0001213900-21-029697.txt : 20210527
0001213900-21-029697.hdr.sgml : 20210527
20210527183114
ACCESSION NUMBER: 0001213900-21-029697
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20210527
FILED AS OF DATE: 20210527
DATE AS OF CHANGE: 20210527
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Haubenreich Adam G.
CENTRAL INDEX KEY: 0001852510
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-38186
FILM NUMBER: 21974835
MAIL ADDRESS:
STREET 1: C/O NESCO HOLDINGS, INC.
STREET 2: 6714 POINTE INVERNESS WAY, SUITE 220
CITY: FORT WAYNE
STATE: IN
ZIP: 46804
FORMER NAME:
FORMER CONFORMED NAME: Haubenreich Adam P.
DATE OF NAME CHANGE: 20210322
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: Custom Truck One Source, Inc.
CENTRAL INDEX KEY: 0001709682
STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-EQUIPMENT RENTAL & LEASING, NEC [7359]
IRS NUMBER: 000000000
STATE OF INCORPORATION: DE
FISCAL YEAR END: 1231
BUSINESS ADDRESS:
STREET 1: 7701 INDEPENDENCE AVENUE
CITY: KANSAS CITY
STATE: MO
ZIP: 64125
BUSINESS PHONE: (816) 241-4888
MAIL ADDRESS:
STREET 1: 7701 INDEPENDENCE AVENUE
CITY: KANSAS CITY
STATE: MO
ZIP: 64125
FORMER COMPANY:
FORMER CONFORMED NAME: NESCO HOLDINGS, INC.
DATE OF NAME CHANGE: 20190730
FORMER COMPANY:
FORMER CONFORMED NAME: Capitol Investment Corp. IV
DATE OF NAME CHANGE: 20170619
4
1
ownership.xml
X0306
4
2021-05-27
0
0001709682
Custom Truck One Source, Inc.
CTOS
0001852510
Haubenreich Adam G.
7701 INDEPENDENCE AVE
KANSAS CITY
MO
64125
0
1
0
0
VP and General Counsel
Restricted Stock Unit
2021-05-27
4
A
0
62500
0
A
Common Stock
62500
62500
D
Performance Stock Unit
2021-05-27
4
A
0
62500
0
A
Common Stock
62500
62500
D
Each restricted stock unit represents a contingent right to receive one share of the Issuer's common stock.
The restricted stock units vest in four equal annual installments beginning on April 1, 2022.
Each performance stock unit represents a contingent right to receive one share of the Issuer's common stock. The performance stock units will vest if the volume weighted average price per share of the Issuer's common stock achieves certain thresholds over the performance period ending December 31, 2024.
By: /s/ Adam Haubenreich, Attorney-in-fact
2021-05-27