Document:

EX-4.1

 EXHIBIT 4.1 
 NEITHER THIS SECURITY NOR THE SECURITIES FOR WHICH THIS SECURITY IS EXERCISABLE HAVE BEEN REGISTERED WITH THE SECURITIES AND EXCHANGE COMMISSION OR THE SECURITIES COMMISSION OF ANY STATE IN RELIANCE UPON
AN EXEMPTION FROM REGISTRATION UNDER THE SECURITIES ACT OF 1933, AS AMENDED (THE “SECURITIES ACT”), OR ANY STATE SECURITIES LAWS AND, ACCORDINGLY, MAY NOT BE OFFERED OR SOLD EXCEPT PURSUANT TO AN EFFECTIVE REGISTRATION STATEMENT UNDER THE
SECURITIES ACT OR PURSUANT TO AN AVAILABLE EXEMPTION FROM, OR IN A TRANSACTION NOT SUBJECT TO, THE REGISTRATION REQUIREMENTS OF THE SECURITIES ACT AND IN ACCORDANCE WITH APPLICABLE STATE SECURITIES LAWS AS EVIDENCED BY A LEGAL OPINION OF COUNSEL TO
THE TRANSFEROR TO SUCH EFFECT, THE SUBSTANCE OF WHICH SHALL BE REASONABLY ACCEPTABLE TO THE COMPANY. THIS SECURITY AND THE SECURITIES ISSUABLE UPON EXERCISE OF THIS SECURITY MAY BE PLEDGED IN CONNECTION WITH A BONA FIDE MARGIN ACCOUNT OR OTHER LOAN
SECURED BY SUCH SECURITIES. 
 COMMON STOCK PURCHASE WARRANT 

UNIVERSITY GENERAL HEALTH SYSTEM, INC. 
  

			
	 Warrant Shares: 1,000,000
	 	 Initial Exercise Date: September 28, 2012

 THIS COMMON STOCK PURCHASE WARRANT (the “Warrant”) certifies that, for value received,
MIDCAP FINANCIAL, LLC, a Delaware limited liability company, or its assigns (the “Holder”) is entitled, upon the terms and subject to the limitations on exercise and the conditions hereinafter set forth, at any time on or after the
date hereof (the “Initial Exercise Date”) and on or prior to the close of business on the five year anniversary of the Initial Exercise Date (the “Termination Date”) but not thereafter, to subscribe for and purchase
from UNIVERSITY GENERAL HEALTH SYSTEM, INC., a Nevada corporation (the “Company”), up to 1,000,000 shares (as subject to adjustment hereunder, the “Warrant Shares”) of common stock of the Company, par value $0.001
per share (“Common Stock”). The purchase price of one share of Common Stock under this Warrant shall be equal to the Exercise Price, as defined in Section 2(b). 

Section 1. Definitions. Capitalized terms used and not otherwise defined herein shall have the meanings set forth in
that certain Credit and Security Agreement (the “Agreement”), dated as of the Initial Exercise Date, among the Company, the Holder and the additional borrower and lender parties thereto. 

  
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 Section 2. Exercise. 

a) Exercise of Warrant. Exercise of the purchase rights represented by this Warrant may be made, in whole or in
part, at any time or times on or after the Initial Exercise Date and on or before the Termination Date by delivery to the Company (or such other office or agency of the Company as it may designate by notice in writing to the registered Holder at the
address of the Holder appearing on the books of the Company) of a duly executed copy of the Notice of Exercise form annexed hereto (the “Notice of Exercise”), whether by facsimile, email or otherwise, and within three
(3) Trading Days (as defined below) of the date said Notice of Exercise is delivered to the Company, the Company shall have received payment of the aggregate Exercise Price of the shares thereby purchased by wire transfer or cashier’s
check drawn on a United States bank or, if available, pursuant to the cashless exercise procedure specified in Section 2(c) below. “Trading Day” means a day on which the applicable Trading Market (as defined in
Section 2(c)) is open for trading. Notwithstanding anything herein to the contrary, the Holder shall not be required to physically surrender this Warrant to the Company until the Holder has exercised its purchase rights with respect to all of
the Warrant Shares available hereunder and the Warrant has been exercised in full, in which case, the Holder shall surrender this Warrant to the Company for cancellation within three (3) Trading Days of the date the final Notice of Exercise is
delivered to the Company. Partial exercises of this Warrant resulting in purchases of a portion of the total number of Warrant Shares available hereunder shall have the effect of lowering the outstanding number of Warrant Shares purchasable
hereunder in an amount equal to the applicable number of Warrant Shares purchased. The Holder and the Company shall maintain records showing the number of Warrant Shares purchased and the date of such purchases. The Company shall deliver any
objection to any Notice of Exercise Form within one (1) Business Day of receipt of such notice. The Holder and any assignee, by acceptance of this Warrant, acknowledge and agree that, by reason of the provisions of this paragraph, following
the purchase of a portion of the Warrant Shares hereunder, the number of Warrant Shares available for purchase hereunder at any given time may be less than the amount stated on the face hereof. 

b) Exercise Price. The exercise price per share of the Common Stock under this Warrant shall be $0.32, subject to
adjustment hereunder (the “Exercise Price”). 
 c) Cashless Exercise. If at any time
after the six-month anniversary of the Initial Exercise Date, there is no effective registration statement registering, and no current prospectus available for, the resale of the Warrant Shares by the Holder, then this Warrant may also be exercised,
in whole or in part, at such time by means of a “cashless exercise” in which the Holder shall be entitled to receive a certificate evidencing that number of Warrant Shares equal to the quotient obtained by dividing [(A-B)*(X)] by (A),
where: 
  

			
	(A) =	 	the Closing Price (as defined below) on the Trading Day immediately preceding the date on which Holder elects to exercise this Warrant by means of a “cashless exercise,”
as set forth in the applicable Notice of Exercise;
		
	(B) =	 	the Exercise Price of this Warrant, as adjusted hereunder; and

  
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	(X) =	 	the number of Warrant Shares that would be issuable upon exercise of this Warrant in accordance with the terms of this Warrant if such exercise were by means of a cash exercise
rather than a cashless exercise.

 Notwithstanding anything herein to the contrary, on the Termination Date, this
Warrant shall be automatically exercised via cashless exercise pursuant to this Section 2(c). “Closing Price” means on any particular date (a) the last reported closing bid price per share of Common Stock on such date on
the Trading Market (as reported by Bloomberg Financial Markets (“Bloomberg”) at 4:15 p.m. (New York City time)), (b) if there is no such price on such date, then the closing bid price on the Trading Market on the date nearest
preceding such date (as reported by Bloomberg at 4:15 p.m. (New York City time)), (c) if the Common Stock is not then listed or quoted on a Trading Market and if prices for the Common Stock are then reported in the “pink sheets”
published by Pink OTC Markets, Inc. (or a similar organization or agency succeeding to its functions of reporting prices), the most recent bid price per share of the Common Stock so reported, or (d) if the shares of Common Stock are not then
publicly traded, the fair market value as of such date of a share of Common Stock as determined by an independent appraiser selected in good faith by the Holders of a majority in interest of the Warrants then outstanding and reasonably acceptable to
the Company, the fees and expenses of which shall be paid by the Company. “Trading Market” means any of the following markets or exchanges on which the Common Stock is listed or quoted for trading on the date in question: the NYSE
AMEX, the Nasdaq Capital Market, the Nasdaq Global Market, the Nasdaq Global Select Market, the New York Stock Exchange or the OTC Bulletin Board (or any successors to any of the foregoing). 

d) Mechanics of Exercise. 

i. Delivery of Certificates Upon Exercise. The Company shall cause any and all Warrant Shares issuable hereunder
to be transmitted by Clear Trust LLC, Inc., or any successor transfer agent of the Company (the “Transfer Agent”), to the Holder by, as specified in the Notice of Exercise, either (1) crediting the account of the Holder’s
prime broker, if any, with The Depository Trust Company (“DTC”) through its Deposit or Withdrawal at Custodian system (“DWAC”), provided that the Company is then a participant in such system and either
(A) there is an effective registration statement permitting the issuance of the Warrant Shares to or resale of the Warrant Shares by the Holder or (B) the shares are eligible for resale by the Holder without volume or manner-of-sale
limitations pursuant to Rule 144 under the Securities Act, or (2) physical delivery of a certificate evidencing the Warrant Shares to the address specified by the Holder in the Notice of Exercise by the date that is three (3) Trading Days
after the latest of (A) the delivery to the Company of the Notice of Exercise, (B) surrender of this Warrant (if required), and (C) payment of the aggregate Exercise Price as set forth above (including by cashless exercise, if
permitted) (such date, the “Warrant Share Delivery Date”). The Warrant Shares shall be deemed to have been issued, and Holder or 

  
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any other person so designated to be named therein shall be deemed to have become a holder of record of such shares for all purposes, as of the date the Warrant has been exercised, with payment
to the Company of the Exercise Price (or by cashless exercise, if permitted) and all taxes required to be paid by the Holder, if any, pursuant to Section 2(d)(vi) prior to the issuance of such shares, having been paid. If the Company fails for
any reason to deliver to the Holder certificates evidencing the Warrant Shares subject to a Notice of Exercise or to credit the Holder’s account with DTC for such number of Warrant Shares by the Warrant Share Delivery Date, the Company shall
pay to the Holder, in cash, as liquidated damages and not as a penalty, for each $1,000 of Warrant Shares subject to such exercise (based on the Closing Price of the Common Stock on the date of the applicable Notice of Exercise), $10 per Trading Day
(increasing to $20 per Trading Day on the fifth Trading Day after such liquidated damages begin to accrue) for each Trading Day after such Warrant Share Delivery Date until such certificates are delivered, such DTC account is credited or Holder
rescinds such exercise. 
 ii. Delivery of New Warrants Upon Exercise. If this Warrant shall have been
exercised in part, the Company shall, at the request of a Holder and upon surrender of this Warrant certificate, at the time of delivery of the certificate or certificates representing Warrant Shares or the crediting of the Holder’s DTC account
with such number of Warrant Shares, deliver to the Holder a new Warrant evidencing the rights of the Holder to purchase the unpurchased Warrant Shares called for by this Warrant, which new Warrant shall in all other respects be identical with this
Warrant. 
 iii. Rescission Rights. If the Company fails to cause the Transfer Agent to transmit to the
Holder a certificate or the certificates representing the Warrant Shares or credit the Holder’s DTC account with such number of Warrant Shares pursuant to Section 2(d)(i) by the Warrant Share Delivery Date, then the Holder will have the
right to rescind such exercise. 
 iv. Compensation for Buy-In on Failure to Timely Deliver Certificates Upon
Exercise. In addition to any other rights available to the Holder, if the Company fails to cause the Transfer Agent to transmit to the Holder a certificate or the certificates representing the Warrant Shares or to credit the Holder’s
balance account with DTC for such number of Warrant Shares pursuant to an exercise on or before the Warrant Share Delivery Date, and if after such date the Holder is required by its broker to purchase (in an open market transaction or otherwise) or
the Holder’s brokerage firm otherwise purchases, shares of Common Stock to deliver in satisfaction of a sale by the Holder of the Warrant Shares which the Holder anticipated receiving upon such exercise (a “Buy-In”), then the
Company shall (A) pay in cash to the Holder the amount, if any, by which 

  
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(x) the Holder’s total purchase price (including brokerage commissions, if any) for the shares of Common Stock so purchased exceeds (y) the amount obtained by multiplying (1) the
number of Warrant Shares that the Company was required to deliver to the Holder in connection with the exercise at issue times (2) the price at which the sell order giving rise to such purchase obligation was executed, and (B) at the
option of the Holder, either reinstate the portion of the Warrant and equivalent number of Warrant Shares for which such exercise was not honored (in which case such exercise shall be deemed rescinded) or deliver to the Holder the number of shares
of Common Stock that would have been issued had the Company timely complied with its exercise and delivery obligations hereunder. For example, if the Holder purchases Common Stock having a total purchase price of $11,000 to cover a Buy-In with
respect to an attempted exercise of shares of Common Stock with an aggregate sale price giving rise to such purchase obligation of $10,000, under clause (A) of the immediately preceding sentence, the Company shall be required to pay the Holder
$1,000. The Holder shall provide the Company written notice indicating the amounts payable to the Holder in respect of the Buy-In and, upon request of the Company, evidence of the amount of such loss. Nothing herein shall limit a Holder’s right
to pursue any other remedies available to it hereunder, at law or in equity including, without limitation, a decree of specific performance and/or injunctive relief with respect to the Company’s failure to timely deliver certificates
representing shares of Common Stock upon exercise of the Warrant as required pursuant to the terms hereof. 
 v.
No Fractional Shares or Scrip. No fractional shares or scrip representing fractional shares shall be issued upon the exercise of this Warrant. As to any fraction of a share which the Holder would otherwise be entitled to purchase upon such
exercise, the Company shall, at its election, either pay a cash adjustment in respect of such final fraction in an amount equal to such fraction multiplied by the Exercise Price or round up to the next whole share. 

vi. Charges, Taxes and Expenses. Issuance of certificates for Warrant Shares shall be made without charge to the
Holder for any issue or transfer tax or other incidental expense in respect of the issuance of such certificate, all of which taxes and expenses shall be paid by the Company, and such certificates shall be issued in the name of the Holder or in such
name or names as may be directed by the Holder; provided, however, that in the event certificates for Warrant Shares are to be issued in a name other than the name of the Holder, this Warrant when surrendered for exercise shall be
accompanied by the Assignment Form attached hereto duly executed by the Holder and the Company may require, as a condition thereto, the payment of a sum sufficient to reimburse it for any transfer tax incidental thereto. The Company shall pay all
Transfer Agent fees required for same-day processing of any Notice of Exercise. 

  
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 vii. Closing of Books. The Company will not close its stockholder
books or records in any manner which prevents the timely exercise of this Warrant, pursuant to the terms hereof. 

e) Holder’s Exercise Limitations. The Company shall not effect any exercise of this Warrant, and a Holder
shall not have the right to exercise any portion of this Warrant, pursuant to Section 2 or otherwise, to the extent that after giving effect to such issuance after exercise as set forth on the applicable Notice of Exercise, the Holder (together
with the Holder’s Affiliates (as defined in Rule 405 under the Securities Act), and any other Persons acting as a group together with the Holder or any of the Holder’s Affiliates), would beneficially own in excess of the Beneficial
Ownership Limitation (as defined below). For purposes of the foregoing sentence, the number of shares of Common Stock beneficially owned by the Holder and its Affiliates shall include the number of shares of Common Stock issuable upon exercise
of this Warrant with respect to which such determination is being made, but shall exclude the number of shares of Common Stock which would be issuable upon (i) exercise of the remaining, nonexercised portion of this Warrant beneficially owned
by the Holder or any of its Affiliates and (ii) exercise or conversion of the unexercised or nonconverted portion of any other securities of the Company (including, without limitation, any debt, preferred stock, right, option, warrant or other
instrument that is at any time convertible into or exercisable or exchangeable for, or otherwise entitles the holder thereof to receive, Common Stock) subject to a limitation on conversion or exercise analogous to the limitation contained herein
beneficially owned by the Holder or any of its Affiliates. Except as set forth in the preceding sentence, for purposes of this Section 2(e), beneficial ownership shall be calculated in accordance with Section 13(d) of the Securities
Exchange Act of 1934, as amended (the “Exchange Act”), and the rules and regulations promulgated thereunder, it being acknowledged by the Holder that the Company is not representing to the Holder that such calculation is in
compliance with Section 13(d) of the Exchange Act and the Holder is solely responsible for any schedules required to be filed in accordance therewith. To the extent that the limitation contained in this Section 2(e) applies, the
determination of whether this Warrant is exercisable (in relation to other securities owned by the Holder together with any Affiliates) and of which portion of this Warrant is exercisable shall be in the sole discretion of the Holder, and the
submission of a Notice of Exercise shall be deemed to be the Holder’s determination of whether this Warrant is exercisable (in relation to other securities owned by the Holder together with any Affiliates) and of which portion of this Warrant
is exercisable, in each case subject to the Beneficial Ownership Limitation, and the Company shall have no obligation to verify or confirm the accuracy of such determination. In addition, a determination as to any group status as contemplated above
shall be determined in accordance with Section 13(d) of the Exchange Act and the rules and regulations promulgated thereunder. For purposes of this Section 2(e), in determining the number of outstanding shares

  
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of Common Stock, a Holder may rely on the number of outstanding shares of Common Stock as reflected in (A) the Company’s most recent Form 10-K, Form 10-Q, Current Report on Form 8-K or
other public filing with the Securities and Exchange Commission (the “Commission”), as the case may be, (B) a more recent public announcement by the Company or (C) a more recent written notice by the Company or the
Transfer Agent setting forth the number of shares of Common Stock outstanding. Upon the written or oral request of a Holder, the Company shall within two Trading Days confirm orally and in writing to the Holder the number of shares of Common
Stock then outstanding. In any case, the number of outstanding shares of Common Stock shall be determined after giving effect to the conversion or exercise of securities of the Company, including this Warrant, by the Holder or its Affiliates
since the date as of which such number of outstanding shares of Common Stock was reported. The “Beneficial Ownership Limitation” shall be 4.99% of the number of shares of the Common Stock outstanding immediately after giving effect
to the issuance of shares of Common Stock issuable upon exercise of this Warrant. The Holder, upon not less than 61 days’ prior notice to the Company, may increase or decrease the Beneficial Ownership Limitation provisions of this
Section 2(e), provided that the Beneficial Ownership Limitation in no event exceeds 9.99% of the number of shares of the Common Stock outstanding immediately after giving effect to the issuance of shares of Common Stock upon exercise of this
Warrant held by the Holder and the provisions of this Section 2(e) shall continue to apply. Any such increase or decrease will not be effective until the 61st day after such notice is delivered to the Company. The provisions of this paragraph shall be construed and implemented
in a manner otherwise than in strict conformity with the terms of this Section 2(e) to correct this paragraph (or any portion hereof) which may be defective or inconsistent with the intended Beneficial Ownership Limitation herein contained or
to make changes or supplements necessary or desirable to properly give effect to such limitation. The limitations contained in this paragraph shall apply to a successor holder of this Warrant. 

Section 3. Certain Adjustments. 

a) Stock Dividends and Splits. If the Company, at any time while this Warrant is outstanding: (i) pays a stock
dividend or otherwise makes a distribution or distributions on shares of its Common Stock or any other equity or equity equivalent securities payable in shares of Common Stock (which, for avoidance of doubt, shall not include any shares of Common
Stock issued by the Company upon exercise of this Warrant), (ii) subdivides outstanding shares of Common Stock into a larger number of shares, (iii) combines (including by way of reverse stock split) outstanding shares of Common Stock into
a smaller number of shares or (iv) issues by reclassification of shares of the Common Stock any shares of capital stock of the Company, then in each case the Exercise Price shall be multiplied by a fraction of which the numerator shall be the
number of shares of Common Stock (excluding treasury shares, if any) outstanding immediately before such event and of which the denominator shall be the number of shares of Common Stock outstanding immediately after such event, and the number of
Warrant Shares issuable upon exercise of this Warrant shall be increased or decreased 

  
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proportionately, so that after such adjustment the aggregate Exercise Price payable hereunder for the adjusted number of Warrant Shares shall be the same as the aggregate Exercise Price in effect
immediately prior to such adjustment (without regard to any limitations on exercise contained herein). Any adjustment made pursuant to this Section 3(a) shall become effective immediately after the record date for the determination of
stockholders entitled to receive such dividend or distribution and shall become effective immediately after the effective date in the case of a subdivision, combination or re-classification. 

b) Subsequent Equity Sales. If the Company or any Subsidiary thereof, as applicable, at any time while this Warrant
is outstanding, shall sell or grant any option to purchase, or sell or grant any right to reprice, or otherwise dispose of or issue (or announce any offer, sale, grant or any option to purchase or other disposition) any Common Stock or other
securities of the Company which would entitle the holder thereof to acquire at any time Common Stock (including, without limitation, any debt, preferred stock, right, option, warrant or other instrument that is at any time convertible into or
exercisable or exchangeable for, or otherwise entitles the holder thereof to receive, Common Stock) (“Common Stock Equivalents”), at an effective price per share less than the Exercise Price then in effect (such lower price, the
“Base Share Price” and such issuances collectively, a “Dilutive Issuance”) (it being understood and agreed that if the holder of the Common Stock or Common Stock Equivalents so issued shall at any time, whether by
operation of purchase price adjustments, reset provisions, floating conversion, exercise or exchange prices or otherwise, or due to warrants, options or rights per share which are issued in connection with such issuance, be entitled to receive
shares of Common Stock at an effective price per share that is less than the Exercise Price, such issuance shall be deemed to have occurred for less than the Exercise Price on such date of the Dilutive Issuance at such effective price), then
simultaneously with the consummation of each Dilutive Issuance the Exercise Price shall be reduced and only reduced to equal the Base Share Price. Such adjustment shall be made whenever such Common Stock or Common Stock Equivalents are issued.
Notwithstanding the foregoing, no adjustments shall be made, paid or issued under this Section 3(b) in respect of the issuance of (i) shares of Common Stock or options exercisable therefor to employees, officers or directors of the Company
pursuant to any stock or option plan duly adopted for such purpose; provided, however, no such issuance shall be made to Don Sapaugh, Ed Laborde, Hassan Chahadeh or Michael Griffin, unless such issuance has been approved by at least two out of three
independent members of the Company’s board of directors, which members satisfy the requirements of an independent director under the rules and regulations of the New York Stock Exchange or the NASDAQ Stock Market, or (ii) shares of Common
Stock issuable upon the exercise or exchange of or conversion of any Common Stock Equivalents issued and outstanding on the date of this Warrant, provided that the terms applicable to such securities have not been amended since the date of this
Warrant to increase the number of such shares of Common Stock issuable thereunder or to decrease the exercise price, exchange price or conversion price of such securities. The Company shall notify the Holder, in writing, no later than the Trading
Day following the issuance or deemed issuance of any Common Stock or Common Stock Equivalents subject to this Section 3(b), indicating therein the applicable issuance price, or applicable reset price, exchange price, conversion price and other
pricing terms (such notice, the 

  
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“Dilutive Issuance Notice”). For purposes of clarification, whether or not the Company provides a Dilutive Issuance Notice pursuant to this Section 3(b), upon the occurrence
of any Dilutive Issuance, the Holder is entitled to receive a number of Warrant Shares based upon the Base Share Price regardless of whether the Holder accurately refers to the Base Share Price in the Notice of Exercise. 

c) Subsequent Rights Offerings. In addition to any adjustments pursuant to the other subsections of this
Section 3, if at any time the Company grants, issues or sells any Common Stock Equivalents or rights to purchase stock, warrants, securities or other property pro rata to the record holders of any class of shares of Common Stock (the
“Purchase Rights”), then the Holder will be entitled to acquire, upon the terms applicable to such Purchase Rights, the aggregate Purchase Rights which the Holder could have acquired if the Holder had held the number of shares of
Common Stock acquirable upon complete exercise of this Warrant (without regard to any limitations on exercise hereof, including without limitation, the Beneficial Ownership Limitation) immediately before the date on which a record is taken for the
grant, issuance or sale of such Purchase Rights, or, if no such record is taken, the date as of which the record holders of shares of Common Stock are to be determined for the grant, issue or sale of such Purchase Rights. 

d) Pro Rata Distributions. During such time as this Warrant is outstanding, if the Company shall declare or make
any dividend or other distribution of its assets (or rights to acquire its assets) to holders of shares of Common Stock, by way of return of capital or otherwise (including, without limitation, any distribution of cash, stock or other securities,
property or options by way of a dividend, spin off, reclassification, corporate rearrangement, scheme of arrangement or other similar transaction) (a “Distribution”), at any time after the issuance of this Warrant, then, in each
such case, the Holder shall be entitled to participate in such Distribution to the same extent that the Holder would have participated therein if the Holder had held the number of shares of Common Stock acquirable upon complete exercise of this
Warrant (without regard to any limitations on exercise hereof, including without limitation, the Beneficial Ownership Limitation) immediately before the date of which a record is taken for such Distribution, or, if no such record is taken, the date
as of which the record holders of shares of Common Stock are to be determined for the participation in such Distribution. 
 e) Fundamental Transaction. If, at any time while this Warrant is outstanding, (i) the Company, directly or indirectly, in one or more related transactions effects any merger or consolidation
of the Company with or into another Person, (ii) the Company, directly or indirectly, effects any sale, lease, license, assignment, transfer, conveyance or other disposition of all or substantially all of its assets in one or a series of
related transactions, (iii) any, direct or indirect, purchase offer, tender offer or exchange offer (whether by the Company or another Person) is completed pursuant to which holders of Common Stock are permitted to sell, tender or exchange
their shares for other securities, cash or property and has been accepted by the holders of 50% or more of the outstanding Common Stock (not including any shares of Common Stock held by the Person or Persons making or party to, or associated or
affiliated with the Persons making or party to, such purchase, tender or exchange offer), (iv) the Company, directly or indirectly, in one or more related transactions effects any reclassification, reorganization

  
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or recapitalization of the Common Stock or any compulsory share exchange pursuant to which the Common Stock is effectively converted into or exchanged for other securities, cash or property,
(v) the Company, directly or indirectly, in one or more related transactions consummates a stock or share purchase agreement or other business combination (including, without limitation, a reorganization, recapitalization, spin-off or scheme of
arrangement) with another Person or group of Persons whereby such other Person or group acquires more than 50% of the outstanding shares of Common Stock (not including any shares of Common Stock held by the other Person or other Persons making or
party to, or associated or affiliated with the other Persons making or party to, such stock or share purchase agreement or other business combination), or (vi) any “person” or “group” (as such terms are used for purposes of
Sections 13(d) and 14(d) of the Exchange Act) is or shall become the “beneficial owner” (as defined in Rule 13d-3 under the Exchange Act), directly or indirectly, of 50% of the aggregate ordinary voting power represented by shares of
issued and outstanding Common Stock (each a “Fundamental Transaction”), then, upon any subsequent exercise of this Warrant, the Holder shall have the right to receive, for each Warrant Share that would have been issuable upon such
exercise immediately prior to the occurrence of such Fundamental Transaction, at the option of the Holder (without regard to any limitation in Section 2(e) on the exercise of this Warrant), the number of shares of common stock or comparable
security of the Successor Entity (as defined below) and any additional consideration (the “Alternate Consideration”) receivable as a result of such Fundamental Transaction by a holder of the number of shares of Common Stock for
which this Warrant is exercisable immediately prior to such Fundamental Transaction (without regard to any limitation in Section 2(e) on the exercise of this Warrant). For purposes of any such exercise, the determination of the Exercise Price
shall be appropriately adjusted to apply to such Alternate Consideration based on the amount of Alternate Consideration issuable in respect of one share of Common Stock in such Fundamental Transaction, and the Company shall apportion the Exercise
Price among the Alternate Consideration in a reasonable manner reflecting the relative value of any different components of the Alternate Consideration. If holders of Common Stock are given any choice as to the securities, cash or property to be
received in a Fundamental Transaction, then the Holder shall be given the same choice as to the Alternate Consideration it receives upon any exercise of this Warrant following such Fundamental Transaction. Notwithstanding anything to the contrary,
in the event of a Fundamental Transaction that is (1) an all cash transaction, (2) a “Rule 13e-3 transaction” as defined in Rule 13e-3 under the Exchange Act, or (3) a Fundamental Transaction involving a person or entity not
traded on a national securities exchange, the Company or any Successor Entity shall, at the Holder’s option, exercisable at any time concurrently with, or within 30 days after, the consummation of the Fundamental Transaction, purchase this
Warrant from the Holder by paying to the Holder an amount of cash equal to the Black Scholes Value of the remaining unexercised portion of this Warrant on the date of the consummation of such Fundamental Transaction. “Black Scholes
Value” means the value of this Warrant based on the Black and Scholes Option Pricing Model obtained from the “OV” function on Bloomberg determined as of the day of consummation of the applicable Fundamental Transaction for pricing
purposes and reflecting (A) a risk-free interest rate corresponding to the U.S. Treasury rate for a period equal to the time between the date of the public announcement of the applicable 

  
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 Fundamental Transaction and the Termination Date, (B) an expected volatility equal to
the greater of 100% and the 100 day volatility obtained from the HVT function on Bloomberg as of the Trading Day immediately following the public announcement of the applicable Fundamental Transaction, (C) the underlying price per share of
Common Stock used in such calculation shall be the sum of the price per share being offered in cash, if any, plus the value of any non-cash consideration, if any, being offered in such Fundamental Transaction and (D) a remaining option time
equal to the time between the date of the public announcement of the applicable Fundamental Transaction and the Termination Date. The Company shall cause any successor entity in a Fundamental Transaction in which the Company is not the survivor (the
“Successor Entity”) to assume in writing all of the obligations of the Company under this Warrant in accordance with the provisions of this Section 3(e) pursuant to written agreements in form and substance reasonably
satisfactory to the Holder and approved by the Holder (without unreasonable delay) prior to such Fundamental Transaction and shall, at the option of the Holder, deliver to the Holder in exchange for this Warrant a security of the Successor Entity
evidenced by a written instrument substantially similar in form and substance to this Warrant which is exercisable for a corresponding number of shares of common stock or comparable security of such Successor Entity (or its parent entity) equivalent
to the shares of Common Stock acquirable and receivable upon exercise of this Warrant (without regard to any limitations on the exercise of this Warrant) prior to such Fundamental Transaction, and with an exercise price which applies the exercise
price hereunder to such shares of common stock or comparable security (but taking into account the relative value of the shares of Common Stock pursuant to such Fundamental Transaction and the value of such shares of common stock or comparable
security, such number of shares of common stock or comparable security and such exercise price being for the purpose of protecting the economic value of this Warrant immediately prior to the consummation of such Fundamental Transaction), and which
is reasonably satisfactory in form and substance to the Holder. Upon the occurrence of any such Fundamental Transaction, the Successor Entity shall succeed to, and be substituted for (so that from and after the consummation of such Fundamental
Transaction, the provisions of this Warrant referring to the “Company” shall refer instead to the Successor Entity), and may exercise every right and power of the Company and shall assume all of the obligations of the Company under this
Warrant with the same effect as if such Successor Entity had been named as the Company herein. 
 f)
Calculations. All calculations under this Section 3 shall be made to the nearest cent or the nearest 1/100th of a share, as the case may be. For purposes of this Section 3, the number of shares of Common Stock deemed to be issued
and outstanding as of a given date shall not include shares owned or held by or for the account of the Company. 

g) Notice to Holder. 
 i. Adjustment to Exercise Price. Whenever the Exercise Price is adjusted pursuant to any provision of this Section 3, the Company shall promptly mail to the Holder a notice setting forth the
Exercise Price after such adjustment and any resulting adjustment to the number of Warrant Shares and setting forth a brief statement of the facts requiring such adjustment. 

  
 11 

 ii. Notice to Allow Exercise by Holder. If (A) the Company
shall declare a dividend (or any other distribution in whatever form) on the Common Stock, (B) the Company shall declare a special nonrecurring cash dividend on or a redemption of the Common Stock, (C) the Company shall authorize the
granting to all holders of the Common Stock rights or warrants to subscribe for or purchase any shares of capital stock of any class or of any rights, (D) the approval of any stockholders of the Company shall be required in connection with any
reclassification of the Common Stock, any consolidation or merger to which the Company is a party, any sale or transfer of all or substantially all of the assets of the Company, or any compulsory share exchange whereby the Common Stock is converted
into other securities, cash or property, or (E) the Company shall authorize the voluntary or involuntary dissolution, liquidation or winding up of the affairs of the Company, then, in each case, the Company shall cause to be mailed to the
Holder at its last address as it shall appear upon the Warrant Register of the Company (as defined in Section 4(c)), at least 20 calendar days prior to the applicable record or effective date hereinafter specified, a notice stating (x) the
date on which a record is to be taken for the purpose of such dividend, distribution, redemption, rights or warrants, or if a record is not to be taken, the date as of which the holders of the Common Stock of record to be entitled to such dividend,
distributions, redemption, rights or warrants are to be determined or (y) the date on which such reclassification, consolidation, merger, sale, transfer or share exchange is expected to become effective or close, and the date as of which it is
expected that holders of the Common Stock of record shall be entitled to exchange their shares of the Common Stock for securities, cash or other property deliverable upon such reclassification, consolidation, merger, sale, transfer or share
exchange; provided that the failure to mail such notice or any defect therein or in the mailing thereof shall not affect the validity of the corporate action required to be specified in such notice or the Holder’s rights hereunder. To the
extent that any notice provided hereunder constitutes, or contains, material, non-public information regarding the Company or any of its subsidiaries, the Company shall simultaneously file such notice with the Commission pursuant to a Current Report
on Form 8-K. The Holder shall remain entitled to exercise this Warrant during the period commencing on the date of such notice to the effective date of the event triggering such notice, except as may otherwise be expressly set forth herein.

 Section 4. Transfer of Warrant. 

a) Transferability. Subject to compliance with any applicable securities laws and the conditions set forth in
Section 4(d) hereof, this Warrant and all rights hereunder (including, without limitation, any registration rights) are transferable, in whole or in part, 

  
 12 

 
upon surrender of this Warrant at the principal office of the Company or its designated agent, together with a written assignment of this Warrant substantially in the form attached hereto duly
executed by the Holder or its agent or attorney and funds sufficient to pay any transfer taxes payable upon the making of such transfer. Upon such surrender and, if required, such payment, the Company shall execute and deliver a new Warrant or
Warrants in the name of the assignee or assignees, as applicable, and in the denomination or denominations specified in such instrument of assignment, and shall issue to the assignor a new Warrant evidencing the portion of this Warrant not so
assigned, and this Warrant shall promptly be cancelled. The Warrant, if properly assigned in accordance herewith, may be exercised by a new holder for the purchase of Warrant Shares without having a new Warrant issued. 

b) New Warrants. This Warrant may be divided or combined with other Warrants upon presentation hereof at the
aforesaid office of the Company, together with a written notice specifying the names and denominations in which new Warrants are to be issued, signed by the Holder or its agent or attorney. Subject to compliance with Section 4(a), as to any
transfer which may be involved in such division or combination, the Company shall execute and deliver a new Warrant or Warrants in exchange for the Warrant or Warrants to be divided or combined in accordance with such notice. All Warrants issued on
transfers or exchanges shall be dated the Initial Exercise Date and shall be identical with this Warrant except as to the number of Warrant Shares issuable pursuant thereto and any applicable adjustment to the Exercise Price. 

c) Warrant Register. The Company shall register this Warrant, upon records to be maintained by the Company for that
purpose (the “Warrant Register”), in the name of the record Holder hereof from time to time. The Company may deem and treat the registered Holder of this Warrant as the absolute owner hereof for the purpose of any exercise hereof or
any distribution to the Holder, and for all other purposes, absent actual notice to the contrary. 
 d)
Representation by the Holder. The Holder, by the acceptance hereof, represents and warrants that it is acquiring this Warrant and, upon any exercise hereof, will acquire the Warrant Shares issuable upon such exercise, for its own account and
not with a view to or for distributing or reselling such Warrant Shares or any part thereof in violation of the Securities Act or any applicable state securities law, except pursuant to sales registered or exempted under the Securities Act.

 Section 5. Miscellaneous. 

a) No Rights as Stockholder Until Exercise. This Warrant does not entitle the Holder to any voting rights,
dividends or other rights as a stockholder of the Company prior to the exercise hereof as set forth in Section 2(d)(i), except as expressly set forth in Section 3. 

b) Loss, Theft, Destruction or Mutilation of Warrant. The Company covenants that upon receipt by the Company of
evidence reasonably satisfactory to it of the loss, theft, destruction or mutilation of this Warrant or any stock certificate relating to 

  
 13 

 
the Warrant Shares, and in case of loss, theft or destruction, of indemnity or security reasonably satisfactory to it (which, in the case of the Warrant, shall not include the posting of any
bond), and upon surrender and cancellation of such Warrant or stock certificate, if mutilated, the Company will make and deliver a new Warrant or stock certificate of like tenor and dated as of such cancellation, in lieu of such Warrant or stock
certificate. 
 c) Saturdays, Sundays, Holidays, etc. If the last or appointed day for the taking of any
action or the expiration of any right required or granted herein shall not be a Business Day, then, such action may be taken or such right may be exercised on the next succeeding Business Day. 

d) Authorized Shares. 
 The Company covenants that, during the period the Warrant is outstanding, it will reserve from its authorized and unissued Common Stock a sufficient number of shares to provide for the issuance of the
Warrant Shares upon the exercise of any purchase rights under this Warrant (without regard to any limitations on exercise). The Company further covenants that its issuance of this Warrant shall constitute full authority to its officers who are
charged with the duty of executing stock certificates to execute and issue the necessary certificates for the Warrant Shares upon the exercise of the purchase rights under this Warrant. The Company will take all such reasonable action as may be
necessary to assure that such Warrant Shares may be issued as provided herein without violation of any applicable law or regulation, or of any requirements of the Trading Market upon which the Common Stock may be listed, traded or quoted. The
Company covenants that all Warrant Shares which may be issued upon the exercise of the purchase rights represented by this Warrant will, upon exercise of the purchase rights represented by this Warrant and payment for such Warrant Shares in
accordance herewith, be duly authorized, validly issued, fully paid and nonassessable and free from all taxes, liens and charges created by the Company in respect of the issue thereof (other than taxes in respect of any transfer occurring
contemporaneously with such issue). 
 Except and to the extent as waived or consented to by the Holder, the
Company shall not by any action, including, without limitation, amending its certificate of incorporation or through any reorganization, transfer of assets, consolidation, merger, dissolution, issue or sale of securities or any other voluntary
action, avoid or seek to avoid the observance or performance of any of the terms of this Warrant, but will at all times in good faith assist in the carrying out of all such terms and in the taking of all such actions as may be necessary or
appropriate to protect the rights of Holder as set forth in this Warrant against impairment. Without limiting the generality of the foregoing, the Company will (i) not increase the par value of any Warrant Shares above the Exercise Price then
in effect, (ii) take all such action as may be necessary or appropriate in order that the Company may validly and legally issue fully paid and nonassessable Warrant Shares upon the exercise of this Warrant and (iii) use commercially
reasonable efforts to obtain all such authorizations, exemptions or consents from any public regulatory body having jurisdiction thereof, as may be, necessary to enable the Company to perform its obligations under this Warrant. 

  
 14 

 Before taking any action which would result in an adjustment in the number
of Warrant Shares for which this Warrant is exercisable or in the Exercise Price, the Company shall obtain all such authorizations or exemptions thereof, or consents thereto, as may be necessary from any public regulatory body or bodies having
jurisdiction thereof. 
 e) Jurisdiction. All questions concerning the construction, validity, enforcement
and interpretation of this Warrant shall be determined in accordance with the provisions of the Agreement. 
 f)
Restrictions. The Holder acknowledges that the Warrant Shares acquired upon the exercise of this Warrant, if not registered and the Holder does not utilize cashless exercise, will have restrictions upon resale imposed by state and federal
securities laws. 
 g) Nonwaiver and Expenses. No course of dealing or any delay or failure to exercise
any right hereunder on the part of Holder shall operate as a waiver of such right or otherwise prejudice the Holder’s rights, powers or remedies, notwithstanding the fact that all rights hereunder terminate on the Termination Date. If the
Company willfully and knowingly fails to comply with any provision of this Warrant, which results in any material damages to the Holder, the Company shall pay to the Holder such amounts as shall be sufficient to cover any costs and expenses
including, but not limited to, reasonable attorneys’ fees, including those of appellate proceedings, incurred by the Holder in collecting any amounts due pursuant hereto or in otherwise enforcing any of its rights, powers or remedies hereunder.

 h) Notices. Any notice, request or other document required or permitted to be given or delivered to the
Holder by the Company shall be delivered in accordance with the notice provisions of the Agreement. 
 i)
Limitation of Liability. No provision hereof, in the absence of any affirmative action by the Holder to exercise this Warrant to purchase Warrant Shares, and no enumeration herein of the rights or privileges of the Holder, shall give rise to
any liability of the Holder for the purchase price of any Common Stock or as a stockholder of the Company, whether such liability is asserted by the Company or by creditors of the Company. 

j) Remedies. The Holder, in addition to being entitled to exercise all rights granted by law, including recovery of
damages, will be entitled to specific performance of its rights under this Warrant. The Company 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 Warrant and
hereby agrees to waive and not to assert the defense in any action for specific performance that a remedy at law would be adequate. 
 k) Successors and Assigns. Subject to applicable securities laws, this Warrant and the rights and obligations evidenced hereby shall inure to the benefit of and be binding upon the successors and
permitted assigns of the Company and the successors 

  
 15 

 
and permitted assigns of Holder. The provisions of this Warrant are intended to be for the benefit of any Holder from time to time of this Warrant and shall be enforceable by the Holder or holder
of Warrant Shares. 
 l) Amendment. This Warrant may be modified or amended or the provisions hereof
waived with the written consent of the Company and the Holder. 
 m) Severability. Wherever possible, each
provision of this Warrant shall be interpreted in such manner as to be effective and valid under applicable law, but if any provision of this Warrant shall be prohibited by or invalid under applicable law, such provision shall be ineffective to the
extent of such prohibition or invalidity, without invalidating the remainder of such provisions or the remaining provisions of this Warrant. 
 n) Headings. The headings used in this Warrant are for the convenience of reference only and shall not, for any purpose, be deemed a part of this Warrant. 

******************** 
 (Signature Page Follows) 

  
 16 

 IN WITNESS WHEREOF, the Company has caused this Warrant to be executed by its officer
thereunto duly authorized as of the date first above indicated. 
  

			
	UNIVERSITY GENERAL HEALTH SYSTEM, INC.
		
	By:	 	  

	 Name:
 Title:
	 	

  
 17 

 NOTICE OF EXERCISE 

 

	TO:	UNIVERSITY GENERAL HEALTH SYSTEM, INC. 

 (1) The undersigned hereby exercises the right to purchase              Warrant Shares of University General Health System, Inc. pursuant to the
terms of the attached Warrant. Capitalized terms used herein and not otherwise defined shall have the respective meanings set forth in the Warrant. 
 (2) Payment shall take the form of (check applicable box): 

[    ] lawful money of the United States; or 

[    ] if permitted, the cancellation of such number of Warrant Shares as is necessary, in accordance with the
formula set forth in subsection 2(c), to exercise this Warrant with respect to the maximum number of Warrant Shares purchasable pursuant to the cashless exercise procedure set forth in subsection 2(c). 

(3) In the event that the Holder has elected a cash exercise with respect to some or all of the Warrant Shares to be issued pursuant
hereto, the Holder tenders herewith payment of the aggregate Exercise Price of $         in full, together with all applicable transfer taxes, if any. 

(4) Please issue a certificate or certificates representing said Warrant Shares in the name of the undersigned or in such other name as
is specified below: 
  

			
	     
	 	  

  
 The Warrant
Shares shall be delivered to the following DWAC Account Number or by physical delivery of a certificate to: 
  

			
	     
	 	  
		
	     
	 	  
		
	     
	 	  

 (4) Accredited Investor. The undersigned is an
“accredited investor” as defined in Regulation D promulgated under the Securities Act of 1933, as amended. 
  

	
	[SIGNATURE OF HOLDER]
	
	Name of Holder:                         
                                         
                                         
                                         
                                         
                                    
	Signature of Authorized Signatory
of Holder:                                      
                                         
                                         
                                         
         
	Name of Authorized Signatory:                      
                                         
                                         
                                         
                                         
           
	Title of Authorized Signatory:                      
                                         
                                         
                                         
                                         
             
	Date:                             
                                         
                                         
                                         
                                         
                                         
             

 ASSIGNMENT FORM 

(To assign the foregoing warrant, execute 
 this form and supply required information. 
 Do not use this form to exercise the
warrant.) 
 FOR VALUE RECEIVED, [             all of or
[             shares of the foregoing Warrant and all rights evidenced thereby are hereby assigned to 
                                  
                                         
       whose address is 

                         
                                         
                                         
                                     . 

 
 Dated:
            ,          
  

					
	Holder’s Signature:	 	  
	 	
			
	Holder’s Address:	 	  
	 	
			
		 	  
	 	

  

							
	Signature Guaranteed:	  	  
	  		  	

 NOTE: The signature to this Assignment Form must correspond with the name as it appears on the face of the Warrant,
without alteration or enlargement or any change whatsoever, and must be guaranteed by a bank or trust company. Officers of corporations and those acting in a fiduciary or other representative capacity should file proper evidence of authority to
assign the foregoing Warrant.EX-10.1

 EXHIBIT 10.1 
 LOAN AGREEMENT 
 THIS LOAN AGREEMENT, dated as of
October 5th, 2006 (this “Agreement”), is
between UNIVERSITY HOSPITAL SYSTEMS, LLP, a Delaware limited liability partnership (“Borrower”), and FELIX SPIEGEL, M.D., an individual (“Lender”). 

RECITALS: 

Borrower has requested that Lender extend credit to Borrower in the form of a revolving line of credit in the amount of $2,000,000.00.
Lender is willing to make such extensions of credit to Borrower upon the terms and conditions hereinafter set forth. 
 NOW
THEREFORE, in consideration of the premises and the mutual covenants herein contained, the parties hereto agree as follows: 

ARTICLE I. 

Definitions 

Section 1.1. Definitions. As used in this Agreement, the following terms have the following meanings: 

“Advance” means an advance of funds by Lender to Borrower pursuant to Article II. 

“Advance Request Form” means a certificate, in substantially the form of Exhibit “C”, properly
completed and signed by Borrower requesting an Advance. 
 “Advance Termination Date” means
September 30, 2007. 
 “Affiliate” means, with respect to any Person, any other Person
which, directly or indirectly, controls or is controlled by or is under common control with such Person, including , (a) any Person which beneficially owns or holds ten percent (10%) or more of any class of voting stock of such Person or
ten percent (10%) or more of the equity interest in such Person, (b) any Person of which such Person beneficially owns or holds ten percent (10%) or more of any class of voting shares or in which such Person beneficially owns or holds
ten percent (10%) or more of the equity interests in such Person, and (c) any officer or director of such Person. 
 “Authorized Representative” means any officer or employee of Borrower who has been designated in writing by Borrower to Lender to be an Authorized Representative. 

“Business Day” means any day on which commercial banks are not authorized or required to close in Houston,
Texas. 
 “Closing Date” means the date on which this Agreement has been executed and delivered by the
parties hereto and the conditions set forth in Section 6.1 have been satisfied. 

 EXHIBIT 10.1 

 

 “Commitment” means the obligation of Lender to make Advances
hereunder in an aggregate principal amount at any time outstanding up to but not exceeding $2,000,000.00, except as otherwise provided in Section 2.1. 
 “Debt” means for any Person (a) all indebtedness, whether or not represented by bonds, debentures, notes, securities or other evidences of indebtedness, for the repayment of money
borrowed, including, with respect to Borrower, the indebtedness evidenced by the Note and all other indebtedness of Borrower to Lender, (b) all indebtedness representing deferred payment of the purchase price of property or assets, (c) all
indebtedness under any lease which is required to be capitalized for balance sheet purposes, (d) all indebtedness under guaranties, endorsements, assumptions or other contingent obligations, in respect of, or to purchase or otherwise acquire,
indebtedness of others, (e) all indebtedness secured by a Lien existing on property owned, subject to such Lien, whether or not the indebtedness secured thereby shall have been assumed by the owner thereof, and (f) any obligation to redeem
or repurchase any of such Person’s capital stock, partnership or membership interests or other ownership interests as applicable. 
 “Default Rate” means the lesser of (a) the sum of the Prime Rate in effect from day to day plus five percent (5.0%) or (b) the Maximum Rate. 

“Distribution” means (a) any distribution, dividend or any other payment or distribution (in cash,
property or obligations) made by Borrower on account of its partnership interests, (b) any redemption, purchase, retirement or other acquisition by Borrower of any of its partnership interests, or (c) the establishment of any fund for any
such distribution, dividend, payment or acquisition. 
 “Environmental Laws” means any and all
laws, rules, regulations, codes, ordinances, orders, decrees, judgments, injunctions, notices or binding agreements issued, promulgated or entered into by any federal, state, county, municipal or other governmental unit, relating in any way to the
environment, preservation or reclamation of natural resources, the management, release or threatened release of Hazardous Substance or to health and safety matters. 

“ERISA” means the Employee Retirement Income Security Act of 1974, as amended from time to time, and the
regulations and published interpretations thereof. 
 “Event of Default” has the meaning
specified in Section 11.1. 
 “Field Audits” means audits, verifications and inspections of
the accounts receivable of Borrower, conducted by an independent third Person selected by Lender. 

“Funded Debt” means, at any time, for Borrower, the sum of (a) all indebtedness for borrowed money,
whether or not evidenced by bonds, debentures, notes or similar instruments, including the Note, (b) all obligations as lessee under capital leases, (c)all obligations to pay the deferred purchase price of property or services (but excluding
trade accounts payable or trade notes in the ordinary course of business that are not past due by more than 90 days), (d) all indebtedness secured by a Lien on the property of such Borrower. 

  
 2 

 EXHIBIT 10.1 

 

 “Guarantors” means Kamran Nezami, Hassan Chahadeh,
M.D., Octavio Calvillo, M.D. and Henry Small, M.D., and “Guarantor” means any one of them. 

“Guaranty Agreement” means a Guaranty Agreement executed by a Guarantor in favor of Lender in
substantially the form of Exhibit “B”, as the same may be amended, supplemented or modified. 

“Hazardous Substance” means any substance, product, waste, pollutant, material, chemical, contaminant,
constituent or other material which is or becomes listed, regulated or addressed under any Environmental Law. 

“Income Tax Expense” means for Borrower for any period, all state and federal income taxes paid or due to
be paid during such period. 
 “Lien” means any lien, mortgage, security interest, tax lien,
financing statement, pledge, charge, hypothecation, assignment, preference, priority or other encumbrance of any kind or nature whatsoever (including, without limitation, any conditional sale or title retention agreement), whether arising by
contract, operation of law or otherwise. 
 “Loan Documents” means this Agreement and all
promissory notes, security agreements, deeds of trust, assignments, letters of credit, guaranties, and other instruments, documents and agreements executed and delivered pursuant to or in connection with this Agreement, as such instruments,
documents and agreements maybe amended, modified, renewed, extended or supplemented. 
 “Material Adverse
Effect” means a material adverse effect on (a) the business, operations, property or condition (financial or otherwise) of Borrower and its Subsidiaries, taken as a whole, or the Obligated Parties, taken as a whole, (b) the
ability of Borrower to pay the Obligations or the ability of Borrower or the Obligated Parties, taken as a whole, to perform their respective obligations under this Agreement or any of the other Loan Documents or (c) the validity or
enforceability of this Agreement or any of the other Loan Documents, or the rights or remedies of Lender hereunder or there under. 
 “Maximum Rate” means the maximum rate of nonusurious interest permitted from day to day by applicable law, including Chapter 303 of the Texas Finance Code(the “Code”) (and as
the same may be incorporated by reference in other Texas statutes). To the extent that Chapter 303 of the Code is relevant to Lender for the purposes of determining the Maximum Rate, Lender may elect to determine such applicable legal rate pursuant
to the “weekly ceiling,” from time to time in effect, as referred to and defined in Chapter 303 of the Code; subject, however, to the limitations on such applicable ceiling referred to and defined in the Code, and further subject to any
right Lender may have subsequently 
 “Note” means the promissory note executed by Borrower
payable to the order of Lender, in substantially the form of Exhibit “A”, as the same may be renewed, extended or modified and all promissory notes executed in renewal, extension, modification or substitution thereof. 

  
 3 

 EXHIBIT 10.1 

 

 “Obligated Party” means each Guarantor and any other
Person who is or becomes a party to any agreement pursuant to which such Person guarantees or secures payment and performance of the Obligations or any part thereof. 

“Obligations” means all obligations, indebtedness and liabilities of Borrower to Lender, now existing or
hereafter arising, including, without limitation, the obligations, indebtedness and liabilities of Borrower under the Note, and all interest accruing thereon and all attorneys’ fees and other expenses incurred in the enforcement or collection
thereof. 
 “Organizational Documents” means, for any Person, (a) the articles of
incorporation and bylaws of such Person if such Person is a corporation, (b) the articles of organization and regulations of such Person if such Person is a limited liability company, (c) the limited partnership agreement of such Person if
such Person is a limited partnership, or (d) the documents under which such Person was created and is governed if such person is not a corporation, limited liability company or limited partnership. 

“Person” means any individual, corporation, limited liability company, partnership, joint venture,
company, trust, governmental authority or other entity. 
 “Plans and Specifications” means the plans
and specifications for the development, construction and renovation of the Project, approved by Borrower and Lender as required herein, and all amendments and modifications thereof. 

“Prime Rate” means that variable rate of interest per annum established by Lender from time to time as
its prime rate which shall vary from time to time. Such rate is set by Lender as a general reference rate of interest, taking into account such factors as Lender may deem appropriate, it being understood that many of Lender’s commercial or
other loans are priced in relation to such rate, that it is not necessarily the lowest or best rate charged to any customer and that Lender may make various commercial or other loans at rates of interest having no relationship to such rate.

 “Regulatory Change” means, with respect to Lender, any change after the date of this
Agreement in United States federal, state or foreign laws or regulations(including Regulation D of the Board of Governors of the Federal Reserve System), or the adoption or making after such date of any interpretations, directives or requests
applying to a class of banks including Lender of or under any United States federal, state or foreign laws or regulations (whether or not having the force of law) by any court or governmental or monetary authority charged with the interpretation or
administration thereof. 
 “Subsidiary” means any Person of which or in which Borrower or its
other Subsidiaries own or control, directly or indirectly, fifty percent (50%) or more of (a) the combined voting power of all classes having general voting power under ordinary circumstances to elect a majority of the directors, managers
or equivalent body of such Person, if it is a corporation, (b) the capital interest or profits interest of such Person, if it is a partnership, limited liability company, joint venture or similar entity, or (c) the beneficial interest of
such Person, if it is a trust, association or other unincorporated association or organization. 

  
 4 

 EXHIBIT 10.1 

 

 “Tax Distribution” means any Distribution made by
Borrower in amounts which are sufficient to permit the partners of Borrower to pay their federal income taxes which arise solely and directly as a result of their ownership interest in Borrower. 

“Termination Date” means 11:00 a.m., Houston, Texas time on September 30, 2007, or such earlier date
on which the Commitment terminates as provided in this Agreement. 
 “Unmatured Event of
Default” means the occurrence of an event or the existence of a condition which, with the giving of notice or the passage of time would constitute an Event of Default. 

Section 1.2. All definitions contained in this Agreement are equally applicable to the singular and plural forms of the terms
defined. The words “hereof’, “herein” and “hereunder” and words of similar import referring to this Agreement refer to this Agreement as a whole and not to any particular provision of this Agreement. Unless otherwise
specified, all Article and Section references pertain to this Agreement. All accounting terms not specifically defined herein shall be construed in accordance with GAAP. Terms used herein that are defined in the Uniform Commercial Code as adopted by
the State of Texas, unless otherwise defined herein, shall have the meanings specified in the Uniform Commercial Code as adopted by the State of Texas. In the event that, at any time, Borrower has no Subsidiaries, all references to the Subsidiaries
of Borrower and the consolidation of certain financial information shall be deemed to be inapplicable until such time as Borrower has a Subsidiary. 
 ARTICLE II. 
 Advances 

Section 2.1. Advances. Subject to the terms and conditions of this Agreement, Lender agrees to make one or more Advances to
Borrower from time to time from the date hereof to and including the Termination Date in an aggregate principal amount at any timeout standing up to but not exceeding the Commitment; provided that the aggregate amount of all Advances at any time
outstanding shall not exceed the Commitment. Lender shall have no obligation to make any Advance if an Event of Default or an Unmatured Event of Default has occurred and is continuing. Subject to the foregoing limitations, and the other terms and
provisions of this Agreement, Borrower may borrow, repay and reborrow hereunder. 
 Section 2.2. Note. The
obligation of Borrower to repay the Advances shall be evidenced by Note executed by Borrower, payable to the order of Lender, in the principal amount of the Commitment. 
 Section 2.3. Repayment of Advances. Borrower shall repay the unpaid principal amount of all Advances on the earlier of (a) the Termination Date or (b) such other dates on which the
Advances are or may be required to be paid pursuant to this Agreement. 

  
 5 

 EXHIBIT 10.1 

 

 Section 2.4. Interest. The unpaid principal amount of the Advances shall bear
interest prior to maturity at a varying rate per annum equal from day to day to the lesser of (a)the Maximum Rate or (b) the greater of (i) TEN percent (10%) per annum or (ii) the sum of the Prime Rate in effect from day to day
plus TWO percent (2.0%), and each change in the rate of interest charged on the Advances shall become effective, without notice to Borrower, on the effective date of each change in the Prime Rate or the Maximum Rate, as the case may be; provided,
however, if at any time the rate of interest specified in clause (b) preceding shall exceed the Maximum Rate, thereby causing the interest on the Advances to be limited to the Maximum Rate, then any subsequent reduction in the Prime Rate shall
not reduce the rate of interest on the Advances below the Maximum Rate until the aggregate amount of interest actually accrued on the Advances equals the amount of interest which would have accrued on the Advances if the interest rate specified in
clause (b) preceding had at all times been in effect. Accrued and unpaid interest on the Advances shall be payable on the last day of each month commencing on October 31, 2006, and on the Termination Date. If an Event of Default has
occurred and is continuing, all principal of the Advances shall bear interest at the Default Rate. 
 Section 2.5.
Requests for Advances. Borrower shall give Lender notice of each requested Advance by delivery to Lender of an Advance Request Form executed by an Authorized Representative, properly completed and containing the information required therein,
including the purpose for each Advance. Assuming that each Advance Request Form is in proper form, if Lender receives an Advance Request Form prior to 1:00 p.m. on any Business Day, Lender will make the requested Advance on the same Business Day,
and if Lender receives an Advance Request Form after 1:00 p.m., Lender will make the requested Advance on the next Business Day. 
 Section 2.6. Use of Proceeds. The proceeds of Advances shall be used for working capital purposes or operating expenses. 

ARTICLE III. 

Intentionally Omitted 
 ARTICLE IV. 
 Payments 

Section 4.1. Method of Payment. All payments of principal, interest and other amounts to be made by Borrower under this
Agreement, the Note or any other Loan Documents shall be made to Lender at its designated office, without setoff, deduction or counterclaim in immediately available funds. Whenever any payment under this Agreement, the Note or any other Loan
Document shall be stated to be due on a day that is not a Business Day, such payment may be made on the next Business Day, and interest shall continue to accrue until the payment is received. 

Section 4.2. Voluntary Prepayment. Borrower may prepay the Note in whole or in part at any time or from time to time without
premium or penalty but with accrued interest to the date of prepayment on the amount so prepaid. 

  
 6 

 EXHIBIT 10.1 

 

 Section 4.3. Computation of Interest. Interest on the indebtedness evidenced
by the Note shall be computed on the basis of a year of 360 days and the actual number of days elapsed (including the first day but excluding the last day) unless such calculation would result in a usurious rate, in which case interest shall be
calculated on the basis of a year of 365 or 366 days, as the case may be. 
 ARTICLE V. 

Guaranty 

Section 5.1. Guaranty. Guarantors shall unconditionally and irrevocably guarantee payment and performance of the Obligations as
provided in the Guaranty Agreement by execution and delivery of the Guaranty Agreement, respectively. 
 ARTICLE VI. 

Conditions Precedent 
 Section 6.1. Initial Extension of Credit. The obligation of Lender to make the initial Advance is subject to the condition precedent that prior thereto Lender shall have received all of the
documents set forth below in form and substance satisfactory to Lender. 
 (a) Certificate –
Borrower. A certificate of a Manager or another officer of Borrower acceptable to Lender certifying (i) resolutions of the partners of Borrower which authorize the execution, delivery and performance by Borrower of this Agreement and the other
Loan Documents to which Borrower is or is to be a party and (ii) the names of the officers of Borrower authorized to sign this Agreement and each of the other Loan Documents to which Borrower is or is to be a party together with specimen
signatures of such Persons. 
 (b) Organizational Documents – Borrower. The Partnership Agreement of
Borrower and the Certificate of Partnership of Borrower certified by an officer of Borrower acceptable to Lender. 
 (c) Governmental Certificates – Borrower. A certificate issued by the appropriate government official of the state of organization of Borrower as to the existence of Borrower. 

(d) Note. The Note executed by Borrower. 

(e) Guaranty Agreements. The Guaranty Agreements executed by each of the Guarantors, respectively. 

(f) Attorneys’ Fees and Expenses. Evidence that the costs and expenses (including reasonable attorneys’
fees) referred to in Section 12.1, to the extent incurred, have been paid in full by Borrower. 

  
 7 

 EXHIBIT 10.1 

 

 (g) Additional Documentation. Such additional approvals, opinions
or documents as Lender may reasonably request. 
 Section 6.2. Conditions to Advances. The obligation of Lender to
make any Advance (including the initial Advance) is subject to receipt by Lender of the items required by Section 2.5, as applicable, and such additional approvals or documents as Lender may reasonably request. 

ARTICLE VII. 

Representations and Warranties 
 To induce Lender to enter into this Agreement, Borrower represents and warrants to Lender that: 
 Section 7.1. Existence. Borrower and each Subsidiary (a) are duly organized, validly existing and in good standing under the laws of their respective jurisdictions of organization,(b)
have all requisite power and authority to own their assets and carry on their business as now being or as proposed to be conducted and (c) are qualified to do business in all jurisdictions necessary and where failure to so qualify would have a
Material Adverse Effect. Borrower has the power and authority to execute, deliver and perform its obligations under this Agreement and the other Loan Documents to which it is or may become a party. 

Section 7.2. Requisite Action; No Breach. The execution, delivery and performance by Borrower of this Agreement and the other
Loan Documents to which Borrower is or may become a party have been duly authorized by all requisite action on the part of Borrower and do not and will not violate or conflict with the Organizational Documents of Borrower or any law, rule or
regulation or any order, writ, injunction or decree of any court, governmental authority or arbitrator, and do not and will not conflict with, result in a breach of, or constitute a default under, or result in the imposition of any Lien (except as
provided in this Agreement) upon any of the revenues or assets of Borrower or any Subsidiary pursuant to the provisions of any indenture, mortgage, deed of trust, security agreement, franchise, permit, license or other instrument or agreement by
which Borrower or any Subsidiary or any of their respective properties is bound. 
 Section 7.3. Operation of Business.
Borrower and each Subsidiary possess all licenses, permits, franchises, patents, copyrights, trademarks and trade names, or rights thereto, to conduct their respective businesses substantially as now conducted and as presently proposed to be
conducted. 
 Section 7.4. Litigation and Judgments. There is no action, suit, investigation or proceeding before or
by any court, governmental authority or arbitrator pending, or to the knowledge of Borrower, threatened against or affecting Borrower or any Subsidiary, that could, if adversely determined, have a Material Adverse Effect. There are no outstanding
judgments against Borrower or any Subsidiary. 
 Section 7.5. Rights in Properties; Liens. Borrower and each Subsidiary
have good and marketable title to or valid leasehold interests in their respective properties and assets, real and personal, and none of the properties, assets or leasehold interests of Borrower or any Subsidiary is subject to any Lien, except as
permitted by this Agreement. 

  
 8 

 EXHIBIT 10.1 

 

 Section 7.6. Enforceability. This Agreement constitutes, and the other Loan
Documents to which Borrower is a party, when delivered, shall constitute the legal, valid and binding obligations of Borrower, enforceable against Borrower in accordance with their respective terms, except as enforceability thereof may be limited by
bankruptcy, insolvency or other laws of general application relating to the enforcement of creditor’s rights. 

Section 7.7. Approvals. No authorization, approval or consent of, and no filing or registration with, any court,
governmental authority or third party is or will be necessary for the execution, delivery or performance by Borrower of this Agreement and the other Loan Documents to which Borrower is or may become a party or the validity or enforceability thereof.

 Section 7.8. Use of Proceeds; Margin Securities. Neither Borrower nor any Subsidiary is engaged principally, or
as one of its important activities, in the business of extending credit for the purpose of purchasing or carrying margin stock (within the meaning of Regulations T, U or X of the Board of Governors of the Federal Reserve System), and no part of the
proceeds of any extension of credit under this Agreement will be used to purchase or carry any such margin stock or to extend credit to others for the purpose of purchasing or carrying margin stock. 

Section 7.9. ERISA. Borrower and each Subsidiary have complied with all applicable minimum funding requirements and all other
applicable and material requirements of ERISA, and there are no existing conditions that would give rise to liability thereunder. No Reportable Event (as defined in Section 4043 of ERISA) has occurred in connection with any employee benefit
plan that might constitute grounds for the termination thereof by the Pension Benefit Guaranty Corporation or for the appointment by the appropriate United States District Court of a trustee to administer such plan. 

Section 7.10. Taxes. Borrower and each Subsidiary have filed all tax returns (federal, state and local) required to be filed,
including all income, franchise, employment, property and sales taxes, and have paid all of their liabilities for taxes, assessments, governmental charges and other levies that are due and payable, and Borrower knows of no pending investigation of
Borrower or any Subsidiary by any taxing authority or of any pending but unassessed tax liability of Borrower or any Subsidiary. 
 Section 7.11. Disclosure. There is no fact known to Borrower which has a Material Adverse Effect on the Borrower or which might in the future have a Material Adverse Effect on the Borrower
that has not been disclosed in writing to Lender. 
 Section 7.12. Subsidiaries. Borrower has no Subsidiaries.

 Section 7.13. Compliance with Laws. Neither Borrower nor any Subsidiary is in violation in any material respect
of any law, rule, regulation, order or decree of any court, governmental authority or arbitrator. 

  
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 EXHIBIT 10.1 

 

 Section 7.14. Compliance with Agreements. Neither Borrower nor any
Subsidiary is in violation in any material respect of any document, agreement, contract or instrument to which it is a party or by which it or its properties are bound. 
 Section 7.15. Environmental Matters. Borrower and each Subsidiary, and their respective properties, are in compliance with all applicable Environmental Laws and neither Borrower nor any
Subsidiary is subject to any liability or obligation for remedial action thereunder. There is no pending or threatened investigation or inquiry by any governmental authority of Borrower or any Subsidiary or any of their respective properties
pertaining to any Hazardous Substance. Except in the ordinary course of business and in compliance with all Environmental Laws, there are no Hazardous Substances located on or under any of the properties of Borrower or any Subsidiary. Except in the
ordinary course of business and incompliance with all Environmental Laws, neither Borrower nor any Subsidiary has caused or permitted any Hazardous Substance to be disposed of on or under or released from any of its properties. Borrower and each
Subsidiary have obtained or will obtain prior to the time required all permits, licenses and authorizations which are required under and by all Environmental Laws. 
 Section 7.16. Solvency. Borrower and its Subsidiaries, on an individual and a consolidated basis, are not insolvent, Borrower’s and its Subsidiaries’ assets, on an individual and a
consolidated basis, exceed their liabilities, and Borrower will not be rendered insolvent by the execution and performance of this Agreement and the Loan Documents. 
 Section 7.17. Investment Company Act. Neither Borrower nor any Subsidiary is an “investment company” within the meaning of the Investment Company Act of 1940, as amended. 

ARTICLE VIII.  
 Affirmative Covenants 
 Borrower covenants and agrees that, as long as the
Obligations or any part thereof are outstanding or Lender has any Commitment hereunder, Borrower will perform and observe the covenants set forth below, unless Lender shall otherwise consent in writing 

Section 8.1. Reporting Requirements. Borrower will deliver to Lender: 

(a) Tax Returns. Within fifteen (15) days following the filing thereof, copies of each federal income tax
return filed by Borrower. 
 (b) Notice of Litigation. Promptly after the commencement thereof, notice of all
actions, suits and proceedings before any court or governmental department, commission, board, agency or instrumentality, domestic or foreign, affecting Borrower, any Guarantor or any Subsidiary which could have a Material Adverse Effect.

 (c) Judgments. Within five (5) days of obtaining knowledge thereof, notice of any judgment against
Borrower, any Guarantor or any Subsidiary in an amount which is greater than $25,000.00. 

  
 10 

 EXHIBIT 10.1 

 

 (d) Notice of Default. As soon as possible and in any event within five
(5)days after the occurrence of each Event of Default and Unmatured Event of Default a written notice setting forth the details of such Event of Default or Unmatured Event of Default or event and the action which Borrower has taken and proposes to
take with respect thereto. 
 (e) Notice of Material Adverse Effect. As soon as possible, and in any event within
five (5) days after Borrower becomes aware thereof, notice of the occurrence of any event or the existence of any condition which could have a Material Adverse Effect. 

(f) General Information. Promptly, such other information concerning Borrower, any Guarantor or any Subsidiary as Lender
may from time to time reasonably request. 
 Section 8.2. Maintenance of Existence; Conduct of Business. Borrower
will preserve and maintain, and will cause each Subsidiary to preserve and maintain, its corporate existence and all of its leases, privileges, licenses, permits, franchises, qualifications and rights that are necessary in the ordinary conduct of
its business 
 Section 8.3. Maintenance of Properties. Borrower will maintain, and will cause each Subsidiary to maintain
its assets and properties in good condition and repair. 
 Section 8.4. Taxes and Claims. Borrower will pay or discharge,
and will cause each Subsidiary to pay or discharge, at or before maturity or before becoming delinquent (a) all taxes, levies, assessments and governmental charges imposed on it or its income or profits or any of its property and (b) all
lawful claims for labor, material and supplies, which, if unpaid, might become a Lien upon any of its property; provided, however, that neither Borrower nor any Subsidiary shall be required to pay or discharge any claim, tax, levy, assessment or
governmental charge with respect to which no Lien has been filed of record, which is being contested in good faith by appropriate proceedings diligently pursued and for which adequate reserves have been established. 

Section 8.5. Insurance. 
 (a) Borrower will maintain, and will cause each Subsidiary to maintain, with financially sound and reputable insurance companies workmen’s compensation insurance, liability insurance and insurance on
its property, assets and business, all at least in such amounts and against such risks as are usually insured against by Persons engaged in similar businesses. Each insurance policy covering Collateral shall name Lender as lender loss payee
and provide that such policy will not be cancelled without thirty (30) days prior written notice to Lender. 

(b) Borrower will cause its partners to maintain malpractice insurance in at least in such amounts and against such risks
as are usually insured against by physicians engaged in similar practices. 

  
 11 

 EXHIBIT 10.1 

 

 Section 8.6. Inspection; Field Audits. At any reasonable time and from time
to time, Borrower will permit, and will cause Guarantor and each Subsidiary to permit, representatives of Lender: 
 (a) To examine and make copies of the books and records of, and visit and inspect the properties or assets of Borrower, Guarantors and any Subsidiary and to discuss the business, operations and financial
condition of any such Persons with their respective officers and employees and with their independent certified public accountants; and 
 (b) To conduct Field Audits; provided, however, that (i) Lender intends to conduct at least one Field Audit during each fiscal year of Borrower, and (ii) the cost of one Field Audit during each
fiscal year shall be paid by Borrower. 
 Section 8.7. Keeping Books and Records. Borrower will maintain, and will
cause each Subsidiary to maintain, proper books of record and account in which full, true and correct entries in conformity with Borrower’s historical accounting methods and procedures and in compliance with good accounting principles
consistently applied shall be made of all dealings and transactions in relation to its business and activities. 

Section 8.8. Compliance with Laws. Borrower will comply, and will cause each Subsidiary to comply, in all material respects
with all applicable laws, rules, regulations and orders of any court, governmental authority or arbitrator. 
 Section 8.9.
Compliance with Agreements. Borrower will comply, and will cause each Subsidiary to comply, in all material respects with all agreements, contracts and instruments binding on it or affecting its properties or business. 

Section 8.10. Further Assurances. Borrower will execute and deliver, and will cause each Subsidiary to execute and deliver, such
further instruments as may be requested by Lender to carry out the provisions and purposes of this Agreement and the other Loan Documents and to preserve and perfect the Liens of Lender in the Collateral. 

Section 8.11. ERISA. Borrower will comply, and will cause each Subsidiary to comply, with all minimum funding requirements, and all
other material requirements, of ERJSA, if applicable, so as not to give rise to any liability thereunder. 
 Section 8.12.
Continuity of Operations. Borrower will continue to conduct, and will cause each Subsidiary to continue to conduct, its primary businesses as conducted as of the Closing Date and to continue its operations in such businesses. 

ARTICLE IX. 

Negative Covenants 
 Borrower covenants and agrees that, as long as the Obligations or any part thereof are outstanding or Lender has any Commitment hereunder, Borrower will perform and observe the covenants set forth
below, unless Lender shall otherwise consent in writing. 

  
 12 

 EXHIBIT 10.1 

 

 Section 9.1. Mergers. Acquisitions, Dissolutions and Disposition of Assets.
Borrower will not, and will not permit any Subsidiary to, (a) become a party to a merger, consolidation, partnership or joint venture or purchase or otherwise acquire all or a substantial part of the assets of any Person or any shares or other
evidence of beneficial ownership of any Person,(b) dissolve or liquidate, (c) amend its Organizational Documents, (d) sell, lease, assign, transfer or otherwise dispose of substantially all of its assets, except dispositions of inventory
in the ordinary course of business, (e) create any new Subsidiary or (f) enter into any agreement to do any of the foregoing. 
 Section 9.2. Restricted Payments. Borrower will not declare or pay any Distribution if (a) at the time of making such Distribution, an Event of Default or Unmatured Event of Default exists, or
(b) an Event of Default or Unmatured Event of Default would arise as a result of making such Distribution. 

Section 9.3. Loans and Advances. Other than advances for normal business expenses, Borrower will not make, and will not permit any
Subsidiary to make, any advance, loan or extension of credit to any Person, including any employee, officer or director of Borrower or any Subsidiary. 
 Section 9.4. Investments. Borrower will not make, and will not permit any Subsidiary to make, any capital contribution to or investment in, or purchase, or permit any Subsidiary to purchase, any
stock, bonds, notes, debentures, or other securities of any Person, except (a) readily marketable direct obligations of the United States of America, (b) fully insured certificates of deposit with maturities of one year or less from the
date of acquisition of Lender or any commercial bank operating in the United States having capital and surplus in excess of $100,000,000.00, (c) commercial paper of a domestic issuer if at the time of purchase such paper is rated in one of the
two highest rating categories of Standard and Poor’s Corporation or Moody’s Investors Service, Inc., and (d) investments made through Lender or its Affiliates and approved by Lender. 

Section 9.5. Compliance with Environmental Laws. Borrower will not, and will not permit any Subsidiary to, (a) use (or permit
any tenant to use) any of their respective properties or assets for the handling, processing, storage, transportation or disposal of any Hazardous Substance, except in the ordinary course of business and in compliance with all Environmental Laws,
(b) generate any Hazardous Substance, except in the ordinary course of business and in compliance with all Environmental Laws, (c) conduct any activity which is likely to cause a release or threatened release of any Hazardous Substance, or
(d) otherwise conduct any activity or use any of their respective properties or assets in any manner that is likely to violate any Environmental Law. 
 Section 9.6. Accounting. Borrower will not make, and will not permit any Subsidiary to make, any change in accounting methods unless Borrower shall have received the consent of Lender and
Borrower’s accounting treatments and reporting practices shall be in accordance Borrower’s historical accounting methods and procedures and in compliance with good accounting principles consistently applied. 

  
 13 

 EXHIBIT 10.1 

 

 Section 9.7. Change of Business. Borrower will not enter into, or permit any
Subsidiary to enter into, any type of business which is materially different from the business in which Borrower or such Subsidiary is presently engaged. 
 Section 9.8. Transactions With Affiliates. Borrower will not enter into, or permit to exist, and will not permit any Subsidiary to enter into or permit to exist, any transaction, arrangement
or contract (including any lease or other rental agreement) with any of its Affiliates which is on terms which are less favorable than are obtainable from any Person who is not an Affiliate of Borrower or such Subsidiary. 

ARTICLE X.  
 Intentionally Omitted 
 ARTICLE XI. 

Default 

Section 11.1. Events of Default. Each of the following shall be deemed an “Event of Default”: 

(a) Borrower shall fail to pay the Obligations or any part thereof within five (5) days of the date when due.

 (b) Any representation or warranty made or deemed made by Borrower or any Obligated Party (or any of their
respective officers) in any Loan Document or in any certificate, report, notice or financial statement furnished at any time in connection with this Agreement shall be false, misleading or erroneous in any material respect when made or deemed to
have been made. 
 (c) Borrower or any Obligated Party shall fail to perform, observe or comply with (i) any
covenant, agreement or term contained in Sections 8.1, 8.5, 8.13, or 8.15, or Article IX or Article X of this Agreement or (ii) any covenant, agreement or term contained in this Agreement (other than in Sections 8.1, 8.5, 8.13, or 8.15, or
Article IX or Article X of this Agreement) or any other Loan Document and such failure shall continue for fifteen (15) days following the date on which Lender gives Borrower notice of such failure. 

(d) Borrower, any Subsidiary, or any Obligated Party shall commence a voluntary proceeding seeking liquidation,
reorganization or other relief with res pect to itself or its debts under any bankruptcy, insolvency or other similar law now or hereafter in effect or seeking the appointment of a trustee, receiver, liquidator, custodian or other similar official
of it or a substantial part of its property or shall consent to any such relief or to the appointment of or taking possession by any such official in an involuntary case or other proceeding commenced against it or shall make a general assignment for
the benefit of creditors or shall generally fail to pay its debts as they become due or shall take any corporate action to authorize any of the foregoing. 

  
 14 

 EXHIBIT 10.1 

 

 (e) An involuntary proceeding shall be commenced against Borrower, any
Subsidiary or any Obligated Party seeking liquidation, reorganization or other relief with respect to it or its debts under any bankruptcy, insolvency or other similar law now or hereafter in effect or seeking the appointment of a trustee, receiver,
liquidator, custodian or other similar official for it or a substantial part of its property, and such involuntary proceeding shall remain undismissed and unstayed for a period of thirty (30) days. 

(f) Borrower, any Subsidiary or any Obligated Party shall fail to discharge within a period of thirty (30) days after
the commencement thereof any attachment, sequestration or similar proceeding or proceedings involving an aggregate amount m excess of $25,000.00 against any of its assets or properties. 

(g) Borrower, any Subsidiary or any Obligated Party shall fail to satisfy and discharge promptly any judgment or judgments
against it for the payment of money in an aggregate amount in excess of $25,000.00. 
 (h) Borrower, any
Subsidiary or any Obligated Party shall fail to pay when due any principal of or interest on any Debt (other than the Obligations), or the maturity of any such Debt shall have been accelerated, or any such Debt shall have been required to be prepaid
prior to the stated maturity thereof, or any event shall have occurred that permits (or, with the giving of notice or lapse of time or both, would permit) any holder or holders of such Debt or any Person acting on behalf of such holder or holders to
accelerate the maturity thereof or require any such prepayment. 
 (i) This Agreement or any other Loan Document
shall cease to be in full force and effect or shall be declared null and void or the validity or enforceability thereof shall be contested or challenged by Borrower, any Subsidiary, any Obligated Party or any of their respective owners, or Borrower
or any Obligated Party shall deny that it has any further liability or obligation under any of the Loan Documents, or any Lien or security interest created by the Loan Documents shall for any reason cease to be a valid, first priority perfected
security interest in and Lien upon any of the Collateral purported to be covered thereby. 
 (j) A Material
Adverse Effect shall have occurred. 
 (k) The ownership of more than twenty percent (20%) of the ownership
interests of either the limited partners or the General Partner of Borrower shall change, on a cumulative basis, during the term of this Agreement. 
 Section 11.2. Remedies Upon Default. If any Event of Default shall occur, Lender may do any one or more of the following: (a) declare the outstanding principal of and accrued and unpaid interest
on the Note and the Obligations or any part thereof to be immediately due and payable, and the san1e shall thereupon become immediately due and payable, without notice, demand, presentment, notice of dishonor, notice of acceleration, notice of
intent to accelerate, notice of intent to demand, protest or other formalities of any kind, all of which are hereby expressly waived by Borrower, (b) terminate the Commitment without notice to Borrower, (c) foreclose or otherwise enforce
any Lien granted to Lender to secure payment and 

  
 15 

 EXHIBIT 10.1 

 

 
performance of the Obligations and (d) exercise any and all rights and remedies afforded byte laws of the State of Texas or any other jurisdiction by any of the Loan Documents, by equity or
otherwise; provided, however, that upon the occurrence of an Event of Default under Section 11.1(d) or Section 11.1(e), the Commitment shall automatically terminate, and the outstanding principal of and accrued and unpaid interest on the
Note and the other Obligations shall become immediately due and payable without notice, demand, presentment, notice of dishonor, notice of acceleration, notice of intent to accelerate, notice of intent to demand, protest or other formalities of any
kind, all of which are hereby expressly waived by Borrower. 
 Section 11.3. Performance by Lender. If Borrower shall
fail to perform any covenant, duty or agreement contained in any of the Loan Documents, Lender may after five (5) days prior written notice to Borrower perform or attempt to perform such covenant, duty or agreement on behalf of
Borrower. In such event, Borrower shall, at the request of Lender, promptly pay any amount expended by Lender in such performance or attempted performance to Lender, together with interest thereon at the Default Rate from the date of such
expenditure until paid. Notwithstanding the foregoing, it is expressly agreed that Lender shall not have any liability or responsibility for the performance of any obligation of Borrower under this Agreement or any other Loan Document. 

ARTICLE XII. 

Miscellaneous 

Section 12.1. Expenses of Lender. Borrower hereby agrees to pay Lender on demand (a) all reasonable costs and expenses incurred by
Lender in connection with the preparation, negotiation and execution of this Agreement and the other Loan Documents and any and all amendments, modifications, renewals, extensions and supplements thereof and thereto, including, without limitation,
the reasonable fees and expenses of Lender’s legal counsel, (b) all reasonable costs and expenses incurred by Lender in connection with the enforcement of this Agreement or any other Loan Document, including, without limitation, the fees
and expenses of Lender’s legal counsel and (c) all other reasonable costs and expenses incurred by Lender in connection with this Agreement or any other Loan Document, including, without limitation, all costs, expenses, taxes, assessments,
filing fees and other charges levied by any governmental authority or otherwise payable in respect of this Agreement or any other Loan Document or in obtaining any insurance policy, audit or appraisal in respect of the Collateral. 

Section 12.2. INDEMNIFICATION. BORROWER HEREBY INDEMNIFIES LENDER AND EACH AFFILIATE THEREOF AND THEIR RESPECTIVE OFFICERS,
DIRECTORS, EMPLOYEES., ATTORNEYS AND AGENTS FROM, AND HOLDS EACH OF THEM HARMLESS AGAINST, ANY AND ALL LOSSES, LIABILITIES, CLAIMS, DAMAGES, PENALTIES, JUDGMENTS, DISBURSEMENTS, COSTS AND EXPENSES (INCLUDING ATTORNEYS’ FEES) (COLLECTIVELY,
“CLAIMS”) TO WHICH ANY OF THEM MAY BECOME SUBJECT WHICH · DIRECTLY OR INDIRECTLY ARISE FROM OR RELATE TO (A) THE NEGOTIATION, EXECUTION, DE LIVERY, PERFORMANCE, ADMINISTRATION OR ENFORCEMENT OF ANY OF THE LOAN DOCUMENTS,
(B) ANY OF THE TRANSACTIONS CONTEMPLATED BY THE LOAN DOCUMENTS, (C) ANY 

  
 16 

 EXHIBIT 10.1 

 

 
BREACH BY BORROWER OF ANY REPRESENTATION, WARRANTY, COVENANT OR OTHER AGREEMENT CONTAINED IN ANY OF THE LOAN DOCUMENTS, (D) THE PRESENCE, RELEASE, THREATENED RELEASE, DISPOSAL, REMOVAL OR
CLEANUP OF ANY HAZARDOUS SUBSTANCE LOCATED ON, ABOUT, WITHIN OR AFFECTING ANY OF THE PROPERTIES OR ASSETS OF BORROWER OR ANY SUBSIDIARY, (E) ANY ACT OR OMISSION OF LENDER BASED UPON ANY FAX OR ELECTRONIC TRANSMISSION OR (F)ANY MATTER RELATED TO
ANY LETTER OF CREDIT, INCLUDING, WITH RESPECT TO ALL OF THE ABOVE, ANY CLAIM WHICH ARISES AS A RESULT OF THE NEGLIGENCE OF LENDER; PROVIDED, HOWEVER, THAT BORROWER’S INDEMNIFICATION OBLIGATIONS UNDER THIS SECTION 12.2 SHALL NOT APPLY TO
THE EXTENT THAT THE CLAIMS ARISE AS A RESULT OF THE GROSS NEGLIGENCE OR WILLFUL MISCONDUCT OF ANY INDEMNIFIED PERSON. 

Section 12.3. Limitation of Liability. Neither Lender nor any Affiliate, officer, director, employee, attorney or agent of Lender
shall have any liability with respect to, and Borrower hereby waives, releases and agrees not to sue any of them upon, any claim for any special, indirect, incidental or consequential damages suffered or incurred by Borrower in connection with,
arising out of, or in any way related to, this Agreement or any of the other Loan Documents, or any of the transaction contemplated by this Agreement or any of the other Loan Documents. Borrower hereby waives, releases and agrees not to sue Lender
or any of Lender’s Affiliates, officers, directors, employees, attorneys or agents for punitive damages in respect of any claim in connection with, arising out of, or in any way related to, this Agreement or any of the other Loan Documents, or
any of the transactions contemplated by this Agreement or any of the other Loan Documents. 
 Section 12.4. No Waiver;
Cumulative Remedies. No failure on the part of Lender to exercise and no delay in exercising, and no course of dealing with respect to, any right, power or privilege under this Agreement shall operate as a waiver thereof, nor shall any single or
partial exercise of any right, power or privilege under this Agreement preclude any other or further exercise thereof or the exercise of any other right, power or privilege. The rights and remedies provided for in this Agreement and the other Loan
Documents are cumulative and not exclusive of any rights and remedies provided by law. 
 Section 12.5. Successors and
Assigns. This Agreement is binding upon and shall inure to the benefit of Lender and Borrower and their respective successors and assigns, except that Borrower may not assign or transfer any of its rights or obligations under this Agreement
without prior written consent of Lender. 
 Section 12.6. Survival. All representations and warranties made in this
Agreement or any other Loan Document or in any document, statement or certificate furnished in connection with this Agreement shall survive the execution and delivery of this Agreement and the other Loan Documents, and no investigation by Lender or
any closing shall affect the representations and warranties or the right of Lender to rely upon them. Without prejudice to the survival of any other obligation of Borrower hereunder, the obligations of Borrower under Sections 12.1 and 13.2 shall
survive repayment of the Note and termination of the Commitment. 

  
 17 

 EXHIBIT 10.1 

 

 Section 12.7. Amendment. The provisions of this Agreement may be amended or waived
only by an instrument in writing signed by the parties hereto. 
 Section 12.8. Maximum Interest Rate. No provision
of this Agreement or of any other Loan Documents shall require the payment or the collection of interest in excess of the Maximum Rate. If any excess of interest in such respect is hereby provided for, or shall be adjudicated to be so provided, in
any other Loan Documents or otherwise in connection with this loan transaction, the provisions of this Section shall govern and prevail and neither Borrower nor the sureties, guarantors, successors or assigns of Borrower shall be obligated to pay
the excess amount of such interest or any other excess sum paid for the use, forbearance or detention of sums loaned pursuant hereto. In the event Lender ever receives, collects or applies as interest any such sum, such amount which would be in
excess of the maximum amount permitted by applicable law shall be applied as a payment and reduction of the principal of the indebtedness evidenced by the Note; and, if the principal of the Note has been paid in full, any remaining excess shall
forthwith be paid to Borrower. In determining whether or not the interest paid or payable exceeds the Maximum Rate, Borrower and Lender shall, to the extent permitted by applicable law, (a) characterize any non-principal payment as an expense,
fee or premium rather than as interest, (b) exclude voluntary prepayments and the effects thereof and (c) amortize, prorate, allocate and spread in equal or unequal parts the total amount of interest throughout the entire contemplated term
of the indebtedness evidenced by the Note so that interest for the entire term does not exceed the Maximum Rate. 

Section 12.9. Notices. 
 (a) All notices and other communications provided for in this Agreement and the other Loan Documents shall be in writing and may (subject to paragraph (b) below) be telecopied (faxed), mailed by
certified mail return receipt requested, or delivered by hand or overnight courier service to the intended recipient at the addresses specified below or at such other address as shall be designated by any party listed below in a notice to the other
parties listed below given in accordance with this Section. 
  

					
		 	If to Borrower:	  	University Hospital Systems, LLP
		 		  	1 Houston Center- 1221 McKinney Street
		 		  	Suite 3240
		 		  	Houston, TX 77010
		 		  	Attention: Kamran Nezami
		 		  	Telephone No.:
                            
		 		  	Fax No.:
                            

  

					
		 		  	
		 	With a copy to:	  	Winstead, Sechrest & Minick
		 		  	2400 Bank One Center
		 		  	910 Travis Street
		 		  	Houston, TX 77002
		 		  	Attention: Ed Laborde
		 		  	Telephone No.: 713.650.2797
		 		  	Fax No.: 713.650.2400

  
 18 

 EXHIBIT 10.1 

 

							
		 	If to Lender:	  	Felix Spiegel, M.D.	  	
		 		  	  
	  	
		 		  	  
	  	
		 		  	Telephone No.:
                            	  	
		 		  	Fax No.:
                            	  	
				
		 	With a Copy to:	  	John Creighton	  	
		 		  	  
	  	
		 		  	  
	  	
		 		  	Telephone No.:
                            	  	
		 		  	Fax No.: 409.838.6959	  	

 Except as otherwise provided in this Agreement, all such communications shall be deemed to have been duly
given when transmitted by telecopy (fax), subject to confirmation of receipt, when delivered if by hand or overnight courier service or, in the case of a mailed notice, three (3) days after the date when duly deposited in the mails, in each
case given or addressed as aforesaid; provided, however, that notices to Lender pursuant to Article II shall not be effective until received by Lender. 
 (b) Lender or Borrower may, in its discretion, agree to accept notices and other communications to it hereunder by electronic communications pursuant to procedures approved by it; provided that approval
of such procedures may be limited to particular notices or communications. Unless Lender otherwise prescribes, (i) notices and other communications sent to an e-mail address shall be deemed received upon the sender’s receipt of an
acknowledgment from the intended recipient (such as by the “return receipt requested function, as available, return e-mail or other written acknowledgment), provided, that if such notice or other communication is not sent during the normal
business hours of the recipient, such notice or communication shall be deemed to have been sent at the opening of business on the next Business Day for the recipient. Provided, however, no notice of an Event of Default or notice of acceleration or
the exercise of any remedy shall be provided via e-mail. 
 Section 12.10. Applicable Law; Venue; Service of Process. This
Agreement shall be governed by and construed in accordance with the laws of the State of Texas and the applicable laws of the United States of America. This Agreement has been entered into in Harris County, Texas and it shall be performable for all
purposes in Harris County, Texas. Any action or proceeding against Borrower under or in connection with any of the Loan Documents may be brought in any state or federal court in Harris County, Texas, and Borrower hereby irrevocably submits to the
nonexclusive jurisdiction of such courts and waives: my objection it may now or hereafter have as to the venue of any such action or proceeding brought in any such court or that any such court is an inconvenient forum. Borrower agrees that service
of process upon it may be made by certified or registered mail, return receipt requested, at its office specified in this Agreement. Nothing herein or in any of the other Loan Documents shall affect the right of Lender to serve process in any other
manner permitted by law or shall limit the right of Lender to bring any action or proceeding against Borrower or with respect to any of its property in courts in other jurisdictions. Any action or proceeding by Borrower against Lender shall be
brought only in a court located in Harris County, Texas. 

  
 19 

 EXHIBIT 10.1 

 

 Section 12.11. Counterparts. This Agreement may be executed in one or more
counterparts, each of which shall be deemed an original, but all of which together shall constitute one and the same instrument. 
 Section 12.12. Severability. Any provision of this Agreement held by a court of competent jurisdiction to be invalid or unenforceable shall not impair or invalidate the remainder of this
Agreement and the effect thereof shall be confined to_ the provision held to be invalid or illegal. 
 Section 12.13.
Headings. The headings, captions and arrangements used in this Agreement are for convenience only and shall not affect the interpretation of this Agreement. 
 Section 12.14. Non-Application of Chapter 346 of Texas Finance Code. The provisions of Chapter 346 of the Texas Finance Code are specifically declared by the parties hereto not to be applicable to
this Agreement or any of the other Loan Documents or to the transactions contemplated hereby. 
 Section 12.15.
USA Patriot Act. Lender hereby notifies Borrower that pursuant to the requirements of the USA Patriot Act (Title III of Pub. L. 107-56 (signed into law October 26, 2001)) (the “Act”), it is required to obtain, verify and record
information that identifies Borrower, which information includes the name and address of Borrower and other information that will allow Lender to identify Borrower in accordance with the Act. 

Section 12.16. ENTIRE AGREEMENT. THIS AGREEMENT, THE NOTE(S) AND THE OTHER LOAN DOCUMENTS REFERRED TO HEREIN EMBODY THE FINAL,
ENTIRE AGREEMENT AMONG THE PARTIES HERETO WITH RESPECT TO THE SUBJECT MATTER HEREOF AND THEREOF AND SUPERSEDE ANY AND ALL PRIOR COMMITMENTS, AGREEMENTS, REPRESENTATIONS AND UNDERSTANDINGS, WHETHER WRITTEN OR ORAL, RELATING TO THE SUBJECT MATTER
HEREOF AND THEREOF AND MAY NOT BE CONTRADICTED OR VARIED BY EVIDENCE OF PRIOR, CONTEMPORANEOUS OR SUBSEQUENT ORAL AGREEMENTS OR DISCUSSIONS OF THE PARTIES HERETO. THERE ARE NO ORAL AGREEMENTS AMONG THE PARTIES HERETO. 

IN WITNESS WHEREOF, the parties hereto have duly executed this Agreement as of the day and year first above written. 

 

			
	BORROWER:
	
	 UNIVERSITY HOSPITAL SYSTEMS, LLP,

a Delaware limited liability partnership

		
	By:	 	/s/ Kamran Nezami
		 	 Kamran Nezami
 President and
Chief Executive Officer

  
 20 

 EXHIBIT 10.1 

 

 
	
	LENDER:
	
	/s/ FELIX SPIEGEL
	FELIX SPIEGEL, M.D.

  
 21 

 EXHIBIT 10.1 

 

 LIST OF EXHIBITS 

 

			
	Exhibits	  	Documents
		
	A	  	Note
		
	B	  	Form of Guaranty
		
	C	  	Advance Request Form

  
 22 

 EXHIBIT 10.1 

 

 EXHIBIT “A” 

REVOLVING CREDIT PROMISSORY NOTE 
  

					
	$2,000,000.00	 	Houston, Texas	 	October    , 2006

 FOR VALUE RECEIVED, the undersigned, UNIVERSITY HOSPITAL SYSTEMS, LLP, a Delaware limited liability
partnership (“Borrower”), hereby promises to pay to the order of FELIX SPIEGEL, M.D. (“Lender”), at his designated office, in lawful money of the United States of America, the principal sum of TWO MILLION AND NO/100 DOLLARS
($2,000,000.00), or so much thereof as may be advanced and outstanding hereunder, together with interest on the outstanding principal balance from day to day remaining, at a rate per annum which shall from day to day be equal to the lesser of
(a) the Maximum Rate (hereinafter defined) or (b) the greater of (i) TEN percent (10%) per annum or (ii) the sum of the Prime Rate (hereinafter defined) of Amegy Bank, N.A. in effect from day to day plus TWO percent (2.0%),
and each change in the rate of interest charged hereunder shall become effective, without notice to Borrower, on the effective date of each change in the Prime Rate or the Maximum Rate, as the case may be. Provided, however, if at any time the rate
of interest specified in clause (b) preceding shall exceed the Maximum Rate, thereby causing the interest rate hereon to be limited to the Maximum Rate, then any subsequent reduction in the Prime Rate shall not reduce the rate of interest
hereon below the Maximum Rate until the total amount of interest accrued hereon equals the amount of interest which would have accrued hereon if the rate specified in clause (b) preceding had at all times been in effect. If an Event of Default
(as defined in the Loan Agreement) occurs, the principal hereof shall bear interest at the Default Rate (hereinafter defined.) 

Principal of and interest on this Note shall be due and payable as follows: 

(a) Accrued and unpaid interest on this Note shall be payable monthly, on the last day of each month commencing on
October 31, 2006 and upon the maturity of this Note, however such maturity may be brought about; and 
 (b)
All outstanding principal of this Note and all accrued interest hereon shall be due and payable on September 30, 2007. 

If an Event of Default (hereinafter defined) has occurred and is existing, the principal hereof shall bear interest at the Default Rate
(hereinafter defined). 
 Interest on the indebtedness evidenced by this Note shall be computed on the basis of a year of 360
days and the actual number of days elapsed (including the first day but excluding the last day) unless such calculation would result in a usurious rate in which case interest shall be calculated on the basis of a year of 365 or 366 days, as the case
may be. 

  

 EXHIBIT 10.1 

 

 As used in this Note, the following terms shall have the respective meanings indicated
below: 
 “Agreement” means that certain Loan Agreement dated as of even date herewith between Borrower
and Lender, as the same may be amended or modified from time to time. 
 “Default Rate” means the
lesser of(a) the sum of the Prime Rate plus five percent (5.0%), or (b) the Maximum Rate. 
 “Event
of Default” shall have the meaning given to such term in the Agreement. 
 “Maximum Rate”
means the maximum rate of nonusurious interest permitted from day to day by applicable law, including Chapter 303 of the Texas Finance Code (the “Code”) (and as the same may be incorporated by reference in other Texas statutes). To the
extent that Chapter 303 of the Code is relevant to any holder of this Note for the purposes of determining the Maximum Rate, each such holder elects to determine such applicable legal rate pursuant to the “weekly ceiling,” from time to
time in effect, as referred to and defined in Chapter 303 of the Code; subject, however, to the limitations on such applicable ceiling referred to and defined in the Code, and further subject to any right such holder may have subsequently, under
applicable law, to change the method of determining the Maximum Rate. 
 “Prime Rate” shall mean
that variable rate of interest per annum established by Lender from time to time as its prime rate which shall vary from time to time. Such rate is set by Lender as a general reference rate of interest, taking into account such factors as Lender may
deem appropriate, it being understood that many of Lender’s commercial or other loans are priced in relation to such rate, that it is not necessarily the lowest or best rate charged to any customer and that Lender may make various commercial or
other loans at rates of interest having no relationship to such rate. 
 This Note is the Note provided for in the Agreement.
Borrower may prepay the principal of this Note upon the terms and conditions specified in the Agreement. Borrower may borrow, repay, and reborrow hereunder upon the terms and conditions specified in the Agreement. 

Notwithstanding anything to the contrary contained herein, no provisions of this Note shall require the payment or permit the collection
of interest in excess of the Maximum Rate. If any excess of interest in such respect is herein provided for, or shall be adjudicated to be so provided, in this Note or otherwise in connection with this loan transaction, the provisions of this
paragraph shall govern and prevail, and neither Borrower nor the sureties, guarantors, successors or assigns of Borrower shall be obligated to pay the excess amount of such interest, or any other excess sum paid for the use, forbearance or detention
of sums loaned pursuant hereto. If for any reason interest in excess of the Maximum Rate shall be deemed charged, required or permitted by any court of competent jurisdiction, any such excess shall be applied as a payment and reduction of the
principal of indebtedness evidenced by this Note; and, if the principal amount hereof has been paid in full, any remaining excess shall forthwith be paid to Borrower. In determining whether or not the interest paid or payable exceeds the Maximum
Rate, Borrower and Lender shall, to the extent permitted by applicable law, (a) characterize any non-principal payment as an expense, fee, or premium rather than as interest, (b) exclude voluntary prepayments and the effects thereof, and
(c) amortize, prorate, allocate, and spread in equal or 

  
 2 

 EXHIBIT 10.1 

 

 
unequal parts the total amount of interest throughout the entire contemplated term of the indebtedness evidenced by this Note so that the interest for the entire term does not exceed the Maximum
Rate. 
 If default occurs in the payment of principal or interest under this Note, or upon the occurrence of any other Event of
Default, as such term is defined in the Agreement, the holder hereof may, at its option, (a) declare the entire unpaid principal of and accrued interest on this Note immediately due and payable without notice, demand or presentment, all of
which are hereby waived, and upon such declaration, the same shall become and shall be immediately due and payable, (b) foreclose or otherwise enforce all liens or security interests securing payment hereof, or any part hereof, (c) offset
against this Note any sum or sums owed by the holder hereof to Borrower and (d) take any and all other actions available to Lender under this Note, the Agreement, the Loan Documents (as such term is defined in the Agreement) at law, in equity
or otherwise. Failure of the holder hereof to exercise any of the foregoing options shall not constitute a waiver of the right to exercise the same upon the occurrence of a subsequent Event of Default. 

If the holder hereof expends any effort in any attempt to enforce payment of all or any part or installment of any sum due the holder
hereunder, or if this Note is placed in the hands of an attorney for collection, or if it is collected through any legal proceedings, Borrower agrees to pay all costs, expenses, and fees incurred by the holder, including all reasonable
attorneys’ fees. 
 THIS NOTE SHALL BE GOVERNED BY AND CONSTRUED IN ACCORDANCE WITH THE LAWS OF THE STATE OF TEXAS AND THE
APPLICABLE LAWS OF THE UNITED STATES OF AMERICA. THIS NOTE IS PERFORMABLE IN HARRIS COUNTY, TEXAS. 
 Borrower and each surety,
guarantor, endorser, and other party ever liable for payment of any sums of money payable on this Note jointly and severally waive notice, presentment, demand for payment, protest, notice of protest and non-payment or dishonor, notice of
acceleration, notice of intent to accelerate, notice of intent to demand, diligence in collecting, grace, and all other formalities of any kind, and consent to all extensions without notice for any period or periods of time and partial payments,
before or after maturity, and any impairment of any collateral securing this Note, all without prejudice to the holder. The holder shall similarly have the right to deal in any way, at any time, with one or more of the foregoing parties without
notice to any other party, and to grant any such party any extensions of time for payment of any of said indebtedness, or to release or substitute part or all of the collateral securing this Note, or to grant any other indulgences or forbearances
whatsoever, without notice to any other party and without in any way affecting the personal liability of any party hereunder. 
  

			
	 UNIVERSITY HOSPITAL SYSTEMS, LLP,
 a Delaware limited liability partnership

		
	By:	 	  

		 	Karnran Nezami
		 	President

  
 3 

 EXHIBIT 10.1 

 

 EXHIBIT “B” 

GUARANTY AGREEMENT 
 WHEREAS, the execution of this Guaranty Agreement dated as of October     , 2006 is a condition to FELIX SPIEGEL, M.D. (“Lender”), making a loan to UNIVERSITY HOSPITAL
SYSTEMS, LLP, a Delaware limited liability partnership (“Borrower”), pursuant to that certain Loan Agreement dated of even date, between Borrower and Lender (such Loan Agreement as it my hereafter be amended or modified from time to time,
is hereinafter referred to as the “Loan Agreement”); 
 NOW, THEREFORE, for valuable consideration, the receipt and
adequacy of which are hereby acknowledged, the undersigned, Karman Nezami, an individual (the “Guarantor”), hereby irrevocably and unconditionally guarantees to Lender the full and prompt payment and performance of the Guaranteed
Indebtedness (hereinafter defined). This Guaranty Agreement shall be upon the following terms: 
 1. The term “Guaranteed
Indebtedness”, as used herein means all of the “Obligations”, as defined in the Loan Agreement. The term “Guaranteed Indebtedness” shall include any and all post-petition interest and expenses (including attorneys’
fees) whether or not allowed under any bankruptcy, insolvency, or other similar law. As of the date of this Guaranty Agreement, the Obligations include, but are not limited to, the indebtedness evidenced by (i) that certain revolving credit
promissory note in the maximum principal amount of $2,000,000.00, dated of even date, executed by Borrower and payable to the order of Lender (the “Note”), and (ii) all renewals, extensions, amendments, decreases or other
modifications of any of the foregoing and all promissory notes given in renewal, extension, amendment, decrease or other modification thereof. 
 2. This instrument shall be an absolute, continuing, irrevocable, and unconditional guaranty of payment and performance, and not a guaranty of collection, and Guarantor shall remain liable on its
obligations hereunder until the payment and performance in full of the Guaranteed Indebtedness. No setoff, counterclaim, recoupment, reduction, or diminution of any obligation, or any defense of any kind or nature which Borrower may have against
Lender or any other party, or which Guarantor may have against Borrower, Lender, or any other party, shall be available to, or shall be asserted by, Guarantor against Lender or any subsequent holder of the Guaranteed Indebtedness or any part thereof
or against payment of the Guaranteed Indebtedness or any part thereof. 
 3. If Guarantor becomes liable for any indebtedness
owing by Borrower to Lender by endorsement or otherwise, other than under this Guaranty Agreement, such liability shall not be in any manner impaired or affected hereby, and the rights of Lender hereunder shall be cumulative of any and all other
rights that Lender may ever have against Guarantor. The exercise by Lender of any right or remedy hereunder or under any other instrument, or at law or in equity, shall not preclude the concurrent or subsequent exercise of any other right or remedy.

 4. In the event of default by Borrower in payment or performance of the Guaranteed Indebtedness, or any part thereof, when
such Guaranteed Indebtedness becomes due, whether by 

  

 EXHIBIT 10.1 

 

 
its terms, by acceleration, or otherwise, Guarantor shall promptly pay the amount due hereunder to Lender within two (2) business days after notice and demand in lawful money of the United
States of America and it shall not be necessary for Lender, in order to enforce such payment by Guarantor, first to institute suit or exhaust its remedies against Borrower or others liable on such Guaranteed Indebtedness, or to enforce any rights
against any collateral which shall ever have been given to secure such Guaranteed Indebtedness. Until payment in full of the Guaranteed Indebtedness and the passage of a period of ninety (90) days thereafter, Guarantor waives any and all rights
it may now or hereafter have under any agreement or at law or in equity (including, without limitation, any law subrogating the Guarantor to the rights of Lender) to assert any claim against or seek contribution, indemnification or any other form of
reimbursement from Borrower or any other party liable for payment of any or all of the Guaranteed Indebtedness for any payment made by Guarantor under or in connection with this Guaranty Agreement or otherwise. 

5. If acceleration of the time for payment of any amount payable by Borrower under the Guaranteed Indebtedness is stayed upon the
insolvency, bankruptcy, or reorganization of Borrower, all such amounts otherwise subject to acceleration under the terms of the Guaranteed Indebtedness shall nonetheless be payable by Guarantor hereunder forthwith on demand by Lender. 

6. Guarantor hereby agrees that its obligations under this Guaranty Agreement shall not be released, discharged, diminished, impaired,
reduced, or affected for any reason or by the occurrence of any event, including, without limitation, one or more of the following events, whether or not with notice to or the consent of Guarantor: (a) the taking or accepting of collateral as
security for any or all of the Guaranteed Indebtedness or the release, surrender, exchange, or subordination of any collateral now or hereafter securing any or all of the Guaranteed Indebtedness; (b) any partial release of the liability of
Guarantor hereunder, or the full or partial release of any other guarantor or obligor from liability for any or all of the Guaranteed Indebtedness; (c) any disability of Borrower, or the dissolution, insolvency, or bankruptcy of Borrower,
Guarantor, or any other party at any time liable for the payment of any or all of the Guaranteed Indebtedness; (d) any renewal, extension, modification, waiver, amendment, or rearrangement of any or all of the Guaranteed Indebtedness or any
instrument, document, or agreement evidencing, securing, or otherwise relating to any or all of the Guaranteed Indebtedness; (e) any adjustment, indulgence, forbearance, waiver, or compromise that may be granted or given by Lender to Borrower,
Guarantor, or any other party ever liable for any or all of the Guaranteed Indebtedness; (f) any neglect, delay, omission, failure, or refusal of Lender to take or prosecute any action for the collection of any of the Guaranteed Indebtedness or
to foreclose or take or prosecute any action in connection with any instrument, document, or agreement evidencing, securing, or otherwise relating to any or all of the Guaranteed Indebtedness; (g) the unenforceability or invalidity of any or
all of the Guaranteed Indebtedness or of any instrument, document, or agreement evidencing, securing, or otherwise relating to any or all of the Guaranteed Indebtedness; (h) any payment by Borrower or any other party to Lender is held to
constitute a preference under applicable bankruptcy or insolvency law or if for any other reason Lender is required to refund any payment or pay the amount thereof to someone else; (i) the settlement or compromise of any of the Guaranteed
Indebtedness; (j) the non-perfection of any security interest or lien securing any or all of the Guaranteed Indebtedness; (k) any impairment of any collateral securing any or all of the Guaranteed Indebtedness; (l) any change in the
corporate existence, structure, or ownership of Borrower; or (m) any other circumstance which might otherwise constitute a defense available to, or discharge of, Borrower or Guarantor. 

  
 2 

 EXHIBIT 10.1 

 

 7. Guarantor represents and warrants to Lender as follows: 

(a) Guarantor has the power and authority and legal right to execute, deliver, and perform its obligations under this
Guaranty Agreement and this Guaranty Agreement constitutes the legal, valid, and binding obligation of Guarantor, enforceable against Guarantor in accordance with its terms, except as limited by bankruptcy, insolvency, or other laws of general
application relating to the enforcement of creditor’s rights. 
 (b) The execution, delivery, and
performance by Guarantor of this Guaranty Agreement do not and will not violate or conflict with any law, rule, or regulation or any order, writ, injunction, or decree of any court, governmental authority or agency, or arbitrator and do not and will
not conflict with, result in a breach of, or constitute a default under, or result in the imposition of any lien upon any assets of Guarantor pursuant to the provisions of any indenture, mortgage, deed of trust, security agreement, franchise,
permit, license, or other instrument or agreement to which Guarantor or its properties is bound. 
 (c) No
authorization, approval, or consent of, and no filing or registration with, any court, governmental authority, or third party is necessary for the execution, delivery, or performance by Guarantor of this Guaranty Agreement or the validity or
enforceability thereof. 
 (d) The value of the consideration received and to be received by Guarantor as a
result of Borrower and Lender entering into the Loan Agreement and Guarantor executing and delivering this Guaranty Agreement is reasonably worth at least as much as the liability and obligation of Guarantor hereunder, and such liability and
obligation and the Loan Agreement have benefited and may reasonably be expected to benefit Guarantor directly or indirectly. 
 (e) Guarantor represents and warrants to Lender that Guarantor IS not insolvent and Guarantor’s assets exceed its liabilities. 

8. Guarantor covenants and agrees that, as long as the Guaranteed Indebtedness or any part thereof is outstanding or Lender has any
commitment under the Loan Agreement: 
 (a) Within ten {10) days after Lender’s request therefore, Guarantor
will furnish to Lender such financial information concerning Guarantor as Lender may reasonably request. 
 9. Should the
Guarantor fail to repay the Guaranteed Indebtedness in the manner required by Section 4 hereof, Lender shall have the right to set off and apply against this Guaranty Agreement or the Guaranteed Indebtedness or both, at any time and without
notice to Guarantor, any and all deposits (general or special, time or demand, provisional or final) or other sums at any time credited by or owing from Lender to Guarantor (but not as to funds owing to Guarantor in its capacity as trustee or
agent). In addition to Lender’s right of setoff and as further 

  
 3 

 EXHIBIT 10.1 

 

 
security for this Guaranty Agreement and the Guaranteed Indebtedness, Guarantor hereby grants Lender a security interest in all deposits (general or special, time or demand, provisional or final)
and all other accounts of Guarantor (but not as to funds owing to Guarantor in its capacity as trustee or agent) now or hereafter on deposit with or held by Lender and all other sums at any time credited by or owing from Lender to Guarantor. The
rights and remedies of Lender hereunder are in addition to other rights and remedies (including, without limitation, other rights of setoff) which Lender may have. 
 10. Guarantor hereby agrees that the Subordinated Indebtedness (as hereinafter defined) shall be subordinate and junior in right of payment to the prior payment in full of all Guaranteed Indebtedness, and
Guarantor hereby assigns the Subordinated Indebtedness to Lender as security for the Guaranteed Indebtedness. If any sums shall be paid to Guarantor by Borrower or any other person or entity on account of the Subordinated Indebtedness, such sums
shall be held in trust by Guarantor for the benefit of Lender and shall forthwith be paid to Lender as a credit against the liability of Guarantor under this Guaranty Agreement. For purposes of this Guaranty Agreement, the term “Subordinated
Indebtedness” means all indebtedness, liabilities, and obligations of Borrower to Guarantor other than payment for services performed and reimbursement for ordinary business expenses, whether such indebtedness, liabilities, and obligations now
exist or are hereafter incurred or arise, or whether the obligations of Borrower thereon are direct, indirect, contingent, primary, secondary, several, joint and several, or otherwise, and irrespective of the person or persons in whose favor such
indebtedness, obligations, or liabilities may, at their inception, have been, or may hereafter be created, or the manner in which they have been or may hereafter be acquired by Guarantor. 

11. No amendment or waiver of any provision of this Guaranty Agreement nor consent to any departure by the Guarantor therefrom shall in
any event be effective unless the same shall be in writing and signed by Lender. No failure on the part of Lender to exercise, and no delay in exercising, any right, power, or privilege hereunder shall operate as a waiver thereof; nor shall any
single or partial exercise of any right, power, or privilege hereunder preclude any other or further exercise thereof or the exercise of any other right, power, or privilege. The - remedies herein provided are cumulative and not exclusive of any
remedies provided by law. The provisions of this paragraph shall not waive the Guarantor’s rights that any action arising hereunder be brought within the time established by any applicable statue of limitations. 

12. This Guaranty Agreement is for the benefit of Lender and its successors and assigns, and in the event of an assignment of the
Guaranteed Indebtedness, or any part thereof, the rights and benefits hereunder, to the extent applicable to the indebtedness so assigned, may be transferred with such indebtedness. This Guaranty Agreement is binding not only on Guarantor, but on
Guarantor’s heirs and personal representatives. 
 13. Guarantor recognizes that Lender is relying upon this Guaranty
Agreement and the undertakings of Guarantor hereunder in making extensions of credit to Borrower under the Loan Agreement and further recognizes that the execution and delivery of this Guaranty Agreement is a material inducement to Lender in
entering into the Loan Agreement. Guarantor hereby acknowledges that there are no conditions to the full effectiveness of this Guaranty Agreement other than the advance by the Lender of the Guaranteed Indebtedness. 

  
 4 

 EXHIBIT 10.1 

 

 14. This Guaranty Agreement is executed and delivered as an incident to a lending
transaction negotiated, consummated, and performable in Harris County, Texas, and shall be governed by and construed in accordance with the laws of the State of Texas. Any action or proceeding against Guarantor under or in connection with this
Guaranty Agreement may be brought in any state or federal court in Harris County, Texas, and Guarantor hereby irrevocably submits to the nonexclusive jurisdiction of such courts, and waives any objection it may now or hereafter have as to the venue
of any such action or proceeding brought in such court. Guarantor agrees that service of process upon it may be made by certified or registered mail. return receipt requested, at its address specified on the signature page of this Guaranty
Agreement. Nothing herein shall limit the right of Lender to bring any action or proceeding against Guarantor or with respect to any of Guarantor’s property in courts in other jurisdictions. Any action or proceeding by Guarantor against Lender
shall be brought only in a court located in Harris County, Texas. 
 15. Guarantor shall pay on demand all reasonable
attorneys’ fees and all other costs and expenses incurred by Lender in connection with the enforcement, or collection of this Guaranty Agreement. 
 16. Other than such notice as if expressly provided for herein, Guarantor hereby waives promptness, diligence, notice of any default under the Guaranteed Indebtedness, demand for payment, notice of
acceptance of this Guaranty Agreement, presentment, notice of protest, notice of dishonor, notice of the incurring by Borrower of additional indebtedness, and all other notices and demands with respect to the Guaranteed Indebtedness and this
Guaranty Agreement. 
 17. Any notices given hereunder shall be given in the manner provided by and to the addresses set forth
in the Loan Agreement. 
 18. Guarantor hereby represents and warrants to Lender that Guarantor has adequate means to obtain
from Borrower on a continuing basis information concerning the financial condition and assets of Borrower and that Guarantor is not relying upon Lender to provide (and Lender shall have no duty to provide) any such information to Guarantor either
now or in the future. 
 19. Guarantor understands and agrees that (a) Lender’s document retention policy involves the
imaging of executed loan documents and the destruction of the paper originals, and (b) Guarantor waives any right that it may have to claim that the imaged copies of the Loan Documents are not originals. 

20. This notice is being supplied in compliance with 12 C.F.R. 227, Regulation AA, promulgated by the Federal Reserve Board and applies
to any Guaranteed Indebtedness which may be a consumer credit obligation as defined in such Regulation AA. You are being asked to guarantee the debt of Borrower now existing or hereafter arising. There is no limit as to the amount unless this
Guaranty expressly provides for such limitation. Think carefully before you guarantee the existing and future debts of Borrower. If Borrower doesn’t pay any of such debts, you will have to. Be sure that you can afford to pay all such debts if
you have to and that you want to accept this responsibility. You may have to pay up to the full amount of all Borrower’s debts if Borrower does not pay. You may also have to pay late fees or collection costs, which increase this amount. Lender
can collect such debts from you without first trying to collect from 

  
 5 

 EXHIBIT 10.1 

 

 
Borrower. Lender can use the same collection methods against you that can be used against Borrower, such as suing you, etc. If any such debts is ever in default, that fact may become part of your
credit record. This notice is not the contract that makes you liable for Borrower’s debts. The Guaranty that is set forth in this instrument is, however, a contract that makes you liable for Borrower’s debts. 

21. THIS GUARANTY AGREEMENT EMBODIES THE FINAL, ENTIRE AGREEMENT · OF GUARANTOR AND LENDER WITH RESPECT TO GUARANTOR’S
GUARANTY OF THE GUARANTEED INDEBTEDNESS AND SUPERSEDES ANY AND ALL PRIOR COMMITMENTS, AGREEMENTS, REPRESENTATIONS, AND UNDERSTANDINGS, WHETHER WRITTEN OR ORAL, RELATING TO THE SUBJECT MATTER HEREOF AND MAY NOT BE CONTRADICTED OR VARIED BY EVIDENCE
OF PRIOR, CONTEMPORANEOUS OR SUBSEQUENT ORAL AGREEMENTS OR DISCUSSIONS OR OTHER EXTRINSIC EVIDENCE OF ANY NATURE. THERE ARE NO ORAL AGREEMENTS BETWEEN GUARANTOR AND LENDER. THIS GUARANTY AGREEMENT MAY NOT BE AMENDED EXCEPT IN WRITING BY GUARANTOR
AND LENDER. 
 DATED and EFFECTIVE as of the day and year first written above. 

 

	
	GUARANTOR:
	
	  

	KAMRAN NEZAMI
	
	Address:
	  

	  

	  

	  

  
 6 

 EXHIBIT 10.1 

 

 EXHIBIT “C” 

ADVANCEREQUESTFORM 
  

	TO:	Felix Spiegel, M.D. 

 The
undersigned is an authorized representative of UNIVERSITY HOSPITAL SYSTEMS, LLP (the “Borrower”), and is authorized to make and deliver this certificate pursuant to that certain Loan Agreement dated as of October    ,
2006 between the Borrower and Felix Spiegel, M.D. (the “Lender”). (Such Loan Agreement, as it may be amended is referred to as the “Loan Agreement”.) All terms defined in the Loan Agreement shall have the same meaning herein.

 Borrower hereby requests an Advance (the “Requested Advance”) m the amount of
$         in accordance with the Loan Agreement. 
 In connection with the foregoing and
pursuant to the terms and provisions of the Loan Agreement, the undersigned hereby certifies that the following statements are true and correct: 
 (a) The representations and warranties contained in Article VIII of the Loan Agreement and in each of the other Loan Documents are true and correct on and as of the date hereof with the same force and
effect as if made on and as of such date. 
 (b) No Event of Default or Unmatured Event of Default has occurred
and is continuing or would result from the Requested Advance. Borrower acknowledges that if an Event of Default or Unmatured Event of Default exists Lender is not obligated to fund the Requested Advance. 

(c) Since the date of the financial statements of Borrower most recently delivered to Lender, there has been no Material
Adverse Effect. 
 (d) The amount of the Requested Advance, when added to the principal amount of all Advances
outstanding, will not exceed the Commitment. 

  

 EXHIBIT 10.1 

 

 Advance Request Information 

 

							
	1.	  	 Commitment
	  	$	2,000,000.00	  
			
	2.	  	 Amount of Outstanding Advances
	  	$	            	  
			
	3.	  	 Available Amount (line (1) minus line (2))
	  	$	            	  
			
	4.	  	 Amount of Requested Advance
	  	$	            	  

 Dated as
of:                     
  

			
	BORROWER:
	
	UNIVERSITY HOSPITAL SYSTEMS, LLP,
		
	By:	 	  

		 	Kamran Nezami
		 	President

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