0001179110-17-004506.txt : 20170313 0001179110-17-004506.hdr.sgml : 20170313 20170313173055 ACCESSION NUMBER: 0001179110-17-004506 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20170310 FILED AS OF DATE: 20170313 DATE AS OF CHANGE: 20170313 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: American Renal Associates Holdings, Inc. CENTRAL INDEX KEY: 0001498068 STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-MISC HEALTH & ALLIED SERVICES, NEC [8090] IRS NUMBER: 272170749 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: AMERICAN RENAL HOLDINGS, INC. STREET 2: 500 CUMMINGS CENTER, SUITE 6550 CITY: BEVERLY STATE: MA ZIP: 01915 BUSINESS PHONE: 978-922-3080 MAIL ADDRESS: STREET 1: AMERICAN RENAL HOLDINGS, INC. STREET 2: 500 CUMMINGS CENTER, SUITE 6550 CITY: BEVERLY STATE: MA ZIP: 01915 FORMER COMPANY: FORMER CONFORMED NAME: C.P. Atlas Holdings, Inc. DATE OF NAME CHANGE: 20100802 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Costa Michael Ray CENTRAL INDEX KEY: 0001655689 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-37751 FILM NUMBER: 17686239 MAIL ADDRESS: STREET 1: C/O AMERICAN RENAL ASSOCIATES HOLDINGS STREET 2: 500 CUMMINGS CENTER CITY: BEVERLY STATE: MA ZIP: 01915 4 1 edgar.xml FORM 4 - X0306 4 2017-03-10 0 0001498068 American Renal Associates Holdings, Inc. ARA 0001655689 Costa Michael Ray C/O ARAH INC. 500 CUMMING CENTER, SUITE 6550 BEVERLY MA 01915 0 1 0 0 VP and General Counsel Common Stock 2017-03-10 4 A 0 7188 0 A 7188 D Common Stock 14000 I See Footnote Stock Option (Right to Buy Common Stock) 17.39 2017-03-10 4 A 0 12000 0 A 2027-03-10 Common Stock 12000 12000 I See Footnote Reflects grant of restricted stock that vests in three equal annual installments beginning on March 10, 2018. Securities held in trust for the benefit of the Reporting Person's family. The Reporting Person disclaims beneficial ownership of the shares held by such trusts, except to the extent of his pecuniary interest therein. The filing of this statement by the Reporting Person shall not be deemed to be an admission that, for purposes of Section 16 of the Securities Exchange Act of 1934 or otherwise, such Reporting Person is the beneficial owners of the securities reported therein. An option that vests in three equal annual installments beginning on March 10, 2018. /s/ Michael R. Costa, by power of attorney 2017-03-13