0001045829-11-000002 Sample Contracts

AMENDMENT NO. 3 TO PURCHASE AND SALE AGREEMENT
Purchase and Sale Agreement • January 5th, 2011 • Vanguard Health Systems Inc • Hospital & medical service plans

This Amendment No. 3 to Purchase and Sale Agreement (the “Amendment”) is made and entered into as of December 31, 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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SETTLEMENT AGREEMENT
Settlement Agreement • January 5th, 2011 • Vanguard Health Systems Inc • Hospital & medical service plans

This Settlement Agreement (Agreement) is entered into among the United States of America, acting through the United States Department of Justice and on behalf of the Office of Inspector General (OIG-HHS) of the Department of Health and Human Services (HHS) (collectively the United States); and Detroit Medical Center and Vanguard Health Systems, Inc. (hereafter collectively referred to as "the Parties"), through their authorized representatives.

AMENDMENT NO. 4 TO PURCHASE AND SALE AGREEMENT
Purchase and Sale Agreement • January 5th, 2011 • Vanguard Health Systems Inc • Hospital & medical service plans

This Amendment No. 4 to Purchase and Sale Agreement (the “Amendment”) is made and entered into as of December 31, 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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