Document:

Intellectual Property Security Agreement

 Exhibit 4.2 
 INTELLECTUAL PROPERTY SECURITY AGREEMENT 
 This Intellectual Property Security Agreement (the
“Agreement”), is made as of December 24, 2003, by and among U.S. BANK NATIONAL ASSOCIATION, as trustee for the Noteholders (“Trustee”), SILICON GRAPHICS, INC., a Delaware corporation (the
“Grantor”), with reference to the following facts: 
 A. The Grantor has adopted certain trademarks and service marks, as
identified herein and in Schedule A annexed hereto and made a part hereof, and 
 B. The Grantor is the owner and holder of certain patents,
patent applications, inventions and trade secret information, as identified herein and in Schedule B annexed hereto and made a part hereof. 
 C. The Grantor is the owner of the copyrights in certain works of authorship, as described herein and in Schedule C annexed hereto and made a part hereof. 
 WHEREAS, the Grantor and U.S. Bank National Association, as Trustee are parties to (1) certain indentures, pursuant to which the Grantor is issuing notes in an aggregate principal amount of up to $230,591,000
(the “Notes”) and (2) a security agreement (the “Security Agreement”) dated as of the date hereof, pursuant to which Grantor has granted the Trustee a security interest in certain collateral, including the
intellectual property collateral set forth in Schedules A, B and C hereto (the “ IP Collateral”); 
 WHEREAS, pursuant to the
Security Agreement, the Grantor is required to execute and deliver this Agreement; 
 WHEREAS, the Grantor, the Trustee and the Wells Fargo
Foothill, Inc. have entered into an Intercreditor Agreement, dated as of the date hereof setting forth the relative priorities of the parties’ security interests in the IP Collateral and other collateral in which the Trustee has been granted a
security interest pursuant to the Security Agreement; and 
 WHEREAS, pursuant to the terms of the Indentures and the Security Agreement and
subject to the terms of the Intercreditor Agreement, U.S. Bank National Association, in its capacity as Trustee has agreed to accept the pledge and assignment and the grant of a security interest in the IP Collateral under this Agreement as security
for the Notes. 
 NOW, THEREFORE, for good and valuable consideration, the receipt and sufficiency of which are hereby acknowledged, and in
order to induce the Trustee to enter into the Indentures and to induce holders of the Grantor’s 5.25% Senior Convertible Notes due 2004 (the “Old Notes”) to exchange the Old Notes for the Notes, the parties hereto agree as
follows: 
 D. This Agreement is the Intellectual Property Security Agreement as defined and described in the Security Agreement. Capitalized
terms used herein and not otherwise defined shall have the meaning set forth in the Security Agreement. 

 NOW, THEREFORE, IT IS AGREED that, for and in consideration of the premises set forth above, the terms
and conditions contained herein, and other good and valuable consideration, the receipt and sufficiency of which are hereby acknowledged, and as collateral security for the prompt payment in full when due (whether at stated maturity, by acceleration
or otherwise) of the Notes, the Grantor hereby grants to Trustee, subject to the Intercreditor Agreement and any other agreement or instrument evidencing Senior Priority Debt, for the benefit of the Noteholders, a continuing security interest in all
of the Grantor’s right, title and interest in and to the IP Collateral, except for the Excluded Intellectual Property described in Schedule D annexed hereto and made a part hereof, including: 
 (a) all of the Grantor’s customer lists and other records of the Grantor relating to the distribution of products bearing,
constituting or incorporating the Trademarks, Patent Collateral and Copyrights; and 
 (b) the proceeds and products, whether
tangible or intangible, of any of the foregoing, including (w) proceeds from any claims by the Grantor against third parties for past, present or future infringement of the Trademarks, Patent Collateral or Copyrights and any royalties from
licenses to third parties of the Trademarks, Patent Collateral or Copyrights, (x) proceeds of insurance covering any or all of the foregoing, and (y) any and all money, deposit accounts, or other tangible or intangible property, solely to
the extent, in the case of each of the foregoing clauses (w), (x) and (y), resulting from the sale, exchange, collection, or other disposition of any of the foregoing, or any portion thereof or interest therein, and the proceeds thereof;
provided, however, that the IP Collateral shall not include (A) such General Intangibles: (i) which cannot be subject to a consensual security interest in favor of Trustee without the consent of the licensor or other party thereto,
(ii) as to which any such restriction described in clause (i) is effective and enforceable under applicable law including Section 9318(4) of the Code or, from and after the effective date thereof, Section 9408 of the revised
Article 9 of the Code, and (iii) to which such consent described in clause (i) has not been obtained by the party granting the security interest and (B) any property not subject to a Senior Priority Lien, other than any such property
that was, immediately prior to the discharge of such Senior Priority Lien Obligations, subject to a Senior Priority Lien, except to the extent that such property, or any portion thereof, was disposed of in order to repay Senior Priority Lien
Obligations. 
 1. The Grantor hereby represents, warrants, covenants and agrees as follows, except with respect to the
Excluded Intellectual Property: 
 (a) The Grantor will promptly perform all acts and execute all documents, including,
without limitation, grants of security in forms acceptable to Trustee and suitable for recording with (i) the United States Patent and Trademark Office and the United States Register of Copyrights, and (ii) the appropriate offices and
agencies of foreign jurisdictions reasonably requested by the Trustee at any time to evidence, perfect, maintain, record or enforce Noteholders’ security interest in the IP Collateral or otherwise in furtherance of the provisions of this
Agreement. The Grantor hereby authorizes the Trustee to execute and file one or 

  

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more financing statements (and any similar documents) or copies thereof or of this Agreement with respect to the IP Collateral signed only by Trustee (with a
copy sent to the Grantor). 
 (b) In the event that either the Grantor, either itself or through any subsidiary, affiliate,
trustee, employee, licensee or designee, shall file an application for the registration of any trademark with the United States Patent and Trademark Office, or any similar office of the United States or in any office of the Secretary of State (or
equivalent) of any state thereof, or for the registration of any copyright with the United States Register of Copyrights, or for the registration of any Trademark or Copyright in any similar office or agency of any country or political subdivision
thereof throughout the world, or shall obtain registration of any Trademark or Copyright previously applied for, or shall adopt, acquire or obtain rights to any new trademark, or work for which a copyright application has been or is expected to be
filed, the Grantor shall (i) inform the Trustee of any such event or action in reports which the Grantor is required to deliver to Trustee pursuant to the Security Agreement and, (ii) execute and deliver any and all assignments,
agreements, instruments, documents and papers as are necessary or appropriate or as the Trustee may reasonably request to evidence the Noteholders’ security interest in such Trademark, or Copyright and the goodwill and general intangibles of
the Grantor’s relating thereto or represented thereby. The Grantor hereby constitutes the Trustee, or its Trustee, its attorney-in-fact to execute and file all such writings for the foregoing purposes, all acts of such attorney being hereby
ratified and confirmed; such power being coupled with an interest is irrevocable until the Notes are paid in full. The Grantor authorizes the amendment of the schedules hereto to include any future Trademark, or Copyright registrations or
applications which may be acquired or made by the Grantor. 
 2. Upon the occurrence and during the continuance of an Event of
Default (as defined in the Indentures), the Trustee may, subject to the Intercreditor Agreement and except with respect to the Excluded Intellectual Property and except to the extent otherwise expressly provided or required below, do any one or more
of the following, all of which are authorized by the Grantor, in addition to all other rights and remedies provided for in the Security Agreement, all such rights and remedies being cumulative, not exclusive, and enforceable alternatively,
successively or concurrently, without (except as provided herein or in the Security Agreement) notice to, or consent by the Grantor: 
 (a) Trustee may (without assuming any obligations or liability thereunder), at any time, enforce (and shall have the exclusive right to enforce) against any licensee or sublicensee all rights and remedies of the Grantor in, to and under any
one or more license agreements with respect to the IP Collateral, and take or refrain from taking any action under any thereof, and the Grantor hereby releases Noteholders from, and agrees to hold the Noteholders free and harmless from and against
any claims arising out of, any action taken or omitted to be taken with respect to any such license agreement; 
  

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 (b) The Trustee, for the benefit of the Noteholders, may, at any time and from time to
time, upon ten (10) days’ prior notice to the Grantor, assign, sell, or otherwise dispose of the IP Collateral or any of it, either with or without special or other conditions or stipulations, with power to buy the IP Collateral or any
part of it, and do all other acts and things for completing the assignment, sale or disposition which Trustee shall, in its sole discretion, deem appropriate or proper; 
 (c) In addition to the foregoing, in order to implement the assignment, sale, license or other disposal of any of the IP Collateral
pursuant to subparagraphs 2(b) hereof, the Trustee may, at any time, pursuant to the authority granted in the Powers of Attorney described in paragraph 3 hereof (such authority becoming effective upon an Event of Default), execute and deliver
on behalf of the Grantor one or more instruments of assignment sale, license or other disposition of the IP Collateral. The Grantor agrees to pay when due all reasonable costs incurred in any such transfer of the IP Collateral, including any taxes,
fees and reasonable attorneys’ fees. The Trustee may apply the proceeds actually received from any such license, assignment, sale or other disposition in accordance with paragraph (d) of this Section 2; and the Grantor shall remain
liable and will pay the Trustee on demand any deficiency remaining, together with interest thereon at a rate equal to the rate then payable on the Notes and the balance of any expenses unpaid. Nothing herein contained shall be construed as requiring
the Trustee to take any such action at any time; and 
 (d) Except as otherwise herein expressly provided, the proceeds of any
collection, sale or other realization of all or any part of the IP Collateral pursuant hereto, shall be applied to the Notes until the Notes shall have been paid in full in cash. The application of proceeds hereunder to the Notes shall be made by
the Trustee in accordance with the provisions of Article 6 of the Indentures. 
 3. The following documents will be
concurrently executed and delivered to the Trustee as conditions precedent to the execution and delivery of this Agreement: 
 (a) Three original Powers of Attorney, in the form of Exhibit A, Exhibit B, and Exhibit C hereto, respectively, executed by the Grantor, for the implementation of any assignment, sale or other disposition of the Trademarks, Patent
Collateral or Copyrights, respectively, pursuant to paragraphs 2(a) and (b) hereof; 
 4. No provision hereof shall be
modified, altered or limited except by a written instrument expressly referring to this Agreement and executed by the party to be charged. This Agreement shall be binding upon the successors, permitted assigns or other legal representatives of the
Grantor, and shall, together with the rights and remedies of the Noteholders hereunder inure to the benefit of the Noteholders, its successors, permitted assigns or other legal representatives. This Agreement and the IP Collateral, except for the
Excluded Intellectual Property, shall be governed in all respects by the laws of the United States and the laws of the State of New York. If any term of this 

  

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Agreement shall be held to be invalid, illegal or unenforceable, the validity of all other terms hereof shall in no way be affected thereby. 
 5. This Agreement shall continue to be effective and shall be reinstated in the event that at any time after the Notes have been paid in
full, any payment of the Notes is rescinded or must otherwise be restored or returned by the Noteholders. 
 6. Upon payment
and performance in full in cash by the Grantor of all of the obligations with respect to the Notes under the Indentures (other than indemnification obligations for which no claim has been made) and upon the termination of the Indentures, this
Agreement shall terminate and the Trustee shall execute, file and record in each office in which any financing statement or assignment relative to the IP Collateral, or any part thereof, shall have been filed, a termination statement, assignment or
other appropriate instrument releasing its interest therein, all without recourse to or warranty by the Noteholders and at the sole cost and expense of the Grantor. 
 7. This Agreement may be executed in any number of counterparts, all of which taken together shall constitute one and the same instrument
and any of the parties hereto may execute this Agreement by signing any such counterpart. 
 IN WITNESS WHEREOF, the undersigned have caused
this Agreement to be duly executed and delivered on the day and year first above written. 
  

			
	 SILICON GRAPHICS, INC.,

	 a Delaware corporation

		
	 By:
	 	 /s/ Jeffrey V. Zellmer

	 Name:
	 	 Jeffrey V. Zellmer

	 Its:
	 	 Senior Vice President and
 Chief Financial Officer

	
	 US BANK NATIONAL ASSOCIATION,

	 a California corporation, as Trustee

		
	 By:
	 	 /s/ Paula Oswald

	 Name:
	 	 Paula Oswald

	 Its:
	 	 Vice President

  

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 Schedule A: 
 See Tab 6, Schedule 5.16A to the Security Agreement 
 attached as Exhibit 4.1 to the 

Current Report on Form 8-K filed on April 25, 2006 

 Schedule B: 
 See Tab 6, Schedule 5.16A 

 Schedule C: 
 See Tab 6, Schedule 5.16A 

 Schedule D: 
 See Tab 6, Schedule 5.16BAsset Exchange and Substitution Agreement

 Exhibit 10.1 
 ASSET EXCHANGE AND SUBSTITUTION AGREEMENT 
 This Asset Exchange and Substitution Agreement (the
“Agreement”) is dated as of April 24, 2006, and is by and among Universal Health Realty Income Trust, a Maryland real estate investment trust (the “Trust”), and Universal Health Services, Inc., a Delaware corporation and
certain of its wholly-owned subsidiaries (“UHS”). 
 W I T N E S S E T H: 
 WHEREAS, the Trust currently owns the property described in Exhibit A hereto, which property constitutes the real property comprising Chalmette Medical
Center (“Chalmette”), located in Chalmette, Louisiana, other than the certain capital additions to Chalmette that are owned by UHS (the “Trust Property”); 
 WHEREAS, the Trust Property was leased by the Trust, as lessor, to Chalmette Medical Center, Inc., a Louisiana corporation f/k/a UHS of De La Ronde, Inc.
(“CMC”), a wholly-owned subsidiary of UHS, as lessee, pursuant to that certain lease dated March 24, 1988 (the “Lease”), which Lease incorporates the terms and conditions of that certain Master Lease Document, General Terms
and Conditions, dated December 24, 1986, by and among the Trust and certain wholly-owned subsidiaries of UHS, together with all amendments thereto (the “Master Lease”); 
 WHEREAS, during the third quarter of 2005, the Trust Property was severely damaged and closed as a result of Hurricane Katrina and the medical center
located thereon was rendered Unsuitable for its Primary Intended Use, as such phrase is defined in the Master Lease; 
 WHEREAS, in
accordance with the terms of Section 14.2 of the Master Lease, and as part of an overall evaluation of certain other leases between subsidiaries of UHS and the Trust, UHS has elected to exchange and substitute new properties pursuant to and in
accordance with the provisions of Article XXII of the Master Lease rather than restore the Trust Property or simply purchase the Trust Property from the Trust for cash; 
 WHEREAS, independent appraisals were obtained by the Trust and UHS which indicated that the pre-Hurricane Katrina fair market value of the Trust Property was $23,965,000, including the fair market value of the land,
which was appraised for approximately $2.6 million; 
 WHEREAS, the Trust currently owns the real property comprising Southwest Healthcare
System- Inland Valley Campus, The Bridgeway and Wellington Regional Medical Center, other than the certain capital additions to such properties, and leases such properties to subsidiaries of UHS; 
 WHEREAS, the property described in Exhibit B hereto, which property consists solely of the certain capital additions located at the Southwest Healthcare
System- Inland Valley Campus, The Bridgeway and Wellington Regional Medical Center (such capital additions at the respective properties are collectively the “UHS Property”) will be transferred to UHT by the respective owners, each
wholly-owned subsidiaries of Universal Health Services, Inc.; 
 WHEREAS, UHS is the current owner of the UHS Property; 
 WHEREAS, certain capital additions are underway at Southwest Healthcare—Inland Valley Campus but not yet completed and UHS desires to complete them
for the benefit of the Trust; 

 WHEREAS, the Trust has agreed to accept (1) $2.6 million of assets of The Bridgeway in exchange for
the Chalmette land (the “Exchange”), (2) the remaining assets of the UHS Property in substitution for the Trust Property (the “Substitution”) and (3) to pay an amount in cash equal to the value of the UHS Property
transferred pursuant to the Exchange and Substitution upon the completion of the capital additions at Southwest Healthcare System- Inland Valley Campus in excess of the $23,965,000 fair market value of the Trust Property (the “Payment”),
in full and complete satisfaction of the obligations of UHS under Article XXII of the Master Lease, and UHS desires to effect the Exchange, Substitution and Payment; 
 WHEREAS, the Trust intends to structure the Exchange herein contemplated as a like-kind exchange of property under the provisions of Section 1031 of the Internal Revenue Code of 1986, as amended (the
“IRC”); 
 WHEREAS, the Trust intends to structure the Substitution herein contemplated as a receipt of proceeds as a result of an
involuntary conversion under the provisions of Section 1033 of the IRC; and 
 WHEREAS, in connection with the Exchange and
Substitution, UHS desires that the Trust terminate the Lease, in accordance with the terms thereof. 
 NOW, THEREFORE, in consideration of
the mutual premises herein and other good and valuable consideration, the receipt and sufficiency of which are hereby acknowledged, the parties hereto agree as follows: 
 ARTICLE I 
 EXCHANGE AND SUBSTITUTION OF ASSETS AND TERMINATION OF LEASE 
 Section 1.1 As soon as is practicable, on such date agreed to by the parties hereto (the “Closing Date”), subject to the terms and
conditions of the Agreement, the Trust agrees to convey to UHS good and marketable fee simple title to the Trust Property, free and clear of all liens and encumbrances except for Permitted Encumbrances (as hereinafter defined) and the Trust will
terminate the Lease. Contemporaneously therewith, subject to the terms of this Agreement, UHS agrees to convey to the Trust, in exchange and substitution for the Trust Property and the Payment, good and marketable title to the UHS Property, free and
clear of all liens and encumbrances except for Permitted Encumbrances. “Permitted Encumbrances” shall mean (a) liens, if any, for taxes, assessments and governmental charges not yet due and payable or delinquent, and (b) such
other matters affecting the Trust Property or the UHS Property as UHS or the Trust may respectively approve. In addition thereto, after the Closing Date, on such date and time as may be designated by the parties hereto, the Trust shall deliver the
Payment to UHS by check, wire transfer, or such other form of payment as may be mutually agreed upon by the parties hereto upon the substantial completion of the capital additions at Southwest Healthcare System-Inland Valley Campus as certified by
HKS Architects, the architects retained by UHS to design and review the construction of such capital additions (the “Architects”). 
 Section 1.2 On the Closing Date, the Trust shall duly deliver an executed and acknowledged special warranty deed to the Trust Property and assignments of any leases and Permits (as hereinafter defined) held by the Trust as owner
of the Trust Property (collectively, the “Trust Deed”). Contemporaneously therewith, UHS shall duly deliver an executed and acknowledged special warranty deed to the UHS Property and assignment of any Permits held by UHS as owner of the
UHS Property. “Permits” means all assignable permits, consents, approvals, franchises, leases, conditional use permits and other certificates, including certificates of 

  

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occupancy or any other governmental approvals or authorizations necessary to permit the use of the Trust Property or the UHS Property, as the case may be, in
accordance with the terms hereof. Notwithstanding anything to the contrary contained herein, including Sections 1.6 and 4.1 hereof, on the Closing Date, the Trust shall deliver the Trust Deed to UHS, duly registered in the name of UHS.

 Section 1.3 The conveyance of the Trust Property and the UHS Property shall include the conveyance of all of the Trust’s
and of UHS’ respective right, title and interest in and to all leases, Permits and warranties and in and to all Fixtures, as defined in the Lease, and, with respect to the Trust Property, all insurance proceeds, but shall not include any other
furniture, equipment, inventory and other items of personal property owned by the Trust or UHS, as the case may be, and located or used in or in connection with the operation of Chalmette Medical Center or at Southwest Healthcare—Inland Valley
Campus, The Bridgeway and Wellington Regional Medical Center, respectively, or any Permits relating to the use of the Trust Property or the UHS Property, respectively, other than those required to be held by the owner of the Trust Property or the
UHS Property, as the case may be, all of which are and shall remain the property of the Trust or UHS, as the case may be. 
 Section 1.4 On the Closing Date, the Trust shall prepare a short form memorandum regarding termination of the Lease, duly executed and acknowledged to be duly recorded or filed for recordation in the manner required by the laws
of St. Bernard Parish, State of Louisiana. 
 Section 1.5 As of the Closing Date, there shall be no adjustment of real or
personal property taxes, assessments, water charges, ground rents, utilities or for premiums on existing insurance policies or any other items relating to the operation of the Trust Property, it being understood by the parties that CMC as lessee
under the Lease was obligated to pay the same under the terms of the Lease and shall remain obligated to pay the same. 
 Section 1.6 On the Closing Date, the Trust and UHS shall respectively transfer, and UHS and the Trust shall respectively take title to, the Trust Property and the UHS Property in their present physical condition, subject to the
completion of the Southwest Healthcare System-Inland Valley Campus capital additions by UHS and subject to reasonable use, wear and tear between the date hereof and the Closing Date without any warranty whatsoever, express or implied, as to its
condition, habitability, or fitness for any particular purpose; and the Trust and UHS hereby waive any of the same. 
 Section 1.7 UHS expects to complete the capital additions at Southwest Healthcare System-Inland Valley Campus, described in Exhibit B hereto on or before December 31, 2006. Upon substantial completion of the capital
additions as certified by the Architects, the Trust shall deliver the Payment as set forth in Section 1.1. If UHS fails to timely complete such capital additions, UHS shall offer to either, subject to the approval of the Trust, provide
alternative substitution property or pay to the Trust an amount in cash equal to the substitution value of the capital addition as determined by the Architects. 
 Section 1.8 The Trust intends to structure (a) the Exchange herein contemplated as a like-kind exchange of property under the provisions of Section 1031 of the IRC, and (b) the Substitution
herein contemplated as an involuntary receipt of proceeds under the provisions of Section 1033 of the IRC. UHS agrees to cooperate with the Trust, when requested, to structure these transactions in such manner, including, without limitation,
the execution of any documents, including an amendment to the Agreement, if required, provided that such actions will 

  

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not require UHS to incur any additional costs, liability or expense, and UHS is held harmless against any liability arising because of the intended like-kind
exchange or substitution, or any challenge to or failure of these transactions to qualify for such treatment. 
 ARTICLE II 
 CLOSING 
 Section 2.1 The
closing shall be held at the offices of Fulbright & Jaworski L.L.P., 666 Fifth Avenue, New York, New York 10103 on the Closing Date or at such other place and at such other time as shall be mutually agreed upon by the parties. 

ARTICLE III 
 CONDITIONS TO THE
OBLIGATION OF THE TRUST TO CLOSE 
 The obligations of the Trust hereunder are subject to the conditions set forth in this Article III.

 Section 3.1 As of the Closing Date, the UHS Property shall have been transferred to the Trust, in accordance with the terms
and conditions of this Agreement, and the representations and warranties made in this Agreement and in any certificates delivered pursuant hereto by UHS shall be true and correct on and as of the Closing Date and all the covenants made by UHS herein
shall have been complied with on or prior to the Closing Date, and the Trust shall have received a certificate, dated the Closing Date, of an executive officer of UHS to that effect. 
 Section 3.2 On or prior to the Closing Date, KPMG LLP shall have furnished its written opinion that addresses the certain items set forth in
Section 22.1(d) of the Master Lease. 
 Section 3.3 All proceedings in connection with the transactions contemplated herein and
all documents and certificates incident thereto shall be satisfactory in form and substance to the Trust. The Trust shall have received such other documents and certificates incident to the transaction as the Trust shall reasonably request.

 ARTICLE IV 
 CONDITIONS TO
THE OBLIGATION OF UHS TO CLOSE 
 The obligations of UHS hereunder are subject to the conditions set forth in this Article IV.

 Section 4.1 As of the Closing Date, the Trust Property shall have been transferred to UHS, in accordance with the terms and
conditions of the Agreement, and the representations and warranties made in the Agreement and in any certificates delivered pursuant hereto by the Trust shall be true and correct on and as of the Closing Date and all the covenants made by the Trust
herein shall have been complied with on or prior to the Closing Date, and UHS shall have received a certificate, dated the Closing Date, of an executive officer of the Trust to that effect. 
 Section 4.2 On the Closing Date, the Lease shall terminate, provided that CMC and UHS, as guarantor under the Lease, shall remain liable for
all rents or other sums to be paid by CMC under the Lease for the period up to the Closing Date and for all obligations surviving termination of the Lease in accordance with its terms. 
  

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 Section 4.3 All trust and other proceedings in connection with the transactions contemplated
herein and all documents and certificates incident thereto shall be satisfactory in form and substance to UHS. UHS shall have received such other documents and certificates incident to the transaction as UHS shall reasonably request. 
 ARTICLE V 
 REPRESENTATIONS, WARRANTIES AND
COVENANTS OF THE PARTIES 
 Section 5.1 To induce UHS to acquire the Trust Property, the Trust represents and warrants to and
agrees with UHS as to itself or the Trust Property, as follows: 
 Section 5.1.1 The Trust is a real estate investment trust duly
organized, validly existing and in good standing under the laws of the State of Maryland with full power, authority and legal right to execute and deliver, and to perform and observe the provisions of the Agreement and all other instruments provided
for herein to which it is a party and to carry out the transactions contemplated hereby. 
 Section 5.1.2 This Agreement has
been, and on the Closing Date all other Documents (as hereinafter defined) to be delivered pursuant to this Agreement on or before the Closing Date will have been, duly authorized, executed and delivered by the Trust, as required, and constitute the
valid and binding agreements of the Trust, enforceable in accordance with their terms except (i) that such enforcement may be subject to bankruptcy, insolvency, reorganization, moratorium or other similar laws now or hereafter in effect
relating to creditors’ rights and (ii) that the remedy of specific performance and injunctive and other forms of equitable relief may be subject to equitable defenses and to the discretion of the court before which any proceeding therefor
may be brought. For the purposes hereof, “Documents” shall include this Agreement, the deed to the Trust Property, the assignment of the leases, Permits and warranties relating to the Trust Property and any notes, mortgages or deeds of
trust or other agreements entered into by the Trust pursuant to the terms hereof. 
 Section 5.1.3 The Trust is a solvent entity
and (a) has filed all tax returns which are required to be filed by it and (b) is not in default in the payment of any taxes levied or assessed against it or any of its assets, or under judgment, order, decree, rule or regulation of any
court, arbitrator, administrative agency or other governmental authority to which it may be subject which would, in each case or in the aggregate, materially and adversely affect the transactions contemplated hereby. 
 Section 5.1.4 No material consent, approval or other authorization of, or registration, declaration or filing with, any court or governmental
agency or commission is required for the due execution, delivery or performance of this Agreement or any of the other Documents by the Trust, or for the validity or enforceability thereof against the Trust (except those, if any, already obtained),
or for the payment of any amounts by the Trust thereunder other than the recording or filing for recordation of the deed of the Trust Property, or to carry out the transactions contemplated in this Agreement or the other Documents. 
 Section 5.1.5 There are no actions, proceedings or investigations pending or, to the best knowledge of the executive officers of the Trust,
threatened against the Trust, before or by any court, arbitrator, administrative agency or other governmental authority which are expected, in its reasonable judgment, to materially and adversely affect its financial condition or operations, or its
ability to carry out the transactions contemplated in this Agreement. 
  

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 Section 5.1.6 The execution and delivery of this Agreement and the Documents, compliance with
the provisions thereof and the consummation of the transactions therein contemplated by the Trust, will not result in (1) any material breach or violation of (i) any material law or governmental rule or regulation applicable to the Trust
now in effect, (ii) any provision of the Declaration of Trust or By-Laws of the Trust, (iii) any judgment, order or decree of any court, arbitrator, administrative agency or other governmental authority binding upon the Trust,
(iv) any material agreement or instrument to which the Trust is a party or by which it or the Trust Property is bound, or (2) the creation of any material lien, claim or encumbrance (other than the Permitted Encumbrances) upon the Trust
Property. 
 Section 5.1.7 Subject to the responsibility of CMC pursuant to the terms of the Lease, the Trust unconditionally and
irrevocably indemnifies and agrees to defend and hold harmless CMC from and against any and all material damage, liability, loss, cost or expense, including, without limitation, costs and reasonable legal fees arising from (A) the placing of
any lien, mortgage or other encumbrance on the Trust Property in connection with any claim asserted against the Trust; or (B) the failure of any of the Documents to be valid, binding and enforceable in accordance with the terms thereof against
the Trust. 
 Section 5.1.8 The Trust hereby accepts the UHS Property in full and complete satisfaction of the obligations of UHS
under Article XXII of the Master Lease. 
 Section 5.2 To induce the Trust to sell the Trust Property and to terminate the Lease,
UHS represents and warrants to and agrees with the Trust as follows: 
 Section 5.2.1 UHS is a corporation duly organized,
validly existing and in good standing under the laws of the State of Delaware with full power, authority and legal right to execute and deliver, and to perform and observe the provisions of this Agreement and all other instruments provided for
herein to which it is a party and to carry out the transactions contemplated hereby. 
 Section 5.2.2 This Agreement has been,
and on the Closing Date all other Documents to be delivered pursuant to this Agreement on or before the Closing Date will have been, duly authorized, executed and delivered by UHS, as required, and constitute the valid and binding agreements of UHS,
enforceable in accordance with their terms except (i) that such enforcement may be subject to bankruptcy, insolvency, reorganization, moratorium or other similar laws now or hereafter in effect relating to creditors’ rights and
(ii) that the remedy of specific performance and injunctive and other forms of equitable relief may be subject to equitable defenses and to the discretion of the court before which any proceeding therefor may be brought. For the purposes
hereof, “Documents” shall include this Agreement, the assignment of the Permits and warranties relating to the UHS Property and any notes, mortgages or deeds of trust or other agreements entered into by UHS pursuant to the terms hereof.

 Section 5.2.3 UHS is a solvent entity and (a) has filed all tax returns which are required to be filed by it and
(b) is not in default in the payment of any taxes levied or assessed against it or any of its assets, or under judgment, order, decree, rule or regulation of any court, arbitrator, administrative agency or other governmental authority to which
it may be subject which would, in each case or in the aggregate, materially and adversely affect the transactions contemplated hereby. 
 Section 5.2.4 No material consent, approval or other authorization of, or registration, declaration or filing with, any court or governmental agency or commission is required for the due execution, delivery or performance of
this Agreement or any of the other 

  

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Documents by UHS, or for the validity or enforceability thereof against UHS (except those, if any, already obtained), or for the payment of any amounts by
UHS thereunder other than the recording or filing for recordation of the deed or other transfer documents relating to the UHS Property, or to carry out the transactions contemplated in this Agreement or the other Documents. 
 Section 5.2.5 There are no actions, proceedings or investigations pending or, to the best knowledge of the executive officers of UHS,
threatened against UHS, before or by any court, arbitrator, administrative agency or other governmental authority which are expected, in its reasonable judgment, to materially and adversely affect its financial condition or operations, or its
ability to carry out the transactions contemplated in this Agreement. 
 Section 5.2.6 The execution and delivery of this
Agreement and the Documents, compliance with the provisions thereof and the consummation of the transactions therein contemplated by UHS, will not result in (1) any material breach or violation of (i) any material law or governmental rule
or regulation applicable to UHS now in effect, (ii) any provision of the Certificate of Incorporation or By-Laws of UHS, (iii) any judgment, order or decree of any court, arbitrator, administrative agency or other governmental authority
binding upon UHS, (iv) any material agreement or instrument to which UHS is a party or by which it or the UHS Property is bound, or (2) the creation of any material lien, claim or encumbrance (other than the Permitted Encumbrances) upon
the UHS Property, or (3) a revocation, withdrawal, termination, or limitation on any license, consent, certificate of need, approval, eligibility or program described in Section 5.2.9. 
 Section 5.2.7 To the knowledge of UHS: 
 (i) UHS has not received any notice of any actual or claimed violation of any applicable municipal, county, state or Federal laws, regulations, ordinances, standards or orders or any municipal, health, building and
zoning laws and regulations (including, without limitation, the fire safety code) where the failure to comply therewith could have a material adverse effect on the business, property, condition (financial or otherwise) or operation of the UHS
Property as it is presently being operated; 
 (ii) to the best knowledge of UHS, there are no outstanding deficiencies or
work orders of which it has received notice from any authority having jurisdiction over the UHS Property requiring conformity to any applicable statute, regulation, ordinance or bylaw pertaining to the type of facility presently being operated on
the UHS Property, including but not limited to the Medicare and Medicaid Programs; and 
 (iii) UHS is not aware of any notice
of any claim, requirement or demand of any licensing or certifying agency supervising or having authority over the UHS Property or otherwise to rework or redesign it so as to conform to or comply with any existing law, code or standard which has not
been fully satisfied prior to the date hereof. 
 Section 5.2.8 UHS unconditionally and irrevocably indemnifies and agrees to
defend and hold harmless the Trust from and against any and all material damage, liability, loss, cost or expense, including, without limitation, costs and reasonable legal fees arising from (A) the placing of any lien, mortgage or other
encumbrance on the UHS Property in connection with 

  

 7 

 
any claim asserted against the Trust; or (B) the failure of any of the Documents to be valid, binding and enforceable in accordance with the terms
thereof against UHS. 
 Section 5.2.9 The UHS Property is duly and properly licensed under all applicable Federal, state and
local laws, ordinances and regulations and in conformance with all insurance requirements, and holds all other consents, certificates of need and approvals issued, and has satisfied all eligibility and other similar requirements imposed, by
hospital, health or similar regulatory bodies, administrative agencies or other governmental bodies, agencies or officials, or that relate to private or governmental programs for the reimbursement or payment of health care costs. There is no action
pending or, to the best of UHS’ knowledge, recommended or threatened by the appropriate state or Federal agency having jurisdiction thereof, either to revoke, withdraw or suspend any license to operate the UHS Property nor is there any decision
or threat not to renew any provider agreement related to the UHS Property, or any action of any other type which would have a material adverse effect on the UHS Property, its operations or business. 
 Section 5.2.10 The capital additions at Southwest Healthcare System-Inland Valley Campus are being constructed in accordance with the plans
and design of the Architects. 
 ARTICLE VI 
 MISCELLANEOUS 
 Section 6.1 Except as otherwise provided by the same, all agreements,
representations and warranties made by the Trust and UHS herein and in all certificates and other instruments delivered pursuant to this Agreement shall survive the execution and delivery of this Agreement for a period of three years from the
Closing Date. 
 Section 6.2 All notices, demands and other communications hereunder shall be in writing and delivered,
telegraphed or mailed (by first class registered or certified mail, postage prepaid or by overnight courier service) addressed as follows: 
  

	 	(a)	If to the Trust: 

 Universal Health
Realty Income Trust 
 Universal Corporate Center 
 367 South Gulph Road 
 P.O. Box 61558 
 King of Prussia, PA 19406-0958 
 Attention: Chief Financial Officer 
 with a copy to: 
 Fulbright & Jaworski L.L.P. 
 666 Fifth Avenue 
 New York, NY 10103 
 Attention: Warren J. Nimetz 
  

	 	(b)	if to UHS: 

 Universal Health Services,
Inc. 
 Universal Corporate Center 
 367 South Gulph Road 
 P.O. Box 61558 
 King of Prussia, PA 19406-0958 
 Attention: President 
  

 8 

 or to such other address as may hereafter be designated by any party for such other purpose, and shall be effective upon
receipt if hand delivered or delivered by overnight courier or upon the expiration of the fifth business day after the day of mailing. 
 Section 6.3 This Agreement shall be binding upon the Trust and UHS, and their respective successors and assigns. The rights and obligations of any party hereto under this Agreement may not be assigned by any party hereto without
the prior written consent of each of the parties hereto. 
 Section 6.4 This Agreement, together with the other Documents, the
Exhibits hereto and such other documents as are referred to herein, constitute the entire agreement of the parties in respect of the subject matter described herein, and may not be changed or modified except by an agreement in writing signed by the
parties. 
 Section 6.5 This Agreement may be executed in any number of counterparts, each of which shall be a valid and binding
original, but all of which together shall constitute one and the same instrument. 
 Section 6.6 In the event any provision of
this Agreement is deemed to be invalid, illegal or unenforceable, the remainder of the Agreement shall be valid and enforceable. 
 Section 6.7 If any legal action is brought for the enforcement of this Agreement, or because of an alleged dispute, breach, default or misrepresentation in connection with any of the provisions of this Agreement, the successful
or prevailing party or parties shall be entitled to recover reasonable attorneys’ fees and other costs incurred in that action in addition to any other relief to which it or they may be entitled. 
 Section 6.8 THE DECLARATION OF TRUST ESTABLISHING UNIVERSAL HEALTH REALTY INCOME TRUST, FILED AUGUST 6, 1986, A COPY OF WHICH, TOGETHER
WITH ALL AMENDMENTS THERETO (THE “DECLARATION”), IS DULY FILED IN THE OFFICE OF THE DEPARTMENT OF ASSESSMENTS AND TAXATION OF THE STATE OF MARYLAND, PROVIDES THAT THE NAME “UNIVERSAL HEALTH REALTY INCOME TRUST,” REFERS TO THE
TRUSTEES UNDER THE DECLARATION COLLECTIVELY AS TRUSTEES, BUT NOT INDIVIDUALLY OR PERSONALLY; AND THAT NO TRUSTEE, OFFICER, SHAREHOLDER, EMPLOYEE OR AGENT OF THE TRUST SHALL BE HELD TO ANY PERSONAL LIABILITY, JOINTLY OR SEVERALLY, FOR ANY OBLIGATION
OF, OR CLAIM AGAINST, THE TRUST. ALL PERSONS DEALING WITH THE TRUST, IN ANY WAY, SHALL LOOK ONLY TO THE ASSETS OF THE TRUST FOR THE PAYMENT OF ANY SUM OR THE PERFORMANCE OF ANY OBLIGATION. 
 Section 6.9 All costs and expenses of consummating the transactions contemplated by this Agreement shall be paid for by UHS. The costs and
expenses payable by UHS shall include, but not be limited to, (i) all taxes, including, without limitation, documentary transfer taxes, documentary stamp taxes, mortgage taxes, intangible taxes, sales and similar taxes applicable to the
transactions contemplated herein together with interest and penalties, if any, thereon, but excluding any income taxes of the Trust, (ii) all legal fees and disbursements of 

  

 9 

 
counsel to UHS incurred in connection with the preparation of this Agreement and the transactions contemplated hereby and (iii) all costs and charges
related to recording fees. 
 IN WITNESS WHEREOF, the parties hereto have caused this Agreement to be executed on the day and year first
above written by their respective duly authorized officers. 
  

			
	 UNIVERSAL HEALTH REALTY
 INCOME TRUST

		
	By:	 	 /s/ Cheryl K. Ramagano

		 	 Cheryl K. Ramagano, Vice President

  

			
	 UNIVERSAL HEALTH SERVICES, INC.

		
	By:	 	 /s/ Steve Filton

		 	 Steve Filton, Senior Vice President and Chief
 Financial Officer

  

			
	UNIVERSAL HEALTH SERVICES OF RANCHO SPRINGS, INC.
		
	By:	 	 /s/ Steve Filton

		 	 Steve Filton, Vice President

  

			
	 THE BRIDGEWAY, INC.

		
	By:	 	 /s/ Steve Filton

		 	 Steve Filton, Vice President

  

			
	WELLINGTON REGIONAL MEDICAL CENTER INCORPORATED
		
	By:	 	 /s/ Steve Filton

		 	 Steve Filton, Vice President

  

 10 

 Exhibit A 
 CHALMETTE MEDICAL CENTER 
 The property is located at 9001 Patricia Street, Chalmette, LA 70043 and contains 10.0
acres, including an estimated 1.5 acres of excess land. The property is rectangular-shaped and has 565.12 feet of frontage on the north side of Patricia Street, and 492.6 feet of frontage on the east side of De LaRone Street (formerly Village Square
Road). 
 Chalmette Medical Center, which was previously located on the property, formerly consisted of 99,706 square feet, including a 1,590 square foot MRI
building and drive-under canopy. The original 64,233 hospital was constructed in 1981. A 5,368 square foot ER/radiology addition was completed in 1990 and a 2,925 square foot ICU addition was added in 1992. A 20-bed, 25,590 square foot medical and
surgery wing was added in 1998. 

 Exhibit B 
 SOUTHWEST HEALTHCARE SYSTEM – INLAND VALLEY CAMPUS 
 The capital addition to the Inland Valley Campus will
expand capacity by adding a second story to the hospital primarily consisting of 44 new medical/surgical beds and an ICU expansion. The planned expansion consists of 3,462 square feet on the first floor, and 20,522 square feet on the second floor,
for a total of 23,984 square feet. The center core of the first floor will consist of a mechanical room, electrical equipment room, and a refrigerated body holding area. The remaining area of the first floor will consist of covered parking. The
second floor will house 44 new beds, which will connect via an enclosed second floor bridge to the current 2-west med/surg unit. The total cost of this capital addition is expected to be $12,160,000 and it is expected to be completed in the fourth
quarter of 2006. 
 THE BRIDGEWAY 
 The
capital addition to The Bridgeway was a two story, 20,000 square foot freestanding psychiatric unit, which includes 14 semi-private rooms for a total of 28 additional patient beds. The total cost of this project was $4,071,823 and it was completed
January 1, 2005. 
 WELLINGTON REGIONAL MEDICAL CENTER 
 The capital addition to Wellington Regional Medical Center was a bed tower expansion including eight ICU beds, six beds of NICU, conversion of 24 semi-private rooms to private, the conversion of seven LDRP rooms to
LDR and the addition of ten observation beds. The total cost of this project was $8,925,718 and it was completed April 1, 2004.

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