0001104659-16-113307.txt : 20160421 0001104659-16-113307.hdr.sgml : 20160421 20160421205245 ACCESSION NUMBER: 0001104659-16-113307 CONFORMED SUBMISSION TYPE: 3 PUBLIC DOCUMENT COUNT: 2 CONFORMED PERIOD OF REPORT: 20160421 FILED AS OF DATE: 20160421 DATE AS OF CHANGE: 20160421 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: American Renal Associates Holdings, Inc. CENTRAL INDEX KEY: 0001498068 STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-MISC HEALTH & ALLIED SERVICES, NEC [8090] IRS NUMBER: 272170749 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: AMERICAN RENAL HOLDINGS, INC. STREET 2: 500 CUMMINGS CENTER, SUITE 6550 CITY: BEVERLY STATE: MA ZIP: 01915 BUSINESS PHONE: 978-922-3080 MAIL ADDRESS: STREET 1: AMERICAN RENAL HOLDINGS, INC. STREET 2: 500 CUMMINGS CENTER, SUITE 6550 CITY: BEVERLY STATE: MA ZIP: 01915 FORMER COMPANY: FORMER CONFORMED NAME: C.P. Atlas Holdings, Inc. DATE OF NAME CHANGE: 20100802 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: ERICKSON THOMAS W CENTRAL INDEX KEY: 0001120226 FILING VALUES: FORM TYPE: 3 SEC ACT: 1934 Act SEC FILE NUMBER: 001-37751 FILM NUMBER: 161585122 MAIL ADDRESS: STREET 1: OMEGA HEALTHCARE INVESTORS INC STREET 2: 900 VICTORS WAY STE. 350 CITY: AMM ARBER STATE: MI ZIP: 48108 3 1 a3.xml 3 X0206 3 2016-04-21 0 0001498068 American Renal Associates Holdings, Inc. ARA 0001120226 ERICKSON THOMAS W C/O ARAH, INC. 500 CUMMINGS CENTER BEVERLY MA 01915 1 0 0 0 Common Stock 18320 I See Footnote Stock Option (Right to Buy) 26.13 2025-08-28 Common Stock 11450 I See Footnote Securities held by a limited partnership for the benefit of the Reporting Person's family. The Reporting Person disclaims beneficial ownership of the shares held by such limited partnership, except to the extent of his pecuniary interest therein. The filing of this statement by the Reporting Person shall not be deemed to be an admission that, for purposes of Section 16 of the Securities Exchange Act of 1934 or otherwise, such Reporting Person is the beneficial owners of the securities reported herein. An option that vests in three equal annual installments beginning on August 28, 2016. The number of shares subject to outstanding options and the exercise prices thereof reflect the applicable anti-dilution adjustments to be effected upon the completion of the initial public offering by American Renal Associates Holdings, Inc. Exhibit 24 - Power of Attorney /s/ Michael R. Costa, by power of attorney 2016-04-21 EX-24 2 ex-24.htm EX-24

Exhibit 24

POWER OF ATTORNEY

Know all by these presents that Thomas W. Erickson, does hereby make, constitute and appoint each of Michael R. Costa and Jonathan L. Wilcox or any one of them, as a true and lawful attorney-in-fact and agent of the undersigned with full powers of substitution and revocation, for and in the name, place and stead of the undersigned (in the undersigned’s individual capacity), to execute and deliver such forms that the undersigned may be required to file with the U.S. Securities and Exchange Commission as a result of the undersigned’s ownership of or transactions in securities of American Renal Associates Holdings, Inc. (i) pursuant to Section 16(a) of the Securities Exchange Act of 1934, as amended, including without limitation, statements on Form 3, Form 4 and Form 5 (including any amendments thereto) and (ii) in connection with any applications for EDGAR access codes, including without limitation the Form ID. The Power of Attorney shall remain in full force and effect until the undersigned is no longer required to file Forms 3, 4 and 5 with regard to the undersigned’s ownership of or transactions in securities of American Renal Associates Holdings, Inc., unless earlier revoked in writing. The undersigned acknowledges that Michael R. Costa and Jonathan L. Wilcox are not assuming any of the undersigned’s responsibilities to comply with Section 16 of the Securities Exchange Act of 1934.

			By:	/s/ Thomas W. Erickson
				Thomas W. Erickson

Date:	10/1/2015