0001445866-20-000310.txt : 20200331 0001445866-20-000310.hdr.sgml : 20200331 20200331180312 ACCESSION NUMBER: 0001445866-20-000310 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20200331 FILED AS OF DATE: 20200331 DATE AS OF CHANGE: 20200331 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Shuda Scott CENTRAL INDEX KEY: 0001486636 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-35020 FILM NUMBER: 20763117 MAIL ADDRESS: STREET 1: 402 RAILROAD AVENUE, SUITE 201 CITY: DANVILLE STATE: CA ZIP: 94526 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Meridian TSV II, LP CENTRAL INDEX KEY: 0001601536 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-35020 FILM NUMBER: 20763118 BUSINESS ADDRESS: STREET 1: 405 WEED STREET CITY: NEW CANAAN STATE: CT ZIP: 06840 BUSINESS PHONE: 203-643-9300 MAIL ADDRESS: STREET 1: 405 WEED STREET CITY: NEW CANAAN STATE: CT ZIP: 06840 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: TSV Investment Partners, LLC CENTRAL INDEX KEY: 0001603326 STATE OF INCORPORATION: CT FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-35020 FILM NUMBER: 20763119 BUSINESS ADDRESS: STREET 1: 405 WEED STREET CITY: NEW CANAAN STATE: CT ZIP: 06840 BUSINESS PHONE: 203-643-9300 MAIL ADDRESS: STREET 1: 405 WEED STREET CITY: NEW CANAAN STATE: CT ZIP: 06840 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: BlueLine Capital Partners II, L.P. CENTRAL INDEX KEY: 0001460781 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-35020 FILM NUMBER: 20763120 BUSINESS ADDRESS: STREET 1: 3480 BUSKIRK AVENUE STREET 2: SUITE 214 CITY: PLEASANT HILL STATE: CA ZIP: 94523 BUSINESS PHONE: 925-236-9790 MAIL ADDRESS: STREET 1: 3480 BUSKIRK AVENUE STREET 2: SUITE 214 CITY: PLEASANT HILL STATE: CA ZIP: 94523 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: BlueLine Partners, L.L.C. CENTRAL INDEX KEY: 0001311443 FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-35020 FILM NUMBER: 20763121 BUSINESS ADDRESS: STREET 1: 3480 BUSKIRK AVENUE STREET 2: SUITE 214 CITY: PLEASANT HILL STATE: CA ZIP: 94523 BUSINESS PHONE: 925-648-2085 MAIL ADDRESS: STREET 1: 3480 BUSKIRK AVENUE STREET 2: SUITE 214 CITY: PLEASANT HILL STATE: CA ZIP: 94523 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: InfuSystem Holdings, Inc CENTRAL INDEX KEY: 0001337013 STANDARD INDUSTRIAL CLASSIFICATION: SURGICAL & MEDICAL INSTRUMENTS & APPARATUS [3841] IRS NUMBER: 203341405 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 31700 RESEARCH PARK DRIVE CITY: MADISON HEIGHTS STATE: MI ZIP: 48071 BUSINESS PHONE: (248) 291-1210 MAIL ADDRESS: STREET 1: 31700 RESEARCH PARK DRIVE CITY: MADISON HEIGHTS STATE: MI ZIP: 48071 FORMER COMPANY: FORMER CONFORMED NAME: HAPC, Inc. DATE OF NAME CHANGE: 20060425 FORMER COMPANY: FORMER CONFORMED NAME: Healthcare Acquisition Partners Corp. DATE OF NAME CHANGE: 20050824 4 1 primary_doc.xml PRIMARY DOCUMENT X0306 4 2020-03-31 0 0001337013 InfuSystem Holdings, Inc INFU 0001486636 Shuda Scott C/O INFUSYSTEM HOLDINGS, INC., 3851 W. HAMLIN RD, ROCHESTER HILLS MI 48309 0 1 1 0 Director 0001601536 Meridian TSV II, LP 405 WEED STREET NEW CANAAN CT 06840 0 0 1 0 0001603326 TSV Investment Partners, LLC 405 WEED STREET NEW CANAAN CT 06840 0 0 1 0 0001460781 BlueLine Capital Partners II, L.P. 3480 BUSKIRK AVENUE SUITE 214 PLEASANT HILL CA 94523 0 0 1 0 0001311443 BlueLine Partners, L.L.C. 3480 BUSKIRK AVENUE SUITE 214 PLEASANT HILL CA 94523 0 0 1 0 Common Stock 2020-03-31 4 S 0 169960 8.3698 D 3356561 I Footnote 1 These securities are owned by Imua T Capital Investments, LLC. The price reported in Column 4 is a weighted average price. These shares reported herein were traded in multiple transactions. The reporting persons undertake to provide to InfuSystem Holdings, Inc., any security holder of InfuSystem Holdings, Inc., or the staff of the Securities and Exchange Commission, upon request, full information regarding the number of shares traded at each separate price. Imua T Capital Investments, LLC is a member of the group described in Amendment No. 1 to Schedule 13D filed by Meridian OHC Partners, LP and others on August 31, 2018. Imua T Capital Investments, LLC is managed separately from the other members of such group, and the securities reported transacting herein were all of the shares held by Imua T Capital Investments, LLC. /s/ Scott Shuda 2020-03-31