0001569608-17-000009.txt : 20170404 0001569608-17-000009.hdr.sgml : 20170404 20170404220005 ACCESSION NUMBER: 0001569608-17-000009 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20170329 FILED AS OF DATE: 20170404 DATE AS OF CHANGE: 20170404 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: 6600 LBJ FREEWAY STREET 2: STE 210 CITY: DALLAS STATE: TX ZIP: 75240 BUSINESS PHONE: 206-395-4152 MAIL ADDRESS: STREET 1: 6600 LBJ FREEWAY STREET 2: STE 210 CITY: DALLAS STATE: TX ZIP: 75240 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: 17740983 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 2017-03-29 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 2017-03-31 4 P 0 10000 0.85 A 7144072 I General Partner Ordinary Shares 2017-04-03 4 P 0 757575 0.66 A 7901647 I General Partner Ordinary Shares 2017-04-04 4 P 0 1091442 0.01 A 8993089 I General Partner Warrants (Right to Buy) 0.01 2017-03-29 4 J 0 735294 0 A 2017-03-29 2020-03-28 Ordinary Shares 735294 735294 I General Partner Warrants (Right to Buy) 0.01 2017-04-04 4 X 0 735294 0.01 D 2017-03-29 2020-03-28 Ordinary Shares, NIS 0.04 par value 735294 0 I General Partner Warrants (Right to Buy) 0.01 2017-04-04 4 X 0 356148 0.01 D 2015-12-29 2018-12-29 Ordinary Shares, NIS 0.04 par value 356148 0 I General Partner Acquired by Columbia Pacific Opportunity Fund, L.P. Columbia Pacific Opportunity Fund, L.P. owns 8,956,556 Ordinary Shares Columbia Pacific Partners Fund (Delaware), L.P. owns 36,533 Ordinary Shares These warrants were received by a Proxy Vote of the shareholders on March 29, 2017. Under Proxy Proposal No. 8, in exchange for extending an existing guaranty to the Credit Agreement between Modern Systems Corporation, a wholly owned subsidiary of the Issuer, and Comerica Bank during 2016, Columbia Pacific Opportunity Fund, L.P. received 367,647 warrants. Under Proxy Proposal No. 9, in exchange for extending the existing guaranty to the Credit Agreement mentioned above during calendar year 2017, Columbia Pacific Opportunity Fund, L.P. received 367,647 warrants. These warrants were issued in exchange for Columbia Pacific Opportunity Fund, L.P. and certain other shareholders providing a guaranty with respect to the Credit Agreement. Exercised by Columbia Pacific Opportunity Fund, L.P. 100,000 of these warrants expiration date was 12/31/2018 Acquired by Columbia Pacific Opportunity Fund, L.P. on the exercise of warrants listed under Derivative Securities Acquired by Columbia Pacific Opportunity Fund, L.P. under Proxy Proposal No. 8 approved by the vote of the shareholders on March 29, 2017. Alexander Washburn 2017-04-04