0001181431-15-004527.txt : 20150312 0001181431-15-004527.hdr.sgml : 20150312 20150312160212 ACCESSION NUMBER: 0001181431-15-004527 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20150311 FILED AS OF DATE: 20150312 DATE AS OF CHANGE: 20150312 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: CLAYTON DUBILIER & RICE FUND VIII LP CENTRAL INDEX KEY: 0001430647 STATE OF INCORPORATION: E9 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-36048 FILM NUMBER: 15695908 BUSINESS ADDRESS: STREET 1: UGLAND HOUSE STREET 2: SOUTH CHURCH STREET, CITY: GEORGE TOWN, GRAND CAYMAN STATE: E9 ZIP: KY1-1104 BUSINESS PHONE: 345 949-8066 MAIL ADDRESS: STREET 1: UGLAND HOUSE STREET 2: SOUTH CHURCH STREET, CITY: GEORGE TOWN, GRAND CAYMAN STATE: E9 ZIP: KY1-1104 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: CD&R ASSOCIATES VIII, LP CENTRAL INDEX KEY: 0001474716 STATE OF INCORPORATION: E9 FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-36048 FILM NUMBER: 15695904 BUSINESS ADDRESS: STREET 1: C/O M&C CORPORATE SERVICES LTD. STREET 2: PO BOX 309 CITY: GEORGE TOWN STATE: E9 ZIP: KY1-1104 BUSINESS PHONE: 345-949-8066 MAIL ADDRESS: STREET 1: C/O M&C CORPORATE SERVICES LTD. STREET 2: PO BOX 309 CITY: GEORGE TOWN STATE: E9 ZIP: KY1-1104 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: CD&R Investment Associates VIII, Ltd. CENTRAL INDEX KEY: 0001474785 STATE OF INCORPORATION: E9 FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-36048 FILM NUMBER: 15695903 BUSINESS ADDRESS: STREET 1: C/O M&C CORPORATE SERVICES LTD. STREET 2: PO BOX 309 CITY: GEORGE TOWN STATE: E9 ZIP: KY1-1104 BUSINESS PHONE: 345-949-8066 MAIL ADDRESS: STREET 1: C/O M&C CORPORATE SERVICES LTD. STREET 2: PO BOX 309 CITY: GEORGE TOWN STATE: E9 ZIP: KY1-1104 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: CD&R Associates VIII, Ltd. CENTRAL INDEX KEY: 0001474786 STATE OF INCORPORATION: E9 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-36048 FILM NUMBER: 15695909 BUSINESS ADDRESS: STREET 1: C/O M&C CORPORATE SERVICES LTD. STREET 2: P.O. BOX 309 CITY: GEORGE TOWN STATE: E9 ZIP: KY1-1104 BUSINESS PHONE: 345-949-8066 MAIL ADDRESS: STREET 1: C/O M&C CORPORATE SERVICES LTD. STREET 2: P.O. BOX 309 CITY: GEORGE TOWN STATE: E9 ZIP: KY1-1104 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: CD&R Advisor Fund VIII Co-Investor, L.P. CENTRAL INDEX KEY: 0001584047 STATE OF INCORPORATION: E9 FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-36048 FILM NUMBER: 15695906 BUSINESS ADDRESS: STREET 1: CLAYTON, DUBILIER & RICE LLC STREET 2: 375 PARK AVENUE, 18TH FL CITY: NEW YORK STATE: NY ZIP: 10152 BUSINESS PHONE: 212-407-5200 MAIL ADDRESS: STREET 1: CLAYTON, DUBILIER & RICE LLC STREET 2: 375 PARK AVENUE, 18TH FL CITY: NEW YORK STATE: NY ZIP: 10152 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: CD&R EMS Co-Investor, L.P. CENTRAL INDEX KEY: 0001518464 STATE OF INCORPORATION: E9 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-36048 FILM NUMBER: 15695907 BUSINESS ADDRESS: STREET 1: CLAYTON, DUBILIER & RICE, LLC STREET 2: 375 PARK AVENUE CITY: NEW YORK STATE: NY ZIP: 10152 BUSINESS PHONE: 212-407-5200 MAIL ADDRESS: STREET 1: CLAYTON, DUBILIER & RICE, LLC STREET 2: 375 PARK AVENUE CITY: NEW YORK STATE: NY ZIP: 10152 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: CD&R FRIENDS & FAMILY FUND VIII LP CENTRAL INDEX KEY: 0001458812 STATE OF INCORPORATION: XX FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-36048 FILM NUMBER: 15695905 BUSINESS ADDRESS: STREET 1: C/O M&C CORPORATE SERVICES LTD STREET 2: P.O. BOX 309 CITY: GEORGE TOWN STATE: XX ZIP: KY1-1104 BUSINESS PHONE: 345-949-8066 MAIL ADDRESS: STREET 1: C/O M&C CORPORATE SERVICES LTD STREET 2: P.O. BOX 309 CITY: GEORGE TOWN STATE: XX ZIP: KY1-1104 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: Envision Healthcare Holdings, Inc. CENTRAL INDEX KEY: 0001578318 STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-GENERAL MEDICAL & SURGICAL HOSPITALS, NEC [8062] IRS NUMBER: 450832318 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 6200 S. SYRACUSE WAY, SUITE 200 CITY: GREENWOOD VILLAGE STATE: CO ZIP: 80111 BUSINESS PHONE: (303) 495-1200 MAIL ADDRESS: STREET 1: 6200 S. SYRACUSE WAY, SUITE 200 CITY: GREENWOOD VILLAGE STATE: CO ZIP: 80111 4 1 rrd423452.xml FORM 4 X0306 4 2015-03-11 1 0001578318 Envision Healthcare Holdings, Inc. EVHC 0001474786 CD&R Associates VIII, Ltd. C/O MAPLES CORPORATE SERVICES LIMITED P.O. BOX 309, UGLAND HOUSE GRAND CAYMAN E9 KY1-1104 CAYMAN ISLANDS 0 0 1 0 0001430647 CLAYTON DUBILIER & RICE FUND VIII LP C/O MAPLES CORPORATE SERVICES LIMITED P.O. BOX 309, UGLAND HOUSE GRAND CAYMAN E9 KY1-1104 CAYMAN ISLANDS 0 0 1 0 0001518464 CD&R EMS Co-Investor, L.P. C/O MAPLES CORPORATE SERVICES LIMITED P.O. BOX 309, UGLAND HOUSE GRAND CAYMAN E9 KY1-1104 CAYMAN ISLANDS 0 0 1 0 0001584047 CD&R Advisor Fund VIII Co-Investor, L.P. C/O MAPLES CORPORATE SERVICES LIMITED P.O. BOX 309, UGLAND HOUSE GRAND CAYMAN E9 KY1-1104 CAYMAN ISLANDS 0 0 1 0 0001458812 CD&R FRIENDS & FAMILY FUND VIII LP C/O MAPLES CORPORATE SERVICES LIMITED P.O. BOX 309, UGLAND HOUSE GRAND CAYMAN E9 KY1-1104 CAYMAN ISLANDS 0 0 1 0 0001474716 CD&R ASSOCIATES VIII, LP C/O MAPLES CORPORATE SERVICES LIMITED P.O. BOX 309, UGLAND HOUSE GRAND CAYMAN E9 KY1-1104 CAYMAN ISLANDS 0 0 1 0 0001474785 CD&R Investment Associates VIII, Ltd. C/O MAPLES CORPORATE SERVICES LIMITED P.O. BOX 309, UGLAND HOUSE GRAND CAYMAN E9 KY1-1104 CAYMAN ISLANDS 0 0 1 0 Common Stock 2015-03-11 4 S 0 50857145 36.05 D 0 I By Affiliates CD&R Associates VIII, Ltd. is the general partner of each of Clayton, Dubilier & Rice Fund VIII, L.P. , CD&R EMS Co-Investor, L.P., CD&R Advisor Fund VIII Co-Investor, L.P. and CD&R Friends and Family Fund VIII, L.P. (the foregoing limited partnerships collectively, the "CD&R Affiliates"). CD&R Associates VIII, Ltd., CD&R Associates VIII, L.P., as the sole stockholder of CD&R Associates VIII, Ltd., and CD&R Investment Associates VIII, Ltd., as the general partner of CD&R Associates VIII, L.P., may each be deemed to beneficially own the shares of common stock held by the CD&R Affiliates. Each of CD&R Associates VIII, Ltd., CD&R Associates VIII, L.P. and CD&R Investment Associates VIII, Ltd. expressly disclaims beneficial ownership of the shares held by the CD&R Affiliates, in each case, except to the extent of its pecuniary interest therein. Each of the CD&R Affiliates expressly disclaims beneficial ownership of the shares held by each of the other CD&R Affiliates, in each case, except to the extent of its pecuniary interest therein. CD&R Associates VIII, Ltd. By: /s/ Theresa A. Gore, VP, Treas. and Asst. Sec. 2015-03-12 Clayton, Dubilier & Rice Fund VIII, L.P., its general partner By: /s/ Theresa A. Gore, VP, Treas. and Asst. Sec. 2015-03-12 CD&R EMS Co-Investor, L.P., its general partner By: /s/ Theresa A. Gore, VP, Treas. and Asst. Sec. 2015-03-12 CD&R Advisor Fund VIII Co-Investor, L.P., its general partner By: /s/ Theresa A. Gore, VP, Treas. and Asst. Sec. 2015-03-12 CD&R Friends and Family Fund VIII, L.P., its general partner By: /s/ Theresa A. Gore, VP, Treas. and Asst. Sec. 2015-03-12 CD&R Associates VIII, L.P., its general partner By: /s/ Theresa A. Gore, VP, Treas. and Asst. Sec. 2015-03-12 CD&R Investment Associates VIII, Ltd. By: /s/ Theresa A. Gore, VP, Treas. and Asst. Sec. 2015-03-12