0001437749-23-025211.txt : 20230905 0001437749-23-025211.hdr.sgml : 20230905 20230905164330 ACCESSION NUMBER: 0001437749-23-025211 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20230831 FILED AS OF DATE: 20230905 DATE AS OF CHANGE: 20230905 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Simpson Ilias CENTRAL INDEX KEY: 0001924606 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-34221 FILM NUMBER: 231236439 MAIL ADDRESS: STREET 1: 6900 LAYTON AVENUE, SUITE 1200 CITY: DENVER STATE: CO ZIP: 80237 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: ModivCare Inc CENTRAL INDEX KEY: 0001220754 STANDARD INDUSTRIAL CLASSIFICATION: TRANSPORTATION SERVICES [4700] IRS NUMBER: 860845127 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 6900 LAYTON AVENUE STREET 2: 12TH FLOOR CITY: DENVER STATE: CO ZIP: 80237 BUSINESS PHONE: 303-728-7030 MAIL ADDRESS: STREET 1: 6900 LAYTON AVENUE STREET 2: 12TH FLOOR CITY: DENVER STATE: CO ZIP: 80237 FORMER COMPANY: FORMER CONFORMED NAME: PROVIDENCE SERVICE CORP DATE OF NAME CHANGE: 20030226 4 1 rdgdoc.xml FORM 4 X0508 4 2023-08-31 0001220754 ModivCare Inc MODV 0001924606 Simpson Ilias 6900 LAYTON AVENUE 12TH FLOOR DENVER CO 80237 1 President, ModivCare Mobility 0 Common Stock 2023-08-31 4 A 0 9345 0 A 10374 D Performance Restricted Stock Units 2023-08-31 4 A 0 14018 0 A 2026-08-31 Common Stock 14018 14018 D Represents restricted stock units scheduled to vest as follows: (i) 3,115 shares will vest on August 31, 2024, (ii) 3,115 shares will vest on August 31, 2025 and (iii) 3,115 shares will vest on August 31, 2026, in each case, subject to the reporting person's continued employment. Represents the contingent right to receive a number of shares of issuer common stock determined by multiplying the number of performance units by a percentage from 50% to 200% that corresponds to specified revenue and Adjusted EBITDA thresholds measured by reference to the issuer's audited financial statements for its fiscal year ending December 31, 2025, subject to the reporting person's continued employment through the vesting date of August 31, 2026. The number of shares of common stock reported assumes a revenue and Adjusted EBITDA performance target achieved that corresponds to a 100% payout level. /s/ Jonathan B. Bush by Power of Attorney 2023-09-05