0001569608-16-000035.txt : 20160121 0001569608-16-000035.hdr.sgml : 20160121 20160121215126 ACCESSION NUMBER: 0001569608-16-000035 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20160119 FILED AS OF DATE: 20160121 DATE AS OF CHANGE: 20160121 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: Modsys International Ltd CENTRAL INDEX KEY: 0001029581 STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-COMPUTER PROGRAMMING SERVICES [7371] IRS NUMBER: 000000000 STATE OF INCORPORATION: L3 FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: TWO UNION SQUARE, SUITE 4616 CITY: SEATTLE STATE: WA ZIP: 98101 BUSINESS PHONE: 206-395-4152 MAIL ADDRESS: STREET 1: TWO UNION SQUARE, SUITE 4616 CITY: SEATTLE STATE: WA ZIP: 98101 FORMER COMPANY: FORMER CONFORMED NAME: BLUEPHOENIX SOLUTIONS LTD DATE OF NAME CHANGE: 20030811 FORMER COMPANY: FORMER CONFORMED NAME: CRYSTAL SYSTEMS SOLUTIONS LTD DATE OF NAME CHANGE: 19961224 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Columbia Pacific Advisors, LLC CENTRAL INDEX KEY: 0001569608 STATE OF INCORPORATION: WA FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 333-06208 FILM NUMBER: 161354623 BUSINESS ADDRESS: STREET 1: 1910 FAIRVIEW AVE E STREET 2: SUITE 200 CITY: SEATTLE STATE: WA ZIP: 98102 BUSINESS PHONE: 206-728-9063 MAIL ADDRESS: STREET 1: 1910 FAIRVIEW AVE E STREET 2: SUITE 200 CITY: SEATTLE STATE: WA ZIP: 98102 4 1 primary_doc.xml PRIMARY DOCUMENT X0306 4 2016-01-19 0 0001029581 Modsys International Ltd MDSY 0001569608 Columbia Pacific Advisors, LLC 1910 FAIRVIEW AVE E SUITE 200 SEATTLE WA 98102 0 0 1 0 Ordinary Shares 2016-01-19 4 P 0 2300 2.2 A 5184776 I General Partner Ordinary Shares 2016-01-20 4 P 0 406 2.15 A 5185182 I General Partner Acquired by Columbia Pacific Opportunity Fund, L.P. Columbia Pacific Opportunity Fund, L.P. owns 5,147,242 Ordinary Shares Columbia Pacific Partners Fund, Ltd. owns 37,940 Ordinary Shares Alexander Washburn 2016-01-21