0001104659-19-051360.txt : 20190925 0001104659-19-051360.hdr.sgml : 20190925 20190925165843 ACCESSION NUMBER: 0001104659-19-051360 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20190925 FILED AS OF DATE: 20190925 DATE AS OF CHANGE: 20190925 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: CD&R Boulder Holdings, L.P. CENTRAL INDEX KEY: 0001726960 FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-50924 FILM NUMBER: 191114711 BUSINESS ADDRESS: STREET 1: UGLAND HOUSE STREET 2: SOUTH CHURCH STREET CITY: GRAND CAYMAN STATE: E9 ZIP: KY1-1104 BUSINESS PHONE: 212-407-5200 MAIL ADDRESS: STREET 1: C/O CLAYTON, DUBILIER & RICE, LLC STREET 2: 375 PARK AVENUE, 18TH FLR CITY: NEW YORK STATE: NY ZIP: 10152 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: CD&R Investment Associates IX, Ltd. CENTRAL INDEX KEY: 0001624514 STATE OF INCORPORATION: E9 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-50924 FILM NUMBER: 191114712 BUSINESS ADDRESS: STREET 1: MAPLES CORPORATE SERVICES LIMITED STREET 2: UGLAND HOUSE CITY: GRAND CAYMAN STATE: E9 ZIP: KY101194 BUSINESS PHONE: 345-949-8066 MAIL ADDRESS: STREET 1: MAPLES CORPORATE SERVICES LIMITED STREET 2: UGLAND HOUSE CITY: GRAND CAYMAN STATE: E9 ZIP: KY101194 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: BEACON ROOFING SUPPLY INC CENTRAL INDEX KEY: 0001124941 STANDARD INDUSTRIAL CLASSIFICATION: WHOLESALE-LUMBER & OTHER CONSTRUCTION MATERIALS [5030] IRS NUMBER: 364173371 STATE OF INCORPORATION: DE FISCAL YEAR END: 0930 BUSINESS ADDRESS: STREET 1: 505 HUNTMAR PARK DRIVE STREET 2: SUITE 300 CITY: HERNDON STATE: VA ZIP: 20170 BUSINESS PHONE: 571-323-3939 MAIL ADDRESS: STREET 1: 505 HUNTMAR PARK DRIVE STREET 2: SUITE 300 CITY: HERNDON STATE: VA ZIP: 20170 4 1 a4.xml 4 X0306 4 2019-09-25 0 0001124941 BEACON ROOFING SUPPLY INC BECN 0001624514 CD&R Investment Associates IX, Ltd. C/O M+C CORPORATE SERVICES LIMITED P.O. BOX 309 UGLAND HSE, SOUTH CHURCH ST GEORGE TOWN E9 KY1-1104 CAYMAN ISLANDS 0 0 1 0 0001726960 CD&R Boulder Holdings, L.P. C/O M+C CORPORATE SERVICES LIMITED P.O. BOX 309 UGLAND HSE, SOUTH CHURCH ST GEORGE TOWN E9 KY1-1104 CAYMAN ISLANDS 0 0 1 0 Common Stock 2019-09-25 4 P 0 3207200 32.0799 A 13757361 I By affiliate These securities are owned directly by CD&R Boulder Holdings, L.P. ("CD&R Stockholder"). CD&R Associates IX, Ltd., as the general partner of CD&R Stockholder may be deemed to beneficially own the shares of common stock held by CD&R Stockholder. CD&R Investment Associates IX, Ltd. expressly disclaims beneficial ownership of the shares of common stock held by CD&R Stockholder, except to the extent of its pecuniary interest therein. CD&R Investment Associates IX, Ltd., By: /s/ Theresa A. Gore, VP, Treas. and Asst. Sec. 2019-09-25 CD&R Boulder Holdings, L.P., By: CD&R Investment Associates IX, Ltd, general partner; By: /s/ Theresa A. Gore, Vice President, Treasurer and Assistant Secretary 2019-09-25