0001104659-19-000917.txt : 20190104 0001104659-19-000917.hdr.sgml : 20190104 20190104194254 ACCESSION NUMBER: 0001104659-19-000917 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20190104 FILED AS OF DATE: 20190104 DATE AS OF CHANGE: 20190104 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Bell Michael Adam CENTRAL INDEX KEY: 0001406455 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-38153 FILM NUMBER: 19511864 MAIL ADDRESS: STREET 1: TWO CANAL PARK CITY: CAMBRIDGE STATE: MA ZIP: 02141 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: Federal Street Acquisition Corp. CENTRAL INDEX KEY: 0001701821 STANDARD INDUSTRIAL CLASSIFICATION: BLANK CHECKS [6770] IRS NUMBER: 000000000 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: C/O THOMAS H LEE PARTNERS, L.P. STREET 2: 100 FEDERAL STREET, 35TH FLOOR CITY: BOSTON STATE: MA ZIP: 02110 BUSINESS PHONE: 617-227-1050 MAIL ADDRESS: STREET 1: C/O THOMAS H LEE PARTNERS, L.P. STREET 2: 100 FEDERAL STREET, 35TH FLOOR CITY: BOSTON STATE: MA ZIP: 02110 4 1 a4.xml 4 X0306 4 2019-01-04 1 0001701821 Federal Street Acquisition Corp. FSAC 0001406455 Bell Michael Adam C/O THOMAS H. LEE PARTNERS, L.P. 100 FEDERAL STREET, 35TH FLOOR BOSTON MA 02210 1 0 0 0 Class A Common Stock, par value $0.0001 per share 2019-01-04 4 C 0 25000 A 25000 D Class A Common Stock, par value $0.0001 per share 2019-01-04 4 D 0 25000 D 0 D Class F Common Stock, par value $0.0001 per share 2019-01-04 4 C 0 25000 D Class A Common Stock, par value $0.0001 per share 25000 0 D Pursuant to the Amended and Restated Certificate of Incorporation of the Issuer, the shares of the Issuer's Class F Common Stock, par value $0.0001 per share ("Class F Common Stock"), automatically converted into shares of the Issuer's Class A Common Stock, par value $0.0001 per share ("Class A Common Stock"), on a one-for-one basis, on January 4, 2019 at the time of the Issuer's initial business combination. The Class F Common Stock had no expiration date. In accordance with the Amended and Restated Agreement and Plan of Merger, dated as of December 19, 2018 by and among the Issuer, Agiliti, Inc., Agiliti Holdco, Inc. and the other parties thereto, at the closing of the business combination contemplated thereby, Mr. Bell disposed of 25,000 shares of the Issuer's Class A Common Stock in exchange for 25,000 shares of common stock of Agiliti, Inc. /s/ Charles P. Holden, Attorney-in-Fact 2019-01-04