0001140361-17-036645.txt : 20170927 0001140361-17-036645.hdr.sgml : 20170927 20170927165719 ACCESSION NUMBER: 0001140361-17-036645 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 2 CONFORMED PERIOD OF REPORT: 20170925 FILED AS OF DATE: 20170927 DATE AS OF CHANGE: 20170927 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: American Securities Partners V(B), L.P. CENTRAL INDEX KEY: 0001401896 STATE OF INCORPORATION: DE FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-32498 FILM NUMBER: 171104788 BUSINESS ADDRESS: STREET 1: 666 Third Avenue STREET 2: 29th Floor CITY: New York STATE: NY ZIP: 10017 MAIL ADDRESS: STREET 1: 666 Third Avenue STREET 2: 29th Floor CITY: New York STATE: NY ZIP: 10017 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: American Securities Partners V, L.P. CENTRAL INDEX KEY: 0001401897 STATE OF INCORPORATION: DE FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-32498 FILM NUMBER: 171104789 BUSINESS ADDRESS: STREET 1: 666 Third Avenue STREET 2: 29th Floor CITY: New York STATE: NY ZIP: 10017 MAIL ADDRESS: STREET 1: 666 Third Avenue STREET 2: 29th Floor CITY: New York STATE: NY ZIP: 10017 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: AMERICAN SECURITIES LLC CENTRAL INDEX KEY: 0001475483 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-32498 FILM NUMBER: 171104785 BUSINESS ADDRESS: STREET 1: 299 PARK AVENUE CITY: NEW YORK STATE: NY ZIP: 10171 BUSINESS PHONE: 212 476-8000 MAIL ADDRESS: STREET 1: 299 PARK AVENUE CITY: NEW YORK STATE: NY ZIP: 10171 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: American Securities Associates V, LLC CENTRAL INDEX KEY: 0001475484 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-32498 FILM NUMBER: 171104786 BUSINESS ADDRESS: STREET 1: C/O AMERICAN SECURITIES LLC STREET 2: THE CHRYSLER CENTER, 666 THIRD AVENUE CITY: NEW YORK STATE: NY ZIP: 10017 BUSINESS PHONE: 212 476-8000 MAIL ADDRESS: STREET 1: C/O AMERICAN SECURITIES LLC STREET 2: THE CHRYSLER CENTER, 666 THIRD AVENUE CITY: NEW YORK STATE: NY ZIP: 10017 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: American Securities Partners V (C) L.P. CENTRAL INDEX KEY: 0001475482 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-32498 FILM NUMBER: 171104787 BUSINESS ADDRESS: STREET 1: C/O AMERICAN SECURITIES LLC STREET 2: THE CHRYSLER CENTER, 666 THIRD AVENUE CITY: NEW YORK STATE: NY ZIP: 10017 BUSINESS PHONE: 212 476-8000 MAIL ADDRESS: STREET 1: C/O AMERICAN SECURITIES LLC STREET 2: THE CHRYSLER CENTER, 666 THIRD AVENUE CITY: NEW YORK STATE: NY ZIP: 10017 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: AS Investors, LLC CENTRAL INDEX KEY: 0001492671 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-32498 FILM NUMBER: 171104790 BUSINESS ADDRESS: STREET 1: C/O AMERICAN SECURITIES LLC STREET 2: THE CHRYSLER CENTER, 666 THIRD AVENUE CITY: NEW YORK STATE: NY ZIP: 10017 BUSINESS PHONE: 212-476-8000 MAIL ADDRESS: STREET 1: C/O AMERICAN SECURITIES LLC STREET 2: THE CHRYSLER CENTER, 666 THIRD AVENUE CITY: NEW YORK STATE: NY ZIP: 10017 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: XERIUM TECHNOLOGIES INC CENTRAL INDEX KEY: 0001287151 STANDARD INDUSTRIAL CLASSIFICATION: BROADWOVEN FABRIC MILS, MAN MADE FIBER & SILK [2221] IRS NUMBER: 421558674 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 14101 CAPITAL BOULEVARD CITY: YOUNGSVILLE STATE: NC ZIP: 27596 BUSINESS PHONE: 919-526-1400 MAIL ADDRESS: STREET 1: 14101 CAPITAL BOULEVARD CITY: YOUNGSVILLE STATE: NC ZIP: 27596 4 1 form4.xml FORM 4 X0306 4 2017-09-25 true 0001287151 XERIUM TECHNOLOGIES INC XRM 0001492671 AS Investors, LLC C/O AMERICAN SECURITIES LLC 299 PARK AVE, 34TH FLOOR NEW YORK NY 10171 true 0001401897 American Securities Partners V, L.P. C/O AMERICAN SECURITIES LLC 299 PARK AVE, 34TH FLOOR NEW YORK NY 10171 true 0001401896 American Securities Partners V(B), L.P. C/O AMERICAN SECURITIES LLC 299 PARK AVE, 34TH FLOOR NEW YORK NY 10171 true 0001475482 American Securities Partners V (C) L.P. C/O AMERICAN SECURITIES LLC 299 PARK AVE, 34TH FLOOR NEW YORK NY 10171 true 0001475484 American Securities Associates V, LLC C/O AMERICAN SECURITIES LLC 299 PARK AVE, 34TH FLOOR NEW YORK NY 10171 true 0001475483 AMERICAN SECURITIES LLC 299 PARK AVE, 34TH FLOOR NEW YORK NY 10171 true Common Stock 2017-09-25 4 J 0 781735 D 1395532 D The Sponsors (as defined below) made an in-kind distribution to their respective limited partners for no consideration. As of September 25, 2017, AS Investors, LLC ("AS Investors") was the direct record owner of 1,382,603 shares of common stock of Xerium Technologies Inc. ("Xerium"). As a result of their relationship to AS Investors, (i) American Securities Partners V, L.P., American Securities Partners V(B), L.P. and American Securities Partners V(C), L.P. (each, a "Sponsor"), the owners of membership interests in AS Investors; (ii) American Securities Associates V, LLC ("GP"), the general partner of each Sponsor; and (iii) American Securities LLC ("Advisor"), which provides investment advisory services to each Sponsor and GP may also be deemed to be beneficial owners of Xerium. Additionally, as of September 25, 2017, Advisor directly owns 12,929 shares of common stock. Accordingly, as of September 25, 2017, Advisor may be deemed to be the beneficial owner of an aggregate of 1,395,532 shares of common stock of Xerium. Each Reporting Person disclaims beneficial ownership of the reported securities except to the extent of such Reporting Person's pecuniary interest therein, and this report shall not be deemed an admission that such Reporting Person is the beneficial owner of the securities for purposes of Section 16 of the Securities Exchange Act of 1934, as amended, or for any other purpose. Exhibit 99.1 Joint Filer Information incorporated herein by reference AS Investors, LLC By: /s/ Marc Saiontz, as Vice President 2017-09-27 American Securities Partners V, L.P. By: American Securities Associates V, LLC, its general partner By: /s/ Michael G. Fisch, as Managing Member 2017-09-27 American Securities Partners V(B), L.P. By: American Securities Associates V, LLC, its general partner By: /s/ Michael G. Fisch, as Managing Member 2017-09-27 American Securities Partners V(C), L.P. By: American Securities Associates V, LLC, its general partner By: /s/ Michael G. Fisch, as Managing Member 2017-09-27 American Securities Associates V, LLC By: /s/ Michael G. Fisch, as Managing Member 2017-09-27 American Securities LLC By: /s/ Michael G. Fisch, as President and Chief Executive Officer 2017-09-27 EX-99.1 2 ex99_1.htm EXHIBIT 99.1
Exhibit 99.1

Joint Filer Information

Name of Joint Filer:
American Securities Partners V, L.P.
   
Address of Joint Filer:
c/o American Securities LLC
 
299 Park Ave, 34th Floor
 
New York, NY  10171
   
Relationship of Joint Filer to Issuer:
10% Owner
   
Issuer Name and Ticker or Trading Symbol:
Xerium Technologies, Inc. [XRM]
   
Date of Earliest Transaction Required to be Reported:
  
(Month/Day/Year):
9/25/2017

Designated Filer:     AS Investors, LLC

Joint Filer Information

Name of Joint Filer:
American Securities Partners V(B), L.P.
   
Address of Joint Filer:
c/o American Securities LLC
 
299 Park Ave, 34th Floor
 
New York, NY  10171
   
Relationship of Joint Filer to Issuer:
10% Owner
   
Issuer Name and Ticker or Trading Symbol:
Xerium Technologies, Inc. [XRM]
   
Date of Earliest Transaction Required to be Reported:
  
(Month/Day/Year):
9/25/2017

Designated Filer:     AS Investors, LLC

Joint Filer Information

Name of Joint Filer:
American Securities Partners V(C), L.P.
   
Address of Joint Filer:
c/o American Securities LLC
 
299 Park Ave, 34th Floor
 
New York, NY  10171
   
Relationship of Joint Filer to Issuer:
10% Owner
   
Issuer Name and Ticker or Trading Symbol:
Xerium Technologies, Inc. [XRM]
   
Date of Earliest Transaction Required to be Reported:
  
(Month/Day/Year):
9/25/2017

Designated Filer:     AS Investors, LLC


Joint Filer Information

Name of Joint Filer:
American Securities Associates V, LLC
   
Address of Joint Filer:
c/o American Securities LLC
 
299 Park Ave, 34th Floor
 
New York, NY  10171
   
Relationship of Joint Filer to Issuer:
10% Owner
   
Issuer Name and Ticker or Trading Symbol:
Xerium Technologies, Inc. [XRM]
   
Date of Earliest Transaction Required to be Reported:
  
(Month/Day/Year):
9/25/2017

Designated Filer:     AS Investors, LLC

Joint Filer Information

Name of Joint Filer:
American Securities LLC
   
Address of Joint Filer:
299 Park Ave, 34th Floor
 
New York, NY  10171
   
Relationship of Joint Filer to Issuer:
10% Owner
   
Issuer Name and Ticker or Trading Symbol:
Xerium Technologies, Inc. [XRM]
   
Date of Earliest Transaction Required to be Reported:
  
(Month/Day/Year):
9/25/2017

Designated Filer:     AS Investors, LLC