0001493152-19-016625.txt : 20191107 0001493152-19-016625.hdr.sgml : 20191107 20191107161533 ACCESSION NUMBER: 0001493152-19-016625 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20191105 FILED AS OF DATE: 20191107 DATE AS OF CHANGE: 20191107 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Nissensohn Carlos Jaime CENTRAL INDEX KEY: 0001745012 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-09047 FILM NUMBER: 191200517 MAIL ADDRESS: STREET 1: TRAVESA DE PRAIA 128 CITY: PRAIA DA LUZ STATE: S1 ZIP: 8600 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: Quest Solution, Inc. CENTRAL INDEX KEY: 0000278165 STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-COMPUTER INTEGRATED SYSTEMS DESIGN [7373] IRS NUMBER: 020314487 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 1865 WEST 2100 SOUTH CITY: SALT LAKE CITY STATE: UT ZIP: 84119 BUSINESS PHONE: 800-242-7272 MAIL ADDRESS: STREET 1: 1865 WEST 2100 SOUTH CITY: SALT LAKE CITY STATE: UT ZIP: 84119 FORMER COMPANY: FORMER CONFORMED NAME: AMERIGO ENERGY, INC. DATE OF NAME CHANGE: 20081112 FORMER COMPANY: FORMER CONFORMED NAME: STRATEGIC GAMING INVESTMENTS, INC. DATE OF NAME CHANGE: 20060501 FORMER COMPANY: FORMER CONFORMED NAME: LEFT RIGHT MARKETING TECHNOLOGY INC DATE OF NAME CHANGE: 20031002 4 1 ownership.xml X0306 4 2019-11-05 0 0000278165 Quest Solution, Inc. QUES 0001745012 Nissensohn Carlos Jaime C/O QUEST SOLUTION, INC. 1865 WEST 2100 SOUTH SALT LAKE CITY UT 84119 0 0 1 0 Common Stock 2019-11-05 4 A 0 317796 0 A 14586111 I See Footnote On October 5, 2018, Quest Solution, Inc. (the "Company") entered into a purchase agreement (the "Purchase Agreement") with Campbeltown Consulting, Ltd. ("Campbeltown"), Pursuant to the Purchase Agreement, the Company issued to Campbeltown a convertible promissory note with a principal amount of $700,000 and an interest rate of six percent (6%) per annum (the "Note"). Pursuant to the Note, Campbeltown may convert any and all accrued and unpaid principal and interest into shares of the Company's common stock at an exercise price of $0.236 per share (the "Exercise Price"). As of November 4, 2019, the accrued and unpaid balance under the Note was $150,000 (the "Balance"). On November 5, 2019, the Company and Campbeltown entered into a conversion agreement, pursuant to which Campbeltown agreed to convert $75,000 of the Balance at the Exercise Price and into 317,796 shares of the Company's common stock. The shares are held by Campbeltown Consulting Ltd., which is beneficially owned by Mr. Nissensohn. /s/ Carlos Jaime Nissensohn 2019-11-07