-----BEGIN PRIVACY-ENHANCED MESSAGE----- Proc-Type: 2001,MIC-CLEAR Originator-Name: webmaster@www.sec.gov Originator-Key-Asymmetric: MFgwCgYEVQgBAQICAf8DSgAwRwJAW2sNKK9AVtBzYZmr6aGjlWyK3XmZv3dTINen TWSM7vrzLADbmYQaionwg5sDW3P6oaM5D3tdezXMm7z1T+B+twIDAQAB MIC-Info: RSA-MD5,RSA, VPp1FrYDabrWxMdKeeMbRnz85/hDqrSEfuATWsvQJIfqPZdbu+nZGKTDAZMUj1vu Dli5X+8hhVoq+9VqKyp/DQ== 0000021212-03-000060.txt : 20031001 0000021212-03-000060.hdr.sgml : 20031001 20031001170547 ACCESSION NUMBER: 0000021212-03-000060 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 2 CONFORMED PERIOD OF REPORT: 20030930 FILED AS OF DATE: 20031001 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: LAVERS RICHARD M CENTRAL INDEX KEY: 0001215511 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-07160 FILM NUMBER: 03921389 BUSINESS ADDRESS: STREET 1: P O BOX 3300 CITY: ELKHART STATE: IN ZIP: 465153300 MAIL ADDRESS: STREET 1: P O BOX 3300 CITY: ELKHART STATE: IN ZIP: 465153300 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: COACHMEN INDUSTRIES INC CENTRAL INDEX KEY: 0000021212 STANDARD INDUSTRIAL CLASSIFICATION: MOTOR HOMES [3716] IRS NUMBER: 351101097 STATE OF INCORPORATION: IN FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 2831 DEXTER DR CITY: ELKHART STATE: IN ZIP: 46514 BUSINESS PHONE: 2192620123 MAIL ADDRESS: STREET 1: 2831 DEXTER DR CITY: ELKHART STATE: IN ZIP: 46514 4 1 lav450.xml X0201 4 2003-09-30 0 0000021212 COACHMEN INDUSTRIES INC COA 0001215511 LAVERS RICHARD M P O BOX 3300 ELKHART IN 46515 0 1 0 0 EVP, Sec'y & General Counsel Common Stock 2003-09-30 4 A 0 63.3238 0 A 11150.3462 D Common Stock 237.0000 I By 401(k) Stock Units 0.00 2003-09-30 4 A 0 146.7661 0 A 1988-08-08 1988-08-08 Common Stock 146.7661 1915.2352 I By Deferred Compensation Plan Stock Option (Right to Buy) 24.88 2000-01-28 2004-01-28 Common Stock 2000.0000 2000.0000 D Stock Option (Right to Buy) 18.81 2000-04-29 2004-04-29 Common Stock 2000.0000 2000.0000 D Stock Option (Right to Buy) 14.50 2000-11-03 2004-11-03 Common Stock 3000.0000 3000.0000 D Stock Option (Right to Buy) 10.00 2001-10-06 2010-10-06 Common Stock 36000.0000 36000.0000 D Stock Option (Right to Buy) 16.50 2003-02-19 2012-02-19 Common Stock 5500.0000 5500.0000 D Stock Option (Right to Buy) 11.18 2004-03-28 2013-03-28 Common Stock 1600.0000 1600.0000 D Shares acquired under the Coachmen Employee Stock Purchase Plan as of September 30, 2003 quarterly purchase Based on shares reported as of October 1, 2003. The stock units represent amounts deferred and employer matching contributions accrued under the Coachmen Industries, Inc. Deferred Compensation Plan. Stock units representing employer matching contributions vest in 5 years (subject to acceleration upon certain events) and are payable following the termination of employment or a change in control, subject to forfetiture if certain post-employment covenants are breached. Stock units representing 50% of the employer matching contributions are payable in common stock (subject to certain diversification rights) and the remainder of stock units are payable in common stock or cash at the reporting person's election. Stock units representing amounts deferred by the reporting person are payable upon termination of employment. Direct holdings in Table I, column 5 include 13.860 shares acquired on Sept. 18, 2003 under the Coachmen Industries, Inc. Dividend Reinvestment Plan. 401(k) holdings based on September 30, 2003 statement. By: Melanie A. DeMorrow as Attorney-in-fact 2003-10-01 EX-24 3 powerofattorney.txt POWER OF ATTORNEY Power of Attorney Know all by these presents, that the undersigned (the "Reporting Person") hereby constitutes and appoints each of Melanie A. DeMorrow, Assistant Vice President-Shareholder Relations; Richard M. Lavers, Secretary; Joseph P. Tomczak, Executive Vice President & C.F.O.; Ellen C. Padesky, Assistant Secretary; and Jessica L. Long, Assistant Secretary, signing singly, as the Reporting Person's true and lawful attorney-in-fact, to: (1) execute for and on behalf of the Reporting Person, in the Reporting Person's capacity as an officer or trustee of Coachmen Industries, Inc. (the "Company"), Forms 3, 4, and 5 and such other similar forms as may be required for filing in accordance with Section 16(a) of the Securities Exchange Act of 1934, or the Sarbanes-Oxley Act of 2002, and the rules thereunder; (2) do and perform all acts for and on behalf of the Reporting Person which may be necessary or desirable to complete and execute any such forms and timely file such forms with the United States Securities and Exchange Commission and any stock exchange or similar authority or other federal agency; and (3) take any other action of any type whatsoever in connection with the foregoing which, in the opinion of such attorney-in-fact, may be of benefit to, and in the best interest of, or legally required by, the Reporting Person. The Reporting Person hereby grants to each such attorney-in-fact full power and authority to do and perform any and every act and thing whatsoever requisite, necessary, or proper to be done in the exercise of any of the rights and powers herein granted, as fully to all intents and purposes as the Reporting Person might or could do if personally present, with full power of substitution or revocation, hereby ratifying and confirming all that such attorney-in-fact, or such attorney-in-facts substitute or substitutes, shall lawfully do or cause to be done by the virtue of this Power of Attorney and the rights and powers herein granted. The Reporting Person acknowledges that the foregoing attorneys-in fact, in serving in such capacity at the request of the Reporting Person, are not assuming, nor is the company assuming, any of the Reporting Persons responsibilities to comply with any of the above specified laws or regulations. This Power of Attorney shall remain in full force and effect until the Reporting Person is no longer required to file such forms with respect to the Reporting Person's holdings of and transactions in securities issued by the Company, unless earlier revoked by the Reporting Person in a signed writing delivered to the Secretary of the Company. IN WITNESS WHEREOF, the Reporting Person has caused this Power of Attorney to be executed as of this 9th day of July, 2003. s/Joseph P. Tomczak -----END PRIVACY-ENHANCED MESSAGE-----