0001179110-17-013350.txt : 20171018 0001179110-17-013350.hdr.sgml : 20171018 20171018162718 ACCESSION NUMBER: 0001179110-17-013350 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20171016 FILED AS OF DATE: 20171018 DATE AS OF CHANGE: 20171018 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Beaulieu David CENTRAL INDEX KEY: 0001673104 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-37787 FILM NUMBER: 171142883 MAIL ADDRESS: STREET 1: C/O COTIVITI HOLDINGS, INC. STREET 2: 115 PERIMETER CENTER PLACE, SUITE 700 CITY: ATLANTA STATE: GA ZIP: 30346 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 4 1 edgar.xml FORM 4 - X0306 4 2017-10-16 0 0001657197 Cotiviti Holdings, Inc. COTV 0001673104 Beaulieu David C/O COTIVITI HOLDINGS, INC. 115 PERIMETER CENTER PLACE, SUITE 700 ATLANTA GA 30346 0 1 0 0 SVP and COO Common Stock, par value $0.001 2017-10-16 4 M 0 5000 11.33 A 43133 D Common Stock, par value $0.001 2017-10-16 4 S 0 5000 35.00 D 38133 D Options (right to buy) 11.33 2017-10-16 4 M 0 5000 0 D 2024-09-26 Common Stock, par value $0.001 5000 141400 D The sales reported in this Form 4 were effected pursuant to a 10b5-1 trading plan adopted by the Reporting Person on August 25, 2017. 87,840 of these options had vested as of September 26, 2017. The remaining 58,560 options vest and become exercisable in equal annual installments of 50% of the shares on September 26, 2018, and September 26, 2019, subject to the Reporting Person's continued service through each applicable vesting date. /s/ Jonathan Olefson, attorney-in-fact 2017-10-18