FORM 3 |
UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549 INITIAL STATEMENT OF BENEFICIAL OWNERSHIP OF SECURITIES Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934 or Section 30(h) of the Investment Company Act of 1940 |
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1. Name and Address of Reporting Person*
(Street)
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2. Date of Event Requiring Statement
(Month/Day/Year) 09/21/2004 |
3. Issuer Name and Ticker or Trading Symbol
VERTEX INTERACTIVE INC [ VETX ] |
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4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
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5. If Amendment, Date of Original Filed
(Month/Day/Year) |
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6. Individual or Joint/Group Filing (Check Applicable Line)
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Table I - Non-Derivative Securities Beneficially Owned | |||
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1. Title of Security (Instr. 4) | 2. Amount of Securities Beneficially Owned (Instr. 4) | 3. Ownership Form: Direct (D) or Indirect (I) (Instr. 5) | 4. Nature of Indirect Beneficial Ownership (Instr. 5) |
Common Stock | 240,000(1) | D(10) | |
Common Stock | 5,928,330(2) | D(10) |
Table II - Derivative Securities Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities) | |||||||
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1. Title of Derivative Security (Instr. 4) | 2. Date Exercisable and Expiration Date (Month/Day/Year) | 3. Title and Amount of Securities Underlying Derivative Security (Instr. 4) | 4. Conversion or Exercise Price of Derivative Security | 5. Ownership Form: Direct (D) or Indirect (I) (Instr. 5) | 6. Nature of Indirect Beneficial Ownership (Instr. 5) | ||
Date Exercisable | Expiration Date | Title | Amount or Number of Shares | ||||
Series C-1 Convertible Preferred Stock | 09/21/2004(11) | (11) | Common Stock | 925,926(3) | $0.054(3) | D(10) | |
Series C-1 Convertible Preferred Stock | 09/21/2004(11) | (11) | Common Stock | 925,926(4) | $0.054(4) | I(10) | By O'Brien Limited Partnership |
Series C-1 Convertible Preferred Stock | 09/21/2004(11) | (11) | Common Stock | 925,926(5) | $0.054(5) | D(10) | |
Series C-1 Convertible Preferred Stock | 09/21/2004(11) | (11) | Common Stock | 148,148(6) | $0.054(6) | D(10) | |
Series C-1 Convertible Preferred Stock | 09/21/2004(11) | (11) | Common Stock | 14,907,407(7) | $0.054(7) | D(10) | |
Series C-1 Convertible Preferred Stock | 09/21/2004(11) | (11) | Common Stock | 629,630(8) | $0.054(8) | D(10) | |
Series D Convertible Preferred Stock | 09/21/2004(11) | (11) | Common Stock | 141,013,118(9) | $0.054(9) | D(10) | |
Stock Options (right to buy) | 05/26/2000 | 01/03/2005 | Common Stock | 300,000(2) | $3.85 | D(10) |
1. Name and Address of Reporting Person*
(Street)
Relationship of Reporting Person(s) to Issuer
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1. Name and Address of Reporting Person*
(Street)
Relationship of Reporting Person(s) to Issuer
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1. Name and Address of Reporting Person*
(Street)
Relationship of Reporting Person(s) to Issuer
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1. Name and Address of Reporting Person*
(Street)
Relationship of Reporting Person(s) to Issuer
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1. Name and Address of Reporting Person*
(Street)
Relationship of Reporting Person(s) to Issuer
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1. Name and Address of Reporting Person*
(Street)
Relationship of Reporting Person(s) to Issuer
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Explanation of Responses: |
1. These securities are beneficially owned by MidMark Capital II, L.P., a ten percent stockholder that is also a member of a "group" with MidMark Capital, L.P., Wayne L. Clevenger, Denis Newman, Joseph R. Robinson, and Matthew W. Finlay for purposes of Section 13(d) of the Securities Exchange Act of 1934. |
2. These securities are beneficially owned by MadMark Capital, L.P. |
3. These securities are beneficially owned by Wayne L. Clevenger. The C-1 Convertible Preferred Stock is convertible into Common Stock at the lower of a fixed price or market price. The number of underlying Common Stock provided above is based on an as converted basis on 9/21/04 ($0.09 * 60%=$0.54). |
4. These securities are beneficially owned by O'Brien Limited Partnership, a family partnership of and controlled by Denis Newman. The C-1 Convertible Preferred Stock is convertible into Common Stock at the lower of a fixed price or market price. The number of underlying Common Stock provided above is based on an as converted basis on 9/21/04 ($0.09 * 60%=$0.54). Denis Newman disclaims beneficial ownership of these securities except to the extent of his pecuniary interest therein, and the inclusion of this report shall not be deemed an admission of beneficial ownership of all of the reported shares for purposes of Section 16 or for any other purposes. |
5. These securities are beneficially owned by Joseph R. Robinson. The C-1 Convertible Preferred Stock is convertible into Common Stock at the lower of a fixed price or market price. The number of underlying Common Stock provided above is based on an as converted basis on 9/21/04 ($0.09 * 60%=$0.54). |
6. These securities are beneficially owned by Matthew W. Finlay and his spouse. The C-1 Convertible Preferred Stock is convertible into Common Stock at the lower of a fixed price or market price. The number of underlying Common Stock provided above is based on an as converted basis on 9/21/04 ($0.09 * 60%=$0.54). |
7. These securities are beneficially owned by MidMark Capital II, L.P. The C-1 Convertible Preferred Stock is convertible into Common Stock at the lower of a fixed price or market price. The number of underlying Common Stock provided above is based on an as converted basis on 9/21/04 ($0.09 * 60%=$0.54). |
8. These securities are beneficially owned by MidMark Capital, L.P. The C-1 Convertible Preferred Stock is convertible into Common Stock at the lower of a fixed price or market price. The number of underlying Common Stock provided above is based on an as converted basis on 9/21/04 ($0.09 * 60%=$0.54). |
9. These securities are beneficially owned by MidMark Capital II, L.P. The D Convertible Preferred Stock is convertible into Common Stock at the lower of a fixed price or market price. The number of underlying Common Stock provided above is based on an as converted basis on 9/21/04 ($0.09 * 60%=$0.54). |
10. Each member of the group disclaims beneficial ownership in any securities in which such member does not have a pecuniary interest, and this report shall not be deemed an admission by such member of beneficial ownership of such securities. |
11. The C-1 Convertible Preferred Stock and D Convertible Preferred Stock are immediately exercisable to the extent Vertex has sufficient authorized shres available, and have no expiration date. |
Wayne L. Clevenger | 11/08/2004 | |
** Signature of Reporting Person | Date | |
Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly. | ||
* If the form is filed by more than one reporting person, see Instruction 5 (b)(v). | ||
** Intentional misstatements or omissions of facts constitute Federal Criminal Violations See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a). | ||
Note: File three copies of this Form, one of which must be manually signed. If space is insufficient, see Instruction 6 for procedure. | ||
Persons who respond to the collection of information contained in this form are not required to respond unless the form displays a currently valid OMB Number. |