Document:

exv10w6

Exhibit 10.6

REGISTRATION RIGHTS AGREEMENT

     REGISTRATION RIGHTS AGREEMENT (the “Agreement”) made and entered into as of
February 4, 2011
(and effective as set forth in Article 24 of this Agreement), by and among MEDQUIST HOLDINGS INC.,
which shall be a Delaware corporation at the time of the IPO (the “Company”), S.A.C. PEI CB
Investment L.P., a Cayman Islands limited partnership (“SAC CBI”), S.A.C. PEI CB Investment
II, LLC, a Delaware limited liability company (“SAC CBI II”) and International Equities
(S.A.C. Asia) Limited, a company incorporated under the Companies Act of 2001 of Mauritius
(“SAC Asia” and, collectively with SAC CBI and SAC CBI II and each of their respective
affiliates, the “Stockholders”).

BACKGROUND

     The Company will be effecting an initial public offering of shares of common stock, par value
of $0.10 per share, of the Company (the “Common Stock”), and has agreed to provide the
Stockholders with the registration rights set forth in this Agreement.

     NOW, THEREFORE, in consideration of the premises and the mutual covenants and agreements
contained in this Agreement, the parties hereto, intending to be legally bound, agree as follows:

1. CERTAIN DEFINITIONS.

     In addition to the other terms defined in this Agreement, the following terms shall have the
following meanings, applicable to both the singular and plural forms thereof:

     “Business Day” means any day on which The NASDAQ Global Market is open for trading.

     “Closing Date” means the date of completion of the IPO.

     “Holders” means the Stockholders for so long as (and to the extent that) each owns any
Registrable Securities, and each of the respective successors and direct and indirect Transferees
to whom a Stockholder (or subsequent Holder) transfers Registrable Securities (or securities
exercisable, exchangeable or convertible into Registrable Securities) and related rights under this
Agreement in accordance with Article 13.

     “IPO” means the first underwritten public offering pursuant to an effective
registration statement of the Company under the Securities Act covering the offering and sale of
Common Stock.

     “Person” means an individual, a partnership (general or limited), corporation, limited
liability company, joint venture, business trust, cooperative, association or other form of
business organization, whether or not regarded as a legal entity under applicable law, a trust
(inter vivos or testamentary), an estate of a deceased, insane or incompetent person, a
quasi-governmental entity, a government or any agency, authority, political subdivision or other
instrumentality thereof, or any other entity.

 

 

     “Registrable Securities” means shares of Common Stock held by a Holder, until such
securities cease to constitute Registrable Securities (i) when a registration statement with
respect to the sale of such securities shall have become effective under the Securities Act and
such securities shall have been disposed of thereunder; or (ii) when such securities are sold
pursuant to Rule 144 (or any similar provision then in force, but not Rule 144A) under the
Securities Act by such Holder, if following such resale such securities do not bear any restrictive
legend relating do the Securities Act and do not bear a restricted CUSIP number; or (iii) when such
securities shall have ceased to be issued and outstanding.

     “Registration Expenses” means all expenses incurred with the performance of or
compliance with the registration requirements set forth in this Agreement including, without
limitation, the following: (i) the fees, disbursements and expenses of the Company’s counsel(s),
accountants, and experts in connection with the registration under the Securities Act of
Registrable Securities (including the expenses of any special audits or “comfort” letters required
by or incident to such performance and compliance); (ii) all expenses in connection with the
preparation, printing and filing of the registration statement, any preliminary prospectus or final
prospectus, any other offering document and amendments and supplements thereto, and the mailing and
delivering of copies thereof to the underwriters and dealers, if any; (iii) the cost of printing or
producing any agreement(s) among underwriters, underwriting agreement(s) and blue sky or legal
investment memoranda, any selling agreements, and any other documents in connection with the
offering, sale or delivery of Registrable Securities to be disposed of; (iv) any other expenses in
connection with the qualification of Registrable Securities for offer and sale under state
securities laws, including the fees and disbursements of counsel for the underwriters in connection
with such qualification and in connection with any blue sky and legal investment surveys; (v) the
filing fees incident to securing any required review by the Financial Industry Regulatory Authority
of the terms of the sale of Registrable Securities to be disposed of and any blue sky registration
or filing fees, (vi) the fees and expenses incurred in connection with the listing of Registrable
Securities on each securities exchange on which the securities of the Company of the same class are
then listed, (vii) the fees and expenses of the Company and the underwriters to the road show
investor presentations, including the cost of any aircraft chartered for such purpose, listing
fees, messenger and delivery expenses, and (viii) the fees and expenses of one counsel for the
Holders as and to the extent provided in Article 11; provided, however, that
Registration Expenses with respect to any registration pursuant to this Agreement shall not include
any underwriting discounts or commissions attributable to Registrable Securities.

     “SEC” means the United States Securities and Exchange Commission, or such other
federal agency at the time having the principal responsibility for administering the Securities
Act.

     “Securities Act” means the Securities Act of 1933, as amended, and the rules and
regulations of the SEC thereunder, all as the same shall be in effect at the relevant time.

2. DEMAND REGISTRATION.

     (a) (i) A Holder or Holders may request (at any time and from time to time, after the Company
completes an IPO) by written notice delivered to the Company that the Company register under the
Securities Act all or any portion of the Registrable Securities then held by such

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Holder or Holders and their affiliates for sale in the manner specified in such notice
(including, but not limited to, in an underwritten public offering). In each such case, such
notice shall specify the number of Registrable Securities for which registration is requested and
the proposed manner of disposition of such securities. Within ten (10) Business Days after receipt
of such notice, the Company shall notify the Holder(s) requesting registration of (A) the proposed
filing date of the registration statement and (B) such other information concerning the offering as
any Holder may have reasonably requested. If any Holder(s) shall have requested that such offering
be underwritten, the managing underwriter for such offering shall be chosen by such Holders, with
the consent of the Company (which consent shall not be unreasonably withheld or delayed), not less
than thirty (30) days prior to the proposed filing date stated in the Company’s notice. On or
before the thirtieth (30th) day prior to such anticipated filing date, any Holder may
give written notice to the Company and the managing underwriter specifying (A) the number of shares
of Registrable Securities of such Holder that are to be included in the underwriting and/or (B) the
number of shares of Registrable Securities of such Holder that are to be registered pursuant to
such registration statement and sold in the open market without any underwriting, on terms and
conditions comparable to those normally applicable to offerings in reasonably similar
circumstances, regardless of the method of disposition originally specified in the applicable
request for registration. Notwithstanding anything to the contrary
contained herein, the obligation of the Company to file a shelf
registration statement prior to the
181st day
following the initial public offering of Common Stock by the Company
shall be subject to the
terms of any lockup agreement applicable to the Company under the terms of the underwriting
agreement entered into by the Company in connection with such initial public offering.

          (ii) The Company shall use all commercially reasonable efforts to file with the SEC within
forty-five (45) days (thirty (30) days if the Company may use a Registration Statement on Form S-3
to register such Registrable Securities) after the Company’s receipt of written notice from a
Holder or Holders pursuant to Section 2(a)(i), a registration statement for the public offering and
sale, in accordance with the method of disposition specified by such Holder(s), of the number of
Registrable Securities specified in such notice, and thereafter use all commercially reasonable
efforts to cause such registration statement to become effective as soon as practicable, but in any
event within sixty (60) days after its filing. Such registration statement may be on Form S-1 or
another appropriate form (including Form S-3) that the Company is eligible to use and that is
reasonably acceptable to the managing underwriter, if any.

          (iii) If the Company is required to use commercially reasonable efforts to register
Registrable Securities in a registration initiated upon the demand of a Holder or Holders pursuant
to Section 2(a)(i) of this Agreement and the managing underwriters for such offering advise the
Company in writing (with a copy to the Holder(s) demanding the registration) that the inclusion of
all Registrable Securities and other securities sought to be registered may interfere with an
orderly sale and distribution of or may materially adversely affect the price of such offering,
then the Company will include in such offering (x) first, the aggregate number of Registrable
Securities requested to be included by the Holder(s) pursuant to Section 2(a)(i) which the managing
underwriters advise will not likely have such effect, allocated pro rata based on the number of
such Registrable Securities duly requested to be included in such registration, (y) second, the
Registrable Securities sought to be included in such registration pursuant to Article 3, allocated
pro rata based on the number of such Registrable Securities duly requested to be included in such
registration and (z) third, all other securities requested to be included in such registration.

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          (iv) Upon the demand of a Holder or Holders made at any time and from time to time, the
Company will facilitate a “takedown” of shares of Common Stock off of an effective shelf
registration statement on Form S-3 (or any successor form thereto).

          (v) Upon the demand of a Holder or Holders, the Company will file and seek the effectiveness
of a post-effective amendment to an existing shelf registration statement on Form S-3 (or any
successor form thereto) in order to register up to the number of shares previously taken down off
of such shelf by such Holder(s) and not yet “reloaded” onto such shelf registration statement. The
Holder(s) and the Company will consult and coordinate with each other in order to accomplish such
replenishments from time to time in a sensible manner.

     (b) No registration of Registrable Securities under this Article 2 shall relieve the Company
of its obligation to effect registrations of Registrable Securities pursuant to Article 3.

3. INCIDENTAL REGISTRATION.

     (a) Until all securities subject to this Agreement have ceased to be Registrable Securities,
if the Company proposes, at any time and from time to time, to register any equity securities of
the Company other than Registrable Securities (collectively, “Other Securities”) for public
sale under the Securities Act in a manner which would permit registration of Registrable Securities
for sale to the public under the Securities Act, it will give written notice (which notice shall
specify the intended method or methods of disposition) to the Holders of its intention to do so
promptly, but in no event less than twenty (20) days before the anticipated filing date, and upon
the written request of any Holder delivered to the Company within ten (10) Business Days after the
giving of any such notice (which request shall specify the number of Registrable Securities
intended to be disposed of by such Holder) the Company will use all commercially reasonable efforts
to effect, in connection with the registration of the Other Securities, the registration under the
Securities Act of all Registrable Securities which the Company has been so requested to register by
the Holders; provided, however, that:

          (i) if, at any time after giving such written notice of its intention to register Other
Securities and prior to the effective date of the registration statement filed in connection with
such registration, the Company shall determine for any reason not to register such Other
Securities, the Company may, at its election, give written notice of such determination to the
Holders requesting registration and thereupon the Company shall be relieved of its obligation to
register such Registrable Securities in connection with the registration of such Other Securities
(but not from its obligation to pay Registration Expenses to the extent incurred in connection
therewith as provided in Article 11), without prejudice, however, to the rights of the Holders to
request that such registration be effected as a registration under Article 2;

          (ii) the Company will not be required to effect any registration of Registrable Securities
pursuant to this Article 3 if the Company shall have been advised in writing (with a copy to the
Holders requesting registration) by a nationally recognized investment banking firm (which may be
the managing underwriter for the offering) that, in such firm’s opinion, the number of Registrable
Securities and Other Securities proposed to be included exceeds the number which can be sold in the
offering without interfering with an orderly sale and distribution or materially and adversely
affecting the offering price; provided,

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however, that if an offering of some but not all of the Registrable Securities and
Other Securities requested to be registered by the Holders and all other Persons having rights to
include securities held by them in such registration would not adversely affect the distribution or
price of the securities to be sold in the offering in the opinion of such firm or are included in
such offering notwithstanding any such opinion, then the Company will include in such offering: (x)
first, any Other Securities to be issued or sold by the Company, (y) second, the Registrable
Securities requested to be registered pursuant to Article 3, on the one hand, and the Other
Securities requested to be registered by other stockholders having similar registration rights as
of the date of this Agreement, on the other hand, allocated pro rata based on the relative number
of Registrable Securities then held by such Holder and Other Securities then held by such other
stockholders eligible to be sold in such offering; provided, that any such amount thereby
allocated to any such Holder or other stockholder that exceeds the request by such Holder or other
stockholder shall be reallocated among the remaining requesting Holders and other stockholders in
like manner and (z) third, all other securities requested to be included in such registration; and

          (iii) the Company shall not be required to give notice of, or effect any registration of
Registrable Securities under this Article 3 incidental to, the registration of any of its
securities in connection with mergers, consolidations, acquisitions, exchange offers, subscription
offers, dividend reinvestment plans or stock options or other employee benefit or compensation
plans.

     (b) In connection with any underwritten shelf takedown (whether pursuant to the exercise of
demand rights pursuant to Article 2 or at the initiative of the Company), the Holders may exercise
piggyback rights to have included in such takedown shares of Common Stock held by them that are
registered on such shelf registration statement on Form S-3 (or any successor form thereto).

     (c) No registration of Registrable Securities effected under this Article 3 shall relieve the
Company of its obligations to effect registrations of Registrable Securities pursuant to Article 2.

4. HOLDBACKS AND OTHER RESTRICTIONS.

     (a) Each Holder hereby covenants and agrees with the Company that such Holder shall not
effect, if requested in writing by the managing underwriters of an underwritten offering by the
Company that includes at least seventy-five percent (75%) of the Registrable Securities of such
Holder that such Holder requested to be included in such registration, any public sale or
distribution of equity securities of the Company, including a sale pursuant to Rule 144 under the
Securities Act (except pursuant to this Agreement), during the ten (10) day period prior to, and
during the ninety (90) day period (or such shorter period specified by the managing underwriters)
beginning on the effective date of the registration statement relating to the underwritten offering
by the Company of equity securities of the Company; provided, however, that the
Stockholders shall not be subject to the restrictions set forth in this Section 4(a) at any time at
which the Stockholders hold Common Stock in an aggregate amount less than five percent (5%) the
then outstanding Common Stock; and provided, further, that this Section 4(a) shall
not apply to any registrations described in Section 3(a)(iii).

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     (b) The Company covenants and agrees with the Holders not to effect any public or private sale
or distribution of securities of the Company (other than distributions pursuant to employee benefit
plans), including a sale pursuant to Regulation D under the Securities Act (or Section 4(2)
thereof), during the ten (10) day period prior to, and during the ninety (90) day period beginning
with, (i) the effective date of a registration statement filed under Section 2(a) hereof or Article
3 hereof (if any Registrable Securities are to be registered thereunder) or (ii) in the event of a
shelf registration statement, the consummation of an underwritten takedown of Registrable
Securities, in each case to the extent requested in writing by the managing underwriters, if any,
or, if there be none, by one or more of the Holders whose securities are included in such
registration statement, except pursuant to registrations on Form S-8 (or any successor forms).

5. REGISTRATION PROCEDURES.

     If and whenever the Company is required by the provisions of this Agreement to use
commercially reasonable efforts to effect or cause a registration as provided in this Agreement,
and at such times as customarily occur in registered offerings or shelf takedowns, as applicable,
the Company will:

     (a) Use all commercially reasonable efforts to prepare and file with the SEC, a registration
statement within the time periods specified herein, and use all commercially reasonable efforts to
cause such registration statement to become effective as promptly as practicable and to remain
effective under the Securities Act until the earlier of such time as all securities covered thereby
are no longer Registrable Securities or twenty-four (24) months after such registration statement
becomes effective with respect to registrations pursuant to Section 2(a), in every case as any such
period may be extended pursuant to Section 5(l) or Article 7 hereto (provided that the Company may
replace a shelf registration statement filed on Form S-1 with a shelf registration statement filed
on Form S-3 as and when the Company becomes eligible to file S-3 registration statements as long as
such a shelf registration statement filed on Form S-1 remains effective until such time as the
replacement shelf registration statement filed on Form S-3 becomes effective);

     (b) Prepare and file with the SEC such amendments, post-effective amendments and supplements
to such registration statement and the prospectus used in connection therewith as may be necessary
to keep such registration statement effective for such period of time required by Section 5(a)
above, as such period may be extended pursuant to Section 5(l) or Article 7 hereto;

     (c) Within a reasonable time prior to the filing of any registration statement, any
prospectus, any amendment to a registration statement, amendment or supplement to a prospectus or
any free writing prospectus, provide copies of such documents to the Holders of the Registrable
Securities being sold and to the underwriter or underwriters of an underwritten offering, if
applicable, and to their respective counsel; fairly consider such reasonable changes in any such
documents prior to or after the filing thereof as the counsel to the Holders of the Registrable
Securities being sold or the underwriter or the underwriters may request; and make such of the
representatives of the Company as shall be reasonably requested by the Holders of

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the Registrable Securities being sold or any underwriter available for discussion of such
documents;

     (d) Within a reasonable time prior to the filing of any document which is to be incorporated
by reference into a registration statement or a prospectus, provide copies of such document to
counsel for the Holders and underwriters; fairly consider such reasonable changes in such document
prior to or after the filing thereof as counsel for such Holders or such underwriter shall request;
and make such of the representatives of the Company as shall be reasonably requested by such
counsel available for discussion of such document;

     (e) Comply in all material respects with the provisions of the Securities Act with respect to
the disposition of all securities covered by such registration statement during the period during
which any such registration statement is required to be effective;

     (f) Furnish to any Holder and any underwriter of Registrable Securities, without charge (i)
such number of copies (including manually executed and conformed copies) of such registration
statement and of each amendment thereof and supplement thereto (including all annexes, appendices,
schedules and exhibits), (ii) such number of copies of the prospectus, used in connection with such
registration statement (including each preliminary prospectus, any summary prospectus and the final
prospectus), and (iii) such number of copies of other documents, in each case as such Holder or
such underwriter may reasonably request;

     (g) Use all commercially reasonable efforts to register or qualify all Registrable Securities
covered by such registration statement under the securities or “blue sky” laws of states of the
United States as any Holder or any underwriter shall reasonably request, and do any and all other
acts and things which may be reasonably requested by such Holder or such underwriter to consummate
the offering and disposition of Registrable Securities in such jurisdictions; provided,
however, that the Company shall not be required to qualify generally to do business as a
foreign corporation or as a dealer in securities, subject itself to taxation, or consent to general
service of process in any jurisdiction wherein it is not then so qualified or subject;

     (h) Cooperate with the Holders of the Registrable Securities being sold and the sole
underwriter or managing underwriter of an underwritten offering shares, if any, to facilitate the
timely preparation and delivery of certificates representing the shares to be sold and not bearing
any restrictive legends; and enable such shares to be in such denominations (consistent with the
provisions of the governing documents thereof) and registered in such names as the Holders of the
Registrable Securities being sold or the sole underwriter or managing underwriter of an
underwritten offering of shares, if any, may reasonably request at least five (5) days prior to any
sale of such shares;

     (i) Use all commercially reasonable efforts to cause the Registrable Securities covered by
such registration statement to be registered with, or approved by, such other United States public,
governmental or regulatory authorities, if any, as may be required in connection with the
disposition of such Registrable Securities;

     (j) Use all commercially reasonable efforts to list the securities covered by such
registration statement on any securities exchange on which any securities of the Company is then

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listed, if the listing of such Registrable Securities are then permitted under the applicable
rules of such exchange;

     (k) Use all commercially reasonable efforts to facilitate the distribution and sale of any
shares of Common Stock to be offered pursuant to this Agreement, including without limitation by
making road show presentations, holding meetings with and making calls to potential investors and
taking such other actions as shall be requested by the Holders of the Registrable Securities being
sold or the lead managing underwriter of an underwritten offering;

     (l) Notify each Holder as promptly as practicable and, if requested by any Holder, confirm
such notification in writing, (i) when a prospectus or any prospectus supplement has been filed
with the SEC, and, with respect to a registration statement or any post-effective amendment
thereto, when the same has been declared effective by the SEC, (ii) of the issuance by the SEC of
any stop order or the coming to the Company’s attention of the initiation of any proceedings for
such or a similar purpose, (iii) of the receipt by the Company of any notification with respect to
the suspension of the qualification of any of the Registrable Securities for sale in any
jurisdiction or the initiation or threatening of any proceeding for such purpose, (iv) of the
occurrence of any event which requires the making of any changes to a registration statement or
related prospectus so that such documents will not contain any untrue statement of a material fact
or omit to state any material fact required to be stated therein or necessary to make the
statements therein, in light of the circumstances under which they were made, not misleading (and
the Company shall promptly prepare and furnish to each Holder a reasonable number of copies of a
supplemented or amended prospectus such that, as thereafter delivered to the purchasers of such
Registrable Securities, such prospectus shall not include an untrue statement of a material fact or
omit to state a material fact required to be stated therein or necessary to make the statements
therein, in light of the circumstances under which they are made, not misleading), and (v) of the
Company’s determination that the filing of a post-effective amendment to the Registration Statement
shall be necessary or appropriate. Upon the receipt of any notice from the Company of the
occurrence of any event of the kind described in clause (iv) or (v) of this Section 5(l), the
Holders shall forthwith discontinue any offer and disposition of Registrable Securities pursuant to
the registration statement covering such Registrable Securities until all Holders shall have
received copies of a supplemented or amended prospectus which is no longer defective and, if so
directed by the Company, shall deliver to the Company, at the Company’s expense, all copies (other
than permanent file copies) of the defective prospectus covering such Registrable Securities which
are then in the Holders’ possession. If the Company shall provide any notice of the type referred
to in the preceding sentence, the period during which the registration statements are required to
be effective as set forth under Section 5(a) shall be extended by the number of days from and
including the date such notice is provided, to and including the date when Holders shall have
received copies of the corrected prospectus; and

     (m) Enter into such agreements and take such other appropriate actions as are customary and
reasonably necessary to expedite or facilitate the disposition of such Registrable Securities
(including, in the case of an underwritten offering, underwriting agreements in customary form, and
including provisions with respect to indemnification and contribution in customary form and
consistent with the provisions relating to indemnification and contribution contained herein), and
in that regard, deliver to the Holders such documents and certificates as may be reasonably
requested by any Holder of the Registrable Securities being sold or, as

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applicable, the managing underwriters, to evidence the Company’s compliance with this
Agreement including, without limitation, using all commercially reasonable efforts to cause its
independent accountants to deliver to the Company (and to the Holders of Registrable Securities
being sold in any registration) an accountants’ comfort letter substantially similar to that in
scope delivered in an underwritten public offering and covering audited and interim financial
statements included in the registration statement or, if such letter can not be obtained through
the exercise of all commercially reasonable efforts, cause its independent accountants to deliver
to the Company (and to the Holders of Registrable Securities being sold in any registration) a
comfort letter based on negotiated procedures providing comfort with respect to the Company’s
financial statements included or incorporated by reference in the registration statement at the
highest level permitted to be given by such accountants under the then applicable standards of the
Association of Independent Certified Accountants with respect to such registration statement. In
addition, the Company shall furnish to the Holders of Registrable Securities being included in any
registration hereunder an opinion of counsel in substance and scope as are customarily delivered to
underwriters in public offerings.

6. UNDERWRITING.

     (a) If requested by the underwriters for any underwritten offering of Registrable Securities
pursuant to a registration hereunder, the Company will enter into and perform its obligations under
an underwriting agreement with the underwriters for such offering, such agreement to contain such
representations and warranties by the Company and such other terms and provisions as are
customarily contained in underwriting agreements of that nature, including, without limitation,
customary provisions relating to indemnities and contribution to the effect and extent provided in
Article 10, and the provision of opinions of counsel and accountants’ letters.

     (b) If any registration pursuant to Article 3 hereof shall involve, in whole or in part, an
underwritten offering, the Company may require Registrable Securities requested to be registered
pursuant to Article 3 to be included in such underwriting on the same terms and conditions as shall
be applicable to the securities being sold through underwriters under such registration. In such
case, each Holder requesting registration shall be a party to any such underwriting agreement.
Such agreement shall contain such representations and warranties by the Holders requesting
registration and such other terms and provisions as are customarily contained in underwriting
agreements with respect to secondary distributions, including, without limitation, provisions
relating to indemnities and contribution to the effect and extent provided in Article 10.

     (c) In any offering of Registrable Securities pursuant to a registration hereunder, each
Holder requesting registration shall also enter into such additional or other agreements as may be
customary in such transactions, which agreements may contain, among other provisions, such
representations and warranties as the Company or the underwriters of such offering may reasonably
request (including, without limitation, those concerning such Holder, its Registrable Securities,
such Holder’s intended plan of distribution and any other information supplied by it to the Company
for use in such registration statement), and customary provisions relating to indemnities and
contribution.

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7. INFORMATION BLACKOUT.

     (a) Upon written notice from the Company to the Holders that the Company has determined in
good faith that the sale of Registrable Securities pursuant to the registration statement would
require disclosure of non-public material information not otherwise required to be disclosed under
applicable law (A) which disclosure would have a material adverse effect on the Company or (B)
relating to a material business combination involving the Company (an “Information
Blackout”), the Company may postpone the filing of effectiveness of any registration statement
required hereunder and, if such registration statement has become effective, the Company shall not
be required to maintain the effectiveness of such registration statement and all Holders shall
suspend sales of Registrable Securities pursuant to such registration statement, in each case,
until the earlier of:

          (i) forty-five (45) days after the Company makes such good faith determination, and

          (ii) such time as the Company notifies the Holders that such material information has been
disclosed to the public or has ceased to be material or that sales pursuant to such registration
statement may otherwise be resumed (the number of days from such notice from the Company until the
day when the Information Blackout terminates hereunder is hereinafter called a “Blackout
Period”).

     (b) Any delivery by the Company of notice of an Information Blackout following effectiveness
of any registration statement effected pursuant to Section 2(a) or Article 3 hereof shall give each
Holder the right, by written notice to the Company within twenty (20) Business Days after the end
of such Blackout Period, to withdraw therefrom.

     (c) Notwithstanding the foregoing, there shall be no more than two (2) Information Blackouts
during the term of this Agreement and no Blackout Period shall continue for more than forty-five
(45) consecutive days.

8. RULE 144.

     The Company shall use all commercially reasonable efforts to take all actions necessary to
comply with the filing requirements described in Rule 144(c)(1) or any successor thereto so as to
enable the Holders to sell Registrable Securities without registration under the Securities Act.
Upon the written request of any Holder, the Company will deliver to such Holder a written statement
as to whether it has complied with the filing requirements under Rule 144(c)(1) or any successor
thereto.

9. PREPARATION; REASONABLE INVESTIGATION; INFORMATION.

     (a) In connection with the preparation and filing of each registration statement registering
Registrable Securities under the Securities Act, (i) the Company will give the Holders and the
underwriters, if any, and their respective counsel and accountants, drafts of such registration
statement for their review and comment prior to filing and (during normal business hours and
subject to such reasonable limitations as the Company may impose to prevent disruption of its
business) such reasonable and customary access to its books and records and

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such opportunities to discuss the business of the Company with its officers and the
independent public accountants who have certified its financial statements as shall be necessary,
in the reasonable opinion of the Holders of a majority in aggregate amount of the Registrable
Securities being registered and such underwriters or their respective counsel, to conduct a
reasonable investigation within the meaning of the Securities Act and (ii) as a condition precedent
to including any Registrable Securities of any Holder in any such registration, the Company may
require such Holder to furnish the Company such information regarding such Holder and the
distribution of such securities as the Company may from time to time reasonably request in writing
or as shall be required by law or the SEC in connection with any registration; provided,
however, that, upon the reasonable request of the supplier of any such information, the
recipient thereof shall enter into a confidentiality agreement respecting such information in
customary form for an underwritten public offering.

     (b) In connection with each registration and offering of Registrable Securities to be sold by
Holders, the Company will, in accordance with customary practice, make available for inspection by
representatives of the Holders and underwriters and any counsel or accountant retained by such
Holders or underwriters all relevant financial and other records, pertinent corporate documents and
properties of the Company and cause appropriate officers, managers and employees of the Company to
supply all information reasonably requested by any such representative, underwriter, counsel or
accountant in connection with their due diligence exercise.

10. INDEMNIFICATION AND CONTRIBUTION.

     (a) In the case of each offering of Registrable Securities made pursuant to this Agreement,
the Company shall indemnify and hold harmless each Holder, its officers, directors, employees,
agents and affiliates, each underwriter of Registrable Securities so offered and each Person, if
any, who controls any of the foregoing Persons within the meaning of the Securities Act
(“Holder Indemnitees”), from and against any and all claims, liabilities, losses, damages,
expenses and judgments, joint or several, to which they or any of them may become subject, under
the Securities Act or otherwise, including any amount paid in settlement of any litigation
commenced or threatened, and shall promptly reimburse them, as and when incurred, for any legal or
other expenses reasonably incurred by them in connection with investigating any claims and
defending any actions, insofar as such losses, claims, damages, liabilities or actions, shall arise
out of, or should be based upon, any violation or alleged violation by the Company of the
Securities Act, any blue sky laws, securities laws or other applicable laws of any state or country
in which the Registrable Securities are offered and relating to action taken or action or inaction
required of the Company in connection with such offering, or shall arise out of, or shall be based
upon, any untrue statement or alleged untrue statement of a material fact contained in the
registration statement under which such securities were registered under the Securities Act (or in
any preliminary or final prospectus included therein) or any amendment thereof or supplement
thereto, or in any document incorporated by reference therein, or any omission or alleged omission
to state therein a material fact required to be stated therein or necessary to make the statements
therein not misleading; provided, that the Company shall not be liable to any Holder
Indemnitee in any such case to the extent that any such loss, claim, damage, liability or action
arises out of, or is based upon, any untrue statement or alleged untrue statement, or any omission,
if such statement or omission shall have been made in reliance upon and in conformity with

11

 

information furnished to the Company in writing by or on behalf of such Holder specifically
for use in the preparation of the registration statement (or in any preliminary or final prospectus
included therein), or any amendment thereof or supplement thereto. Such indemnity shall remain in
full force and effect regardless of any investigation made by or on behalf of any Holder and shall
survive the transfer of such securities. The foregoing indemnity agreement is in addition to any
liability which the Company may otherwise have to any Holder Indemnitee.

     (b) In the case of each offering of Registrable Securities made pursuant to this Agreement,
each Holder participating in the offering, severally and not jointly, shall indemnify and hold
harmless the Company, its officers and affiliates, and each Person, if any, who controls any of the
foregoing within the meaning of the Securities Act and (if requested by the underwriters) each
underwriter who participates in the offering and each Person, if any, who controls any such
underwriter within the meaning of the Securities Act (the “Company Indemnitees”), from and
against any and all claims, liabilities, losses, damages, expenses and judgments, joint or several,
to which they or any of them may become subject, under the Securities Act or otherwise, including
any amount paid in settlement of any litigation commenced or threatened, and shall promptly
reimburse them, as and when incurred, for any legal or other expenses incurred by them in
connection with investigating any claims and defending any actions, insofar as any such losses,
claims, damages, liabilities or actions shall arise out of, or shall be based upon, any violation
or alleged violation by such Holder of the Securities Act, any blue sky laws, securities laws or
other applicable laws of any state or country in which the Registrable Securities are offered and
relating to action taken or action or inaction required of such Holder in connection with such
offering, or shall arise out of, or shall be based upon, any untrue statement or alleged untrue
statement of a material fact contained in the registration statement (or in any preliminary or
final prospectus included therein) relating to the offering and sale of such Registrable Securities
or any amendment thereof or supplement thereto, or any omission or alleged omission to state
therein a material fact required to be stated therein or necessary to make the statements therein
not misleading, but in each case only to the extent that such untrue statement is contained in, or
such fact is omitted from, such registration statement (or in any preliminary or final prospectus
included therein) and was made in reliance upon and in conformity with information furnished in
writing to the Company by or on behalf of such Holder specifically for use in the preparation of
such registration statement (or in any preliminary or final prospectus included therein). The
liability of each Holder under such indemnity provision shall be limited to an amount equal to the
total net proceeds received by such Holder from such offering. Such indemnity shall remain in full
force and effect regardless of any investigation made by or on behalf of the Company and shall
survive the transfer of such securities. The foregoing indemnity is in addition to any liability
which such Holder may otherwise have to any Company Indemnitee.

     (c) In case any proceeding (including any governmental investigation) shall be instituted
involving any Person in respect of which indemnity may be sought pursuant to this Article 10, such
Person (the “indemnified party”) shall promptly notify the Person against whom such
indemnity may be sought (the “indemnifying party”) in writing. Indemnification provided for
in Section 10(a) or (b) shall not be available to any person who shall fail to give notice as
provided in this Section 10(c) to the extent the indemnifying party to whom notice was not given
was unaware of the proceeding to which such notice would have related and was prejudiced by the
failure to give such notice, but the failure to give such notice shall not relieve the

12

 

indemnifying party for contribution or otherwise than on account of the provision of Section
10(a) or (b). In case any such proceeding shall be brought against any indemnified party and it
shall notify the indemnifying party of the commencement thereof, the indemnifying party shall be
entitled to participate therein and, to the extent that it shall wish, jointly with any other
indemnifying party similarly notified, to assume the defense thereof, with counsel reasonably
satisfactory to such indemnified party and shall pay as incurred the reasonable fees and
disbursements of such counsel related to such proceeding. In any such proceeding, any indemnified
party shall have the right to retain its own counsel at its own expense. Notwithstanding the
foregoing, the indemnifying party shall pay as incurred the fees and expenses of one counsel
retained by the indemnified party in the event (i) the indemnifying party and the indemnified party
shall have mutually agreed to the retention of such counsel or (ii) the named parties to any such
proceeding (including any impleaded parties) include both the indemnifying party and the
indemnified party and representation of both parties by the same counsel, in the written opinion of
such counsel, would be inappropriate due to actual or potential differing interests between them.
It is understood that the indemnifying party shall not, in connection with any proceeding or
related proceedings in the same jurisdiction, be liable for the reasonable fees and expenses of
more than one separate firm for all such indemnified parties. Such firm shall be designated in
writing by the Holders of a majority of the Registrable Securities held by such Holders in the case
of parties indemnified pursuant to Section 10(a) and by the Company in the case of parties
indemnified pursuant to Section 10(b). The indemnifying party shall not be liable for any
settlement of any proceeding effected without its written consent but if settled with such consent
or if there be a final judgment for the plaintiff, the indemnifying party agrees to indemnify the
indemnified party from and against any loss or liability by reason of such settlement or judgment.
No indemnifying party will consent to entry of any judgment or enter into any settlement which (i)
does not include as an unconditional term the giving by the claimant or plaintiff, to the
indemnified party, of a release from all liability in respect of such claim or litigation or (ii)
involves the imposition of equitable remedies or the imposition of any non-financial obligations on
the indemnified party.

     (d) If the indemnification provided for in this Article 10 is unavailable in respect of any
losses, claims, damages or liabilities (or actions or proceedings in respect thereof) referred to
herein, then each indemnifying party shall contribute to the amount paid or payable by the
indemnified party as a result of such losses, claims, damages or liabilities (or actions or
proceedings in respect thereof) in proportion as is appropriate to reflect the relative fault of
all parties in connection with the statements or omissions which resulted in such losses, claims,
damages or liabilities (or actions or proceedings in respect thereof), as well as any other
relevant equitable considerations. Relative fault shall be determined by reference to, among other
things, whether the untrue or alleged untrue statement of a material fact or the omission or
alleged omission to state a material fact relates to information supplied by the party and the
parties’ relative intent, knowledge, access to information and opportunity to correct or prevent
such statement or omission.

     The parties agree that it would not be just and equitable if contributions pursuant to this
Section 10(d) were determined by pro rata allocation or by any other method of allocation which
does not take account of the equitable considerations referred to above in this Section 10(d). The
amount paid or payable by an indemnified party as a result of the losses, claims, damages or
liabilities (or actions or proceedings in respect thereof) referred to above shall be

13

 

deemed to include any legal or other expenses reasonably incurred by such indemnified party in
connection with investigating or defending any such action or claim. Notwithstanding the provisions
of this subsection (d), no person guilty of fraudulent misrepresentation (within the meaning of
Section 11(f) of the Securities Act) shall be entitled to contribution from any person who was not
guilty of such fraudulent misrepresentation and no indemnifying party shall be required to
contribute any amount in excess of the amount by which the total price at which the securities were
offered to the public by the indemnifying party exceeds the amount of any damages which the
indemnifying party has otherwise been required to pay by reason of an untrue statement or omission.

11. EXPENSES.

     In connection with any registration under this Agreement, the Company shall pay all
Registration Expenses. In addition, in connection with each registration, the Company shall pay the
reasonable fees and expenses of one counsel to represent the interests of the Holders selling
Registrable Securities in such registration.

12. IN-KIND DISTRIBUTIONS.

     If any Holder seeks to effectuate an in-kind distribution of all or part of its shares to its
direct or indirect equityholders, the Company will, subject to applicable lockups, work with such
Holder and the Company’s transfer agent to facilitate such in-kind distribution in the manner
reasonably requested by such Holder.

13. TRANSFER OF RIGHTS.

     (a) Any Holder may transfer all or any portion of its rights under this Agreement to any
transferee (the “Transferee”) of any interests in the Registrable Securities held by such
Holder. Any such transfer of rights under this Agreement will be effective upon receipt by the
Company of (i) written notice from such Holder stating the name and address of the Transferee and
identifying the number of Registrable Securities with respect to which rights under this Agreement
are being transferred and the nature and extent of the rights so transferred, and (ii) a written
agreement from the Transferee to be bound by the terms of this Agreement, upon which such
Transferee will be deemed to be a party hereto and have the rights and obligations of the
Transferring Holder hereunder (to the extent so transferred as indicated in such notice) with
respect to the Registrable Securities transferred.

14

 

     (b) In the event the Company engages in a merger, consolidation or other business combination
in which the shares of Common Stock are converted into securities of another company, appropriate
arrangements will be made so that the registration and related rights provided under this Agreement
continue to be provided to Holders by the issuer of such securities. To the extent such new
issuer, or any other company acquired by the Company in a merger, consolidation or other business
combination, was bound by registration rights obligations that would conflict with the provisions
of this Agreement, the Company will use all commercially reasonable efforts to modify any such
“inherited” registration rights obligations so as not to interfere in any material respects with
the rights provided under this Agreement, unless otherwise agreed by the Holders.

14. LIMITED LIABILITY.

     Notwithstanding any other provision of this Agreement, neither the members, managers, general
partners, limited partners or affiliates of any Holder, nor the directors, officers or employees of
any Holder or of any such member, manager, general partner, limited partner or affiliate shall have
any personal liability for performance of any obligation of such Holder under this Agreement.

15. NOTICES.

     Except as otherwise provided below, whenever it is provided in this Agreement that any notice,
demand, request, consent, approval, declaration or other communication shall or may be given to or
served upon any of the parties hereto, or whenever any of the parties hereto desires to provide to
or serve upon the other party any other communication with respect to this Agreement, each such
notice, demand, request, consent, approval, declaration or other communication shall be in writing
and shall be delivered in person, mailed by registered or certified mail (return receipt requested)
or sent by overnight courier service or via facsimile transmission (which is confirmed), as
follows:

     (a) if to any of the Stockholders, to it:

c/o S.A.C. Capital Advisors, L.P.

72 Cummings Point Road

Stamford, Connecticut 06902

Attention: General Counsel

Facsimile: (203) 823-4209

           with a copy to:

Simpson Thacher & Bartlett LLP

425 Lexington Avenue

New York, New York 10017

Attn: D. Rhett Brandon

Facsimile: (212) 455-2502

15

 

     (b) if to the Company, to:

MedQuist Holdings Inc.

9009 Carothers Parkway

Franklin, TN 37067

Attention: Chief Financial Officer

     The furnishing of any notice required hereunder may be waived in writing by the party entitled
to receive such notice. Every notice, demand, request, consent, approval, declaration or other
communication hereunder shall be deemed to have been duly furnished or served on the party to which
it is addressed, in the case of delivery in person or by facsimile, on the date when sent, in the
case of overnight mail, on the day after it is sent and in all other cases, five (5) Business Days
after it is sent.

16. ENTIRE AGREEMENT.

     This Agreement represents the entire agreement and understanding among the parties hereto with
respect to the subject matter hereof and supersedes any and all prior oral and written agreements,
arrangements and understandings among the parties hereto with respect to such subject matter; and
this Agreement can be amended, supplemented or changed, and any provision hereof can be waived or a
departure from any provision hereof can be consented to, only by a written instrument making
specific reference to this Agreement signed by the Company and the Holders.

17. PARAGRAPH HEADINGS.

     The paragraph headings contained in this Agreement are for general reference purposes only and
shall not affect in any manner the meaning, interpretation or construction of the terms or other
provisions of this Agreement.

18. APPLICABLE LAW.

     This Agreement shall be governed by, construed and enforced in accordance with the laws of the
State of New York applicable to contracts to be made, executed, delivered and performed wholly
within such state and, in any case, without regard to the conflicts of law principles of such
state.

19. SEVERABILITY.

     If at any time subsequent to the date hereof, any provision of this Agreement shall be held by
any court of competent jurisdiction to be illegal, void or unenforceable, such provision shall be
of no force and effect, but the illegality or unenforceability of such provision shall have no
effect upon and shall not impair the enforceability of any other provision of this Agreement.

20. EQUITABLE REMEDIES.

     The parties hereto agree that irreparable harm would occur in the event that any of the
agreements and provisions of this Agreement were not performed fully by the parties hereto in
accordance with their specific terms or conditions or were otherwise breached, and that money

16

 

damages are an inadequate remedy for breach of this Agreement because of the difficulty of
ascertaining and quantifying the amount of damage that will be suffered by the parties hereto in
the event that this Agreement is not performed in accordance with its terms or conditions or is
otherwise breached. It is accordingly hereby agreed that the parties hereto shall be entitled to an
injunction or injunctions to restrain, enjoin and prevent breaches of this Agreement by the other
parties and to enforce specifically the terms and provisions hereof in any court of the United
States or any state having jurisdiction, such remedy being in addition to and not in lieu of, any
other rights and remedies to which the other parties are entitled to at law or in equity.

21. NO WAIVER.

     The failure of any party at any time or times to require performance of any provision hereof
shall not affect the right at a later time to enforce the same. No waiver by any party of any
condition, and no breach of any provision, term, covenant, representation or warranty contained in
this Agreement, whether by conduct or otherwise, in any one or more instances, shall be deemed to
be construed as a further or continuing waiver of any such condition or of the breach of any other
provision, term, covenant, representation or warranty of this Agreement.

22. COUNTERPARTS.

     This Agreement may be executed in two or more counterparts, each of which shall be deemed an
original, but all of which together shall constitute but one and the same original instrument.

23. SUCCESSORS AND ASSIGNS.

     This Agreement shall inure to the benefit of and be binding upon the successors and
Transferees of each of the parties hereto; provided, that nothing herein shall be deemed to
permit any assignment, transfer or other disposition of Registrable Securities in violation of the
terms of applicable law.

24. EFFECTIVE DATE.

     This Agreement shall become effective upon the Closing Date.

17

 

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

	 	 	 	 	 

	 	 	MEDQUIST HOLDINGS INC.
	 
	 	 	 	 
	 

	 	By:	 	/s/ Clyde Swoger 
	 

	 	 	 	 
	 

	 	Name:
	 	Clyde Swoger
	 

	 	Title:
	 	CFO
	 
	 	 	 	 
	 	 	S.A.C. PEI CB INVESTMENT, L.P.
	 
	 	 	 	 
	 	 	By: S.A.C. PEI CB Investment GP, Limited, its general partner
	 
	 	 	 	 
	 

	 	By:	 	/s/ Peter Nussbaum 
	 

	 	 	 	 
	 

	 	Name:
	 	Peter Nussbaum
	 

	 	Title:
	 	Authorized Signatory
	 
	 	 	 	 
	 	 	S.A.C. PEI CB INVESTMENT II, LLC
	 
	 	 	 	 
	 

	 	By:
	 	S.A.C. Private Capital Group, LLC, its manager
	 
	 	 	 	 
	 

	 	By:	 	/s/ Peter Nussbaum 
	 

	 	 	 	 
	 

	 	Name:
	 	Peter Nussbaum
	 

	 	Title:
	 	Authorized Signatory
	 
	 	 	 	 
	 	 	INTERNATIONAL EQUITIES (S.A.C. ASIA) LIMITED
	 
	 	 	 	 
	 

	 	By:	 	/s/ Peter Nussbaum
	 

	 	 	 	 
	 

	 	Name:
	 	Peter Nussbaum
	 

	 	Title:
	 	Authorized Signatoryexv10w7

Exhibit 10.7

Stockholders Agreement

STOCKHOLDERS AGREEMENT

Dated as of February 11, 2011

among

CBaySystems Holdings Limited,

S.A.C. PEI CB Investment, L.P.,

S.A.C. PEI CB Investment II, LLC,

International Equities (S.A.C. Asia) Limited

and

the other Stockholders party hereto

 

 

TABLE OF CONTENTS

	 	 	 	 	 
	 	 	Page
	ARTICLE I DEFINITIONS
	 	 	1	 
	 
	 	 	 	 
	Section 1.1 Definitions
	 	 	1	 
	 
	 	 	 	 
	ARTICLE II CERTAIN RESTRICTIONS ON TRANSFERS
	 	 	4	 
	 
	 	 	 	 
	Section 2.1 Agreement to be Bound
	 	 	4	 
	Section 2.2 Share Certificates
	 	 	4	 
	 
	 	 	 	 
	ARTICLE III GOVERNANCE
	 	 	5	 
	 
	 	 	 	 
	Section 3.1 Board Size
	 	 	5	 
	Section 3.2 Officer Appointment
	 	 	7	 
	Section 3.3 Proxy
	 	 	7	 
	 
	 	 	 	 
	ARTICLE IV REGISTRATION
	 	 	7	 
	 
	 	 	 	 
	Section 4.1 Piggyback Registrations
	 	 	7	 
	Section 4.2 Lockup Agreements
	 	 	8	 
	Section 4.3 Registration Procedures
	 	 	8	 
	Section 4.4 Registration Expenses
	 	 	10	 
	Section 4.5 Additional Procedures
	 	 	10	 
	Section 4.6 Termination of Registration Rights
	 	 	11	 
	 
	 	 	 	 
	ARTICLE V INDEMNIFICATION AND CONTRIBUTION
	 	 	11	 
	 
	 	 	 	 
	Section 5.1 Indemnification by the Company
	 	 	11	 
	Section 5.2 Indemnification by Stockholders of Registrable Securities
	 	 	11	 
	Section 5.3 Conduct of Indemnification Proceedings
	 	 	11	 
	Section 5.4 Contribution
	 	 	12	 
	 
	 	 	 	 
	ARTICLE VI MISCELLANEOUS
	 	 	13	 
	 
	 	 	 	 
	Section 6.1 Recapitalization, Exchanges, etc.
	 	 	13	 
	Section 6.2 Entire Agreement; Successors and Assigns
	 	 	13	 
	Section 6.3 No Waivers, Amendments
	 	 	14	 
	Section 6.4 Notices
	 	 	14	 
	Section 6.5 Termination
	 	 	15	 
	Section 6.6 Governing Law
	 	 	15	 
	Section 6.7 Consent to Jurisdiction
	 	 	15	 
	Section 6.8 Waiver of Jury Trial
	 	 	16	 
	Section 6.9 Descriptive Headings
	 	 	16	 
	Section 6.10 Severability
	 	 	16	 
	Section 6.11 Counterparts
	 	 	17	 

i

 

 

	 	 	 	 	 
	 	 	Page
	Section 6.12 Confidentiality
	 	 	17	 
	Section 6.13 Authority; Effect
	 	 	17	 
	Section 6.14 Enforcement; Further Assurances
	 	 	18	 

ii

 

1

STOCKHOLDERS AGREEMENT

          STOCKHOLDERS AGREEMENT dated as of February 11, 2011 (this “Agreement”) by and among:

          (i) CBaySystems Holdings Limited, a Delaware corporation (the “Company”);

          (ii) S.A.C. PEI CB Investment, L.P., a Cayman Islands limited partnership (“SAC CBI”);

          (iii) S.A.C. PEI CB Investment II, LLC, a Delaware limited liability company (“SAC CBI
II”);

          (iv) International Equities (S.A.C. Asia) Limited, a company incorporated under the Companies
Act 2001 of Mauritius (“SAC Asia” and, together with SAC CBI and SAC CBI II, collectively,
the “SAC Group”);

          (iv) the Investors (as defined below); and

          (v) such other Persons who from time to time become party hereto by executing a counterpart
signature page hereof in the form of Exhibit A hereto or such other form as may be designated by
the Board (together with the SAC Group and the Investors, the “Stockholders”).

WITNESSETH:

          WHEREAS, the Company and the Investors have entered into an Exchange Agreement, dated as of
September 30, 2010, and further amended by Amendment No. 1 thereto, dated December 30, 2010,
pursuant to which the Investors agreed to exchange (the “Exchange”) their shares of common
stock, no par value, of MedQuist, Inc., a subsidiary of the Company, for shares of Common Stock (as
defined hereinafter); and

          WHEREAS, the parties hereto desire to enter into certain arrangements relating to the Company,
the CBAY Shares and the Stockholders.

          NOW, THEREFORE, in consideration of the mutual terms, conditions and other covenants and
agreements set forth herein, the parties hereto hereby agree as follows:

ARTICLE I

DEFINITIONS

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

          “Affiliate”, as applied to any Person, means any other Person directly or indirectly
through one or more intermediaries, controlling, controlled by, or under common control with, that
Person. For the purposes of this definition “control” (including, with correlative
meanings, the terms “controlling”, “controlled by” and “under common control
with”), as applied to any

 

2

Person, means the possession, directly or indirectly, of the power to direct or cause the
direction of the management and policies of that Person, whether through the ownership of voting
securities, by contract or otherwise.

          “Agreement” shall have the meaning set forth in the preamble of this Agreement.

          “Board” shall have the meaning set forth in Section 3.1.

          “Business Day” means any day other than a Saturday, a Sunday or a day on which banks
are required to be closed in New York, New York.

          “By-Laws” means the by-laws of the Company and any amendments thereto and restatements
thereof.

          “Certificate of Incorporation” means the Certificate of Incorporation of the Company
and any amendments thereto and restatements thereof filed on behalf of the Company with the
Delaware Secretary of State.

          “Change in Control” means the occurrence, in a single transaction or in a series of
related transactions, of any one or more of the following events: (i) the sale or disposition of
all or substantially all of the assets of the Company to any Person or “group” (as such term is
used for the purposes of Sections 13(d)(3) and 14(d)(2) of the Securities Exchange Act of 1934, as
amended), other than the Stockholders as of the date of this Agreement and their Affiliates and
Permitted Transferees; or (ii) any Person, other than the Stockholders as of the date of this
Agreement, their Affiliates and Permitted Transferees, is or becomes the beneficial owner, directly
or indirectly, of more than fifty percent (50%) of the total voting power of the outstanding voting
stock of the Company, including by way of merger, consolidation or otherwise.

          “Commission” shall have meaning set forth in Section 4.3(a).

          “Common Stock” means the common stock of the Company, par value $0.01 per share.

          “Company” shall have the meaning set forth in the preamble of this Agreement.

          “Indemnified Party” shall have the meaning set forth in Section 5.3.

          “Indemnifying Party” shall have the meaning set forth in Section 5.3.

          “Investors” means each of the Stockholders as of the date hereof other than the SAC
Group, and the Permitted Transferees of such Stockholders other than the SAC Group.

          “NASDAQ” means the NASDAQ Global Market.

          “Permitted Transferee” means, with respect to each Stockholder, (a) any Affiliates
thereof (or their Permitted Transferees), (b) any general or limited partner, member, director,
officer or employee of such Stockholder (or their Permitted Transferees) and (c) any Person to

 

3

whom a Stockholder (or any direct or indirect Permitted Transferee thereof) Transfers equity
interests of the Company in accordance with the terms of this Agreement (including, for the
avoidance of doubt, any consent or waiver pursuant to and in accordance with the terms of this
Agreement) by which such Transferor is bound and, in the case of Transfers other than Transfers of
Common Stock pursuant to a Public Offering or pursuant to Rule 144 under the Securities Act after a
Public Offering, if such Transferee becomes a party to, and is bound to the same extent as its
Transferor by the terms of, this Agreement; provided, that any such Permitted Transferee
referred to in the foregoing clauses agrees in writing to be bound by the terms of this Agreement
in accordance with Section 2.1.

          “Person” means an individual, partnership, corporation, business trust, joint stock
company, limited liability company, unincorporated association, joint venture or other entity of
whatever nature.

          “Piggyback Registration” shall have the meaning set forth in Section 4.1.

          “Public Offering” means any public offering pursuant to an effective registration
statement under the Securities Act.

          “Registrable Securities” means any outstanding shares of Common Stock held by a
Stockholder from time to time until the earlier of (i) a registration statement covering such
Common Stock has been declared effective by the Commission and such stock has been disposed of
pursuant to such effective registration statement, (ii) such Common Stock is eligible to be sold to
the public pursuant to Rule 144 (or any similar provisions then in force) by such Stockholder
without restriction as to volume or manner of sale under the Securities Act, under circumstances in
which any legend borne by the Common Stock relating to restrictions on transferability thereof
under the Securities Act is or can be removed or (iii) such Common Stock is no longer subject to
restrictions under Rule 144 of the Securities Act.

          “Registration Expenses” shall have the meaning set forth in Section 4.4.

          “SAC CBI” shall have the meaning set forth in the preamble of this Agreement.

          “SAC CBI II” shall have the meaning set forth in the preamble of this Agreement.

          “SAC Directors” shall have the meaning set forth in Section 3.1.

          “SAC Group” shall have the meaning set forth in the preamble of this Agreement.

          “Securities Act” means the United States Securities Act of 1933, as amended.

          “Selling Stockholder” shall have the meaning set forth in Section 4.3(c).

          “Shares” means shares of Common Stock.

          “Stockholder” shall have the meaning set forth in the preamble of this Agreement.

 

4

          “Subsidiary” means, with respect to any Person, any corporation or other entity of
which a majority of the capital stock or other ownership interests having ordinary voting power to
elect a majority of the board of directors or other persons performing a similar function at the
time directly or indirectly owned by such Person.

          “Transfer” means any direct or indirect transfer, sale, assignment, pledge, mortgage,
hypothecation, encumbrance or other disposition of all or a portion of any Shares or any economic
interest therein (including without limitation by means of any participation or swap transaction),
but for the avoidance of doubt shall not include an ordinary course transfer of an ownership
interest in any investment fund or similar entity having an investment in Shares.

          “Transferee” means any Person to whom Shares subject to this Agreement are
Transferred.

          “Transferor” means any Person who Transfers Shares subject to this Agreement.

          “Underwriter” means a securities dealer that purchases any Registrable Securities as
principal in an underwritten offering and not as part of such dealer’s market making activities.

ARTICLE II

CERTAIN RESTRICTIONS ON TRANSFERS

          Section 2.1 Agreement to be Bound. Until the earlier of (a) such time as the Shares held by an Investor may be sold pursuant
to Rule 144 under the Securities Act under circumstances in which any legend borne by the Shares
relating to restrictions on transferability thereof under the Securities Act may be removed or (b)
the first anniversary of the closing of the Exchange (the “Closing”), no Transfer of Shares
by an Investor (other than Transfers in a Public Offering or pursuant to Rule 144 of the Securities
Act (or any successor provision)) shall be effective unless (i) the Transferee, if not already a
party hereto, shall have executed and delivered to the Company, as a condition precedent to such
Transfer, an instrument reasonably satisfactory to the Company confirming that the Transferee
agrees to be bound by the terms of this Agreement with respect to the Shares so Transferred to the
same extent applicable to the Transferor thereof and acknowledging that such Transferee shall be
deemed to be an Investor hereunder and (ii) the Transferee has delivered to the Company an opinion
of counsel reasonably satisfactory to the Company indicating that the proposed Transfer is exempt
from registration pursuant to applicable securities laws.

          Section 2.2 Share Certificates.

	 	(a)	 	Each certificate representing Shares held by an Investor will bear a legend on
the face thereof substantially to the following effect (with such additions thereto or
changes therein as the Company may be advised by counsel are required by law or
necessary or appropriate):

“THE SHARES REPRESENTED BY THIS CERTIFICATE ARE SUBJECT TO THE STOCKHOLDERS
AGREEMENT AMONG CBAYSYSTEMS HOLDINGS LIMITED AND THE OTHER

 

5

STOCKHOLDERS PARTY THERETO, DATED AS OF FEBRUARY 11, 2011, AS AMENDED AND
SUPPLEMENTED FROM TIME TO TIME IN ACCORDANCE WITH THE TERMS THEREOF, A COPY
OF WHICH IS ON FILE WITH THE SECRETARY OF CBAYSYSTEMS HOLDINGS LIMITED. THE
STOCKHOLDERS AGREEMENT CONTAINS, AMONG OTHER THINGS, CERTAIN PROVISIONS
RELATING TO THE VOTING AND TRANSFER OF THE SHARES SUBJECT TO THE AGREEMENT.
NO TRANSFER, SALE, ASSIGNMENT, PLEDGE, HYPOTHECATION OR OTHER DISPOSITION OF
THE SECURITIES REPRESENTED BY THIS CERTIFICATE, DIRECTLY OR INDIRECTLY, MAY
BE MADE EXCEPT IN ACCORDANCE WITH THE PROVISIONS OF SUCH STOCKHOLDERS
AGREEMENT. THE HOLDER OF THIS CERTIFICATE, BY ACCEPTANCE OF THIS
CERTIFICATE, AGREES TO BE BOUND BY ALL OF THE PROVISIONS OF SUCH
STOCKHOLDERS AGREEMENT.”

“THE SHARES REPRESENTED BY THIS CERTIFICATE HAVE NOT BEEN REGISTERED UNDER
THE SECURITIES ACT OF 1933 OR ANY STATE SECURITIES ACTS AND MAY NOT BE
TRANSFERRED OR OTHERWISE DISPOSED OF UNLESS THEY HAVE BEEN REGISTERED UNDER
SUCH ACTS OR AN EXEMPTION FROM REGISTRATION IS AVAILABLE.”

ARTICLE III

GOVERNANCE

          Section 3.1 Board Size.

	 	(a)	 	The Board of Directors of the Company (the “Board”) shall initially
consist of nine (9) directors. Thereafter, the size of the Board shall be determined
in the manner set forth from time to time in the Company’s Certificate of Incorporation
and By-Laws. SAC CBI shall have the right to nominate three (3) directors to the Board
(the “SAC Directors”). As of the date hereof, the SAC Directors shall be
Messrs. Frank Baker, Peter Berger and Jeffrey Hendren.
	 
	 	(b)	 	For so long as SAC CBI has the right to nominate the SAC Directors, the Company
at all times shall take such actions as may be required under applicable Law, NASDAQ
rules, the Certificate of Incorporation and the By-Laws to cause the Board to consist
of the number of directors in accordance with Section 3.1(a), and to include on the
Board or in the slate of nominees recommended by the Board such persons nominated by
SAC CBI pursuant to this Section 3.1.
	 
	 	(c)	 	For as long as SAC CBI has the right to nominate the SAC Directors, each
Investor hereby agrees that it will vote all of the voting Shares owned or held of
record by

 

6

	 	 	 	such Investor, or (as applicable) provide its written consent in respect thereof, in
order to elect or appoint (as applicable) the SAC Directors to the Board.
	 
	 	(d)	 	For so long as SAC CBI has the right to nominate the SAC Directors, without the
prior written consent of SAC CBI, each Investor agrees not to take any action that
would cause the number of directors constituting the entire Board to be greater than
nine (9).
	 
	 	(e)	 	For so long as SAC CBI has the right to nominate the SAC Directors, in the
event a vacancy is created at any time, including by the death, disability, retirement,
resignation or removal (with or without cause) of any SAC Director, SAC CBI may
nominate another individual to be elected to fill each such vacancy created thereby and
the parties hereto agree to take, at any time, and from time to time, all actions
necessary or appropriate in order to effect the election or appointment (as applicable)
of each such individual to the Board.
	 
	 	(f)	 	Any proposed SAC Director, at the time when such person is nominated to serve
as a director, shall be reasonably acceptable to the Company’s Nominating and Corporate
Governance Committee as determined in good faith. SAC CBI shall notify the Company of
any proposed SAC Director, in writing, a reasonable time in advance of the mailing of
any proxy statement, information statement or registration statement in which such
proposed SAC Director would be named, together with all information concerning such
nominee reasonably requested by the Company so that the Company can comply with
applicable disclosure rules; provided that in the absence of such notice, SAC
CBI shall be deemed to have designated or nominated the same SAC Directors currently in
office or, if applicable, set forth in the most recent notice delivered to the Company
pursuant to this Section 3.1(f).
	 
	 	(g)	 	For as long as SAC CBI has the right to nominate the SAC Directors, each
Investor agrees that, (i) if at any time SAC CBI shall notify such Investor of its
desire to remove, with or without cause, any SAC Director, such Investor will vote, or
cause to be voted, all of the voting Shares owned or held of record by such Investor,
and shall take all such other actions promptly as shall be necessary or appropriate to
cause the removal of such director and (ii) it will not take any action to remove any
SAC Director unless so notified by SAC CBI.
	 
	 	(h)	 	The parties acknowledge that the Company may enter into agreements with each of
the SAC Directors providing for the payment of a total aggregate compensation amount
for each SAC Director equal to $4 million to be paid in equal installments of $1
million due and payable on each of the first four (4) anniversaries of the date hereof,
and such payments will be structured to minimize their effect on the on-going valuation
of the Company (including, without limitation, through lump sum payments at the time of
any Initial Public Offering). Each of the other parties hereto agrees to take, at any
time, and from time to time, all actions necessary or appropriate to effect such
payments and further agrees not, at any time, directly or indirectly, any action in
opposition to such payments.

 

7

	 	(i)	 	After the first anniversary of the Closing, the obligations provided by
Sections 3.1(c) and 3.1(g) will terminate with respect to each Investor when such
Investor owns less than 3.0% of the Company’s outstanding shares of Common Stock. The
provisions of this Section 3.1 shall terminate and be of no further force or effect
upon the earlier of consummation of a Change in Control or, with respect to any
Investor, at such time as all Common Stock held by such Investor are sold, in
accordance with this Agreement, to a third party not bound by this Agreement or
required to become a party hereto, and otherwise upon the tenth anniversary hereof.

          Section 3.2 Officer Appointment. The Company and each Investor acknowledge and agree that as of the date hereof and until the
fourth anniversary of the date hereof, at the discretion of SAC CBI, Mr. Jeffrey Hendren shall
have the opportunity to serve as Vice-Chairman, Finance of the Company. In the event that a
vacancy in such position is created at any time prior to the fourth anniversary of the date
hereof, including as a result of the death, disability, retirement, resignation or removal
(with or without cause) of Mr. Hendren or any successor, SAC CBI may nominate another
individual to be appointed by the Company to fill the vacancy created thereby and the parties
hereto agree to take, at any time, and from time to time, all actions necessary or appropriate
to effect such appointment, to the extent requested by SAC CBI.

          Section 3.3 Proxy. In the event that any Investor entitled or required to vote on or provide its written
consent with respect to a matter specified in Sections 3.1 and 3.2 shall fail at any time to vote
or act by written consent (as applicable) with respect to any Shares held of record or beneficially
owned by such Investor (or as to which such Investor otherwise has direct or indirect voting
control), as set forth in this Agreement, such Investor hereby irrevocably appoints SAC CBI as such
Investor’s proxy and attorney-in-fact (with full power of substitution), for and in the name, place
and stead of such Investor, to vote or act by written consent with respect to such Shares and to
grant a consent, proxy or approval in respect of such Shares, in each case in such manner and to
the extent as is necessary or appropriate to vote such Shares in accordance with this Agreement.
Each Investor hereby affirms that the irrevocable proxy and irrevocable power of attorney set forth
in this Section 3.3 will be valid for the term of this Agreement and are given to secure the
performance of the obligations of such Investor under this Agreement. Each Investor hereby further
affirms that each proxy and power of attorney hereby granted shall, for the term of this Agreement,
be irrevocable and shall be deemed coupled with an interest.

ARTICLE IV

REGISTRATION

          Section 4.1 Piggyback Registrations.

	 	(a)	 	Right to Piggyback. Until the earlier of (a) such time as the Shares
held by an Investor may be sold pursuant to Rule 144 under the Securities Act under
circumstances in which any legend borne by the Shares relating to restrictions on
transferability thereof under the Securities Act may be removed or (b) the first
anniversary of the Closing, if the Company proposes to register and sell any of its

 

8

	 	 	 	Common Stock under the Securities Act and the registration form to be used may be used
for the registration of the Investors’ Registrable Securities (a “Piggyback
Registration”), the Company shall give prompt written notice to the Investors of its
intention to effect such a registration at least ten (10) days before the anticipated
offering date or as promptly thereafter as reasonably practicable, and will include in
such registration the Shares of the Investors with respect to which the Company has
received written requests for inclusion therein within five (5) days after delivery of
the Company’s notice.
	 
	 	(b)	 	Piggyback Expenses. The Registration Expenses shall be paid by the
Company in all Piggyback Registrations; provided, however, that for the avoidance of
doubt, each of the Investors shall bear its pro rata portion of any discounts and
commissions with respect to Shares sold by it in connection therewith.
	 
	 	(c)	 	Priority on Registrations. If a Piggyback Registration is an
underwritten registration on behalf of the Company, and the managing Underwriters
advise the Company in writing that in their opinion the number of Shares requested to
be included in such registration exceeds the number which can be sold in such offering
without adversely affecting the marketability of the offering, then the number of
Shares available for registration shall be allocated (i) first, 100% to the Shares to
be sold by the Company and (ii) second, pro rata based on the relative number of
Registrable Securities then held by each Investor and Shares held by each other holder
of Shares eligible to be sold in such offering; provided, that any such amount thereby
allocated to any such holder that exceeds such holder’s request shall be reallocated
among the remaining requesting holders in like manner.

          Section 4.2 Lockup Agreements. With respect to any underwritten Public Offering, each Investor agrees not to effect any
sale or distribution (except as part of such underwritten registration) of Registrable Securities,
including a sale pursuant to Rule 144 under the Securities Act, (i) during the fifteen (15) days
prior to such offering, (ii) during the 180-day period beginning on the effective date of the
Initial Public Offering, unless the investment banks or Underwriters managing the Public Offering
otherwise agree, and (iii) during the 90-day period beginning on the effective date of any other
Public Offering, unless the investment banks or Underwriters managing the Public Offering otherwise
agree.

          Section 4.3 Registration Procedures. Whenever Investors with the right to do so pursuant to Section 4.1 request that any of
their Registrable Securities be registered pursuant to Section 4.1, the Company will use its
reasonable best efforts to effect the registration of such Registrable Securities in accordance
with the intended method of disposition thereof as quickly as reasonably practicable, and in
connection with any such request:

	 	(a)	 	The Company will as expeditiously as reasonably practicable prepare and file
with the Securities and Exchange Commission (the “Commission”) a registration
statement on any form for which the Company then qualifies and which counsel for the
Company shall deem appropriate and which form shall be available for the sale of the
Registrable Securities to be registered thereunder in accordance with the intended
method of distribution thereof (it being understood that the Company shall use Form

 

9

	 	 	 	S-3 (or any replacement form) if such form is then available), and use its reasonable
best efforts to cause such filed registration statement to become effective and keep
such registration statement effective for a period of up to one hundred twenty (120)
days or, if earlier, until the distribution contemplated in the registration statement
has been completed; provided, however, that in the case of any registration of
Registrable Securities on Form S-3 (or any replacement form) that are intended to be
offered on a continuous or delayed basis, subject to compliance with applicable
Commission rules, such period shall be extended to the extent reasonably requested in
order to allow sufficient time for all such Registrable Securities to be sold.
	 
	 	(b)	 	The Company will prepare and file with the Commission such amendments and
supplements to such registration statement and the prospectus used in connection
therewith as may be necessary to comply with the provisions of the Securities Act with
respect to the disposition of all securities covered by such registration statement.
	 
	 	(c)	 	The Company will, prior to filing a registration statement or prospectus or any
amendment or supplement thereto, furnish to each Investor selling Registrable
Securities pursuant to a registration statement under this Section 4 (each, a
“Selling Stockholder”), copies of such registration statement as proposed to be
filed, together with exhibits thereto, which documents will be subject to review by the
foregoing persons within five (5) Business Days after delivery, and thereafter furnish
to such Selling Stockholder such number of copies of such registration statement, each
amendment and supplement thereto (in each case including all exhibits thereto and
documents incorporated by reference therein), the prospectus included in such
registration statement (including each preliminary prospectus) and such other documents
as such Selling Stockholder may reasonably request in order to facilitate the
disposition of the Registrable Securities owned by such Selling Stockholder and
registered thereunder.
	 
	 	(d)	 	After the filing of the registration statement, the Company will promptly
notify each Selling Stockholder covered by such registration statement of any stop
order issued or threatened by the Commission and take reasonable actions to prevent the
entry of such stop order or to remove it if entered.
	 
	 	(e)	 	The Company will use its reasonable best efforts to register or qualify the
Registrable Securities under such other securities or blue sky laws of such
jurisdictions in the United States and such other jurisdictions as any Selling
Stockholder reasonably (in light of such Selling Stockholder’s intended plan of
distribution) requests; provided that the Company will not be required to (A) qualify
generally to do business in any jurisdiction where it would not otherwise be required
to qualify but for this paragraph (e), (B) subject itself to taxation in any such
jurisdiction or (C) consent to general service of process in any such jurisdiction.
	 
	 	(f)	 	The (i) Company will promptly notify each Selling Stockholder covered by such
registration statement and (ii) each Investor will promptly notify the Company, at any
time when a prospectus relating to such registration statement is required to be
delivered under the Securities Act, of the occurrence of an event of which it is aware

 

10

	 	 	 	that requires the preparation of a supplement or amendment to such prospectus so that,
as thereafter delivered to the purchasers of such Registrable Securities, such
prospectus will not contain an untrue statement of a material fact or omit to state any
material fact required to be stated therein or necessary to make the statements therein
not misleading, and the Company will promptly make available to each Selling Stockholder
any such supplement or amendment.
	 
	 	(g)	 	The Company will use its reasonable best efforts to comply with all applicable
rules and regulations of the Commission.
	 
	 	(h)	 	The Company will use its reasonable best efforts to cause all Registrable
Securities covered by such registration statement to be listed on each national
securities exchange on which similar securities issued by the Company are then listed
(if any), if the listing of such Registrable Securities is then permitted under the
rules of such exchange.
	 
	 	(i)	 	The Company may require each Selling Stockholder of Registrable Securities to
promptly furnish in writing to the Company such information regarding the Selling
Stockholder and the distribution of the Registrable Securities as the Company may from
time to time reasonably request, and such other information as may be necessary or
appropriate in connection with such registration.
	 
	 	(j)	 	Each Selling Stockholder agrees that, upon receipt of any notice from the
Company of the happening of any event of the kind described in Section 4.3(f), such
Selling Stockholder will immediately discontinue disposition of Registrable Securities
pursuant to the registration statement covering such Registrable Securities until such
Selling Stockholder’s receipt of the copies of the supplemented or amended prospectus
contemplated by Section 4.3(f), and, if so directed by the Company, such Selling
Stockholder will deliver to the Company all copies, other than permanent file copies
then in such Selling Stockholder’s possession, of the most recent prospectus covering
such Registrable Securities at the time of receipt of such notice.

          Section 4.4 Registration Expenses. All expenses incident to the Company’s performance of or compliance with this Agreement,
including all registration and filing fees, fees and expenses of compliance with securities or blue
sky laws, printing expenses, messenger and delivery expenses, and fees and disbursements of counsel
for the Company and all independent certified public accountants, Underwriters (excluding
underwriting discounts and commissions) and other Persons retained by the Company (all such
expenses being herein called “Registration Expenses”) shall be borne as provided in this
Agreement, except that the Company shall, in any event, pay its internal expenses (including all
salaries and expenses of its officers and employees performing legal or accounting duties), the
expense of any annual audit or quarterly review, the expense of any liability insurance and the
expenses and fees for listing the securities to be registered on each securities exchange on which
similar securities issued by the Company are then listed or on the NASD automated quotation system.

          Section 4.5 Additional Procedures. All Selling Stockholders will take all such actions and execute all such documents and
instruments that are reasonably requested by the

 

11

Company to effect the registration and sale of their securities pursuant to this Section 4,
including, without limitation, being parties to the underwriting agreement entered into by the
Company and any other Selling Stockholders in connection therewith; provided,
however, that the aggregate amount of any liability of any Selling Stockholder pursuant to
such underwriting or other agreement will not exceed such Selling Stockholder’s net proceeds from
such offering.

          Section 4.6 Termination of Registration Rights. The registration rights and the obligations provided by this Section 4 will terminate with
respect to each Investor when such Investor owns less than 3.0% of the Company’s outstanding shares
of Common Stock.

ARTICLE V

INDEMNIFICATION AND CONTRIBUTION

          Section 5.1 Indemnification by the Company. To the fullest extent permitted by law, the Company agrees to indemnify and hold harmless
each Selling Stockholder of Registrable Securities included in the applicable registration
statement, its officers, directors, employees and agents, and each person, if any, who controls
such Selling Stockholder within the meaning of the Securities Act, from and against any loss,
claim, damage or liability, joint or several, or any action in respect thereof to which such
Selling Stockholder, officer, director, employee or agent or controlling Person may become subject
under the Securities Act or otherwise, insofar as such loss, claim, damage, liability or action
arises out of, or is based upon, (i) any untrue statement or alleged untrue statement of a material
fact contained in any registration statement, prospectus or any preliminary prospectus or any
amendment or supplement thereto relating to the Registrable Securities or (ii) any omission or
alleged omission to state therein a material fact required to be stated therein or necessary to
make the statements therein not misleading, in each case except insofar as the same are contained
in any information furnished to the Company by a Selling Stockholder or on a Selling Stockholder’s
behalf for use therein.

          Section 5.2 Indemnification by Stockholders of Registrable Securities. To the fullest extent permitted by law, each Selling Stockholder agrees, severally but not
jointly, to indemnify and hold harmless the Company, each Underwriter and each other Selling
Stockholder, their respective officers, directors and agents and each Person, if any, who controls
the Company, any such Underwriter or any such other Selling Stockholder within the meaning of the
Securities Act, to the same extent as the indemnity from the Company to such Selling Stockholder
pursuant to Section 5.1, but only with respect to information furnished to the Company by such
Selling Stockholder or on such Selling Stockholder’s behalf for use in any registration statement
or prospectus relating to the Registrable Securities, or any amendment or supplement thereto, or
any preliminary prospectus.

          Section 5.3 Conduct of Indemnification Proceedings. Promptly after receipt by any Person in respect of which indemnity may be sought pursuant
to Section 5.1 or 5.2 (an “Indemnified Party”) of notice of any claim or the commencement
of any action, the Indemnified Party shall, if a claim in respect thereof is to be made against the
Person against whom such indemnity may be sought (an “Indemnifying Party”), notify the
Indemnifying Party in writing of the claim or the commencement of such action provided that the
failure to notify the

 

12

Indemnifying Party shall not relieve it from any liability which it may have to an Indemnified
Party, except to the extent of any actual prejudice resulting therefrom. If any such claim or
action shall be brought against an Indemnified Party, the Indemnifying Party shall be entitled to
participate therein, and, to the extent that it wishes, jointly with any other Indemnifying Party,
assume the defense thereof with counsel reasonably satisfactory to the Indemnified Party. After
notice from the Indemnifying Party to the Indemnified Party of its election to assume the defense
of such claim or action, the Indemnifying Party shall not be liable to the Indemnified Party for
any legal or other expenses subsequently incurred by the Indemnified Party in connection with the
defense thereof unless (i) the Indemnifying Party shall have agreed in writing to be liable for
such expenses or (ii) the Indemnifying Party engages the same counsel to represent itself and the
Indemnified Party in such action and such counsel advises that representation of both parties by
the same counsel would be inappropriate due to an actual or reasonably likely potential conflict of
interests between them. No Indemnifying Party will, without the prior written consent of the
Indemnified Party (not to be unreasonably withheld), effect any settlement of any claim or pending
or threatened proceeding in respect of which the Indemnified Party is a party and indemnity has
been sought hereunder by such Indemnified Party, unless such settlement includes an unconditional
release of such Indemnified Party from all liability arising out of such claim or proceeding. No
Indemnified Party will, without the prior written consent of the Indemnifying Party (not to be
unreasonably withheld), effect any settlement of any claim or pending or threatened proceeding in
respect of which indemnity has or may be sought hereunder by such Indemnified Party.

          Section 5.4 Contribution. If the indemnification provided for in this Article V is unavailable to any Indemnified
Parties in respect of any losses, claims, damages, liabilities or expenses referred to herein, then
each Indemnifying Party, in lieu of indemnifying such Indemnified Party, shall contribute to the
amount paid or payable by such Indemnified Party as a result of such losses, claims, damages,
liabilities or expenses (i) as between the Company and the Selling Stockholders on the one hand and
the Underwriters on the other, in such proportion as is appropriate to reflect the relative
benefits received by the Company and the Selling Stockholders on the one hand and the Underwriters
on the other from the offering of the Registrable Securities, or if such allocation is not
permitted by applicable law, in such proportion as is appropriate to reflect not only the relative
benefits but also the relative fault of the Company and the Selling Stockholders on the one hand
and of the Underwriters on the other in connection with the statements or omissions which resulted
in such losses, claims, damages or liabilities, as well as any other relevant equitable
considerations and (ii) as between the Company and/or one or more other Selling Stockholders on the
one hand and any Selling Stockholder on the other, in such proportion as is appropriate to reflect
the relative fault of the Company and of each Selling Stockholder in connection with such
statements or omissions, as well as any other relevant equitable considerations. The relative
benefits received by the Company and the Selling Stockholders on the one hand and the Underwriters
on the other shall be deemed to be in the same proportion as the total proceeds from the offering
(net of underwriting discounts and commissions but before deducting expenses) received by the
Company and the Selling Stockholders bear to the total underwriting discounts and commissions
received by the Underwriters, in each case as set forth in the table on the cover page of the
prospectus. The relative fault of the Company and the Selling Stockholders on the one hand and of
the Underwriters on the other shall be determined by reference to, among other things, whether the
untrue or alleged untrue statement of a material fact or the omission or alleged omission to state

 

13

a material fact relates to information supplied by the Company and the Selling Stockholders or
by the Underwriters. The relative fault of the Company and/or one or more other Selling
Stockholders on the one hand and of any Selling Stockholder on the other shall be determined by
reference to, among other things, whether the untrue or alleged untrue statement of a material fact
or the omission or alleged omission to state a material fact relates to information supplied by
such Person, and the Persons’ relative intent, knowledge, access to information and opportunity to
correct or prevent such statement or omission.

     The Company and the Selling Stockholders agree that it would not be just and equitable if
contribution pursuant to this Section 5.4 were determined by pro rata allocation (even if the
Underwriters were treated as one entity for such purpose) or by any other method of allocation
which does not take account of the equitable considerations referred to in the immediately
preceding paragraph. The amount paid or payable by an Indemnified Party as a result of the losses,
claims, damages or liabilities referred to in the immediately preceding paragraph shall be deemed
to include, subject to the limitations set forth above, any legal or other expenses reasonably
incurred by such Indemnified Party in connection with investigating or defending any such action or
claim. Notwithstanding the foregoing provisions of this Section 5.4, no Underwriter shall be
required to contribute any amount in excess of the amount by which the total price at which the
Registrable Securities underwritten by it and distributed to the public were offered to the public
exceeds the amount of any damages which such Underwriter has otherwise been required to pay by
reason of such untrue or alleged untrue statement or omission or alleged omission, and no Selling
Stockholder shall be required to contribute any amount in excess of the amount by which the total
price at which the Registrable Securities of such Selling Stockholder were offered to the public
(less underwriting discounts and commissions) exceeds the amount of any damages which such Selling
Stockholder has otherwise been required to pay by reason of such untrue or alleged untrue statement
or omission or alleged omission. Notwithstanding the foregoing provisions of this Section 5.4, no
Person guilty of fraudulent misrepresentation (within the meaning of Section 11(f) of the
Securities Act) shall be entitled to contribution from any Person who was not guilty of such
fraudulent misrepresentation.

ARTICLE VI

MISCELLANEOUS

          Section 6.1 Recapitalization, Exchanges, etc.
In the event that any capital stock or other securities are issued in respect of, in exchange
for, or in substitution of, any Registrable Securities by reason of any reorganization,
recapitalization, reclassification, merger, consolidation, spin-off, partial or complete
liquidation, stock dividend, split-up, sale of assets, distribution to Stockholders or combination
of the Shares or any other change in capital structure of the Company, appropriate adjustments
shall be made with respect to the relevant provisions of this Agreement so as to fairly and
equitably preserve, as far as reasonably practicable, the original rights and obligations of the
parties hereto under this Agreement and the term “Registrable Securities,” as used herein, shall be
deemed to include shares of such capital stock or other securities, as appropriate.

          Section 6.2 Entire Agreement; Successors and Assigns. Except for restrictions on Transfer of Shares set forth in other agreements, plans or other
documents, this Agreement

 

14

constitutes the entire agreement of the parties with respect to its subject matter, supersedes
all prior or contemporaneous oral or written agreements or discussions with respect to such subject
matter, and shall be binding upon and inure to the benefit of the parties hereto and their
respective heirs, representatives, successors and assigns. Except as otherwise expressly provided
herein, no Stockholder party hereto may assign any of its respective rights or delegate any of its
respective obligations under this Agreement without the prior written consent of the other parties
hereto, and any attempted assignment or delegation in violation of the foregoing shall be null and
void.

          Section 6.3 No Waivers, Amendments.

	 	(a)	 	No delay of or omission in the exercise of any right, power or remedy accruing
to any party as a result of any breach or default by any other party under this
Agreement shall impair any such right, power or remedy, nor shall it be construed as a
waiver of or acquiescence in any such breach or default, or of any similar breach or
default occurring later; nor shall any such delay, omission nor waiver of any single
breach or default be deemed a waiver of any other breach or default occurring before or
after that waiver.
	 
	 	(b)	 	This Agreement may be amended or modified, or any provision hereof may be
waived, provided that such amendment, modification or waiver is set forth in a writing
executed by (i) the Company, (ii) the SAC Group and (iii) each Investor that would be
adversely affected thereby. Notwithstanding the foregoing, each of the Stockholders
acknowledges and agrees that in respect of a Transfer pursuant to Section 2.1 of this
Agreement, the Transferee may be added as an additional party to this Agreement by a
written joinder, provided that such addition is done in accordance with and pursuant to
the provisions of this Agreement. No course of dealing between or among any Persons
having any interest in this Agreement will be deemed effective to modify, amend or
discharge any part of this Agreement or any rights or obligations of any Person under
or by reason of this Agreement.

          Section 6.4 Notices. Any notices and other communications required or permitted in this Agreement shall be
effective if in writing and (a) delivered personally or (b) sent (i) by nationally-known, reputable
overnight carrier or (ii) by facsimile, in each case, addressed as follows:

if to the Company:

CBaySystems Holdings Limited

2661 Riva Road, Building 800

Annapolis, MD 21401

Fax: 416-266-9409

Attention: Chief Financial Officer

if to the SAC Group:

c/o S.A.C. Capital Advisors, L.P.

72 Cummings Point Road

 

15

Stamford, Connecticut 06902

Fax: (203) 823-4209

Attention: General Counsel

in each case, with a copy to:

Simpson Thacher & Bartlett LLP

425 Lexington Avenue

New York, New York 10017

Fax: 212-455-2502

Attention: D. Rhett Brandon

          If to any Investor, to such Investor at the address set forth in the stock record book of the
Company or as otherwise provided in writing by such Investor to the Company.

          Unless otherwise specified herein, such notices or other communications shall be deemed
effective (a) on the date received, if personally delivered, (b) two (2) Business Days (or one (1)
Business Day if sent for next Business Day delivery) after being sent by nationally-known,
reputable overnight carrier or (c) upon transmission and confirmation of receipt by a facsimile
operator, in the case of facsimile. Each of the parties hereto shall be entitled to specify a
different address by giving notice as aforesaid to each of the other parties hereto.

          Section 6.5 Termination. Unless earlier terminated, the provisions of this Agreement shall terminate and be of no
further force or effect upon the earlier of consummation of a Change in Control or, with respect to
any Investor, at such time as all Common Stock held by such Investor are sold, in accordance with
this Agreement, to a third party not bound by this Agreement or required to become a party hereto,
and otherwise upon the tenth anniversary hereof.

          Section 6.6 Governing Law. THIS AGREEMENT IS GOVERNED BY AND SHALL BE CONSTRUED IN ACCORDANCE WITH THE LAW OF THE
STATE OF NEW YORK, WITHOUT GIVING EFFECT TO ANY CONFLICT OF LAWS OR SIMILAR RULES OR PRINCIPLES
THAT MIGHT REQUIRE THE APPLICATION TO THIS AGREEMENT OF THE LAWS OF ANOTHER JURISDICTION.

          Section 6.7 Consent to Jurisdiction. Each party to this Agreement, by its execution hereof, (a) hereby irrevocably submits to
the exclusive jurisdiction of the state and federal courts sitting in New York, New York for the
purpose of any action, claim, cause of action or suit (in contract, tort or otherwise), inquiry,
proceeding or investigation arising out of or based upon this Agreement or relating to the subject
matter hereof, (b) hereby waives to the extent not prohibited by applicable law, and agrees not to
assert, and agrees not to allow any of its subsidiaries to assert, by way of motion, as a defense
or otherwise, in any such action, any claim that it is not subject personally to the jurisdiction
of the above-named courts, that its property is exempt or immune from attachment or execution, that
any such proceeding brought in one of the above-named courts is improper, or that this Agreement or
the subject matter hereof may not be enforced in or by such court and (c) hereby agrees not to
commence or maintain any

 

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action, claim, cause of action or suit (in contract, tort or otherwise), inquiry, proceeding
or investigation arising out of or based upon this Agreement or relating to the subject matter
hereof other than before one of the above-named courts nor to make any motion or take any other
action seeking or intending to cause the transfer or removal of any such action, claim, cause of
action or suit (in contract, tort or otherwise), inquiry, proceeding or investigation to any court
other than one of the above-named courts whether on the grounds of inconvenient forum or otherwise.
Notwithstanding the foregoing, to the extent that any party hereto is or becomes a party in any
litigation in connection with which it may assert indemnification rights set forth in this
Agreement, the court in which such litigation is being heard shall be deemed to be included in
clause (a) above with respect to the assertion of such rights in such matter. Each party hereto
hereby consents to service of process in any such proceeding in any manner permitted by New York
law, and agrees that service of process by registered or certified mail, return receipt requested,
at its address specified pursuant to Section 6.4 hereof is reasonably calculated to give actual
notice. Notwithstanding the foregoing in this Section 6.7, a party may commence any action in a
court other than the above-named courts solely for the purpose of enforcing an order or judgment
issued by one of the above-named courts.

          Section 6.8 Waiver of Jury Trial. TO THE EXTENT NOT PROHIBITED BY APPLICABLE LAW WHICH CANNOT BE WAIVED, EACH PARTY HERETO
HEREBY WAIVES AND COVENANTS THAT IT WILL NOT ASSERT (WHETHER AS PLAINTIFF, DEFENDANT OR OTHERWISE)
ANY RIGHT TO TRIAL BY JURY IN ANY FORUM IN RESPECT OF ANY ISSUE OR ACTION, CLAIM, CAUSE OF ACTION
OR SUIT (IN CONTRACT, TORT OR OTHERWISE), INQUIRY, PROCEEDING OR INVESTIGATION ARISING OUT OF OR
BASED UPON THIS AGREEMENT OR THE SUBJECT MATTER HEREOF OR IN ANY WAY CONNECTED WITH OR RELATED OR
INCIDENTAL TO THE TRANSACTIONS CONTEMPLATED HEREBY, IN EACH CASE WHETHER NOW EXISTING OR HEREAFTER
ARISING. EACH PARTY HERETO ACKNOWLEDGES THAT IT HAS BEEN INFORMED BY THE OTHER PARTIES HERETO THAT
THIS SECTION 6.8 CONSTITUTES A MATERIAL INDUCEMENT UPON WHICH THEY ARE RELYING AND WILL RELY IN
ENTERING INTO THIS AGREEMENT. ANY PARTY HERETO MAY FILE AN ORIGINAL COUNTERPART OR A COPY OF THIS
SECTION 6.8 WITH ANY COURT AS WRITTEN EVIDENCE OF THE CONSENT OF EACH SUCH PARTY TO THE WAIVER OF
ITS RIGHT TO TRIAL BY JURY.

          Section 6.9 Descriptive Headings. The descriptive headings of this Agreement are for convenience of reference only, are not
to be considered a part hereof and shall not be construed to define or limit any of the terms or
provisions hereof.

          Section 6.10 Severability. In the event that any provision hereof would, under applicable law, be invalid or
unenforceable in any respect, such provision shall be construed by modifying or limiting it so as
to be valid and enforceable to the maximum extent compatible with, and possible under, applicable
law and the parties shall negotiate in good faith to modify this Agreement so as to effect the
original intent of the parties as closely as possible in an acceptable manner to the fullest extent
possible. The provisions hereof are severable, and in the event any provision hereof should be held
invalid or unenforceable in any respect, it shall not invalidate, render unenforceable or otherwise
affect any other provision hereof.

 

17

          Section 6.11 Counterparts. This Agreement may be executed in multiple counterparts, each of which shall be deemed an
original, but all of which taken together shall constitute one instrument. A manual signature of a
counterpart hereto delivered via facsimile signature or by other electronic means shall be
considered due execution and shall be binding upon the signatory thereto with the same force and
effect as if the signature were an original.

          Section 6.12 Confidentiality. Each Investor agrees that it will keep confidential and will not disclose, divulge or use
for any purpose, other than to monitor its investment in the Company and its subsidiaries, any
confidential information obtained from the Company, unless such confidential information (a) is
known or becomes known to the public in general (other than as a result of a breach of this Section
6.12 by such Investor or its Affiliates), (b) is or has been independently developed or conceived
by such Investor without use of the Company’s confidential information or (c) is or has been made
known or disclosed to such Investor by a third party (other than another Stockholder or an
Affiliate of such Investor or of another Stockholder) without a breach of any obligation of
confidentiality such third party may have to the Company that is known to such Investor;
provided, however, that an Investor may disclose confidential information on a
confidential basis (v) to its attorneys, accountants, consultants and other professionals to the
extent necessary to obtain their services in connection with monitoring its investment in the
Company, (w) to any prospective purchaser of any Shares from such Investor as long as such
prospective purchaser agrees to be bound by the provisions of this Section 6.12 as if an Investor,
(x) to any Affiliate, partner, member or related investment fund of such Investor and their
respective directors, employees and consultants, in each case in the ordinary course of business,
(y) as may be reasonably determined by such Investor to be necessary in connection with such
Investor’s enforcement of its rights in connection with this Agreement or its investment in the
Company and its subsidiaries or (z) as may otherwise be required by law or legal, judicial or
regulatory process, provided that such Investor takes reasonable steps to minimize the extent of
any required disclosure described in this clause (z); and provided, further,
however, that the acts and omissions of any Person to whom such Investor may disclose
confidential information pursuant to clauses (v) through (x) of the preceding proviso shall be
attributable to such Investor for purposes of determining such Investor’s compliance with this
Section 6.12. Each of the parties hereto acknowledge that the SAC Group, the Investors or any of
their respective Affiliates and related investment funds may review the business plans and related
proprietary information of many enterprises, including enterprises which may have products or
services which compete directly or indirectly with those of the Company, and may trade in the
securities of such enterprises. Nothing in this Section 6.12 shall preclude or in any way restrict
the SAC Group, the Investors or their respective Affiliates or related investment funds from
investing or participating in any particular enterprise, or trading in any particular securities,
whether or not such enterprise has products or services that compete with those of the Company.

          Section 6.13 Authority; Effect. Each party hereto represents and warrants (as to itself only) to and agrees with each other
party that (a) the execution and delivery of this Agreement and the consummation of the
transactions contemplated hereby have been duly authorized on behalf of such party and do not
violate any agreement or other instrument applicable to such party or by which its assets are bound
and (b) this Agreement constitutes a legal, valid and binding obligation of such party, enforceable
against such party in accordance with its terms, except to the extent that the enforcement of the
rights and remedies created hereby

 

18

is subject to (i) bankruptcy, insolvency, reorganization, moratorium and other laws of general
application affecting the rights and remedies of creditors generally and (ii) general principles of
equity. This Agreement does not, and shall not be construed to, give rise to the creation of a
partnership among any of the parties hereto, or to constitute any of such parties members of a
joint venture or other association.

          Section 6.14 Enforcement; Further Assurances.

	 	(a)	 	The parties hereto agree that irreparable damage would occur in the event that
any of the provisions of this Agreement were not performed in accordance with their
specific terms. It is accordingly agreed that the parties shall be entitled to
specific performance of the terms hereof, this being in addition to any other remedy to
which they are entitled at law or in equity.
	 
	 	(b)	 	The parties hereto agree to execute, acknowledge, deliver, file and record such
further certificates, amendments, instruments, agreements and documents, and to do all
such other acts and things, as may be required by law or as may be necessary or
appropriate to carry out the intent and purposes of this Agreement.

 

19

          IN WITNESS WHEREOF, the undersigned have executed this Agreement as of the date set forth
above.

	 	 	 	 	 
	 	CBAYSYSTEMS HOLDINGS LIMITED

 	 
	 	By:  	/s/ Clyde Swoger
 	 
	 	 	Name:  	Clyde Swoger 	 
	 	 	Title:  	Chief Financial Officer 	 
	 

 

20

          IN WITNESS WHEREOF, the undersigned have executed this Agreement as of the date set forth
above.

	 	 	 	 	 
	 	S.A.C. PEI CB INVESTMENT, L.P.

 	 
	 	By:  	S.A.C. PEI CB Investment GP, Limited,
 	 
	 	 	its general partner 	 
	 	 	 
	 	By:  	                                              /s/ Peter Nussbaum
 	 
	 	 	Name:  	Peter Nussbaum 	 
	 	 	Title:  	Authorized Person 	 
	 

 

21

          IN WITNESS WHEREOF, the undersigned have executed this Agreement as of the date set forth
above.

	 	 	 	 	 
	 	S.A.C. PEI CB INVESTMENT II, LLC

 	 
	 	By:  	S.A.C. Private Capital Group, LLC,
 	 
	 	 	its manager 	 
	 	 	 	 
	 	By:  	                                              /s/ Peter Nussbaum
 	 
	 	 	Name:  	Peter Nussbaum 	 
	 	 	Title:  	Authorized Person 	 
	 

 

22

          IN WITNESS WHEREOF, the undersigned have executed this Agreement as of the date set forth
above.

	 	 	 	 	 
	 	INTERNATIONAL EQUITIES (S.A.C. ASIA) LIMITED

 	 
	 	By:  	/s/ Peter Nussbaum
 	 
	 	 	Name:  	Peter Nussbaum 	 
	 	 	Title:  	Authorized Person 	 
	 

 

23

          IN WITNESS WHEREOF, the undersigned have executed this Agreement as of the date set forth
above.

	 	 	 	 	 
	 	COSTA BRAVA PARTNERSHIP III, L.P.

 	 
	 	By:  	/s/ Seth Hamot
 	 
	 	 	Name:  	Seth Hamot 	 
	 	 	Title:  	Managing Member of GP 	 
	 

 

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          IN WITNESS WHEREOF, the undersigned have executed this Agreement as of the date set forth
above.

	 	 	 	 	 
	 	NEWCASTLE PARTNERS, L.P.

 	 
	 	By:  	/s/ Mark E. Schwarz
 	 
	 	 	Name:  	Mark E. Schwarz 	 
	 	 	Title:  	General Partner 	 
	 

 

25

          IN WITNESS WHEREOF, the undersigned have executed this Agreement as of the date set forth
above.

	 	 	 	 	 
	 	Black Horse Capital Management LLC

 	 
	 	By:  	/s/ Dale B. Chappell
 	 
	 	 	Name:  	Dale B. Chappell 	 
	 	 	Title:  	Manager 	 
	 

 

26

          IN WITNESS WHEREOF, the undersigned have executed this Agreement as of the date set forth
above.

	 	 	 	 	 
	 	American Hallmark Insurance Company of Texas

 	 
	 	By:  	/s/ Mark E. Schwarz
 	 
	 	 	Name:  	Mark E. Schwarz 	 
	 	 	Title:  	Executive Chairman
 Hallmark Financial Services, Inc.

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