0001209191-11-039834.txt : 20110718 0001209191-11-039834.hdr.sgml : 20110718 20110718192533 ACCESSION NUMBER: 0001209191-11-039834 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20110414 FILED AS OF DATE: 20110718 DATE AS OF CHANGE: 20110718 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: INSITE VISION INC CENTRAL INDEX KEY: 0000802724 STANDARD INDUSTRIAL CLASSIFICATION: PHARMACEUTICAL PREPARATIONS [2834] IRS NUMBER: 943015807 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 965 ATLANTIC AVE STREET 2: -- CITY: ALAMEDA STATE: CA ZIP: 94501 BUSINESS PHONE: 5108658800 MAIL ADDRESS: STREET 1: 965 ATLANTIC AVE STREET 2: --- CITY: ALAMEDA STATE: CA ZIP: 94501 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Coliseum Capital Management, LLC CENTRAL INDEX KEY: 0001409751 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-22332 FILM NUMBER: 11973603 BUSINESS ADDRESS: STREET 1: 767 THIRD AVENUE STREET 2: 35TH FLOOR CITY: NEW YORK STATE: NY ZIP: 10017 BUSINESS PHONE: 212-488-5555 MAIL ADDRESS: STREET 1: 767 THIRD AVENUE STREET 2: 35TH FLOOR CITY: NEW YORK STATE: NY ZIP: 10017 4 1 c20021_4x0.xml MAIN DOCUMENT DESCRIPTION X0303 4 2011-04-14 0000802724 INSITE VISION INC INSV 0001409751 Coliseum Capital Management, LLC 767 THIRD AVENUE 35TH FLOOR NEW YORK NY 10017 0 0 1 0 Common Stock 2011-04-14 4 P 0 41200 0.91 A 9685673 I See Footnote Common Stock 2011-04-18 4 P 0 36050 0.89 A 9721723 I See Footnote Common Stock 2011-04-25 4 P 0 132815 0.80 A 9854538 I See Footnote Common Stock 2011-07-12 4 P 0 5000000 A 14854538 I See Footnote Common Stock Warrants (right to buy) 0.75 2011-07-12 4 P 0 2000000 A 2011-07-18 2016-07-18 Common Stock 2000000 2000000 I See Footnote These securities are held directly by (a) Coliseum Capital Partners, L.P., an investment limited partnership of which Coliseum Capital, LLC, a Delaware limited liability company ("CC"), is general partner and for which Coliseum Capital Management, LLC, a Delaware limited liability company ("CCM"), serves as investment adviser, and (b) Blackwell Partners, LLC ("Blackwell"), a separate account investment advisory client of CCM. Christopher Shackelton and Adam Gray manage CCM and CC. Each of Christopher Shackelton, Adam Gray, Blackwell, CCP, CC and CCM disclaims beneficial ownership of these securities except to the extent of that person's pecuniary interest therein. This transaction was executed in multiple trades at prices ranging from $0.88 to $0.92. The reported price reflects the weighted average purchase price. The Reporting Person filing this report hereby undertakes to provide upon request by the SEC staff, Insite Vision, Inc. or a shareholder of Insite Vision, Inc. full information regarding the number of shares purchased at each separate price. This transaction was executed in multiple trades at prices ranging from $0.87 to $0.92. The reported price reflects the weighted average purchase price. The Reporting Person filing this report hereby undertakes to provide upon request by the SEC staff, Insite Vision, Inc. or a shareholder of Insite Vision, Inc. full information regarding the number of shares purchased at each separate price. This transaction was executed in multiple trades at a price of $0.80. The reported price reflects the weighted average purchase price. The Reporting Person filing this report hereby undertakes to provide upon request by the SEC staff, Insite Vision, Inc. or a shareholder of Insite Vision, Inc. full information regarding the number of shares purchased at each separate price. On July 12, 2011, CCM purchased 5,000,000 unregistered shares of Common Stock and warrants to purchase 2,000,000 shares of Common Stock from the Issuer in a private placement transaction for a total purchase price of $3,000,000. /s/ Christopher Shackelton, Manager 2011-07-18