0001209191-17-048750.txt : 20170814 0001209191-17-048750.hdr.sgml : 20170814 20170814161643 ACCESSION NUMBER: 0001209191-17-048750 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20170810 FILED AS OF DATE: 20170814 DATE AS OF CHANGE: 20170814 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: ADVENT INTERNATIONAL LLC CENTRAL INDEX KEY: 0001227759 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-37787 FILM NUMBER: 171030299 BUSINESS ADDRESS: STREET 1: 75 STATE STREET CITY: BOSTON STATE: MA ZIP: 02109 BUSINESS PHONE: 6179519400 MAIL ADDRESS: STREET 1: C/O ADVENT INTERNATIONAL CORPORATION STREET 2: 75 STATE STREET, 29TH FLOOR CITY: BOSTON STATE: MA ZIP: 02109 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: ADVENT INTERNATIONAL GPE VI-C LP CENTRAL INDEX KEY: 0001430925 STATE OF INCORPORATION: DE FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-37787 FILM NUMBER: 171030348 BUSINESS ADDRESS: STREET 1: C/O ADVENT INTERNATIONAL CORP STREET 2: 75 STATE STREET CITY: BOSTON STATE: MA ZIP: 02109 BUSINESS PHONE: 617 951-9400 MAIL ADDRESS: STREET 1: C/O ADVENT INTERNATIONAL CORP STREET 2: 75 STATE STREET CITY: BOSTON STATE: MA ZIP: 02109 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: ADVENT INTERNATIONAL GPE VI-D LP CENTRAL INDEX KEY: 0001430923 STATE OF INCORPORATION: DE FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-37787 FILM NUMBER: 171030347 BUSINESS ADDRESS: STREET 1: C/O ADVENT INTERNATIONAL CORP STREET 2: 75 STATE STREET CITY: BOSTON STATE: MA ZIP: 02109 BUSINESS PHONE: 617 951-9400 MAIL ADDRESS: STREET 1: C/O ADVENT INTERNATIONAL CORP STREET 2: 75 STATE STREET CITY: BOSTON STATE: MA ZIP: 02109 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: ADVENT INTERNATIONAL GPE VI-E LP CENTRAL INDEX KEY: 0001430921 STATE OF INCORPORATION: DE FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-37787 FILM NUMBER: 171030346 BUSINESS ADDRESS: STREET 1: C/O ADVENT INTERNATIONAL CORP STREET 2: 75 STATE STREET CITY: BOSTON STATE: MA ZIP: 02109 BUSINESS PHONE: 617 951-9400 MAIL ADDRESS: STREET 1: C/O ADVENT INTERNATIONAL CORP STREET 2: 75 STATE STREET CITY: BOSTON STATE: MA ZIP: 02109 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: ADVENT INTERNATIONAL GPE VI LP CENTRAL INDEX KEY: 0001430919 STATE OF INCORPORATION: XX FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-37787 FILM NUMBER: 171030296 BUSINESS ADDRESS: STREET 1: C/O ADVENT INTERNTAIONAL CORP STREET 2: 75 STATE STREET CITY: BOSTON STATE: MA ZIP: 02109 BUSINESS PHONE: 617 951-9400 MAIL ADDRESS: STREET 1: C/O ADVENT INTERNTAIONAL CORP STREET 2: 75 STATE STREET CITY: BOSTON STATE: MA ZIP: 02109 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: ADVENT INTERNATIONAL GPE VI-A LP CENTRAL INDEX KEY: 0001430920 STATE OF INCORPORATION: XX FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-37787 FILM NUMBER: 171030351 BUSINESS ADDRESS: STREET 1: C/O ADVENT INTERNATIONAL CORP STREET 2: 75 STATE STREET CITY: BOSTON STATE: MA ZIP: 02109 BUSINESS PHONE: 617 951-9400 MAIL ADDRESS: STREET 1: C/O ADVENT INTERNATIONAL CORP STREET 2: 75 STATE STREET CITY: BOSTON STATE: MA ZIP: 02109 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: ADVENT INTERNATIONAL GPE VI-B LP CENTRAL INDEX KEY: 0001430926 STATE OF INCORPORATION: XX FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-37787 FILM NUMBER: 171030350 BUSINESS ADDRESS: STREET 1: C/O ADVENT INTERNATIONAL CORP STREET 2: 75 STATE STREET CITY: BOSTON STATE: MA ZIP: 02109 BUSINESS PHONE: 617 951-9400 MAIL ADDRESS: STREET 1: C/O ADVENT INTERNATIONAL CORP STREET 2: 75 STATE STREET CITY: BOSTON STATE: MA ZIP: 02109 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: ADVENT INTERNATIONAL GPE VI-F LP CENTRAL INDEX KEY: 0001430922 STATE OF INCORPORATION: XX FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-37787 FILM NUMBER: 171030345 BUSINESS ADDRESS: STREET 1: C/O ADVENT INTERNATIONAL CORP STREET 2: 75 STATE STREET CITY: BOSTON STATE: MA ZIP: 02109 BUSINESS PHONE: 617 951-9400 MAIL ADDRESS: STREET 1: C/O ADVENT INTERNATIONAL CORP STREET 2: 75 STATE STREET CITY: BOSTON STATE: MA ZIP: 02109 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: ADVENT INTERNATIONAL GPE VI-G LP CENTRAL INDEX KEY: 0001432552 STATE OF INCORPORATION: XX FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-37787 FILM NUMBER: 171030325 BUSINESS ADDRESS: STREET 1: C/O ADVENT INTERNATIONAL CORP STREET 2: 75 STATE STREET CITY: BOSTON STATE: MA ZIP: 02109 BUSINESS PHONE: 617-951-9400 MAIL ADDRESS: STREET 1: C/O ADVENT INTERNATIONAL CORP STREET 2: 75 STATE STREET CITY: BOSTON STATE: MA ZIP: 02109 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: ADVENT INTERNATIONAL CORP/MA CENTRAL INDEX KEY: 0001034196 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-37787 FILM NUMBER: 171030308 BUSINESS ADDRESS: STREET 1: 75 STATE STREET CITY: BOSTON STATE: MA ZIP: 02109 BUSINESS PHONE: 6179510555 MAIL ADDRESS: STREET 1: 75 STATE STREET CITY: BOSTON STATE: MA ZIP: 02109 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: Cotiviti Holdings, Inc. CENTRAL INDEX KEY: 0001657197 STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-BUSINESS SERVICES, NEC [7389] IRS NUMBER: 460595918 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 115 PERIMETER CENTER PLACE STREET 2: SUITE 700 CITY: ATLANTA STATE: GA ZIP: 30346 BUSINESS PHONE: 770 379-2800 MAIL ADDRESS: STREET 1: 115 PERIMETER CENTER PLACE STREET 2: SUITE 700 CITY: ATLANTA STATE: GA ZIP: 30346 4 1 doc4.xml FORM 4 SUBMISSION X0306 4 2017-08-10 0 0001657197 Cotiviti Holdings, Inc. COTV 0001034196 ADVENT INTERNATIONAL CORP/MA C/O ADVENT INTERNATIONAL CORPORATION 75 STATE STREET, 29TH FLOOR BOSTON MA 02109 0 0 1 0 0001227759 ADVENT INTERNATIONAL LLC C/O ADVENT INTERNATIONAL CORPORATION 75 STATE STREET, 29TH FLOOR BOSTON MA 02109 0 0 1 0 0001430919 ADVENT INTERNATIONAL GPE VI LP C/O ADVENT INTERNATIONAL CORPORATION 75 STATE STREET, 29TH FLOOR BOSTON MA 02109 0 0 1 0 0001430920 ADVENT INTERNATIONAL GPE VI-A LP C/O ADVENT INTERNATIONAL CORPORATION 75 STATE STREET, 29TH FLOOR BOSTON MA 02109 0 0 1 0 0001430926 ADVENT INTERNATIONAL GPE VI-B LP C/O ADVENT INTERNATIONAL CORPORATION 75 STATE STREET, 29TH FLOOR BOSTON MA 02109 0 0 1 0 0001430925 ADVENT INTERNATIONAL GPE VI-C LP C/O ADVENT INTERNATIONAL CORPORATION 75 STATE STREET, 29TH FLOOR BOSTON MA 02109 0 0 1 0 0001430923 ADVENT INTERNATIONAL GPE VI-D LP C/O ADVENT INTERNATIONAL CORPORATION 75 STATE STREET, 29TH FLOOR BOSTON MA 02109 0 0 1 0 0001430921 ADVENT INTERNATIONAL GPE VI-E LP C/O ADVENT INTERNATIONAL CORPORATION 75 STATE STREET, 29TH FLOOR BOSTON MA 02109 0 0 1 0 0001430922 ADVENT INTERNATIONAL GPE VI-F LP C/O ADVENT INTERNATIONAL CORPORATION 75 STATE STREET, 29TH FLOOR BOSTON MA 02109 0 0 1 0 0001432552 ADVENT INTERNATIONAL GPE VI-G LP C/O ADVENT INTERNATIONAL CORPORATION 75 STATE STREET, 29TH FLOOR BOSTON MA 02109 0 0 1 0 Common Stock 2017-08-10 4 S 0 9257651 36.87 D 41433699 I See Footnotes Represents 17,778,618 shares held directly by Advent-Cotiviti Acquisition Limited Partnership ("ACA LP"), 18,817,920 shares held directly by Advent-Cotiviti Acquisition II Limited Partnership ("ACA II LP"), 918,209 shares directly owned by Advent International GPE VI-C Limited Partnership ("AI GPE VI-C"), 875,864 shares directly owned by Advent International GPE VI-D Limited Partnership ("AI GPE VI-D"), 2,215,460 shares directly owned by Advent International GPE VI-E Limited Partnership ("AI GPE VI-E"), 651,453 shares directly owned by Advent Partners GPE VI 2008 Limited Partnership ("AP GPE VI 2008"), TO BE CONTINUED IN NEXT FOOTNOTE CONTINUTED FROM PREVIOUS FOOTNOTE: 19,762 directly owned by Advent Partners GPE VI 2009 Limited Partnership ("AP GPE VI 2009"), 46,608 shares directly owned by Advent Partners GPE VI 2010 Limited Partnership ("AP GPE VI 2010"), 51,762 shares directly owned by Advent Partners GPE VI-A 2010 Limited Partnership ("AP GPE VI-A 2010") and 58,043 shares directly owned by Advent Partners GPE VI-A Limited Partnership ("AP GPE VI-A"). Advent International Corporation ("AIC") is the manager of Advent International LLC ("AILLC"), which is the general partner of each of GPE VI GP Limited Partnership ("GPE VI GP"), GPE VI GP (Delaware) Limited Partnership ("GPE VI (DE) GP"), AP GPE VI 2008, AP GPE VI 2009, AP GPE VI 2010, AP GPE VI-A and AP GPE VI-A 2010 (AP GPE VI 2008, AP GPE VI 2009, AP GPE VI 2010, AP GPE VI-A and AP GPE VI-A 2010 are collectively the "AP Funds"). Advent-Cotiviti GP Corporation ("AC GP") is the general partner of ACA LP and ACA II LP. Advent International GPE VI Limited Partnership ("AI GPE VI"), Advent International GPE VI-A Limited Partnership ("AI GPE VI-A"), Advent International GPE VI-B Limited Partnership ("AI GPE VI-B"), Advent International GPE VI-F Limited Partnership ("AI GPE VI-F") and Advent International GPE VI-G Limited Partnership ("AI GPE VI-G" and, together with AI GPE VI, AI GPE VI-A, AI GPE VI-B and AI GPE VI-F, the "GPE VI GP Funds") collectively own 100% of AC GP. AI GPE VI owns 100% of the limited partnership interests in ACA LP and the other GPE VI GP Funds collectively own 100% of the limited partnership interests in ACA II LP. GPE VI GP is the general partner of the GPE VI GP Funds. GPE VI (DE) GP is the general partner of AI GPE VI-C, AI GPE VI-D and AI GPE VI-E (collectively, the "GPE VI (DE) GP Funds" and together with the GPE VI GP Funds and the AP Funds, the "Advent Funds"). Each of AIC, AILLC, GPE VI GP, GPE VI (DE) GP, ACA LP, ACA II LP, AC GP and the Advent Funds are referred to herein as the "Reporting Persons". Each Reporting Person disclaims Section 16 beneficial ownership of the shares reported herein except to the extent of its respective pecuniary interest therein, if any, and the inclusion of these shares in their report shall not be deemed an admission of beneficial ownership of all of the reported shares for purposes of Section 16 or any other purpose. This Form 4 is the first of three Forms 4 being filed relating to the same event. The Form 4 has been split into three filings because there are more than 10 Reporting Persons in total, and the SEC's EDGAR filing system limits a single Form 4 to a maximum of 10 Reporting Persons. Each Form 4 will be filed by Designated Filer Advent International Corporation. /s/ Richard Terranova, Attorney-in-Fact for Advent International Corp 2017-08-14 /s/ Richard Terranova, Attorney-in-Fact for Advent International LLC 2017-08-14 /s/ Richard Terranova, Attorney-in-Fact for Advent International GPE VI LP 2017-08-14 /s/ Richard Terranova, Attorney-in-Fact for Advent International GPE VI-A LP 2017-08-14 /s/ Richard Terranova, Attorney-in-Fact for Advent International GPE VI-B LP 2017-08-14 /s/ Richard Terranova, Attorney-in-Fact for Advent International VI-C LP 2017-08-14 /s/ Richard Terranova, Attorney-in-Fact for Advent International GPE VI-D LP 2017-08-14 /s/ Richard Terranova, Attorney-in-Fact for Advent International GPE VI-E LP 2017-08-14 /s/ Richard Terranova, Attorney-in-Fact for Advent International GPE VI-F LP 2017-08-14 /s/ Richard Terranova, Attorney-in-Fact for Advent International GPE VI-G LP 2017-08-14