0001045829-06-000005 Sample Contracts

AMENDMENT NO. 1
Limited Liability Company Operating Agreement • February 9th, 2006 • Vanguard Health Systems Inc • Hospital & medical service plans • Delaware

This AMENDMENT NO. 1 (this “Amendment”), dated as of November 3, 2005, to AMENDED AND RESTATED LIMITED LIABILITY COMPANY OPERATING AGREEMENT, dated as of September 23, 2004 (the "Agreement"), concerning VHS Holdings LLC (the "Company"), a Delaware limited liability company, is entered into by and among the Investor Members (as defined in the Agreement) and the Management Members (as defined in the Agreement).

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AMENDMENT NO. 2 TO AMENDED AND RESTATED EMPLOYMENT AGREEMENT
Employment Agreement • February 9th, 2006 • Vanguard Health Systems Inc • Hospital & medical service plans

This Amendment No. 2 (this “Amendment’) dated as of December 1, 2005, is made by and between Vanguard Health Systems, Inc., a Delaware corporation (the “Company”), and Joseph D. Moore (the “Executive”).

AMENDMENT NO. 2 TO AMENDED AND RESTATED EMPLOYMENT AGREEMENT
Employment Agreement • February 9th, 2006 • Vanguard Health Systems Inc • Hospital & medical service plans

This Amendment No. 2 (this “Amendment’) dated as of December 1, 2005, is made by and between Vanguard Health Systems, Inc., a Delaware corporation (the “Company”), and Ronald P. Soltman (the “Executive”).

AMENDMENT NO. 2 TO AMENDED AND RESTATED EMPLOYMENT AGREEMENT
Employment Agreement • February 9th, 2006 • Vanguard Health Systems Inc • Hospital & medical service plans

This Amendment No. 2 (this “Amendment’) dated as of December 1, 2005, is made by and between Vanguard Health Systems, Inc., a Delaware corporation (the “Company”), and Charles N. Martin, Jr. (the “Executive”).

AMENDMENT NO. 2 TO AMENDED AND RESTATED EMPLOYMENT AGREEMENT
Employment Agreement • February 9th, 2006 • Vanguard Health Systems Inc • Hospital & medical service plans

This Amendment No. 2 (this “Amendment’) dated as of December 1, 2005, is made by and between Vanguard Health Systems, Inc., a Delaware corporation (the “Company”), and Keith B. Pitts (the “Executive”).

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