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