Document:

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                                                                   EXHIBIT 10.15

                                 LIFE INSURANCE

                      ENDORSEMENT METHOD SPLIT DOLLAR PLAN

                                    AGREEMENT

Insurer:                           Jefferson Pilot Life Insurance Company
                                   Mass Mutual Life Insurance Company

Policy Number:                     JP5221290
                                   0046684

Bank:                              The East Carolina Bank

Insured:                           Gary M. Adams

Relationship of Insured to Bank:   Executive

Trust:                             Rabbi Trust for the Executive Supplemental
                                   Retirement Plan Agreement, Director
                                   Supplemental Retirement Plan Agreement, and
                                   the Endorsement Method Split Dollar Plan
                                   Agreement

The respective rights and duties of the Bank and the Insured in the
above-referenced policy shall be pursuant to the terms set forth below:

I.   DEFINITIONS

     Refer to the policy contract for the definition of any terms in this
     Agreement that are not defined herein. If a definition of a term in the
     policy is inconsistent with the definition of a term in this Agreement,
     then the definition of the term as set forth in this Agreement shall
     supersede and replace the definition of the terms as set forth in the
     policy.

II.  POLICY TITLE AND OWNERSHIP

     Title and ownership shall reside in the Trustee for the Rabbi Trust for the
     Executive Supplemental Retirement Plan Agreement, Director Supplemental
     Retirement Plan Agreement, and the Endorsement Method Split Dollar Plan
     Agreement for its use and for the use of the Insured all in accordance with
     this Agreement. The Trustee at the direction of the Bank may, to the extent
     of the

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     Bank's interest, exercise the right to borrow or withdraw on the policy
     cash values. Where the Trustee at the direction of the Bank and the Insured
     (or assignee, with the consent of the Insured) mutually agree to exercise
     the right to increase the coverage under the subject policy, then, in such
     event, the rights, duties and benefits of the parties to such increased
     coverage shall continue to be subject to the terms of this Agreement.

III. BENEFICIARY DESIGNATION RIGHTS

     The Insured (or assignee) shall have the right and power to designate a
     beneficiary or beneficiaries to receive the Insured's share of the proceeds
     of the policy payable upon the death of the Insured, and to elect and
     change a payment option for such beneficiary, subject to any right or
     interest of the Bank or the Trust may have in such proceeds, as provided in
     this Agreement. Any such designation by the Insured shall be made in
     writing in the form attached hereto as Exhibit A and incorporated herein by
     reference. Any such designation or change therein shall be effective three
     (3) business days from delivery of said written notice by Insured to the
     Bank.

IV.  PREMIUM PAYMENT METHOD

     Subject to Subparagraph IX (B), the Bank or the Trustee at the direction of
     the Bank shall pay an amount equal to the planned premiums and any other
     premium payments that might become necessary to keep the policy in force.

V.   TAXABLE BENEFIT

     Annually the Insured will receive a taxable benefit equal to the value of
     the insurance protection as required by the Internal Revenue Service. The
     Bank or the Trustee at the direction of the Bank will report to the Insured
     the amount of imputed income each year on Form W-2 or its equivalent.

VI.  DIVISION OF DEATH PROCEEDS

     Subject to Paragraphs VII and IX herein, the division of the death proceeds
     of the policy is as follows:

     A.   At the time of the Insured's death, should the Insured be employed by
          the Bank, retired from the Bank, or have had his or her employment
          terminated from the Bank due to disability*, the Insured's
          beneficiary(ies), designated in accordance with Paragraph III or the
          Insured's estate if no beneficiary has been so designated, shall be
          entitled to an amount equal to eighty percent (80%) of the net-at-risk
          insurance portion of the proceeds. The net-at-risk insurance portion
          is the total proceeds less the cash value of the policy.

                                       2

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     B.   Should the Insured not be employed by the Bank at the time of his or
          her death for reasons other than disability* or retirement, the
          Insured's beneficiary(ies), designated in accordance with Paragraph
          III or the Insured's estate if no beneficiary has been so designated,
          shall be entitled to the percentage as set forth hereinbelow of the
          proceeds described in Subparagraph VI (A) above.

          Date of Hire                 10% for each full year of service
                                       from the date of first service
                                       to a maximum of 80%

          PLUS

          If Insured is at least 62
          years of age on his or her
          date of death                20%
                                       For a maximum total of 100%

          *Subject to the Bank's obligations and Insured's rights under Title I
          of the Americans with Disabilities Act and the Family and Medical
          Leave Act, if applicable, and any other applicable federal or state
          laws, for purposes of this Agreement, disability shall be defined as
          the Insured not being able to perform the duties of the Insured's own
          job and shall be as further defined in the Bank's long term disability
          policy in effect at the time of said disability. If no such policy
          exists at the time of the disability, then disability shall be defined
          as a physical or mental impairment of Insured which renders Insured
          incapable of performing Insured's normal and regular essential
          employment duties and which shall be medically determined to be of
          permanent duration as the same is construed for purposes of disability
          benefits under the federal Social Security laws and regulations.

     C.   The Bank shall be entitled to the remainder of such proceeds of the
          policy, including but not limited to the cash surrender value as
          provided in Paragraph VII herein.

     D.   The Bank and the Insured (or assignees) shall share in any interest
          due on the death proceeds on a pro rata basis as the proceeds due each
          respectively bears to the total proceeds, excluding any such interest.

VII. DIVISION OF THE CASH SURRENDER VALUE OF THE POLICY

     The Bank or the Trust, in the discretion of the Bank, shall at all times be
     entitled to an amount equal to the policy's cash value, as that term is
     defined in the policy

                                       3

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     contract, less any policy loans and unpaid interest or cash withdrawals
     previously incurred by the Bank or the Trustee at the direction of the Bank
     and any applicable surrender charges. Such cash value shall be determined
     as of the date of surrender or death of the Insured as the case may be.

VIII. RIGHTS OF PARTIES WHERE POLICY ENDOWMENT OR ANNUITY ELECTION EXISTS

     In the event the policy involves an endowment or annuity element, the
     Bank's or the Trust's right and interest in any endowment proceeds or
     annuity benefits, on expiration of the deferment period, shall be
     determined under the provisions of this Agreement by regarding such
     endowment proceeds or the commuted value of such annuity benefits as the
     policy's cash value. Such endowment proceeds or annuity benefits shall be
     considered to be death proceeds for the purposes of division under this
     Agreement.

IX.  TERMINATION OF AGREEMENT

     This Agreement shall terminate upon the occurrence of any one of the
     following:

     A.   The Insured is terminated by the Bank with cause. For purposes of this
          Agreement, the term "with cause" shall have the same meaning as the
          Employment Agreement between the Bank and the Insured. If no such
          employment agreement exists at the time of termination, the term "with
          cause" shall be deemed to mean, but is not limited to, personal
          dishonesty, incompetence, willful material misconduct, breach of
          fiduciary duty, failure to perform the obligations of the Insured as
          stated herein, willful violation of any law, rule, or regulation
          (other than minor traffic infractions), or, any material breach of any
          provision of this agreement.

     B.   Surrender, lapse, or other termination of the Policy by the Bank.

     Upon such termination, the Insured (or assignee) shall have a fifteen (15)
     day option, which period shall begin to run on the date of termination of
     the policy, to receive from the Bank or the Trustee at the direction of the
     Bank an absolute assignment of the policy in consideration of a cash
     payment to the Bank or the Trustee at the direction of the Bank, whereupon
     this Agreement shall terminate. Such cash payment referred to hereinabove
     shall be the greater of:

     1)   The Bank's or the Trust's share of the cash value of the policy on the
          date of such assignment, as defined in this Agreement; or

     2)   The amount of the premiums which have been paid by the Bank or the
          Trustee at the direction of the Bank prior to the date of such
          assignment.

                                       4

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     If, within said fifteen (15) day period, the Insured fails to exercise said
     option, fails to procure the entire aforestated cash payment, or dies, then
     the option shall terminate and the Insured (or assignee) agrees that all of
     the Insured's rights, interest and claims in the policy shall terminate as
     of the date of the termination of this Agreement.

     The Insured expressly agrees that this Agreement shall constitute
     sufficient written notice to the Insured of the Insured's option to receive
     an absolute assignment of the policy as set forth herein.

     Except as provided above, this Agreement shall terminate upon distribution
     of the death benefit proceeds in accordance with Paragraph VI above.

X.   INSURED'S OR ASSIGNEE'S ASSIGNMENT RIGHTS

     The Insured may not, without the written consent of the Bank, assign to any
     individual, trust or other organization, any right, title or interest in
     the subject policy nor any rights, options, privileges or duties created
     under this Agreement.

XI.  AGREEMENT BINDING UPON THE PARTIES

     This Agreement shall bind the Insured and the Bank or the Trustee, their
     heirs, successors, personal representatives and assigns.

XII. ERISA PROVISIONS

     The following provisions are part of this Agreement and are intended to
     meet the requirements of the Employee Retirement Income Security Act of
     1974 ("ERISA"):

     A.   Named Fiduciary and Plan Administrator.

          The "Named Fiduciary and Plan Administrator" of this Endorsement
          Method Split Dollar Agreement shall be The East Carolina Bank until
          its resignation or removal by the Board of Directors. As Named
          Fiduciary and Plan Administrator, the Bank or the Trustee at the
          direction of the Bank shall be responsible for the management,
          control, and administration of this Split Dollar Plan as established
          herein. The Named Fiduciary may delegate to others certain aspects of
          the management and operation responsibilities of the Plan, including
          the employment of advisors and the delegation of any ministerial
          duties to qualified individuals.

                                       5

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     B.   Funding Policy.

          Subject to Subparagraph IX (B), the funding policy for this Split
          Dollar Plan shall be to maintain the subject policy in force by
          paying, when due, all premiums required.

     C.   Basis of Payment of Benefits.

          Direct payment by the Insurer is the basis of payment of benefits
          under this Agreement, with those benefits in turn being based on the
          payment of premiums as provided in this Agreement.

     D.   Claim Procedures.

          Claim forms or claim information as to the subject policy can be
          obtained by contacting Benmark, Inc. (800-544-6079). When the Named
          Fiduciary has a claim which may be covered under the provisions
          described in the insurance policy, they should contact the office
          named above, and they will either complete a claim form and forward it
          to an authorized representative of the Insurer or advise the named
          Fiduciary what further requirements are necessary. The Insurer will
          evaluate and make a decision as to payment. If the claim is payable, a
          benefit check will be issued in accordance with the terms of this
          Agreement.

          In the event that a claim is not eligible under the policy, the
          Insurer will notify the Named Fiduciary of the denial pursuant to the
          requirements under the terms of the policy. If the Named Fiduciary is
          dissatisfied with the denial of the claim and wishes to contest such
          claim denial, they should contact the office named above and they will
          assist in making an inquiry to the Insurer. All objections to the
          Insurer's actions should be in writing and submitted to the office
          named above for transmittal to the Insurer.

     E.   Notices.

          All notices required or permitted to be given pursuant to this
          Agreement shall be in writing, unless otherwise specified, and shall
          be delivered personally, deposited in the United States mail,
          registered or certified and postage prepaid with return receipt
          requested, or deposited with a reputable overnight courier which
          provides a day and time stamped receipt, addressed to the Executive,
          Bank or Trustee, as applicable, at the address set forth herein or to
          such other address as hereafter may be furnished to the other parties
          in writing pursuant to this paragraph. All notices so given shall be
          deemed effective and received upon the earlier of (i) actual receipt,
          (ii) receipt and refusal; or (iii) five (5) days from (1) the

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          postmark date, if deposited with the United States Postal Service, or
          (2) the date of deposit, if deposited with an overnight courier,
          unless otherwise provided herein.

               Bank:        The East Carolina Bank
                            Hwy. 264
                            Engelhard, North Carolina 27824

               Trustee:     Thomas A. Nussbaum
                            Eastern Bank & Trust Co.
                            2 Adams Place, AP06
                            Quincy, MA  02169-7456

               Executive:   Gary M. Adams

                            -------------------------

                            -------------------------

                            -------------------------

XIII. GENDER

     Whenever in this Agreement words are used in the masculine or neuter
     gender, they shall be read and construed as in the masculine, feminine or
     neuter gender, whenever they should so apply.

XIV. INSURANCE COMPANY NOT A PARTY TO THIS AGREEMENT

     The Insurer shall not be deemed a party to this Agreement, but will respect
     the rights of the parties as herein developed upon receiving an executed
     copy of this Agreement. Payment or other performance in accordance with the
     policy provisions shall fully discharge the Insurer from any and all
     liability.

XV.  CHANGE OF CONTROL

     Change of Control shall mean the direct or indirect acquisition by another
     person, firm or corporation, by merger, share exchange, consolidation,
     purchase or otherwise, all or substantially all of the assets or stock of
     the Bank or its parent company. Upon a Change of Control, if the Insured's
     employment is subsequently terminated, except for cause, then the Insured
     shall be one hundred percent (100%) vested in the benefits promised in this
     Agreement and, therefore, upon the death of the Insured, the Insured's
     beneficiary(ies) (designated in accordance with Paragraph III) shall
     receive the death benefit provided herein as if the Insured had died while
     employed by the Bank (See Subparagraph VI [A]).

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XVI. AMENDMENT OR REVOCATION

     It is agreed by and between the parties hereto that, during the lifetime of
     the Insured, this Agreement may be amended or revoked at any time or times,
     in whole or in part, by the mutual written consent of the Insured and the
     Bank.

XVII. EFFECTIVE DATE

     The Effective Date of this Agreement shall be November 5, 2001.

XVIII. SEVERABILITY AND INTERPRETATION

     If a provision of this Agreement is held to be invalid or unenforceable,
     the remaining provisions shall nonetheless be enforceable according to
     their terms. Further, in the event that any provision is held to be over
     broad as written, such provision shall be deemed amended to narrow its
     application to the extent necessary to make the provision enforceable
     according to law and enforced as amended.

XIX. APPLICABLE LAW

     The validity and interpretation of this Agreement shall be governed by the
     laws of the State of North Carolina.

Executed at Engelhard, North Carolina this 22nd day of January, 2002.

                                          THE EAST CAROLINA BANK
                                          Engelhard, North Carolina

                                          By: /s/ J. Dorson White
-------------------------------------         ----------------------------------
Witness                                       Title: Executive Vice President

                                            /s/ Gary M. Adams
-------------------------------------     --------------------------------------
Witness                                   Gary M. Adams

                                       8

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                                    EXHIBIT A
                          BENEFICIARY DESIGNATION FORM
                      FOR LIFE INSURANCE ENDORSEMENT METHOD
                           SPLIT DOLLAR PLAN AGREEMENT

PRIMARY DESIGNATION:

     Name                        Address                   Relationship
     ----                        -------                   ------------

--------------------------------------------------------------------------------

--------------------------------------------------------------------------------

--------------------------------------------------------------------------------

SECONDARY (CONTINGENT) DESIGNATION:

--------------------------------------------------------------------------------

--------------------------------------------------------------------------------

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All sums payable under the Life Insurance Endorsement Method Split Dollar Plan
Agreement by reason of my death shall be paid to the Primary Beneficiary, if he
or she survives me, and if no Primary Beneficiary shall survive me, then to the
Secondary (Contingent) Beneficiary.

---------------------------------        ---------------------------------------
Gary M. Adams                            Date

                                       9Fourth Amendment to Amended and Restated Credit Agreement

EXHIBIT 10.6 
 
FOURTH AMENDMENT TO 
AMENDED AND RESTATED CREDIT AGREEMENT 
 
THIS FOURTH AMENDMENT TO AMENDED AND RESTATED CREDIT AGREEMENT (this “Amendment”), dated as of January 10, 2003, is entered into by and among AMN HEALTHCARE, INC., a Nevada
corporation (the “Borrower”), AMN HEALTHCARE SERVICES, INC. (formerly known as AMN Holdings, Inc.), a Delaware corporation (the “Parent”), the Subsidiary Guarantors signatory hereto, the lenders identified on the
signature pages hereto as the Lenders (the “Lenders”) and BANK OF AMERICA, N. A., as Agent for the Lenders (in such capacity, the “Agent”). 
 
RECITALS 
 
A. The Borrower, the Parent, the Subsidiary Guarantors, the Lenders and the Agent, are party to that certain
Amended and Restated Credit Agreement dated as of November 16, 2001, as amended by that certain First Amendment to Amended and Restated Credit Agreement dated as of April 8, 2002, as amended by that certain Second Amendment to Amended and Restated
Credit Agreement dated as of May 2, 2002 and as amended by that certain Third Amendment to Amended and Restated Credit Agreement dated as of November 8, 2002 (as amended, the “Existing Credit Agreement”). 
 
B. The Credit Parties have requested that the Lenders amend
the Existing Credit Agreement as provided herein. 
 
C. The Lenders have agreed to amend the Existing Credit Agreement on the terms and conditions hereinafter set forth. 
 
NOW, THEREFORE, in consideration of the agreements herein contained, the parties hereto hereby agree as follows: 
 
PART I 
DEFINITIONS 
 
SUBPART 1.1 Certain Definitions. Unless otherwise defined herein or the context otherwise requires, the following terms used
in this Amendment, including its preamble and recitals, have the following meanings: 
 
“Amended Credit Agreement” means the Existing Credit Agreement as amended hereby. 
 
“Amendment No. 4 Effective
Date” is defined in Part III. 

 
SUBPART 1.2
Other Definitions. Unless otherwise defined herein or the context otherwise requires, terms used in this Amendment, including its preamble and recitals, have the meanings provided in the Existing Credit Agreement. 
 
PART II 
AMENDMENTS TO EXISTING CREDIT AGREEMENT 
 
Effective on (and subject to the occurrence of) the Amendment No. 4 Effective Date, the Existing Credit Agreement is hereby amended in
accordance with this Part II. 
 
SUBPART
2.1 Amendments to Section 1.1. Section 1.1 of the Existing Credit Agreement is hereby amended in the following respects: 
 
(a) The definition of “Applicable Percentage” appearing in Section 1.1 of the Existing Credit Agreement
is hereby amended and restated in its entirety to read as follows: 
 
“Applicable Percentage” means, for purposes of calculating the applicable interest rate for any day for any Loan, the applicable rate of the Standby Letter of Credit Fee for any day
for purposes of Section 3.5(c)(i) or the applicable rate of the Trade Letter of Credit Fee for any day for purposes of Section 3.5(c)(ii), the appropriate applicable percentage corresponding to the Leverage Ratio in effect as of the most recent
Calculation Date: 
 

	 	  	 	    	 Applicable Percentages

	 
	 Pricing
 Level

	  	 Leverage Ratio

	    	 Eurodollar Loans

	 	  	 Base Rate Loans

	 	    	 For Standby Letter of Credit Fee

	 	  	 For Trade Letter of Credit Fee

	 
	 I
	  	 3
	 0.75 to 1.0
	    	 1.75
	 %
	  	 0.75
	 %
	    	 1.75
	 %
	  	 0.875
	 %

	 II
	  	 <
	  0.75 to 1.0
	    	 1.50
	 %
	  	 0.50
	 %
	    	 1.50
	 %
	  	 0.75
	 %

	

The Applicable Percentages shall be determined and adjusted
quarterly on the date (each a “Calculation Date”) five Business Days after the date by which the Credit Parties are required to provide the Required Financial Information for the most recently ended fiscal quarter or fiscal year, as
the case may be, of the Consolidated Parties; provided, however, that (i) the initial Applicable Percentages shall be based on Pricing Level II (as shown above) and shall remain at Pricing Level II until the Calculation Date for the
fiscal year of the Consolidated Parties ending on December 31, 2002, on and after which time the Pricing Level shall be determined by the Leverage Ratio as of the last day of the most recently ended fiscal quarter or fiscal year, as the case may be,
of the Consolidated Parties preceding the applicable Calculation Date and (ii) if the Credit Parties fail to provide the Required Financial Information to the Agent as required for the fiscal quarter or fiscal year, as the case may be, of the
Consolidated Parties preceding the applicable Calculation Date, the Applicable Percentage from such Calculation Date shall be based on Pricing Level I until such time as the Required Financial Information is provided, whereupon the Pricing

 

2 

 
Level shall
be determined by the Leverage Ratio as of the last day of the most recently ended fiscal quarter or fiscal year, as the case may be, of the Consolidated Parties preceding such Calculation Date. Each Applicable Percentage shall be effective from one
Calculation Date until the next Calculation Date. Any adjustment in the Applicable Percentages shall be applicable to all existing Loans and Letters of Credit as well as any new Loans and Letters of Credit made or issued. 
 
(b) The definition of “Consolidated
Capital Expenditures” appearing in Section 1.1 of the Existing Credit Agreement is hereby amended and restated in its entirety to read as follows: 
 
“Consolidated Capital Expenditures” means, as of any date for the four fiscal quarter period ending on
such date with respect to the Consolidated Parties on a consolidated basis, all capital expenditures, as determined in accordance with GAAP; provided, however, that Consolidated Capital Expenditures shall not include (i) Eligible
Reinvestments made with proceeds of any Involuntary Disposition and (ii) up to $10,000,000 in capital expenditures related to a new headquarter building. 
 
(c) The definition of “Excess Cash Flow” appearing in Section 1.1 of the Existing Credit Agreement is
hereby amended and restated in its entirety to read as follows: 
 
“Excess Cash Flow” means, with respect to any fiscal year period of the Consolidated Parties on a consolidated basis, an amount equal to (a) Consolidated EBITDA minus (b)
Consolidated Capital Expenditures minus (c) capital expenditures related to the new headquarter building in an amount not to exceed $10,000,000 minus (d) Consolidated Cash Interest Expense minus (e) to the extent not taken into
account in the calculation of Excess Cash Flow for any prior fiscal year, Federal, state and other income taxes accrued or paid (without duplication) by the Parent and the Consolidated Parties on a consolidated basis minus (f) Consolidated
Scheduled Funded Debt Payments minus (g) increases in Consolidated Net Working Capital minus (h) the cash amount of all Investments of the types referred to in clauses (ix) and (xiii) of the definition of “Permitted
Investments” set forth in this Section 1.1 plus (i) decreases in Consolidated Net Working Capital. 
 
(d) The definition of “Fixed Charge Coverage Ratio” appearing in Section 1.1 of the Existing Credit
Agreement is hereby amended and restated in its entirety to read as follows: 
 
“Fixed Charge Coverage Ratio” means, as of the end of any fiscal quarter of the Consolidated Parties for the four fiscal quarter period ending on such date with respect to the
Consolidated Parties on a consolidated basis, the ratio of (a) the sum of (i) Consolidated EBITDA for such period minus (ii) Consolidated Capital Expenditures for such period minus (iii) Consolidated Cash Taxes for such period
minus (iv) the cash amount of all Restricted Payments made pursuant to clause (k) of Section 8.7 to (b) the sum of (i) Consolidated Cash Interest Expense for such period 
 

3 

 
plus
(ii) Consolidated Scheduled Funded Debt Payments for such period (other than Consolidated Scheduled Funded Debt Payments for any period prior to the Closing Date). 
 
(e) The definition of “Maturity Date” appearing in Section 1.1 of the
Existing Credit Agreement is hereby amended and restated in its entirety to read as follows: 
 
“Maturity Date” means December 31, 2006. 
 
(f) Clause (vii) of the definition of “Permitted Acquisition” appearing in
Section 1.1 of the Existing Credit Agreement is amended and restated in its entirety to read as follows: 
 
(vii) the total Qualifying Consideration for any such Acquisition shall not exceed an amount equal to (A) $200,000,000
plus (B) 50% of Excess Cash Flow for each fiscal year ended after December 31, 2002 minus (C) the aggregate amount of Qualifying Consideration paid with respect to all Acquisitions occurring after December 31, 2002 minus (D) the
aggregate amount expended under Section 8.7(f); provided, further, however, prior to and after giving effect to all Permitted Acquisitions, on a pro forma basis, the Unused Revolving Committed Amount shall not be less than $25,000,000.

 
SUBPART 2.2 Amendments to Section
2.1. Section 2.1(a) of the Existing Credit Agreement is hereby amended and restated in its entirety to read as follows: 
 
2.1 Revolving Loans. 
 
(a) Revolving Commitment. Subject to the terms and conditions hereof and in reliance upon the representations and
warranties set forth herein, each Lender severally agrees to make available to the Borrower such Lender’s Commitment Percentage of revolving credit loans requested by the Borrower in Dollars (“Revolving Loans”) from time to
time from the Closing Date until the Maturity Date, or such earlier date as the Revolving Commitments shall have been terminated as provided herein; provided, however, that the sum of the aggregate outstanding principal amount of
Revolving Loans shall not exceed SEVENTY-FIVE MILLION DOLLARS ($75,000,000) (as such aggregate maximum amount may be reduced from time to time as provided in Section 3.4, the “Revolving Committed Amount”); provided, further,
(A) with regard to each Lender individually, such Lender’s outstanding Revolving Loans shall not exceed such Lender’s Commitment Percentage of the Revolving Committed Amount, and (B) the sum of the aggregate outstanding principal amount of
Revolving Loans plus LOC Obligations plus Swingline Loans shall not exceed the Revolving Committed Amount. Revolving Loans may consist of Base Rate Loans or Eurodollar Loans, or a combination thereof, as the Borrower may request;
provided, however, that no more than 6 Eurodollar Loans which are Revolving Loans shall be outstanding hereunder at any time (it being understood that, for purposes hereof, Eurodollar Loans with different 
 

4 

 
Interest
Periods shall be considered as separate Eurodollar Loans, even if they begin on the same date, although borrowings, extensions and conversions may, in accordance with the provisions hereof, be combined at the end of existing Interest Periods to
constitute a new Eurodollar Loan with a single Interest Period). Revolving Loans hereunder may be repaid and reborrowed in accordance with the provisions hereof. 
 
SUBPART 2.3 Amendments to Section 7.1. Section 7.1(b) of the Existing Credit Agreement is
hereby amended and restated in its entirety to read as follows: 
 
7.1 Information Covenants. 
 
(b) Quarterly Statements. As soon as available, and in any event within 45 days after the close of each of the first three fiscal quarters of the Parent, (i) a consolidated and consolidating
balance sheet and income statement of the Parent as of the end of such fiscal quarter, together with related consolidated statements of retained earnings and cash flows for such fiscal quarter, in each case setting forth in comparative form figures
for the corresponding period of the preceding fiscal year, all such financial information described above to be in reasonable form and detail and reasonably acceptable to the Agent, and accompanied by a certificate of an Executive Officer of the
Borrower to the effect that such quarterly financial statements fairly present in all material respects the financial condition of the Parent and have been prepared in accordance with GAAP, subject to changes resulting from audit and normal year-end
audit adjustments and the absence of footnotes (the Lenders agree that, to the extent that the requirements of this clause (i) are contained in the quarterly report of the Parent for such fiscal quarter on Form 10-Q as filed with the SEC (the
“Quarterly Report”), the obligations of the Credit Parties under this clause (i) will be satisfied by delivering to the Agent, within 45 days after the end of such fiscal quarter, the Quarterly Report, with copies for each Lender) and (ii)
a disclosure statement (the “Disclosure Statement”) in reasonable form and detail and reasonably acceptable to the Agent setting forth the adjustments to the financial statements delivered pursuant to clause (i) above necessary to
determine the consolidated and consolidating balance sheet and income statement and the related consolidated statements of retained earnings and cash flows of the Consolidated Parties as of the end of such fiscal quarter, and accompanied by a
certificate of an Executive Officer of the Borrower to the effect that such Disclosure Statement when combined with the Quarterly Report present in all material respects the financial condition of the Consolidated Parties and have been prepared in
accordance with GAAP, subject to changes resulting from audit and normal year-end audit adjustments and the absence of footnotes. 
 
SUBPART 2.4 Amendments to Section 7.11. Section 7.11(a) of the Existing Credit Agreement is hereby amended and restated in
its entirety to read as follows: 
 

5 

 
7.11
Financial Covenants. 
 
(a)
Leverage Ratio. The Credit Parties shall not permit the Leverage Ratio as of the last day of any fiscal quarter of the Consolidated Parties to be greater than 1.50 to 1.00. 
 
SUBPART 2.5 Replacement of Schedule 2.1(a). Schedule 2.1(a) of the Existing Credit
Agreement is hereby deleted in its entirety and a new schedule in the form of Schedule 2.1(a) attached hereto is substituted therefor. 
 
PART III 
CONDITIONS TO EFFECTIVENESS 
 
This Amendment shall be and become effective as of the date (the “Amendment No. 4 Effective Date”) when all of the conditions set forth in this Part III shall have been satisfied. 
 
SUBPART 3.1 Execution of Counterparts of
Amendment. The Agent shall have received counterparts of this Amendment, which collectively shall have been duly executed on behalf of each of the Borrower, each of the Guarantors and the Lenders. 
 
SUBPART 3.2 Corporate Documents. The Agent shall
have received the following: 
 
(i) Resolutions. Copies of resolutions of the Board of Directors of each Credit Party approving and adopting this Amendment, the transactions contemplated therein and authorizing execution and delivery thereof, certified by a
secretary or assistant secretary of such Credit Party to be true and correct and in force and effect as of the Amendment No. 4 Effective Date. 
 
(ii) Good Standing. Copies of certificates of good standing, existence or its equivalent with respect to each
Credit Party certified as of a recent date by the appropriate Governmental Authorities of the state or other jurisdiction of incorporation. 
 
(iii) Incumbency. An incumbency certificate of each Credit Party certified by a secretary or assistant secretary to
be true and correct as of the Amendment No. 4 Effective Date. 
 
SUBPART 3.3 Execution of Revolving Notes. Receipt by the Agent for each applicable Lender of a duly executed new Revolving Note. 
 
SUBPART 3.4 Opinions of Counsel. The Agent shall have received a legal opinion of (i) Paul, Weiss, Rifkind, Wharton &
Garrison and (ii) a legal opinion of special Nevada counsel for the Borrower, each in form and substance reasonably satisfactory to the Agent. 
 

6 

 
SUBPART 3.5
Amendment Fee. The Agent shall have received for the account of each Lender an amendment fee equal to (a) 1.25% of the Revolving Commitment of each such Lender (after giving effect to any such increase) that increases its Revolving
Commitment by an amount greater than or equal to $5,000,000 or (b) 0.75% of the Revolving Commitment of each such Lender (after giving effect to any such increase) that increases its Revolving Commitment by less than $5,000,000. 
 
SUBPART 3.6 Other Items. The Agent shall have
received such other documents, agreements or information which may be reasonably requested by the Agent. 
 
PART IV 
MISCELLANEOUS 
 
SUBPART 4.1 Construction. This Amendment is a
Credit Document executed pursuant to the Existing Credit Agreement and shall (unless otherwise expressly indicated therein) be construed, administered and applied in accordance with the terms and provisions of the Amended Credit Agreement.

 
SUBPART 4.2 Representations and
Warranties. Each Credit Party hereby represents and warrants that (i) each Credit Party that is party to this Amendment: (a) has the requisite corporate power and authority to execute, deliver and perform this Amendment, as applicable and (b) is
duly authorized to, and has been authorized by all necessary corporate action, to execute, deliver and perform this Amendment, (ii) the representations and warranties contained in Section 6 of the Amended Credit Agreement are true and correct in all
material respects on and as of the date hereof upon giving effect to this Amendment as though made on and as of such date (except for those which expressly relate to an earlier date) and (iii) no Default or Event of Default exists under the Existing
Credit Agreement on and as of the date hereof upon giving effect to this Amendment. 
 
SUBPART 4.3 Acknowledgment. The Guarantors acknowledge and consent to all of the terms and conditions of this Amendment and agree that this Amendment does not operate to reduce or
discharge the Guarantors’ obligations under the Amended Credit Agreement or the other Credit Documents. The Guarantors further acknowledge and agree that the Guarantors have no claims, counterclaims, offsets, or defenses to the Credit Documents
and the performance of the Guarantors’ obligations thereunder or if the Guarantors did have any such claims, counterclaims, offsets or defenses to the Credit Documents or any transaction related to the Credit Documents, the same are hereby
waived, relinquished and released in consideration of the Lenders’ execution and delivery of this Amendment. 
 
SUBPART 4.4 Counterparts. This Amendment may be executed by the parties hereto in several counterparts, each of which shall
be deemed to be an original and all of which shall constitute together but one and the same agreement. 
 
SUBPART 4.5 Binding Effect. This Amendment, the Amended Credit Agreement and the other Credit Documents embody the entire
agreement between the parties and supersede all prior agreements and understandings, if any, relating to the subject matter hereof. These Credit Documents represent the final agreement between the parties and may not be contradicted by 
 

7 

evidence of prior, contemporaneous or subsequent oral agreements of the parties. Except as expressly
modified and amended in this Amendment, all the terms, provisions and conditions of the Credit Documents shall remain unchanged and shall continue in full force and effect. 
 
SUBPART 4.6 GOVERNING LAW. THIS AGREEMENT AND THE RIGHTS AND OBLIGATIONS OF THE PARTIES
HEREUNDER SHALL BE GOVERNED BY AND CONSTRUED AND INTERPRETED IN ACCORDANCE WITH THE LAWS OF THE STATE OF NEW YORK. 
 
SUBPART 4.7 Severability. If any provision of this Amendment is determined to be illegal, invalid or unenforceable, such
provision shall be fully severable and the remaining provisions shall remain in full force and effect and shall be construed without giving effect to the illegal, invalid or unenforceable provisions. 
 
[REMAINDER OF PAGE INTENTIONALLY LEFT BLANK] 
 
 

8 

 
IN WITNESS
WHEREOF, each of the parties hereto has caused a counterpart of this Amendment to be duly executed and delivered as of the date first above written. 
 

	 BORROWER:
	 	 	 	 AMN HEALTHCARE, INC.

	
	 	 	 	 	 	 	 By:
	 	 /s/    DONALD R. MYLL
        

	 	 	 	 	 	 	 Name:
	 	 DONALD R. MYLL

	 	 	 	 	 	 	 Title:
	 	 CFO, CAO & Treasurer

 

	 PARENT:
	 	 	 	 AMN HEALTHCARE SERVICES, INC

	
	 	 	 	 	 	 	 By:
	 	 /s/    DONALD R. MYLL
        

	 	 	 	 	 	 	 Name:
	 	 DONALD R. MYLL

	 	 	 	 	 	 	 Title:
	 	 CFO, CAO & Treasurer

 

	 SUBSIDIARY
 GUARANTORS:
	 	 	 	 WORLDVIEW HEALTHCARE, INC.

	
	 	 	 	 	 	 	 By:
	 	 /s/    DONALD R. MYLL
        

	 	 	 	 	 	 	 Name:
	 	 DONALD R. MYLL

	 	 	 	 	 	 	 Title:
	 	 CFO, CAO

 

	 	 	 	 	 O’GRADY-PEYTON INTERNATIONAL (USA), INC.

	
	 	 	 	 	 	 	 By:
	 	 /s/    DONALD R. MYLL
        

	 	 	 	 	 	 	 Name:
	 	 DONALD R. MYLL

	 	 	 	 	 	 	 Title:
	 	 CAO

 

	 	 	 	 	 INTERNATIONAL HEALTHCARE RECRUITERS, INC.

	
	 	 	 	 	 	 	 By:
	 	 /s/    DONALD R. MYLL
        

	 	 	 	 	 	 	 Name:
	 	 DONALD R. MYLL

	 	 	 	 	 	 	 Title:
	 	 CFO & Treasurer

 
[Signatures Continued] 

 

	 AGENT:
	 	 	 	 BANK OF AMERICA, N. A.,
 in its capacity as Agent

	
	 	 	 	 	 	 	 By:
	 	 /s/    CHARLES GRABER

	 	 	 	 	 	 	 Name:
	 	 CHARLES GRABER

	 	 	 	 	 	 	 Title:
	 	 Vice President 

 

	 LENDERS:
	 	 	 	 BANK OF AMERICA, N. A.,

	
	 	 	 	 	 	 	 By:
	 	 /s/    ROBERT KLAWINKSKI

	 	 	 	 	 	 	 Name:
	 	 ROBERT KLAWINSKI

	 	 	 	 	 	 	 Title:
	 	 Managing Director

 
[Signatures Continued] 

 

	 GENERAL ELECTRIC CAPITAL
 CORPORATION

	
	 By:
	 	 /s/    CURTIS R. HART

	 Name:
	 	 CURTES R. HART

	 Title:
	 	 Duly Authorized Signatory

 

	 UNION BANK OF CALIFORNIA, N.A

	
	 By:
	 	 /s/    DOUGLAS S. LAMBELL

	 Name:
	 	 DOUGLAS S. LAMBELL

	 Title:
	 	 Vice President/SCM

 
Schedule
2.1(a) 
 
LENDER ADDRESSES AND COMMITMENTS

 

	
	 Operations Contact

	  	 Credit Contact

	  	 Revolving Commitment

	  	 Commitment Percentage

	 
	
	 Bank of America
 101 N. Tryon Street
 15th Floor
 Charlotte, NC 28255
 Attn: Sam Maynard
 Ph: (704) 386-9368
 Fax: (704) 409-0283
	  	 Bank of America, N.A.
 John A. Fulton
 Associate
 NC1-007-17-11
 100 North Tryon Street
 Charlotte, NC 28255
 Fax: 704-388-6002
 Phone: 704-386-2998
 Email: john.a.fulton@bankofamerica.com
	  	 $
	 26,250,000
	  	 35.0000000
	 %

	
	 Union Bank of California, N.A.
 445 South Figueroa Street
 15th Floor
 Los Angeles, CA 90071
 Attn: Ruby Gonzales
 Ph: (323) 720-7055
 Fax: (323) 720-6198
	  	 Union Bank of California N.A.
 Doug Lambell
 4th Floor
 530 B Street
 San Diego, CA 92101
 Work Email: douglas.lambell@uboc.com
 Fax Phone : (619) 230-3766
 Office Phone :
(619) 230-3029
	  	 $
	 22,500,000
	  	 30.0000000
	 %

	
	 General Electric Capital Corporation
 Lisa Labon
 120 Long Ridge Rd.
 Stamford, CT 06927
 Fax: (312) 419-5726
 Ph: (312) 419-5559
	  	 General Electric Capital Corporation
 Care Of: GE Capital Commercial Finance
 Ken A. Brown
 Suite 2700
 10 S. LaSalle St
 Chicago, IL 60603
 Work
 Email: ken.brown@gecapital.com
 Fax Phone :
(312) 419-7711
 Office Phone : (312) 419-5747
	  	 $
	 26,250,000
	  	 35.0000000
	 %

	
	 	  	 	  	
	
	  	
	

	
	 TOTAL:
	  	 	  	 $
	 75,000,000
	  	 100
	 %

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