VANGUARD HEALTH SYSTEMS INC Contracts & Agreements

AMENDMENT NO. [_]1 TO [AMENDED AND RESTATED]2 EMPLOYMENT AGREEMENT (Filed With SEC on October 1, 2013)

NONCOMPETITION AGREEMENT (Filed With SEC on October 1, 2013)

AGREEMENT AND PLAN OF MERGER by and among TENET HEALTHCARE CORPORATION, ORANGE MERGER SUB, INC. and VANGUARD HEALTH SYSTEMS, INC. Dated as of June 24, 2013 TABLE OF CONTENTS (Filed With SEC on June 24, 2013)

Janice K. Brewer, GovernorThomas J. Betlach, Director801 East Jefferson, Phoenix, AZ 8503-1 PO Box 25520, Phoenix, AZ 85002 Phone: 602 ###-###-#### www.azahcccs.govOur first care... (Filed With SEC on May 2, 2013)

SUPPLEMENTAL INDENTURE (Filed With SEC on November 1, 2012)

AMENDMENT NO. 4 TO EMPLOYMENT AGREEMENT (Filed With SEC on November 1, 2012)

MEMORANDUM OF UNDERSTANDING (Filed With SEC on November 1, 2012)

SUPPLEMENTAL INDENTURE (Filed With SEC on August 24, 2012)

AMENDMENT NO. 6 TO AMENDED AND RESTATED EMPLOYMENT AGREEMENT (Filed With SEC on August 24, 2012)

AMENDMENT NO. 3 TO EMPLOYMENT AGREEMENT (Filed With SEC on August 24, 2012)

EMPLOYMENT AGREEMENT (Filed With SEC on August 24, 2012)

ARIZONA HEALTH CARE COST CONTAINMENT SYSTEM ADMINISTRATION DIVISION OF BUSINESS AND FINANCE SECTION A: CONTRACT (Filed With SEC on August 24, 2012)

AMENDMENT NO. 1 TO 2011 STOCKHOLDERS AGREEMENT (Filed With SEC on May 3, 2012)

EMPLOYMENT AGREEMENT (Filed With SEC on May 3, 2012)

Incremental Commitment Agreement, dated as of April 24, 2012, between Vanguard Health Holding Company II, LLC, Vanguard Holding Company II, Inc., Vanguard Health Holding Company... (Filed With SEC on April 30, 2012)

SUPPLEMENTAL INDENTURE (Filed With SEC on April 2, 2012)

REGISTRATION RIGHTS AGREEMENT by and among Vanguard Health Holding Company II, LLC, Vanguard Holding Company II, Inc., Vanguard Health Systems, Inc. and the Other Guarantors Party... (Filed With SEC on April 2, 2012)

EX-101 INSTANCE DOCUMENT (Filed With SEC on November 4, 2011)

Our high degree of leverage and interest rate risk (Filed With SEC on August 25, 2011)

Growing need for healthcare services. The U.S. Census Bureau estimates that the number of individuals age 65 and older has grown 1.3% compounded annually over the past 20 years... (Filed With SEC on June 21, 2011)

Growing need for healthcare services. The U.S. Census Bureau estimates that the number of individuals age 65 and older has grown 1.3% compounded annually over the past 20 years... (Filed With SEC on June 6, 2011)

Growing Need for Healthcare Services. The U.S. Census Bureau estimates that the number of individuals age 65 and older has grown 1.3% compounded annually over the past 20 years... (Filed With SEC on April 8, 2011)

Financial Statements (Filed With SEC on February 9, 2011)

VANGUARD HEALTH HOLDING COMPANY II, LLC (Filed With SEC on January 28, 2011)

CROSS-REFERENCE TABLE* Trust Indenture IndentureAct Section Section310 (a)(1) 7.10 (a)(2) 7.10 (a)(3) N.A. (a)(4) N.A. (a)(5) 7.10 (b) 7.10 (c) N.A.311 (a) 7.11 (b) 7.11 (c)... (Filed With SEC on January 28, 2011)

REGISTRATION RIGHTS AGREEMENT (Filed With SEC on January 28, 2011)

AMENDMENT NO. 3 TO PURCHASE AND SALE AGREEMENT (Filed With SEC on January 5, 2011)

AMENDMENT NO. 4 TO PURCHASE AND SALE AGREEMENT (Filed With SEC on January 5, 2011)

SETTLEMENT AGREEMENT (Filed With SEC on January 5, 2011)

Our high degree of leverage and interest rate risk (Filed With SEC on March 3, 2010)

AMENDMENT NO. 1 (Filed With SEC on February 9, 2010)

Credit Agreement (Filed With SEC on February 3, 2010)

[AHCCCS LOGO] (Filed With SEC on November 10, 2009)

ARIZONA HEALTH CARE COST CONTAINMENT SYSTEM ADMINISTRATION DIVISION OF BUSINESS AND FINANCE SECTION A: CONTRACT (Filed With SEC on September 3, 2009)

AMENDMENT NO. 4 TO AMENDED AND RESTATED EMPLOYMENT AGREEMENT (Filed With SEC on September 3, 2009)

AMENDMENT NO. 1 TO EMPLOYMENT AGREEMENT (Filed With SEC on September 3, 2009)

EMPLOYMENT AGREEMENT (Filed With SEC on September 3, 2009)

AMENDMENT NO. 1 TO EMPLOYMENT AGREEMENT (Filed With SEC on September 3, 2009)

EMPLOYMENT AGREEMENT (Filed With SEC on September 3, 2009)

Amendment Number 7 to Vanguard Health Systems, Inc. 2004 Stock Incentive Plan (Filed With SEC on August 21, 2009)

Vanguard Health Systems, Inc. 2009 Long Term Incentive Plan (Filed With SEC on August 21, 2009)

Eighth Supplemental Indenture, dated as of March 24, 2009, among Vanguard Health Holding Company II, LLC, Vanguard Holding Company II, Inc., the Guarantors party thereto and the... (Filed With SEC on May 12, 2009)

Contract Amendment Number 3, executed on April 6, 2009, but effective as of May 1, 2009, to the Arizona Health Care Cost Containment System Administration Contract No.... (Filed With SEC on May 12, 2009)

Amendment Number 6 to the Vanguard Health Systems, Inc. 2004 Stock Incentive Plan, effective February 13, 2009 (Filed With SEC on May 12, 2009)

Form of Indemnification Agreement between the Company and each of its directors and executive officers (Filed With SEC on May 6, 2009)

Seventh Supplemental Indenture, dated as of November 3, 2008, among Vanguard Health Holding Company II, LLC, Vanguard Holding Company II, Inc., the Guarantors party thereto and... (Filed With SEC on February 12, 2009)

Contract Amendment Number 2, executed on January 16, 2009, but effective as of January 15, 2009, to the Arizona Health Care Cost Containment System Administration Contract No.... (Filed With SEC on February 12, 2009)

ARIZONA HEALTH CARE COST CONTAINMENT SYSTEM ADMINISTRATION DIVISION OF BUSINESS AND FINANCE SECTION A: CONTRACT AMENDMENT (Filed With SEC on November 12, 2008)

WAIVER NO. 1 (Filed With SEC on September 23, 2008)

AMENDMENT NO. 5 TO AMENDED AND RESTATED EMPLOYMENT AGREEMENT (Filed With SEC on September 23, 2008)

FORM OF SEVERANCE PROTECTION AGREEMENT (Filed With SEC on September 23, 2008)

ARIZONA HEALTH CARE COST CONTAINMENT SYSTEM ADMINISTRATION DIVISION OF BUSINESS AND FINANCE CONTRACT AMENDMENT (Filed With SEC on September 23, 2008)

[AHCCCS LOGO] (Filed With SEC on September 23, 2008)

SOLICITATION AMENDMENT (Filed With SEC on September 23, 2008)

Letter dated May 13, 2008, from AHCCCS to VHS Phoenix Health Plan, LLC , countersigned by VHS Phoenix Health Plan, LLC on May 13, 2008 (Filed With SEC on May 16, 2008)

Amendment Number 5 to the Vanguard Health Systems, Inc. 2004 Stock Incentive Plan, effective May 6, 2008 (Filed With SEC on May 12, 2008)

Amendment No. 3 to Amended and Restated Employment Agreement between Vanguard Health Systems, Inc. and Charles N. Martin, Jr., dated as of October 1, 2007 (Filed With SEC on February 12, 2008)

Amendment No. 3 to Amended and Restated Employment Agreement between Vanguard Health Systems, Inc. and Keith B. Pitts, dated as of October 1, 2007 (Filed With SEC on February 12, 2008)

Amendment No. 3 to Amended and Restated Employment Agreement between Vanguard Health Systems, Inc. and Joseph D. Moore, dated as of October 1, 2007 (Filed With SEC on February 12, 2008)

Amendment No. 4 to Amended and Restated Employment Agreement between Vanguard Health Systems, Inc. and Joseph D. Moore, dated as of November 7, 2007 (Filed With SEC on February 12, 2008)

Amendment No. 3 to Amended and Restated Employment Agreement between Vanguard Health Systems, Inc. and Ronald P. Soltman, dated as of October 1, 2007 (Filed With SEC on February 12, 2008)

Employment Agreement between Vanguard Health Systems, Inc. and Kent H. Wallace dated as of November 15, 2007 (Filed With SEC on February 12, 2008)

Employment Agreement between Vanguard Health Systems, Inc. and Phillip W. Roe dated as of November 15, 2007 (Filed With SEC on February 12, 2008)

Form of Amendment No. 1 to Severance Protection Agreement dated as of October 1, 2007, entered into between Vanguard Health Systems, Inc. and each of its executive officers (other... (Filed With SEC on February 12, 2008)

SUPPLEMENTAL INDENTURE (Filed With SEC on November 13, 2007)

Fourth Supplemental Indenture, dated as of June 25, 2007, among Vanguard Health Holding Company II, LLC, Vanguard Holding Company II, Inc., the Guarantors party thereto and the... (Filed With SEC on September 19, 2007)

Fifth Supplemental Indenture, dated as of July 1, 2007, among Vanguard Health Holding Company II, LLC, Vanguard Holding Company II, Inc., the Guarantors party thereto and the... (Filed With SEC on September 19, 2007)

Contract Amendment Number 17, executed on September 6, 2007, but effective as of October 1, 2007, to the Arizona Health Care Cost Containment System Administration Contract No.... (Filed With SEC on September 7, 2007)

Contract Amendment Number 16, executed on April 26, 2007, but effective as of October 1, 2006, to the Arizona Health Care Cost Containment System Administration Contract No.... (Filed With SEC on May 9, 2007)

Amendment Number 4 to the Vanguard Health Systems, Inc. 2004 Stock Incentive Plan, effective November 13, 2006 (Filed With SEC on February 13, 2007)

SUPPLEMENTAL INDENTURE (Filed With SEC on September 20, 2006)

Contract Amendment Number 15, executed on September 5, 2006, but effective as of October 1, 2006, to the Arizona Health Care Cost Containment System Administration Contract No.... (Filed With SEC on September 8, 2006)

Amendment Number 2 to the Vanguard Health Systems, Inc. 2004 Stock Incentive Plan, effective February 15, 2006 (Filed With SEC on May 12, 2006)

Amendment Number 3 to the Vanguard Health Systems, Inc. 2004 Stock Incentive Plan, effective April 15, 2006 (Filed With SEC on May 12, 2006)

Amendment No. 2 to Amended and Restated Employment Agreement between Vanguard Health Systems, Inc. and Charles N. Martin, Jr., dated as of December 1, 2005 (Filed With SEC on February 9, 2006)

Amendment No. 2 to Amended and Restated Employment Agreement between Vanguard Health Systems, Inc. and Joseph D. Moore , dated as of December 1, 2005 (Filed With SEC on February 9, 2006)

Amendment No. 2 to Amended and Restated Employment Agreement between Vanguard Health Systems, Inc. and Ronald P. Soltman, dated as of December 1, 2005 (Filed With SEC on February 9, 2006)

Amendment No. 2 to Amended and Restated Employment Agreement between Vanguard Health Systems, Inc. and Keith B. Pitts, dated as of December 1, 2005 (Filed With SEC on February 9, 2006)

Amendment No. 1, dated as of November 3, 2005, to Amended and Restated Limited Liability Company Operating Agreement of VHS Holdings LLC (Filed With SEC on February 9, 2006)

Amendment Number 1 to the Vanguard Health Systems, Inc. 2004 Stock Incentive Plan, effective November 28, 2005 (Filed With SEC on February 9, 2006)

Contract Amendment Number 12, executed on December 21, 2005, but effective as of January 1, 2006, to the Arizona Health Care Cost Containment System Administration Contract No.... (Filed With SEC on February 9, 2006)

Contract Amendment Number 10, executed on September 7, 2005, but effective as of October 1, 2005, to the Arizona Health Care Cost Containment System Administration Contract No.... (Filed With SEC on November 9, 2005)

Contract Amendment Number 11, executed on September 7, 2005, but effective as of September 1, 2005, to the Arizona Health Care Cost Containment System Administration Contract No.... (Filed With SEC on November 9, 2005)

Amended and Restated Severance Protection Agreement, dated as of September 23, 2004, between Vanguard Health Systems, Inc. and Kent H. Wallace (Filed With SEC on September 30, 2005)

Amendment No. 1 to Amended and Restated Severance Protection Agreement, dated as of September 30, 2005, between Vanguard Health Systems, Inc. and Kent H. Wallace (Filed With SEC on September 30, 2005)

FIRST AMENDMENT TO CREDIT AGREEMENT (Filed With SEC on September 27, 2005)

FIRST AMENDMENT OF VHS HOLDINGS LLC 2004 Unit Plan (Filed With SEC on September 13, 2005)

FIRST AMENDMENT TO CREDIT AGREEMENT (Filed With SEC on August 26, 2005)

SUPPLEMENTAL INDENTURE (Filed With SEC on May 10, 2005)

AMENDMENT NO. 1 TO ASSET SALE AGREEMENT (Filed With SEC on January 4, 2005)

AGREEMENT AND PLAN OF MERGER (Filed With SEC on November 12, 2004)

FIRST AMENDMENT TO THE AGREEMENT AND PLAN OF MERGER (Filed With SEC on November 12, 2004)

INDEMNIFICATION AGREEMENT (Filed With SEC on November 12, 2004)

FIRST SUPPLEMENTAL INDENTURE (Filed With SEC on November 12, 2004)

REGISTRATION RIGHTS AGREEMENT RE 9% SENIOR SUBORNINATED NOTES (Filed With SEC on November 12, 2004)

REGISTRATION RIGHTS AGREEMENT, RE 11 1/4% SENIOR DISCOUNT NOTES (Filed With SEC on November 12, 2004)

REGISTRATION RIGHTS AGREEMENT (Filed With SEC on November 12, 2004)

CREDIT AGREEMENT (Filed With SEC on November 12, 2004)

SECURITY AGREEMENT (Filed With SEC on November 12, 2004)

VANGUARD GUARANTY (Filed With SEC on November 12, 2004)

SUBSIDIARIES GUARANTY (Filed With SEC on November 12, 2004)

PLEDGE AGREEMENT (Filed With SEC on November 12, 2004)

TRANSACTION AND MONITORING FEE AGREEMENT (Filed With SEC on November 12, 2004)

AMENDED AND RESTATED LIMITED LIABILITY COMPANY OPERATING AGREEMENT (Filed With SEC on November 12, 2004)

2004 STOCK INCENTIVE PLAN (Filed With SEC on November 12, 2004)

2004 UNIT PLAN (Filed With SEC on November 12, 2004)

AMENDED AND RESTATED EMPLOYMENT AGREEMENT (Filed With SEC on November 12, 2004)

AMENDED AND RESTATED SEVERANCE PROTECTION AGREEMENT (Filed With SEC on November 12, 2004)

FORM OF AMENDED AND RESTATED SEVERANCE PROTECTION AGREEMENT (Filed With SEC on November 12, 2004)

CONTRACT AMENDMENT NUMBER 07 (Filed With SEC on November 12, 2004)

CONTRACT AMENDMENT NUMBER 08 (Filed With SEC on November 12, 2004)

CONTRACT AMENDMENT NUMBER 09 (Filed With SEC on November 12, 2004)

AMENDED AND RESTATED AGREEMENT (Filed With SEC on November 12, 2004)

CERTIFICATE OF DESIGNATIONS, PREFERENCES AND RIGHTS OF SERIES A PREFERRED STOCK (Filed With SEC on November 12, 2004)

ASSET SALE AGREEMENT (Filed With SEC on November 12, 2004)

GUARANTY OF PERFORMANCE (Filed With SEC on November 12, 2004)

Credit Agreement dated as of May 18, 2004, among Vanguard Health Systems, Inc.; various lenders; Bank of America, N.A., as administrative agent; Citicorp North America, Inc., as... (Filed With SEC on May 20, 2004)

AMENDMENT NO. 2 TO EMPLOYMENT AGREEMENT (Filed With SEC on February 10, 2004)

AHCCCS LOGO SOLICITATION AMENDMENTSolicitation Number: RFP YH04-0001 Amendment Number One Solicitation Due Date: March 31, 2003, 3:00 PM (MST)Arizona Health Care Cost Containment... (Filed With SEC on September 24, 2003)

Agreement Between the Shareholders of VHS Acquisition Subsidiary Number 5, Inc. dated as of January 1, 2003 (Filed With SEC on January 14, 2003)

License Agreement between Baptist Health System and VHS San Antonio Partners, L.P. dated as of January 1, 2003 (Filed With SEC on January 14, 2003)

Second Amendment to Credit Agreement, dated as of December 31, 2002, among Vanguard Health Systems, Inc., as Borrower, Bank of America, N.A.., as Administrative Agent, and the... (Filed With SEC on January 14, 2003)

Incremental Term Loan Commitment Agreement, dated as of January 3, 2003, among Vanguard Health Systems, Inc., as Borrower, Bank of America, N.A., as Administrative Agent, and the... (Filed With SEC on January 14, 2003)

Form of License Agreement between Baptist Health System and VHS San Antonio Partners, L.P (Filed With SEC on October 9, 2002)

First Amendment to Credit Agreement, dated as of October 8, 2002, among Vanguard Health Systems, Inc., as Borrower, Bank of America, N.A., as Administrative Agent, and the lenders... (Filed With SEC on October 9, 2002)

Purchase and Sale Agreement, dated as of April 23, 2002, among The University of Chicago Hospitals, Louis A. Weiss Memorial Hospital, Vanguard Health Financial Company, Inc., VHS... (Filed With SEC on June 7, 2002)

First Amendment to Purchase and Sale Agreement dated as of May 31, 2002, among The University of Chicago Hospitals, Louis A. Weiss Memorial Hospital, Vanguard Health Financial... (Filed With SEC on June 7, 2002)

Subscription and Contribution Agreement dated as of June 1, 2002, among The University of Chicago Hospitals, Vanguard Health Financial Company, Inc. and VHS Acquisition Subsidiary... (Filed With SEC on June 7, 2002)

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VANGUARD HEALTH SYSTEMS INC Contracts & Agreements