0001144204-17-045200.txt : 20170825 0001144204-17-045200.hdr.sgml : 20170825 20170825163530 ACCESSION NUMBER: 0001144204-17-045200 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20170823 FILED AS OF DATE: 20170825 DATE AS OF CHANGE: 20170825 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Burgess R William JR CENTRAL INDEX KEY: 0001366123 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-37874 FILM NUMBER: 171052377 MAIL ADDRESS: STREET 1: 950 WINTER STREET CITY: WALTHAM STATE: MA ZIP: 02451 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: ABS VENTURES IX L P CENTRAL INDEX KEY: 0001351784 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-37874 FILM NUMBER: 171052379 BUSINESS ADDRESS: STREET 1: 950 WINTER STREET CITY: WALTHAM STATE: MA ZIP: 02451 BUSINESS PHONE: 617-283-0418 MAIL ADDRESS: STREET 1: 950 WINTER STREET CITY: WALTHAM STATE: MA ZIP: 02451 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: CALVERT CAPITAL V L.L.C. CENTRAL INDEX KEY: 0001684577 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-37874 FILM NUMBER: 171052378 BUSINESS ADDRESS: STREET 1: C/O EVERBRIDGE, INC. STREET 2: 25 CORPORATE DRIVE, SUITE 400 CITY: BURLINGTON STATE: MA ZIP: 01803 BUSINESS PHONE: 818-230-9700 MAIL ADDRESS: STREET 1: C/O EVERBRIDGE, INC. STREET 2: 25 CORPORATE DRIVE, SUITE 400 CITY: BURLINGTON STATE: MA ZIP: 01803 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 4 1 v474007_4.xml OWNERSHIP DOCUMENT X0306 4 2017-08-23 1 0001437352 EVERBRIDGE, INC. EVBG 0001351784 ABS VENTURES IX L P 950 WINTER STREET WALTHAM MA 02451 0 0 1 0 0001684577 CALVERT CAPITAL V L.L.C. C/O ABS VENTURES IX, L.P. 950 WINTER STREET WALTHAM MA 02451 0 0 1 0 0001366123 Burgess R William JR C/O ABS VENTURES IX, L.P. 950 WINTER STREET WALTHAM MA 02451 0 0 1 0 Common Stock 2017-08-23 4 J 0 780835 0.00 D 2000000 D Common Stock 219165 D Common Stock 2017-08-23 4 J 0 118644 0.00 D 0 D Common Stock 55409 D Common Stock 2489 I By controlled corp. Refers to shares held in the name of ABS Ventures IX, L.P. ("ABS"). Calvert Capital V L.L.C. ("CCV"), the general partner of ABS, and R. William Burgess, Jr. ("Burgess"), a managing member of CCV, have indirect beneficial ownership of the shares held by ABS. ABS made a pro-rata distribution for no consideration of Common Stock of Everbridge, Inc. (the "Issuer") to its general partner and limited partners on August 23, 2017. The limited partners received 780,835 shares in the distribution. CCV, general partner of ABS, received 219,165 shares in the distribution (a change of form of beneficial ownership without a change of pecuniary interest exempt from reporting under Rule 16a-13). The total number of shares distributed was 1,000,000 shares. Refers to shares held by CCV (see footnote 2). CCV, a limited liability company organized in a manner similar to a limited partnership, made a pro rata distribution for no consideration to its members on August 23, 2017. 118,644 shares were distributed to certain non-managing members and 100,521 shares were distributed as follows: (i) CCV managing member Burgess received 48,978 shares and his IRA received 1,652 shares (a change of form of beneficial ownership without a change of pecuniary interest exempt from reporting under Rule 16a-13), (ii) Calvert Capital Management Company ("CCMC"), a company which is controlled by CCV managing members Burgess and Bruns Grayson ("Grayson"), received 2,086 shares (a change of form of beneficial ownership without a change of pecuniary interest exempt from reporting under Rule 16a-13), (continued from footnote 4) (iii) CCV managing member Grayson, a director of the Issuer who files Section 16 reports separately, received 37,376 shares and a trust for his daughter (of which he is the sole trustee) received 10,429 shares (a change of form of beneficial ownership without a change of pecuniary interest exempt from reporting under Rule 16a-13). The total number of shares distributed was 219,165 shares. Refers to shares held by Burgess or his IRA (see footnote 4). Refers to shares held by CCMC (see footnote 4). /s/ R. William Burgess on behalf of ABS Ventures IX L.P. 2017-08-25 /s/ R. William Burgess on behalf of Calvert Capital V L.L.C. 2017-08-25 /s/ R. William Burgess, Jr., individual 2017-08-25