0001659166-21-000170.txt : 20210610 0001659166-21-000170.hdr.sgml : 20210610 20210610171014 ACCESSION NUMBER: 0001659166-21-000170 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20210608 FILED AS OF DATE: 20210610 DATE AS OF CHANGE: 20210610 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Hayes Rejji P CENTRAL INDEX KEY: 0001611961 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-37654 FILM NUMBER: 211008915 MAIL ADDRESS: STREET 1: ONE ENERGY PLAZA CITY: JACKSON STATE: MI ZIP: 49201 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: Fortive Corp CENTRAL INDEX KEY: 0001659166 STANDARD INDUSTRIAL CLASSIFICATION: INDUSTRIAL INSTRUMENTS FOR MEASUREMENT, DISPLAY, AND CONTROL [3823] IRS NUMBER: 000000000 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 6920 SEAWAY BLVD. CITY: EVERETT STATE: WA ZIP: 98203 BUSINESS PHONE: (425) 446-5000 MAIL ADDRESS: STREET 1: 6920 SEAWAY BLVD. CITY: EVERETT STATE: WA ZIP: 98203 FORMER COMPANY: FORMER CONFORMED NAME: TGA Holding Corp. DATE OF NAME CHANGE: 20151123 4 1 wf-form4_162335939627652.xml FORM 4 X0306 4 2021-06-08 0 0001659166 Fortive Corp FTV 0001611961 Hayes Rejji P 6920 SEAWAY BLVD EVERETT WA 98203 1 0 0 0 Common Stock 2021-06-08 4 A 0 2525 0 A 3150 D Common Stock 2021-06-08 4 A 0 1965 71.37 A 5115 D On June 8, 2021, the Issuer granted to the Reporting Person restricted stock units ("Annual Grant RSUs") of the Issuer in the amount indicated as the annual equity grant made to the Reporting Person. Since the Annual Grant RSUs are payable solely in common stock, they are being reported in Table I of this Form 4. The Annual Grant RSUs vest on the earlier of the first anniversary of the grant date or the date of the Issuer's 2022 annual meeting of the stockholders, but the underlying shares will not be issued until the earlier of the Reporting Person's death or the first anniversary of the grant date following the Reporting Person's retirement from the Board of Directors of the Issuer. On June 8, 2021, the Issuer granted to the Reporting Person restricted stock units ("Deferral RSUs") of the Issuer in the amount indicated, based on a 20-day average price of $71.37, pursuant to deferral election made by the Reporting Person of $140,000 in annual retainer that would otherwise have been paid in cash. Since the Deferral RSUs are payable solely in common stock, they are being reported in Table I of this Form 4. The Deferral RSUs vest on the earlier of the first anniversary of the grant date or the date of the Issuer's 2022 annual meeting of the stockholders, but the underlying shares will not be issued until the earlier of the Reporting Person's death or the first day of the seventh month following the Reporting Person's retirement from the Board of Directors of the Issuer. Daniel B. Kim, attorney-in-fact 2021-06-10