-----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, E0Ee7qJ5hqA3LEaAydJvgP19RlTE63/NYnmWLtLcJhdT4R/GBWq2tV3HLizYUbXi keQuH20X1Un64Opf+/m87Q== 0000950144-96-007499.txt : 19961104 0000950144-96-007499.hdr.sgml : 19961104 ACCESSION NUMBER: 0000950144-96-007499 CONFORMED SUBMISSION TYPE: 3 PUBLIC DOCUMENT COUNT: 1 FILED AS OF DATE: 19961101 SROS: NASD SUBJECT COMPANY: COMPANY DATA: COMPANY CONFORMED NAME: REPUBLIC INDUSTRIES INC CENTRAL INDEX KEY: 0000350698 STANDARD INDUSTRIAL CLASSIFICATION: REFUSE SYSTEMS [4953] IRS NUMBER: 731105145 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 3 SEC ACT: 1934 Act SEC FILE NUMBER: 000-09787 FILM NUMBER: 96652733 BUSINESS ADDRESS: STREET 1: 200 E LAS OLAS BLVD STREET 2: STE 1400 CITY: FT. LAUDERDALE STATE: FL ZIP: 33301 BUSINESS PHONE: 3057618333 MAIL ADDRESS: STREET 1: 200 EAST LAS OLAS BLVD STREET 2: SUITE 1400 CITY: FT. LAUDERDALE STATE: FL ZIP: 33301 FORMER COMPANY: FORMER CONFORMED NAME: REPUBLIC WASTE INDUSTRIES INC DATE OF NAME CHANGE: 19920703 FORMER COMPANY: FORMER CONFORMED NAME: REPUBLIC RESOURCES CORP DATE OF NAME CHANGE: 19900226 COMPANY DATA: COMPANY CONFORMED NAME: BERRARD STEVEN R CENTRAL INDEX KEY: 0001026212 STANDARD INDUSTRIAL CLASSIFICATION: [] DIRECTOR FILING VALUES: FORM TYPE: 3 BUSINESS ADDRESS: STREET 1: C/O REPUBLIC INDUSTRIES INC STREET 2: 200 EAST LAS OLAS BLVD CITY: FORT LAUDERDALE STATE: FL ZIP: 33301 BUSINESS PHONE: 9546276018 MAIL ADDRESS: STREET 1: C/O REPUBLIC INDUSTRIES INC STREET 2: 200 EAST LAS OLAS BLVD CITY: FORT LAUDERDALE STATE: FL ZIP: 33301 3 1 STEVEN BERRARD FORM 3-REPUBLIC INDUSTRIES, INC. 1 - -------- FORM 3 - -------- U.S. SECURITIES AND EXCHANGE COMMISSION WASHINGTON, DC 20549 INITIAL STATEMENT OF BENEFICIAL OWNERSHIP OF SECURITIES Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934, Section 17(a) of the Public Utility Holding Company Act of 1935 or Section 30(f) of the Investment Company Act of 1940 - ------------------------------------------------------------------------------------------------------------------------------------ 1. Name and Address of Reporting Person* 2. Date of Event Requiring 4. Issuer Name and Ticker or 6. If Amendment, Date Berrard, Steven R. Statement Trading Symbol of Original - ---------------------------------------- (Month/Day/Year) Republic Industries, Inc. (Month/Day/Year) (Last) (First) (Middle) 10/22/96 RWIN 100 Southeast 3rd Avenue, Ste. 1700 ---------------------------- ---------------------------------- ----------------------- - ---------------------------------------- 3. IRS or Social Security 5. Relationship of Reporting 7. Individual or Joint/ (Street) Number of Reporting Person(s) to Issuer Group Filing (Check Ft. Lauderdale FL 33394 Person (Voluntary) (Check all applicable) applicable line) - -------------------------------------- X Director 10% Owner X Form filed by (City) (State) (Zip) ---------------------------- ----- ----- ----- One Reporting X Officer Other Person ----- (give ----- (specify Form filed by title below) below) ----- More than One Co-Chief Executive Officer Reporting Person and President ---------------------------------- - ------------------------------------------------------------------------------------------------------------------------------------ USA TABLE 1 -- NON-DERIVATIVE SECURITIES BENEFICIALLY OWNED - ------------------------------------------------------------------------------------------------------------------------------------ 1. Title of Security 2. Amount of Securities 3. Ownership Form: 4. Nature of Indirect (Instr. 4) Beneficially Owned Direct (D) or Beneficial (Instr. 4) Indirect (I) Ownership (Instr. 5) (Instr. 5) - ------------------------------------------------------------------------------------------------------------------------------------ Common Stock -0- - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ *If the Form is filed by more than one Reporting Person, see Instruction 5(b)(v). Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly. (Over) (Print or Type Responses)
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FORM 3 (CONTINUED) TABLE II -- DERIVATIVE SECURITIES BENEFICIALLY OWNED (E.G., PUTS, CALLS, WARRANTS, OPTIONS, CONVERTIBLE SECURITIES) - ------------------------------------------------------------------------------------------------------------------------------------ 1. Title of Derivative Security 2. Date 3. Title and Amount of 4. Conver- 5. Owner- 6. Nature of Indirect (Instr. 4) Exercisable and Securities Underlying sion or ship Beneficial Ownership Expiration Date Derivative Security Exercise Form of (Instr. 5) (Month/Day/ (Instr. 4) Price of Deriv- Year) Deri- ative vative Security: Security ------------------------------------------------- Direct Date Expira- Amount or (D) or Exercis- tion Title Number Indirect (I) able Date of Shares (Instr. 5) - ------------------------------------------------------------------------------------------------------------------------------------ Common Stock Warrants (Right to Buy) Immed. 08/31/97 Common Stock 200,000 2.25 D - ------------------------------------------------------------------------------------------------------------------------------------ Common Stock Warrants (Right to Buy) Immed. 08/31/98 Common Stock 100,000 2.75 D - ------------------------------------------------------------------------------------------------------------------------------------ Common Stock Warrants (Right to Buy) Immed. 08/31/99 Common Stock 100,000 3.50 D - ------------------------------------------------------------------------------------------------------------------------------------ Common Stock Options (Right to Buy) (1) 05/8/06 Common Stock 428,572 17.50 D - ------------------------------------------------------------------------------------------------------------------------------------ Common Stock Options (Right to Buy) (2) 10/22/06 Common Stock 500,000 28.25 D - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ Explanation of Responses: /s/ Steven R. Berrard November 1, 1996 **Intentional misstatements or omissions of facts constitute Federal Criminal ------------------------------- ------------------- Violations. See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a). **Signature of Reporting Person Date Steven R. Berrard Note. File three copies of this Form, one of which must be manually signed. Page 2 If space provided is insufficient, See Instruction 6 for procedure. (Print or Type Responses)
(1) The options have been granted pursuant to the Amended and Restated 1995 Employee Stock Option Plan and have a term of ten years, expiring on 5/8/2006. The options are exercisable to the extent of 25% on each anniversary thereafter, commencing 5/8/1997, until fully vested. (2) The options have been granted pursuant to the Amended and Restated 1995 Employee Stock Option Plan and have a term of ten years, expiring on 10/22/2006. The options are exercisable to the extent of 25% on each anniversary thereafter, commencing 10/22/1997, until fully vested. -----END PRIVACY-ENHANCED MESSAGE-----