0001209191-22-042656.txt : 20220719 0001209191-22-042656.hdr.sgml : 20220719 20220719213142 ACCESSION NUMBER: 0001209191-22-042656 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20220715 FILED AS OF DATE: 20220719 DATE AS OF CHANGE: 20220719 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Paunovich Vukasin CENTRAL INDEX KEY: 0001938690 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-39515 FILM NUMBER: 221092648 MAIL ADDRESS: STREET 1: C/O AMERICAN WELL CORPORATION STREET 2: 75 STATE STREET, 26TH FLOOR CITY: BOSTON STATE: MA ZIP: 02109 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: American Well Corp CENTRAL INDEX KEY: 0001393584 STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-BUSINESS SERVICES, NEC [7389] IRS NUMBER: 000000000 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 75 STATE STREET STREET 2: 26TH FLOOR CITY: Boston STATE: MA ZIP: 02109 BUSINESS PHONE: 617-205-3500 MAIL ADDRESS: STREET 1: 75 STATE STREET STREET 2: 26TH FLOOR CITY: Boston STATE: MA ZIP: 02109 4 1 doc4.xml FORM 4 SUBMISSION X0306 4 2022-07-15 0 0001393584 American Well Corp AMWL 0001938690 Paunovich Vukasin C/O AMERICAN WELL CORPORATION 75 STATE STREET, 26TH FLOOR BOSTON MA 02109 0 1 0 0 EVP, Enterprise Platforms Class A Common Stock 2022-07-15 4 A 0 563266 0.00 A 563266 D Class A Common Stock 2022-07-15 4 F 0 68051 4.25 D 495215 D Performance Share Units 2022-07-15 4 A 0 563266 0.00 A Class A Common Stock 563266 563266 D Represents a grant of restricted stock units, with 40% vesting upon the grant date, 40% vesting on the first anniversary of the grant date, and the remaining 20% vesting upon the 18th month anniversary of the grant date. Each Performance Share Unit represents a contingent right to receive one share of Class A Common Stock of the Issuer. The Performance Share Units are eligible to vest over a three-year performance period ending July 14, 2025, and may be earned between 0%-300% of target levels, based upon the Issuer's achievement of specified market capitalization performance thresholds, subject to the reporting person's continued employment through the date on which performance is certified. /s/ Bradford Gay as attorney-in-fact for Vukasin Paunovich 2022-07-19