0001045829-12-000065 Sample Contracts

EMPLOYMENT AGREEMENT
Employment Agreement • August 24th, 2012 • Vanguard Health Systems Inc • Hospital & medical service plans • Tennessee

THIS EMPLOYMENT AGREEMENT (this “Agreement”) dated as of October 1, 2011, is made by and between Vanguard Health Systems, Inc., a Delaware corporation (the “Company”), and Alan G. Thomas (the “Executive”).

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SUPPLEMENTAL INDENTURE
Supplemental Indenture • August 24th, 2012 • Vanguard Health Systems Inc • Hospital & medical service plans • New York

FIRST SUPPLEMENTAL INDENTURE (this “Supplemental Indenture”), dated as of September 22, 2011, among VHS Valley Management Company, Inc. (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”), and U.S. Bank National Association, as trustee under the Indenture referred to below (the “Trustee”).

AMENDMENT NO. 6 TO AMENDED AND RESTATED EMPLOYMENT AGREEMENT
Employment Agreement • August 24th, 2012 • Vanguard Health Systems Inc • Hospital & medical service plans

This Amendment No. 6 (this “Amendment’) dated as of October 1, 2011, is made by and between Vanguard Health Systems, Inc., a Delaware corporation (the “Company”), and Keith B. Pitts (the “Executive”).

AMENDMENT NO. 3 TO EMPLOYMENT AGREEMENT
Employment Agreement • August 24th, 2012 • Vanguard Health Systems Inc • Hospital & medical service plans

This Amendment No. 3 (this “Amendment’) dated as of October 1, 2011, is made by and between Vanguard Health Systems, Inc., a Delaware corporation (the “Company”), and Kent H. Wallace (the “Executive”).

AMENDMENT NO. 6 TO AMENDED AND RESTATED EMPLOYMENT AGREEMENT
Employment Agreement • August 24th, 2012 • Vanguard Health Systems Inc • Hospital & medical service plans

This Amendment No. 6 (this “Amendment’) dated as of October 1, 2011, is made by and between Vanguard Health Systems, Inc., a Delaware corporation (the “Company”), and Charles N. Martin, Jr. (the “Executive”).

SUPPLEMENTAL INDENTURE
Supplemental Indenture • August 24th, 2012 • Vanguard Health Systems Inc • Hospital & medical service plans • New York

SEVENTH SUPPLEMENTAL INDENTURE (this “Supplemental Indenture”), dated as of March 30, 2012, among VANGUARD HEALTH HOLDING COMPANY II, LLC, a Delaware limited liability company (the “Company”), VANGUARD HOLDING COMPANY II, INC., a Delaware corporation (the “Co-Issuer” and, together with the Company, the “Issuers”), the guarantors listed on the signature pages hereto (the “Guarantors”) and U.S. BANK NATIONAL ASSOCIATION, as trustee under the Indenture referred to below (the “Trustee”).

SUPPLEMENTAL INDENTURE
Supplemental Indenture • August 24th, 2012 • Vanguard Health Systems Inc • Hospital & medical service plans • New York

SIXTH SUPPLEMENTAL INDENTURE (this “Supplemental Indenture”), dated as of September 22, 2011, among VHS Valley Management Company, 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”).

AMENDMENT NO. 3 TO EMPLOYMENT AGREEMENT
Employment Agreement • August 24th, 2012 • Vanguard Health Systems Inc • Hospital & medical service plans

This Amendment No. 3 (this “Amendment”) dated as of October 1, 2011, is made by and between Vanguard Health Systems, Inc., a Delaware corporation (the “Company”), and Phillip W. Roe (the “Executive”).

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