBIT 10.1 

 

 
BREACH BY BORROWER OF ANY REPRESENTATION, WARRANTY, COVENANT OR OTHER AGREEMENT CONTAINED IN ANY OF THE LOAN DOCUMENTS, (D) THE PRESENCE, RELEASE, THREATENED RELEASE, DISPOSAL, REMOVAL OR
CLEANUP OF ANY HAZARDOUS SUBSTANCE LOCATED ON, ABOUT, WITHIN OR AFFECTING ANY OF THE PROPERTIES OR ASSETS OF BORROWER OR ANY SUBSIDIARY, (E) ANY ACT OR OMISSION OF LENDER BASED UPON ANY FAX OR ELECTRONIC TRANSMISSION OR (F)ANY MATTER RELATED TO
ANY LETTER OF CREDIT, INCLUDING, WITH RESPECT TO ALL OF THE ABOVE, ANY CLAIM WHICH ARISES AS A RESULT OF THE NEGLIGENCE OF LENDER; PROVIDED, HOWEVER, THAT BORROWER’S INDEMNIFICATION OBLIGATIONS UNDER THIS SECTION 12.2 SHALL NOT APPLY TO
THE EXTENT THAT THE CLAIMS ARISE AS A RESULT OF THE GROSS NEGLIGENCE OR WILLFUL MISCONDUCT OF ANY INDEMNIFIED PERSON. 

Section 12.3. Limitation of Liability. Neither Lender nor any Affiliate, officer, director, employee, attorney or agent of Lender
shall have any liability with respect to, and Borrower hereby waives, releases and agrees not to sue any of them upon, any claim for any special, indirect, incidental or consequential damages suffered or incurred by Borrower in connection with,
arising out of, or in any way related to, this Agreement or any of the other Loan Documents, or any of the transaction contemplated by this Agreement or any of the other Loan Documents. Borrower hereby waives, releases and agrees not to sue Lender
or any of Lender’s Affiliates, officers, directors, employees, attorneys or agents for punitive damages in respect of any claim in connection with, arising out of, or in any way related to, this Agreement or any of the other Loan Documents, or
any of the transactions contemplated by this Agreement or any of the other Loan Documents. 
 Section 12.4. No Waiver;
Cumulative Remedies. No failure on the part of Lender to exercise and no delay in exercising, and no course of dealing with respect to, any right, power or privilege under this Agreement shall operate as a waiver thereof, nor shall any single or
partial exercise of any right, power or privilege under this Agreement preclude any other or further exercise thereof or the exercise of any other right, power or privilege. The rights and remedies provided for in this Agreement and the other Loan
Documents are cumulative and not exclusive of any rights and remedies provided by law. 
 Section 12.5. Successors and
Assigns. This Agreement is binding upon and shall inure to the benefit of Lender and Borrower and their respective successors and assigns, except that Borrower may not assign or transfer any of its rights or obligations under this Agreement
without prior written consent of Lender. 
 Section 12.6. Survival. All representations and warranties made in this
Agreement or any other Loan Document or in any document, statement or certificate furnished in connection with this Agreement shall survive the execution and delivery of this Agreement and the other Loan Documents, and no investigation by Lender or
any closing shall affect the representations and warranties or the right of Lender to rely upon them. Without prejudice to the survival of any other obligation of Borrower hereunder, the obligations of Borrower under Sections 12.1 and 13.2 shall
survive repayment of the Note and termination of the Commitment. 

  
 17 

 EXHIBIT 10.1 

 

 Section 12.7. Amendment. The provisions of this Agreement may be amended or waived
only by an instrument in writing signed by the parties hereto. 
 Section 12.8. Maximum Interest Rate. No provision
of this Agreement or of any other Loan Documents shall require the payment or the collection of interest in excess of the Maximum Rate. If any excess of interest in such respect is hereby provided for, or shall be adjudicated to be so provided, in
any other Loan Documents or otherwise in connection with this loan transaction, the provisions of this Section shall govern and prevail and neither Borrower nor the sureties, guarantors, successors or assigns of Borrower shall be obligated to pay
the excess amount of such interest or any other excess sum paid for the use, forbearance or detention of sums loaned pursuant hereto. In the event Lender ever receives, collects or applies as interest any such sum, such amount which would be in
excess of the maximum amount permitted by applicable law shall be applied as a payment and reduction of the principal of the indebtedness evidenced by the Note; and, if the principal of the Note has been paid in full, any remaining excess shall
forthwith be paid to Borrower. In determining whether or not the interest paid or payable exceeds the Maximum Rate, Borrower and Lender shall, to the extent permitted by applicable law, (a) characterize any non-principal payment as an expense,
fee or premium rather than as interest, (b) exclude voluntary prepayments and the effects thereof and (c) amortize, prorate, allocate and spread in equal or unequal parts the total amount of interest throughout the entire contemplated term
of the indebtedness evidenced by the Note so that interest for the entire term does not exceed the Maximum Rate. 

Section 12.9. Notices. 
 (a) All notices and other communications provided for in this Agreement and the other Loan Documents shall be in writing and may (subject to paragraph (b) below) be telecopied (faxed), mailed by
certified mail return receipt requested, or delivered by hand or overnight courier service to the intended recipient at the addresses specified below or at such other address as shall be designated by any party listed below in a notice to the other
parties listed below given in accordance with this Section. 
  

					
		 	If to Borrower:	  	University Hospital Systems, LLP
		 		  	1 Houston Center- 1221 McKinney Street
		 		  	Suite 3240
		 		  	Houston, TX 77010
		 		  	Attention: Kamran Nezami
		 		  	Telephone No.:
                            
		 		  	Fax No.:
                            

  

					
		 		  	
		 	With a copy to:	  	Winstead, Sechrest & Minick
		 		  	2400 Bank One Center
		 		  	910 Travis Street
		 		  	Houston, TX 77002
		 		  	Attention: Ed Laborde
		 		  	Telephone No.: 713.650.2797
		 		  	Fax No.: 713.650.2400

  
 18 

 EXHIBIT 10.1 

 

							
		 	If to Lender:	  	Felix Spiegel, M.D.	  	
		 		  	  
	  	
		 		  	  
	  	
		 		  	Telephone No.:
                            	  	
		 		  	Fax No.:
                            	  	
				
		 	With a Copy to:	  	John Creighton	  	
		 		  	  
	  	
		 		  	  
	  	
		 		  	Telephone No.:
                            	  	
		 		  	Fax No.: 409.838.6959	  	

 Except as otherwise provided in this Agreement, all such communications shall be deemed to have been duly
given when transmitted by telecopy (fax), subject to confirmation of receipt, when delivered if by hand or overnight courier service or, in the case of a mailed notice, three (3) days after the date when duly deposited in the mails, in each
case given or addressed as aforesaid; provided, however, that notices to Lender pursuant to Article II shall not be effective until received by Lender. 
 (b) Lender or Borrower may, in its discretion, agree to accept notices and other communications to it hereunder by electronic communications pursuant to procedures approved by it; provided that approval
of such procedures may be limited to particular notices or communications. Unless Lender otherwise prescribes, (i) notices and other communications sent to an e-mail address shall be deemed received upon the sender’s receipt of an
acknowledgment from the intended recipient (such as by the “return receipt requested function, as available, return e-mail or other written acknowledgment), provided, that if such notice or other communication is not sent during the normal
business hours of the recipient, such notice or communication shall be deemed to have been sent at the opening of business on the next Business Day for the recipient. Provided, however, no notice of an Event of Default or notice of acceleration or
the exercise of any remedy shall be provided via e-mail. 
 Section 12.10. Applicable Law; Venue; Service of Process. This
Agreement shall be governed by and construed in accordance with the laws of the State of Texas and the applicable laws of the United States of America. This Agreement has been entered into in Harris County, Texas and it shall be performable for all
purposes in Harris County, Texas. Any action or proceeding against Borrower under or in connection with any of the Loan Documents may be brought in any state or federal court in Harris County, Texas, and Borrower hereby irrevocably submits to the
nonexclusive jurisdiction of such courts and waives: my objection it may now or hereafter have as to the venue of any such action or proceeding brought in any such court or that any such court is an inconvenient forum. Borrower agrees that service
of process upon it may be made by certified or registered mail, return receipt requested, at its office specified in this Agreement. Nothing herein or in any of the other Loan Documents shall affect the right of Lender to serve process in any other
manner permitted by law or shall limit the right of Lender to bring any action or proceeding against Borrower or with respect to any of its property in courts in other jurisdictions. Any action or proceeding by Borrower against Lender shall be
brought only in a court located in Harris County, Texas. 

  
 19 

 EXHIBIT 10.1 

 

 Section 12.11. Counterparts. This Agreement may be executed in one or more
counterparts, each of which shall be deemed an original, but all of which together shall constitute one and the same instrument. 
 Section 12.12. Severability. Any provision of this Agreement held by a court of competent jurisdiction to be invalid or unenforceable shall not impair or invalidate the remainder of this
Agreement and the effect thereof shall be confined to_ the provision held to be invalid or illegal. 
 Section 12.13.
Headings. The headings, captions and arrangements used in this Agreement are for convenience only and shall not affect the interpretation of this Agreement. 
 Section 12.14. Non-Application of Chapter 346 of Texas Finance Code. The provisions of Chapter 346 of the Texas Finance Code are specifically declared by the parties hereto not to be applicable to
this Agreement or any of the other Loan Documents or to the transactions contemplated hereby. 
 Section 12.15.
USA Patriot Act. Lender hereby notifies Borrower that pursuant to the requirements of the USA Patriot Act (Title III of Pub. L. 107-56 (signed into law October 26, 2001)) (the “Act”), it is required to obtain, verify and record
information that identifies Borrower, which information includes the name and address of Borrower and other information that will allow Lender to identify Borrower in accordance with the Act. 

Section 12.16. ENTIRE AGREEMENT. THIS AGREEMENT, THE NOTE(S) AND THE OTHER LOAN DOCUMENTS REFERRED TO HEREIN EMBODY THE FINAL,
ENTIRE AGREEMENT AMONG THE PARTIES HERETO WITH RESPECT TO THE SUBJECT MATTER HEREOF AND THEREOF AND SUPERSEDE ANY AND ALL PRIOR COMMITMENTS, AGREEMENTS, REPRESENTATIONS AND UNDERSTANDINGS, WHETHER WRITTEN OR ORAL, RELATING TO THE SUBJECT MATTER
HEREOF AND THEREOF AND MAY NOT BE CONTRADICTED OR VARIED BY EVIDENCE OF PRIOR, CONTEMPORANEOUS OR SUBSEQUENT ORAL AGREEMENTS OR DISCUSSIONS OF THE PARTIES HERETO. THERE ARE NO ORAL AGREEMENTS AMONG THE PARTIES HERETO. 

IN WITNESS WHEREOF, the parties hereto have duly executed this Agreement as of the day and year first above written. 

 

			
	BORROWER:
	
	 UNIVERSITY HOSPITAL SYSTEMS, LLP,

a Delaware limited liability partnership

		
	By:	 	/s/ Kamran Nezami
		 	 Kamran Nezami
 President and
Chief Executive Officer

  
 20 

 EXHIBIT 10.1 

 

 
	
	LENDER:
	
	/s/ FELIX SPIEGEL
	FELIX SPIEGEL, M.D.

  
 21 

 EXHIBIT 10.1 

 

 LIST OF EXHIBITS 

 

			
	Exhibits	  	Documents
		
	A	  	Note
		
	B	  	Form of Guaranty
		
	C	  	Advance Request Form

  
 22 

 EXHIBIT 10.1 

 

 EXHIBIT “A” 

REVOLVING CREDIT PROMISSORY NOTE 
  

					
	$2,000,000.00	 	Houston, Texas	 	October    , 2006

 FOR VALUE RECEIVED, the undersigned, UNIVERSITY HOSPITAL SYSTEMS, LLP, a Delaware limited liability
partnership (“Borrower”), hereby promises to pay to the order of FELIX SPIEGEL, M.D. (“Lender”), at his designated office, in lawful money of the United States of America, the principal sum of TWO MILLION AND NO/100 DOLLARS
($2,000,000.00), or so much thereof as may be advanced and outstanding hereunder, together with interest on the outstanding principal balance from day to day remaining, at a rate per annum which shall from day to day be equal to the lesser of
(a) the Maximum Rate (hereinafter defined) or (b) the greater of (i) TEN percent (10%) per annum or (ii) the sum of the Prime Rate (hereinafter defined) of Amegy Bank, N.A. in effect from day to day plus TWO percent (2.0%),
and each change in the rate of interest charged hereunder shall become effective, without notice to Borrower, on the effective date of each change in the Prime Rate or the Maximum Rate, as the case may be. Provided, however, if at any time the rate
of interest specified in clause (b) preceding shall exceed the Maximum Rate, thereby causing the interest rate hereon to be limited to the Maximum Rate, then any subsequent reduction in the Prime Rate shall not reduce the rate of interest
hereon below the Maximum Rate until the total amount of interest accrued hereon equals the amount of interest which would have accrued hereon if the rate specified in clause (b) preceding had at all times been in effect. If an Event of Default
(as defined in the Loan Agreement) occurs, the principal hereof shall bear interest at the Default Rate (hereinafter defined.) 

Principal of and interest on this Note shall be due and payable as follows: 

(a) Accrued and unpaid interest on this Note shall be payable monthly, on the last day of each month commencing on
October 31, 2006 and upon the maturity of this Note, however such maturity may be brought about; and 
 (b)
All outstanding principal of this Note and all accrued interest hereon shall be due and payable on September 30, 2007. 

If an Event of Default (hereinafter defined) has occurred and is existing, the principal hereof shall bear interest at the Default Rate
(hereinafter defined). 
 Interest on the indebtedness evidenced by this Note shall be computed on the basis of a year of 360
days and the actual number of days elapsed (including the first day but excluding the last day) unless such calculation would result in a usurious rate in which case interest shall be calculated on the basis of a year of 365 or 366 days, as the case
may be. 

  

 EXHIBIT 10.1 

 

 As used in this Note, the following terms shall have the respective meanings indicated
below: 
 “Agreement” means that certain Loan Agreement dated as of even date herewith between Borrower
and Lender, as the same may be amended or modified from time to time. 
 “Default Rate” means the
lesser of(a) the sum of the Prime Rate plus five percent (5.0%), or (b) the Maximum Rate. 
 “Event
of Default” shall have the meaning given to such term in the Agreement. 
 “Maximum Rate”
means the maximum rate of nonusurious interest permitted from day to day by applicable law, including Chapter 303 of the Texas Finance Code (the “Code”) (and as the same may be incorporated by reference in other Texas statutes). To the
extent that Chapter 303 of the Code is relevant to any holder of this Note for the purposes of determining the Maximum Rate, each such holder elects to determine such applicable legal rate pursuant to the “weekly ceiling,” from time to
time in effect, as referred to and defined in Chapter 303 of the Code; subject, however, to the limitations on such applicable ceiling referred to and defined in the Code, and further subject to any right such holder may have subsequently, under
applicable law, to change the method of determining the Maximum Rate. 
 “Prime Rate” shall mean
that variable rate of interest per annum established by Lender from time to time as its prime rate which shall vary from time to time. Such rate is set by Lender as a general reference rate of interest, taking into account such factors as Lender may
deem appropriate, it being understood that many of Lender’s commercial or other loans are priced in relation to such rate, that it is not necessarily the lowest or best rate charged to any customer and that Lender may make various commercial or
other loans at rates of interest having no relationship to such rate. 
 This Note is the Note provided for in the Agreement.
Borrower may prepay the principal of this Note upon the terms and conditions specified in the Agreement. Borrower may borrow, repay, and reborrow hereunder upon the terms and conditions specified in the Agreement. 

Notwithstanding anything to the contrary contained herein, no provisions of this Note shall require the payment or permit the collection
of interest in excess of the Maximum Rate. If any excess of interest in such respect is herein provided for, or shall be adjudicated to be so provided, in this Note or otherwise in connection with this loan transaction, the provisions of this
paragraph shall govern and prevail, and neither Borrower nor the sureties, guarantors, successors or assigns of Borrower shall be obligated to pay the excess amount of such interest, or any other excess sum paid for the use, forbearance or detention
of sums loaned pursuant hereto. If for any reason interest in excess of the Maximum Rate shall be deemed charged, required or permitted by any court of competent jurisdiction, any such excess shall be applied as a payment and reduction of the
principal of indebtedness evidenced by this Note; and, if the principal amount hereof has been paid in full, any remaining excess shall forthwith be paid to Borrower. In determining whether or not the interest paid or payable exceeds the Maximum
Rate, Borrower and Lender shall, to the extent permitted by applicable law, (a) characterize any non-principal payment as an expense, fee, or premium rather than as interest, (b) exclude voluntary prepayments and the effects thereof, and
(c) amortize, prorate, allocate, and spread in equal or 

  
 2 

 EXHIBIT 10.1 

 

 
unequal parts the total amount of interest throughout the entire contemplated term of the indebtedness evidenced by this Note so that the interest for the entire term does not exceed the Maximum
Rate. 
 If default occurs in the payment of principal or interest under this Note, or upon the occurrence of any other Event of
Default, as such term is defined in the Agreement, the holder hereof may, at its option, (a) declare the entire unpaid principal of and accrued interest on this Note immediately due and payable without notice, demand or presentment, all of
which are hereby waived, and upon such declaration, the same shall become and shall be immediately due and payable, (b) foreclose or otherwise enforce all liens or security interests securing payment hereof, or any part hereof, (c) offset
against this Note any sum or sums owed by the holder hereof to Borrower and (d) take any and all other actions available to Lender under this Note, the Agreement, the Loan Documents (as such term is defined in the Agreement) at law, in equity
or otherwise. Failure of the holder hereof to exercise any of the foregoing options shall not constitute a waiver of the right to exercise the same upon the occurrence of a subsequent Event of Default. 

If the holder hereof expends any effort in any attempt to enforce payment of all or any part or installment of any sum due the holder
hereunder, or if this Note is placed in the hands of an attorney for collection, or if it is collected through any legal proceedings, Borrower agrees to pay all costs, expenses, and fees incurred by the holder, including all reasonable
attorneys’ fees. 
 THIS NOTE SHALL BE GOVERNED BY AND CONSTRUED IN ACCORDANCE WITH THE LAWS OF THE STATE OF TEXAS AND THE
APPLICABLE LAWS OF THE UNITED STATES OF AMERICA. THIS NOTE IS PERFORMABLE IN HARRIS COUNTY, TEXAS. 
 Borrower and each surety,
guarantor, endorser, and other party ever liable for payment of any sums of money payable on this Note jointly and severally waive notice, presentment, demand for payment, protest, notice of protest and non-payment or dishonor, notice of
acceleration, notice of intent to accelerate, notice of intent to demand, diligence in collecting, grace, and all other formalities of any kind, and consent to all extensions without notice for any period or periods of time and partial payments,
before or after maturity, and any impairment of any collateral securing this Note, all without prejudice to the holder. The holder shall similarly have the right to deal in any way, at any time, with one or more of the foregoing parties without
notice to any other party, and to grant any such party any extensions of time for payment of any of said indebtedness, or to release or substitute part or all of the collateral securing this Note, or to grant any other indulgences or forbearances
whatsoever, without notice to any other party and without in any way affecting the personal liability of any party hereunder. 
  

			
	 UNIVERSITY HOSPITAL SYSTEMS, LLP,
 a Delaware limited liability partnership

		
	By:	 	  

		 	Karnran Nezami
		 	President

  
 3 

 EXHIBIT 10.1 

 

 EXHIBIT “B” 

GUARANTY AGREEMENT 
 WHEREAS, the execution of this Guaranty Agreement dated as of October     , 2006 is a condition to FELIX SPIEGEL, M.D. (“Lender”), making a loan to UNIVERSITY HOSPITAL
SYSTEMS, LLP, a Delaware limited liability partnership (“Borrower”), pursuant to that certain Loan Agreement dated of even date, between Borrower and Lender (such Loan Agreement as it my hereafter be amended or modified from time to time,
is hereinafter referred to as the “Loan Agreement”); 
 NOW, THEREFORE, for valuable consideration, the receipt and
adequacy of which are hereby acknowledged, the undersigned, Karman Nezami, an individual (the “Guarantor”), hereby irrevocably and unconditionally guarantees to Lender the full and prompt payment and performance of the Guaranteed
Indebtedness (hereinafter defined). This Guaranty Agreement shall be upon the following terms: 
 1. The term “Guaranteed
Indebtedness”, as used herein means all of the “Obligations”, as defined in the Loan Agreement. The term “Guaranteed Indebtedness” shall include any and all post-petition interest and expenses (including attorneys’
fees) whether or not allowed under any bankruptcy, insolvency, or other similar law. As of the date of this Guaranty Agreement, the Obligations include, but are not limited to, the indebtedness evidenced by (i) that certain revolving credit
promissory note in the maximum principal amount of $2,000,000.00, dated of even date, executed by Borrower and payable to the order of Lender (the “Note”), and (ii) all renewals, extensions, amendments, decreases or other
modifications of any of the foregoing and all promissory notes given in renewal, extension, amendment, decrease or other modification thereof. 
 2. This instrument shall be an absolute, continuing, irrevocable, and unconditional guaranty of payment and performance, and not a guaranty of collection, and Guarantor shall remain liable on its
obligations hereunder until the payment and performance in full of the Guaranteed Indebtedness. No setoff, counterclaim, recoupment, reduction, or diminution of any obligation, or any defense of any kind or nature which Borrower may have against
Lender or any other party, or which Guarantor may have against Borrower, Lender, or any other party, shall be available to, or shall be asserted by, Guarantor against Lender or any subsequent holder of the Guaranteed Indebtedness or any part thereof
or against payment of the Guaranteed Indebtedness or any part thereof. 
 3. If Guarantor becomes liable for any indebtedness
owing by Borrower to Lender by endorsement or otherwise, other than under this Guaranty Agreement, such liability shall not be in any manner impaired or affected hereby, and the rights of Lender hereunder shall be cumulative of any and all other
rights that Lender may ever have against Guarantor. The exercise by Lender of any right or remedy hereunder or under any other instrument, or at law or in equity, shall not preclude the concurrent or subsequent exercise of any other right or remedy.

 4. In the event of default by Borrower in payment or performance of the Guaranteed Indebtedness, or any part thereof, when
such Guaranteed Indebtedness becomes due, whether by 

  

 EXHIBIT 10.1 

 

 
its terms, by acceleration, or otherwise, Guarantor shall promptly pay the amount due hereunder to Lender within two (2) business days after notice and demand in lawful money of the United
States of America and it shall not be necessary for Lender, in order to enforce such payment by Guarantor, first to institute suit or exhaust its remedies against Borrower or others liable on such Guaranteed Indebtedness, or to enforce any rights
against any collateral which shall ever have been given to secure such Guaranteed Indebtedness. Until payment in full of the Guaranteed Indebtedness and the passage of a period of ninety (90) days thereafter, Guarantor waives any and all rights
it may now or hereafter have under any agreement or at law or in equity (including, without limitation, any law subrogating the Guarantor to the rights of Lender) to assert any claim against or seek contribution, indemnification or any other form of
reimbursement from Borrower or any other party liable for payment of any or all of the Guaranteed Indebtedness for any payment made by Guarantor under or in connection with this Guaranty Agreement or otherwise. 

5. If acceleration of the time for payment of any amount payable by Borrower under the Guaranteed Indebtedness is stayed upon the
insolvency, bankruptcy, or reorganization of Borrower, all such amounts otherwise subject to acceleration under the terms of the Guaranteed Indebtedness shall nonetheless be payable by Guarantor hereunder forthwith on demand by Lender. 

6. Guarantor hereby agrees that its obligations under this Guaranty Agreement shall not be released, discharged, diminished, impaired,
reduced, or affected for any reason or by the occurrence of any event, including, without limitation, one or more of the following events, whether or not with notice to or the consent of Guarantor: (a) the taking or accepting of collateral as
security for any or all of the Guaranteed Indebtedness or the release, surrender, exchange, or subordination of any collateral now or hereafter securing any or all of the Guaranteed Indebtedness; (b) any partial release of the liability of
Guarantor hereunder, or the full or partial release of any other guarantor or obligor from liability for any or all of the Guaranteed Indebtedness; (c) any disability of Borrower, or the dissolution, insolvency, or bankruptcy of Borrower,
Guarantor, or any other party at any time liable for the payment of any or all of the Guaranteed Indebtedness; (d) any renewal, extension, modification, waiver, amendment, or rearrangement of any or all of the Guaranteed Indebtedness or any
instrument, document, or agreement evidencing, securing, or otherwise relating to any or all of the Guaranteed Indebtedness; (e) any adjustment, indulgence, forbearance, waiver, or compromise that may be granted or given by Lender to Borrower,
Guarantor, or any other party ever liable for any or all of the Guaranteed Indebtedness; (f) any neglect, delay, omission, failure, or refusal of Lender to take or prosecute any action for the collection of any of the Guaranteed Indebtedness or
to foreclose or take or prosecute any action in connection with any instrument, document, or agreement evidencing, securing, or otherwise relating to any or all of the Guaranteed Indebtedness; (g) the unenforceability or invalidity of any or
all of the Guaranteed Indebtedness or of any instrument, document, or agreement evidencing, securing, or otherwise relating to any or all of the Guaranteed Indebtedness; (h) any payment by Borrower or any other party to Lender is held to
constitute a preference under applicable bankruptcy or insolvency law or if for any other reason Lender is required to refund any payment or pay the amount thereof to someone else; (i) the settlement or compromise of any of the Guaranteed
Indebtedness; (j) the non-perfection of any security interest or lien securing any or all of the Guaranteed Indebtedness; (k) any impairment of any collateral securing any or all of the Guaranteed Indebtedness; (l) any change in the
corporate existence, structure, or ownership of Borrower; or (m) any other circumstance which might otherwise constitute a defense available to, or discharge of, Borrower or Guarantor. 

  
 2 

 EXHIBIT 10.1 

 

 7. Guarantor represents and warrants to Lender as follows: 

(a) Guarantor has the power and authority and legal right to execute, deliver, and perform its obligations under this
Guaranty Agreement and this Guaranty Agreement constitutes the legal, valid, and binding obligation of Guarantor, enforceable against Guarantor in accordance with its terms, except as limited by bankruptcy, insolvency, or other laws of general
application relating to the enforcement of creditor’s rights. 
 (b) The execution, delivery, and
performance by Guarantor of this Guaranty Agreement do not and will not violate or conflict with any law, rule, or regulation or any order, writ, injunction, or decree of any court, governmental authority or agency, or arbitrator and do not and will
not conflict with, result in a breach of, or constitute a default under, or result in the imposition of any lien upon any assets of Guarantor pursuant to the provisions of any indenture, mortgage, deed of trust, security agreement, franchise,
permit, license, or other instrument or agreement to which Guarantor or its properties is bound. 
 (c) No
authorization, approval, or consent of, and no filing or registration with, any court, governmental authority, or third party is necessary for the execution, delivery, or performance by Guarantor of this Guaranty Agreement or the validity or
enforceability thereof. 
 (d) The value of the consideration received and to be received by Guarantor as a
result of Borrower and Lender entering into the Loan Agreement and Guarantor executing and delivering this Guaranty Agreement is reasonably worth at least as much as the liability and obligation of Guarantor hereunder, and such liability and
obligation and the Loan Agreement have benefited and may reasonably be expected to benefit Guarantor directly or indirectly. 
 (e) Guarantor represents and warrants to Lender that Guarantor IS not insolvent and Guarantor’s assets exceed its liabilities. 

8. Guarantor covenants and agrees that, as long as the Guaranteed Indebtedness or any part thereof is outstanding or Lender has any
commitment under the Loan Agreement: 
 (a) Within ten {10) days after Lender’s request therefore, Guarantor
will furnish to Lender such financial information concerning Guarantor as Lender may reasonably request. 
 9. Should the
Guarantor fail to repay the Guaranteed Indebtedness in the manner required by Section 4 hereof, Lender shall have the right to set off and apply against this Guaranty Agreement or the Guaranteed Indebtedness or both, at any time and without
notice to Guarantor, any and all deposits (general or special, time or demand, provisional or final) or other sums at any time credited by or owing from Lender to Guarantor (but not as to funds owing to Guarantor in its capacity as trustee or
agent). In addition to Lender’s right of setoff and as further 

  
 3 

 EXHIBIT 10.1 

 

 
security for this Guaranty Agreement and the Guaranteed Indebtedness, Guarantor hereby grants Lender a security interest in all deposits (general or special, time or demand, provisional or final)
and all other accounts of Guarantor (but not as to funds owing to Guarantor in its capacity as trustee or agent) now or hereafter on deposit with or held by Lender and all other sums at any time credited by or owing from Lender to Guarantor. The
rights and remedies of Lender hereunder are in addition to other rights and remedies (including, without limitation, other rights of setoff) which Lender may have. 
 10. Guarantor hereby agrees that the Subordinated Indebtedness (as hereinafter defined) shall be subordinate and junior in right of payment to the prior payment in full of all Guaranteed Indebtedness, and
Guarantor hereby assigns the Subordinated Indebtedness to Lender as security for the Guaranteed Indebtedness. If any sums shall be paid to Guarantor by Borrower or any other person or entity on account of the Subordinated Indebtedness, such sums
shall be held in trust by Guarantor for the benefit of Lender and shall forthwith be paid to Lender as a credit against the liability of Guarantor under this Guaranty Agreement. For purposes of this Guaranty Agreement, the term “Subordinated
Indebtedness” means all indebtedness, liabilities, and obligations of Borrower to Guarantor other than payment for services performed and reimbursement for ordinary business expenses, whether such indebtedness, liabilities, and obligations now
exist or are hereafter incurred or arise, or whether the obligations of Borrower thereon are direct, indirect, contingent, primary, secondary, several, joint and several, or otherwise, and irrespective of the person or persons in whose favor such
indebtedness, obligations, or liabilities may, at their inception, have been, or may hereafter be created, or the manner in which they have been or may hereafter be acquired by Guarantor. 

11. No amendment or waiver of any provision of this Guaranty Agreement nor consent to any departure by the Guarantor therefrom shall in
any event be effective unless the same shall be in writing and signed by Lender. No failure on the part of Lender to exercise, and no delay in exercising, any right, power, or privilege hereunder shall operate as a waiver thereof; nor shall any
single or partial exercise of any right, power, or privilege hereunder preclude any other or further exercise thereof or the exercise of any other right, power, or privilege. The - remedies herein provided are cumulative and not exclusive of any
remedies provided by law. The provisions of this paragraph shall not waive the Guarantor’s rights that any action arising hereunder be brought within the time established by any applicable statue of limitations. 

12. This Guaranty Agreement is for the benefit of Lender and its successors and assigns, and in the event of an assignment of the
Guaranteed Indebtedness, or any part thereof, the rights and benefits hereunder, to the extent applicable to the indebtedness so assigned, may be transferred with such indebtedness. This Guaranty Agreement is binding not only on Guarantor, but on
Guarantor’s heirs and personal representatives. 
 13. Guarantor recognizes that Lender is relying upon this Guaranty
Agreement and the undertakings of Guarantor hereunder in making extensions of credit to Borrower under the Loan Agreement and further recognizes that the execution and delivery of this Guaranty Agreement is a material inducement to Lender in
entering into the Loan Agreement. Guarantor hereby acknowledges that there are no conditions to the full effectiveness of this Guaranty Agreement other than the advance by the Lender of the Guaranteed Indebtedness. 

  
 4 

 EXHIBIT 10.1 

 

 14. This Guaranty Agreement is executed and delivered as an incident to a lending
transaction negotiated, consummated, and performable in Harris County, Texas, and shall be governed by and construed in accordance with the laws of the State of Texas. Any action or proceeding against Guarantor under or in connection with this
Guaranty Agreement may be brought in any state or federal court in Harris County, Texas, and Guarantor hereby irrevocably submits to the nonexclusive jurisdiction of such courts, and waives any objection it may now or hereafter have as to the venue
of any such action or proceeding brought in such court. Guarantor agrees that service of process upon it may be made by certified or registered mail. return receipt requested, at its address specified on the signature page of this Guaranty
Agreement. Nothing herein shall limit the right of Lender to bring any action or proceeding against Guarantor or with respect to any of Guarantor’s property in courts in other jurisdictions. Any action or proceeding by Guarantor against Lender
shall be brought only in a court located in Harris County, Texas. 
 15. Guarantor shall pay on demand all reasonable
attorneys’ fees and all other costs and expenses incurred by Lender in connection with the enforcement, or collection of this Guaranty Agreement. 
 16. Other than such notice as if expressly provided for herein, Guarantor hereby waives promptness, diligence, notice of any default under the Guaranteed Indebtedness, demand for payment, notice of
acceptance of this Guaranty Agreement, presentment, notice of protest, notice of dishonor, notice of the incurring by Borrower of additional indebtedness, and all other notices and demands with respect to the Guaranteed Indebtedness and this
Guaranty Agreement. 
 17. Any notices given hereunder shall be given in the manner provided by and to the addresses set forth
in the Loan Agreement. 
 18. Guarantor hereby represents and warrants to Lender that Guarantor has adequate means to obtain
from Borrower on a continuing basis information concerning the financial condition and assets of Borrower and that Guarantor is not relying upon Lender to provide (and Lender shall have no duty to provide) any such information to Guarantor either
now or in the future. 
 19. Guarantor understands and agrees that (a) Lender’s document retention policy involves the
imaging of executed loan documents and the destruction of the paper originals, and (b) Guarantor waives any right that it may have to claim that the imaged copies of the Loan Documents are not originals. 

20. This notice is being supplied in compliance with 12 C.F.R. 227, Regulation AA, promulgated by the Federal Reserve Board and applies
to any Guaranteed Indebtedness which may be a consumer credit obligation as defined in such Regulation AA. You are being asked to guarantee the debt of Borrower now existing or hereafter arising. There is no limit as to the amount unless this
Guaranty expressly provides for such limitation. Think carefully before you guarantee the existing and future debts of Borrower. If Borrower doesn’t pay any of such debts, you will have to. Be sure that you can afford to pay all such debts if
you have to and that you want to accept this responsibility. You may have to pay up to the full amount of all Borrower’s debts if Borrower does not pay. You may also have to pay late fees or collection costs, which increase this amount. Lender
can collect such debts from you without first trying to collect from 

  
 5 

 EXHIBIT 10.1 

 

 
Borrower. Lender can use the same collection methods against you that can be used against Borrower, such as suing you, etc. If any such debts is ever in default, that fact may become part of your
credit record. This notice is not the contract that makes you liable for Borrower’s debts. The Guaranty that is set forth in this instrument is, however, a contract that makes you liable for Borrower’s debts. 

21. THIS GUARANTY AGREEMENT EMBODIES THE FINAL, ENTIRE AGREEMENT · OF GUARANTOR AND LENDER WITH RESPECT TO GUARANTOR’S
GUARANTY OF THE GUARANTEED INDEBTEDNESS AND SUPERSEDES ANY AND ALL PRIOR COMMITMENTS, AGREEMENTS, REPRESENTATIONS, AND UNDERSTANDINGS, WHETHER WRITTEN OR ORAL, RELATING TO THE SUBJECT MATTER HEREOF AND MAY NOT BE CONTRADICTED OR VARIED BY EVIDENCE
OF PRIOR, CONTEMPORANEOUS OR SUBSEQUENT ORAL AGREEMENTS OR DISCUSSIONS OR OTHER EXTRINSIC EVIDENCE OF ANY NATURE. THERE ARE NO ORAL AGREEMENTS BETWEEN GUARANTOR AND LENDER. THIS GUARANTY AGREEMENT MAY NOT BE AMENDED EXCEPT IN WRITING BY GUARANTOR
AND LENDER. 
 DATED and EFFECTIVE as of the day and year first written above. 

 

	
	GUARANTOR:
	
	  

	KAMRAN NEZAMI
	
	Address:
	  

	  

	  

	  

  
 6 

 EXHIBIT 10.1 

 

 EXHIBIT “C” 

ADVANCEREQUESTFORM 
  

	TO:	Felix Spiegel, M.D. 

 The
undersigned is an authorized representative of UNIVERSITY HOSPITAL SYSTEMS, LLP (the “Borrower”), and is authorized to make and deliver this certificate pursuant to that certain Loan Agreement dated as of October    ,
2006 between the Borrower and Felix Spiegel, M.D. (the “Lender”). (Such Loan Agreement, as it may be amended is referred to as the “Loan Agreement”.) All terms defined in the Loan Agreement shall have the same meaning herein.

 Borrower hereby requests an Advance (the “Requested Advance”) m the amount of
$         in accordance with the Loan Agreement. 
 In connection with the foregoing and
pursuant to the terms and provisions of the Loan Agreement, the undersigned hereby certifies that the following statements are true and correct: 
 (a) The representations and warranties contained in Article VIII of the Loan Agreement and in each of the other Loan Documents are true and correct on and as of the date hereof with the same force and
effect as if made on and as of such date. 
 (b) No Event of Default or Unmatured Event of Default has occurred
and is continuing or would result from the Requested Advance. Borrower acknowledges that if an Event of Default or Unmatured Event of Default exists Lender is not obligated to fund the Requested Advance. 

(c) Since the date of the financial statements of Borrower most recently delivered to Lender, there has been no Material
Adverse Effect. 
 (d) The amount of the Requested Advance, when added to the principal amount of all Advances
outstanding, will not exceed the Commitment. 

  

 EXHIBIT 10.1 

 

 Advance Request Information 

 

							
	1.	  	 Commitment
	  	$	2,000,000.00	  
			
	2.	  	 Amount of Outstanding Advances
	  	$	            	  
			
	3.	  	 Available Amount (line (1) minus line (2))
	  	$	            	  
			
	4.	  	 Amount of Requested Advance
	  	$	            	  

 Dated as
of:                     
  

			
	BORROWER:
	
	UNIVERSITY HOSPITAL SYSTEMS, LLP,
		
	By:	 	  

		 	Kamran Nezami
		 	President

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