0001209191-21-014506.txt : 20210225 0001209191-21-014506.hdr.sgml : 20210225 20210225201157 ACCESSION NUMBER: 0001209191-21-014506 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20210202 FILED AS OF DATE: 20210225 DATE AS OF CHANGE: 20210225 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: CRUSCO KATHLEEN M CENTRAL INDEX KEY: 0001237508 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-39449 FILM NUMBER: 21682958 MAIL ADDRESS: STREET 1: C/O CALIX, INC. STREET 2: 1035 N. MCDOWELL BLVD CITY: PETALUMA STATE: CA ZIP: 94954 FORMER NAME: FORMER CONFORMED NAME: CRUSCO KATHY DATE OF NAME CHANGE: 20030531 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: DUCK CREEK TECHNOLOGIES, INC. CENTRAL INDEX KEY: 0001160951 STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-PREPACKAGED SOFTWARE [7372] IRS NUMBER: 843723837 FISCAL YEAR END: 0831 BUSINESS ADDRESS: STREET 1: 22 BOSTON WHARF ROAD, FLOOR 10 CITY: BOSTON STATE: MA ZIP: 02210 BUSINESS PHONE: (833) 798-7789 MAIL ADDRESS: STREET 1: 22 BOSTON WHARF ROAD, FLOOR 10 CITY: BOSTON STATE: MA ZIP: 02210 FORMER COMPANY: FORMER CONFORMED NAME: DUCK CREEK TECHNOLOGIES INC DATE OF NAME CHANGE: 20011016 4 1 doc4.xml FORM 4 SUBMISSION X0306 4 2021-02-02 0 0001160951 DUCK CREEK TECHNOLOGIES, INC. DCT 0001237508 CRUSCO KATHLEEN M C/O DUCK CREEK TECHNOLOGIES, INC. 22 BOSTON WHARF ROAD BOSTON MA 02210 1 0 0 0 Common Stock, par value $0.01 per share 2021-02-02 4 A 0 3470 A 46032 D Option 27.00 2021-02-02 4 A 0 3901 A 2021-02-02 2030-08-14 Common Stock, par value $0.01 per share 3901 35107 D Represents vested restricted shares of Duck Creek Technologies, Inc. (the "Company") the reporting person acquired upon the satisfaction of a performance condition associated with previously awarded restricted share units in Disco Topco Holdings (Cayman) L.P. (the "Operating Partnership") that converted into unvested restricted shares in connection with the initial public offering, as described in the Registration Statement on Form S-1 (File No. 333-240050) (the "Registration Statement") of the Company pursuant to the Company's 2020 Omnibus Incentive Plan. Represents vested options of the Company the reporting person acquired upon the satisfaction of a performance condition associated with previously awarded options to acquire restricted share units in the Operating Partnership that converted into unvested options to acquire shares of common stock of the Company in connection with the initial public offering, as described in the Registration Statement of the Company pursuant to the Company's 2020 Omnibus Incentive Plan. /s/ Christopher R. Stone as Attorney-in-Fact 2021-02-24