0001209191-18-021167.txt : 20180321
0001209191-18-021167.hdr.sgml : 20180321
20180321192055
ACCESSION NUMBER: 0001209191-18-021167
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 2
CONFORMED PERIOD OF REPORT: 20180309
FILED AS OF DATE: 20180321
DATE AS OF CHANGE: 20180321
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: GRAY PATRICK M.
CENTRAL INDEX KEY: 0001619328
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-36623
FILM NUMBER: 18705479
MAIL ADDRESS:
STREET 1: C/O CIVITAS SOLUTIONS, INC.
STREET 2: 313 CONGRESS STREET, 6TH FLOOR
CITY: BOSTON
STATE: MA
ZIP: 02210
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: Civitas Solutions, Inc.
CENTRAL INDEX KEY: 0001608638
STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-HOME HEALTH CARE SERVICES [8082]
IRS NUMBER: 651309110
STATE OF INCORPORATION: DE
FISCAL YEAR END: 0930
BUSINESS ADDRESS:
STREET 1: 313 CONGRESS STREET
STREET 2: 6TH FLOOR
CITY: BOSTON
STATE: MA
ZIP: 02210
BUSINESS PHONE: 617-790-4800
MAIL ADDRESS:
STREET 1: 313 CONGRESS STREET
STREET 2: 6TH FLOOR
CITY: BOSTON
STATE: MA
ZIP: 02210
FORMER COMPANY:
FORMER CONFORMED NAME: CIVITAS SOLUTIONS, INC.
DATE OF NAME CHANGE: 20140523
FORMER COMPANY:
FORMER CONFORMED NAME: NMH HOLDINGS, INC.
DATE OF NAME CHANGE: 20140520
4
1
doc4.xml
FORM 4 SUBMISSION
X0306
4
2018-03-09
0
0001608638
Civitas Solutions, Inc.
CIVI
0001619328
GRAY PATRICK M.
C/O CIVITAS SOLUTIONS, INC.
313 CONGRESS STREET
BOSTON
MA
02210
1
0
0
0
Common Stock
2018-03-09
4
A
0
7958
0.00
A
29393
D
Represents restricted stock units issued to the reporting person. The restricted stock units are subject to the terms and conditions of the Civitas Solutions, Inc. 2014 Omnibus Incentive Plan and will vest on March 9, 2019.
/s/ Gina L. Martin, by power of attorney
2018-03-21
EX-24.4_780121
2
poa.txt
POA DOCUMENT
March 20, 2018
POWER OF ATTORNEY
KNOW ALL BY THESE PRESENTS, that the undersigned hereby constitutes and appoints
each of Bruce F. Nardella, Denis M. Holler and Gina L. Martin, signing singly,
the undersigned's true and lawful attorney-in-fact to: (i) execute for and on
behalf of the undersigned, in the undersigned's capacity as an officer and/or
director and/or owner of greater than 10% of the outstanding Common Stock of
Civitas Solutions, Inc. (the "Company"), Forms 3, 4 and 5 (including any
amendments, supplements or exhibits thereto) in accordance with Section 16(a) of
the Securities Exchange Act of 1934, as amended (the "Exchange Act"), and the
rules thereunder, as well as Schedule 13D or Schedule 13G in accordance with
Section 13(d) of the Exchange Act and the rules thereunder and any amendments
thereto; (ii) 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 and Schedule 13D or 13G (including any amendments, supplements or
exhibits thereto) and timely file such forms with the United States Securities
and Exchange Commission and any stock exchange or similar authority, including
the New York Stock Exchange; and (iii) 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 Section 16 or Section 13(d) of the Exchange Act.
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 Schedule 13D or
Schedule 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.
[Remainder of page intentionally left blank.]
IN WITNESS WHEREOF, the undersigned has caused this Power of Attorney to be
executed as of date first written above.
By: /s/ Patrick M. Gray
Name: Patrick M. Gray