0001104659-22-066699.txt : 20220531
0001104659-22-066699.hdr.sgml : 20220531
20220531180201
ACCESSION NUMBER: 0001104659-22-066699
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: WILLIAMS MICHAEL BRADLEY
CENTRAL INDEX KEY: 0001912103
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-40147
FILM NUMBER: 22985004
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
tm2217357-3_4seq1.xml
OWNERSHIP DOCUMENT
X0306
4
2022-05-26
0
0001839412
QualTek Services Inc.
QTEK
0001912103
WILLIAMS MICHAEL BRADLEY
C/O QUALTEK SERVICES INC.
475 SENTRY PARKWAY E, SUITE 200
BLUE BELL
PA
19422
0
1
0
0
Chief Business Officer
Employee Stock Option
7.50
2022-05-26
4
A
0
250000
0
A
2032-05-26
Class A Common Stock
250000
250000
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/ Michael Williams
2022-05-31