0001179110-17-013785.txt : 20171106
0001179110-17-013785.hdr.sgml : 20171106
20171106173434
ACCESSION NUMBER: 0001179110-17-013785
CONFORMED SUBMISSION TYPE: 3
PUBLIC DOCUMENT COUNT: 2
CONFORMED PERIOD OF REPORT: 20171106
FILED AS OF DATE: 20171106
DATE AS OF CHANGE: 20171106
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Ferguson Bradley A
CENTRAL INDEX KEY: 0001434773
FILING VALUES:
FORM TYPE: 3
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-37787
FILM NUMBER: 171180425
MAIL ADDRESS:
STREET 1: 1170 PEACHTREE STREET, SUITE 900
CITY: ATLANTA
STATE: GA
ZIP: 30309
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
3
1
edgar.xml
FORM 3 -
X0206
3
2017-11-06
1
0001657197
Cotiviti Holdings, Inc.
COTV
0001434773
Ferguson Bradley A
C/O COTIVITI HOLDINGS, INC.
115 PERIMETER CENTER PLACE, SUITE 700
ATLANTA
GA
30346
0
1
0
0
SVP, Chief Financial Officer
/s/ Jonathan Olefson, Attorney-in-fact
2017-11-06
EX-24
2
ex24ferguson.txt
POWER OF ATTORNEY
Know all by these present, that the undersigned hereby constitutes and appoints
Jonathan Olefson and Sara Epstein, or any one of them signing singly, and with
full power of substitution, the undersigned's true and lawful
attorney-in-fact to:
(1) execute for and on behalf of the undersigned, in the undersigned's
capacity as an officer and/or director of Cotiviti Holdings, Inc.
(the "Company") or as a stockholder of the Company or as a trustee of a
stockholder of the Company, Forms 3, 4, and 5 and Schedules 13D or 13G,
including amendments thereto, relating to the securities of the Company in
accordance with Section 16(a) of the Securities Exchange Act of 1934 and the
rules thereunder;
(2) do and perform any and all acts for and on behalf of the undersigned
which may be necessary or desirable to complete and execute any such Form 3,
4, or 5 or Schedule 13D or 13G, complete and execute any amendment or amendments
thereto, and timely file such form with the United States Securities and
Exchange Commission and any stock exchange or similar authority; and
(3) take any other action of any type whatsoever in connection with the
foregoing which, in the opinion of such attorney-in-fact, may be of benefit to,
in the best interest of, or legally required by, the undersigned, it being
understood that the documents executed by such attorney-in-fact on behalf of
the undersigned pursuant to this Power of Attorney shall be in such form and
shall contain such terms and conditions as such attorney-in-fact may approve
in such attorney-in-fact's discretion.
The undersigned hereby grants to each such attorney-in-fact full power and
authority to do and perform any and every act and thing whatsoever requisite,
necessary, or proper to be done in the exercise of any of the rights and powers
herein granted, as fully to all intents and purposes as the undersigned might
or could do if personally present, with full power of substitution or
revocation, hereby ratifying and confirming all that such attorney-in-fact,
or such attorney-in-fact's substitute or substitutes, shall lawfully do or
cause to be done by virtue of this Power of Attorney and the rights and powers
herein granted.The undersigned acknowledges that the foregoing
attorneys-in-fact, in serving in such capacity at the request of the
undersigned, are not assuming,nor is the Company assuming, any of the
undersigned's responsibilities to comply with, or liabilities that may arise
under, Section 16 of the Securities Exchange Act of 1934.
This Power of Attorney shall remain in full force and effect until the
undersigned is no longer required to file Forms 3, 4, and 5 or Schedules
13D or 13G with respect to the undersigned's holdings of and transactions in
securities issued by the Company, unless earlier revoked by the undersigned in
a signed writing delivered to the foregoing attorneys-in-fact.
This Power of Attorney shall not revoke any powers of attorney previously
executed by the undersigned. This Power of Attorney shall not be revoked by any
subsequent power of attorney that the undersigned may execute, unless such
subsequent power of attorney specifically provides that it revokes this Power
of Attorney by referring to the date of the undersigned's execution of this
Power of Attorney.
[The remainder of this page has been intentionally left blank]
IN WITNESS WHEREOF, the undersigned has caused this Power of Attorney to be
executed as of this 10/23/2017 .
/s/ Bradley Ferguson
Signature
Brad Ferguson
Printed Name