0001209191-16-142318.txt : 20160921 0001209191-16-142318.hdr.sgml : 20160921 20160921181005 ACCESSION NUMBER: 0001209191-16-142318 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20160921 FILED AS OF DATE: 20160921 DATE AS OF CHANGE: 20160921 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: EVERBRIDGE, INC. CENTRAL INDEX KEY: 0001437352 STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-PREPACKAGED SOFTWARE [7372] IRS NUMBER: 000000000 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 25 CORPORATE DRIVE STREET 2: SUITE 400 CITY: BURLINGTON STATE: MA ZIP: 01803 BUSINESS PHONE: 818-230-9700 MAIL ADDRESS: STREET 1: 25 CORPORATE DRIVE STREET 2: SUITE 400 CITY: BURLINGTON STATE: MA ZIP: 01803 FORMER COMPANY: FORMER CONFORMED NAME: 3N GLOBAL INC DATE OF NAME CHANGE: 20080611 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: ELLERTSON JAIME WALLACE CENTRAL INDEX KEY: 0001215063 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-37874 FILM NUMBER: 161896397 MAIL ADDRESS: STREET 1: C/O SI CORP STREET 2: 3500 LENOX ROAD SUITE 200 CITY: ATLANTA STATE: GA ZIP: 30326 4 1 doc4.xml FORM 4 SUBMISSION X0306 4 2016-09-21 0 0001437352 EVERBRIDGE, INC. EVBG 0001215063 ELLERTSON JAIME WALLACE C/O EVERBRIDGE, INC. 25 CORPORATE DRIVE, SUITE 400 BURLINGTON MA 01803 1 1 0 0 President, CEO and Chairman Common Stock 2016-09-21 4 C 0 200591 A 2533920 D Common Stock 2016-09-21 4 S 0 236548 11.16 D 2297372 D Common Stock 86956 I Held of record by one of the Reporting Person's children Series A-1 Preferred Stock 2016-09-21 4 C 0 200591 D Common Stock 200591 0 D The Series A-1 Preferred Stock, which had no expiration date, automatically converted to common stock on a 1-for-1 basis upon the completion of the Issuer's initial public offering. The shares were sold in the Issuer's initial public offering, pursuant to a Form S-1 Registration Statement which was declared effective on September 15, 2016. The reported sale price reflects the price at which the shares were sold to the underwriters. /s/ Richard Segal, Attorney-in-Fact 2016-09-21