SUPPLEMENTAL INDENTURESupplemental Indenture • February 9th, 2011 • Vanguard Health Systems Inc • Hospital & medical service plans • New York
FIFTH SUPPLEMENTAL INDENTURE (this “Supplemental Indenture”), dated as of January 11, 2011, among VHS of Michigan, Inc., a Delaware corporation (“VHS-M”), VHS Children’s Hospital of Michigan, Inc., a Delaware corporation (“VHS-CH”), VHS Detroit Businesses, Inc., a Delaware corporation (“VHS-DB”), VHS Detroit Receiving Hospital, Inc., a Delaware corporation (“VHS-DR”), VHS Detroit Ventures, Inc., a Delaware corporation (“VHS-DV”), VHS Harper-Hutzel Hospital, Inc., a Delaware corporation (“VHS-HH”), VHS Huron Valley-Sinai Hospital, Inc., a Delaware corporation (“VHS-HV”), VHS Rehabilitation Institute of Michigan, Inc., a Delaware corporation (“VHS-RI”), VHS Sinai-Grace Hospital, Inc., a Delaware corporation (“VHS-SG”) and VHS University Laboratories, Inc., a Delaware corporation (“VHS-UL”), (VHS-M, VHS-CH, VHS-DB, VHS-DR, VHS-DV, VHS-HH, VHS-HV, VHS-RI, VHS-SG AND VHS-UL, collectively, the “New Guarantors”), each a subsidiary of Vanguard Health Holding Company II, LLC, a Delaware limited
SUPPLEMENTAL INDENTURESupplemental Indenture • February 9th, 2011 • Vanguard Health Systems Inc • Hospital & medical service plans • New York
FOURTH SUPPLEMENTAL INDENTURE (this “Supplemental Indenture”), dated as of November 1, 2010, among VHS Arizona Heart Institute, Inc., a Delaware corporation (the “New Guarantor”), a subsidiary of Vanguard Health Holding Company II, LLC, a Delaware limited liability company (“VHS Holdco II”); Vanguard Holding Company II, Inc., a Delaware corporation and a wholly owned subsidiary of VHS Holdco II (together with VHS Holdco II, the “Issuers”); Vanguard Health Holding Company I, LLC; Vanguard Health Systems, Inc.; and U.S. Bank National Association, as trustee under the Indenture referred to below (the “Trustee”).
