Document:

Registration Rights Agreement dated as of June 21, 2005

 Exhibit 4.2 
  

REGISTRATION RIGHTS AGREEMENT 
  
 by and among 
  
 MSC-Medical Services Company 
  
 MCP-MSC Acquisition, Inc. 
  
 and 
  
 Banc of America Securities LLC 

J.P. Morgan Securities Inc. 
  
 Dated as of [•], 2005 

 REGISTRATION RIGHTS AGREEMENT 
  
 This Registration Rights Agreement (this “Agreement”) is made and entered into as of [•], 2005, by and among
MSC-Medical Services Company, a Florida corporation (the “Company”), MCP-MSC Acquisition, Inc., a Delaware corporation, as guarantor (“Holdings”) and Banc of America Securities LLC and J.P. Morgan Securities Inc. (each an
“Initial Purchaser” and, collectively, the “Initial Purchasers”), each of whom has agreed to purchase the Company’s Senior Secured Floating Rate Notes due 2012 (the “Initial Notes”) fully and unconditionally
guaranteed by Holdings (such guarantee being “the Guarantee”) pursuant to the Purchase Agreement (as defined below). The Initial Notes and the Guarantee attached thereto are herein collectively referred to as the “Initial
Securities.” 
  
 This Agreement is made pursuant to the
Purchase Agreement, dated as of [•], 2005 (the “Purchase Agreement”), by and among the Company, Holdings and the Initial Purchasers (i) for the benefit of each Initial Purchaser and (ii) for the benefit of the holders from
time to time of the Initial Securities (including each Initial Purchaser). In order to induce the Initial Purchasers to purchase the Initial Securities, the Company and Holdings have agreed to provide the registration rights set forth in this
Agreement. The execution and delivery of this Agreement is a condition to the obligations of the Initial Purchasers set forth in Section 5(h) of the Purchase Agreement. 
  
 The parties hereby agree as follows: 
  
 SECTION 1. Definitions. As used in this Agreement, the following capitalized terms shall have the
following meanings: 
  
 Additional Interest: As defined in
Section 5 hereof. 
  
 Broker-Dealer: Any broker or
dealer registered under the Exchange Act. 
  
 Business Day:
Any day other than a Saturday, Sunday or a day on which banking institutions in The City of New York or at a place of payment with respect to the Securities are authorized or required by law, regulation or executive order to remain closed.

  
 Closing Date: The date of this Agreement.

  
 Commission: The Securities and Exchange Commission.

  
 Consummate: The Exchange Offer shall be deemed
“Consummated” for purposes of this Agreement upon the occurrence of (i) the filing and effectiveness under the Securities Act of the Exchange Offer Registration Statement relating to the Exchange Notes to be issued in the Exchange
Offer, (ii) the maintenance of such Registration Statement continuously effective and the keeping of the Exchange Offer open for a period not less than the minimum period required pursuant to Section 3(b) hereof, and (iii) the
delivery by the Company to the Registrar under the Indenture of Exchange Securities in the same aggregate principal amount as the aggregate principal amount of Initial Securities that were tendered by Holders thereof pursuant to the Exchange Offer.

 Effectiveness Target Date: As defined in Section 5. 
  
 Exchange Act: The Securities Exchange Act of 1934, as amended.

  
 Exchange Offer: The registration by the Company under
the Securities Act of the Exchange Securities pursuant to a Registration Statement pursuant to which the Company offers the Holders of all outstanding Transfer Restricted Securities the opportunity to exchange all such outstanding Transfer
Restricted Securities held by such Holders for Exchange Securities in an aggregate principal amount equal to the aggregate principal amount of the Transfer Restricted Securities tendered in such exchange offer by such Holders. 
  
 Exchange Offer Registration Statement: The Registration Statement
relating to the Exchange Offer, including the related Prospectus. 
  
 Exempt Resales: The transactions in which the Initial Purchasers propose to sell the Initial Securities to certain “qualified institutional buyers,” as such term is defined in Rule 144A under the Securities Act, and to
non-U.S. persons pursuant to Regulation S under the Securities Act. 
  
 Exchange Securities: The [•]% Senior Secured Floating Rate Notes due 2012, of the same series under the Indenture as the Initial Securities, to be issued to Holders in exchange for Transfer Restricted Securities pursuant to this
Agreement. 
  
 Effectiveness Target Date: As defined in
Section 3(b) hereof. 
  
 Holders: As defined in
Section 2(b) hereof. 
  
 Indemnified Holder: As
defined in Section 8(a) hereof. 
  
 Indenture: The
Indenture, dated as of [•], 2005, among the Company, Holdings and [•], as trustee (the “Trustee”), pursuant to which the Securities are to be issued, as such Indenture is amended or supplemented from time to time in accordance
with the terms thereof. 
  
 Initial Placement: The issuance
and sale by the Company of the Initial Securities to the Initial Purchasers pursuant to the Purchase Agreement. 
  
 Initial Purchasers: As defined in the preamble hereto. 
  
 Initial Securities: As defined in the preamble hereto. 
  
 NASD: National Association of Securities Dealers, Inc. 
  
 Person: An individual, partnership, corporation, trust or unincorporated organization, or a government or agency or political subdivision thereof.

  
 Prospectus: The prospectus included in a Registration
Statement (including, without limitation, a prospectus that discloses information previously omitted from a prospectus filed as part of an effective registration statement in reliance upon Rule 430A under the Securities Act), 

  

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as amended or supplemented by any prospectus supplement and by all other amendments thereto, including post-effective amendments, and all material
incorporated by reference into such Prospectus. 
  
 Registration Default: As defined in Section 5 hereof. 
  
 Registration Statement: Any registration statement of the Company relating to (a) an offering of Exchange Securities pursuant to an Exchange Offer or (b) the registration for resale of Transfer
Restricted Securities pursuant to the Shelf Registration Statement, which is filed pursuant to the provisions of this Agreement, in each case, including the Prospectus included therein, all amendments and supplements thereto (including
post-effective amendments) and all exhibits and material incorporated by reference therein. 
  
 Securities: The Initial Securities and the Exchange Securities. 
  
 Securities Act: The Securities Act of 1933, as amended. 
  
 Shelf Filing Deadline: As defined in Section 4(a) hereof. 
  
 Shelf Registration Statement: As defined in Section 4(a) hereof. 
  
 Transfer Restricted Securities: Each Security, until the earliest to
occur of (a) the date on which such Security is exchanged in the Exchange Offer and entitled to be resold to the public by the Holder thereof without complying with the prospectus delivery requirements of the Securities Act, (b) the date
on which such Security has been effectively registered under the Securities Act and disposed of in accordance with a Shelf Registration Statement and (c) the date on which such Security is distributed to the public pursuant to Rule 144 under
the Securities Act or by a Broker-Dealer pursuant to the “Plan of Distribution” contemplated by the Exchange Offer Registration Statement (including delivery of the Prospectus contained therein). 
  
 Trust Indenture Act: The Trust Indenture Act of 1939, as amended and
in effect on the date hereof. 
  
 Underwritten Registration or
Underwritten Offering: A registration in which securities of the Company are sold to an underwriter for reoffering to the public. 
  
 SECTION 2. Securities Subject to this Agreement.  
  
 (a) Transfer Restricted Securities. The securities entitled to the benefits of this Agreement are the Transfer
Restricted Securities. 
  
 (b) Holders of Transfer Restricted
Securities. A Person is deemed to be a holder of Transfer Restricted Securities (each, a “Holder”) whenever such Person owns Transfer Restricted Securities. 
  

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 SECTION 3. Registered Exchange Offer.  
  
 (a) Unless the Exchange Offer shall not be permissible under applicable law
or Commission policy (after the procedures set forth in Section 6(a) below have been complied with), the Company and Holdings shall (i) cause to be filed with the Commission as soon as practicable after the Closing Date, but in no event
later than March 31, 2006, an Exchange Offer Registration Statement under the Securities Act relating to the Exchange Securities and the Exchange Offer, (ii) use their reasonable best efforts to cause the Exchange Offer Registration
Statement to become effective at the earliest possible time, but in no event later than June 30, 2006 (the “Effectiveness Target Date”), (iii) in connection with the foregoing, file (A) all pre-effective amendments to such
Registration Statement as may be necessary in order to cause such Registration Statement to become effective, (B) if applicable, a post-effective amendment to such Registration Statement pursuant to Rule 430A under the Securities Act and
(C) cause all necessary filings in connection with the registration and qualification of the Exchange Securities to be made under the state securities and Blue Sky laws of such jurisdictions as are necessary to permit Consummation of the
Exchange Offer, and (iv) upon the effectiveness of such Exchange Offer Registration Statement, commence the Exchange Offer. The Exchange Offer shall be on the appropriate form permitting registration of the Exchange Securities to be offered in
exchange for the Transfer Restricted Securities and to permit resales of Initial Securities held by Broker-Dealers as contemplated by Section 3(c) below. 
  

(b) The Company and Holdings shall cause the Exchange Offer Registration Statement to be effective continuously and shall keep the Exchange Offer open
for a period of not less than the minimum period required under applicable federal and state securities laws to Consummate the Exchange Offer; provided, however, that in no event shall such period be less than 30 days after the date notice of
the Exchange Offer is mailed to the Holders. The Company and Holdings shall cause the Exchange Offer to comply with all federal and state securities laws applicable to the Exchange Offer. No securities other than the Exchange Securities shall be
included in the Exchange Offer Registration Statement. The Company and Holdings shall use their best efforts to cause the Exchange Offer to be Consummated on the earliest practicable date after the Effectiveness Target Date but in no event later
than 40 Business Days after the Effectiveness Target Date. 
  
 (c)
The Company shall indicate in a “Plan of Distribution” section contained in the Prospectus forming a part of the Exchange Offer Registration Statement that any Broker-Dealer who holds Initial Securities that are Transfer Restricted
Securities and that were acquired for its own account as a result of market-making activities or other trading activities (other than Transfer Restricted Securities acquired directly from the Company), may exchange such Initial Securities pursuant
to the Exchange Offer; however, such Broker-Dealer may be deemed to be an “underwriter” within the meaning of the Securities Act and must, therefore, deliver a prospectus meeting the requirements of the Securities Act in connection with
any resales of the Exchange Securities received by such Broker-Dealer in the Exchange Offer, which prospectus delivery requirement may be satisfied by the delivery by such Broker-Dealer of the Prospectus contained in the Exchange Offer Registration
Statement. Such “Plan of Distribution” section shall also contain all other information with respect to such resales by Broker-Dealers that the Commission may require in order to permit such resales pursuant thereto, but such “Plan of
Distribution” shall not name any such Broker-Dealer or disclose the amount of Initial Securities 

  

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held by any such Broker-Dealer except to the extent required by the Commission as a result of a change in policy after the date of this Agreement.

  
 The Company and Holdings shall use their best efforts to keep
the Exchange Offer Registration Statement continuously effective, supplemented and amended as required by the provisions of Section 6(c) below to the extent necessary to ensure that it is available for resales of Initial Securities acquired by
Broker-Dealers for their own accounts as a result of market-making activities or other trading activities, and to ensure that it conforms with the requirements of this Agreement, the Securities Act and the policies, rules and regulations of the
Commission as announced from time to time, for a period ending on the earlier of (i) 180 days from the date on which the Exchange Offer Registration Statement is declared effective and (ii) the date on which a Broker-Dealer is no longer
required to deliver a prospectus in connection with market-making or other trading activities. 
  
 The Company and Holdings shall provide sufficient copies of the latest version of such Prospectus to Broker-Dealers promptly upon request at any time during such 180-day (or shorter as provided in the foregoing
sentence) period in order to facilitate such resales. 
  
 SECTION 4. Shelf Registration.  
  
 (a) Shelf Registration. If (i) the Company and Holdings are not required to file an Exchange Offer Registration Statement or to consummate the Exchange Offer because the Exchange Offer is not permitted by applicable law or
Commission policy (after the procedures set forth in Section 6(a) below have been complied with), (ii) for any reason, the Exchange Offer is not Consummated within 40 Business Days after the Effectiveness Target Date, or (iii) with
respect to any Holder of Transfer Restricted Securities (A) such Holder is prohibited by applicable law or Commission policy from participating in the Exchange Offer, or (B) such Holder may not resell the Exchange Securities acquired by it
in the Exchange Offer to the public without delivering a prospectus and that the Prospectus contained in the Exchange Offer Registration Statement is not appropriate or available for such resales by such Holder, or (C) such Holder is a
Broker-Dealer and holds Initial Securities acquired directly from the Company or one of its affiliates, then, upon such Holder’s request, the Company and Holdings shall: 
  
 (x) cause to be filed a shelf registration statement pursuant to Rule 415 under the Securities Act, which
may be an amendment to the Exchange Offer Registration Statement (in either event, the “Shelf Registration Statement”) as soon as practicable but in any event not later than the later of March 31, 2006 and 180 days after the date on
which such filing obligation arises pursuant to this Section 4(a) (such date being the “Shelf Filing Deadline”), which Shelf Registration Statement shall provide for resales of all Transfer Restricted Securities the Holders of which
shall have provided the information required pursuant to Section 4(b) hereof; and 
  
 (y) use their reasonable best efforts to cause such Shelf Registration Statement to be declared effective by the Commission on or prior to
the later of June 30, 2006 and 240 days after the Shelf Filing Deadline. 
  

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 The Company and Holdings shall use their best efforts to keep such Shelf Registration Statement
continuously effective, supplemented and amended as required by the provisions of Sections 6(b) and (c) hereof to the extent necessary to ensure that it is available for resales of Securities by the Holders of Transfer Restricted Securities
entitled to the benefit of this Section 4(a), and to ensure that it conforms with the requirements of the Securities Act and the policies, rules and regulations of the Commission as announced from time to time, until the earliest of
(i) two years following the effective date of such Shelf Registration Statement, (ii) the date on which all the Securities covered by such Shelf Registration Statement are no longer restricted securities (as defined in Rule 144 under the
Securities Act) and (iii) the date on which all the Securities covered by such Shelf Registration Statement have been sold pursuant to such Shelf Registration Statement. 
  
 (b) Provision by Holders of Certain Information in Connection with the Shelf Registration Statement. No Holder of
Transfer Restricted Securities may include any of its Transfer Restricted Securities in any Shelf Registration Statement pursuant to this Agreement unless and until such Holder furnishes to the Company in writing, within 20 Business Days after
receipt of a request therefor, such information as the Company may reasonably request for use in connection with any Shelf Registration Statement or Prospectus or preliminary Prospectus included therein. Each Holder as to which any Shelf
Registration Statement is being effected agrees to furnish promptly to the Company all information required to be disclosed in order to make the information previously furnished to the Company by such Holder not materially misleading. 
  
 SECTION 5. Additional Interest. If (i) any
Registration Statement required by this Agreement is not filed with the Commission on or prior to the date specified for such filing in this Agreement, (ii) any of such Registration Statements has not been declared effective by the Commission
on or prior to the Effectiveness Target Date, (iii) the Exchange Offer has not been Consummated within 40 Business Days after the Effectiveness Target Date with respect to the Exchange Offer Registration Statement or (iv) any Registration
Statement required by this Agreement is filed and declared effective but shall thereafter cease to be effective or fail to be usable for its intended purpose without being succeeded immediately by a post-effective amendment to such Registration
Statement that cures such failure and that is itself immediately declared effective (each such event referred to in clauses (i) through (iv), a “Registration Default”), the Company and Holdings hereby agree that the interest rate
borne by the Transfer Restricted Securities shall be increased by 0.25% per annum during the 90-day period immediately following the occurrence of any Registration Default and shall increase by an additional 0.25% per annum with respect to
each subsequent 90-day period, but in no event shall such increase exceed 1.00% per annum (all such additional interest being referred to as “Additional Interest”). Immediately following the cure of all Registration Defaults relating
to any particular Transfer Restricted Securities, the accrual of Additional Interest will cease and the interest rate borne by the relevant Transfer Restricted Securities will be reduced to the original interest rate borne by such Transfer
Restricted Securities; provided, however, that, if after any such reduction in interest rate, a different Registration Default occurs, the interest rate borne by the relevant Transfer Restricted Securities shall again be increased
pursuant to the foregoing provisions. 
  

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 All obligations of the Company and Holdings set forth in the preceding paragraph that are outstanding
with respect to any Transfer Restricted Security at the time such security ceases to be a Transfer Restricted Security shall survive until such time as all such obligations with respect to such Security shall have been satisfied in full. 

 
 SECTION 6. Registration Procedures. 

  
 (a) Exchange Offer Registration Statement. In
connection with the Exchange Offer, the Company and Holdings shall comply with all of the provisions of Section 6(c) below, shall use their best efforts to effect such exchange to permit the sale of Transfer Restricted Securities being sold in
accordance with the intended method or methods of distribution thereof, and shall comply with all of the following provisions: 
  
 (i) If in the reasonable opinion of counsel to the Company there is a question as to whether the Exchange Offer is permitted by applicable
law, the Company and Holdings hereby agree to seek a no-action letter or other favorable decision from the Commission allowing the Company and Holdings to Consummate an Exchange Offer for such Initial Securities. The Company and Holdings each hereby
agrees to pursue the issuance of such a decision to the Commission staff level but shall not be required to take commercially unreasonable action to effect a change of Commission policy. The Company and Holdings each hereby agrees, however, to
(A) participate in telephonic conferences with the Commission staff, (B) deliver to the Commission staff an analysis prepared by counsel to the Company setting forth the legal bases, if any, upon which such counsel has concluded that such
an Exchange Offer should be permitted and (C) diligently pursue a favorable resolution by the Commission staff of such submission. 
  
 (ii) As a condition to its participation in the Exchange Offer pursuant to the terms of this Agreement, each Holder of Transfer Restricted
Securities shall furnish, upon the request of the Company, prior to the Consummation thereof, a written representation to the Company (which may be contained in the letter of transmittal contemplated by the Exchange Offer Registration Statement) to
the effect that (A) it is not an affiliate of the Company, (B) it is not engaged in, and does not intend to engage in, and has no arrangement or understanding with any person to participate in, a distribution of the Exchange Securities to
be issued in the Exchange Offer and (C) it is acquiring the Exchange Securities in its ordinary course of business. In addition, all such Holders of Transfer Restricted Securities shall otherwise cooperate in the Company’s preparations for
the Exchange Offer. Each Holder hereby acknowledges and agrees that any Broker-Dealer and any such Holder using the Exchange Offer to participate in a distribution of the securities to be acquired in the Exchange Offer (1) could not under
Commission policy as in effect on the date of this Agreement rely on the position of the Commission enunciated in Morgan Stanley and Co., Inc. (available June 5, 1991) and Exxon Capital Holdings Corporation (available May 13, 1988), as
interpreted in the Commission’s letter to Shearman & Sterling dated July 2, 1993, and similar no-action letters (which may include any no-action letter obtained pursuant to clause (i) above), and (2) must comply with the
registration and prospectus delivery requirements of the Securities Act in connection with a secondary resale transaction and that such a secondary resale transaction should be covered by an effective registration statement containing the selling

  

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security holder information required by Item 507 or 508, as applicable, of Regulation S-K thereunder if the resales are of Exchange Securities obtained
by such Holder in exchange for Initial Securities acquired by such Holder directly from the Company. 
  
 (b) Shelf Registration Statement. In connection with the Shelf Registration Statement, the Company and Holdings shall comply with all the
provisions of Section 6(c) below and shall use their reasonable best efforts to effect such registration to permit the sale of the Transfer Restricted Securities being sold in accordance with the intended method or methods of distribution
thereof, and pursuant thereto the Company and Holdings will as expeditiously as possible prepare and file with the Commission a Registration Statement relating to the registration on any appropriate form under the Securities Act, which form shall be
available for the sale of the Transfer Restricted Securities in accordance with the intended method or methods of distribution thereof. 
  
 (c) General Provisions. In connection with any Registration Statement and any Prospectus required by this Agreement to permit the sale or resale of
Transfer Restricted Securities (including, without limitation, any Registration Statement and the related Prospectus required to permit resales of Securities by Broker-Dealers), the Company and Holdings shall: 
  
 (i) upon the occurrence of any event that would cause any
such Registration Statement or the Prospectus contained therein (A) to contain a material misstatement or omission or (B) not to be effective and usable for resale of Transfer Restricted Securities during the period required by this
Agreement, the Company and Holdings shall file promptly an appropriate amendment to such Registration Statement, in the case of clause (A), correcting any such misstatement or omission, and, in the case of either clause (A) or (B), use their
best efforts to cause such amendment to be declared effective and such Registration Statement and the related Prospectus to become usable for their intended purpose(s) as soon as practicable thereafter; 
  
 (ii) prepare and file with the Commission such amendments
and post-effective amendments to the Registration Statement as may be necessary to keep the Registration Statement effective for the applicable period set forth in Section 3 or 4 hereof, as applicable, or such shorter period as will terminate
when all Transfer Restricted Securities covered by such Registration Statement have been sold; cause the Prospectus to be supplemented by any required Prospectus supplement, and as so supplemented to be filed pursuant to Rule 424 under the
Securities Act, and to comply fully with the applicable provisions of Rules 424 and 430A under the Securities Act in a timely manner; and comply with the provisions of the Securities Act with respect to the disposition of all securities covered by
such Registration Statement during the applicable period in accordance with the intended method or methods of distribution by the sellers thereof set forth in such Registration Statement or supplement to the Prospectus; 
  
 (iii) advise the underwriter(s), if any, and Holders of the
Securities covered by any Shelf Registration Statement as soon as is reasonably practicable and, if requested by such Persons, to confirm such advice in writing, (A) when the Prospectus or any Prospectus supplement or post-effective amendment
has been filed, and, with respect to any Registration Statement or any post-effective amendment thereto, when the same has 

  

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become effective, (B) of any request by the Commission for amendments to the Registration Statement or amendments or supplements to the Prospectus or
for additional information relating thereto, (C) of the issuance by the Commission of any stop order suspending the effectiveness of the Registration Statement under the Securities Act or of the suspension by any state securities commission of
the qualification of the Transfer Restricted Securities for offering or sale in any jurisdiction, or the initiation of any proceeding for any of the preceding purposes, (D) of the existence of any fact or the happening of any event that makes
any statement of a material fact made in the Registration Statement, the Prospectus, any amendment or supplement thereto, or any document incorporated by reference therein untrue, or that requires the making of any additions to or changes in the
Registration Statement or the Prospectus in order to make the statements therein not misleading. If at any time the Commission shall issue any stop order suspending the effectiveness of the Registration Statement, or any state securities commission
or other regulatory authority shall issue an order suspending the qualification or exemption from qualification of the Transfer Restricted Securities under state securities or Blue Sky laws, the Company and Holdings shall use their best efforts to
obtain the withdrawal or lifting of such order at the earliest possible time; 
  
 (iv) furnish without charge to each of the Initial Purchasers, each of the underwriter(s), if any, and to any other Holder who so requests in writing, before filing with the Commission, copies of any Registration
Statement or any Prospectus included therein or any amendments or supplements to any such Registration Statement or Prospectus (including all documents incorporated by reference after the initial filing of such Registration Statement) and reflect in
each such document when filed with the Commission, such comments as the Holders and the underwriters reasonably propose; 
  
 (v) make available at reasonable times for inspection by the Initial Purchasers, any managing underwriter participating in any disposition
pursuant to such Registration Statement and any attorney or accountant retained by such Initial Purchasers or any of the underwriter(s), all financial and other records, pertinent corporate documents and properties of the Company and Holdings and
cause the Company’s and Holdings’ officers, directors and employees to supply all information reasonably requested by any such Holder, underwriter, attorney or accountant in connection with such Registration Statement subsequent to the
filing thereof and prior to its effectiveness; 
  
 (vi) if requested by any selling Holders or the underwriter(s), if any, promptly incorporate in any Registration Statement or Prospectus, pursuant to a supplement or post-effective amendment if necessary, such information as such selling
Holders and underwriter(s), if any, may reasonably request to have included therein, including, without limitation, information relating to the “Plan of Distribution” of the Transfer Restricted Securities, information with respect to the
principal amount of Transfer Restricted Securities being sold to such underwriter(s), the purchase price being paid therefor and any other terms of the offering of the Transfer Restricted Securities to be sold in such offering; and make all required
filings of such Prospectus supplement or post-effective amendment as soon as practicable after the Company is notified of the matters to be incorporated in such Prospectus supplement or post-effective amendment; 
  

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 (vii) cause the Transfer Restricted Securities covered by the Registration Statement to
be rated with the appropriate rating agencies, if so requested by the Holders of a majority in aggregate principal amount of Securities covered thereby or the underwriter(s), if any; 
  
 (viii) furnish to each Initial Purchaser, each selling Holder and each of the underwriter(s), if any,
without charge, at least one copy of the Registration Statement, as first filed with the Commission, and of each amendment thereto, including financial statements and schedules, all documents incorporated by reference therein and all exhibits
(including exhibits incorporated therein by reference); 
  
 (ix) deliver to each selling Holder and each of the underwriter(s), if any, without charge, as many copies of the Prospectus (including each preliminary prospectus) and any amendment or supplement thereto as such
Persons reasonably may request in writing; the Company and Holdings hereby consent to the use of the Prospectus and any amendment or supplement thereto by each of the selling Holders and each of the underwriter(s), if any, in connection with the
offering and the sale of the Transfer Restricted Securities covered by the Prospectus or any amendment or supplement thereto; 
  
 (x) in the case of any Shelf Registration Statement, the Company shall, enter into, and cause Holdings to enter into, such agreements
(including an underwriting agreement in customary form), and make, and cause Holdings to make, such representations and warranties, and take all such other actions in connection therewith in order to expedite or facilitate the disposition of the
Transfer Restricted Securities pursuant to any Registration Statement contemplated by this Agreement, all to such extent as may be requested by any Initial Purchaser or underwriter or the Holders of a majority in aggregate principal amount of
Securities covered by such Shelf Registration Statement in connection with any sale or resale pursuant to any Registration Statement contemplated by this Agreement; and whether or not an underwriting agreement is entered into and whether or not the
registration is an Underwritten Registration, the Company and Holdings shall: 
  
 (A) furnish to each Initial Purchaser, each selling Holder and each underwriter, if any, in such substance and scope as they may request and as are customarily made by issuers to underwriters in primary underwritten
offerings, upon the date of the Consummation of the Exchange Offer and, if applicable, the effectiveness of the Shelf Registration Statement: 
  
 (1) a certificate, dated the date of Consummation of the Exchange Offer or the date of effectiveness of the Shelf Registration Statement,
as the case may be, signed by (y) the President or any Vice President and (z) a principal financial or accounting officer of each of the Company and Holdings, confirming, as of the date thereof, the matters set forth in Section 5
(e) of the Purchase Agreement and such other matters as such parties may reasonably request; 

  

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 (2) opinions, dated the date of Consummation of the Exchange Offer or the date of
effectiveness of the Shelf Registration Statement, as the case may be, of counsel for the Company and Holdings, covering the matters set forth in Section 5(c) of the Purchase Agreement and such other matter as such parties may reasonably
request; and 
  
 (3) a customary comfort letter,
dated as of the date of Consummation of the Exchange Offer or the date of effectiveness of the Shelf Registration Statement, as the case may be, from the Company’s independent accountants, in the customary form and covering matters of the type
customarily covered in comfort letters by underwriters in connection with primary underwritten offerings, and affirming the matters set forth in the comfort letters delivered pursuant to Section 5(a) of the Purchase Agreement, without
exception; 
  
 (B) set forth in full or
incorporate by reference in the underwriting agreement, if any, the indemnification provisions and procedures of Section 8 hereof with respect to all parties to be indemnified pursuant to said Section; and 
  
 (C) deliver such other documents and certificates as may be
reasonably requested by such parties to evidence compliance with clause (A) above and with any customary conditions contained in the underwriting agreement or other agreement entered into by the Company or Holdings pursuant to this clause (xi),
if any. 
  
 (xi) prior to any public offering of
Transfer Restricted Securities, cooperate with, and cause Holdings to cooperate with, the selling Holders, the underwriter(s), if any, and their respective counsel in connection with the registration and qualification of the Transfer Restricted
Securities under the securities or Blue Sky laws of such jurisdictions as the selling Holders or underwriter(s) may request and do any and all other acts or things necessary or advisable to enable the disposition in such jurisdictions of the
Transfer Restricted Securities covered by the Shelf Registration Statement; provided, however, that neither the Company nor Holdings shall be required to register or qualify as a foreign corporation where it is not then so qualified or to
take any action that would subject it to the service of process in suits or to taxation, other than as to matters and transactions relating to the Registration Statement, in any jurisdiction where it is not then so subject; 
  
 (xii) issue, upon the request of any Holder of Initial
Securities covered by the Shelf Registration Statement, Exchange Securities, having an aggregate principal amount equal to the aggregate principal amount of Initial Securities surrendered to the Company by such Holder in exchange therefor or being
sold by such Holder; such Exchange Securities to be registered in the name of such Holder or in the name of the purchaser(s) of such Securities, as the case may be; in return, the Initial Securities held by such Holder shall be surrendered to the
Company for cancellation; 
  

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 (xiii) cooperate with, and cause Holdings to cooperate with, the selling Holders and the
underwriter(s), if any, to facilitate the timely preparation and delivery of certificates representing Transfer Restricted Securities to be sold and not bearing any restrictive legends; and enable such Transfer Restricted Securities to be in such
denominations and registered in such names as the Holders or the underwriter(s), if any, may request at least two Business Days prior to any sale of Transfer Restricted Securities made by such underwriter(s); 
  
 (xiv) use their best efforts to cause the Transfer
Restricted Securities covered by the Registration Statement to be registered with or approved by such other governmental agencies or authorities as may be necessary to enable the seller or sellers thereof or the underwriter(s), if any, to consummate
the disposition of such Transfer Restricted Securities, subject to the proviso contained in clause (xii) above; 
  
 (xv) if any fact or event contemplated by clause (c)(iii)(D) above shall exist or have occurred, prepare a supplement or post-effective
amendment to the Registration Statement or related Prospectus or any document incorporated therein by reference or file any other required document so that, as thereafter delivered to the purchasers of Transfer Restricted Securities, the Prospectus
will not contain an untrue statement of a material fact or omit to state any material fact necessary to make the statements therein not misleading; 
  
 (xvi) provide a CUSIP number for all Transfer Restricted Securities not later than the effective date of the Registration Statement and
provide the Trustee under the Indenture with printed certificates for the Transfer Restricted Securities which are in a form eligible for deposit with the Depositary Trust Company; 
  
 (xvii) cooperate and assist in any filings required to be made with the NASD and in the performance of any
due diligence investigation by any underwriter (including any “qualified independent underwriter”) that is required to be retained in accordance with the rules and regulations of the NASD; 
  
 (xviii) otherwise use their best efforts to comply with all
applicable rules and regulations of the Commission, and make generally available to their security holders, as soon as practicable, a consolidated earnings statement meeting the requirements of Rule 158 (which need not be audited) for the
twelve-month period (A) commencing at the end of any fiscal quarter in which Transfer Restricted Securities are sold to underwriters in a firm or best efforts Underwritten Offering or (B) if not sold to underwriters in such an offering,
beginning with the first month of the Company’s first fiscal quarter commencing after the effective date of the Registration Statement; 
  
 (xix) cause the Indenture to be qualified under the Trust Indenture Act in a timely manner, and in no event later than the effective date
of the first Registration Statement required by this Agreement, and containing such changes, if any, as shall be necessary for such qualification; in the event that such qualification would require the appointment of a new trustee under the
Indenture, the Company shall appoint a new trustee thereunder; 
  

 12 

 (xx) cause all Transfer Restricted Securities covered by the Registration Statement to be
listed on each securities exchange on which similar securities issued by the Company are then listed if requested by the Holders of a majority in aggregate principal amount of Initial Securities or the managing underwriter(s), if any; and

  
 (xxi) provide promptly to each Holder upon
request each document filed with the Commission pursuant to the requirements of Section 13 and Section 15 of the Exchange Act. 
  
 By its acquisition of a Transfer Restricted Security, each Holder agrees that, upon receipt of any notice from the Company of the existence of any fact of
the kind described in Section 6(c)(iii)(D) hereof, such Holder will forthwith discontinue disposition of Transfer Restricted Securities pursuant to the applicable Registration Statement until such Holder’s receipt of the copies of the
supplemented or amended Prospectus contemplated by Section 6(c)(xvi) hereof, or until it is advised in writing (the “Advice”) by the Company that the use of the Prospectus may be resumed, and has received copies of any additional or
supplemental filings that are incorporated by reference in the Prospectus. If so directed by the Company, each Holder will deliver to the Company (at the Company’s expense) all copies, other than permanent file copies then in such Holder’s
possession, of the Prospectus covering such Transfer Restricted Securities that was current at the time of receipt of such notice. In the event the Company shall give any such notice, the time period regarding the effectiveness of such Registration
Statement set forth in Section 3 or 4 hereof, as applicable, shall be extended by the number of days during the period from and including the date of the giving of such notice pursuant to Section 6(c)(iii)(D) hereof to and including the
date when each selling Holder covered by such Registration Statement shall have received the copies of the supplemented or amended Prospectus contemplated by Section 6(c)(xvi) hereof or shall have received the Advice; however, no such extension
shall be taken into account in determining whether Additional Interest is due pursuant to Section 5 hereof or the amount of such Additional Interest, it being agreed that the Company’s option to suspend use of a Registration Statement
pursuant to this paragraph shall be treated as a Registration Default for purposes of Section 5. 
  
 SECTION 7. Registration Expenses. 
  
 (a) All expenses incident to the Company’s or Holdings’ performance of or compliance with this Agreement will be borne by the Company or
Holdings, jointly and severally, regardless of whether a Registration Statement becomes effective, including without limitation: (i) all registration and filing fees and expenses (including filings made by any Initial Purchaser or Holder with
the NASD (and, if applicable, the fees and expenses of any “qualified independent underwriter” and its counsel that may be required by the rules and regulations of the NASD)); (ii) all fees and expenses of compliance with federal
securities and state Blue Sky or securities laws; (iii) all expenses of printing (including printing certificates for the Exchange Securities to be issued in the Exchange Offer and printing of Prospectuses), messenger and delivery services and
telephone; (iv) all fees and disbursements of counsel for the Company, Holdings and, subject to Section 7(b) below, the Holders of Transfer Restricted Securities; (v) all application and filing fees in connection with listing the
Exchange Securities on a national securities exchange or automated quotation system pursuant to the requirements thereof; and (vi) all fees and disbursements of independent certified public accountants of the Company and Holdings (including the
expenses of any special audit and comfort letters required by or incident to such performance). 
  

 13 

 Each of the Company and Holdings will, in any event, bear their internal expenses (including, without
limitation, all salaries and expenses of their respective officers and employees performing legal or accounting duties), the expenses of any annual audit and the fees and expenses of any Person, including special experts, retained by the Company or
Holdings, as the case may be. 
  
 (b) In connection with any
Registration Statement required by this Agreement (including, without limitation, the Exchange Offer Registration Statement and the Shelf Registration Statement), the Company and Holdings jointly and severally agree to reimburse the Initial
Purchasers and the Holders of Transfer Restricted Securities being tendered in the Exchange Offer and/or resold pursuant to the “Plan of Distribution” contained in the Exchange Offer Registration Statement or registered pursuant to the
Shelf Registration Statement, as applicable, for the reasonable fees and disbursements of not more than one counsel, who shall be Shearman & Sterling LLP or such other counsel as may be chosen by the Holders of a majority in principal
amount of the Transfer Restricted Securities for whose benefit such Registration Statement is being prepared. 
  
 SECTION 8. Indemnification. 
  
 (a) The Company and Holdings jointly and severally agree to indemnify and hold harmless (i) each Holder and (ii) each person, if any, who
controls (within the meaning of Section 15 of the Securities Act or Section 20 of the Exchange Act) any Holder (any of the persons referred to in this clause (ii) being hereinafter referred to as a “controlling person”) and
(iii) the respective officers, directors, partners, employees, representatives and agents of any Holder or any controlling person (any person referred to in clause (i), (ii) or (iii) may hereinafter be referred to as an
“Indemnified Holder”), to the fullest extent lawful, from and against any and all losses, claims, damages, liabilities, judgments, actions and expenses (including without limitation and as incurred, reimbursement of all reasonable costs of
investigating, preparing, pursuing, settling, compromising, paying or defending any claim or action, or any investigation or proceeding by any governmental agency or body, commenced or threatened, including the reasonable fees and expenses of
counsel to any Indemnified Holder), joint or several, directly or indirectly caused by, related to, based upon, arising out of or in connection with any untrue statement or alleged untrue statement of a material fact contained in any Registration
Statement or Prospectus (or any amendment 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, except insofar as such
losses, claims, damages, liabilities or expenses are caused by an untrue statement or omission or alleged untrue statement or omission that is made in reliance upon and in conformity with information relating to any of the Holders furnished in
writing to the Company by any of the Holders expressly for use therein. This indemnity agreement shall be in addition to any liability which the Company or Holdings may otherwise have. 
  
 In case any action or proceeding (including any governmental or regulatory investigation or proceeding) shall be brought or
asserted against any of the Indemnified Holders with respect 

  

 14 

 
to which indemnity may be sought against the Company or Holdings, such Indemnified Holder (or the Indemnified Holder controlled by such controlling person)
shall promptly notify the Company and Holdings in writing (provided, that the failure to give such notice shall not relieve the Company or Holdings of their respective obligations pursuant to this Agreement). Such Indemnified Holder shall
have the right to employ its own counsel in any such action and the fees and expenses of such counsel shall be paid, as incurred, by the Company and Holdings (regardless of whether it is ultimately determined that an Indemnified Holder is not
entitled to indemnification hereunder). The Company and Holdings shall not, in connection with any one such action or proceeding or separate but substantially similar or related actions or proceedings in the same jurisdiction arising out of the same
general allegations or circumstances, be liable for the reasonable fees and expenses of more than one separate firm of attorneys (in addition to any local counsel) at any time for such Indemnified Holders, which firm shall be designated by the
Holders. The Company and Holdings shall be jointly and severally liable for any settlement of any such action or proceeding effected with the Company’s or Holdings’ prior written consent, which consent shall not be withheld unreasonably,
and the Company and Holdings jointly and severally agree to indemnify and hold harmless any Indemnified Holder from and against any loss, claim, damage, liability or expense by reason of any settlement of any action effected with the written consent
of the Company or Holdings. Neither the Company nor Holdings shall, without the prior written consent of each Indemnified Holder, settle or compromise or consent to the entry of judgment in or otherwise seek to terminate any pending or threatened
action, claim, litigation or proceeding in respect of which indemnification or contribution may be sought hereunder (whether or not any Indemnified Holder is a party thereto), unless such settlement, compromise, consent or termination includes an
unconditional release of each Indemnified Holder from all liability arising out of such action, claim, litigation or proceeding. 
  
 (b) Each Holder of Transfer Restricted Securities agrees, severally and not jointly, to indemnify and hold harmless the Company and Holdings and their
respective directors and officers who sign a Registration Statement, and any person controlling (within the meaning of Section 15 of the Securities Act or Section 20 of the Exchange Act) the Company, and the respective officers, directors,
partners, employees, representatives and agents of each such person, to the same extent as the foregoing indemnity from the Company and Holdings to each of the Indemnified Holders, but only with respect to claims and actions based on information
relating to such Holder furnished in writing by such Holder expressly for use in any Registration Statement; and, subject to the foregoing clause, the Company and Holdings shall have the right to employ their own counsel in any such action and the
fees and expenses of such counsel shall be paid, as incurred, by each Holder of Transfer Restricted Securities. In case any action or proceeding shall be brought against the Company, any Guarantor, or their respective directors or officers or any
such controlling person in respect of which indemnity may be sought against a Holder of Transfer Restricted Securities, such Holder shall have the rights and duties given the Company or Holdings, as the case may be, and the Company, Holdings or
their directors or officers or such controlling person shall have the rights and duties given to each Holder by the preceding paragraph. 
  
 (c) If the indemnification provided for in this Section 8 is unavailable to an indemnified party under Section 8(a) or Section 8(b) hereof
(other than by reason of exceptions provided in those Sections) in respect of any losses, claims, damages, liabilities, judgments, actions or expenses referred to therein, then each applicable indemnifying party, in lieu of indemnifying 

  

 15 

 
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 in such proportion as is appropriate to reflect the relative benefits received by the Company and Holdings, on the one hand, and the Holders, on the other hand, from the Initial Placement (which in the case of the Company and Holdings shall
be deemed to be equal to the total gross proceeds from the Initial Placement as set forth on the cover page of the Offering Memorandum (as defined in the Purchase Agreement)), the amount of Additional Interest which did not become payable as a
result of the filing of the Registration Statement resulting in such losses, claims, damages, liabilities, judgments actions or expenses, and such Registration Statement, or if such allocation is not permitted by applicable law, the relative fault
of the Company and Holdings on the one hand, and of the Indemnified Holder, on the other hand, in connection with the statements or omissions which resulted in such losses, claims, damages, liabilities or expenses, as well as any other relevant
equitable considerations. The relative fault of the Company and Holdings on the one hand and of the Indemnified Holder 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 the Company and Holdings or by the Indemnified Holder and the parties’ relative intent, knowledge, access to information and opportunity to
correct or prevent such statement or omission. The amount paid or payable by a party as a result of the losses, claims, damages, liabilities and expenses referred to above shall be deemed to include, subject to the limitations set forth in the
second paragraph of Section 8(a), any legal or other fees or expenses reasonably incurred by such party in connection with investigating or defending any action or claim. 
  
 The Company, Holdings and each Holder of Transfer Restricted Securities agree that it would not be just and equitable if
contribution pursuant to this Section 8(c) were determined by pro rata allocation (even if the Holders 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, liabilities or expenses 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 provisions of this Section 8, none
of the Holders (and its related Indemnified Holders) shall be required to contribute, in the aggregate, any amount in excess of the amount by which the total discount received by such Holder with respect to the Initial Securities exceeds the amount
of any damages which such Holder has otherwise been required to pay by reason of such untrue or alleged untrue statement or omission or alleged omission. 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. The Holders’ obligations to contribute pursuant to this Section 8(c) are several in proportion to the respective
principal amount of Initial Securities held by each of the Holders hereunder and not joint. 
  
 SECTION 9. Rule 144A. The Company and Holdings each hereby agrees with each Holder, for so long as any Transfer Restricted Securities remain outstanding, to make available to any
Holder or beneficial owner of Transfer Restricted Securities in connection with any sale thereof and any prospective purchaser of such Transfer Restricted Securities from such Holder or beneficial owner, the information required by Rule 144A(d)(4)
under the Securities Act in order 

  

 16 

 
to permit resales of such Transfer Restricted Securities pursuant to Rule 144A under the Securities Act. 
  
 SECTION 10. Participation In Underwritten
Registrations. No Holder may participate in any Underwritten Registration hereunder unless such Holder (a) agrees to sell such Holder’s Transfer Restricted Securities on the basis provided in any underwriting arrangements approved by
the Persons entitled hereunder to approve such arrangements and (b) completes and executes all reasonable questionnaires, powers of attorney, indemnities, underwriting agreements, lock-up letters and other documents required under the terms of
such underwriting arrangements. 
  
 SECTION 11. Selection Of Underwriters. The Holders of Transfer Restricted Securities covered by the Shelf Registration Statement who desire to do so may sell such Transfer Restricted Securities in an
Underwritten Offering. In any such Underwritten Offering, the investment banker or investment bankers and manager or managers that will administer the offering will be selected by the Holders of a majority in aggregate principal amount of the
Transfer Restricted Securities included in such offering; provided, that such investment bankers and managers must be reasonably satisfactory to the Company. 
  
 SECTION 12. Miscellaneous.  
  
 (a) Remedies. The Company and Holdings each hereby agrees that monetary damages would not be adequate compensation
for any loss incurred by reason of a breach by it of the provisions of this Agreement and hereby agree to waive the defense in any action for specific performance that a remedy at law would be adequate. 
  
 (b) No Inconsistent Agreements. The Company will not, and will cause
Holdings not to, on or after the date of this Agreement enter into any agreement with respect to its securities that is inconsistent with the rights granted to the Holders in this Agreement or otherwise conflicts with the provisions hereof. Neither
the Company nor Holdings has entered into any agreement granting any registration rights with respect to its securities to any Person. The rights granted to the Holders hereunder do not in any way conflict with and are not inconsistent with the
rights granted to the holders of the Company’s securities under any agreement in effect on the date hereof. 
  
 (c) Adjustments Affecting the Securities. Neither the Company nor Holdings will take any action, or permit any change to occur, with respect to the
Securities that would materially and adversely affect the ability of the Holders to Consummate any Exchange Offer. 
  
 (d) Amendments and Waivers. The provisions of this Agreement may not be amended, modified or supplemented, and waivers or consents to or departures
from the provisions hereof may not be given unless the Company has obtained the written consent of Holders of a majority of the outstanding principal amount of Transfer Restricted Securities. Notwithstanding the foregoing, a waiver or consent to
departure from the provisions hereof that relates exclusively to the rights of Holders whose securities are being tendered pursuant to the Exchange Offer and that does not affect directly or indirectly the rights of other Holders whose securities
are not being tendered pursuant to such Exchange Offer may be given by the Holders of a majority of the outstanding principal amount of Transfer Restricted Securities being tendered or registered; 

  

 17 

 
provided that, with respect to any matter that directly or indirectly affects the rights of any Initial Purchaser hereunder, the Company shall obtain the
written consent of each such Initial Purchaser with respect to which such amendment, qualification, supplement, waiver, consent or departure is to be effective. 
  

(e) Notices. All notices and other communications provided for or permitted hereunder shall be made in writing by hand-delivery, first-class
mail (registered or certified, return receipt requested), telex, telecopier, or air courier guaranteeing overnight delivery: 
  
 (i) if to a Holder, at the address set forth on the records of the Registrar under the Indenture, with a copy to the Registrar under the
Indenture; 
  
 (ii) if to the Initial Purchasers:

  
 Banc of America Securities LLC 
 9 West 57th Street

 New York, NY 10019 
 Facsimile: (212) 847-6441 
 Attention: High Yield Capital Markets 
  
 with a copy to: 
  
 Shearman & Sterling LLP 
 599 Lexington Avenue 
 New York, NY 10022

 Facsimile: (212) 848-4000 
 Attention: Rohan Weerasinghe, Esq. 
  
 (iii) if to the Company and/or Holdings: 
  
 MSC-Medical Services Company 
 11764-1 Marco Beach Dr. 
 Jacksonville, Florida 32224 
 Facsimile:
(800) 848-1989 
 Attention: Chief Executive Officer 
  
 With a copy to: 
  
 Monitor Clipper Partners, LLC 
 Two Coral
Park, 4th Floor 
 Cambridge, MA 02141 
 Facsimile: (617) 252-2211 
 Attention: Adam Doctoroff 
  
 Ropes & Gray LLP 
 One
International Place 
 Boston, MA 02110-2624 
 Facsimile: (617) 951-7050 
 Attention: Jane Goldstein, Esq. 
  

 18 

 All such notices and communications shall be deemed to have been duly given: at the time delivered by
hand, if personally delivered; five Business Days after being deposited in the mail, postage prepaid, if mailed; when answered back, if telexed; when receipt acknowledged, if telecopied; and on the next business day, if timely delivered to an air
courier guaranteeing overnight delivery. 
  
 Copies of all such
notices, demands or other communications shall be concurrently delivered by the Person giving the same to the Trustee at the address specified in the Indenture. 
  

(f) Successors and Assigns. This Agreement shall inure to the benefit of and be binding upon the successors and assigns of each of the parties,
including without limitation and without the need for an express assignment, subsequent Holders of Transfer Restricted Securities; provided, however, that this Agreement shall not inure to the benefit of or be binding upon a successor or
assign of a Holder unless and to the extent such successor or assign acquired Transfer Restricted Securities from such Holder. 
  
 (g) Counterparts. This Agreement may be executed in any number of counterparts and by the parties hereto in separate counterparts, each of which
when so executed shall be deemed to be an original and all of which taken together shall constitute one and the same agreement. 
  
 (h) Headings. The headings in this Agreement are for convenience of reference only and shall not limit or otherwise affect the meaning hereof.

  
 (i) Governing Law. THIS AGREEMENT SHALL BE GOVERNED BY
AND CONSTRUED IN ACCORDANCE WITH THE LAWS OF THE STATE OF NEW YORK. 
  
 (j) Severability. In the event that any one or more of the provisions contained herein, or the application thereof in any circumstance, is held invalid, illegal or unenforceable, the validity, legality and enforceability of any such
provision in every other respect and of the remaining provisions contained herein shall not be affected or impaired thereby. 
  
 (k) Entire Agreement. This Agreement is intended by the parties as a final expression of their agreement and intended to be a complete and
exclusive statement of the agreement and understanding of the parties hereto in respect of the subject matter contained herein. There are no restrictions, promises, warranties or undertakings, other than those set forth or referred to herein with
respect to the registration rights granted by the Company with respect to the Transfer Restricted Securities. This Agreement supersedes all prior agreements and understandings between the parties with respect to such subject matter. 
  

 19 

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

  

			
	MSC-Medical Services Company
		
	By:	 	 /S/ ROBERT J. BUNKER

	 	 	 Name:  Robert J. Bunker

	 	 	 Title:    President

  

			
	MCP-MSC Acquisition, Inc.
		
	By:	 	 /S/ ROBERT J. BUNKER

	 	 	 Name:  Robert J. Bunker

	 	 	 Title:    Chief Executive Officer

  
 The foregoing
Registration Rights Agreement is hereby confirmed and accepted as of the date first above written: 
  

			
	BANC OF AMERICA SECURITIES LLC
J.P. MORGAN SECURITIES INC.
	
	By: Banc of America Securities LLC
		
	By:	 	/S/    JOHN MCCUSKER
	 	 	Name: John McCusker
	 	 	Title: Managing Director

  

 20Purchase Agreement dated June 15, 2005

 Exhibit 4.3 
  
 EXECUTION COPY 
  
 MSC-Medical Services Company 
  
 MCP-MSC Acquisition, Inc. 
  
 $150,000,000 
  
 Senior Secured Floating Rate Notes due 2011 
  
 PURCHASE AGREEMENT 
  
 dated June 15, 2005 
  
 Banc of America Securities LLC 
 J.P. Morgan Securities Inc. 

 PURCHASE AGREEMENT 
  
 June 15, 2005 
  
 BANC OF AMERICA SECURITIES LLC 
 J.P. MORGAN SECURITIES INC. 
 As Initial Purchasers 
 c/o Banc of America Securities LLC

 9 West 57th Street

 New York, New York 10019 
  
 Ladies and Gentlemen: 
  
 Introductory. MSC-Medical Services Company, a Florida corporation (the “Company”), proposes to issue and sell to the several Initial
Purchasers named in Schedule A hereto (the “Initial Purchasers”), acting severally and not jointly, the respective amounts set forth in such Schedule A of $150,000,000 aggregate principal amount of the Company’s Senior
Secured Floating Rate Notes due 2011 (the “Notes”). Banc of America Securities LLC and J.P. Morgan Securities Inc. have agreed to act as the Initial Purchasers in connection with the offering and sale of the Notes. 
  
 The Notes will be issued pursuant to an indenture, to be dated on or about
June 21, 2005 (the “Indenture”), between the Company, MCP-MSC Acquisition, Inc., the parent corporation of the Company, as guarantor (the “Holdings”) and U.S. Bank National Association, as trustee (the “Trustee”).
Notes issued in book-entry form will be issued in the name of Cede & Co., as nominee of The Depository Trust Company (the “Depository”) pursuant to a letter of representations, to be dated on or before the Closing Date (as defined
in Section 2) (the “DTC Agreement”), among the Company, the Trustee and the Depository. 
  
 The holders of the Notes will be entitled to the benefits of a registration rights agreement, to be dated on or about June 21, 2005 (the
“Registration Rights Agreement”), among the Company, Holdings and the Initial Purchasers, substantially in the form of Exhibit C hereto, pursuant to which the Company and Holdings will agree to file on or prior to March 31, 2006
a registration statement with the Securities and Exchange Commission (the “Commission”) registering the Exchange Securities (as defined below) under the Securities Act of 1933, as amended (the “Securities Act”, which term, as
used herein, includes the rules and regulations of the Commission promulgated thereunder). 

 The payment of principal of, premium, interest and, Additional Interest (as defined in the Registration
Rights Purchase Agreement) if any, on the Notes and the Exchange Notes (as defined below) will be fully and unconditionally guaranteed on a senior secured basis by (i) Holdings, the direct parent corporation of the Company, and (ii) any
domestic subsidiary of the Company formed or acquired after the Closing Date that executes an additional guarantee in accordance with the terms of the Indenture, and their respective successors and assigns (each guarantee described in
clause (i) or (ii) being a “Guarantee”). The Notes and the Guarantees attached thereto are herein collectively referred to as the “Securities”; and the Exchange Notes and the Guarantees attached thereto are herein
collectively referred to as the “Exchange Securities”. 
  
 Pursuant to the security and pledge documents to be dated as of the Closing Date (together, the “Security Documents”) each among the Company, Holdings, U.S. Bank National Association as collateral agent (the “Collateral
Agent”), and the other parties thereto, the Securities are secured by a lien on substantially all of the Company’s and Holdings’ existing and future tangible and intangible property and assets, as well as 100% of the capital stock of
the Company and each domestic subsidiary of the Company and Holdings and 65% of the capital stock of each direct foreign subsidiary of the Company and Holdings, as so described in the Security Documents, subject to the limitations specified therein
(the “Collateral”). Pursuant to an intercreditor agreement among the Collateral Agent, the administrative agent under the Revolving Credit Agreement (as defined below), the Company and Holdings, the lien created by the Security Documents
is subordinated in rank to the lien on the Collateral created by the security agreements entered into by the Company, Holdings and such administrative agent to secure the Company’s and Holdings obligations under the Revolving Credit Agreement.

  
 The Securities are being issued and sold in connection with
the refinancing (the “Refinancing”) of a portion of the Company’s indebtedness incurred in connection with the acquisition of the Company by investment funds affiliated with Monitor Clipper Partners, LLC, certain institutional
investors and members of the Company’s management, which was completed on March 31, 2005. 
  
 The Company understands that the Initial Purchasers propose to make an offering of the Securities on the terms and in the manner set forth herein and in
the Offering Memorandum (as defined below) and agrees that the Initial Purchasers may resell, subject to the conditions set forth herein, all or a portion of the Securities to purchasers (the “Subsequent Purchasers”) at any time after the
date of this Agreement. The Securities are to be offered and sold to or through the Initial Purchasers without being registered with the Commission under the Securities Act, in reliance upon exemptions therefrom. The terms of the Securities and the
Indenture will require that investors that acquire Securities expressly agree that Securities may only be resold or otherwise transferred, after the date hereof, if such Securities are registered for sale under the Securities Act or if an exemption
from the registration requirements of the Securities Act is available (including the exemptions afforded by Rule 144A (“Rule 144A”) or Regulation S (“Regulation S”) thereunder). 
  
 The Company has prepared and delivered to each Initial Purchaser copies of a
Preliminary Offering Memorandum, dated June 3, 2005 (the “Preliminary Offering Memorandum”), and has prepared and will deliver to each Initial Purchaser, copies of the 

  

 2 

 
Offering Memorandum, describing the terms of the Securities, each for use by such Initial Purchaser in connection with its solicitation of offers to purchase
the Securities. As used herein, the “Offering Memorandum” shall mean, with respect to any date or time referred to in this Agreement, the Company’s Offering Memorandum, dated June 15, 2005, including amendments or supplements
thereto and any exhibits thereto, in the most recent form that has been prepared and delivered by the Company to the Initial Purchasers in connection with their solicitation of offers to purchase the Securities. Further, any reference to the
Preliminary Offering Memorandum or the Offering Memorandum shall be deemed to refer to and include any Additional Issuer Information (as defined in Section 3) furnished by the Company pursuant to Section 3. 
  
 The Company and Holdings hereby confirm their agreements with the Initial
Purchasers as follows: 
  
 SECTION 1.
Representations and Warranties. The Company and Holdings, jointly and severally, hereby represent, warrant and covenant to each Initial Purchaser as follows: 
  
 (a) No Registration Required. Subject to compliance by the Initial Purchasers with the representations and warranties
set forth in Section 2 hereof and with the procedures set forth in Section 7 hereof, it is not necessary in connection with the offer, sale and delivery of the Securities to the Initial Purchasers and to each Subsequent Purchaser in the
manner contemplated by this Agreement and the Offering Memorandum to register the Securities under the Securities Act or, until such time as the Exchange Securities are issued pursuant to an effective registration statement, to qualify the Indenture
under the Trust Indenture Act of 1939 (the “Trust Indenture Act,” which term, as used herein, includes the rules and regulations of the Commission promulgated thereunder). 
  
 (b) No Integration of Offerings or General Solicitation. Neither the Company nor Holdings has, directly or
indirectly, solicited any offer to buy or offered to sell, and will not, directly or indirectly, solicit any offer to buy or offer to sell, in the United States or to any United States citizen or resident, any security which is or would be
integrated with the sale of the Securities in a manner that would require the Securities to be registered under the Securities Act. 
  
 None of the Company, Holdings, their respective affiliates (as such term is defined in Rule 501 under the Securities Act (each, an
“Affiliate”) or any person acting on any of their behalf (other than the Initial Purchasers, as to whom neither the Company nor Holdings makes any representation or warranty) has engaged or will engage, in connection with the offering of
the Securities, in any form of general solicitation or general advertising within the meaning of Rule 502 under the Securities Act. 
  
 With respect to those Securities sold in reliance upon Regulation S, (i) none of the Company, Holdings, their respective Affiliates or any
person acting on any of their behalf (other than the Initial Purchasers, as to whom neither the Company nor Holdings makes any representation or warranty) has engaged or will engage in any directed selling efforts within the meaning of
Regulation S and (ii) each of the Company, Holdings, each of their respective Affiliates and any person acting on any of their behalf (other than the Initial Purchasers, as to whom neither the 

  

 3 

 
Company nor Holdings makes any representation or warranty) has complied and will comply with the offering restrictions set forth in Regulation S.

  
 (c) Eligibility for Resale Under Rule 144A. The
Securities, when issued, will be eligible for resale pursuant to Rule 144A and will not be, at the Closing Date, of the same class as securities listed on a national securities exchange registered under Section 6 of the Securities Exchange
Act of 1934, as amended (the “Exchange Act”, which term, as used herein, includes the rules and regulations of the Commission promulgated thereunder) or quoted in a U.S. automated interdealer quotation system. 
  
 (d) The Offering Memorandum. The Offering Memorandum does not, and at
the Closing Date will not, include an untrue statement of a material fact or omit to state a material fact necessary in order to make the statements therein, in the light of the circumstances under which they were made, not misleading; provided that
this representation, warranty and agreement shall not apply to statements in or omissions from the Offering Memorandum made in reliance upon and in conformity with information furnished to the Company in writing by any Initial Purchaser through Banc
of America Securities LLC expressly for use in the Offering Memorandum. Each of the Preliminary Offering Memorandum and the Offering Memorandum, as of its respective date, contains all the information specified in, and meeting the requirements of,
Rule 144A(d)(4). Neither the Company nor Holdings has distributed or will distribute, prior to the later of the Closing Date and the completion of the Initial Purchasers’ distribution of the Securities, any offering material in connection
with the offering and sale of the Securities other than the Preliminary Offering Memorandum, the Offering Memorandum or as otherwise agreed upon by the Initial Purchasers. 
  
 (e) The Purchase Agreement. This Agreement has been duly authorized, executed and delivered by the Company and
Holdings, and, assuming the due authorization, execution and delivery thereof by the Initial Purchasers, is a valid and binding agreement of, each of the Company and Holdings, enforceable in accordance with its terms, except as rights to
indemnification hereunder may be limited by applicable law or considerations of public policy and except as the enforcement hereof may be limited by bankruptcy, insolvency, reorganization, moratorium or other similar laws relating to or affecting
the rights and remedies of creditors or by general equitable principles and except as rights to indemnification under the Registration Rights Agreement may be limited by applicable law or considerations of public policy. 
  
 (f) The Registration Rights Agreement. The Registration Rights
Agreement has been duly authorized and, at the Closing Date, will have been duly executed and delivered by, and, assuming the due authorization, execution and delivery by the Initial Purchasers, will be a valid and binding agreement of, each of the
Company and Holdings, enforceable in accordance with its terms, except as the enforcement thereof may be limited by bankruptcy, insolvency, reorganization, moratorium or other similar laws relating to or affecting the rights and remedies of
creditors or by general equitable principles and except as rights to indemnification may be limited by applicable law or considerations of public policy. Pursuant to the Registration Rights Agreement, the Company will agree to file with the
Commission, under the circumstances set forth therein, (i) a registration statement under the Securities Act relating to another series of debt securities of the Company with terms substantially identical to the Notes (the “Exchange
Notes”) to be offered in exchange for the Notes (the “Exchange Offer”) and (ii) to the extent 

  

 4 

 
required by the Registration Rights Agreement, a shelf registration statement pursuant to Rule 415 of the Securities Act relating to the resale by
certain holders of the Notes, and in each case, to use its best efforts to cause such registration statements to be declared effective. 
  
 (g) The DTC Agreement. At the Closing Date, the DTC Agreement will have been duly authorized and duly executed and delivered by, and, assuming due
authorization, execution and delivery thereof by the Depository, will be a valid and binding agreement of, the Company, enforceable in accordance with its terms, except as the enforcement thereof may be limited by bankruptcy, insolvency,
reorganization, moratorium or other similar laws relating to or affecting the rights and remedies of creditors or by general equitable principles. 
  
 (h) Authorization of the Securities and the Exchange Securities. The Notes to be purchased by the Initial Purchasers from the Company are in the
form contemplated by the Indenture and have been duly authorized for issuance and sale pursuant to this Agreement and the Indenture and, at the Closing Date, will have been duly executed by the Company and, when authenticated in the manner provided
for in the Indenture and delivered against payment of the purchase price therefor, will constitute valid and binding agreements of the Company, enforceable in accordance with their terms, except as the enforcement thereof may be limited by
bankruptcy, insolvency, reorganization, moratorium or other similar laws relating to or affecting the rights and remedies of creditors or by general equitable principles and will be entitled to the benefits of the Indenture. The Exchange Notes have
been duly and validly authorized for issuance by the Company, and when issued and authenticated in accordance with the terms of the Indenture, the Registration Rights Agreement and the Exchange Offer (as defined in the Registration Rights
Agreement), will constitute valid and binding obligations of the Company, enforceable against the Company in accordance with their terms, except as the enforcement thereof may be limited by bankruptcy, insolvency, reorganization, moratorium, or
similar laws relating to or affecting enforcement of the rights and remedies of creditors or by general principles of equity and will be entitled to the benefits of the Indenture. The Guarantees of the Notes and the Exchange Notes are in the
respective forms contemplated by the Indenture, have been duly authorized for issuance pursuant to the Indenture and, at the Closing Date, will have been duly executed by Holdings and, when the Notes have been authenticated in the manner provided
for in the Indenture and delivered against payment of the purchase price therefor, will constitute valid and binding agreements of Holdings, enforceable in accordance with their terms, except as the enforcement thereof may be limited by bankruptcy,
insolvency, reorganization, moratorium or other similar laws relating to or affecting the rights and remedies of creditors or by general equitable principles and will be entitled to the benefits of the Indenture. 
  
 (i) Authorization of the Indenture. The Indenture has been duly
authorized by each of the Company and Holdings and, at the Closing Date, will have been duly executed and delivered by each of the Company and Holdings and, assuming due authorization, execution and delivery by the Trustee, will constitute a valid
and binding agreement of each of the Company and Holdings, enforceable against each of the Company and Holdings in accordance with its terms, except as the enforcement thereof may be limited by bankruptcy, insolvency, reorganization, moratorium or
other similar laws relating to or affecting the rights and remedies of creditors or by general equitable principles. 
  

 5 

 (j) Description of the Securities and the Indenture. The Notes, the Exchange Notes, the Guarantees
of the Notes and the Exchange Notes and the Indenture conform or will, on the Closing Date, conform in all material respects to the respective statements relating thereto contained in the Offering Memorandum. 
  
 (k) Authorization of the Security Documents and Intercreditor
Agreement. Each of the Security Documents has been duly authorized by each of the Company and Holdings and, at the Closing Date, each of the Security Documents will have been duly executed and delivered by each of the Company and Holdings and
will constitute a valid and binding agreement of each of the Company and Holdings, enforceable against each of the Company and Holdings in accordance with its terms, except as the enforcement thereof may be limited by bankruptcy, insolvency,
reorganization, moratorium or similar laws relating to or affecting the rights and remedies of creditors or by general equitable principles. The Intercreditor Agreement has been duly authorized by the Company and Holdings and, at the Closing Date,
the Intercreditor Agreement will have been duly executed and delivered by the Company and Holdings and will constitute a valid and binding agreement of each of the Company and Holdings, enforceable against each of the Company and Holdings in
accordance with its terms, except as the enforcement thereof may be limited by bankruptcy, insolvency, reorganization, moratorium or similar laws relating to or affecting the rights and remedies of creditors or by general equitable principles.

  
 (l) Security Documents. At the Closing Date, the
Security Documents will create a valid and enforceable security interest in the Collateral in favor of the Collateral Agent for the benefit of the Trustee and the holders of the Securities, among others, except as the enforcement thereof may be
limited by bankruptcy, insolvency, reorganization, moratorium or other similar laws relating to or affecting the rights and remedies of creditors or by general equitable principles. 
  
 (m) Collateral. Except as disclosed in the Offering Memorandum, the Company and Holdings own the Collateral, free and
clear of any security interest, mortgage, pledge, lien, encumbrance, equity, claim or other defect (collectively, “Liens”). 
  
 (n) Perfection of the Security Interests in the Collateral. As of the Closing Date, all filings and other actions necessary to perfect and protect
the security interest in the Collateral created under the Security Documents will have been duly made or taken and will be in full force and effect, and the Security Documents, together with such filings and other actions, will create in favor of
the Collateral Agent for the benefit of the Trustee and the holders of the Securities a perfected security interest in the Collateral (other than, with respect to the perfection of collateral that requires perfection by “control” as such
term is defined in the Uniform Commercial Code of the State of New York, which Collateral shall only be perfected upon the Collateral Agent obtaining control thereof) securing the obligations of the Company and Holdings under the Securities and the
Indenture. 
  
 (o) No Material Adverse Change. Except as
otherwise disclosed in the Offering Memorandum, subsequent to the respective dates as of which information is given in the Offering Memorandum: (i) there has been no material adverse change, or any development that would reasonably be expected
to result in a material adverse change, in the condition, financial or otherwise, or in the earnings, business, operations or prospects, whether or not arising from 

  

 6 

 
transactions in the ordinary course of business, of the Company and Holdings, considered as one entity (any such change being referred to hereinafter as a
“Material Adverse Change”); (ii) the Company and Holdings, considered as one entity, have not incurred any material liability or obligation, indirect, direct or contingent, not in the ordinary course of business nor entered into any
material transaction or agreement not in the ordinary course of business; and (iii) there has been no dividend or distribution of any kind declared, paid or made by the Company or Holdings on any class of capital stock or repurchase or
redemption by the Company or Holdings of any class of capital stock. 
  
 (p) Independent Accountants. To the knowledge of the Company and Holdings, Ernst & Young LLP, who have expressed their opinion with respect to the financial statements (which term as used in this Agreement includes the
related notes thereto) included in the Offering Memorandum are independent public or certified public accountants within the meaning of Regulation S-X under the Securities Act and the Exchange Act. 
  
 (q) Preparation of the Financial Statements. Except as otherwise
disclosed in the Offering Memorandum, the financial statements, together with the related schedules and notes, included in the Offering Memorandum present fairly in all material respects the consolidated financial position of the Company and its
subsidiaries as of and at the dates indicated and the results of their operations and cash flows for the periods specified. The financial statements included in the Offering Memorandum comply as to form with the requirements of the Securities Act
that would be applicable if the Securities were being issued and sold in a public offering. Except as otherwise disclosed in the Offering Memorandum, such financial statements have been prepared in conformity with generally accepted accounting
principles applied on a consistent basis throughout the periods involved, except as may be expressly stated in the related notes thereto. Except as otherwise disclosed in the Offering Memorandum, the historical financial data set forth in the
Offering Memorandum under the caption “Offering Memorandum Summary – Summary Historical and Pro Forma Financial and Operating Data” and the financial data set forth in “Selected Historical Financial Data” fairly present in
all material respects the information set forth therein on a basis consistent with that of the audited financial statements contained in the Offering Memorandum. Except as otherwise disclosed in the Offering Memorandum, the pro forma consolidated
financial information of the Company and the related notes thereto included under the captions “Offering Memorandum Summary – Summary Historical and Pro Forma Financial and Operating Data” and “Unaudited Pro Forma Consolidated
Financial Data” and elsewhere in the Offering Memorandum present fairly in all material respects the information contained therein have been prepared in accordance with the Commission’s rules and guidelines with respect to pro forma
financial statements and have been properly presented on the bases described therein, and the assumptions used in the preparation thereof are reasonable and the adjustments used therein are appropriate to give effect to the transactions and
circumstances referred to therein. In addition, the quarterly and annual revenue figures used for purposes of supporting the statements in the offering memorandum regarding the Company’s quarterly and annual revenue growth have been derived
from quarterly or annual financial statements, and, with respect to periods beginning after June 7, 2002, such annual and quarterly financial statements have been prepared in conformity with generally accepted accounting principles applied on a
consistent basis throughout such periods, except as may be expressly stated in the related notes (if any) thereto. Notwithstanding the foregoing paragraph, it 

  

 7 

 
is expressly noted that certain financial data contained in the Offering Memorandum, as disclosed therein, are not audited financial data. 
  
 (r) Incorporation and Good Standing of Holdings and the Company. Each
of Holdings and the Company has been duly incorporated and is validly existing as a corporation in good standing under the laws of the jurisdiction of its incorporation and has corporate power and authority to own, lease and operate its properties
and to conduct its business as described in the Offering Memorandum and each of Holdings and the Company has the power and authority to enter into and perform their respective obligations under each of this Agreement, the Registration Rights
Agreement, the Security Documents, the Intercreditor Agreement, the DTC Agreement, the Notes, the Exchange Notes, the Guarantee of the Notes and the Exchange Notes, and the Indenture. Each of Holdings and the Company is duly qualified as a foreign
corporation to transact business and is in good standing in each jurisdiction in which such qualification is required, whether by reason of the ownership or leasing of property or the conduct of business, except for such jurisdictions where the
failure to so qualify or to be in good standing would not, individually or in the aggregate, result in a Material Adverse Change. All of the issued and outstanding capital stock of the Company has been duly authorized and validly issued, is fully
paid and nonassessable and is owned directly by Holdings free and clear of any Liens other than Liens as are described in the Offering Memorandum. Holdings does not own or control, directly or indirectly, any corporation, association or other entity
other than the Company and the Company has no subsidiaries. 
  
 (s) Capitalization and Other Capital Stock Matters. At March 31, 2005, on a consolidated basis, after giving pro forma effect to (i) the issuance and sale of the Securities pursuant hereto and (ii) the application of
the net proceeds from the sale of the securities in the manner described under the caption “Use of Proceeds” in the Offering Memorandum, the Company would have had the capitalization as set forth in the Offering Memorandum under the
caption “Capitalization”. 
  
 (t) Non-Contravention
of Existing Instruments; No Further Authorizations or Approvals Required. Neither Holdings nor the Company is in violation of its charter or by-laws or is in default (or, with the giving of notice or lapse of time, would be in default)
(“Default”) under any indenture, mortgage, loan or credit agreement, note, contract, franchise, lease or other instrument to which either Holdings or the Company is a party or by which it or any of them may be bound, or to which any of the
property or assets of Holdings or the Company is subject (each, an “Existing Instrument”), except for such Defaults as would not, individually or in the aggregate, result in a Material Adverse Change. The execution, delivery and
performance of this Agreement, the Registration Rights Agreement, the DTC Agreement, the Indenture, the Intercreditor Agreement and any other agreements or documents relating to any of the foregoing by each of the Company and Holdings (each to the
extent a party thereto), and the issuance and delivery of the Securities or the Exchange Securities, and consummation of the transactions contemplated hereby and thereby and by the Offering Memorandum (i) have been duly authorized by all
necessary corporate action by the Company and Holdings (each to the extent a party thereto) and will not result in any violation of the provisions of the charter or by-laws of Holdings or the Company, (ii) will not conflict with or constitute a
breach of, or Default or a Debt Repayment Triggering Event (as defined below) under, or result in the creation or imposition of any lien, charge or encumbrance upon any property or assets of Holdings or the 

  

 8 

 
Company pursuant to, or require the consent of any other party to, any Existing Instrument, except for such conflicts, breaches, Defaults, liens, charges or
encumbrances as would not, individually or in the aggregate, result in a Material Adverse Change and (iii) (assuming the accuracy of the representations, warranties and agreements of the Initial Purchasers contained herein) will not result in
any violation of any law, administrative regulation or administrative or court decree applicable to Holdings or the Company. No consent, approval, authorization or other order of, or registration or filing with, any court or other governmental
or regulatory authority or agency, is required for the Company’s or Holdings’ execution, delivery and performance of this Agreement, the Registration Rights Agreement, the DTC Agreement, the Indenture, the Intercreditor Agreement or any
other agreements or documents relating to any of the foregoing, or the issuance and delivery of the Securities or the Exchange Securities, or consummation of the transactions contemplated hereby and thereby and by the Offering Memorandum, except
such as have been obtained or made by the Company or Holdings and are in full force and effect under the Securities Act, applicable state securities or blue sky laws and except such as may be required by federal and state securities laws with
respect to the Company’s and Holdings’ obligations under the Registration Rights Agreement. As used herein, a “Debt Repayment Triggering Event” means any event or condition which gives, or with the giving of notice or lapse of
time would give, the holder of any note, debenture or other evidence of indebtedness (or any person acting on such holder’s behalf) the right to require the repurchase, redemption or repayment of all or a portion of such indebtedness by
Holdings or the Company. 
  
 (u) No Material Actions or
Proceedings. Except as otherwise disclosed in the Offering Memorandum, there are no legal or governmental actions, suits or proceedings pending or, to the Company’s or Holdings’ knowledge, threatened (i) against or affecting
Holdings or the Company, (ii) which have as the subject thereof any property owned or leased by, Holdings or the Company, where in any such case there is a reasonable possibility that such action, suit or proceeding might be determined
adversely to Holdings or the Company and any such action, suit or proceeding, if so determined adversely, would reasonably be expected to result in a Material Adverse Change or adversely affect the consummation of the transactions contemplated by
this Agreement. Except as otherwise disclosed in the Offering Memorandum, no material labor dispute with the employees of Holdings or the Company, or with the employees of any principal supplier of Holdings or the Company, exists or, to the
Company’s or Holdings’ knowledge, is threatened or imminent. 
  
 (v) Intellectual Property Rights. Each of Holdings and the Company owns or possesses sufficient trademarks, trade names, patent rights, copyrights, licenses, approvals, trade secrets and other similar rights (collectively,
“Intellectual Property Rights”) reasonably necessary to conduct their businesses as now conducted; and the expected expiration of any of such Intellectual Property Rights would not result in a Material Adverse Change. Neither Holdings nor
the Company has received any written notice of infringement or conflict with asserted Intellectual Property Rights of others, which infringement or conflict, if the subject of an unfavorable decision, would result in a Material Adverse Change.

  
 (w) All Necessary Permits, Etc. Except as otherwise
disclosed in the Offering Memorandum or as would not reasonably be expected to result in a Material Adverse Change, each of Holdings and the Company possesses such valid and current certificates, authorizations or permits issued by the appropriate
state, federal or foreign regulatory agencies or bodies 

  

 9 

 
necessary to conduct its business. Neither Holdings nor the Company has received any written notice of proceedings relating to the revocation or modification
of, or non-compliance with, any such certificate, authorization or permit which, singly or in the aggregate, if the subject of an unfavorable decision, ruling or finding, would result in a Material Adverse Change. 
  
 (x) Title to Properties. Except as otherwise disclosed in the Offering
Memorandum, each of Holdings and the Company has good and marketable title to all the properties and assets reflected as owned in the financial statements referred to in Section 1 above (or elsewhere in the Offering Memorandum), in each case
free and clear of any Liens except Liens as described in the Offering Memorandum and Liens such as do not materially and adversely affect the value of such property and do not materially interfere with the use made or proposed to be made of such
property by Holdings and the Company, taken as a whole. The real property, improvements, equipment and personal property held under lease by Holdings or the Company are held under valid and enforceable leases, with such exceptions as are not
material and do not materially interfere with the use made or proposed to be made of such real property, improvements, equipment or personal property by Holdings or the Company. 
  
 (y) Tax Law Compliance. Except as otherwise disclosed in the Offering Memorandum, Holdings and the Company have each
filed all necessary federal, state and foreign income and franchise tax returns and have each paid all taxes required to be paid by any of them and, if due and payable, any related or similar assessment, fine or penalty levied against any of them,
except where failure to do so would not result in a Material Adverse Change. Holdings and the Company have each made adequate charges, accruals and reserves in the applicable financial statements referred to in Section 1 above in respect of all
federal, state and foreign income and franchise taxes for all periods as to which the tax liability of Holdings or the Company has not been finally determined, except where failure to do so would result in a Material Adverse Change. 
  
 (z) Neither the Company nor Holdings Is an “Investment
Company”. The Company and Holdings have been advised of the rules and requirements under the Investment Company Act of 1940, as amended (the “Investment Company Act”). Neither the Company nor Holdings is, and after receipt of
payment for the Securities will be, an “investment company” within the meaning of Investment Company Act and each of the Company and Holdings will conduct its business in a manner so that it will not become subject to the Investment
Company Act. 
  
 (aa) Insurance. Each of Holdings and the
Company is insured by recognized, financially sound institutions with policies in such amounts and with such deductibles and covering such risks as are generally deemed adequate and customary for their businesses. Neither the Company nor Holdings
has any reason to believe that Holdings or the Company will not be able (i) to renew its existing insurance coverage as and when such policies expire or (ii) to obtain comparable coverage from similar institutions as may be necessary or
appropriate to conduct its business as now conducted and at a cost that would not result in a Material Adverse Change. Neither Holdings nor the Company has been denied any insurance coverage which it has sought or for which it has applied.

  
 (bb) No Price Stabilization or Manipulation. Neither
the Company nor Holdings has taken or will take, directly or indirectly, any action designed to or that would be reasonably 

  

 10 

 
expected to cause or result in stabilization or manipulation of the price of any security of the Company to facilitate the sale or resale of the Securities.

  
 (cc) Solvency. Each of Holdings and the Company is, and
immediately after the Closing Date will be, Solvent. As used herein, the term “Solvent” means, with respect to Holdings or the Company on a particular date, that on such date (i) the fair market value of the assets of Holdings (on a
consolidated basis) or the Company, as the case may be, is greater than the total amount of its stated liabilities (including identified contingent liabilities), (ii) the present fair salable value of the assets of Holdings (on a consolidated
basis) or the Company, as the case may be, is greater than the amount that will be required to pay the probable liabilities on the debts of Holdings or the Company, as the case may be, as they become absolute and mature, (iii) the Company or
Holdings, as the case may be, is able to realize upon its assets and pay its debts and other liabilities, including contingent obligations, as they mature and (iv) neither the Company nor Holdings, as the case may be, has unreasonably small
capital with which to carry on its business as it is currently conducted. 
  
 (dd) No Unlawful Contributions or Other Payments. Neither Holdings nor the Company nor, to the best of Holdings’ or the Company’s knowledge, any employee of Holdings or the Company, has made any
contribution or other payment to any official of, or candidate for, any federal, state or foreign office in violation of any law or of the character necessary to be disclosed in the Offering Memorandum in order to make the statements therein not
misleading. 
  
 (ee) Company’s Accounting System. Each
of Holdings and the Company maintains a system of internal controls over financial reporting sufficient to provide reasonable assurances that: (i) transactions are executed in accordance with management’s general or specific authorization;
(ii) transactions are recorded as necessary to permit preparation of financial statements in conformity with generally accepted accounting principles as applied in the United States and to maintain accountability for assets; (iii) access
to assets is permitted only in accordance with management’s general or specific authorization; and (iv) the recorded accountability for assets is compared with existing assets at reasonable intervals and appropriate action is taken with
respect to any differences. 
  
 (ff) Compliance with
Environmental Laws. Except as would not, individually or in the aggregate, result in a Material Adverse Change: (i) neither of Holdings nor the Company is in violation of any federal, state, local or foreign law or regulation relating to
pollution or protection of human health or the environment (including, without limitation, ambient air, surface water, groundwater, land surface or subsurface strata) or wildlife, including without limitation, laws and regulations relating to
emissions, discharges, releases or threatened releases of chemicals, pollutants, contaminants, wastes, toxic substances, hazardous substances, petroleum and petroleum products (collectively, “Materials of Environmental Concern”), or
otherwise relating to the manufacture, processing, distribution, use, treatment, storage, disposal, transport or handling of Materials of Environmental Concern (collectively, “Environmental Laws”), which violation includes, but is not
limited to, noncompliance with any permits or other governmental authorizations required for the operation of the business of Holdings or the Company under applicable Environmental Laws, nor has Holdings or the Company received any written
communication, whether from a governmental authority, citizens group, employee or otherwise, that alleges that Holdings or the Company is in violation of any Environmental Law; 

  

 11 

 
(ii) there is no claim, action or cause of action filed with a court or governmental authority, no investigation with respect to which Holdings or the
Company has received written notice, and no written notice by any person or entity alleging potential liability for investigatory costs, cleanup costs, governmental responses costs, natural resources damages, property damages, personal injuries,
attorneys’ fees or penalties arising out of, based on or resulting from the presence, or release into the environment, of any Material of Environmental Concern at any location owned, leased or operated by Holdings or the Company, now or in the
past (collectively, “Environmental Claims”), pending or, to the best of Holdings’ or the Company’s knowledge, threatened against Holdings or the Company or any person or entity whose liability for any Environmental Claim Holdings
or the Company has retained or assumed either contractually or by operation of law; and (iii) to the best of Holdings’ or the Company’s knowledge, there are no past or present actions, activities, circumstances, conditions, events or
incidents, including, without limitation, the release, emission, discharge, presence or disposal of any Material of Environmental Concern, that reasonably could result in a violation of any Environmental Law or form the basis of a potential
Environmental Claim against Holdings or the Company or against any person or entity whose liability for any Environmental Claim Holdings or the Company has retained or assumed either contractually or by operation of law. 
  
 (gg) ERISA Compliance. Except as would not, individually or in the
aggregate, result in a Material Adverse Change: (i) Holdings and the Company and any “employee benefit plan” (as defined under the Employee Retirement Income Security Act of 1974, as amended, and the regulations and published
interpretations thereunder (collectively, “ERISA”)) established or maintained by Holdings or the Company or their “ERISA Affiliates” (as defined below) are in compliance in all material respects with ERISA (“ERISA
Affiliate” means, with respect to Holdings or the Company, any member of any group of organizations described in Section 414, of the Internal Revenue Code of 1986, as amended, and the regulations and published interpretations thereunder
(the “Code”) of which Holdings or the Company is a member. No “reportable event” (as defined under ERISA) has occurred or is reasonably expected to occur with respect to any “employee benefit plan” established or
maintained by Holdings, the Company or any of their ERISA Affiliates; (ii) no “employee benefit plan” established or maintained by Holdings or the Company or any of their ERISA Affiliates, if such “employee benefit plan”
were terminated, would have any “amount of unfunded benefit liabilities” (as defined under ERISA); (iii) none of Holdings, the Company or any of their ERISA Affiliates has incurred or reasonably expects to incur any liability under
(a) Title IV of ERISA with respect to termination of, or withdrawal from, any “employee benefit plan” or (b) Section 412, 4971, 4975 or 4980B of the Code; and (iv) each “employee benefit plan” established or
maintained by Holdings, the Company or any of their ERISA Affiliates, if any, that is intended to be qualified under Section 401 of the Code is so qualified and nothing has occurred, whether by action or failure to act, which would cause the
loss of such qualification. 
  
 (hh) No Default in First
Priority Lien Obligations. No event of default exists under any contract, indenture, mortgage, loan agreement, note, lease or other agreement or instrument constituting any Indebtedness (as defined by the Indenture) secured by Liens on the
Collateral (as defined in the Indenture). 
  
 (ii) Regulation
S. The Company, Holdings and their respective Affiliates and all persons acting on their behalf (other than the Initial Purchasers, as to whom neither the Company nor 

  

 12 

 
Holdings makes any representation) have complied with and will comply with the offering restrictions requirements of Regulation S in connection with the
offering of the Securities outside the United States and, in connection therewith, the Offering Memorandum will contain the disclosure required by Rule 902 of the Security Act. The Securities sold in reliance on Regulation S will be
represented upon issuance by a temporary global security that may not be exchanged for definitive securities until the expiration of the 40-day restricted period referred to in Rule 903 of the Securities Act and only upon certification of
beneficial ownership of such Securities by non-U.S. persons or U.S. persons who purchased such Securities in transactions that were exempt from the registration requirements of the Securities Act. 
  
 (jj) Compliance with Laws. 
  

	 	(i)	Except as disclosed in the Offering Memorandum, each of Holdings and the Company is in compliance in all material respects with all international, foreign, federal, state and local
statutes, treaties, rules, guidelines, regulations, ordinances, codes and administrative or judicial precedents or authorities, including the interpretation or administration thereof by any governmental authority charged with the enforcement,
interpretation or administration thereof, and all applicable administrative orders, directed duties, requests, licenses, authorizations and permits of, and agreements with, any governmental authority, in each case, whether or not having the force of
law. 

  

	 	(ii)	Except as disclosed in the Offering Memorandum, each of Holdings and the Company possesses such permits, licenses, provider numbers, certificates, approvals (including, without
limitation, certificate of need approvals), consents, orders, certifications and other authorizations (collectively, “Licenses”) issued by, and have made all declarations and filings with, the appropriate federal, state, local or foreign
regulatory agencies or bodies necessary to conduct its business as now being conducted and as described in the Offering Memorandum (including, without limitation, Licenses as are required under such federal and state laws as are applicable to
Holdings or the Company, except where the failure to possess such Licenses or to make such declarations and filings would not, individually or in the aggregate, result in a Material Adverse Change; each of Holdings and the Company is in compliance
with the terms and conditions of all such Licenses, except where the failure so to comply would not, individually or in the aggregate, result in a Material Adverse Change; all of the Licenses are valid and in full force and effect, except where the
invalidity of such Licenses or the failure of such Licenses to be in full force and effect would not result in a Material Adverse Change; and neither Holdings nor the Company has received any notice of proceedings relating to the revocation or
modification of any such Licenses which, singly or in the aggregate, if the subject of an unfavorable decision, ruling or finding, would result in a Material Adverse Change. 

  

 13 

	 	(iii)	Except as disclosed in the Offering Memorandum, neither Holdings nor the Company has engaged in, nor, to the knowledge of Holdings or the Company have any officers, directors or
employees of Holdings or the Company (during the course of their employment) engaged in, any activities that are prohibited by (1) any federal, state or local statute, rule, or regulation applicable to individuals or entities operating in the
workers’ compensation industry, and (2) other statutes, rules, or regulations governing federal or state government workers’ compensation programs, except for any such activities which would not, individually or in the aggregate,
result in a Material Adverse Change. 

  
 Any
certificate signed by an officer of the Company or Holdings and delivered to the Initial Purchasers or to counsel for the Initial Purchasers shall be deemed to be a representation and warranty by the Company or Holdings, as the case may be, to each
Initial Purchaser as to the matters set forth therein. 
  
 SECTION 2. Purchase, Sale and Delivery of the Securities. 
  
 (a) The Securities. The Company agrees to issue and sell to the several Initial Purchasers, severally and not jointly, all of the Notes upon the
terms herein set forth. On the basis of the representations, warranties and agreements herein contained, and upon the terms but subject to the conditions herein set forth, the Initial Purchasers agree, severally and not jointly, to purchase from the
Company the aggregate principal amount of Notes set forth opposite their names on Schedule A, at a purchase price of 96.75% of the principal amount thereof payable on the Closing Date. 
  
 (b) The Closing Date. Delivery of certificates for the Notes in
definitive form to be purchased by the Initial Purchasers and payment therefor shall be made at the offices of Ropes & Gray LLP, 45 Rockefeller Plaza, New York, New York 10111 (or such other place as may be agreed to by the Company and the
Initial Purchasers) at 9:00 a.m. New York City time, on June 21, 2005, or such other time and date as the Initial Purchasers shall designate by notice to the Company (the time and date of such closing are called the “Closing
Date”). The Company hereby acknowledges that circumstances under which the Initial Purchasers may provide notice to postpone the Closing Date as originally scheduled include, but are not limited to, any determination by the Company or the
Initial Purchasers to recirculate to investors copies of an amended or supplemented Offering Memorandum or a delay as contemplated by the provisions of Section 16. 
  
 (c) Delivery of the Securities. The Company shall deliver, or cause to be delivered, to Banc of America Securities
LLC for the accounts of the several Initial Purchasers certificates for the Securities at the Closing Date against the irrevocable release of a wire transfer of immediately available funds for the amount of the purchase price therefor. The
certificates for the Securities shall be in such denominations and registered in the name of Cede & Co., as nominee of the Depository, pursuant to the DTC Agreement, and shall be made available for inspection on the business day preceding
the Closing Date at a location in New York City, as the Initial Purchasers may designate. Time shall be of the essence, and delivery at the time and 

  

 14 

 
place specified in this Agreement is a further condition to the obligations of the Initial Purchasers. 
  
 (d) Delivery of Offering Memorandum to the Initial Purchasers. Not
later than 12:00 p.m. on the second business day following the date of this Agreement, the Company shall deliver or cause to be delivered copies of the Offering Memorandum in such quantities and at such places as the Initial Purchasers shall
reasonably request. 
  
 (e) Initial Purchasers as Qualified
Institutional Buyers. Each Initial Purchaser severally and not jointly represents and warrants to, and agrees with, the Company that it is a “qualified institutional buyer” within the meaning of Rule 144A (a “Qualified
Institutional Buyer”) and an “accredited investor” within the meaning of Rule 501 under the Securities Act (an “Accredited Investor”). 
  
 SECTION 3. Additional Covenants. The Company and, as applicable, Holdings, jointly and
severally, further covenant and agree with each Initial Purchaser as follows: 
  
 (a) Initial Purchasers’ Review of Proposed Amendments and Supplements. The Company shall notify the Initial Purchasers promptly of any proposal to amend or supplement the Offering Memorandum, and the
Company shall not use any such proposed amendment or supplement to which the Initial Purchasers reasonably object, which objection shall be delivered promptly to the Company following such notice. 
  
 (b) Amendments and Supplements to the Offering Memorandum and Other
Securities Act Matters. If, prior to the completion of the placement of the Securities by the Initial Purchasers with the Subsequent Purchasers, any event shall occur or condition exist as a result of which it is, in the opinion of the Initial
Purchasers or counsel for the Initial Purchasers, necessary to amend, update or supplement the Offering Memorandum (including the financial statements therein) in order to make the statements therein, in the light of the circumstances under which
they were made, not misleading, or if in the opinion of the Initial Purchasers or counsel for the Initial Purchasers it is otherwise necessary to amend, update or supplement the Offering Memorandum (including the financial statements therein) to
comply with law (including Regulation S-X under the Securities Act whether or not actually applicable) or customary practice with respect to offerings of high yield debt securities under Rule 144A, the Company agrees to promptly prepare
(subject to Section 3 hereof) and furnish at its own expense to the Initial Purchasers amendments, updates or supplements to the Offering Memorandum (including the financial statements therein) so that the statements in the Offering Memorandum
as so amended, updated or supplemented will not, in the light of the circumstances under which they were made, be misleading or so that the Offering Memorandum, as amended, updated or supplemented, will comply with law (including Regulation S-X
under the Securities Act whether or not actually applicable) or customary practice with respect to offerings of high yield debt securities under Rule 144A. 
  

The Company and Holdings hereby expressly acknowledge that the indemnification and contribution provisions of Sections 8 and 9 hereof are
specifically applicable and relate to each offering memorandum, registration statement, prospectus, amendment or supplement referred to in this Section 3. 
  

 15 

 (c) Copies of the Offering Memorandum. The Company agrees to furnish the Initial Purchasers,
without charge, as many copies of the Offering Memorandum and any amendments and supplements thereto as they shall have reasonably requested. 
  
 (d) Blue Sky Compliance. The Company and Holdings jointly and severally agree to cooperate with the Initial Purchasers and counsel for the Initial
Purchasers to qualify or register the Securities for sale under (or obtain exemptions from the application of) the Blue Sky or state securities laws of those jurisdictions designated by the Initial Purchasers, shall comply with such laws and shall
continue such qualifications, registrations and exemptions in effect so long as required for the distribution of the Securities. Neither the Company nor Holdings shall be required to qualify as a foreign corporation or to take any action that would
subject it to general service of process in any such jurisdiction where it is not presently qualified or where it would be subject to taxation as a foreign corporation. The Company will advise the Initial Purchasers promptly of the suspension of the
qualification or registration of (or any such exemption relating to) the Securities for offering, sale or trading in any jurisdiction or any initiation or threat of any proceeding for any such purpose, and in the event of the issuance of any order
suspending such qualification, registration or exemption, the Company shall use its reasonable best efforts to obtain the withdrawal thereof at the earliest possible moment. 
  
 (e) Use of Proceeds. The Company shall apply the net proceeds from the sale of the Securities sold by it in the
manner described under the caption “Use of Proceeds” in the Offering Memorandum. 
  
 (f) The Depository. The Company and Holdings jointly and severally agree to cooperate with the Initial Purchasers in arranging for the Securities to be eligible for clearance and settlement through the
facilities of the Depository. 
  
 (g) Additional Issuer
Information. If at any time during the two-year period following the later of the Closing Date and the date of issuance of additional notes under the Indenture, if any, the Company or Holdings is not subject to Section 13 or 15(d), for the
benefit of holders and beneficial owners from time to time of Securities, the Company shall furnish, at its expense, upon request, to holders and beneficial owners of Securities and prospective purchasers of Securities information (“Additional
Issuer Information”) satisfying the requirements of subsection of Rule 144A. 
  
 (h) Agreement Not to Offer or Sell Additional Securities. During the period of 90 days following the date of the Offering Memorandum, the Company and Holdings will not, without the prior written consent of Banc
of America Securities LLC (which consent may be withheld at the sole discretion of Banc of America Securities LLC), directly or indirectly, sell, offer, contract or grant any option to sell, pledge, transfer or establish an open “put equivalent
position” within the meaning of Rule 16a-1 under the Exchange Act, or otherwise dispose of or transfer, or announce the offering of, or file any registration statement under the Securities Act in respect of, any debt securities of the
Company or Holdings or securities exchangeable for or convertible into debt securities of the Company or Holdings (other than as contemplated by this Agreement and the Registration Rights Agreement). 
  

 16 

 (i) Future Reports to the Initial Purchasers. For so long as any Securities or Exchange Securities
remain outstanding, the Company will furnish to Banc of America Securities LLC: copies of all reports or documents required to be furnished to holders of the Securities and beneficial owners of the Securities under the Indenture, which shall include
the balance sheet of the Company or Holdings, as applicable, as of the close of such fiscal year and statements of income, stockholders’ equity and cash flows for the year then ended and the opinion thereon of the Company’s or
Holdings’, as applicable, independent public or certified public accountants. 
  
 (j) No Integration, General Solicitation or Directed Selling Efforts. The Company and Holdings jointly and severally agree that they will not, and will cause their respective Affiliates not to, make any offer
or sale of securities of the Company or Holdings of any class if, as a result of the doctrine of “integration” referred to in Rule 502 under the Securities Act, such offer or sale would render invalid (for the purpose of (i) the
sale of the Securities by the Company to the Initial Purchasers, (ii) the resale of the Securities by the Initial Purchasers to Subsequent Purchasers or (iii) the resale of the Securities by such Subsequent Purchasers to others) the
exemption from the registration requirements of the Securities Act provided by Section 4 thereof or by Rule 144A or by Regulation S thereunder or otherwise. The Company, Holdings, their respective Affiliates, or any person acting on
its or any of their behalf (other than the Initial Purchasers), will not engage, in connection with the offering of the Securities, (i) in any form of general solicitation or general advertising within the meaning of Rule 502 under the
Securities Act or (ii) in any directed selling efforts within the meaning of Regulation S. 
  
 (k) Legended Securities. Each certificate for a Note will bear the legend contained in “Notice to Investors” in the Offering Memorandum
for the time period and upon the other terms stated in the Offering Memorandum. 
  
 (l) PORTAL. The Company will assist the Initial Purchasers in arranging for the Securities to be eligible for the National Association of Securities Dealers, Inc. PORTAL market (the “PORTAL Market”).

  
 (m) Rating of the Securities. The Company and Holdings
jointly and severally agree that they will take all reasonable action necessary to enable Standard & Poor’s Rating Services, a Division of The McGraw-Hill, Inc. Companies (“S&P”), and Moody’s Investor Services, Inc.
(“Moody’s”) to provide their respective credit ratings to the Securities at or prior to the time of their initial issuance. 
  
 (n) No Resale of Reacquired Securities. During the period of two years after the Closing Date or until such earlier time when all the Securities
are registered under the Securities Act, the Company will not, and will not permit any of its “affiliates” (as defined in Rule 144 under the Securities Act) to, resell any of the Securities that constitute “restricted
securities” under Rule 144 that have been reacquired by any of them. 
  
 Banc of America Securities LLC, on behalf of the several Initial Purchasers, may, in its sole discretion, waive in writing the performance by the Company or Holdings of any one or more of the foregoing covenants or
extend the time for their performance. 
  

 17 

 SECTION 4. Payment of Expenses. The Company and Holdings, jointly and
severally, agree to pay all costs, fees and expenses incurred in connection with the performance of their obligations hereunder and in connection with the transactions contemplated hereby, including without limitation, (i) all expenses incident
to the issuance and delivery of the Securities (including all printing and engraving costs), (ii) all necessary issue, transfer and other stamp taxes in connection with the issuance and sale of the Securities to the Initial Purchasers,
(iii) all fees and expenses of the Company’s and Holdings’ counsel, independent public or certified public accountants and other advisors, (iv) all costs and expenses incurred in connection with the preparation, printing,
shipping and distribution of each preliminary Offering Memorandum and the Offering Memorandum (including financial statements), and all amendments and supplements thereto, this Agreement, the Registration Rights Agreement, the Indenture, the DTC
Agreement, the Security Documents, the Intercreditor Agreement and the Securities, (v) all filing fees, attorneys’ fees and expenses incurred by the Company, Holdings or the Initial Purchasers in connection with qualifying or registering
(or obtaining exemptions from the qualification or registration of) all or any part of the Securities for offer and sale under the Blue Sky laws and, if requested by the Initial Purchasers, preparing and printing a “Blue Sky Survey” or
memorandum, and any supplements thereto, advising the Initial Purchasers of such qualifications, registrations and exemptions, (vi) the fees and expenses of the Trustee, including the fees and disbursements of counsel for the Trustee in
connection with the Indenture, the Securities and the Exchange Securities, (vii) any fees payable in connection with the rating of the Securities or the Exchange Securities with the ratings agencies and the listing of the Securities with the
PORTAL market, (viii) any filing fees incident to, and any reasonable fees and disbursements of counsel to the Initial Purchasers in connection with the review by the National Association of Securities Dealers, Inc., if any, of the terms of the
sale of the Securities or the Exchange Securities, (ix) all fees and expenses (including reasonable fees and expenses of counsel) of the Company and Holdings in connection with approval of the Securities by DTC for “book-entry”
transfer, and the performance by the Company and Holdings of their respective other obligations under this Agreement. Except as provided in this Section 4, Section 6, Section 8 and Section 9 hereof, the Initial Purchasers shall
pay their own expenses, including the fees and disbursements of their counsel. 
  
 SECTION 5. Conditions of the Obligations of the Initial Purchasers. The obligations of the several Initial Purchasers to purchase and pay for the Securities as provided herein on the
Closing Date shall be subject to the accuracy of the representations and warranties on the part of the Company and Holdings set forth in Section 1 hereof as of the date hereof and as of the Closing Date as though then made and to the timely
performance by the Company and Holdings of their respective covenants and other obligations hereunder, and to each of the following additional conditions: 
  
 (a) Accountants’ Comfort Letter. On the date hereof, the Initial Purchasers shall have received from Ernst & Young LLP, independent
public or certified public accountants for the Company, a letter dated the date hereof addressed to the Initial Purchasers, in form and substance satisfactory to the Initial Purchasers, containing statements and information of the type ordinarily
included in accountant’s “comfort letters” to the Initial Purchasers, delivered according to Statement of Auditing Standards Nos. 72, 76 and 100 (or any successor bulletins), with respect to the audited and unaudited financial
statements and certain financial information contained in the Offering Memorandum. 
  

 18 

 (b) No Material Adverse Change or Ratings Agency Change. For the period from and after the date of
this Agreement and prior to the Closing Date: 
  
 (i) there shall not have occurred any Material Adverse Change; and 
  
 (ii) there shall not have occurred any downgrading, nor shall any notice have been given of any intended or potential downgrading or of any review for a possible change with possible negative implications, in the
rating accorded any securities of the Company or Holdings by any “nationally recognized statistical rating organization” as such term is defined for purposes of Rule 436 under the Securities Act. 
  
 (c) Opinion of Counsel for the Company and Holdings. On the Closing
Date the Initial Purchasers shall have received the favorable opinion of (i) Ropes & Gray LLP, counsel for the Company and Holdings, dated as of such Closing Date, substantially to the effect set forth in Exhibit A and
(ii) Akerman Senterfitt, Florida counsel for the Company, dated as of such Closing Date, substantially to the effect set forth in Exhibit B. 
  
 (d) Opinion of Counsel for the Initial Purchasers. On the Closing Date the Initial Purchasers shall have received the favorable opinion of
Shearman & Sterling LLP, counsel for the Initial Purchasers, dated as of such Closing Date, with respect to such matters as may be reasonably requested by the Initial Purchasers. 
  
 (e) Officers’ Certificate. On the Closing Date the Initial Purchasers shall have received a written certificate
executed by the Chairman of the Board, Chief Executive Officer or President and the Chief Financial Officer or Chief Accounting Officer of each of (i) the Company and (ii) Holdings, in each case, dated as of the Closing Date, to the effect
set forth in subsection (b)(ii) of this Section 5, and further to the effect that: 
  
 (i) for the period from and after the date of this Agreement and prior to the Closing Date there has not occurred any Material Adverse
Change; 
  
 (ii) the representations, warranties
and covenants of the Company or Holdings, as applicable, set forth in Section 1 of this Agreement are true and correct with the same force and effect as though expressly made on and as of the Closing Date; and 
  
 (iii) the Company or Holdings, as applicable, has complied
with all the agreements and satisfied all the conditions on its part to be performed or satisfied at or prior to the Closing Date. 
  
 (f) Bring-down Comfort Letter. On the Closing Date, the Initial Purchasers shall have received from Ernst & Young LLP, independent public
or certified public accountants for the Company, a letter dated such date, in form and substance satisfactory to the Initial Purchasers, to the effect that they reaffirm the statements made in the letter furnished by them pursuant to
subsection (a) of this Section 5, except that the specified date referred to therein for the carrying out of procedures shall be no more than three business days prior to the Closing Date. 
  

 19 

 (g) DTC Eligibility and PORTAL Listing. At the Closing Date the Securities shall have been
designated for trading on the PORTAL market and shall be eligible for trading through the Depository. 
  
 (h) Registration Rights Agreement. The Company and Holdings shall have entered into the Registration Rights Agreement and the Initial Purchasers
shall have received executed counterparts thereof. 
  
 (i)
Security Documents and the Intercreditor Agreement. At the Closing Date, the Security Documents (and the documents required to be delivered thereunder) and the Intercreditor Agreement , in form and substance satisfactory to the Initial
Purchasers, shall have been duly executed and delivered by the Company and Holdings and be in full force and effect. 
  
 (j) Revolving Credit Agreement. At the Closing Date, the grant of a first priority lien on the Collateral, to secure the Company’s and
Holdings’ respective obligations under that certain Revolving Credit Agreement, dated as of March 31, 2005, as amended by Amendment No. 1, dated as of May 12, 2005, in each case, by and among the Company, Holdings, Bank of
America, N.A., as administrative agent, and the other lenders party thereto from time to time (the “Revolving Credit Agreement”) shall be evidenced by instruments to the satisfaction of the Initial Purchasers. 
  
 (k) Perfected Security Interest. Except as otherwise permitted under
the Security Documents, as of the Closing Date, the Collateral Agent for the benefit of the Trustee and the holders of the Securities (the “Lien Creditors”), among others, shall have a valid and perfected security interest in respect of
the Collateral securing the obligations of the Company and Holdings under the Indenture and the Securities and such security interest of the Lien Creditors will not be subject to or subordinated to any Liens other than the Liens granted pursuant to
Section 5(j) and Permitted Liens as defined in the Indenture. 
  
 (l) Additional Documents. On or before the Closing Date, the Initial Purchasers and counsel for the Initial Purchasers shall have received such information, documents and opinions as they may reasonably require for the purposes of
enabling them to pass upon the issuance and sale of the Securities as contemplated herein, or in order to evidence the accuracy of any of the representations and warranties, or the satisfaction of any of the conditions or agreements, herein
contained. 
  
 If any condition specified in this Section 5
is not satisfied when and as required to be satisfied, this Agreement may be terminated by the Initial Purchasers by notice to the Company at any time on or prior to the Closing Date, which termination shall be without liability on the part of any
party to any other party, except that Section 4, Section 6, Section 8 and Section 9 shall at all times be effective and shall survive such termination. 
  
 SECTION 6. Reimbursement of Initial Purchasers’ Expenses. If this Agreement is
terminated by the Initial Purchasers pursuant to Section 5 or 10 hereof, including if the sale to the Initial Purchasers of the Securities on the Closing Date is not consummated because of any refusal, inability or failure on the part of the
Company or Holdings to perform any agreement herein or to comply with any provision hereof, the Company and Holdings, jointly and severally, 

  

 20 

 
agree to reimburse the Initial Purchasers (or such Initial Purchaser as has terminated this Agreement with respect to itself), severally, upon demand for all
out-of-pocket expenses that shall have been reasonably incurred by the Initial Purchasers in connection with the proposed purchase and the offering and sale of the Securities, including but not limited to fees and disbursements of counsel, printing
expenses, travel expenses, postage, facsimile and telephone charges. 
  
 SECTION 7. Offer, Sale and Resale Procedures. Each of the Initial Purchasers, on the one hand, and the Company and Holdings, on the other hand, hereby establish and agree to observe the following procedures
in connection with the offer and sale of the Securities: 
  
 (A)
Offers and sales of the Securities will be made only by the Initial Purchasers or Affiliates thereof qualified to do so in the jurisdictions in which such offers or sales are made. Each such offer or sale shall only be made to persons whom the
offeror or seller reasonably believes to be qualified institutional buyers (as defined in Rule 144A under the Securities Act) or to non-U.S. persons outside the United States to whom the offeror or seller reasonably believes offers and sales of
the Securities may be made in reliance upon Regulation S under the Securities Act, upon the terms and conditions set forth in Annex I hereto, which Annex I is hereby expressly made a part hereof. 
  
 (B) The Securities will be offered by approaching prospective Subsequent
Purchasers on an individual basis. No general solicitation or general advertising (within the meaning of Rule 502 under the Securities Act) will be used in the United States in connection with the offering of the Securities. 
  
 (C) Upon original issuance by the Company, and until such time as the same is
no longer required under the applicable requirements of the Securities Act, the Securities (and all securities issued in exchange therefor or in substitution thereof, other than the Exchange Securities) shall bear the following legend: 

 
 “THIS NOTE (OR ITS PREDECESSORS) EVIDENCED HEREBY WAS ORIGINALLY
ISSUED IN A TRANSACTION EXEMPT FROM REGISTRATION UNDER THE UNITED STATES SECURITIES ACT OF 1933 (THE “SECURITIES ACT”), AND THIS NOTE MAY NOT BE OFFERED, SOLD OR OTHERWISE TRANSFERRED IN THE ABSENCE OF SUCH REGISTRATION OR AN APPLICABLE
EXEMPTION THEREFROM. EACH PURCHASER OF THIS NOTE IS HEREBY NOTIFIED THAT THE SELLER OF THIS NOTE MAY BE RELYING ON THE EXEMPTION FROM THE PROVISIONS OF SECTION 5 OF THE SECURITIES ACT PROVIDED BY RULE 144A THEREUNDER. THE HOLDER OF THIS
NOTE AGREES FOR THE BENEFIT OF THE COMPANY THAT (A) THIS NOTE MAY BE OFFERED, RESOLD, PLEDGED OR OTHERWISE TRANSFERRED, ONLY (I) TO THE COMPANY OR ANY SUBSIDIARY THEREOF, (II) IN THE UNITED STATES TO A PERSON WHOM THE SELLER
REASONABLY BELIEVES IS A QUALIFIED INSTITUTIONAL BUYER (AS DEFINED IN RULE 144A UNDER THE SECURITIES ACT) IN A TRANSACTION MEETING THE REQUIREMENTS OF RULE 144A, (III) OUTSIDE THE 

  

 21 

 
UNITED STATES IN AN OFFSHORE TRANSACTION IN ACCORDANCE WITH RULE 904 UNDER THE SECURITIES ACT, (IV) PURSUANT TO AN EXEMPTION FROM REGISTRATION
UNDER THE SECURITIES ACT PROVIDED BY RULE 144 THEREUNDER (IF AVAILABLE) OR (V) PURSUANT TO AN EFFECTIVE REGISTRATION STATEMENT UNDER THE SECURITIES ACT, IN EACH OF CASES (I) THROUGH (V) IN ACCORDANCE WITH ANY APPLICABLE
SECURITIES LAWS OF ANY STATE OF THE UNITED STATES, AND (B) THE HOLDER WILL, AND EACH SUBSEQUENT HOLDER IS REQUIRED TO, NOTIFY ANY PURCHASER OF THIS NOTE FROM IT OF THE RESALE RESTRICTIONS REFERRED TO IN (A) ABOVE.” 
  
 Following the sale of the Securities to Subsequent Purchasers pursuant to the
terms hereof, the Initial Purchasers shall not be liable or responsible to the Company for any losses, damages or liabilities suffered or incurred by the Company, including any losses, damages or liabilities under the Securities Act, arising from or
relating to any resale or transfer of any Security. 
  
 SECTION 8. Indemnification. 
  
 (a) Indemnification of the Initial Purchasers. The Company and Holdings jointly and severally agree to indemnify and hold harmless each Initial Purchaser, its directors, officers, employees and affiliates, and each person, if any,
who controls any Initial Purchaser within the meaning of the Securities Act and the Exchange Act against any loss, claim, damage, liability or expense, as incurred, to which such Initial Purchaser or such controlling person may become subject, under
the Securities Act, the Exchange Act or other federal or state statutory law or regulation, or at common law or otherwise (including in settlement of any litigation, if such settlement is effected with the written consent of the Company or Holdings
(unless such consent is not required under Section 8(d) hereof)), insofar as such loss, claim, damage, liability or expense (or actions in respect thereof as contemplated below) arises out of or is based: (i) upon any untrue statement or
alleged untrue statement of a material fact contained in the Preliminary Offering Memorandum or the Offering Memorandum (or any amendment or supplement thereto), or the omission or alleged omission therefrom of a material fact necessary in order to
make the statements therein, in the light of the circumstances under which they were made, not misleading; or (ii) in whole or in part upon any inaccuracy in the representations and warranties of the Company or Holdings contained herein; or
(iii) in whole or in part upon any failure of the Company or Holdings to perform its obligations hereunder or under law; or (iv) upon any act or failure to act or any alleged act or failure to act by any Initial Purchaser in connection
with, or relating in any manner to, the offering contemplated hereby, and which is included as part of or referred to in any loss, claim, damage, liability or action arising out of or based upon any matter covered by clause (i) above
(provided that neither the Company nor Holdings shall be liable under this clause (iv) to the extent that a court of competent jurisdiction shall have determined by a final judgment that such loss, claim, damage, liability or action
resulted directly from any such acts or failures to act undertaken or omitted to be taken by such Initial Purchaser through its gross negligence or willful misconduct); and to reimburse each Initial Purchaser and each such director, officer,
employee, affiliate or controlling person for any and all expenses (including the fees and disbursements of counsel chosen by Banc of America Securities LLC) as such expenses 

  

 22 

 
are reasonably incurred by such Initial Purchaser or such controlling person in connection with investigating, defending, settling, compromising or paying
any such loss, claim, damage, liability, expense or action; provided, however, that the foregoing indemnity agreement shall not apply to any loss, claim, damage, liability or expense to the extent, but only to the extent, arising out
of or based upon any untrue statement or alleged untrue statement or omission or alleged omission made in reliance upon and in conformity with written information furnished to the Company by the Initial Purchasers expressly for use in the
Preliminary Offering Memorandum or the Offering Memorandum (or any amendment or supplement thereto). The indemnity agreement set forth in this Section 8 shall be in addition to any liabilities that the Company or Holdings may otherwise have.

  
 (b) Indemnification of the Company, Its Directors and
Officers. Each Initial Purchaser agrees, severally and not jointly, to indemnify and hold harmless the Company, Holdings and each of their respective affiliates, directors and officers and each person, if any, who controls the Company within the
meaning of the Securities Act or the Exchange Act, against any loss, claim, damage, liability or expense, as incurred, to which the Company, Holdings or any such director, or controlling person may become subject, under the Securities Act, the
Exchange Act, or other federal or state statutory law or regulation, or at common law or otherwise (including in settlement of any litigation, if such settlement is effected with the written consent of such Initial Purchaser), insofar as such loss,
claim, damage, liability or expense (or actions in respect thereof as contemplated below) arises out of or is based upon any untrue or alleged untrue statement of a material fact contained in any Preliminary Offering Memorandum or the Offering
Memorandum (or any amendment or supplement thereto), or arises out of or is based upon the 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 to the extent, but only to the extent, that such untrue statement or alleged untrue statement or omission or alleged omission was made in any Preliminary Offering Memorandum or the Offering Memorandum (or any amendment or supplement
thereto), in reliance upon and in conformity with written information furnished to the Company by such Initial Purchaser expressly for use therein; and to reimburse the Company, Holdings or any such affiliate, director, officer or controlling person
for any legal and other expenses reasonably incurred by the Company, Holdings or such affiliate, director, officer or controlling person in connection with investigating, defending, settling, compromising or paying any such loss, claim, damage,
liability, expense or action. Each of the Company and Holdings hereby acknowledges that the only information that the Initial Purchasers have furnished to the Company expressly for use in any Preliminary Offering Memorandum or the Offering
Memorandum (or any amendment or supplement thereto) are the statements set forth in the letter provided to the Company dated the Closing Date. The indemnity agreement set forth in this Section 8 shall be in addition to any liabilities that each
Initial Purchaser may otherwise have. 
  
 (c) Notifications and
Other Indemnification Procedures. Promptly after receipt by an indemnified party under this Section 8 of notice of the commencement of any action, such indemnified party will, if a claim in respect thereof is to be made against an
indemnifying party under this Section 8, notify the indemnifying party in writing of the commencement thereof, but the omission so to notify the indemnifying party will not relieve it from any liability which it may have to any indemnified
party for contribution or otherwise than under the indemnity agreement contained in this Section 8 or to the extent it is not prejudiced as a proximate result of such failure. In case any such action is brought against any indemnified party and
such 

  

 23 

 
indemnified party seeks or intends to seek indemnity from an indemnifying party, the indemnifying party will be entitled to participate in and, to the extent
that it shall elect, jointly with all other indemnifying parties similarly notified, by written notice delivered to the indemnified party promptly after receiving the aforesaid notice from such indemnified party, to assume the defense thereof with
counsel reasonably satisfactory to such indemnified party; provided, however, if the defendants in any such action include both the indemnified party and the indemnifying party and the indemnified party shall have reasonably concluded that a
conflict may arise between the positions of the indemnifying party and the indemnified party in conducting the defense of any such action or that there may be legal defenses available to it and/or other indemnified parties which are different from
or additional to those available to the indemnifying party, the indemnified party or parties shall have the right to select separate counsel to assume such legal defenses and to otherwise participate in the defense of such action on behalf of such
indemnified party or parties. Upon receipt of notice from the indemnifying party to such indemnified party of such indemnifying party’s election so to assume the defense of such action and approval by the indemnified party of counsel, the
indemnifying party will not be liable to such indemnified party under this Section 8 for any legal or other expenses subsequently incurred by such indemnified party in connection with the defense thereof unless (i) the indemnified party
shall have employed separate counsel in accordance with the proviso to the next preceding sentence (it being understood, however, that the indemnifying party shall not be liable for the expenses of more than one separate counsel (together with local
counsel), approved by the indemnifying party (Banc of America Securities LLC in the case of Section 8 and Section 9), representing the indemnified parties who are parties to such action) or (ii) the indemnifying party shall not have
employed counsel satisfactory to the indemnified party to represent the indemnified party within a reasonable time after notice of commencement of the action, in each of which cases the fees and expenses of counsel shall be at the expense of the
indemnifying party. 
  
 (d) Settlements. The indemnifying
party under this Section 8 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 against any loss, claim, damage, liability or expense by reason of such settlement or judgment. Notwithstanding the foregoing sentence, if at any time an indemnified party shall have requested an indemnifying party to
reimburse the indemnified party for fees and expenses of counsel as contemplated by Section 8 hereof, the indemnifying party agrees that it shall be liable for any settlement of any proceeding effected without its written consent if
(i) such settlement is entered into more than 30 days after receipt by such indemnifying party of the aforesaid request and (ii) such indemnifying party shall not have reimbursed the indemnified party in accordance with such request prior
to the date of such settlement. No indemnifying party shall, without the prior written consent of the indemnified party, effect any settlement, compromise or consent to the entry of judgment in any pending or threatened action, suit or proceeding in
respect of which any indemnified party is or could have been a party and indemnity was or could have been sought hereunder by such indemnified party, unless such settlement, compromise or consent includes an unconditional release of such indemnified
party from all liability on claims that are the subject matter of such action, suit or proceeding. 
  
 SECTION 9. Contribution. If the indemnification provided for in Section 8 is for any reason held to be unavailable
to or otherwise insufficient to hold harmless an indemnified party 

  

 24 

 
in respect of any losses, claims, damages, liabilities or expenses referred to therein, then (i) each indemnifying party shall contribute to the
aggregate amount paid or payable by such indemnified party, as incurred, as a result of any losses, claims, damages, liabilities or expenses referred to therein in such proportion as is appropriate to reflect the relative benefits received by the
Company and Holdings, on the one hand, and the Initial Purchasers, on the other hand, from the offering of the Securities pursuant to this Agreement or (ii) if the allocation provided by clause (i) above is not permitted by applicable law,
in such proportion as is appropriate to reflect not only the relative benefits referred to in clause (i) above but also the relative fault of the Company and Holdings, on the one hand, and the Initial Purchasers, on the other hand, in
connection with the statements or omissions or inaccuracies in the representations and warranties herein which resulted in such losses, claims, damages, liabilities or expenses, as well as any other relevant equitable considerations. The relative
benefits received by the Company and Holdings, on the one hand, and the Initial Purchasers, on the other hand, in connection with the offering of the Securities pursuant to this Agreement shall be deemed to be in the same respective proportions as
the total net proceeds from the offering of the Securities pursuant to this Agreement (before deducting expenses) received by the Company, and the total discount received by the Initial Purchasers bear to the aggregate initial offering price of the
Securities. The relative fault of the Company and Holdings, on the one hand, and the Initial Purchasers, on the other hand, shall be determined by reference to, among other things, whether any such untrue or alleged untrue statement of a material
fact or omission or alleged omission to state a material fact or any such inaccurate or alleged inaccurate representation or warranty relates to information supplied by the Company or Holdings, on the one hand, or the Initial Purchasers, on the
other hand, and the parties’ relative intent, knowledge, access to information and opportunity to correct or prevent such statement or omission. 
  
 The amount paid or payable by a party as a result of the losses, claims, damages, liabilities and expenses referred to above shall be deemed to include,
subject to the limitations set forth in Section 8, any legal or other fees or expenses reasonably incurred by such party in connection with investigating or defending any action or claim. The provisions set forth in Section 8 with respect
to notice of commencement of any action shall apply if a claim for contribution is to be made under this Section 9; provided, however, that no additional notice shall be required with respect to any action for which notice has been given under
Section 8 for purposes of indemnification. 
  
 The Company,
Holdings and the Initial Purchasers agree that it would not be just and equitable if contribution pursuant to this Section 9 were determined by pro rata allocation (even if the Initial Purchasers 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 this Section 9. 
  
 Notwithstanding the provisions of this Section 9, no Initial Purchaser shall be required to contribute any amount in excess of the discount received
by such Initial Purchaser in connection with the Securities distributed by it. No person guilty of fraudulent misrepresentation (within the meaning of Section 11 of the Securities Act) shall be entitled to contribution from any person who was
not guilty of such fraudulent misrepresentation. The Initial Purchasers’ obligations to contribute pursuant to this Section 9 are several, and not joint, in proportion to their respective commitments as set forth opposite their names in
Schedule A. For purposes of this Section 9, 

  

 25 

 
each director, officer and employee of an Initial Purchaser and each person, if any, who controls an Initial Purchaser within the meaning of the Securities
Act and the Exchange Act shall have the same rights to contribution as such Initial Purchaser, and each director of the Company or Holdings, and each person, if any, who controls the Company or Holdings, within the meaning of the Securities Act and
the Exchange Act shall have the same rights to contribution as the Company or Holdings. 
  
 SECTION 10. Termination of This Agreement. Prior to the Closing Date, this Agreement may be terminated by the Initial Purchasers by notice given to the Company if at any time:
(i) trading in securities generally on either the Nasdaq Stock Market or the New York Stock Exchange shall have been suspended or limited, or minimum or maximum prices shall have been generally established on any of such stock exchanges by the
Commission or the NASD; (ii) a general banking moratorium shall have been declared by any of federal, New York or Florida authorities; (iii) there shall have occurred any outbreak or escalation of national or international hostilities or
any crisis or calamity, or any change in the United States or international financial markets, or any substantial change or development involving a prospective substantial change in United States’ or international political, financial or
economic conditions, as in the judgment of the Initial Purchasers is material and adverse and makes it impracticable to proceed with the offering, sale or delivery of the Securities in the manner and on the terms described in the Offering Memorandum
or to enforce contracts for the sale of securities; (iv) in the judgment of the Initial Purchasers there shall have occurred any Material Adverse Change; or (v) the Company or Holdings shall have sustained a loss by strike, fire, flood,
earthquake, accident or other calamity of such character as in the judgment of the Initial Purchasers may interfere materially with the conduct of the business and operations of the Company regardless of whether or not such loss shall have been
insured. Any termination pursuant to this Section 10 shall be without liability on the part of (i) the Company or Holdings to any Initial Purchaser, except that the Company and Holdings shall be jointly and severally obligated to reimburse
the expenses of the Initial Purchasers pursuant to Sections 4 and 6 hereof, (ii) any Initial Purchaser to the Company or Holdings, or (iii) any party hereto to any other party except that the provisions of Section 8 and
Section 9 shall at all times be effective and shall survive such termination. 
  
 SECTION 11. Representations and Indemnities to Survive Delivery. The respective indemnities, agreements, representations, warranties and other statements of the Company and Holdings,
of their respective officers and of the several Initial Purchasers set forth in or made pursuant to this Agreement will remain in full force and effect, regardless of any investigation made by or on behalf of any Initial Purchaser or the Company or
Holdings or any of its or their partners, officers or directors or any controlling person, as the case may be, and will survive delivery of and payment for the Securities sold hereunder and any termination of this Agreement. 
  

 26 

 SECTION 12. Notices. All communications hereunder shall be in writing
and shall be mailed, hand delivered or telecopied and confirmed to the parties hereto as follows: 
  
 If to the Initial Purchasers: 
  
 Banc of America Securities LLC 
 9 West
57th Street 
 New York, NY 10019 
 Facsimile: (212) 847-6441 
 Attention: High Yield Capital Markets 
  
 with a copy to: 
  
 Shearman & Sterling LLP

 599 Lexington Avenue 
 New
York, NY 10022 
 Facsimile: (212) 848-4000 
 Attention: Rohan Weerasinghe, Esq. 
  
 If to the Company or Holdings: 
  
 MSC-Medical Services
Company 
 11764-1 Marco Beach Dr. 
 Jacksonville, Florida 32224 
 Facsimile: (800) 848-1989 
 Attention: Chief Executive Officer 
  
 With a copy to: 
  
 Monitor Clipper Partners, LLC 
 Two Canal
Park, 4th Floor 
 Cambridge, MA 02141 
 Facsimile: (617) 252-2211 
 Attention: Adam Doctoroff 
  
 Ropes & Gray LLP 
 One International Place 
 Boston, MA 02110-2624 
 Facsimile: (617) 951-7050 
 Attention: Jane Goldstein, Esq. 
  
 Any party hereto may change the address for receipt of communications by giving written notice to the others. 
  
 SECTION 13. Successors. This Agreement will
inure to the benefit of and be binding upon the parties hereto, including any substitute Initial Purchasers pursuant to Section 16 hereof, and to the benefit of the employees, officers and directors and controlling persons referred to in
Section 8 and Section 9, and in each case their respective successors, and no other person will have any right or obligation hereunder. The term “successors” shall not include any purchaser of the Securities as such from any of
the Initial Purchasers merely by reason of such purchase. 
  

 27 

 SECTION 14. Partial Unenforceability. The invalidity or
unenforceability of any Section, paragraph or provision of this Agreement shall not affect the validity or enforceability of any other Section, paragraph or provision hereof. If any Section, paragraph or provision of this Agreement is for any reason
determined to be invalid or unenforceable, there shall be deemed to be made such minor changes (and only such minor changes) as are necessary to make it valid and enforceable. 
  
 SECTION 15. Governing Law; Consent to Jurisdiction Provisions.  
  
 (a) Governing Law. THIS AGREEMENT SHALL BE GOVERNED BY AND CONSTRUED
IN ACCORDANCE WITH THE LAWS OF THE STATE OF NEW YORK. 
  
 (b)
Consent to Jurisdiction. Any legal suit, action or proceeding arising out of or based upon this Agreement or the transactions contemplated hereby (“Related Proceedings”) may be instituted in the federal courts of the United States
of America located in the City and County of New York or the courts of the State of New York in each case located in the City and County of New York (collectively, the “Specified Courts”), and each party irrevocably submits to the
non-exclusive jurisdiction (except for proceedings instituted in regard to the enforcement of a judgment of any such court (a “Related Judgment”), as to which such jurisdiction is non-exclusive) of such courts in any such suit, action or
proceeding. Service of any process, summons, notice or document by mail to such party’s address set forth above shall be effective service of process for any suit, action or other proceeding brought in any such court. The parties irrevocably
and unconditionally waive any objection to the laying of venue of any suit, action or other proceeding in the Specified Courts and irrevocably and unconditionally waive and agree not to plead or claim in any such court that any such suit, action or
other proceeding brought in any such court has been brought in an inconvenient forum. 
  
 SECTION 16. Default of an Initial Purchaser. If either of the Initial Purchasers shall fail or refuse to purchase Securities that it or they have agreed to purchase hereunder on the
Closing Date, and the aggregate principal amount of Securities which such defaulting Initial Purchaser agreed but failed or refused to purchase does not exceed 10% of the aggregate principal amount of the Securities to be purchased on such date, the
other Initial Purchaser shall be obligated to purchase the Securities which such defaulting Initial Purchaser agreed but failed or refused to purchase on such date. If either of the Initial Purchasers shall fail or refuse to purchase Securities and
the aggregate principal amount of Securities with respect to which such default occurs exceeds 10% of the aggregate principal amount of Securities to be purchased on the Closing Date, and arrangements satisfactory to the Initial Purchasers and the
Company for the purchase of such Securities are not made within 48 hours after such default, this Agreement shall terminate without liability of any party to any other party except that the provisions of Section 4, Section 6,
Section 8 and Section 9 shall at all times be effective and shall survive such termination, but only as to such non-defaulting Initial Purchaser. In any such case either the Initial Purchasers or the Company shall have the right to
postpone the Closing Date, as the case may be, but in no event for longer than seven days in order that the required changes, if any, to the Offering Memorandum or any other documents or arrangements may be effected. 
  
 As used in this Agreement, the term “Initial Purchaser” shall be
deemed to include any person substituted for a defaulting Initial Purchaser under this Section 16. Any action taken 

  

 28 

 
under this Section 16 shall not relieve any defaulting Initial Purchaser from liability in respect of any default of such Initial Purchaser under this
Agreement. 
  
 SECTION 17. Tax
Disclosure. Notwithstanding anything to the contrary contained herein, each of the Initial Purchasers, the Company and Holdings shall be permitted to disclose the tax treatment and tax structure of each of the transactions contemplated by this
Agreement and the Offering Memorandum (each, a “Transactions”) (including any materials, opinions or analyses relating to such tax treatment or tax structure, but without disclosure of identifying information or, except to the extent
relating to such tax structure or tax treatment, any nonpublic commercial or financial information); provided, however, that if any Transaction is not consummated for any reason, the provisions of this sentence shall cease to apply
with respect to such Transaction. 
  
 SECTION 18. General Provisions. This Agreement constitutes the entire agreement of the parties to this Agreement and supersedes all prior written or oral and all contemporaneous oral agreements,
understandings and negotiations with respect to the subject matter hereof. This Agreement may be executed in two or more counterparts, each one of which shall be an original, with the same effect as if the signatures thereto and hereto were upon the
same instrument. This Agreement may not be amended or modified unless in writing by all of the parties hereto, and no condition herein (express or implied) may be waived unless waived in writing by each party whom the condition is meant to benefit.
The Table of Contents and the section headings herein are for the convenience of the parties only and shall not affect the construction or interpretation of this Agreement. 
  

 29 

 If the foregoing is in accordance with your understanding of our agreement, kindly sign and return to the
Company the enclosed copies hereof, whereupon this instrument, along with all counterparts hereof, shall become a binding agreement in accordance with its terms. 
  

			
	 Very truly yours,

	
	 MSC-MEDICAL SERVICES COMPANY

		
	 By:
	 	 /S/ ROBERT J. BUNKER

	 	 	 Name: Robert J. Bunker

	 	 	 Title: President

	
	 MCP-MSC ACQUISITION, INC.

		
	 By:
	 	 /S/ ROBERT J. BUNKER

	 	 	 Name: Robert J. Bunker

	 	 	 Title: Chief Executive Officer

  
 The foregoing
Purchase Agreement is hereby confirmed and accepted by the Initial Purchasers as of the date first above written. 
  

			
	 BANC OF AMERICA SECURITIES LLC
 J.P. MORGAN SECURITIES INC.

		
	 By:
	 	 BANC OF AMERICA SECURITIES LLC

		
	 By:
	 	 /S/ JOHN MCCUSKER

	 	 	 Name:  John McCusker

	 	 	 Title:    Managing Director

  

 30 

 SCHEDULE A 
  

				
	 Initial Purchasers

	  	Aggregate
Principal
Amount of
Securities to Be
Purchased

	 Banc of America Securities LLC
	  	$	97,500,000
	 J.P. Morgan Securities Inc.
	  	 	52,500,000
	 Total
	  	$	150,000,000

 EXHIBIT A 
  

FORM OF OPINION OF ROPES & GRAY LLP 

 EXHIBIT B 
  

FORM OF OPINION OF AKERMAN SENTERFITT 

 ANNEX I 
  
 Resale Pursuant to Regulation S or Rule 144A. Each Initial Purchaser understands that: 
  
 Such Initial Purchaser agrees that it has not offered or sold and will not
offer or sell the Securities in the United States or to, or for the benefit or account of, a U.S. Person (other than a distributor), in each case, as defined in Rule 902 under the Securities Act (i) as part of its distribution at any time
and (ii) otherwise until 40 days after the later of the commencement of the offering of the Securities pursuant hereto and the Closing Date, other than in accordance with Regulation S of the Securities Act or another exemption from the
registration requirements of the Securities Act. Such Initial Purchaser agrees that, during such 40-day restricted period, it will not cause any advertisement with respect to the Securities (including any “tombstone” advertisement) to be
published in any newspaper or periodical or posted in any public place and will not issue any circular relating to the Securities, except such advertisements as permitted by and include the statements required by Regulation S. 
  
 Such Initial Purchaser agrees that, at or prior to confirmation of a sale of
Securities by it to any distributor, dealer or person receiving a selling concession, fee or other remuneration during the 40-day restricted period referred to in Rule 903 under the Securities Act, it will send to such distributor, dealer or
person receiving a selling concession, fee or other remuneration a confirmation or notice to substantially the following effect: 
  
 “The Securities covered hereby have not been registered under the U.S. Securities Act of 1933, as amended (the “Securities Act”), and may
not be offered and sold within the United States or to, or for the account or benefit of, U.S. persons (i) as part of your distribution at any time or (ii) otherwise until 40 days after the later of the commencement of the Offering and the
Closing Date, except in either case in accordance with Regulation S under the Securities Act (or Rule 144A or to Accredited Institutions in transactions that are exempt from the registration requirements of the Securities Act), and in
connection with any subsequent sale by you of the Notes covered hereby in reliance on Regulation S during the period referred to above to any distributor, dealer or person receiving a selling concession, fee or other remuneration, you must
deliver a notice to substantially the foregoing effect. Terms used above have the meanings assigned to them in Regulation S.” 
  
 Such Initial Purchaser agrees that the Securities offered and sold in reliance on Regulation S will be represented upon issuance by a global security
that may not be exchanged for definitive securities until the expiration of the 40-day restricted period referred to in Rule 903 of the Securities Act and only upon certification of beneficial ownership of such Securities by non-U.S. persons or
U.S. persons who purchased such Securities in transactions that were exempt from the registration requirements of the Securities Act.

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