0001179110-18-001485.txt : 20180205 0001179110-18-001485.hdr.sgml : 20180205 20180205162219 ACCESSION NUMBER: 0001179110-18-001485 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20180201 FILED AS OF DATE: 20180205 DATE AS OF CHANGE: 20180205 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: 18574461 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 2018-02-01 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 per share 2018-02-01 4 M 0 1817 A 39950 D Common Stock, par value $0.001 per share 2018-02-01 4 F 0 525 34.70 D 39425 D Options (right to buy) 34.70 2018-02-01 4 A 0 50927 34.70 A 2028-02-01 Common Stock, par value $0.001 50927 50927 D Restricted Stock Units 2018-02-01 4 A 0 20371 0 A Common Stock, par value $0.001 20371 20371 D Restricted Stock Units 2018-02-01 4 M 0 1817 0 D Common Stock, par value $0.001 1817 5453 D Restricted Stock Units convert into Common Stock on a one-for-one basis. These options vest and become exercisable in equal annual installments of 25% of the shares over a 4-year period on each anniversary date of the grant, February 1, 2018, subject to the Reporting Person's continued service through each applicable vesting date. Each Restricted Stock Unit represents the right to receive, at settlement, one (1) share of common stock, par value $0.001 per share. The Restricted Stock Units vest in equal annual installments of 25% of the shares over a 4-year period on each anniversary date of the grant, February 1, 2018, subject to the Reporting Person's continued service through each applicable vesting date. On February 1, 2017, the Reporting Person was granted 7,270 Restricted Stock Units, vesting in equal annual installments of 25% over a 4-year period on each anniversary date of the date of the grant, subject to the Reporting Person's continued service through each applicable vesting date. /s/ Jonathan Olefson, attorney-in-fact 2018-02-05