Document:

Exhibit 10.1a

 

FIRST AMENDMENT TO PURCHASED SERVICES AGREEMENT

 

This FIRST AMENDMENT TO
PURCHASED SERVICES AGREEMENT (this “Amendment”) is dated effective as of the 11 day of June, 2009, and is entered into
between GK FINANCING, LLC, a California limited liability company (“GKF”), or its wholly owned subsidiary whose obligations
hereunder shall be guaranteed by GKF, and KETTERING MEDICAL CENTER, an Ohio non-profit corporation, (“Medical Center”).

 

Recitals:

 

WHEREAS, GKF and Medical
Center are parties to a certain Purchased Services Agreement dated December 9, 2008 (the “Agreement”), which the parties
desire to amend as set forth herein.

 

NOW, THEREFORE, for valuable
consideration, the receipt and sufficiency of which are acknowledged, the parties hereby amend the Agreement as follows:

 

Agreement:

 

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

 

2.          Extension
of Term. Pursuant to Sections 5.1 and 23.19 of the Agreement, the parties agreed that if the Equipment is delivered to
the Site in advance of the expiration of the current term of the Prior Agreement, then (i) the Prior Agreement would terminate
early upon the deinstallation of the Model B; and (ii) the parties would negotiate an extension to the Term of the Agreement to
offset the effect of the early termination of the Prior Agreement. It is acknowledged that the term of the Prior Agreement originally
expired on June 13, 2009, but was terminated one hundred three (103) days early (on March 3, 2009) by reason of the deinstallation
of the Model B. Accordingly, in order to offset the early termination of the Prior Agreement, the Term of the Agreement as set
forth in Section 3 of the Agreement is hereby extended by an additional one hundred three (103) days beyond the date that is seven
(7) years following the date of the First Procedure Date at the Site.

 

3.          Amendment
to Section 6.7. Section 6.7 of the Agreement is hereby deleted in its entirety and replaced with the following:

 

“6.7           Notwithstanding
anything to the contrary contained in this Agreement, GKF’s responsibility for all costs and expenses incurred in connection
with Section 6.1, 6.2, and 6.3 shall not exceed One Hundred Sixty Thousand Dollars ($160,000) in the aggregate. All costs and expenses
in excess of One Hundred Sixty Thousand Dollars ($160,000) shall be the responsibility of Medical Center.”

 

     

     

    

 

4.          Full
Force and Effect. Except as amended by this Amendment, all of the terms and provisions of the Agreement shall remain in
full force and effect. Notwithstanding the foregoing, to the extent of any conflict or inconsistency between the terms and provisions
of this Amendment and that of the Agreement, the terms and provisions of this Amendment shall prevail and control.

 

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

 

	GKF:	 	Hospital:
	 	 	 
	GK FINANCING, LLC	 	KETTERING MEDICAL CENTER
	 	 	 	 	 
	By:	/s/ Ernest A. Bates	 	By:	/s/ Brett Spenst
	 	Ernest A. Bates, M.D.	 	Name:	Brett Spenst
	 	Policy Committee Member	 	Title:	VP of Finance & Operations

 

    - 2 -Exhibit 10.2

 

ADDENDUM

TO LEASE AGREEMENT FOR A GAMMA KNIFE UNIT

 

This ADDENDUM TWO TO LEASE
AGREEMENT FOR A GAMMA KNIFE UNIT (this “Addendum”) is dated effective as of April 13, 2007, and is entered into between
GK FINANCING, LLC, a California limited liability company (“GKF”) or its wholly owned subsidiary whose obligation under
this Agreement shall be guaranteed by GKF, and OSF Healthcare System, an Illinois not for profit corporation, owner and operator
of St. Francis Medical Center (“Medical Center”), with reference to the following recitals:

 

Recitals:

 

WHEREAS, on February 18,
2000, GKF and Medical Center executed a Lease Agreement for a Gamma Knife Unit (the “Lease”); and

 

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

 

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

 

Agreement:

 

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

 

		2.	Extension of Lease Term.

 

		a.	It is acknowledged that the Commencement Date of the Lease is May 14, 2001. In view of the provisions
set forth below in this Section, Section 18 of the Lease is hereby deleted in its entirety.

		b.	In consideration of the “Upgrade and First Reload” described below, the Term of the
Lease as set forth in Section 6 of the Lease is hereby extended for an additional five (5) years (collectively, the “First
Extension”). The First Extension shall commence on May 14, 2011 (which is the expiration date of the initial Term of the
Lease).

		c.	If the “Second Reload” is performed as described below, then, in consideration thereof,
the Term of the Lease (as extended by the First Extension) shall be automatically extended for an additional three (3) years (collectively,
the “Second Extension”). The Second Extension shall commence on May 14, 2016 (which is the expiration date of the First
Extension).

		d.	All references in the Lease to the “Term” shall be deemed to refer to the Term, as
extended by the First Extension and the Second Extension, as applicable.

 

     

     

    

 

		3.	Upgrade and Cobalt Reload of the Equipment. Section 15 of the Lease is hereby deleted
in its entirety and replaced with the following:

 

“15.1 Upgrade and First Reload.
Subject to the terms and conditions set forth below, (a) GKF, at GKF’s cost and expense, shall replace and upgrade the Equipment
to a Leksell Gamma Knife Perfexion model (the “Perfexion Model”) and reload the Equipment (as upgraded) with new cobalt-60
(the “Upgrade and First Reload”), which Upgrade and First Reload shall be performed at the Site; and (b) GKF shall
use its commercially reasonable efforts to perform the Upgrade and First Reload during summer/fall 2007, subject to availability
of the Perfexion Model from the equipment manufacturer. It is anticipated that the Equipment will be unavailable to perform procedures
for approximately four to five weeks due to the Upgrade and First Reload process. Medical Center agrees to be responsible for all
insurance, rigging, site modifications and installation costs related to the Upgrade and First Reload, and the de-installation
and removal of the existing Equipment.

 

“15.2 Second Reload. Subject
to the terms and conditions set forth below, (a) GKF may elect, at its sole option and at its cost and expense, to reload the Perfexion
Model with new cobalt-60 (the “Second Reload”), which Second Reload shall be performed at the Site; and (b) if GKF
has elected to do so, GKF shall use its commercially reasonable efforts to perform the Second Reload during the 13th
year of the Lease. Medical Center agrees to be responsible for all insurance, rigging, site modifications and installation costs
related to the Second Reload.

 

“15.3 Medical Center Support.
In connection with both the Upgrade and First Reload and the Second Reload, Medical Center, at Medical Center’s cost and
expense, shall provide GKF with Medical Center personnel (including Medical Center physicists) and services upon request and as
required by GKF, among other things, to oversee, supervise and assist with construction and compliance with local, state and federal
regulatory requirements and with nuclear regulatory compliance issues and the calibration of the Perfexion model.

 

“15.4 Permits. Notwithstanding
the foregoing, the Upgrade and First Reload and the Second Reload (if applicable) shall be performed by GKF only after all necessary
and appropriate licenses, permits, approvals, consents and authorizations, including, without limitation, the proper handling of
the cobalt-60 (collectively, the “Permits”), have been obtained by Medical Center at Medical Center’s sole cost
and expense (other than any filing or registration fees which shall be paid for by GKF). The timing and procedure for such Upgrade
and First Reload and the Second Reload (if applicable) shall be as mutually agreed upon between the parties. Notwithstanding anything
to the contrary contained in this Agreement, GKF makes no representation or warranty to Medical Center concerning the Upgrade and
First Reload and/or the Second Reload (if applicable), and GKF shall have no obligation or liability to pay any damages to Medical
Center resulting therefrom.

 

“15.5 All references in this
Agreement to (a) “Installation” shall be deemed to refer to the Upgrade and First Reload and the Second Reload, as
applicable; and (b) “Equipment” shall be deemed, immediately following its upgrade, to mean the Perfexion Model.”

 

		4.	Per Procedure Payment. 

 

		a.	Notwithstanding the provisions of Section 7 of the Lease, commencing from and after the first day
of the first month after installation of the Perfexion Model, the per procedure payment set forth in Section 7 of the Lease shall
be amended to equal Nine Thousand Two Hundred and Fifty Dollars ($9,250) per procedure, and no further adjustment to such per procedure
payment shall be made based on the number of procedures performed during any year or other time period under the Lease. As used
in the Lease, the term “procedure” shall mean each individual treatment session (fraction), whether performed on an
inpatient or outpatient basis, during which a patient receives treatment, imaging or other procedures, including, without limitation,
treatment planning and delivery, imaging and other ancillary services, using the Equipment and/or any other equipment or devices
that are used in lieu of, or as an alternative to, the Equipment.

 

    - 2 - 

     

    

 

		5.	No Responsibility for Additional Upgrades or Reloading. Notwithstanding anything to the contrary
contained herein or in the Lease, it is understood by the parties that GKF is not responsible for any additional upgrades, hardware,
cobalt reloading, software changes and/or other modifications to the Perfexion Model, except as expressly set forth herein or otherwise
agreed upon in writing by Medical Center and GKF.

 

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

 

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

 

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

 

	GKF:	 	Medical Center:
	 	 	 	 
	GK FINANCING, LLC	 	OSF HEALTHCARE SYSTEM, owner and
    operator of Saint Francis Medical Center
	 	 	 	 
	By:	/s/ Ernest A. Bates	 	By:	/s/ John Moore
	Name:	Ernest A. Bates, M.D.	 	Name:	John Moore
	Title:	GKF Policy Committee Member	 	Title:	Chief Executive Officer
	 	 	 	 	

 

    - 3 -

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