0001144204-17-045200.txt : 20170825
0001144204-17-045200.hdr.sgml : 20170825
20170825163530
ACCESSION NUMBER: 0001144204-17-045200
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20170823
FILED AS OF DATE: 20170825
DATE AS OF CHANGE: 20170825
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Burgess R William JR
CENTRAL INDEX KEY: 0001366123
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-37874
FILM NUMBER: 171052377
MAIL ADDRESS:
STREET 1: 950 WINTER STREET
CITY: WALTHAM
STATE: MA
ZIP: 02451
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: ABS VENTURES IX L P
CENTRAL INDEX KEY: 0001351784
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-37874
FILM NUMBER: 171052379
BUSINESS ADDRESS:
STREET 1: 950 WINTER STREET
CITY: WALTHAM
STATE: MA
ZIP: 02451
BUSINESS PHONE: 617-283-0418
MAIL ADDRESS:
STREET 1: 950 WINTER STREET
CITY: WALTHAM
STATE: MA
ZIP: 02451
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: CALVERT CAPITAL V L.L.C.
CENTRAL INDEX KEY: 0001684577
STATE OF INCORPORATION: DE
FISCAL YEAR END: 1231
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-37874
FILM NUMBER: 171052378
BUSINESS ADDRESS:
STREET 1: C/O EVERBRIDGE, INC.
STREET 2: 25 CORPORATE DRIVE, SUITE 400
CITY: BURLINGTON
STATE: MA
ZIP: 01803
BUSINESS PHONE: 818-230-9700
MAIL ADDRESS:
STREET 1: C/O EVERBRIDGE, INC.
STREET 2: 25 CORPORATE DRIVE, SUITE 400
CITY: BURLINGTON
STATE: MA
ZIP: 01803
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: EVERBRIDGE, INC.
CENTRAL INDEX KEY: 0001437352
STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-PREPACKAGED SOFTWARE [7372]
IRS NUMBER: 000000000
STATE OF INCORPORATION: DE
FISCAL YEAR END: 1231
BUSINESS ADDRESS:
STREET 1: 25 CORPORATE DRIVE
STREET 2: SUITE 400
CITY: BURLINGTON
STATE: MA
ZIP: 01803
BUSINESS PHONE: 818-230-9700
MAIL ADDRESS:
STREET 1: 25 CORPORATE DRIVE
STREET 2: SUITE 400
CITY: BURLINGTON
STATE: MA
ZIP: 01803
FORMER COMPANY:
FORMER CONFORMED NAME: 3N GLOBAL INC
DATE OF NAME CHANGE: 20080611
4
1
v474007_4.xml
OWNERSHIP DOCUMENT
X0306
4
2017-08-23
1
0001437352
EVERBRIDGE, INC.
EVBG
0001351784
ABS VENTURES IX L P
950 WINTER STREET
WALTHAM
MA
02451
0
0
1
0
0001684577
CALVERT CAPITAL V L.L.C.
C/O ABS VENTURES IX, L.P.
950 WINTER STREET
WALTHAM
MA
02451
0
0
1
0
0001366123
Burgess R William JR
C/O ABS VENTURES IX, L.P.
950 WINTER STREET
WALTHAM
MA
02451
0
0
1
0
Common Stock
2017-08-23
4
J
0
780835
0.00
D
2000000
D
Common Stock
219165
D
Common Stock
2017-08-23
4
J
0
118644
0.00
D
0
D
Common Stock
55409
D
Common Stock
2489
I
By controlled corp.
Refers to shares held in the name of ABS Ventures IX, L.P. ("ABS"). Calvert Capital V L.L.C. ("CCV"), the general partner of ABS, and R. William Burgess, Jr. ("Burgess"), a managing member of CCV, have indirect beneficial ownership of the shares held by ABS.
ABS made a pro-rata distribution for no consideration of Common Stock of Everbridge, Inc. (the "Issuer") to its general partner and limited partners on August 23, 2017. The limited partners received 780,835 shares in the distribution. CCV, general partner of ABS, received 219,165 shares in the distribution (a change of form of beneficial ownership without a change of pecuniary interest exempt from reporting under Rule 16a-13). The total number of shares distributed was 1,000,000 shares.
Refers to shares held by CCV (see footnote 2).
CCV, a limited liability company organized in a manner similar to a limited partnership, made a pro rata distribution for no consideration to its members on August 23, 2017. 118,644 shares were distributed to certain non-managing members and 100,521 shares were distributed as follows: (i) CCV managing member Burgess received 48,978 shares and his IRA received 1,652 shares (a change of form of beneficial ownership without a change of pecuniary interest exempt from reporting under Rule 16a-13), (ii) Calvert Capital Management Company ("CCMC"), a company which is controlled by CCV managing members Burgess and Bruns Grayson ("Grayson"), received 2,086 shares (a change of form of beneficial ownership without a change of pecuniary interest exempt from reporting under Rule 16a-13),
(continued from footnote 4) (iii) CCV managing member Grayson, a director of the Issuer who files Section 16 reports separately, received 37,376 shares and a trust for his daughter (of which he is the sole trustee) received 10,429 shares (a change of form of beneficial ownership without a change of pecuniary interest exempt from reporting under Rule 16a-13). The total number of shares distributed was 219,165 shares.
Refers to shares held by Burgess or his IRA (see footnote 4).
Refers to shares held by CCMC (see footnote 4).
/s/ R. William Burgess on behalf of ABS Ventures IX L.P.
2017-08-25
/s/ R. William Burgess on behalf of Calvert Capital V L.L.C.
2017-08-25
/s/ R. William Burgess, Jr., individual
2017-08-25