Document:

SelectMRI Acquisition, LLC Supplemental Indenture

 EXHIBIT 4.10 
 EXECUTION VERSION 
 SUPPLEMENTAL INDENTURE 
 TO BE DELIVERED BY SUBSEQUENT SUBSIDIARY GUARANTORS 
 Supplemental Indenture (this “Supplemental Indenture”), dated as of February 5, 2008, among SelectMRI Acquisition, LLC (the “Subsidiary Guarantor”), a subsidiary of MSC-Medical
Services Company (or its permitted successor), a Florida corporation (“MSC”), with MSC as a wholly-owned subsidiary of MCP-MSC Acquisition, Inc. (or its permitted successor), a Delaware corporation (the “Company”), the
Company and U.S. Bank National Association, a national banking association, as trustee under the Indenture referred to below (the “Trustee”). 
 WITNESSETH 
 WHEREAS, the Company has heretofore executed and delivered to the Trustee an indenture (the
“Indenture”), dated as of June 21, 2005, providing for the issuance of Senior Secured Floating Rate Notes due 2011 (the “Notes”); 
 WHEREAS, the Indenture provides that under certain circumstances the Subsidiary Guarantor shall execute and deliver to the Trustee a supplemental indenture pursuant to which the Subsidiary Guarantor shall
unconditionally guarantee all of the obligations of the Company under the Notes and the Indenture on the terms and conditions set forth herein (the “Note Guarantee”); and 
 WHEREAS, pursuant to Section 9.01 of the Indenture, the Trustee is authorized to execute and deliver this Supplemental Indenture. 
 NOW THEREFORE, in consideration of the foregoing and for other good and valuable consideration, the receipt of which is hereby acknowledged, the
Subsidiary Guarantor and the Trustee mutually covenant and agree for the equal and ratable benefit of the Holders of the Notes as follows: 
 1. Capitalized Terms. Capitalized terms used herein without definition shall have the meanings assigned to them in the Indenture. 
 2. Agreement to Guarantee. The Subsidiary Guarantor hereby agrees as follows: 
 (a) Along with any and all
other Subsidiary Guarantors, to jointly and severally Guarantee to each Holder of a Note authenticated and delivered by the Trustee and to the Trustee and its successors and assigns, irrespective of the validity and enforceability of the Indenture,
the Notes or the obligations of the Company hereunder or thereunder, that: 
  

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 (i) Interest on the Notes shall be promptly paid in full when due, whether at maturity,
by acceleration, redemption or otherwise, and interest on the overdue principal of and interest on the Notes, if any, if lawful, and all other obligations of the Company to the Holders or the Trustee hereunder or thereunder shall be promptly paid in
full or performed, all in accordance with the terms hereof and thereof; and 
 (ii) in case of any extension of time of
payment or renewal of any Notes or any of such other obligations, the same shall be promptly paid in full when due or performed in accordance with the terms of the extension or renewal, whether at stated maturity, by acceleration or
otherwise. Failing payment when due of any amount so guaranteed or any performance so guaranteed for whatever reason, the Subsidiary Guarantor shall be, jointly and severally with all other Subsidiary Guarantors, obligated to pay the same
immediately. This Note Guarantee is a guarantee of payment and not of collection. 
 (b) The obligations hereunder shall be
unconditional, irrespective of the validity, regularity or enforceability of the Notes or the Indenture, the absence of any action to enforce the same, any waiver or consent by any Holder of the Notes with respect to any provisions hereof or
thereof, the recovery of any judgment against the Company, any action to enforce the same or any other circumstance that might otherwise constitute a legal or equitable discharge or defense of the Subsidiary Guarantor. 
 (c) Subject to Section 6.06 of the Indenture, the following is hereby waived: diligence, presentment, demand of payment, filing of
claims with a court in the event of insolvency or bankruptcy of the Company, any right to require a proceeding first against the Company, protest, notice and all demands whatsoever. 
 (d) The Note Guarantee shall not be discharged except by complete performance of the obligations contained in the Notes and the Indenture.

 (e) If any Holder or the Trustee is required by any court or otherwise to return to the Company, the Subsidiary Guarantor,
or any Custodian, Trustee, liquidator or other similar official acting in relation to either the Company or the Subsidiary Guarantor, any amount paid by either to the Trustee or such Holder, this Note Guarantee, to the extent theretofore discharged,
shall be reinstated in full force and effect. 
 (f) The Subsidiary Guarantor shall not be entitled to any right of
subrogation in relation to the Holders in respect of any obligations guaranteed hereby until payment in full of all obligations guaranteed hereby. 
 (g) As between the Subsidiary Guarantor, on the one hand, and the Holders and the Trustee, on the other hand, (x) the maturity of the obligations guaranteed hereby may be accelerated as provided in Article Six of
the Indenture for the purposes of this Note Guarantee, notwithstanding any stay, injunction or other prohibition preventing such acceleration in respect of the obligations guaranteed hereby, and (y) in the event of any declaration of
acceleration of such obligations as provided in Article Six of the Indenture, such obligations (whether or not due and payable) shall forthwith become due and payable by the Subsidiary Guarantors for the purpose of this Note Guarantee. 

 

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 (h) The Subsidiary Guarantor, and by its acceptance of Notes, each Holder, hereby confirm
that it is the intention of all such parties that this Note Guarantee not constitute a fraudulent transfer or conveyance for purposes of Bankruptcy Law, the Uniform Fraudulent Conveyance Act, the Uniform Fraudulent Transfer Act or any similar
federal or state law to the extent applicable to any Note Guarantee. To effectuate the foregoing intention, the Trustee, the Holders and the Subsidiary Guarantor hereby irrevocably agree that the obligations of the Subsidiary Guarantor shall not,
after giving effect to such maximum amount and all other contingent and fixed liabilities of the Subsidiary Guarantor that are relevant under such laws, and after giving effect to any collections from, rights to receive contribution from or payments
made by or on behalf of any other Subsidiary Guarantor in respect of the obligations of such other Subsidiary Guarantor under this Supplemental Indenture, result in the obligations of the Subsidiary Guarantor under this Note Guarantee constituting a
fraudulent transfer or conveyance. 
 3. Execution and Delivery. The Subsidiary Guarantor agrees that this Note Guarantee shall remain
in full force and effect notwithstanding any failure to endorse on each Note a notation of this Note Guarantee. 
 4. NEW YORK LAW TO
GOVERN. THIS SUPPLEMENTAL INDENTURE SHALL BE GOVERNED BY, AND CONSTRUED IN ACCORDANCE WITH, THE LAWS OF THE STATE OF NEW YORK. 
 5.
Counterparts. The parties may sign any number of copies of this Supplemental Indenture. Each signed copy shall be an original, but all of them together represent the same agreement. 
 6. Effect of Headings. The Section headings herein are for convenience only and shall not affect the construction hereof. 
 7. Trustee. The Trustee shall not be responsible in any manner whatsoever for or in respect of the validity or sufficiency of this Supplemental
Indenture or for or in respect of the recitals contained herein, all of which recitals are made solely by the Subsidiary Guarantor and the Company. 
 *  *  *  *  *  *  *  * 
  

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 IN WITNESS WHEREOF, the parties hereto have caused this Supplemental Indenture to be duly executed and
attested, all as of the date first above written. 
 Dated: February 5, 2008 
  

			
	SELECTMRI ACQUISITION, LLC
		
	By:	 	 /s/ Adam Doctoroff

	Name:	 	Adam Doctoroff
	Title:	 	Vice President
	
	MCP-MSC ACQUISITION, INC.
		
	By:	 	 /s/ Adam Doctoroff

	Name:	 	Adam Doctoroff
	Title:	 	Vice President
	
	 U.S. BANK NATIONAL ASSOCIATION
 AS TRUSTEE

		
	By:	 	 /s/

	Name:	 	
	Title:	 	
	
	MSC-MEDICAL SERVICES COMPANY
		
	By:	 	 /s/ Adam Doctoroff

	Name:	 	Adam Doctoroff
	Title:	 	Vice President

 SelectMRI Supplemental Indenture Signature Page 
  

 4ZoneCareUSA of Delray, LLC Second Lien Security Supplement

 EXHIBIT 4.11 
 EXECUTION VERSION 
 SECOND LIEN SECURITY AGREEMENT SUPPLEMENT 
 February 5, 2008 
 To: U.S. Bank National Association,
as Trustee 
 and Collateral Agent for the benefit of the 
 Secured Parties referred to in the Second Lien 
 Security Agreement referred to below. 
 Re: MSC-Medical Services Company – Creation of New Subsidiary 
 Ladies and Gentlemen: 
 MSC-Medical Services Company, a Florida corporation (“Issuer”) has entered into (i) an
Indenture dated as of June 21, 2005 (as may be amended, amended and restated, supplemented or otherwise modified from time to time, being the “Indenture”) with U.S. Bank National Association (the “Trustee” or
“Collateral Agent”), (ii) a Revolving Credit Agreement dated as of March 31, 2005 (as amended, amended and restated, supplemented or otherwise modified from time to time, the “Revolving Credit
Agreement”), among Issuer (as the surviving entity of the Merger), as the Borrower, the Lenders party thereto, Bank of America, N.A., as administrative agent (together with any successor Administrative Agent appointed pursuant to
Article XI of the Revolving Credit Agreement, the “Administrative Agent”) and L/C Issuer, (iii) a Security Agreement dated March 31, 2005 (as amended, amended and restated, supplemented or otherwise modified
from time to time, the “First Lien Security Agreement”) made by the Grantors from time to time party thereto in favor of the Administrative Agent for the Secured Parties and (iv) a Second Lien Security Agreement dated
June 21, 2005 (as amended, amended and restated, supplemented or otherwise modified from time to time, the “Second Lien Security Agreement”) among Issuer, MCP-MSC Acquisition, Inc. (“Holdings”, and, together
with Issuer, collectively, the “Grantors”), to Trustee, as indenture trustee and collateral agent for the benefit of Trustee and the holders from time to time of the Second Lien Notes (such holders, together with the Trustee and the
Collateral Agent, each a “Secured Party” and, collectively, the “Secured Parties”). Terms defined in the Indenture or the Second Lien Security Agreement and not otherwise defined herein are used herein as defined in the Indenture
or the Second Lien Security Agreement. 
 SECTION 1. Grant of Security. Subject to the rights and obligations described in the
Intercreditor Agreement which sets forth the relative rights, interests and priorities of the Secured Parties (as defined therein) with respect to the Collateral, the undersigned hereby grants to the Trustee, for the ratable benefit of the Secured
Parties, a security interest in all of its right, title and interest in and to the following, in each case whether now owned or hereafter acquired by the undersigned, wherever located and whether now or hereafter existing or arising (collectively,
the undersigned’s “Collateral”): all Equipment, Inventory, Receivables, 

  

 ZoneCare 2d Lien Security Agreement 
  

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Related Contracts, Security Collateral (including, without limitation, the shares of stock and other Equity Interests set forth on Part I of
Schedule I hereto, the indebtedness set forth on Part II of Schedule I hereto and the securities and securities/deposit accounts set forth on Schedule II hereto), Agreement Collateral (including, without limitation,
each of the agreements listed on Schedule III hereto), Account Collateral (including, without limitation, the deposit accounts set forth on Schedule IV hereto), Intellectual Property Collateral, Commercial Tort Claims Collateral
(including, without limitation, the commercial tort claims described in Schedule V hereto), all books and records (including, without limitation, subject to applicable law, customer lists, credit files, printouts and other computer output
materials and records) of the undersigned pertaining to any of the undersigned’s Collateral, and all proceeds of, collateral for, income, royalties and other payments now or hereafter due and payable with respect to, and supporting obligations
relating to, any and all of the undersigned’s Collateral (including, without limitation, proceeds, collateral and supporting obligations that constitute property of the types described in this Section 1) and, to the extent not
otherwise included, all (A) payments under insurance (whether or not the Administrative Agent is the loss payee thereof), or any indemnity, warranty or guaranty, payable by reason of loss or damage to or otherwise with respect to any of the
foregoing Collateral, and (B) cash. 
 Notwithstanding the foregoing provisions of this Section 1, in no event shall the
security interest granted hereunder attach to any contract, license, permit or franchise to which the undersigned is a party or any of its rights or interests thereunder, or any property or assets subject to any contract, license, permit or
franchise, if and for so long as the grant of such security interest shall constitute or result in (x) the abandonment, invalidation or unenforceability of any right, title or interest of the undersigned therein or (y) a breach or
termination pursuant to the terms of, or a default under, any such contract, license, permit or franchise, except, in each case, to the extent that any such term would be rendered ineffective pursuant to Sections 9-406, 9-407, 9-408 or 9-409 of the
UCC (or any successor provision or provisions) of any relevant jurisdiction or any other applicable law or principles of equity; provided, that notwithstanding the foregoing, such security interest shall attach immediately at such time as the
condition causing such abandonment, invalidation or unenforceability shall be remedied and, to the extent severable, shall attach immediately to any portion of such contract, license, permit or franchise, or property subject thereto, that does not
result in any of the consequences specified in clause (x) or (y) above. 
 SECTION 2. Security for Obligations. The
grant of a security interest in the Collateral by the undersigned under this Second Lien Security Agreement Supplement and the Second Lien Security Agreement secures the payment of all Obligations of the undersigned now or hereafter existing under
or in respect of the Loan Documents, whether direct or indirect, absolute or contingent, and whether for principal, reimbursement obligations, interest, premiums, penalties, fees, indemnifications, contract causes of action, costs, expenses or
otherwise. Without limiting the generality of the foregoing, this Second Lien Security Agreement Supplement and the Second Lien Security Agreement secures the payment of all amounts that constitute part of the Secured Obligations and that would be
owed by the undersigned to any Secured Party under the Loan Documents but for the fact that such Secured Obligations are deemed unenforceable by the judgment, decree or similar order of a bankruptcy court with respect to a bankruptcy, reorganization
or similar proceeding involving a Loan Party. 
  

 ZoneCare 2d Lien Security Agreement 
  

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 SECTION 3. Representations and Warranties. (a) The undersigned’s exact legal name,
location, chief executive office, type of organization, jurisdiction of organization and organizational identification number is set forth in Schedule VI hereto. The undersigned has no trade names other than as listed on
Schedule VI hereto. Within the five years preceding the date hereof, the undersigned has not changed its name, location, chief executive office, type of organization, jurisdiction of organization or organizational identification number
from those set forth in Schedule VI hereto except as set forth in Schedule VII hereto. 
 (b) All of the Equipment and
Inventory of the undersigned are located at the places specified therefor in Schedule VIII hereto. 
 (c) The undersigned is not
a beneficiary or assignee under any letter of credit, other than the letters of credit described in Schedule IX hereto. 
 (d) The
undersigned hereby makes each other representation and warranty set forth in Section 6 of the Second Lien Security Agreement with respect to itself and the Collateral granted by it. 
 SECTION 4. Obligations Under the Second Lien Security Agreement. The undersigned hereby agrees, as of the date first above written, to be bound as
a Grantor by all of the terms and provisions of the Second Lien Security Agreement to the same extent as each of the other Grantors. The undersigned further agrees, as of the date first above written, that each reference in the Second Lien Security
Agreement to an “Additional Grantor” or a “Grantor” shall also mean and be a reference to the undersigned, that each reference to the “Collateral” or any part thereof shall also mean and be a reference to the
undersigned’s Collateral or part thereof, as the case may be, and that each reference in the Second Lien Security Agreement to a Schedule shall also mean and be a reference to the schedules attached hereto. 
 SECTION 5. Governing Law. This Second Lien Security Agreement Supplement shall be governed by, and construed in accordance with, the laws of the
State of New York. 
  

			
	Very truly yours,
	
	ZONECARE USA OF DELRAY, LLC
		
	By:	 	 /s/ Adam Doctoroff

	Name:	 	Adam Doctoroff
	Title:	 	Vice President
		
		 	Address for notices:
		 	Two Canal Park, 4th Floor
		 	Cambridge, MA 02141

  

 ZoneCare 2d Lien Security Agreement 
  

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 Schedule I 
 Part I: Equity Interests 
 ZoneCareUSA of Delray, LLC owns all of the outstanding membership interests
of 
 ZoneCareUSA DME, LLC. 
 Part II: Indebtedness 
 None. 
  

 MSC – Schedules to 2d Lien Security Agreement Supplement 
  

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 Schedule II 
 Securities and Securities/Deposit Accounts 
 ZoneCare USA of Delray, LLC will be added as an account
holder on the deposit accounts held at Commerce Bank to be identified. 
  

 MSC – Schedules to 2d Lien Security Agreement Supplement 
  

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 Schedule III 
 Agreement Collateral 
 Membership Interest Purchase Agreement dated as of January 28, 2008 by and among MSC
– Medical Services Company, ZoneCareUSA of Delray, LLC and the Members named therein. 
 Escrow Agreement dated as of January 28, 2008 by and among
MSC – Medical Services Company, ZoneCareUSA of Delray, LLC, SunTrust Bank, NA and Behn Wilson. 
  

 MSC – Schedules to 2d Lien Security Agreement Supplement 
  

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 Schedule IV 
 Account Collateral – Deposit Accounts 
 ZoneCare USA of Delray, LLC will be added as an account
holder on the deposit accounts held at Commerce Bank to be identified. 
  

 MSC – Schedules to 2d Lien Security Agreement Supplement 
  

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 Schedule V 
 Commercial Tort Claims 
 None. 
  

 MSC – Schedules to 2d Lien Security Agreement Supplement 
  

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 Schedule VI 
 Legal Name, Location, Chief Executive Office, Type of Organization, Jurisdiction of 
 Organization,
Organizational Identification Number, Trade Names 
  

			
	Legal Name:	  	ZoneCareUSA of Delray, LLC
		
	Location:	  	 223 N.E. 5th Avenue
 Delray Beach,
FL 33483

		
	Chief Executive Office:	  	 223 N.E. 5th Avenue
 Delray Beach,
FL 33483

		
	Type of Organization:	  	Limited Liability Company
		
	Jurisdiction:	  	Florida
		
	State ID No.	  	L03000029703
		
	FEIN:	  	81-0633083
		
	Trade Names:	  	ZoneCare; Transportation Zone

  

 MSC – Schedules to 2d Lien Security Agreement Supplement 
  

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 Schedule VII 
 Changes to Legal Name, Location, Chief Executive Office, Type of Organization, Jurisdiction of 
 Organization, Organizational Identification Number 
 None. 
  

 MSC – Schedules to 2d Lien Security Agreement Supplement 
  

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 Schedule VIII 
 Location of Equipment and Inventory 
 223 N.E.
5th Avenue 
 Delray Beach, FL 33483 
 210 N.E. 6th Avenue 
 Delray Beach, FL 33483 
 246 N.E. 6th Avenue

 Delray Beach, FL 33483 
  

 MSC – Schedules to 2d Lien Security Agreement Supplement 
  

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 Schedule IX 
 Letters of Credit 
 None. 
  

 MSC – Schedules to 2d Lien Security Agreement Supplement 
  

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