Document:

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                                                                    EXHIBIT 4.10

                                AMENDMENT TO NOTE

        This is an Amendment dated as of March 30, 2001 amending a certain
Amended and Restated Revolving Credit Note Secured by Security Agreement and
Other Collateral (the "Note") in the original principal amount of Two Million
Five Hundred Thousand ($2,500,000) Dollars dated August 8, 2000, made by Shared
Technologies Cellular, Inc. ("Maker") payable to the order of Citizens Bank of
Massachusetts ("Citizens").

        Citizens has endorsed and conveyed said note to Anthony Autorino
("Autorino") as of March 1, 2001, and Autorino has endorsed and conveyed said
Note to Mobile Investments, LLC ("Lender") as of March 14, 2001.

        In consideration of the Lender entering into the Fifth Amendment
Agreement and these premises and for other good and valuable consideration, the
receipt and sufficiency of which are hereby acknowledged, the Note is hereby
amended as follows:

a) The amount of the Note is hereby increased to Five Million Dollars
($5,000,000.00) For value received, the Maker promises to pay to the order of
the Lender said amount, or such lesser amount advanced under the Credit
Agreement (hereafter defined).

b) The maturity date of the Note is hereby extended to September 30, 2001, at
which time the full amount of all outstanding principal, interest and other
charges owing under the Note, Credit Agreement and other Loan Documents executed
in connection therewith shall be done.

c) Maker shall pay on the date hereof prepaid interest in the amount of $300,000
representing six (6) months interest, which amount shall be advanced to the
Maker pursuant to the terms of the Credit Agreement.

d) Unless an Event of Default shall have occurred, no principal or interest
shall be payable until said maturity date.

e) The Note may be prepaid prior to said maturity date, but no portion of the
prepaid interest will be refunded.

        The Note as amended hereby is the Note referred to in and is entitled
to the benefits of, and subject to the terms of that certain Loan Agreement
dated July 7, 1999 among Maker and Lender, as amended by that certain First
Amendment Agreement dated as of December 3, 1999, that certain Second Amendment
Agreement dated May 1, 2000, that certain Third Amendment Agreement dated August
8, 2000 and that certain Fourth Amendment Agreement dated March 1, 2001, and
that certain Fifth Amendment Agreement dated of even date herewith (said Credit
Agreement and the previously mentioned Amendments, as they may be further
amended or modified from time to time, are herein collectively referred to as
the "Credit Agreement"). The Credit Agreement is incorporated herein by
reference.
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The Maker expressly acknowledges that:

        a)      this Agreement constitutes an amendment to the Note, which is an
                amendment and restatement in its entirety of that certain
                $10,000,000.00 Promissory Note dated July 7, 1999 payable by the
                Maker to State Street Bank and Trust, as assigned to the Lender,
                as previously amended and restated by that certain $5,000,000.00
                Promissory Note dated May 1, 2000 payable to Citizens Bank of
                Massachusetts ("Citizens") as modified by the Third Amendment
                Agreement dated as of August 8, 2000 between Maker and Citizens
                as assigned to the Lender (collectively the "Original Note");
                and

        b)      this Amendment is not a discharge or novation of the Original
                Note; and

        c)      notwithstanding the terms hereof, the Lender has expressly
                reserved its rights against the Maker under the Original Note as
                provided under Massachusetts Law and pursuant to judicial
                precedent, both as in effect from time to time.

        This Agreement and all transactions hereunder and/or evidenced herein
shall be governed by, construed, and enforced in accordance with the substantive
laws of The Commonwealth of Massachusetts.

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        IN WITNESS WHEREOF, the Maker has caused this Amendment to Note to be
executed as an instrument under seal by its duly authorized representative all
as of the date first above written.

WITNESS:                                    SHARED TECHNOLOGIES CELLULAR, INC.

/s/ J. Rieber                               By: /s/ Anthony D. Autorino
------------------                              -------------------------------
                                                    Anthony D. Autorino
                                                    Its Chairman and CEO

                                            MOBILE INVESTMENTS LLC
                                            By: Oakes, Fitzwilliams & Co., Inc.
                                                Its Manager

/s/ Parveen Abbas                           By: /s/ Herbert L. Oakes, Jr.
------------------                              -------------------------------
                                                    Herbert L. Oakes, Jr.
                                                    Its President

                                       3Exhibit 10.1

                       FIRST AMENDMENT TO VOTING AGREEMENT
                           REGARDING SIMIONE DIRECTORS

     This First Amendment to Voting  Agreement  Regarding  Simione  Directors is
made and  entered  into as of the 12th day of July,  2000 by and  among  SIMIONE
CENTRAL HOLDINGS,  INC., a Delaware  corporation  ("Simione"),  MESTEK,  INC., a
Pennsylvania  corporation  ("Mestek"),  JOHN E.  REED,  STEWART  B.  REED and E.
HERBERT  BURK  (collectively,  the  "Mestek  Major  Stockholders"),   DANIEL  J.
MITCHELL,  individually  and as  Representative  of the former  stockholders  of
CareCentric Solutions, Inc. ("Mitchell") and JESSE I. TREU ("Treu").

                                   WITNESSETH:

     WHEREAS,  Simione,  Mestek,  the Mestek Major Stockholders and MCS, Inc., a
Pennsylvania  corporation  ("MCS"),  were parties to that certain Second Amended
and Restated  Agreement and Plan of Merger and Investment  Agreement dated as of
October 25, 1999 (the "MCS Merger Agreement")  pursuant to which MCS merged with
and into Simione on March 7, 2000 (the "Closing Date");

     WHEREAS,  pursuant to Section 2.5(c) of the MCS Merger  Agreement,  Simione
agreed for a period of 18 months  after the Closing Date to use its best efforts
to cause six designees of the Mestek Major  Stockholders to be named as nominees
for  election to the  Simione  Board of  Directors  in each proxy  statement  of
Simione  relating  to an annual or a special  meeting of  stockholders  at which
directors will be elected;

     WHEREAS,  the parties to this  Agreement  desire to amend the voting rights
provisions of Section 2.5(c) of the MCS Merger Agreement as provided herein;

     NOW, THEREFORE,  in consideration of the foregoing and the mutual covenants
and agreements herein contained,  and intending to be legally bound hereby,  the
parties hereto hereby agree as follows:

     1. Capitalized  terms used herein and not otherwise  defined shall have the
meaning ascribed to such terms in the MCS Merger Agreement.

     2.  Notwithstanding  any  provision  in  Section  2.5(c) of the MCS  Merger
Agreement,  for a period of eighteen (18) months after the Closing Date, Simione
shall submit for approval by its  stockholders in any proxy statement of Simione
relating to an annual or special meeting of stockholders at which directors will
be elected a proposal to elect seven (7)  directors  to its Board of  Directors,
three (3) of whom shall be designees of the Mestek Major  Stockholders  (each, a
"Mestek  Designee,"  which term shall  include any  successor  designee,  or any
replacement  designee  selected by the remaining Mestek  Designees),  one (1) of
whom  shall be a  designee  of  CareCentric,  one (1) of whom shall be the chief
executive officer of Simione,  and two (2) of whom shall be designated solely by
the Simione  Board of Directors.  During such  eighteen  (18) month period,  (a)

                                       1
<PAGE>

Simione will use its best efforts to cause the Mestek Designees, the CareCentric
designee  and  Simione's  chief  executive  officer to be named as nominees  for
election to the Simione Board in each proxy statement of Simione  relating to an
annual or a special  meeting of stockholders at which directors will be elected,
and (b) the Mestek Major Stockholders will vote their shares of Simione stock in
favor of all nominees  selected in  accordance  with the  provisions  hereof and
recommended by the Simione Board of Directors in any such proxy statement.

     3. Treu shall be the initial designee of CareCentric.

     4. Except as amended hereby, the remaining  provisions set forth in Section
2.5(c) of the Mestek Merger Agreement relating to a possible Disqualification of
a Mestek Designee shall remain in full force and effect.

     5. Treu and Mitchell  acknowledge and agree that the execution and delivery
of this First Amendment,  in providing for only one CareCentric  designee to the
Simione Board of Directors,  does not  constitute a breach by Simione of Section
2.5(d)  of the  Agreement  and Plan of Merger  dated as of July 12,  1999 by and
among Simione, CareCentric and Simione Acquisition Corporation.

     6. This First  Amendment  to Voting  Agreement  may be executed in multiple
counterparts,  each of which shall be deemed an original and all of which, taken
together, shall constitute one and the same instrument.

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<PAGE>

     IN WITNESS WHEREOF,  the parties hereto have executed this First Amendment,
or caused it to be executed by its duly authorized officers,  as of the date and
year first written above.

MESTEK:                            SIMIONE:

MESTEK, INC.                       SIMIONE CENTRAL HOLDINGS, INC.

By:  /s/ Jack E. Nelson            By:    /s/ R. Bruce Dewey
    --------------------------          -------------------------------
        Jack E. Nelson
Title:  VP Human Resources         Title:  President and CEO
       -----------------------           ------------------------------

                                      /s/ John E. Reed
                                   ------------------------------------
                                   John E. Reed

                                      /s/ Stewart B. Reed
                                   ------------------------------------
                                   Stewart B. Reed

                                      /s/ John E. Reed
                                   ------------------------------------
                                   E. Herbert Burk

                                      /s/
                                   ------------------------------------
                                   Daniel J. Mitchell, individually
                                   and in his capacity as Representative
                                   of  the former  shareholders  of
                                   CareCentric   Solutions, Inc.

                                      /s/ Jesse I. Treu
                                   -----------------------------------
                                   Jesse I. Treu

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1253798

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