Document:

Exhibit 10.9d

 

ADDENDUM FOUR 

 

TO LEASE AGREEMENT FOR A GAMMA KNIFE UNIT

 

This ADDENDUM FOUR TO LEASE
AGREEMENT FOR A GAMMA KNIFE UNIT (this “Addendum Four”) is dated effective as of February 8, 2010, and is entered into
between (i) GK FINANCING, LLC, a California limited liability company (“GKF”), and (ii) SUNRISE HOSPITAL AND MEDICAL
CENTER, LLC, a Delaware limited liability company that is qualified to do business in the State of Nevada, d/b/a/ Sunrise Hospital
and Medical Center (“Medical Center”), with reference to the following recitals:

 

Recitals:

 

A.           Medical
Center owns and operates an acute care hospital facility located at 3186 South Maryland Parkway, Las Vegas, NV 89109.

 

B.           On
June 3, 1999, GKF and Medical Center executed a Lease Agreement for a Gamma Knife Unit, which Lease Agreement was amended by (i)
a certain Addendum dated effective December 1, 1998, (ii) a certain Addendum Two (“Addendum Two”) dated effective January
17, 2007, and (iii) a certain Addendum Three (“Addendum Three”) dated effective June 20, 2007 (collectively, and as
amended, the “Lease”).

 

C.           The
parties desire to further amend the terms and provisions of the Lease as set forth herein.

 

NOW THEREFORE, in consideration
of the mutual covenants and agreements set forth herein, and for other good and valuable consideration, the receipt and sufficiency
of which are hereby acknowledged, the parties agree as follows:

 

Agreement:

 

1.          Defined
Terms. Unless otherwise defined herein, the capitalized terms used herein shall have the same meanings set forth in the
Lease.

 

2.          Extension
of Lease Term. It is acknowledged that the Commencement Date of the Lease was January
8, 2001. The Term of the Lease as set forth in Section 5 of the Lease is hereby extended for an additional two (2) years, which
extended Term shall expire on January 8, 2013. All references in the Lease to the “Term” shall be deemed
to refer to the Term, as extended hereby.

 

3.          Per
Procedure Payments. In consideration of the extension of the Lease Term and notwithstanding
anything to the contrary set forth in the Lease, commencing from and after January 8, 2011, Medical Center shall pay to GKF a
per procedure payment in the amount of Six Thousand Dollars ($6,000) per procedure. The term “procedure” shall mean
each individual treatment session (fraction) that involves stereotactic, external, single fraction, conformal radiation, commonly
called radiosurgery, that may include one or more isocenters during the patient treatment session, delivered to any site(s) superior
to the foramen magnum, whether performed on an inpatient or outpatient basis, using the Equipment and/or any other equipment or
devices that are used in lieu of, or as an alternative to, the Equipment. The parties acknowledge that the per procedure payments
represent fair market value for the use of the Equipment as described in the Agreement. Nothing set forth herein shall amend or
otherwise affect (i) the per procedure payments set forth in Addendum Three which shall remain in effect until January 8, 2011,
and (ii) the per case reimbursement rates for medical radiation physicist services payable to GKF pursuant to Addendum Two.

 

    	 	- 1 -	 

     

    

 

4.          Transfer
of Equipment Ownership. If, on the expiration of the Term (as extended), no Event of
Default by Medical Center (and no event or condition which with the giving of notice and/or the lapse of time would constitute
such an Event of Default) then exists and is continuing under the Lease, then, GKF shall quitclaim to Medical Center all of GKF’s
right, title and interest in and to the Equipment on an “as is, where is” basis. 

 

5.          No
Responsibility for Additional Reloading. It is understood by the parties that GKF is not responsible for any cobalt reloading,
except as expressly agreed upon in writing by Medical Center and GKF.

 

6.          Captions.
The captions and paragraph headings used herein are for convenience only and shall not be used in construing or interpreting this
Addendum.

 

7.          Full
Force and Effect. Except as amended by this Addendum Four, all of the terms and provisions of the Lease and its Addendums
shall remain in full force and effect.

 

IN WITNESS WHEREOF, the
parties have executed this Addendum Four effective as of the date first written above.

 

	GK FINANCING, LLC	 	SUNRISE HOSPITAL AND MEDICAL CENTER, LLC
	 	 	 	 	 
	By:	/s/ Ernest A. Bates	 	By:	/s/ Chris Mowan
	 	Ernest A. Bates, M.D.	 	Name:	Chris Mowan
	 	Policy Committee Member	 	Title:	COO

 

    	 	- 2 -Exhibit 10.10

 

LEASE AGREEMENT FOR A GAMMA KNIFE UNIT

 

THIS AGREEMENT FOR A GAMMA KNIFE UNIT on
November 1, 1999, (hereinafter, referred to as the "Agreement") is entered into between GK Financing, LLC, a California
Limited Liability Company, (hereinafter referred to as "GKF"), and Jackson HMA, Inc. d/b/a Central Mississippi Medical
Center, a for profit Mississippi corporation, (hereinafter referred to as "Medical Center").

 

RECITALS

 

WHEREAS, Medical Center wants to lease a
Leksell Stereotactic Gamma Unit Manufactured by Elekta Instruments, Inc., (hereinafter referred to as the "Equipment");
and

 

WHEREAS, GKF is willing to lease the Equipment
which GKF has acquired from Elekta Instruments, Inc., a Georgia corporation (hereinafter referred to as "Elekta"), to
Medical Center, pursuant to the terms and conditions of this Agreement.

 

NOW, therefore, in consideration of the
foregoing premises and the promises contained herein, the parties hereto hereby agree as follows:

 

1.          Execution
of LGK Agreement by and between Medical Center and Elekta. Medical Center agrees that simultaneously with the execution of this
Agreement it shall execute that certain LGK Agreement with Elekta, (hereinafter referred to as the "LGK Agreement"),
a copy of which is attached hereto as Exhibit A and incorporated herein by this reference. Medical Center agrees to fulfill all
of its obligations under the LGK Agreement and acknowledges that GKF is a third party beneficiary of the LGK Agreement. Medical
Center shall fully indemnify and hold harmless GKF in the event that GKF suffers any loss, damage, claim or expense (including
attorneys' fees) solely as a result of Medical Center's breach or alleged breach of the LGK Agreement.

 

2.          Certificate
of Need (CON). If Medical Center requires a CON to install and operate the Equipment, Medical Center will work diligently toward
receipt of a CON for the Equipment and the provision of services related thereto. This Agreement shall become null and void in
the event Medical Center does not receive a CON, if required, for the Equipment and the provision of services related thereto after
using its best efforts to do so.

 

3.          Delivery
of the Equipment and Site preparation. GKF shall arrange to have the Equipment delivered to Medical Center, at 1850 Chadwick Drive,
Jackson, Mississippi (the "Site") in coordination with Elekta. GKF shall exert its best faith efforts to expedite the
delivery of the Equipment in accordance with the terms and conditions of the Purchase Agreement for the Equipment by and between
GKF and Elekta. Notwithstanding the preceding sentence, it is understood and agreed that GKF has made no representations and warranties
to Medical Center concerning actual delivery dates or schedules for the Equipment at the Site.

 

Medical Center shall provide a safe, convenient
and properly prepared Site, at its own expense, in accordance with all of the Equipment manufacturer's (Elekta's) guidelines, specifications,
technical instruments and Site Planning Criteria (which Site Planning Criteria are attached hereto as Exhibit B and incorporated
herein by this reference), which criteria shall include Elekta's estimated delivery schedule when and as received by GKF, on Medical
Center controlled property (The "Site") for the proper performance of Gamma Knife procedures. Site location shall be
mutually acceptable to both parties. Medical Center shall prepare at its sole cost and expense the requisite site plans and specifications
and shall submit them to Elekta and GKF for approval. Medical Center shall obtain, in a timely manner, a User License from the
Nuclear Regulatory Commission and/or appropriate state agency authorizing it to take possession of the Cobalt Supply and shall
obtain such other licenses, permits, approvals, consents and authorizations, which may be required by local governmental or other
regulatory agencies for the Site, its preparation, the charging of the Equipment with its Cobalt Supply, the conduct of Acceptance
tests, and the use of the Equipment all as more fully set forth in Article 2.1 of the LGK Agreement.

 

     

     

    

 

4.          Commencement
of Term. The Term (hereinafter defined) of this Agreement shall commence upon the performance of the first clinical Gamma Knife
procedure at the Site (the "Commencement Date"). Medical Center shall become liable to GKF for the payments referred
to in Paragraph 7 herein below upon the Commencement Date.

 

5.          Costs
of Site Preparation; Costs of Installation. Medical Center's obligations shall include preparation of plans and specifications
for the construction and preparation of the Site in such form as will result in the Site, when constructed in accordance with such
plans and specifications, being in full compliance with Elekta's Site Planning Criteria. Medical Center shall at its own expense
and risk, prepare, construct and make ready the Site as necessary, for the installation of the Equipment, including, but not limited
to, providing any temporary and/or permanent shielding for the charging of the equipment and its use, selecting and preparing a
proper foundation for the Equipment and for such shielding and walls, as well as proper alignment of the Site and wiring. Medical
Center shall be financially responsible for the positioning of the Equipment on its foundation at the Site.

 

Medical Center shall also at its own expense
select, purchase and install all radiation monitoring equipment and devices, safety circuits and radiation warning signs needed
for the Equipment at the Site, according to all applicable federal, state and local laws, regulations, recommendations or custom.

 

Upon completion of the Site, Medical Center
shall warrant that the Site will be safe and suitable for its use of the Equipment. Medical Center shall fully indemnify and hold
harmless GKF from any and all loss, liability, damage, expense or claim (including attorneys' fees) which GKF may suffer and incur
and which relate to the Site and the Equipment's positioning thereon.

 

Medical Center shall be liable to GKF for
any damage to the Equipment caused by (a) defects in construction of the Site or defects in the positioning of the Equipment at
the Site; (b) defects arising out of materials or parts provided, modified or designed by Medical Center with respect to the Site;
or (c) negligent or intentional acts of omission or commission by Medical Center or any of its officers, agents, physicians, and
employees in connection with the Site preparation or operation of the Equipment at the Site.

 

Medical Center warrants that it shall utilize
its best efforts to fulfill on an expeditious basis its obligations under this Paragraph 5. Medical Center further warrants that
it shall on a regular basis keep GKF informed of Medical Center's progress in fulfilling its obligations pursuant to this Paragraph
5. Should Medical Center not have all site preparations completed by the delivery date specified by a separate agreement plus a
sixty (60) day grace period such that the site is acceptable for positioning and installation of the equipment, Medical Center
shall reimburse GKF at an interest rate of Bank of America's prime rate plus 2% on GKF's equipment cost until the site is prepared
to allow positioning and installation of the equipment.

 

6.          Term
of the Equipment. GKF agrees to provide to Medical Center the Equipment pursuant to the terms of this Agreement, for a term of
ten (10) years from the Commencement Date as described in Paragraph 4 hereinabove (the "Term"), unless terminated earlier
as provided herein.

 

7.          Per
Procedure Payments. Medical Center shall pay to GKF a per procedure payment of $8,500 for the use of the Equipment. A procedure
shall be defined as a single patient treatment session that may include one or more isocenters during that session. Medical Center
shall be billed monthly for the actual number of procedures performed during the first and second half of the month, respectively.
Medical Center shall pay the procedures invoiced within thirty (30) days after being invoiced. Interest shall begin to accrue at
the rate of 1-1/2% per month on all invoices remaining unpaid after 45 days.

 

     

     

    

 

8.          Use
of the Equipment. The Equipment may be used by Medical Center only at the location stated above and shall not be removed therefrom.
Medical Center shall not assign or sublease the Equipment or its rights hereunder without the prior written consent of GKF. No
permitted assignment or sublease shall relieve Medical Center of any of its obligations hereunder. Medical Center shall not use
nor permit the Equipment to be used in any manner nor for any purpose for which, in the opinion of Elekta or GKF, the Equipment
is not designed or reasonably suitable. Medical Center shall not permit any liens, whether voluntary or involuntary, to attach
to the Equipment, without the prior written consent of GKF. Medical Center shall have no interest in the Equipment other than the
rights acquired as a lessee hereunder and the Equipment shall remain the property of GKF regardless of the manner in which it may
be installed or attached at the Site. Medical Center shall, at GKF's request, affix to the Equipment tags, decals, or plates furnished
by GKF, indicating GKF's ownership of the Equipment.

 

9.          Additional
Covenants of Medical Center. In addition to the other covenants made by Medical Center, Medical Center shall at its own cost and
expense:

 

(a)          Provide
properly trained professional, technical and support personnel and supplies required for the proper performance of medical procedures
utilizing the Equipment.

 

(b)          Assume
all medical and financial responsibility for the overseers' monitoring of all patients' medical condition and treatment.

 

(c)          Fully
comply with all of its obligations under the LGK Agreement.

 

(d)          Indemnify
GKF as herein provided: (i) Medical Center hereby agrees to fully indemnify and/or reimburse (including attorneys' fees) GKF on
a prompt basis for any and all damage to the Equipment (including any violations by Medical Center, its agents, officers, physicians,
employees, successors and assigns of the Service Agreement described in Paragraph 16 hereof) to the extent such damages are caused
by the negligent or wrongful acts or omissions of Medical Center, its agents, officers, physicians and employees. In the event
the Equipment is destroyed or rendered unusable, this indemnification shall extend up to (but not exceed) the full replacement
value of the Equipment at the time of its destruction less salvage value, if any. (ii) Medical Center hereby further agrees to
indemnify and hold GKF, its agents, officers, employees, successors and assigns, harmless from and against any and all claims,
liabilities, obligations, losses, damages, injuries, penalties, actions, costs and expenses (including attorneys' fees) for all
events and/or occurrences described in Article 7.3 of the LGK Agreement to the same extent that Medical Center agrees to indemnify
Elekta thereunder. Medical Center further agrees to fully indemnify and hold harmless GKF for any loss, damage, claim, or expense
(including attorneys' fees) GKF may suffer or incur as a result of Medical Center's breach or breach alleged in litigation with
regard to the LGK Agreement.

 

(e)          Provide
reasonable and customary marketing materials (i.e. brochures, announcements, etc.) and marketing support from an administrative
and physician (i.e. seminars by neurosurgeons and radiation therapists to referring physicians, etc.) commitment standpoint for
this clinical service.

 

10.         Additional
Covenants, Representations and Warranties of GKF. In addition to the other covenants, representations and warranties, made by GKF
in this Agreement:

 

     

     

    

 

(a)          GKF
represents and warrants that GKF has full power and authority to enter into this Agreement, and that this Agreement does not and
will not violate any agreement, contract or instrument binding upon GKF.

 

(b)          GKF
represents and warrants to Medical Center that, upon delivery of the Equipment to Medical Center, GKF shall use its best faith
efforts to require that Elekta meets its contractual obligations to GKF and in putting the Equipment, as soon as possible, into
good, safe and serviceable condition and fit for its intended use in accordance with the manufacturer's specifications, guidelines
and field modification instructions.

 

(c)          GKF
represents and warrants that throughout the term of this Agreement, Medical Center shall enjoy the use of the Equipment, free of
the rights of any other persons except for those rights reserved by GKF or granted to Elekta under the LGK Agreement or under Elekta's
Purchase Agreement with GKF.

 

(d)          During
the entire term of this agreement and subsequent extension thereof, GKF shall maintain in full force and effect: (i) the Service
Agreement referenced in Paragraph 16 hereof; and (ii) any other service or other agreements required to fulfill GKF's obligations
to Medical Center pursuant to this Paragraph 10(d). GKF represents and warrants that during the entire term of this agreement and
any subsequent extensions thereof, that it will fully pursue any and all remedies it may have against Elekta under the Service
Agreement to insure that the Equipment will be in conformity with Elekta's warranties so that it is free from defects in design,
materials, and workmanship which result in noncompliance with the specifications and/or Elekta's warranties to GKF. In no event,
however, shall the warranty obligations of GKF to Medical Center with respect to the Equipment be greater or more extensive than
Elekta's warranty obligations to GKF with respect to the Equipment.

 

11.         Ownership/Title.
It is expressly understood that Medical Center shall acquire no right, title or interest in or to the Equipment, other than the
right to the possession and use of the same in accordance with the terms of this Agreement.

 

GKF may at its sole discretion finance the
Equipment. Financing may be in the form of an installment loan or a capitalized lease or other commercially available debt instrument.
Should GKF finance the Equipment through an installment loan, GKF shall be required to provide the Equipment as collateral against
the loan. Should GKF finance the Equipment through a capitalized lease title shall vest with the lessor until GKF exercises its
buy-out option. In addition, should GKF finance the Equipment, said agreement may be used as collateral against the loan.

 

12.         Cost
of Use of the Equipment. Except as is otherwise provided herein, Medical Center shall bear the entire cost of using the Equipment
during the Term of this Agreement. This shall include, but not be limited to, providing trained professionals, technical and support
personnel and supplies to properly operate the Equipment. Medical Center shall be fully responsible and liable for all acts and/or
omissions of such professional, technical and support personnel.

 

13.         Taxes.
GKF shall pay any personal property taxes levied against the Equipment and any other taxes or governmental fees or assessments,
however denoted, whether of the federal government, any state government or any local government, levied or based on this Agreement
or the use of the Equipment except for those taxes, if any, pertaining to the gross income or gross receipts of Medical Center.

 

14.         Maintenance
and Inspections. GKF agrees to exercise due and proper care in the maintenance of the Equipment and to keep the Equipment in a
good state of repair, reasonable wear and tear excepted. Medical Center shall be liable to GKF for all damage to the Equipment
caused by the misuse, negligence, improper use or other intentional or negligent acts or omissions of Medical Center's employees,
officers, agents, and physicians.

 

     

     

    

 

GKF (and Elekta) shall have the right of access
to the Equipment for the purpose of inspecting same at all reasonable times and upon reasonable notice and with a minimum of interference
to Medical Center's operations. In the event the Equipment is improperly used by Medical Center or its employees, agents, officers,
and physicians, GKF may service or repair the same as needed and such expense shall be paid by Medical Center, unless the repair
is covered by the Service Agreement described in Paragraph 15 hereof.

 

Any work so performed by or in the service
or maintenance of the Equipment as a result of Medical Center's failure or neglect to do so shall not deprive GKF of any of its
rights, remedies or actions against Medical Center for damages caused by such failure or neglect.

 

15.         Equipment
Modifications/Additions/Upgrades. The parties agree that the necessity and financial responsibility for modifications/additions/upgrades
to the Equipment, including the reloading of the Cobalt-60 source, shall be discussed and mutually decided by GKF and Medical Center.

 

16.         Service
Agreement. GKF warrants that it shall simultaneously with the execution of this Agreement enter into a Service Agreement with Elekta.

 

16.         Termination
If, after the initial twenty-four (24) month period of service, and subsequent 12 month periods of service, Medical Center does
not provide GKF with a reasonable economic justification to continue providing Gamma Knife services hereunder, then and in that
event, GKF shall have the option of terminating this Agreement upon the giving of written notice to Medical Center of said termination
not less than ninety (90) days prior to GKF's designated termination date.

 

17.         Options
to Extend Agreement.

 

(a)          Medical
Center shall have the option at the end of the ten (10) year initial Term to:

 

(i)          Extend
this Agreement for a five (5) year renewal term.

 

(ii)         Terminate
this Agreement. If Medical Center terminates this Agreement at the end of the initial term, GKF at its cost shall remove the Gamma
Knife within an agreed upon period of time after the expiration of the ten (10) year initial Term.

 

Medical Center shall exercise one (1) of
the two (2) options referred to above, by mailing an irrevocable written notice thereof to GKF at Four Embarcadero Center, Suite
3620, San Francisco, California, 94111, by registered mail, postmarked on or before the end of the ninth (9th) year of the ten
(10) year initial Term of this Agreement. Any such notice shall be sufficient if it states in substance that Medical Center elects
to exercise its option and states which of the two (2) options referred to above Medical Center is exercising.

 

     

     

    

 

18.         No
Warranties by GKF. Medical Center warrants that as of the Commencement Date, it shall have (a) thoroughly inspected the Equipment;
(b) determined for itself that all items of the Equipment are of a size, design, capacity and manufacture selected by it; and (c)
satisfied itself that to the best of its knowledge the Equipment is suitable for Medical Center's stated purposes. GKF SUPPLIES
THE EQUIPMENT "AS IS" AND NOT BEING THE MANUFACTURER OF THE EQUIPMENT OR THE MANUFACTURER'S AGENT, MAKES NO WARRANTY
OR REPRESENTATION, EITHER EXPRESSED OR IMPLIED, AS TO THE EQUIPMENT'S MERCHANTABILITY, FITNESS FOR A PARTICULAR PURPOSE, DESIGN,
CONDITION, DURABILITY, CAPACITY, MATERIAL OR WORKMANSHIP OR AS TO PATENT INFRINGEMENT OR THE LIKE, it being agreed that all such
risks as between GKF and Medical Center, shall be borne by Medical Center. Medical Center agrees to look solely to the manufacturer
(Elekta) or to suppliers of the Equipment (and its software) for any and all warranty claims. Any and all warranties made by Elekta
will be in its good faith best efforts enforced by GKF on behalf of Medical Center during the ten (10) year initial Term hereof.
Medical Center agrees that GKF shall not be responsible for the delivery, installation, or operation of the Equipment or for any
delay or inadequacy of any or all of the foregoing. GKF shall not be responsible for any direct or indirect consequential loss
or damage resulting from the installation, operation or use of the Equipment or otherwise. Medical Center expressly waives any
right to hold GKF liable hereunder for any claims, demands and liabilities arising out of or in connection with the design, manufacture,
possession or operation of the Equipment.

 

19.         Events
of Default and Remedies. The occurrence of any one of the following shall constitute an Event of Default hereunder:

 

(a)          Medical
Center fails to pay any installment of semi-monthly procedure payments when due when such default continues for a period of thirty
(30) days after notice thereof from GKF or its assignee is given to Medical Center.

 

(b)          Medical
Center attempts to remove, sell, transfer, encumber, sublet or part with possession of the Equipment or any items thereof, except
as expressly permitted herein;

 

(c)          Medical
Center shall fail to observe or perform any of the other obligations required to be observed or performed by Medical Center hereunder
and such failure shall continue uncured for twenty (20) days after written notice thereof to Medical Center by GKF;

 

(d)          Medical
Center ceases doing business as a going concern, makes an assignment for the benefit of creditors, admits in writing its inability
to pay its debts as they become due, files a voluntary petition in bankruptcy, is adjudicated a bankrupt or an insolvent, files
a petition seeking for itself any reorganization, arrangement, composition, readjustment, liquidation, dissolution or similar arrangement
under any present or future statute, law or regulation or files an answer admitting the material allegations of a petition filed
against it in any such proceeding, consents to or acquiesces in the appointment of a trustee, receiver, or liquidator of it or
of all or any substantial part of its assets or properties, or it or its shareholders shall take any action looking to its dissolution
or liquidation.

 

(e)          Within
sixty (60) days after the commencement of any proceedings against Medical Center seeking reorganization, arrangement, readjustment,
liquidation, dissolution or similar relief under any present or future statute, law or regulation, such proceedings shall not have
been dismissed, or if within thirty (30) days after the appointment without Medical Center's consent or acquiescence of any trustee,
receiver or liquidator of it or of all or any substantial part of its assets and properties, such appointment shall not be vacated.

 

Upon the occurrence of an Event of Default,
GKF may at its option do any or all of the following: (i) by notice to Medical Center, terminate this Agreement as to the Equipment
in default, wherever situated, and for such purposes, enter upon the Site without liability for so doing or GKF may cause Medical
Center and Medical Center hereby agrees to return the Equipment to GKF at Medical Center's sole cost and expense; (ii) recover
from, as liquidated damages for the loss of the bargain and not as a penalty, an amount equal to the present value of the unpaid
estimated future lease payments by Medical Center to GKF through the end of the Agreement term discounted at the rate of nine percent
(9%), which payment shall become immediately due and payable. Unpaid estimated future lease payments shall be based on the prior
12 months lease payments with an annual five (5%) percent increase; (iii) sell, dispose of, hold, use or lease the Equipment in
default, as GKF in its sole discretion may determine (and GKF shall not be obligated to give preference to the sale, lease or other
disposition of the Equipment over the sale, lease or other disposition of similar Equipment owned or leased by GKF). In any event,
Medical Center shall, without further demand, pay to GKF an amount equal to all sums due and payable for all periods up to and
including the date on which GKF had declared this Agreement to be in default.

 

     

     

    

 

In the event, that Medical
Center shall have paid to GKF the liquidated damages referred to in (iii) above, GKF hereby agrees to pay to Medical Center promptly
after receipt thereof, all rentals or proceeds received from the reletting or sale of the Equipment during the balance of the ten
(10) year initial Term (after deduction of all expenses incurred by GKF; said amount never to exceed the amount of the liquidated
damages paid by Medical Center). Medical Center agrees that GKF shall have no obligation to sell the Equipment. Medical Center
shall in any event remain fully liable for reasonable damages as provided by law for all costs and expenses incurred by GKF on
account of such default, including but not limited to, all court costs and reasonable attorneys' fees. Medical Center hereby agrees
that, in any event, it shall be liable for any deficiency after any sale, lease or other disposition of the Equipment by GKF. The
rights afforded GKF hereunder shall not be deemed to be exclusive, but shall be in addition to any other rights or remedies provided
by law.

 

20.         Events
of Default by GKF and Remedies.

 

20.1        The
occurrence of any one of the following shall constitute an Event of Default hereunder:

 

20.1.1           GKF
shall fail to observe or perform any of its covenants, duties or obligations arising under this Agreement and such failure shall
continue for a period of thirty (30) days after written notice thereof is given by Medical Center to GKF; however, if GKF cures
the default within the applicable thirty (30) day period or if the default reasonably requires more than thirty (30) days to cure,
GKF commences to cure the default during the initial thirty (30) day period and GKF diligently completes the cure as soon as reasonably
possible following the end of the thirty (30) day period, such default shall not constitute an Event of Default.

 

20.1.2           GKF
ceases doing business as a going concern, makes an assignment for the benefit of creditors, admits in writing its inability to
pay its debts as they become due, files a voluntary petition in bankruptcy, is adjudicated a bankrupt or an insolvent, files a
petition seeking for itself any reorganization, arrangement, composition, readjustment, liquidation, dissolution or similar arrangement
under any present or future statute, law or regulation or files an answer admitting the material allegations of a petition filed
against it in any such proceeding, consents to or acquiesces in the appointment of a trustee, receiver, or liquidator of it or
of all or any substantial part of its assets or properties, or it or its shareholders shall take any action looking to its dissolution
or liquidation.

 

20.1.3           Within
sixty (60) days after the commencement of any proceedings against GKF seeking reorganization, arrangement, readjustment, liquidation,
dissolution or similar relief under any present or future statute, law or regulation, such proceedings shall not have been dismissed,
or if within thirty (30) days after the appointment without GKF's consent or acquiescence of any trustee, receiver or liquidator
of it or of all or any substantial part of its assets and properties, such appointment shall not be vacated.

 

20.2         Upon
the occurrence of an Event of Default involving GKF, Medical Center may at its option do any or all of the following:

 

     

     

    

 

20.2.1           By
written notice to GKF, immediately terminate this Agreement as to the Equipment and, in such event, GKF shall remove the Equipment
at GKF's sole cost and expense or, in the absence of removal by GKF within a reasonable period of time after a written request
therefor, Medical Center may remove the Equipment with all due care and store the Equipment at GKF's sole cost and expense.

 

20.2.2           Seek
to recover from GKF such loss as may be realized by Medical Center in the ordinary course of events as a result of the Event of
Default.

 

20.3         GKF
shall in any event remain fully liable for reasonable damages as provided by law and for all costs and expenses incurred by Medical
Center on account of such default, including but not limited to, all court costs and reasonable attorneys' fees. However, notwithstanding
anything to the contrary set forth in this Agreement, GKF shall not in any manner be or become liable to Medical Center for any
consequential or incidental damages that may be suffered by Medical Center which arise out of or result from the Event of Default
or any breach by GKF of this Agreement. The rights and remedies afforded Medical Center under this Agreement shall be deemed cumulative
and not exclusive and shall be in addition to any other rights or remedies to GKF provided by law or in equity.

 

20.4         Notwithstanding
the occurrence of an Event of Default with respect to GKF (including any claim which would otherwise be in the nature of a set-off),
Medical Center shall fully perform and pay its obligations hereunder (including payment of all rent). Upon termination of this
Agreement or the exercise of any other rights or remedies under this Agreement or applicable law following an Event of Default,
Medical Center shall, without further request or demand, pay to GKF all rent payments and other sums owing under this Agreement
when and as due.

 

21.         Indemnification.

 

21.1         Medical
Center's Indemnity Agreement. Subject to provisions of this Agreement, Medical Center, for itself and its successors and assigns,
hereby indemnifies and holds GKF harmless from and against any loss, cost or expense (including reasonable attorneys' fees) arising
out of or relating in any manner to the failure of Hospital to properly perform any of its obligations to be performed under the
terms of this Agreement.

 

21.2         GKF's
Indemnity Agreement. Subject to provisions of this agreement, GKF, for itself and its successors and assigns, hereby indemnifies
and holds Hospital harmless from and against any loss, cost or expense (including reasonable attorneys' fees) arising out of or
relating in any manner to the failure of GKF to properly perform any of its obligations to be performed under the terms of this
Agreement.

 

22.         Insurance.

 

(a)          During
the ten (10) year initial Term of this Agreement (and any successive terms) GKF shall, at its own cost and expense, keep in effect
an all risk and hazard insurance policy covering the Equipment. The all risk and hazard insurance policy shall be for an amount
not less than the replacement cost of the Equipment. During the ten (10) year initial Term of this Agreement, Medical Center shall,
at its own cost and expense keep in effect public liability and professional liability insurance policies concerning the operation
of the Equipment by Medical Center. Said policies shall be in the amounts of not less than $1,000,000 per occurrence and $5,000,000
in aggregate per year. University and GKF, their successors and assigns, shall be named as additional insureds and/or loss payees
on the insurance policies maintained hereunder by the other party. Evidence of such insurance coverages shall be furnished by both
parties to the other party upon written request, by no later than the Commencement Date.

 

     

     

    

 

(b)          If
the Equipment is rendered unusable as a result of any physical damage to, or destruction of, the Equipment, Medical Center shall
give to GKF immediate notice. GKF shall determine, within thirty (30) days after the date of occurrence of such damage or destruction,
whether the Equipment can be repaired. In the event GKF determines that the Equipment cannot be repaired, GKF at its sole cost
and expense shall promptly replace the Equipment. This Agreement shall continue in full force and effect as though such damage
or destruction had not occurred. In the event GKF determines that the Equipment can be repaired, GKF shall cause the Equipment
to be promptly repaired.

 

23.         Notices.
Any notices required under this Agreement shall be sent in writing and shall be deemed to have been duly given if delivered by
hand or mailed by certified or registered mail to the following addresses:

 

	To GKF:	Chief Executive Officer 
	 	GKF Financing, LLC
	 	Four Embarcadero Center, Suite 3620 
	 	San Francisco, CA 94111
	 	 
	To Medical Center:	Chief Executive Officer
	 	Central Mississippi Medical Center 
	 	1850 Chadwick Drive
	 	Jackson, Mississippi 39204-3479

 

Or to such other addresses as either party
may specify for the reception of notice from time to time in writing to the other party. Any such notice shall be effective only
when actually received by the party to whom addressed.

 

24.         Integration/Supersedure.
This Agreement contains the full and entire Agreement between the parties hereto, and no oral or written understanding is of any
force or effect whatsoever unless expressly contained in a writing executed subsequent to the date of this Agreement.

 

25.         Waivers.
To the extent that GKF fails or chooses not to pursue any of its remedies under this Agreement or pursuant to applicable law, such
shall not prejudice GKF's rights to pursue any of those remedies at any future time and shall not constitute a waiver of GKF's
rights.

 

26.         Assignments.
This Agreement is binding upon and shall inure to the benefit of the permitted successors or assigns of the respective parties
hereto, except that neither party may assign its rights or obligations under this Agreement without the express written consent
of the other (which consent shall not be unreasonably withheld).

 

27.         Amendments.
This Agreement shall not be amended or altered in any manner unless such amendment or alteration is in a writing signed by both
parties.

 

28.         Record-Keeping
Requirements. To the extent required by the regulations promulgated by the Health Care Financing Administration pursuant to Section
952 of the Omnibus Reconciliation Act of 1980, GKF shall:

 

(a)          Until
the expiration of four (4) years following the furnishing of services pursuant to this Agreement, GKF agrees to make available
upon written request of the Secretary of Health and Human Services or the U.S. Comptroller General or any of their duly authorized
representatives, this Agreement, any books, documents and records necessary to verify the nature and extent of costs incurred by
Medical Center by reason of the activities of GKF under this Agreement; and

     

     

    

 

 

(b)          If
GKF elects to delegate any of its duties under this Agreement (which have a cost or value of Ten Thousand Dollars ($10,000.00)
or more over a twelve (12) month period) to a related organization, GKF may do so only through a subcontractor which is consented
to by Medical Center, it being understood that, inasmuch as Medical Center is entering into this Agreement in reliance on GKF's
reputation and expertise, that Medical Center shall be the sole judge of the reputation and expertise of the proposed delegee,
and only through a subcontractor which provides that, until the expiration of four (4) years following the furnishing of services
under such subcontract, the related organization shall make available, on request of the Secretary of Health and Human Services
or the U.S. Comptroller General or any of their authorized representatives, the subcontract, and books, documents and records of
the nature and extent of costs incurred by Medical Center by reason of activities of such related organization under such subcontract.
No delegation by GKF of its duties hereunder shall relieve GKF from liability hereunder.

 

29.         Miscellaneous
Provisions.

 

(a)          The
invalidity or unenforceability of any portion or provision of this Agreement shall not effect the validity or enforceability of
any other portion, nor shall either party's implied or express consent to the breach or waiver of any provision of this Agreement
constitute a waiver of such provision as to any subsequent breach.

 

(b)          In
the event of any claim or controversy arising hereunder, the prevailing party in such claim or controversy shall be entitled to
a reasonable attorneys' fee in addition to whatever other relief said party would be otherwise entitled.

 

(c)          Force
Majeure. Failure to perform by either party will be excused in the event of any delay or inability to perform its duties under
this Agreement directly or indirectly caused by conditions beyond its reasonable control including without limitation, fires, floods,
earthquakes, snow, ice, disasters, Acts of God, accidents, riots, wars, operation of law, strikes, governmental action or regulations,
shortages of labor, fuel, power, materials, manufacturer delays or transportation problems.

 

IN WITNESS WHEREOF, the parties have signed
this Agreement on the day and year first above written.

 

	Medical Center	GK Financing, LLC
	 	 
	By: /s/ Joseph Mullany	By: /s/ Craig K. Tagawa
	Joseph Mullany	Craig K. Tagawa
	Vice President, Mississippi Division	Chief Executive Officer
	 	 
	By: /s/ Timothy R. Parry	 
	Timothy R. Parry	 
	Vice President & General Counsel	 
	 	 
	By: /s/ Earl P. Holland	 
	Earl P. Holland	 
	Vice Chairman & Chief Operating Officer

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