0001179110-18-010897.txt : 20180827
0001179110-18-010897.hdr.sgml : 20180827
20180827095706
ACCESSION NUMBER: 0001179110-18-010897
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20180827
FILED AS OF DATE: 20180827
DATE AS OF CHANGE: 20180827
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Goulet Kenneth R
CENTRAL INDEX KEY: 0001415516
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-37787
FILM NUMBER: 181038262
MAIL ADDRESS:
STREET 1: 120 MONUMENT CIRCLE
CITY: INDIANAPOLIS
STATE: IN
ZIP: 46204
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: Cotiviti Holdings, Inc.
CENTRAL INDEX KEY: 0001657197
STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-BUSINESS SERVICES, NEC [7389]
IRS NUMBER: 460595918
STATE OF INCORPORATION: DE
FISCAL YEAR END: 1231
BUSINESS ADDRESS:
STREET 1: 115 PERIMETER CENTER PLACE
STREET 2: SUITE 700
CITY: ATLANTA
STATE: GA
ZIP: 30346
BUSINESS PHONE: 770 379-2800
MAIL ADDRESS:
STREET 1: 115 PERIMETER CENTER PLACE
STREET 2: SUITE 700
CITY: ATLANTA
STATE: GA
ZIP: 30346
4
1
edgar.xml
FORM 4 -
X0306
4
2018-08-27
1
0001657197
Cotiviti Holdings, Inc.
COTV
0001415516
Goulet Kenneth R
C/O COTIVITI HOLDINGS, INC.
ONE GLENLAKE PARKWAY, SUITE 1400
ATLANTA
GA
30328
1
0
0
0
Common Stock, par value $0.001 per share
2018-08-27
4
D
0
9108
D
0
D
Options (right to buy)
13.79
2018-08-27
4
D
0
12292
30.96
D
2025-12-01
Common Stock, par value $0.001
12292
0
D
Options (right to buy)
13.79
2018-08-27
4
D
0
12292
30.96
D
2025-12-01
Common Stock, par value $0.001
12292
0
D
Restricted Stock Units
2018-08-27
4
D
0
4708
D
Common Stock, par value $0.001
4708
0
D
Disposed of pursuant to an Agreement and Plan of Merger, dated June 19, 2018, between Cotiviti Holdings, Inc., Verscend Technologies, Inc. and Rey Merger Sub, Inc. in exchange for a cash payment of $44.75 per share.
This option, which provided for vesting in five equal annual installments commencing on December 1, 2016, was cancelled in the merger in exchange for a cash payment equal to: (a) the number of shares of Issuer common stock underlying the option, multiplied by (b) the excess of $44.75 over the per share exercise price of such option.
This option, which was fully vested on September 30, 2016, was cancelled in the merger in exchange for a cash payment equal to: (a) the number of shares of Issuer common stock underlying the option, multiplied by (b) the excess of $44.75 over the per share exercise price of such option.
Each Restricted Stock Unit represents the right to receive, at settlement, one (1) share of common stock, par value $0.001 per share.
These Restricted Stock Units, which provided for vesting on the date of Cotiviti Holdings, Inc.'s first annual meeting of stockholders following the date of grant, June 1, 2018, subject to the Reporting Person's continued service through each applicable vesting date, were cancelled in the merger in exchange for a cash payment equal to $44.75 per share.
Disposed of pursuant to an Agreement and Plan of Merger, dated June 19, 2018, between Cotiviti Holdings, Inc., Verscend Technologies, Inc. and Rey Merger Sub, Inc. in exchange for a cash payment of $44.75 per restricted stock unit.
/s/ Jonathan Olefson, attorney-in-fact
2018-08-27