SEC Form 4
FORM 4 UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549

STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP

Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934
or Section 30(h) of the Investment Company Act of 1940
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Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b).
1. Name and Address of Reporting Person*
GULMI CLAIRE M

(Last) (First) (Middle)
1A BURTON HILLS BLVD

(Street)
NASHVILLE TN 37215

(City) (State) (Zip)
2. Issuer Name and Ticker or Trading Symbol
Envision Healthcare Corp [ EVHC ]
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
Director 10% Owner
X Officer (give title below) Other (specify below)
CFO
3. Date of Earliest Transaction (Month/Day/Year)
12/01/2016
4. If Amendment, Date of Original Filed (Month/Day/Year)
6. Individual or Joint/Group Filing (Check Applicable Line)
X Form filed by One Reporting Person
Form filed by More than One Reporting Person
Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned
1. Title of Security (Instr. 3) 2. Transaction Date (Month/Day/Year) 2A. Deemed Execution Date, if any (Month/Day/Year) 3. Transaction Code (Instr. 8) 4. Securities Acquired (A) or Disposed Of (D) (Instr. 3, 4 and 5) 5. Amount of Securities Beneficially Owned Following Reported Transaction(s) (Instr. 3 and 4) 6. Ownership Form: Direct (D) or Indirect (I) (Instr. 4) 7. Nature of Indirect Beneficial Ownership (Instr. 4)
Code V Amount (A) or (D) Price
Common Stock 12/01/2016 A 121,064 A (1)(2)(3) 121,064 D
Table II - Derivative Securities Acquired, Disposed of, or Beneficially Owned
(e.g., puts, calls, warrants, options, convertible securities)
1. Title of Derivative Security (Instr. 3) 2. Conversion or Exercise Price of Derivative Security 3. Transaction Date (Month/Day/Year) 3A. Deemed Execution Date, if any (Month/Day/Year) 4. Transaction Code (Instr. 8) 5. Number of Derivative Securities Acquired (A) or Disposed of (D) (Instr. 3, 4 and 5) 6. Date Exercisable and Expiration Date (Month/Day/Year) 7. Title and Amount of Securities Underlying Derivative Security (Instr. 3 and 4) 8. Price of Derivative Security (Instr. 5) 9. Number of derivative Securities Beneficially Owned Following Reported Transaction(s) (Instr. 4) 10. Ownership Form: Direct (D) or Indirect (I) (Instr. 4) 11. Nature of Indirect Beneficial Ownership (Instr. 4)
Code V (A) (D) Date Exercisable Expiration Date Title Amount or Number of Shares
Explanation of Responses:
1. Acquisition pursuant to the terms of the Agreement and Plan of Merger, dated as of June 15, 2016, by and among Envision Healthcare Holdings, Inc., Envision Healthcare Corporation (formerly known as New Amethyst Corp.) (the "Company") and AmSurg Corp. (the "Merger Agreement"), exempt under Rule 16b-3.
2. Pursuant to the terms of the Merger Agreement, at the Merger 1 Effective Time (as defined in the Merger Agreement), each share of AmSurg Corp. common stock held by the reporting person immediately prior to the Merger 1 Effective Time was assumed by the Company and converted into one share of the Company's common stock having the same terms and conditions, taking into account any changes thereto by reason of the Mergers (as defined in the Merger Agreement).
3. Pursuant to the Merger Agreement, equity-based awards granted pursuant to AmSurg Corp. plans that were outstanding immediately prior to the effective time of the Mergers were converted into corresponding awards in respect of the Company's common stock at the effective time of the Mergers, subject to the same terms and conditions (including applicable vesting requirements) as were applicable to such awards prior to the consummation of the Mergers; provided, that AmSurg Corp.'s outstanding performance awards issued pursuant to the Performance Share Unit Award Agreement (the "Agreement") under its 2014 Equity and Incentive Plan (the "Plan") that were eligible to vest settled into shares of restricted stock at the Target Award (as defined in the Agreement) upon consummation of the Mergers, as the Mergers constituted a Change of Control (as defined in the Plan).
Remarks:
/s/ Kevin D. Eastridge. Attorney-in-Fact for Claire M. Gulmi 12/02/2016
** Signature of Reporting Person Date
Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly.
* If the form is filed by more than one reporting person, see Instruction 4 (b)(v).
** Intentional misstatements or omissions of facts constitute Federal Criminal Violations See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a).
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