0001045829-10-000030 Sample Contracts

THE DETROIT MEDICAL CENTER CORPORATE OFFICES 3990 JOHN R DETROIT, MICHIGAN 48201-2403 October 29, 2010
Vanguard Health Systems Inc • November 4th, 2010 • Hospital & medical service plans

Reference is made to that certain Purchase and Sale Agreement dated as of June 10, 2010 (as amended, the “Purchase Agreement”), by and among The Detroit Medical Center, a Michigan nonprofit corporation (“DMC”), certain Affiliates of DMC identified therein (together with DMC, “Seller”), VHS of Michigan, Inc., a Delaware corporation (“VHS of Michigan”), certain Affiliates of VHS of Michigan identified therein (together with VHS of Michigan, “Buyer”), and Vanguard Health Systems, Inc., a Delaware corporation (“Vanguard”). Unless otherwise defined herein, terms used in this letter agreement that are defined in the Purchase Agreement shall have the same meaning herein as therein defined.

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AMENDMENT NO. 1 TO PURCHASE AND SALE AGREEMENT
Purchase and Sale Agreement • November 4th, 2010 • Vanguard Health Systems Inc • Hospital & medical service plans

This Amendment No. 1 to Purchase and Sale Agreement (the “Amendment”) is made and entered into as of October 29, 2010 by and between THE DETROIT MEDICAL CENTER, a Michigan nonprofit corporation (“DMC”) and VANGUARD HEALTH SYSTEMS, INC., a Delaware corporation (“Vanguard”).

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