-----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, EqVEqJYaYjLaen+sjdG1cf1W4ikcL6MksieNmvDO1pe5/IZCIpOFVBW6L+1km4Ke eok3pcMALBezV8Ds9tcchw== 0001209191-06-056874.txt : 20061101 0001209191-06-056874.hdr.sgml : 20061101 20061101074601 ACCESSION NUMBER: 0001209191-06-056874 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20061101 FILED AS OF DATE: 20061101 DATE AS OF CHANGE: 20061101 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: CLARION TECHNOLOGIES INC/DE/ CENTRAL INDEX KEY: 0000835409 STANDARD INDUSTRIAL CLASSIFICATION: MOTOR VEHICLE PARTS & ACCESSORIES [3714] IRS NUMBER: 911407411 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 235 CENTRAL AVENUE CITY: HOLLAND STATE: MI ZIP: 49423 BUSINESS PHONE: 6164948885 MAIL ADDRESS: STREET 1: 1901 N ROSELLE RD STREET 2: STE 340 CITY: SCHAUMBURG STATE: IL ZIP: 60195 FORMER COMPANY: FORMER CONFORMED NAME: KAR VENTURES INC DATE OF NAME CHANGE: 19910310 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: WILBLAIRCO ASSOCIATES CENTRAL INDEX KEY: 0001212699 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-24690 FILM NUMBER: 061177125 MAIL ADDRESS: STREET 1: 222 W ADAMS ST CITY: CHICAGO STATE: IL ZIP: 60606 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: WALFISH MARC JAY CENTRAL INDEX KEY: 0001212698 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-24690 FILM NUMBER: 061177126 MAIL ADDRESS: STREET 1: 222 W ADAMS ST CITY: CHICAGO STATE: IL ZIP: 60606 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: MACKENZIE TIMOTHY JOHN CENTRAL INDEX KEY: 0001212695 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-24690 FILM NUMBER: 061177127 MAIL ADDRESS: STREET 1: 222 W ADAMS ST CITY: CHICAGO STATE: IL ZIP: 60606 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: SHIPP TERRANCE MICHAEL CENTRAL INDEX KEY: 0001212696 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-24690 FILM NUMBER: 061177128 MAIL ADDRESS: STREET 1: 222 W ADAMS ST CITY: CHICAGO STATE: IL ZIP: 60606 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: WILLIAM BLAIR MEZZANINE CAPITAL PARTNERS III LLC CENTRAL INDEX KEY: 0001261404 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-24690 FILM NUMBER: 061177129 BUSINESS ADDRESS: STREET 1: 222 WEST ADAMS ST CITY: CHICAGO STATE: IL ZIP: 60606 BUSINESS PHONE: 3123648847 MAIL ADDRESS: STREET 1: 222 WEST ADAMS ST CITY: CHICAGO STATE: IL ZIP: 60606 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: WILLIAM BLAIR MEZZANINE CAPITAL FUND III L P CENTRAL INDEX KEY: 0001095499 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-24690 FILM NUMBER: 061177130 BUSINESS ADDRESS: STREET 1: 222 WEST ADAMS ST CITY: CHICAGO STATE: IL ZIP: 60606 BUSINESS PHONE: 3123648787 MAIL ADDRESS: STREET 1: 222 WEST ADAMS STREET STREET 2: SUITE 2800 CITY: CHICAGO STATE: IL ZIP: 60606 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: BLAIR WILLIAM & CO/IL CENTRAL INDEX KEY: 0000902367 STATE OF INCORPORATION: IL FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-24690 FILM NUMBER: 061177131 BUSINESS ADDRESS: STREET 1: 222 WEST ADAMS ST STREET 2: 34TH FLOOR CITY: CHICAGO STATE: IL ZIP: 60606-5312 BUSINESS PHONE: 3122361600 MAIL ADDRESS: STREET 1: 222 WEST ADAMS CITY: CHICAGO STATE: IL ZIP: 60606 4 1 c09571-01wb.xml MAIN DOCUMENT DESCRIPTION X0202 4 2006-11-01 0000835409 CLARION TECHNOLOGIES INC/DE/ CLAR.OB 0001095499 WILLIAM BLAIR MEZZANINE CAPITAL FUND III L P 222 WEST ADAMS STREET SUITE 2100 CHICAGO IL 60606 0 0 1 0 0001261404 WILLIAM BLAIR MEZZANINE CAPITAL PARTNERS III LLC 222 WEST ADAMS STREET SUITE 2100 CHICAGO IL 60606 0 0 1 0 0001212696 SHIPP TERRANCE MICHAEL 222 WEST ADAMS STREET SUITE 2100 CHICAGO IL 60606 0 0 1 0 0001212695 MACKENZIE TIMOTHY JOHN 222 WEST ADAMS STREET SUITE 2100 CHICAGO IL 60606 0 0 1 0 0001212698 WALFISH MARC JAY 222 WEST ADAMS STREET SUITE 2100 CHICAGO IL 60606 0 0 1 0 0001212699 WILBLAIRCO ASSOCIATES 222 WEST ADAMS STREET SUITE 2100 CHICAGO IL 60606 0 0 1 0 0000902367 BLAIR WILLIAM & CO/IL 222 WEST ADAMS STREET SUITE 2100 CHICAGO IL 60606 0 0 1 0 Series A Convertible Preferred Stock 1.75 2006-11-01 4 A 0 547 A 2006-11-01 Common Stock 312568 547 I See Notes 4, 5 At any time and from time to time, holders of Series A Preferred Stock can convert such shares into shares of common stock of Clarion Technologies, Inc. by multiplying the number of shares to be converted by $1,000 and dividing that result by the conversion price then in effect, initially $1.75. The conversion price is subject to adjustment as a result of subdivisions or combinations of common stock, reorganizations, reclassifications, consolidations, mergers, sales of all or substantially all of Clarion Technologies, Inc.'s assets, or if Clarion Technologies, Inc., in certain circumstances, issues common stock at below fair market value prices. The holder of the Series A Preferred Stock may also convert accrued and unpaid dividends on such shares into a number of shares of common stock of Clarion Technologies, Inc. computed by dividing the amount of accrued and unpaid dividends by the conversion price then in effect. The Series A Preferred Stock is subject to mandatory redemption on June 30, 2007 and does not have an expiration date. Clarion Technologies, Inc. issued 547 shares of Series A Preferred Stock to William Blair Mezzanine Capital Fund III, L.P. as consideration for a loan made to Clarion Technologies, Inc. William Blair Mezzanine Capital Fund III, LP (the "Fund") owns the shares directly. William Blair Mezzanine Capital Partners III, L.L.C. ("Capital Partners") is the sole general partner of the Fund, and William Blair & Company, L.L.C. ("William Blair") and Wilblairco Associates ("Associates") are each members of the Fund. Timothy J. MacKenzie ("MacKenzie"), Terrance M. Shipp ("Shipp") and Marc J. Walfish ("Walfish") is each an Initial Managing Director of Capital Partners (Capital Partners, William Blair, Associates, MacKenzie, Shipp and Walfish are collectively referred to as the "Indirect Holders"). The Indirect Holders may, pursuant to Rule 16-1(a)(2)(ii)(B), be deemed to beneficially own the Series A Preferred Stock or the common stock issuable upon conversion of the Series A Preferred Stock. Each Indirect Holder disclaims beneficial ownership of such Series A Preferred Stock and common stock, except to the extent of its or his pecuniary interest therein. Each of MacKenzie, Shipp and Walfish may attend board meetings of Clarion Technologies, Inc. as a non-voting observer. William Blair Mezzanine Capital Fund III, LP, by /s/ Matthew O'Meara, Attorney-in-Fact 2006-11-01 William Blair Mezzanine Capital Partners III, L.L.C., by /s/ Matthew O'Meara, Attorney-in-Fact 2006-11-01 Terrance M. Shipp, by /s/ Matthew O'Meara, Attorney-in-Fact 2006-11-01 Timothy J. MacKenzie, by /s/ Matthew O'Meara, Attorney-in-Fact 2006-11-01 Marc J. Walfish, by /s/ Matthew O'Meara, Attorney-in-Fact 2006-11-01 Wilblairco Associates, by /s/ Matthew O'Meara, Attorney-in-Fact 2006-11-01 William Blair & Company, L.L.C., by /s/ Matthew O'Meara, Attorney-in-Fact 2006-11-01 -----END PRIVACY-ENHANCED MESSAGE-----