Document:

Filed by Bowne Pure Compliance

EXHIBIT 10.41

INCENTIVE STOCK OPTION AGREEMENT

under the

TRACTOR SUPPLY COMPANY

 2006 STOCK INCENTIVE PLAN

STOCK OPTION AGREEMENT, dated as of                      between TRACTOR SUPPLY COMPANY, a
Delaware corporation (the “Company”), and                      (the “Optionee”).

The Company’s Compensation Committee (the “Committee”) has determined that the objectives of
the Company’s 2006 Stock Incentive Plan (the “Plan”) will be furthered by granting to the Optionee
an option pursuant to the Plan.

In consideration of the foregoing and of the mutual undertakings set forth in this Stock
Option Agreement (the “Agreement”), the Company and the Optionee hereby agree as follows:

SECTION 1. Grant of Option. The Company hereby grants to the Optionee a stock option
to purchase                      shares of the Common Stock of the Company, at a purchase price of                      per
share, which option is intended to qualify for the special incentive stock option tax treatment
described in Code section 422.

The Company cannot guarantee that the special tax treatment will apply. For example, if the
Optionee sells the Common Stock acquired pursuant to the exercise of this option either within two
years after the date of this Agreement or within one year after the date this option (or part
thereof) is exercised, this special tax treatment will not apply.

If the option (or any part thereof) does not qualify for incentive stock option treatment for
any reason, then, to the extent of such nonqualification, the option (or portion thereof) shall be
treated as a nonqualified stock option granted under the Plan, provided that the option (or portion
thereof) otherwise satisfies the terms and conditions of the Plan generally relating to
nonqualified stock options.

SECTION 2. Exercisability. Subject to Section 4 hereof, the option shall be
exercisable as follows:

	 	 	 	 	 	 	 	 	 
	 	 	% of Shares	 	 	Cumulative	 
	 	 	Becoming	 	 	% of Shares	 
	On and After	 	Exercisable	 	 	Exercisable	 
	 
	Vesting Date = Grant Date Plus 1 year 
	 	 	33-1/3	%	 	 	33-1/3	%
	Vesting Date = Grant Date Plus 2 years 
	 	 	33-1/3	%	 	 	66-2/3	%
	Vesting Date = Grant Date Plus 3 years 
	 	 	33-1/3	%	 	 	100.0	%
	 
	 	 	 	 	 	 
	Through Expiration Date = Grant Date Plus 10 years
	 	 	 	 	 	 	100.0	%

 

 

 

The option shall not be exercisable prior to the first anniversary of the date of grant, and shall
become cumulatively exercisable with respect to 33-1/3% of the shares of Common Stock subject
thereto, rounded down to the next lower full share, on the first anniversary of the date of grant,
and with respect to an additional 33-1/3% of the shares of Common Stock subject thereto, rounded
down to the next lower full share, on the second anniversary of the date of grant, and shall become
100% exercisable on the third anniversary of the date of grant, and shall remain 100% exercisable
until Expiration Date plus 1 day and shall terminate and cease to be exercisable on Expiration Date
plus 1 day .

SECTION 3. Method of Option Exercise; Involuntary Option Cash-Out.

(a) The option or any part thereof may be exercised only by giving to the Company written
notice of exercise in the form attached hereto as Exhibit A. The Optionee shall exercise any
options through the Company sponsored exercise program. The Optionee shall have no right to
receive shares of Common Stock with respect to an option exercise, prior to the option exercise
date. For purposes of this Agreement, the option exercise date shall be deemed to be the sixth
business day immediately following the date written notice of exercise is received by the Company.

(b) At any time after the Company’s receipt of written notice of exercise and prior to the
option exercise date, the Committee, in its sole discretion, shall have the right, by written
notice to the Optionee, to cancel the option or any part thereof subject to the written notice of
exercise if the Committee, in its sole judgment, determines that legal or contractual restrictions
and/or blockage and/or other market considerations would make the Company’s acquisition of Common
Stock from, and/or the Optionee’s sale of Common Stock to, the public markets illegal,
impracticable or inadvisable if the Committee determines to so cancel the option or any part
thereof subject to the written notice of exercise, the Company shall pay to the Optionee an amount
equal to the excess (if any) of (i) the aggregate fair market value of the shares of Common Stock
subject to the option or part thereof cancelled (determined as of the option exercise date) over
(ii) the aggregate option exercise price of the shares of Common Stock subject to the option or
part thereof cancelled. Such amount shall be delivered to the Optionee as soon as practicable
after such option or part thereof is cancelled.

SECTION 4. Termination of Employment.

(a) General Rule. The non-vested portion of any option shall terminate and expire
upon the Optionee’s termination of employment for any reason except that upon termination of
Optionee’s employment or service as a result of (1) death, (2) disability (as defined below), or
(3) retirement (as defined below), any unvested portion of the option granted hereunder shall vest
in full as of the date of such termination. The vested portion shall remain exercisable following
termination of employment only under the circumstances and to the extent provided in this Section
4.

 

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(b) Improper Activity; Quit. If the Optionee’s employment is terminated for cause or
if the Optionee quits employment, whether or not the Optionee is a party to a written employment
contract, the option granted hereunder shall terminate and expire on the day the Optionee’s
employment terminates. For purposes of this Section 4, an Optionee’s employment shall be deemed to
have been terminated for “cause” if he is discharged on account of fraud or embezzlement or other
unlawful or tortuous conduct, whether or not involving or against the Company or any Affiliate, or
for violation of a policy of the Company or any Affiliate or for serious and willful acts of
misconduct detrimental to the business or reputation of the Company or any Affiliate (whether or
not such acts constitute “cause” pursuant to any written employment contract with the Optionee) or
if he is discharged for “cause” or any like term as defined in any written employment contract with
the Optionee.

(c) Regular Termination; Leaves of Absence. If the Optionee’s employment terminates
for reasons other than as provided in subsection (b) above or subsections (d), (e) or (f) below,
the vested portion of the option granted hereunder may be exercised until the earlier of (i) three
months after the day his employment terminates and (ii) the date on which the option otherwise
terminates or expires in accordance with the applicable provisions of the Plan and this Agreement;
provided that the Committee may determine, in its sole discretion, such longer or shorter
period for exercise (not to exceed the remaining term of the option) in the case of an individual
whose employment terminates for reasons as provided herein in subsection (c), or solely because his
employer ceases to be an Affiliate or he transfers his employment with the Company’s consent to a
purchaser of a business disposed of by the Company. Subject to Section 2.7(e) below, the Committee
may, in its discretion, determine (A) whether any leave of absence (including short-term or
long-term disability or medical leave) constitutes a termination of employment within the meaning
of the Plan and (B) the impact, if any, of any such leave on awards under the Plan theretofore made
to an Optionee who takes any such leave.

Any extension of the exercise period beyond 90 days from the date of such termination will
automatically disqualify the option from the special tax treatment accorded incentive stock
options.

(d) Death. In the event that the optionee’s employment terminates by reason of death,
or if the Optionee’s employment shall terminate as described in subsection (c) above and he dies
within the period for exercise provided for therein, the vested portion of the option shall be
exercisable by the person to whom the option has passed under the Optionee’s will (or if
applicable, pursuant to the laws of descent and distribution) until the earlier of (i) one year
after the Optionee’s death and (ii) the date on which the option otherwise terminates or expires in
accordance with the applicable provisions of the Plan and this Agreement.

(e) Disability. In the event that Optionee’s employment or service terminates by reason of
Disability (as defined below), the vested portion of the option granted hereunder shall be
exercisable by Optionee until the earlier of (i) three years following the date of such termination
of employment or service, and (ii) the date on which the option granted hereunder otherwise
terminates or expires in accordance with the applicable provisions of the Plan and this Agreement.
For purposes of this Agreement, “Disability” means a disability that would qualify as a total and
permanent disability under the Company’s then current long-term disability plan.

(f) Right of Discharge Reserved. Nothing in the Plan or this Agreement shall confer upon
the Optionee or any other person the right to continue in the employment of the Company or any
Affiliate or affect any right which the Company or any Affiliate may have to terminate the
employment of the Optionee or any other person.

 

3

 

SECTION 5. Withholding Tax Requirements. If as a condition of delivery of shares of
Common Stock upon the Optionee’s exercise of an option granted hereunder the Committee determines
that it is necessary or advisable to withhold an amount sufficient to satisfy any federal, state
and other governmental withholding tax requirements related thereto, then the Optionee shall be
required to satisfy all withholding tax requirements related to such option in accordance with
Section 3.4 of the Plan. By entering into this Agreement, the Optionee hereby agrees that, if the
Committee shall make such determination, then (a) the Optionee shall remit the full amount
necessary to satisfy such withholding tax requirements within 15 days after his receipt of a
statement for such amount from the Committee (unless and to the extent that the Committee permits
the Optionee to use the method of payment described in Section 3.4(b) of the Plan), and (b) the
Company shall be entitled to withhold the amount of any such tax requirements from any salary or
other payments due to the Optionee, and to refuse to recognize such option exercise until full
satisfaction of such withholding tax requirements. The Optionee further agrees and acknowledges
that all other taxes, duties and fees related to such option exercise are for the Optionee’s own
account and must be paid directly by the Optionee.

SECTION 6. Plan Provisions. This Agreement shall be subject to all of the terms and
provisions of the Plan, which are hereby incorporated herein by reference and made a part hereof,
including, without limitation, the provisions of Section 3.2 (generally relating to consents
required by securities and other laws) and 3.11 (generally relating to the effects of certain
reorganizations and other extraordinary transactions) of the Plan. Any term defined in the Plan
shall have the same meaning in this Agreement as in the Plan, except as otherwise defined herein.

SECTION 7. Optionee’s Acknowledgements. By entering into this Agreement the Optionee
agrees and acknowledges that (a) he has received and read a copy of the Plan, including, without
limitation, Section 3.8(c) thereof (generally relating to waivers of claims to continued exercise
or vesting of awards, damages and severance entitlements related to non-continuation of awards),
and accepts this option upon all of the terms thereof, and (b) no member of the Committee shall be
liable for any action or determination made in good faith with respect to the Plan or this
Agreement or any award thereunder or hereunder.

SECTION 8. Nontransferability. No right granted to the Optionee under the Plan or
this Agreement shall be assignable or transferable by the Optionee (whether by operation of law or
otherwise and whether voluntarily or involuntarily), other than by will or by the laws of descent
and distribution. During the lifetime of the Optionee, all rights granted to the Optionee under
the Plan or under this Agreement shall be exercisable only by the Optionee.

SECTION 9. Execution of Agreement. Notwithstanding anything contained in this
Agreement to the contrary, the option may not be exercised until the Optionee has returned an
executed copy of this Agreement to the Company.

 

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SECTION 10. Notices. Any notice to be given to the Company hereunder shall be in
writing and shall be addressed to the Corporate Controller of Tractor Supply Company at 200 Powell
Place, Brentwood, Tennessee 37027, or at such other address as the Company may hereafter designate
to the Optionee by notice as provided herein. Any notice to be given to the Optionee hereunder
shall be addressed to the Optionee at the address set forth below or at such other address as the
Optionee may hereafter designate to the Company by notice as provided herein. Notices hereunder
shall be deemed to have been duly given when received by personal delivery or by registered or
certified mail to the party entitled to receive the same.

SECTION 11. Successors and Assigns. This Agreement shall be binding upon and inure to
the benefit of the parties hereto and the successors and assigns of the Company and, to the extent
set forth in Section 3.3 of the Plan and Section 8 hereof, the heirs and personal representatives
of the Optionee.

SECTION 12. Governing Law. This Agreement shall be governed by and construed in
accordance with the internal laws of the State of New York, without giving effect to the conflicts
of laws principles thereof.

SECTION 13. Modification of Agreement. This Agreement may not be altered, modified,
changed or discharged other than by a written instrument signed by or on behalf of both the Company
and the Optionee.

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

	 	 	 	 	 	 	 	 	 	 	 
	TRACTOR SUPPLY COMPANY	 	 	 	OPTIONEE:	 	 	 	 
	 
	By:
	 	 	 	 	 	 	 	 	 	 
	 

	 

	 	 	 	 	 

	 	 
	 

	 	 	 	 	 	Current Address:	 	 	 	 
	 

	 	 	 	 	 	Address:
	 	please print	 	 
	 
	 

	 

	 	 	 	 	 	 	 
	 
	 
	 
	 	 	 	 	 	 	 	 

 

5

 

EXERCISE NOTICE

Exhibit A

Corporate Controller

Tractor Supply Company

200 Powell Place

Brentwood, TN 37027

The undersigned hereby irrevocably elects to exercise the right of purchase represented by the
Stock Option Agreements (the “Agreement”), dated as of per Exhibit A, for, and to purchase
thereunder, the number of shares of the common stock of Tractor Supply Company (the “Common
Stock”), as provided for therein and set forth in Exhibit A. The full amount of the option
exercise price shall be paid on the option exercise date, at the time this exercise notice is
received by the Company (unless the Committee exercises its right to cancel the option (or any part
thereof) subject hereto in accordance with Section 2.5(f) of the Tractor Supply Company Stock
Incentive Plan (the “Plan”) and Section 3 of the Agreement). Capitalized terms used but not
otherwise defined herein shall have the respective meanings ascribed to them in the Plan or the
Agreement, as applicable.

Payment of the option exercise price shall be made in full in the form of a certified or
official bank check or the equivalent thereof acceptable to the Committee (or if so permitted by
the Committee, (i) by personal check (subject to collection), (ii) by delivery to the Company of an
assignment of the proceeds from the sale of Common Stock acquired upon exercise and an
authorization to the broker or selling agent to pay that amount to the Company or (iii) by delivery
of shares of Common Stock already owned by the undersigned for at least six months prior to such
delivery), or in such other manner as may be determined by the Committee. The undersigned hereby
agrees to provide, if so requested by the Committee, a written opinion of counsel satisfactory to
the Company to the effect that such assignment of proceeds from such broker or selling agent, or
such delivery of shares of Common Stock already owned by the Optionee, if permitted by the
Committee, would not result in the Optionee incurring any liability under Section 16(b) of the
Securities Exchange Act of 1934 and does not require any Consent (as defined in the Plan).

The undersigned hereby agrees and acknowledges that he has received and reviewed a copy of the
current prospectus relating to the issuance of shares under the Plan and the most recent annual
report to stockholders of the Company.

The undersigned hereby further agrees to be bound by the terms and provisions of the Plan and
the Agreement, including, without limitation, Section 5 of the Agreement (generally relating to tax
withholding requirements).

 

6

 

Exercise of Stock Options:

	 	 	 	 	 
	Grant Date	 	Vested Shares
 Available	 	Shares To Be
 Exercised
	 
	 	 	 	 
	 

	 	 
	 	 
	 
	 	 	 	 
	 

	 	 
	 	 
	 
	 	 	 	 
	 

	 	 
	 	 
	 
	 	 	 	 
	 

	 	 
	 	 
	 
	 	 	 	 
	 

	 	 
	 	 
	 
	 	 	 	 
	 

	 	 
	 	 
	 
	 	 	 	 
	 

	 	 
	 	 

Please issue a certificate or certificates for such shares of Common Stock to me at the address set
forth in the Agreement, or in the name of                                          at the address listed
below:

(Print)

Address:

 

 

	 	 	 	 	 	 	 	 	 	 	 
	Signature

	 	 	 	 	 	Date	 	 	 	 
	 

	 	 

	 	 	 	 	 	 

	 	 
	Printed
	 	 	 	 	 	 	 	 	 	 
	 

	 	 

	 	 	 	 	 	 	 	 

 

7Exhibit 10.1

Exhibit 10.1

LEASE AGREEMENT

BY AND BETWEEN

PHILIP ELGHANIAN (“LESSOR”)

AND

DVA HEALTHCARE RENAL CARE, INC. (“LESSEE”)

Dated: February 6, 2009

 

 

 

TABLE OF CONTENTS

	 	 	 	 	 
	1. TERM
	 	 	1	 
	2. RENT
	 	 	2	 
	3. RENT ADJUSTMENTS
	 	 	2	 
	4. RENEWALS
	 	 	2	 
	5. CONDITION OF PREMISES
	 	 	3	 
	6. USE OF PREMISES
	 	 	3	 
	7. ASSIGNMENT/SUBLETTING
	 	 	3	 
	8. TAXES, UTILITIES AND MAINTENANCE, REPAIR AND REPLACEMENT COSTS AND CAM CHARGES
	 	 	4	 
	9. ALTERATIONS/SIGNAGE
	 	 	6	 
	10. ENVIRONMENTAL
	 	 	7	 
	11. DAMAGE TO PREMISES BY FIRE OR CASUALTY
	 	 	8	 
	12. EMINENT DOMAIN
	 	 	10	 
	13. RIGHT OF ENTRY BY LESSOR
	 	 	10	 
	14. INDEMNITY
	 	 	11	 
	15. DEFAULT AND REMEDIES
	 	 	11	 
	16. INSURANCE
	 	 	13	 
	17. SUBROGATION
	 	 	14	 
	18. REPAIRS AND MAINTENANCE
	 	 	14	 
	19. BROKERS
	 	 	15	 
	20. EMERGENCY
	 	 	15	 
	21. TITLE AND PARKING
	 	 	15	 
	22. COMPLIANCE WITH LAWS
	 	 	15	 
	23. INTENTIONALLY OMITTED
	 	 	16	 
	24. LESSEE TO SUBORDINATE
	 	 	16	 
	25. QUIET ENJOYMENT
	 	 	16	 

 

i

 

	 	 	 	 	 
	26. MEMORANDUM OF LEASE
	 	 	17	 
	27. NOTICES
	 	 	17	 
	28. ESTOPPEL CERTIFICATE
	 	 	17	 
	29. HOLDING OVER
	 	 	17	 
	30. BINDING EFFECT
	 	 	17	 
	31. COMPLETE AGREEMENT
	 	 	18	 
	32. SEVERABILITY
	 	 	18	 
	33. APPLICABLE LAW
	 	 	18	 
	34. FORCE MAJEURE
	 	 	18	 
	35. AMENDMENT
	 	 	18	 
	36. LESSEE IMPROVEMENTS
	 	 	18	 
	37. LESSOR’S WORK
	 	 	19	 
	38. LESSOR’S SALE OF THE BUILDING
	 	 	19	 
	39. LESSEE’S ROOF RIGHTS
	 	 	19	 
	40. REGULATORY COMPLIANCE
	 	 	20	 
	41. COOPERATION WITH LESSEE’S COST REPORTING RESPONSIBILITIES
	 	 	23	 
	42. PROTECTED HEALTH INFORMATION
	 	 	23	 
	43. LESSOR’S CONSENT
	 	 	23	 
	44. APPROVAL BY DAVITA INC. AS TO FORM
	 	 	23	 
	45. COUNTERPARTS
	 	 	23	 
	EXHIBIT A- LEGAL DESCRIPTION
	 	 	 	 
	EXHIBIT B- RESERVED
	 	 	 	 
	EXHIBIT C- FORM OF COMMENCEMENT DATE MEMORANDUM
	 	 	 	 
	EXHIBIT D- RESERVED
	 	 	 	 
	EXHIBIT E-FORM OF ESTOPPEL CERTIFICATE
	 	 	 	 

 

ii

 

THIS LEASE AGREEMENT (the “Lease”), made and entered into this                      day of                     , 200
 _____ 

(the “Effective Date”), by and between PHILIP ELGHANIAN (hereinafter called “Lessor”), and DVA
HEALTHCARE RENAL CARE, INC. (hereinafter called the “Lessee”).

W I T N E S S E T H:

WHEREAS, Lessor desires to demise, lease and rent unto Lessee, and the Lessee desires to rent
and lease from Lessor that certain real property located at 17590 Foothill Boulevard, Fontana,
California, as more particularly described on Exhibit A, together with a building consisting of
approximately Ten Thousand Five Hundred Sixty-Eight (10,568) rentable square feet {NOTE: TO BE
CONFIRMED BY LESSEE} (the “Building”) and all improvements thereon and appurtenant rights thereto
including, without limitation, parking areas, easements, declarations and rights of way
(collectively the “Premises”).

NOW, THEREFORE, for and in consideration of the mutual covenants, promises and agreements
herein contained and for other good and valuable consideration, the receipt and sufficiency of
which are hereby acknowledged, Lessor does hereby demise, lease and rent unto the Lessee and Lessee
does hereby rent and lease from Lessor the Premises, under and pursuant to the following terms and
conditions:

1. Term. This Lease shall be effective on the Effective Date. Lessor shall deliver
possession of the Premises upon the later to occur of: (i) Lessor’s completion of the remediation
and disposal of the Hazardous Substances (as defined in Section 10) described in the Lessor
Environmental Report (as defined in Section 10) or (ii) Lessor’s satisfaction of the Acquisition
Contingency (as defined in Section 21) (the “Possession Date”). In the event the Possession Date
does not occur within one hundred fifty (150) days following the Effective Date, Lessee may elect
to terminate this Lease by written notice to Lessor.

The term of the Lease shall commence upon the earlier of: (i) the date that is eight
(8) months following the Possession Date; or (ii) the date in which the Premises are open to the
public for business for the Permitted Use (as defined below) (and such date being referred to
herein as the “Commencement Date”) and shall expire one hundred twenty (120) months following said
Commencement Date (as the same may be extended the “Termination Date”), unless renewed as
hereinafter provided (the “Term”). Each twelve (12) month period beginning on the Commencement
Date or any anniversary thereof shall hereinafter be called a “Lease Year.” Upon determination of
the Commencement Date, Lessor shall execute and forward a memorandum in the form attached hereto as
Exhibit C to Lessee for Lessee’s approval and execution.

 

 

 

2. Rent. Beginning on the Commencement Date, Lessee agrees to pay as an initial
annual base rent (“Rent”) of Two Hundred Fifty-Nine Thousand Nine Hundred Seventy-Two and 80/100
Dollars ($259,972.80), based on a $2.05 per rentable square foot per month amount. Beginning on
the Commencement Date, Lessee shall pay Rent in the amount of $21,664.40 per month in advance on
the first day of each calendar month during the Term, such monthly
installment to be prorated for any partial calendar month in which the Commencement Date or
Termination Date shall occur. The Rent shall be adjusted in accordance with the provisions of
Section 3. All amounts (unless otherwise provided herein) other than the Rent and the adjustments
thereto described in Section 3 hereof owed by Lessee to Lessor hereunder including, without
limitation, the payment of: (i) Taxes (as defined below), (ii) the CAM Expenses (as defined below),
(iii) Premises Insurance Reimbursements (as defined below), and (iv) interest due on amounts not
paid when due (with such past due amounts accruing interest at the Default Interest Rate (as
defined below)) shall be deemed additional rent (“Additional Rent”). Any payment of Rent or
Additional Rent not paid by Lessee to Lessor when due shall bear interest at lesser of: (i) twelve
percent (12%) or (ii) the maximum rate permitted by applicable law from the date of when due until
the date of payment by Lessee to Lessor (the “Default Interest Rate”). Within thirty (30) days
following the Possession Date, Lessor shall complete and deliver to Lessee a Form W-9 — Request for
Taxpayer Identification and Certification.

Except as otherwise provided in this Lease, it is the intention of the parties that Lessor
shall receive Rent, Additional Rent and all sums payable by Lessee under this Lease free of all
taxes, expenses, charges, damages and deductions of any nature whatsoever (except as otherwise
provided hereinafter) and Lessee covenants and agrees to pay all sums (including rent taxes,
maintenance, repair and replacement costs as set forth in Section 8, Taxes, CAM Expenses, and
Premises Insurance Reimbursements) which except for this Lease would have been chargeable against
the Premises and payable by Lessor. Lessee shall, however, be under no obligation to pay principal
or interest on any mortgage on the fee of the Premises, penalties or interest for late or partial
payment nor any income, franchise, inheritance, estate, transfer, excise, gift or capital gain
taxes, that are or may be payable by Lessor or that may be imposed against Lessor or succession tax
by reason of any present, future or retroactive law which may be enacted during the Term of this
Lease.

3. Rent Adjustments. Beginning on the fifth (5th) anniversary of the
Commencement Date, Rent shall increase 12.5%, and Lessee shall pay Rent in the amount of $24,372.45
per month (commencing on the fifth (5th) anniversary of the Commencement Date) and
continuing until the expiration of the tenth (10th) Lease Year, without delays in such
adjustments due to any abatement periods that may be applicable during such Lease Years.

4. Renewals. Lessee shall have the right and option to renew this Lease for three (3)
additional periods of five (5) years each, next immediately ensuing after the expiration of the
initial Term of this Lease and the subsequent renewal periods by notifying Lessor in writing not
less than one hundred eighty (180) days before the expiration of the immediately preceding initial
Term or subsequent renewal Term of this Lease of Lessee’s intention to exercise its option to
renew, but Lessee shall have no option to extend this Lease beyond three (3) renewal periods of
five (5) years each after the initial Term. In the event that Lessee so elects to extend this
Lease, then, for such extended period of the Term, all of the terms, covenants and conditions of
this Lease shall continue to be, and shall be, in full force and effect during such extended period
of the Term hereof, except for the Rent. The Rent for any such extended period shall be increased
by 12.5% over the Rent for the immediately preceding initial Term or subsequent renewal term.

 

2

 

5. Condition of Premises. Lessor shall deliver the Premises in its “AS IS, WHERE IS”
condition.

6. Use of Premises. Lessee may occupy and use the Premises during the Term for
purposes of the operation of an outpatient renal dialysis clinic, renal dialysis home training,
aphaeresis services and similar blood separation and cell collection procedures, general medical
offices, clinical laboratory, including all incidental, related, and necessary elements and
functions of other recognized dialysis disciplines which may be necessary or desirable to render a
complete program of treatment to patients of Lessee (the “Permitted Use”), or for any other lawful
purpose(s) that would not violate any applicable laws with respect to the Premises (e.g., the types
of uses only permitted with respect to the zoning classification of the Premises). Lessee may
operate during such days and hours as Lessee may determine, without the imposition of minimum or
maximum hours of operation by Lessor and Lessee shall have access to the Premises, and may operate,
up to 24 hours per day, seven (7) days per week, 365 days per year.

After the Effective Date, and at all times in which this Lease is in full force and effect,
and so long as Lessee is not in default of this Lease, Lessor shall not lease any property owned,
leased or controlled by Lessor within a radius of five (5) miles from the Premises to be occupied
or used by a business that derives more than ten percent (10%) of its revenues from renal dialysis,
renal dialysis home training, any aphaeresis service(s) or similar blood separation or cell
collection procedures, except services involving the collection of blood or blood components from
volunteer donors. This paragraph shall be of no force or effect following the termination or
expiration of this Lease. Notwithstanding the foregoing, the radius restriction set forth in this
paragraph shall not be applicable to: (i) any existing lease for a renal dialysis operation located
at any property owned, leased or controlled by Lessor within the above-referenced five (5) miles
radius as of the Effective Date, or (ii) any existing lease for a renal dialysis operation which is
in business and located at a property within five (5) miles of the Premises which Lessor acquires
or obtains controls of after the Effective Date (‘Existing Renal Facility Lease”).

7. Assignment/Subletting. Lessee shall not assign this Lease, or sublet the Premises,
or any part thereof, without Lessor’s prior written consent which consent shall not be unreasonably
withheld, conditioned or delayed. Prior to any sublease or assignment (“Lease Transfer”), Lessee
shall first notify Lessor in writing of its election to sublease all or a portion of the Premises
or to assign this Lease or any interest thereunder. At any time within thirty (30) days after
service of said notice, Lessor shall notify Lessee that it consents or refuses to consent to the
Lease Transfer. A failure by Lessor to respond within such thirty (30) day period shall be deemed
to be a consent.

 

3

 

Lessor shall not have the right to recapture any sublease or assignment space. Any denial of
such Lease Transfer by Lessor as hereinabove provided must be predicated upon a commercially
reasonable basis for such denial. Any net profits paid in connection with a Lease Transfer in
excess of Lessee’s Rent obligations hereunder (which net profits shall be calculated after
deducting all reasonable costs incurred by Lessee in connection with the space subject to the Lease
Transfer) shall be divided by Lessor and Lessor on a fifty/fifty (50/50) basis (the “Lease Transfer
Net Profits”). The costs incurred by Lessee in connection with such a Transfer shall
include, but not be limited to, legal fees, rental abatement, vacancy period, allowances, lessee
improvements, leasing commissions and the time to sublease or assign and remodel the Premises (the
“Total Transfer Costs”). Lessor’s fifty percent (50%) share of the Lease Transfer Net Profits
shall be determined as follows: (i) the dollar amount of the Total Transfer Costs shall be divided
by the number of months remaining in either the initial Term or the applicable renewal period
(after the month in which the Lease Transfer occurs), and such amount shall be the “Monthly
Transfer Cost Amount”, (ii) the difference between the new monthly Rent (as a result of the Lease
Transfer) and the monthly Rent (for the month prior to the month in which the Lease Transfer
occurs) shall be determined (the “Monthly Rent Increase Amount”), and (iii) the difference between
the Monthly Rent Increase Amount and the Monthly Transfer Cost Amount shall be determined (the
“Monthly Transfer Profit Amount”). Lessee shall pay to Lessor on a monthly basis fifty percent
(50%) of the Monthly Transfer Profit Amount commencing on the first month after the Lease Transfer
occurs.

Notwithstanding the foregoing, no consent of Lessor is required for Lessee to assign or
otherwise transfer (by operation of law or otherwise) this Lease or any of its rights hereunder to:
(a) any person, corporation, partnership or other entity which acquires all or substantially all of
the business or assets of Lessee or stock in Lessee; (b) any person, corporation, partnership or
other entity which controls, is controlled by or is under common control with Lessee; or (c) any
affiliate (within the meaning of such term as set forth in Rule 501 of Regulation D under the
Federal Securities Act of 1933) of Lessee.

No such assignment or other transfer, in whole or in part, of any Lessee’s rights or
obligations under this Lease shall be or operate as a release of Lessee hereunder and Lessee shall
remain responsible for performing Lessee’s obligations hereunder should Lessee’s assignee or
transferee fail to perform any such obligations, unless specifically provided otherwise by Lessor
in writing.

8. Taxes, Utilities and CAM Expenses.

(a) Taxes. Lessee shall pay, at its sole cost and expense, all Taxes, for the
Premises. The term “Taxes” shall mean all general, special, ordinary, supplemental and
extraordinary real and personal property taxes and assessments, license fees and taxes, rental
taxes, levies, charges, penalties, sewer or water charges (hook-up or otherwise), improvement bonds
and other governmental levies imposed by any authority having direct or indirect power to tax,
including, but not limited to, any city, county, state or federal government, or any school,
agricultural, sanitary, fire, street, lighting, drainage or other improvement district, on,
against, or with respect to the Premises, Lessor’s right to rent and other income therefrom or
Lessor’s business of leasing the Premises, together with any taxes or assessments imposed in
addition to, in substitution of or as a supplement to any taxes or assessments previously included
within the definition of Taxes. Taxes shall not include (except as set forth below) any penalties
or interest for late or partial payment nor any income, franchise, inheritance, estate, excise,
gift or capital gain taxes that are or may be payable by Lessor or that may be imposed against
Lessor. The term “Taxes” shall also include any tax, fee, levy, assessment or charge: (i) the
nature of which was hereinbefore included within the definition of Taxes, (ii) which was imposed

 

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for a
service or right not charged prior to June 1, 1978, or, if previously charged, has been increased since June 1, 1978, (iii)
which is imposed or assessed as a result of any and all changes in ownership (as that term is used
in Article 13A of the California Constitution and/or California Revenue and Taxation Code Sections
60, et seq.) of the Premises, or any portion thereof, or which is added to a tax or charge
hereinbefore included within the definition of Taxes by reason of such transfer(s), (iv) which is
imposed or assessed as a result of any and all alterations, additions or improvements to the
Premises or any portion thereof, or (v) which is imposed by reason of this transaction, any
modifications or changes hereto or any transfers hereof. Should Lessor choose not to contest any
Taxes, Lessee shall have the right to contest the Taxes in Lessor’s name and with Lessor’s
reasonable cooperation, at no expense to Lessor. Lessor, at Lessee’s sole expense, shall join in
any such contestation proceedings if any Law shall so require. Lessee shall pay to Lessor the
Taxes on a semi-annual basis as follows: (i) Lessor shall submit to Lessee semi-annually a copy of
the tax bill for the Premises setting forth the semi-annual installment amount due (the
“Semi-Annual Tax Statement”), and (ii) within fifteen (15) days of Lessee’s receipt of each
Semi-Annual Tax Statement, Lessee shall provide to Lessor a payment in the dollar amount set forth
on the Semi-Annual Tax Statement (“Lessee’s Semi-Annual Tax Payment”). In the event Lessee fails
to provide Lessee’s Semi-Annual Tax Payment to Lessor within the above referenced fifteen (15) day
period, Lessee shall pay to Lessor, in addition to the Semi-Annual Tax Payment, interest accruing
on the Semi-Annual Tax Payment (at the Default Interest Rate), and any penalties or interest
incurred by Lessor for any late payment of Taxes.

(b) Utilities. Lessee shall pay, at its sole cost and expense, for all utilities and
other services necessary in the operation of the Premises, including, but not limited to, gas,
fuel, oil, electrical, telephone and other utility charges, and any “tap fees” or any sewer or
water connection fees in connection with the Premises.

(c) CAM Expenses. Lessee shall pay all common area maintenance charges for the
Premises (“CAM Expenses”). As set forth below, Lessee shall pay to Lessor as Additional Rent, all
of the CAM Expenses. Beginning on the Commencement Date and thereafter in advance on the first day
of each calendar month during the Term, Lessee shall pay to Lessor one twelfth (1/12) of Lessor’s
estimated CAM Expenses for each twelve (12) month period selected by Lessor (the “Yearly CAM
Period”), including a commercially reasonably management or administrative fee for Lessor (the
“Lessee Monthly CAM Payment”). Lessor may cause any services such as sweeping and landscaping work
to be performed by independent contractors. Lessor shall provide Lessee with an estimate of the
CAM Expenses on or before the commencement of each Yearly CAM Period occurring during the Term of
this Lease. After the end of each Yearly CAM Period, Lessor shall provide to Lessee a statement of
the actual CAM Expenses for the Yearly CAM Period (“Yearly CAM Statement”). If the Yearly CAM
Statement shows that the aggregate of all of the Lessee Monthly CAM Payments made during the Yearly
CAM Period was less than the actual amount of the CAM Expenses (as set forth on the Yearly CAM
Statement), Lessee shall pay the balance due to Lessor within ten (10) days after receipt of the
statement; and if the Yearly CAM Statement shows that the aggregate paid exceeded the actual CAM
Expenses, Lessor shall either refund the excess or credit Lessee’s next accruing Lessee Monthly CAM
Payment.

 

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Notwithstanding the foregoing, the term “CAM Expenses” does not include the following: (i)
depreciation of the Building, and all equipment, fixtures, improvements and facilities used in
connection therewith; (ii) payments of principal, interest, loan fees, penalties, attorney’s fees
or amortization relating to any debt Lessor may have incurred or will incur in the future relating
to the ownership, operating and maintenance of the Building; (iii) Reserved; (iv) Reserved; (v)
except as otherwise provided for in this Lease, expenses or costs incurred by Lessor relating to
any violation by Lessor of the terms and conditions of any law or any lease covering the Building;
(vi) the cost of any repair or replacement which would be required to be capitalized under
generally accepted accounting principles; (vii) the costs and expenses of any item included in CAM
Expenses to the extent that Lessor is actually reimbursed for such cost by an insurance company, a
condemning authority, another lessee or any other party; (viii) payments of ground rents and
related sums pursuant to a ground lease in favor of a ground lessor; (ix) Reserved;(x) any costs
representing an amount paid to an entity related to Lessor which is in excess of the commercially
reasonable amount which would have been paid absent such relationship; (xi) any entertainment,
dining, or travel expenses of Lessor for any purpose; (xii) costs related to maintaining Lessor’s
existence, either as a corporation, partnership, or other entity; (xiii) any expenses for repairs
or maintenance to the extent covered by warranties or service contracts; (xiv) Reserved; (xv) the
cost of any environmental remediation for which Lessor is responsible under Section 10 of this
Lease; (xvi) all ad valorem taxes paid or payable by Lessee or other lessees in the Building for
(A) personal property and (B) on the value of the leasehold improvements in the Premises, or the
Building of other lessees in the Building (in this connection it is agreed that Lessee shall be
responsible for the payment of ad valorem taxes on Lessee’s own leasehold improvements); (xvii)
Reserved; and (xviii) any item which is included in CAM Expenses which, but for this provision,
would be included twice.

(d) Lessor appoints Lessee the attorney-in-fact of Lessor for the purpose of making all
payments to be made by Lessee pursuant to any of the provisions of this Lease to persons other than
Lessor. In case any person to whom any sum is directly payable by Lessee under any of the
provisions of this Lease shall refuse to accept payment of such sum from Lessee, Lessee shall
thereupon give written notice of such fact to Lessor and shall pay such sum directly to Lessor, who
shall thereupon pay such sum to such person.

9. Alterations/Signage. Lessee shall not make any alterations, or additions or
leasehold improvements to the Premises following the Commencement Date (“Alterations”) without
Lessor’s prior written consent in each and every instance, such consent not to be unreasonably
withheld or delayed. Notwithstanding the foregoing, Lessee shall have the right to make
non-structural Alterations to the Premises which do not exceed in cost Fifty Thousand Dollars
($50,000.00) in the aggregate during each Lease Year without Lessor’s consent. All Alterations
which may be made by Lessee shall be the property of Lessee and Lessee shall be entitled to remove
from the leased Premises during the Term all Alterations, tenant improvements and any and all
furniture, removable trade fixtures, equipment and personal property (“Fixtures”) installed or
located on or in the Premises provided that Lessee repair any and all damages done by the removal
of the foregoing. All Alterations and tenant improvements which Lessee does not elect to remove at
the expiration of the Term shall be surrendered with the Premises at the termination of this Lease.

 

6

 

To the maximum extent permitted by applicable Laws, Lessor hereby waives any rights which
Lessor may have, as to any of Lessee’s furniture, fixtures, equipment, personal property, tenant
improvements and Alterations, in the nature of a Lessor’s lien, security interest or otherwise and
further waives the right to enforce any such lien or security interest.

Lessee shall have the right to affix Lessee’s standard signage, in accordance with the rules
and regulations of the Premises, including a sign on the exterior of the Premises and a monument
sign located at the Premises. All such signs shall comply with all Laws and codes applicable to
the Premises and Lessor’s prior approval, which approval shall not be unreasonably withheld,
conditioned or delayed.

10. Environmental. Lessee shall not cause or permit any hazardous or toxic
substances, materials or waste, including, without limitation, medical waste and asbestos
(“Hazardous Substances”) to be used, generated, stored or disposed of in, on or under, or
transported to or from the Premises unless such Hazardous Substances are reasonably necessary for
Lessee’s business conducted in the Premises; provided, however, Lessee shall at all times and in
all material respects comply with all local, state, and federal laws, ordinances, rules,
regulations and orders, whether now in existence or hereafter adopted relating to Hazardous
Substances or otherwise pertaining to the environment (the “Environmental Laws”) and further
provided that Lessee shall periodically cause to be removed from the Premises such Hazardous
Substances placed thereon by Lessee or Lessee’s agents, servants, employees, guests, invitees
and/or independent contractors in accordance with good business practices, such removal to be
performed by persons or entities duly qualified to handle and dispose of Hazardous Substances.
Without limiting the generality of the foregoing, Lessor acknowledges that the following Hazardous
Substances, among others, are required for Lessee’s business operations: bleach, cidex, hibiclena,
metrocide, hydrogen peroxide, and formaldehyde. Upon the expiration or earlier termination of this
Lease, Lessee shall cause all Hazardous Substances placed on the Premises by Lessee to be removed,
at Lessee’s cost and expense, from the Premises and disposed of in strict accordance with the
Environmental Laws.

Lessee shall indemnify, defend (by counsel reasonably acceptable to Lessor), protect, and hold
Lessor harmless, from and against any and all claims, liabilities, penalties, fines, judgment,
forfeitures, losses, costs (including clean-up costs) or expenses (including attorney’s fees,
consultant’s fees and expert’s fees) for the death of or injury to any person or damage to any
property whatsoever, arising from or caused in whole or in part, directly or indirectly, by (a) the
presence after the Possession Date in, on, under, or about the Premises of any Hazardous Substances
caused by Lessee or its agents, servants, employees, guests, invitees and/or independent
contractors; (b) any discharge or release by Lessee or its agents, servants, employees, guests,
invitees and/or independent contractors after the Possession Date in or from the Premises of any
Hazardous Substances; (c) Lessee’s use, storage, transportation, generation, disposal, release or
discharge after the Effective Date of Hazardous Substances, to, in, on, under, about or from the
Premises; or (d) Lessee’s failure after the Possession Date to comply with any Environmental Law.

 

7

 

Lessor shall indemnify, defend (by counsel reasonably accepted to Lessee), protect, and hold
Lessee harmless, from and against any and all claims, liabilities, penalties, fines, judgment,
forfeitures, losses, costs (including clean-up costs) or expenses (including attorney’s fees,
consultant’s fees and expert’s fees) for the death of or injury to any person or damage to any
property whatsoever, arising from or caused in whole or in part, directly or indirectly, by (a) the
presence prior to the Possession Date in, on, under, or about the Premises of any Hazardous
Substances; (b) any discharge or release prior to the Possession Date in or from the Premises of
any noxious or Hazardous Substances; (c) the use, storage, transportation, generation, disposal,
release or discharge of Hazardous Substances by Lessor to, in, on, under, about or from the
Premises; or (d) Lessor’s failure to comply with any Environmental Law. Lessor agrees to
encapsulate and/or remediate and dispose of such Hazardous Substances to the extent required by
governmental laws and regulations (e.g. Lessor has no obligations with respect to non-friable
asbestos which became friable as a result of Alterations or Lessee Improvements (as defined below)
made to the Premises, or Lessee’s use or occupancy thereof).

Lessor represents and warrants to Lessee that as of the Effective Date and to the best of
Lessor’s knowledge, and without any duty of investigation or inquiry of any kind whatsoever, except
for the Hazardous Substances as may be disclosed in Environment Site Assessment Report of the
Premises dated October 13, 2008 and prepared by Environmental Solutions (the “Lessor Environmental
Report”), a copy of which Lessor Environmental Report, was provided by Lessor to Lessee prior to
the Effective Date and which Lessee acknowledges receipt, there are no Hazardous Substances on the
Premises not in compliance with applicable Laws. Except for the Lessor Environmental Report,
Lessor, as a party to a contract to acquire the Premises, has received no notice from any
governmental or private entity relating to Hazardous Substances on the Premises. Lessee shall
promptly deliver to Lessor copies of all notices made by Lessee to, or received by Lessee from, any
state, county, municipal or other agency having authority to enforce any environmental law
(“Enforcement Agency”) or from the United States Occupational Safety and Health Administration
concerning environmental matters or Hazardous Substances at the Premises. Lessor shall promptly
deliver to Lessee copies of all notices received by Lessor from any Enforcement Agency or from the
United States Occupational Safety and Health Administration concerning environmental matters or
Hazardous Substances at the Premises. Prior to the Possession Date, Lessor or the Lessor’s
Assignee (as defined in Section 21), at its cost, shall remediate and dispose of the Hazardous
Substances disclosed in the Lessor Environmental Report in accordance with all applicable Laws.

11. Damage to Premises by Fire or Casualty. In the event the Premises shall be
damaged by fire or other casualty during the Term of this Lease, whereby the same shall be rendered
untenantable, then:

(a) Lessor shall have its contractor (the “Lessor Contractor”) estimate when the repair of the
Premises, excluding Lessee’s Fixtures, the Alterations, and the Lessee Improvements (“Lessor’s
Casualty Work”) will be completed, within thirty (30) days following such casualty, and Lessor
shall give Lessee written notice thereof promptly following Lessor’s receipt of the Lessor
Contractor’s estimate of the completion date (the “Contractor’s Estimate”). If the Contractor’s
Estimate provides that such damage will not be completed within six (6) months
following such casualty, then Lessee may elect to terminate this Lease by giving written
notice to Lessor not later than fifteen (15) days after the date of Lessee’s receipt of the
Contractor’s Estimate. The Lessor Contractor shall be subject to Lessee’s reasonable approval
provided Lessee shall accept the qualifications of the Lessor Contractor in a commercially
reasonable manner; or

 

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(b) if the damage to the Premises is so substantial that (i) the estimated repair costs exceed
$100,000.00 and such damage has occurred within the last one hundred eighty (180) days of the then
current term and Lessee does not exercise its next available renewal option, if any, (ii) the
Premises is damaged to the extent of fifty percent (50%) or more of the monetary value thereof, or
(iii) the Contractor’s Estimate provides that the damage to the Premises will not be completed
within eight (8) months following such casualty, then Lessor may elect to terminate this Lease by
giving written notice to Lessee within thirty (30) days of the date of such fire or casualty; or

(c) if not so terminated, Lessor shall proceed with all due diligence to perform and complete
the Lessor’s Casualty Work, to substantially the former condition of the Premises immediately prior
to such damage or destruction, at Lessor’s expense, in which latter event this Lease shall not
terminate (and after completion of Lessor’s Casualty Work, Lessee shall forthwith, at its sole cost
and expense, repair, restore or rehabilitate Lessee’s Fixtures, the Alterations, and the Lessee
Improvements).

If the Premises are rendered untenantable by fire or other casualty, there shall be an
abatement of Rent due Lessor by Lessee for the period of time during which the Premises are
untenantable in proportion to the untenantability of the Premises. Subject to Force Majeure, if
the Lessor’s Casualty Work is not substantially completed within two hundred and ten (210) days of
such damage (the “Lessor’s Casualty Work Outside Date”), then Lessee may not later than fifteen
(15) days after the Lessor’s Casualty Work Outside Date, terminate this Lease by written notice to
Lessor (the “Lessee’s Casualty Termination Notice”). Notwithstanding the foregoing, in the event
Lessor substantially completes Lessor’s Casualty Work within thirty (30) days after Lessor’s
receipt of Lessee’s Casualty Termination Notice (provided within the above referenced fifteen (15)
day period), then Lessee’s Casualty Termination Notice shall be of no force or effect, and this
Lease shall not terminate. In the event of any termination of this Lease as a result of damaged by
fire or other casualty, Rent shall be paid only to the date of such fire or casualty.

Notwithstanding the foregoing provisions of this Section 11, in the event that insurance
proceeds applicable to the Fixtures, the Alterations, and the Lessee Improvements constructed by
Lessee at its expense are made available to Lessee, Lessee shall be responsible for restoring such
Fixtures, Alterations and the Lessee Improvements; provided, however, that the Rent
abatement provided for shall continue during such period of restoration so long as Lessee is
diligently pursuing the completion of such restoration. In the event that Lessor does not restore
the Premises, Lessee may retain all insurance proceeds applicable to Alterations and Lessee
Improvements constructed by Lessee at its expense.

 

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12. Eminent Domain.

(a) Taking. If by any lawful authority through condemnation or under the power of
eminent domain: (i) the whole of the Premises shall be permanently taken; (ii) less than the
entire Premises shall be permanently taken, but the remainder of the Premises, are not, in Lessee’s
sole judgment, fit for Lessee to carry on its business therein; (ii) Lessee determines, in its sole
judgment, that after such taking adequate parking space will not be available near the Premises;
(iv) there is any substantial impairment of ingress or egress from or to or visibility of the
Premises; or (v) all or any portion of the common areas of the Premises shall be taken resulting in
a material interference with the operations of or access to Lessee’s business, then in any such
event, Lessee may terminate this Lease, effective as of the date of such taking, and the Rent and
other sums paid or payable hereunder shall be prorated as of the date of such termination.

(b) Rent Adjustment. Unless this Lease is terminated as above provided, commencing
with the date possession is acquired by the condemning authority the Rent and other sums payable
hereunder shall be reduced by the then applicable per square foot Rent as by the number of square
feet taken and Lessor shall restore the Premises, at Lessor’s cost and expense to a complete
architectural unit. During such restoration the Rent shall be abated to the extent the Premises
are rendered untenantable.

(c) Awards. All compensation awarded or paid in any such eminent domain proceeding
shall belong to and be the property of Lessor without any participation by Lessee, except that
nothing contained herein shall preclude Lessee from prosecuting any claim directly against the
condemning authority in such eminent domain proceeding for its relocation costs, its unamortized
leasehold improvements and trade fixtures, loss of business and the like except Lessee hereby
disclaims and waives any rights Lessee may have to the so called “lease bonus value” associated
with this Lease in the event of a taking.

13. Right of Entry by Lessor. In addition to Lessor’s right of entry pursuant to this
Lease, Lessor, or any of its agents, shall have the right to enter the Premises during all
reasonable hours and upon at least twenty-four (24) hours prior notice (except in cases of
emergency), to examine the same or to exhibit the Premises. Lessor shall have the right to put or
keep upon the doors or windows thereof a notice “FOR RENT” at any time within sixty (60) days
before the expiration of this Lease. Any work performed by Lessor to the Premises shall, if
commercially practicable, be performed during hours that Lessee is not open for business (except in
emergencies) unless Lessee, in the exercise of its commercially reasonable discretion otherwise
agrees. Any restoration work or alteration work at the Premises which is necessitated by or
results from Lessor’s entry, including, without limitation, any work necessary to conceal any
element whose presence is permitted hereunder, shall be performed by Lessor at its expense or, at
Lessee’s election, by Lessee on Lessor’s behalf and at Lessor’s sole cost and expense. Lessor
shall be liable for all loss, damage, or injury to persons or property and shall indemnify and hold
Lessee harmless from all claims, losses, costs, expenses and liability, including reasonable
attorney’s fees resulting from Lessor’s entry except to the extent caused by the negligent or
intentional act of Lessee or its contractors, agents, employees or licensees. If Lessor’s entry
into the Premises pursuant to this Lease interferes with the conduct by Lessee of its business to
such
an extent that Lessee, in the exercise of its commercially reasonable business judgment, must close
the Premises or is unable to use seventy-five percent (75%) of the Premises for business for two
(2) or more business days, then Rent shall totally abate for each day or portion thereof that such
interference continues.

 

10

 

Lessor acknowledges that Lessee is subject to the provisions of the Health Insurance
Portability and Accountability Act of 1996 and related regulations (“HIPAA”), and that HIPAA
requires Lessee to ensure the safety and confidentiality of patient medical records. Lessor
further acknowledges that, in order for Lessee to comply with HIPAA, Lessee must restrict access to
the portions of the Premises where patient medical records are kept or stored. Lessor hereby
agrees that, notwithstanding the rights granted to Lessor pursuant to this Section 13 and under
this Lease, except when accompanied by an authorized representative of Lessee, neither Lessor nor
its employees, agents, representatives or contractors shall be permitted to enter those areas of
the Premises designated by Lessee as locations where patient medical records are kept and/or stored
or where such entry is prohibited by applicable state or federal health care privacy laws. Lessor
further agrees to comply with the provisions of HIPAA and all applicable medical privacy laws in
connection with Lessor’s entry into the Premises.

14. Indemnity. Lessee agrees to indemnify, defend (by counsel reasonably acceptable
to Lessor) protect and hold Lessor harmless from and against any and all liability, claims and loss
for personal injury or property damage, or both, sustained or claimed to have been sustained by any
person or persons, or property in, upon or about the Premises caused or brought about by the acts
or neglect or intentional acts of Lessee, its agents, servants or employees. Lessor agrees to
indemnify, defend (by counsel reasonably acceptable to Lessee) protect and hold Lessee harmless
from and against any and all liability, claims and loss for personal injury or property damage, or
both, sustained or claimed to have been sustained by any person or persons, or property in, upon or
about the Premises caused or brought about by the act or neglect or intentional acts of Lessor, its
agents, servants or employees. The indemnities set forth in this Section 14 shall survive the
expiration of the term of this Lease.

15. Default and Remedies.

(a) Lessee Default and Lessor Remedies. In the event that (i) Lessee defaults in the
payment of Rent hereunder or the payment of any other sums, including CAM Expenses or any other
amount deemed Additional Rent, and such Rent and/or Additional Rent remains due and unpaid for ten
(10) days following written notice of such default from Lessor to Lessee; (ii) or should Lessee
default in the performance of any other provisions of this Lease and such default is not cured
within thirty (30) days following written notice from Lessor specifying such default (unless such
default is not reasonably capable of being cured within such thirty (30) day period and Lessee is
diligently prosecuting such cure to completion and has commenced the prosecution of such cure
within such thirty (30) day period); or (iii) if a petition in bankruptcy shall be filed by or
against Lessee (provided Lessee shall have ninety (90) calendar days to stay any involuntary
proceeding); or (iv) should Lessee make an assignment for the benefit of its creditors, or should a
receiver be appointed for the said Lessee and such receiver is not dismissed within sixty (60) days
of his appointment, then, in any of these events, Lessor may, at its option,
exercise any right or remedy which Lessor may have by reason of such default, including,
without limitation all remedies as may be permitted by law, including without limitation: (i)
terminate Lessee’s right of possession of the Premises by lawful means in which case this Lease
shall terminate and Lessee shall immediately surrender possession to Lessor, or (ii) continue this
Lease and Lessee’s right to possession and recover the rent as it becomes due pursuant to the
remedy described in California Civil Code Section 1951.4 (a lessor may continue lease in effect
after a lessee’s breach and abandonment and recover rent as it becomes due, if lessee has the right
to sublet or assign subject only to reasonable limitations). Acts of maintenance, efforts to
relet, and/or the appointment of a receiver to protect the Lessor’s interests, shall not constitute
a termination of Lessee’s right to possession.

 

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Upon and after termination of this Lease, Lessor shall make commercially reasonable efforts to
mitigate its damages and relet the Premises or any part thereof to any person, firm or corporation
other than Lessee for such rent, for such time and upon such terms as Lessor in Lessor’s reasonable
discretion shall determine. If the consideration collected by Lessor upon any such reletting is
not sufficient to pay monthly the full amount of the Rent and Additional Rent reserved in this
Lease (including, without limitation, all of the CAM Expenses which Lessee is required to pay
pursuant to Section 8 of this Lease) and all other monies to be paid by Lessee pursuant to this
Lease, Lessee shall pay to Lessor the amount of each monthly deficiency upon demand. Whether or
not this Lease is terminated by Lessor or by any provision of law or court decree, Lessee shall
have no obligation to pay any Rent until the date it would otherwise have become due in the absence
of any event of default. Lessor agrees that it shall have no right to accelerate (i.e. declare the
same immediately due and payable) any Rent which would have become due in the future; provided,
however, that upon termination of this Lease by Lessor, Lessee shall pay Lessor for the
unamortized out-of-pocket costs of leasing commissions and the Allowance (as defined below).
Lessee acknowledges and agrees that while Rent and any sums, which shall be deemed Additional Rent
may not be accelerated, Lessee is and shall at all times be liable for and remain liable for all
Rent and all other sums, which shall be deemed Additional Rent, due and payable pursuant to this
Lease throughout the Term.

(b) Lessor Default and Lessee Remedies. Subject to the terms and provisions
hereinbelow, and in addition to any other remedy expressly available to Lessee pursuant to this
Lease or at law or in equity, should Lessor fail to perform any term or covenant under this Lease
(each and any such failure being herein sometimes referred to as a “Lessor Default”) and if any
such Lessor Default shall not be cured and shall accordingly be continuing thirty (30) days
following written notice by Lessee to Lessor of such Lessor Default (unless such default is not
reasonably capable of being cured within such thirty (30) day period and Lessor is diligently
prosecuting such cure to completion), then Lessee shall have the option (at Lessee’s sole
discretion) of (i) abating or withholding Rent, or (ii) remedying such Lessor Default and, in
connection therewith, incurring expenses for the account of Lessor, and any and all such sums
expended or obligations incurred by Lessee in connection therewith shall be paid by Lessor to
Lessee upon demand, and if Lessor fails to immediately reimburse and pay same to Lessee, Lessee
may, in addition to any other right or remedy that Lessee may have under this Lease, deduct such
amount (together with interest thereon at the maximum rate permitted by applicable law from the
date of any such expenditure by Lessee until the date of repayment thereof by
Lessor to Lessee) from subsequent installments of Rent and other charges (if any) that from time to
time thereafter may become due and payable by Lessee to Lessor hereunder. Notwithstanding the
foregoing, in all events Lessee shall have the right to remedy any Lessor Default without prior
notice in the event of an emergency (so long as Lessee gives notice within a reasonable period of
time thereafter) and invoice Lessor and abate Rent (if necessary) in the manner set forth in the
preceding sentences of this Section 15.

 

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16. Insurance.

(a) Lessor’s Insurance. During the Term of this Lease, Lessor shall procure and
maintain in full force and effect with respect to the Building (i) a policy or policies of property
insurance (including, to the extent required, sprinkler leakage, vandalism and malicious mischief
coverage, rental interruption insurance coverage for any period up to eighteen (18) months during
which the Building is partially or totally untenantable, and any other endorsements required by the
holder of any fee or leasehold mortgage and earthquake, terrorism and flood insurance to the extent
Lessor reasonably deems prudent and/or to the extent required by any mortgagee) for full
replacement value; and (ii) a policy of commercial liability insurance in a minimum amount of
$1,000,000.00 per claim and $3,000,000.00 in the aggregate for both bodily injury and property
damage insuring Lessor’s activities with respect to the Premises for loss, damage or liability for
personal injury or death of any person or loss or damage to property occurring in, upon or about
the Premises (collectively the “Lessor Premises Insurance”). Lessee shall pay to Lessor during the
Term the entire cost of the Lessor Premises Insurance within fifteen (15) days after Lessee’s
receipt of each written statement from Lessor setting forth the cost of the Lessor Premises
Insurance (the “Premises Insurance Reimbursements”).

(b) Lessee’s Insurance. Lessee covenants and agrees to keep Lessee Improvements (as
defined in Section 36 hereof) and Lessee’s contents in the Premises insured for full replacement
value against loss by fire and casualty, under an all risk policy with extended coverage
endorsements. In addition thereto, Lessee shall obtain and keep in force with respect to the
Premises comprehensive general liability insurance in a minimum amount of $1,000,000.00 per claim
and $3,000,000.00 in the aggregate for both bodily injury and property damage. In no event shall
Lessee’s insurance provide coverage or indemnity to Lessor for any claim, loss, suit, action or
other legal proceeding in which Lessor, its agents or designees bear responsibility for the claim,
loss, suit, action or other legal proceeding. Rather, it is the intent of this section to provide
general liability coverage to Lessor when it is made a party to a claim, loss, suit, action or
other legal proceeding for which it bears no responsibility. In the event that both Lessor and
Lessee bear responsibility for the claim, loss, suit, action or other legal proceeding, then each
party will look to their own insurance for coverage. Lessee may carry any insurance required by
this Lease under a blanket policy or under a policy containing a self insured retention. Each
policy shall provide that the insurer shall give to Lessor twenty (20) days written notice prior to
any cancellation of the policy.

 

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17. Subrogation. Each of the parties hereto hereby releases the other and the other’s
partners, agents and employees, to the extent of each party’s property insurance coverage, from any
and all liability for any loss or damage which may be inflicted upon the property of such
party even if such loss or damage shall be brought about by the fault or negligence of the
other party, its partners, agents or employees; provided, however, that this release shall be
effective only with respect to loss or damage occurring during such time as the appropriate policy
of insurance shall contain a clause to the effect that this release shall not affect said policy or
the right of the insured to recover thereunder. If any policy does not permit such a waiver, and
if the party to benefit therefrom requests that such a waiver be obtained, the other party agrees
to obtain an endorsement to its insurance policies permitting such waiver of subrogation if it is
commercially available and if such policies do not provide therefor. If an additional premium is
charged for such waiver, the party benefiting therefrom, if it desires to have the waiver, agrees
to pay to the other the amount of such additional premium promptly upon being billed therefor.

18. Repair and Maintenance.

(a) Lessor’s Obligations. Lessor shall timely maintain in good condition and repair
the common areas of the Premises and such costs shall be considered CAM Expenses in accordance with
Section 8 of this Lease. Notwithstanding the foregoing, Lessor, at its sole cost and expense,
shall maintain and keep in good order and repair and make any necessary replacements to the roof,
roof membrane, roof covering (provided that routine roof maintenance but not major repairs or
replacements may be included in CAM Expenses pursuant to Section 8 of the Lease), concrete slab,
footings, foundation, structural components, exterior walls and re-asphalt parking areas of the
Premises when necessary. If Lessor shall not commence such repairs within the fifteen (15) days
following written notice from Lessee that such repairs are necessary then Lessee may, at its
option, cause such Lessor’s repairs to be made and shall furnish Lessor with a statement of the
cost of such repairs upon substantial completion thereof. Lessor shall reimburse Lessee for the
cost of such repairs plus a service charge to cover Lessee’s expenses in an amount equal to 10% of
the cost of such repairs within ten (10) days of the date of the statement from Lessee setting
forth the amount due, provided, however, should Lessor fail to reimburse Lessee within said ten
(10) day period, then Lessee may, at its option, offset such amount against subsequent Rent due
under this Lease.

(b) Lessee’s Obligations. Except for Lessor’s obligations set forth above and except
for any damage caused by the acts of negligence by Lessor or its agents with respect to the
Premises, Lessee shall, at its sole cost, maintain in good condition and repair and replace in
connection with the Premises: the interior, non-structural portions of the Premises, all HVAC
systems, the non-structural elements of all doors and entrances, all pipes, plumbing, electrical
systems, sewer and waste water systems, wiring, cabling, lighting facilities, fire protection and
smoke detection systems, fire extinguishing systems, fire sprinkler systems, all windows, window
glass, plate glass, and floor coverings of the Premises, excepting only normal wear and tear and
damage by fire or other casualty. Lessee shall at its sole cost and expense pay the cost of all
janitorial services. If Lessee does not maintain in good condition and repair and replace the
Premises as required by this Section 18(b), and if Lessee shall not commence such repairs and
replacements within the fifteen (15) days following written notice from Lessor that such repairs
and replacements are necessary then Lessor may, at its option, cause such Lessee’s repairs and
replacements to be made and shall furnish Lessee with a statement of the cost of such repairs upon
substantial completion thereof. Lessee shall reimburse Lessor for the cost of such repairs
and replacements plus a service charge to cover Lessor’s expenses in an amount equal to 10% of the
cost of such repairs within ten (10) days of the date of the statement from Lessor setting forth
the amount due.

 

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19. Brokers. Lessor and Lessee each represent to the other that it has had no
dealings with any real estate broker or agent in connection with the negotiation of this Lease,
except for USI Real Estate Brokerage Services Inc. and Lee & Associates, representing Lessee
(“Lessee’s Brokers”). Lessor shall pay Lessee’s Brokers a brokerage commission pursuant to a
separate agreement. In the event Lessor does not timely pay Lessee’s Brokers such brokerage
commission, Lessee may offset the amount of such brokerage commission against Rent due Lessor.

20. Emergency. If Lessee or Lessor is unable or unwilling to take action which it is
obligated to take hereunder where an emergency has occurred with respect to the Premises
(Non-Acting Party”), then the other party may, at its option, take such action as is reasonably
necessary to protect the Premises and persons or property in the Premises (the “Acting Party”) and
the Non-Acting Party shall, within fifteen (15) days after written notice thereof from the Acting
Party reimburse the Acting Party for its reasonable out-of-pocket expenses incurred in curing such
emergency.

21. Title and Parking. Lessee acknowledges that at all relevant times on or before
the Effective Date: (i), Lessor is a party to a contract to acquire the Premises, and according is
not the titleholder of the Premises (“Lessor Purchase Contract”), (ii) Lessor has the right to
assign the Lessor Purchase Contract to a third party (the “Lessor Assignee”), and upon the
assignment of the Lessor Purchase Contract, Lessor shall have no further duties or obligations
under this Lease, and (iii) this Lease is subject to and contingent upon either Lessor or the
Lessor Assignee acquiring title to the Premises pursuant to the Lessor Purchase Contract (the
“Acquisition Contingency”). In the event that either Lessor or the Lessor Assignee fails to
satisfy the Acquisition Contingency by no later than the date which is one hundred twenty (120)
days after the Effective Date (the “Outside Acquisition Date”), then either Lessor or the Lessor
Assignee (on the one hand) or Lessee (on the other hand) may terminate this Lease by giving written
notice to the other party on or before the date which is thirty (30) days after the Outside
Acquisition Date. Notwithstanding the foregoing, should Lessee give a written notice of
termination pursuant to the failure of the Acquisition Contingency before the expiration of the
thirty (30) day period after the Outside Acquisition Date, and Lessor or the Lessor Assignee
satisfies the Acquisition Contingency on or before the expiration of such thirty (30) day period,
then Lessee’s termination notice shall be of no force or effect. Lessor represents that Lessor and
those signatories executing this Lease on behalf of Lessor have full power and authority to execute
this Lease.

Lessor agrees that Lessor will not make any material modifications to the Premises (including,
without limitation, the parking areas, driveways and walks) without Lessee’s prior written consent,
such consent not to be unreasonably withheld, conditioned or delayed. As of the Effective Date,
the Premises shall contain no less than the number of parking spaces required by applicable codes
or governmental regulations as to the Premises.

22. Compliance with Laws. Both parties hereby agree to comply with all applicable
federal, state and local laws, ordinances, rules and regulations (“Laws”) throughout the Term of
the Lease. Except as set forth in Section 10, Lessor represents and warrants to Lessee, as a party
to the Lessor Purchase Contract, to the best of Lessor’s knowledge, without any duty of
investigation and inquiry of any kind whatsoever, that as of the Effective Date the Premises is in
compliance with all Laws, including, without limitation, applicable zoning laws, ordinances, rules
and regulations and with applicable instruments affecting title to the Premises. Lessor further
represents that as a party to the Lessor Purchase Contract it has received no notices or
communications from any public authority having jurisdiction alleging violation of any Laws
relating to the Premises and has received no notices alleging violation of any title instrument.

 

15

 

If at any time or from time to time any Alterations, including, without limitation, structural
Alterations, are required in order for the Premises to comply with any generally applicable Laws
from time to time applicable to the Premises, Lessor shall immediately make such Alterations at its
sole cost and expense. If at any time or from time to time any Alterations, including, without
limitation, structural Alterations, are required in order for the Premises to comply with any Laws
specifically applicable to the Premises due to Lessee’s use as a dialysis facility and not due to
any act by Lessor, Lessee shall immediately make such Alterations at its sole cost and expense.

Lessor represents and warrants to Lessee that Lessor is not a “referring physician” or a
“referral source” as to Lessee for services paid for by Medicare or a state health care program, as
the terms are defined under any federal or state health care anti-referral or anti-kickback,
regulation, interpretation or opinion (“Referral Source”). Lessor covenants, during the term of
this Lease, it will not knowingly (i) take any action that would cause it to become a Referral
Source as to Lessee, or (ii) sell, exchange or transfer the Premises to any individual or entity
who is a Referral Source as to Lessee.

23. Intentionally Omitted.

24. Lessee to Subordinate. Lessee shall, upon request of the holder of a mortgage or
deed of trust in the nature of a mortgage, which holder is a commercial or institutional lender
(“Mortgagee”) subordinate any interest which it has by virtue of this Lease, and any extensions and
renewals thereof to any mortgages or deeds of trust placed upon the Premises by Lessor, if and only
if such Mortgagee shall execute, deliver and record in the appropriate registry of deeds a
recognition and non-disturbance agreement in a commercially reasonable form. Such agreements shall
provide by their terms that notwithstanding any foreclosure of such mortgage or deeds of trust
Lessee may continue to occupy the Premises during the Term of this Lease or any extensions or
renewals thereof under the same terms, conditions and provisions of this Lease unless Lessee shall
be in default beyond any applicable grace periods provided for herein. Lessor shall within thirty
(30) days of the Commencement Date, secure from Lessor’s present mortgagee of the Premises a
non-disturbance agreement in a form commercially reasonably form. Lessor shall also use its best
efforts to secure from any future mortgagee or lienholders of Lessor non-
disturbance agreements in a commercially reasonable form during the initial Term or any renewal
periods, if exercised.

25. Quiet Enjoyment. Lessee, upon paying the Rent, additional rent and other sums due
under this Lease, and subject to all of the terms and covenants of this Lease, on Lessee’s part to
be kept, observed, and performed, shall quietly have and enjoy the Premises during the Term of this
Lease. Lessor agrees that Lessee shall have continuous, peaceful, uninterrupted and exclusive
possession and quiet enjoyment of the Premises during the Term of this Lease.

 

16

 

26. Memorandum of Lease. Lessor agrees to enter into and record a memorandum or
notice of this Lease in a commercially reasonable form. Lessee shall be responsible for the
preparation thereof and the cost of recording the same.

27. Notices. All notices, demands and requests which may be or are required to be
given by either party to the other shall be in writing and shall be either (i) sent by registered
or certified mail, return receipt requested, postage prepaid or (ii) delivered, by hand, or (iii)
sent by overnight courier such as Federal Express. All notices to Lessor should be addressed to
Lessor at 9901 Sunset Boulevard, Beverly Hills, California; Telephone: (310) 678-3900 or at such
other place as Lessor may from time to time designate in written notice to Lessee. All notices to
Lessee shall be addressed to Lessee c/o DaVita Inc., 601 Hawaii Street, El Segundo, California
90245, Attention: General Counsel, Telephone: (310) 536-2400, Facsimile: (310) 536-2679, with copy
to: c/o DaVita Inc., 15253 Bake Parkway, Irvine, California 92618; Attention: Group General
Counsel, or to any such other place as Lessee may from time to time designate in written notice to
Lessor. All notices, demands and requests which shall be served upon Lessor and Lessee in the
manner aforesaid shall be deemed sufficiently served or given for all purposes hereunder.

28. Estoppel Certificate. Each of Lessor and Lessee agrees at any time and from time
to time upon not less than fifteen (15) business days’ prior written request by the other to
execute, acknowledge and deliver to the other an estoppel certificate in the form attached hereto
as Exhibit E certifying that (a) this Lease is unmodified and in full force and effect (or
if there have been modifications that the same is in full force and effect as modified and stating
the modifications), (b) the dates to which the Rent, additional rent and other charges have been
paid in advance, if any, and (c) all of the defaults of Lessor or Lessee hereunder, if any, (and if
there are no defaults a statement to that effect) and any other information reasonably requested,
it being intended that any such estoppel certificate delivered pursuant to this Section 28 may be
relied upon by any prospective purchaser of the Premises or any mortgagee or assignee of any
mortgage upon the fee or leasehold of the Premises or by any prospective assignee of this Lease or
sublessee of the whole or any portion of the Premises and/or by other party interested in the
Premises or any part thereof.

29. Holding Over. In the event Lessee remains in possession of the Premises after the
expiration of the term of this Lease, or any extensions hereof without the written consent of
Lessor, this Lease shall continue on a month to month basis, terminable by either party upon thirty
(30) days prior notice and Lessee shall be obligated to pay Rent at 125% of the then current
rate (including all adjustments) and all other sums then payable hereunder prorated on a daily
basis for each day that Lessor is kept out of possession of the Premises.

30. Binding Effect. All covenants, agreements, stipulations, provisions, conditions
and obligations herein expressed and set forth shall extend to, bind and inure to the benefit of,
as the case may require, the successors and assigns of Lessor and Lessee respectively, as fully as
if such words were written wherever reference to Lessor or Lessee occurs in this Lease

 

17

 

31. Complete Agreement. Any stipulations, representations, promises or agreements,
oral or written, made prior to or contemporaneously with this agreement shall have no legal or
equitable consequences and the only agreement made and binding upon the parties with respect to the
leasing of the Premises is contained herein, and it is the complete and total integration of the
intent and understanding of Lessor and Lessee with respect to the leasing of the Premises.

32. Severability. If any term, covenant or condition of this Lease or the application
thereof to any person or circumstance shall, to any extent, be invalid or unenforceable, the
remainder of this Lease, or the application of such term, covenant or condition to persons or
circumstances other than those as to which it is held invalid or unenforceable, shall not be
affected thereby and each term, covenant or condition of this Lease shall be valid and be enforced
to the fullest extent permitted by law.

33. Applicable Law. The laws of the State where the Premises is located shall govern
the validity, performance and enforcement of this Lease, without regard to such State’s
conflict-of-law principles.

34. Force Majeure. Whenever a day is appointed herein on which, or a period of time
is appointed within which, either party hereto is required to do or complete any act, matter or
thing, the time for the doing or completion thereof shall be extended by a period of time equal to
the number of days on or during which such party is prevented from, or is interfered with, the
doing or completion of such act, matter or thing because of strikes, lock-outs, embargoes,
unavailability of labor or materials, wars, insurrections, rebellions, civil disorder, declaration
of national emergencies, acts of God, acts of government agencies or other causes beyond such
party’s reasonable control. Financial inability to perform shall not constitute an event of Force
Majeure, and in no event shall this Section 34 be construed to excuse or delay the payment of Rent,
additional rent, or any other monetary obligation of Lessee, or delay the Commencement Date.

35. Amendment. This Lease and the exhibits attached hereto and forming a part hereof set
forth all the covenants, promises, agreements, conditions and understandings between Lessor and
Lessee concerning the Premises, and there are no covenants, promises, agreements, conditions or
understandings, either oral or written, between them other then are herein set forth. Except as
herein otherwise provided, no subsequent alteration, amendment, change or addition to this Lease
shall be binding upon Lessor or Lessee unless reduced to writing and signed by them.

36. Lessee Improvements. Lessee shall, at its sole cost: diligently pursue and obtain
permits and thereafter construct all improvements in connection with the operation of an outpatient
renal dialysis clinic at the Premises in compliance with all applicable Laws, including, without
limitation, the provisions of Title III of the Americans with Disabilities Act of 1990 as it
pertains to Lessee’s specific use, occupancy, alterations and improvements to the Premises (the
“Lessee Improvements”). Lessee shall pay all costs for work performed by or on its account and
shall keep the Premises free and clear of mechanics’ liens or any other liens resulting therefrom.
Lessee shall give Lessor immediate notice of any lien filed against the Premises as a result of any
work of improvement performed by or on behalf of Lessee. Lessee shall discharge, within thirty
(30) days (by payment or by filing the necessary statutory lien release, bond, or otherwise), any
mechanics’, materialmen’s or other lien against the Premises,

 

18

 

which lien may arise out of any
payment due for, or purported to be due for, any labor, services,
materials, supplies, or equipment
alleged to have been furnished to or for Lessee. If Lessee fails to discharge any such lien,
Lessor shall have the right, but not the obligation, in addition to all other rights and remedies
available to it under this Lease or applicable Laws, and after ten (10) days prior notice to
Lessee, either to pay and discharge such lien, without regard to the validity thereof, or to
procure and cause to be recorded a statutory lien release bond and to collect from Lessee (i) all
costs incurred by Lessor in paying and discharging such lien, or in procuring such bond; and (ii)
all expenses incurred by Lessor in connection with such lien, including reasonable attorneys’ fees
and costs, recording fees and administrative costs and expenses. Lessor shall provide Lessee with a
Lessee Improvements allowance in the amount of $300,000.00 (the “Allowance”). Said Allowance shall
be payable to Lessee upon receipt of the certificate of occupancy for the operation of an
outpatient renal dialysis clinic at the Premises from the City of Fontana, California. In the
event Lessor fails to pay Lessee the Allowance within ten (10) days following receipt of the
certificate of occupancy from the City of Fontana, California, a late charge of five percent (5%)
of the Allowance shall become immediately due and payable by Lessor to Lessee as liquidated damages
and Lessee may, at its option, deduct such amount, including the Allowance and the late charge,
plus interest at the maximum rate permitted by law (provided that interest shall not be assessed on
the late charge) from subsequent Rent due under the Lease.

Lessee shall contract for the installation of the Lessee Improvements with a contractor of
choice. Lessor and Lessee shall mutually approve the plans and specifications of the Lessee
Improvements prior to the commencement of the Lessee Improvements. Lessor shall not charge Lessee
any fee or other charges for the supervision and/or overhead associated with the construction of
the Lessee Improvements.

37. Lessor’s Work. Lessor shall deliver the Premises in its “AS-IS” condition.

38. Lessor’s Sale of the Premises. Lessor may, at any time, without the prior consent of
Lessee, contract to and/or perform any of the following transactions with respect to an interest in
Lessor, the Lease, the Premises, and/or any portion of or interest in the Premises: sale, purchase,
exchange, transfer, assignment, lease, conveyance (collectively referred to herein as “Sale”);
and/or encumbrance, pledge, mortgage, deed of trust, hypothecation or sale and leaseback
transaction (collectively referred to herein as “Mortgage”). From and after a Sale, Lessor shall
be released from all liability to Lessee and Lessee’s successors and assigns arising
from this Lease because of any act, occurrence or omission of Lessor occurring after such Sale, and
Lessee shall look solely to Lessor’s successor in connection with the same; provided
however, that Lessor shall not be released from liability to Lessee and Lessee’s successors and
assigns from this Lease because of any act, occurrence or omission of Lessor occurring prior to
such Sale, unless such liability is expressly assumed by Lessor’s successor-in-interest in the
Premises. Within thirty (30) days following the effective date of a Sale, Lessor shall notify
Lessee whether Lessor’s successor-in-interest and assignee to this Lease would or would not be a
Referral Source as described in Section 22 above.

39. Lessee’s Roof Rights. Lessee shall have the right to place a satellite dish on the
roof of the Building at no additional fee.

 

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40. Regulatory Compliance. In the event Lessor, or Lessor’s successors or assigns
become a Referral Source as described in Section 22 above, this Section 40 shall apply but
shall have no effect until such time and so long as Lessor or Lessor’s successors or assigns are
not a Referral Source this Section 40 shall not apply to Lessor or Lessor’s successors or
assigns.

40.1 Referral Source. Lessor and Lessee hereby acknowledge and agree that it is not a
purpose of this Lease or any of the transactions contemplated herein to exert influence in any
manner over the reason or judgment of any party with respect to the referral of patients or
business of any nature whatsoever. It is the intent of the parties hereto that any referrals that
may be made directly or indirectly by Lessor to Lessee’s business, shall be based solely upon the
medical judgment and discretion of a patient’s physician while acting in the best interests of the
patient. Lessor and Lessee hereby agree that the Rent and additional rent and any increases in the
Rent and additional rent reflect fair market value and do not take into account the volume or value
of referrals or business that may otherwise be generated between the parties for which payment may
be made in whole or in part under Medicare, Medicaid or other Federal health care programs.

40.2 Termination Due to Legislative or Administrative Changes. In the event that
there shall be a change in applicable health care law or the interpretation thereof, including,
without limitation, Medicare or Medicaid, statutes, regulations, or general instructions, (or the
application thereof), the adoption of new legislation or regulations applicable to this Lease, the
implementation of a change in payment methodology in any material third party payor reimbursement
system, or the initiation of an enforcement action with respect to any applicable health care law,
any of which affects the continuing legality of this Lease, then either party may, by notice,
propose an amendment to conform this Lease to applicable laws. If notice of such proposed change
is given and the parties hereto are unable to agree within ninety (90) days upon an amendment, then
either party may terminate this Lease by ten (10) days’ advance written notice to the other party,
unless a sooner termination is required under applicable law or circumstances.

40.3 Exclusions. During the term of this Lease, Lessor shall notify Lessee of any
exclusion of Lessor or its affiliates from participation in any federal health care program, as
defined under 42 U.S.C. §1320a-7b (f), for the provision of items or services for which payment
may be made under such federal health care programs (“Exclusion”) within two (2) business days of
learning of any such Exclusion or any basis therefore. Lessee shall have the right to immediately
terminate this Lease and any and all other agreements between Lessor and its affiliates on the one
hand and Lessee and its affiliates on the other hand, upon learning of any Exclusion or any
reasonable basis therefore against the other, its affiliates and/or any employee, contractor or
agent engaged by any of them to provide items or services.

 

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40.4 Medicare Access to Books and Records. In the event, and only in the event, that
Section 952 of P.L. 96-499 (42 U.S.C. Section 1395x(v)(1)(I)) is applicable to this Lease, Lessee
and Lessor agree as follows: (i) until the expiration of four years after the termination of this
Lease, Lessor shall make available, upon written request by the Secretary of the federal Department
of Health and Human Services or upon request by the Comptroller General of the United States, or
any of their duly authorized representatives, this Lease, and books, documents and records of
Lessor that are necessary to certify the nature and extent of the costs incurred pursuant to this
Lease; (ii) if Lessor carries out any of the duties of this Lease or other contract between the
parties through a subcontract, with a value or cost of $10,000 or more over a twelve-month period,
with a related organization, such subcontract shall contain a clause to the effect that until the
expiration of four years after the furnishing of such services pursuant to such subcontract, the
related organization shall make available, upon written request to the Secretary of the federal
Department of Health and Human Services or upon request to the Comptroller General of the United
States, or any of their duly authorized representatives, the subcontract, and books, documents and
records of such organization that are necessary to verify the nature and extent of the costs
incurred pursuant to such subcontract; and (iii) Lessor shall notify Lessee immediately of the
nature and scope of any request for access to books and records described above and shall provide
copies of any books, records or documents to Lessee prior to the provision of same to any
governmental agent to give Lessee an opportunity to lawfully oppose such production of documents if
Lessee believes such opposition is warranted. In addition, Lessor shall indemnify and hold Lessee
harmless from any liability arising out of any refusal by Lessor to grant access to books and
records as required above. Nothing herein shall be deemed to be a waiver of any applicable
privilege (such as attorney client privilege) by Lessee.

40.5. Medical Director or Other Agreements. In the event of the termination of any
existing medical director or other agreement between Lessee, or any of its parent company,
affiliates, or subsidiaries and Lessor, its affiliates or any person, corporation, partnership or
other entity which owns or controls, directly or indirectly any of the business or assets of
Lessor, including an immediate family member, Lessee shall have the right to terminate this Lease
upon written notice to Lessor.

40.6. Representations and Warranties of Lessee. Lessee represents and warrants to
Lessor as follows:

(a) Non-Exclusion. Neither Lessee nor any of its affiliates are excluded from
participation in any federal health care program, as defined under 42 U.S.C. §1320a-7b (f), for the
provision of items or services for which payment may be made under such federal health care
programs; and

(b) Business Terms. To Lessee’s knowledge: (a) the Premises do not exceed that which
is reasonable and necessary for the legitimate business of Lessee; (b) Lessee’s proportionate share
as to the Premises expenses does not exceed Lessee’s pro rata share of the expenses for the
Premises, including the common areas of the Premises, based on the total rentable area of the
Premises, and (c) the rental charges: (i) are set in advance, (ii) are consistent with fair market
value, (iii) do not take into account the volume or value of any referrals or other business
generated between the parties, nor do they include any additional charges attributable to the
proximity or convenience of Lessor as a potential referral source; and (iv) would be commercially
reasonable even if no referrals were made between Lessee and Lessor or their respective affiliates.

 

21

 

40.7. Representations and Warranties of Lessor. Lessor represents and warrants to
Lessee as follows:

(a) Non-Exclusion. Neither Lessor nor any of its affiliates (i) are excluded from
participation in any federal health care program, as defined under 42 U.S.C. §1320a-7b (f), for the
provision of items or services for which payment may be made under such federal health care
programs; or (ii) have arranged or contracted (by employment or otherwise) with any employee,
contractor or agent that Lessor or its affiliates know or should know are excluded from
participation in any federal health care program;

(b) Advisory Opinion. Lessor shall not, directly or indirectly, request or cause an
Advisory Opinion to be requested regarding or relating to the legality of this Lease or the
transactions contemplated hereunder or substantially similar circumstances from any governmental
body, including without limitation the U.S. Department of Health and Human Services Office of
Inspector General or the Centers for Medicare and Medicaid Services without the prior written
concurrence of Lessee, whether pursuant to this Section or otherwise. All submissions of any
nature in connection with an Advisory Opinion request shall be approved in writing by Lessee prior
to submission; and

(c) Business Terms. To Lessor’s knowledge: (a) the Premises do not exceed that which
is reasonable and necessary for the legitimate business of Lessee; (b) Lessee’s proportionate share
as to the Premises expenses does not exceed Lessee’s pro rata share of the expenses for the
Premises, including the common areas of the Premises, based on the total rentable area of the
Premises; and (c) the rental charges: (i) are set in advance, (ii) are consistent with fair market
value, (iii) do not take into account the volume or value of any referrals or other business
generated between the parties, nor do they include any additional charges attributable to the
proximity or convenience of Lessee as a potential referral source, and (iv) would be commercially
reasonable even if no referrals were made between Lessee and Lessor or their respective affiliates.

40.8. Corporate Integrity Agreement.

(a) Lessor acknowledges that Lessee is under a Corporate Integrity Agreement with the Office
of the Inspector General of the Federal Department of Health and Human Services (the “CIA”), and
that such CIA imposes various reporting and operational compliance
related obligations on Lessee. To the extent not otherwise set forth herein, Lessor agrees to
cooperate with Lessee in compliance with the requirements of such CIA, as such requirements may
apply to Lessor’s performance pursuant to this Lease.

(b) Lessor hereby certifies that Lessor will (i) comply with Lessee’s Compliance Plan,
including the training related to compliance with 42 U.S.C. § 1320a- 7b(b) (the “Anti-Kickback
Statute”) as it pertains to Lessor , and (ii) comply with Lessee’s Compliance Critical Concepts and
policies and procedures related to compliance with the Anti-Kickback Statute, a copy of each of
which has been provided to Lessor hereunder, and in each case solely as applicable to performance
of Services under this Lease.

(c) Lessor certifies that it will comply with Lessee’s Compliance Plan and with the terms of
the Anti-Kickback Statute in all matters involving Lessee.

 

22

 

(d) Lessor and Lessee certify that the agreement is not intended to generate referrals for
services or supplies for which payment may be made in whole or in part under any Federal health
care program.

(e) If this Lease is terminated for any reason within one (1) year following the Commencement
Date, then Lessor and Lessee will not enter into any similar agreement with each other for the
Premises before the first anniversary of the Commencement Date.

41. Cooperation with Lessee’s Cost Reporting Responsibilities. Lessor’s full
cooperation with applicable authorities in connection with cost reporting is essential for Lessee’s
continued operation of its business. Therefore, Lessor agrees to provide to Lessee, within thirty
(30) days of Lessee’s request, any and all information that is reasonably necessary for Lessee to
fulfill its cost reporting requirements to such applicable authorities.

42. Protected Health Information.

(a) Lessor acknowledges and agrees that from time to time during the Term, Lessor, its
representatives or assigns may be exposed to, or have access to, Protected Health Information
(“PHI”), as defined by HIPAA, 45 CFR Parts 160 and 164. Lessor agrees that it will not use or
disclose PHI for any purpose unless required by a court of competent jurisdiction or by any
governmental authority in accordance will the requirements or HIPAA and all other applicable
medical privacy laws.

(b) Lessor shall preserve any “Confidential Information” of or pertaining to Lessee and shall
not, without first obtaining Lessee’s prior written consent, disclose to any person or
organization, or use for its own benefit, any Confidential Information of or pertaining to Lessee
during and after the Lease Term, unless such Confidential Information is required to be disclosed
by a court of competent jurisdiction or by any governmental authority. As used herein, the term
“Confidential Information” shall mean any business, financial, personal or technical information
relating to the business or other activities of Lessee that Lessor obtains in connection with this
Lease.

43. Lessor’s Consent. Unless otherwise expressly stated herein, whenever Lessor’s consent
is required under this Lease, such consent shall not be unreasonably withheld or delayed, and
Lessor’s reasonable satisfaction shall be sufficient for any matters under this Lease.

44. Approval by DaVita Inc. as to Form. The parties acknowledge and agree that this Lease
shall take effect and be legally binding upon the parties only upon full execution hereof by the
parties and upon approval by DaVita Inc. as to the form hereof.

45. Counterparts. This Lease may be executed in any number of counterparts, each of
which shall be deemed an original and all of which together shall constitute one and the same
instrument.

[Signature page follows]

 

23

 

IN TESTIMONY WHEREOF, Lessor and Lessee have caused this Lease to be executed as a sealed
instrument, as of the day and year first above written.

	 	 	 
	LESSOR:
	 	 
	 
	 	 
	/s/ Philip Elghanian
 

PHILIP ELGHANIAN

	 	 

LESSEE:

DVA HEALTHCARE RENAL CARE, INC.

	 	 	 	 	 
	By:

	 	/s/ Rich Seebold
 

Name: Rich Seebold
	 	 
	 

	 	Title: DVP	 	 

FOR LESSEE’S INTERNAL PURPOSES ONLY:

APPROVAL BY DAVITA INC. AS TO FORM ONLY

	 	 	 	 	 
	By:

	 	/s/ Jon Kweller
 

Name: Jon Kweller

Title: Vice President and Deputy General Counsel
	 	 

 

24

 

EXHIBIT A

LEGAL DESCRIPTION

THE LAND REFERRED TO HEREIN BELOW IS SITUATED IN THE CITY OF FONTANA, COUNTY OF SAN BERNARDINO,
STATE OF CALIFORNIA, AND IS DESCRIBED AS FOLLOWS:

Parcel 2 of Parcel Map No. 3984, in the City of Fontana, County of San Bernardino, State of
California, as shown by Map on file in Book 38, Page(s) 40 of Parcel Maps, records of San
Bernardino County, California.

Assessor’s Parcel Number: 0190-321-35

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