0001104659-22-066697.txt : 20220531 0001104659-22-066697.hdr.sgml : 20220531 20220531180103 ACCESSION NUMBER: 0001104659-22-066697 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20220526 FILED AS OF DATE: 20220531 DATE AS OF CHANGE: 20220531 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: SPITTLER ADAM PAUL CENTRAL INDEX KEY: 0001910657 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-40147 FILM NUMBER: 22985000 MAIL ADDRESS: STREET 1: C/O QUALTEK SERVICES INC. STREET 2: 475 SENTRY PARKWAY E, SUITE 200 CITY: BLUE BELL STATE: PA ZIP: 19422 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: QualTek Services Inc. CENTRAL INDEX KEY: 0001839412 STANDARD INDUSTRIAL CLASSIFICATION: WATER, SEWER, PIPELINE, COMM AND POWER LINE CONSTRUCTION [1623] IRS NUMBER: 000000000 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 888 SAN CLEMENTE DRIVE, SUITE 400 CITY: NEWPORT BEACH STATE: CA ZIP: 92660 BUSINESS PHONE: 949-887-0331 MAIL ADDRESS: STREET 1: 888 SAN CLEMENTE DRIVE, SUITE 400 CITY: NEWPORT BEACH STATE: CA ZIP: 92660 FORMER COMPANY: FORMER CONFORMED NAME: Roth CH Acquisition III Co DATE OF NAME CHANGE: 20210107 4 1 tm2217357-2_4seq1.xml OWNERSHIP DOCUMENT X0306 4 2022-05-26 0 0001839412 QualTek Services Inc. QTEK 0001910657 SPITTLER ADAM PAUL C/O QUALTEK SERVICES INC. 475 SENTRY PARKWAY E, SUITE 200 BLUE BELL PA 19422 0 1 0 0 Chief Financial Officer Employee Stock Option 7.50 2022-05-26 4 A 0 350000 0 A 2032-05-26 Class A Common Stock 350000 350000 D The option vests as follows: 12.5% on the date of grant, 12.5% on February 14, 2023, and 25% on February 14, 2024, February 14, 2025 and February 14, 2026. /s/ Adam Spittler 2022-05-31