-----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, RcPxmYLV5XUuWQKLPAJCAKf/oVH/ucFnFS05eqqxHLyyrcQntV47u4naoefaJUT9 DMVg5/5hY5w8o8lqtY/SSQ== 0000914427-02-000040.txt : 20020414 0000914427-02-000040.hdr.sgml : 20020414 ACCESSION NUMBER: 0000914427-02-000040 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20020131 FILED AS OF DATE: 20020211 SUBJECT COMPANY: COMPANY DATA: COMPANY CONFORMED NAME: COTT CORP /CN/ CENTRAL INDEX KEY: 0000884713 STANDARD INDUSTRIAL CLASSIFICATION: BOTTLED & CANNED SOFT DRINKS CARBONATED WATERS [2086] IRS NUMBER: 000000000 FISCAL YEAR END: 0125 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-19914 FILM NUMBER: 02534219 BUSINESS ADDRESS: STREET 1: 207 QUEENS QUAY W STREET 2: SUITE 340 CITY: TORONTO ONTARIO CANA STATE: A6 ZIP: 00000 BUSINESS PHONE: 4162033898 MAIL ADDRESS: STREET 1: 207 QUEENS QUAY W STREET 2: SUITE 340 CITY: TORONTO ONTARIO STATE: A6 ZIP: 00000 COMPANY DATA: COMPANY CONFORMED NAME: HAGERTY THOMAS M CENTRAL INDEX KEY: 0001058835 DIRECTOR STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 4 BUSINESS ADDRESS: STREET 1: THOMAS H LEE CO STREET 2: 75 STATE STREET CITY: BOSTON STATE: MA ZIP: 02109 4 1 hag4.txt FORM 4 U.S. SECURITIES AND EXCHANGE COMMISSION Washington, DC 20549 FORM 4 STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP 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 [_] Check box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b). - -------------------------------------------------------------------------------- 1. Name and Address of Reporting Person* Hagerty Thomas M. - -------------------------------------------------------------------------------- (Last) (First) (Middle) c/o Thomas H. Lee Company 75 State Street - -------------------------------------------------------------------------------- (Street) Boston MA 02109 - -------------------------------------------------------------------------------- (City) (State) (Zip) - -------------------------------------------------------------------------------- 2. Issuer Name and Ticker or Trading Symbol Cott Corporation (COTT) - -------------------------------------------------------------------------------- 3. IRS Identification Number of Reporting Person, if an Entity (Voluntary) - -------------------------------------------------------------------------------- 4. Statement for Month/Year January 2002 - -------------------------------------------------------------------------------- 5. If Amendment, Date of Original (Month/Year) - -------------------------------------------------------------------------------- 6. Relationship of Reporting Person to Issuer (Check all applicable) [X] Director [_] 10% Owner [ ] Officer (give title below) [_] Other (specify below) - -------------------------------------------------------------------------------- 7. Individual or Joint/Group Filing (Check applicable line) [X] Form filed by one Reporting Person [_] Form filed by more than one Reporting Person - -------------------------------------------------------------------------------- ================================================================================ Table I -- Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned ================================================================================
6. 4. 5. Owner- Securities Acquired (A) or Amount of ship 3. Disposed of (D) Securities Form: 7. Transaction (Instr. 3, 4 and 5) Beneficially Direct Nature of 2. Code ------------------------------- Owned at End (D) or Indirect 1. Transaction (Instr. 8) (A) of Month Indirect Beneficial Title of Security Date ------------ Amount or Price (Instr. 3 (I) Ownership (Instr. 3) (mm/dd/yy) Code V (D) and 4) (Instr.4) (Instr. 4) - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ ====================================================================================================================================
* ____ If the Form is filed by more than one Reporting Person, see Instruction 4(b)(v). Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly. (Print or Type Response) (Over) FORM 4 (continued) Table II -- Derivative Securities Acquired, Disposed of, or Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities) ================================================================================
10. 9. Owner- Number ship of Form 2. Deriv- of Conver- 5. 7. ative Deriv- 11. sion Number of Title and Amount Secur- ative Nature or Derivative 6. of Underlying 8. ities Secur- of Exer- 4. Securities Date Securities Price Bene- ity: In- cise 3. Trans- Acquired (A) Exercisable and (Instr. 3 and 4) of ficially Direct direct Price Trans- action or Disposed Expiration Date ---------------- Deriv- Owned (D) or Bene- 1. of action Code of(D) (Month/Day/Year) Amount ative at End In- ficial Title of Deriv- Date (Instr. (Instr. 3, ---------------- or Secur- of direct Owner- Derivative ative (Month/ 8) 4 and 5) Date Expira- Number ity Month (I) ship Security Secur- Day/ ------ ------------ Exer- tion of (Instr. (Instr. (Instr. (Instr. (Instr. 3) ity Year) Code V (A) (D) cisable Date Title Shares 5) 4) 4) 4) - ------------------------------------------------------------------------------------------------------------------------------------ Stock Option (right to buy) $14.50(1) 1/14/02 A 5,000 1/14/02 1/14/09 Common 5,000 5,000 D - ------------------------------------------------------------------------------------------------------------------------------------ Convertible Participating Voting Second Preferred Shares, Series I (7) Common 4,926,599 I(2)(6) - ------------------------------------------------------------------------------------------------------------------------------------ Convertible Participating Voting Second Preferred Shares, Series I (7) Common 170,646 I(3)(6) - ------------------------------------------------------------------------------------------------------------------------------------ Convertible Participating Voting Second Preferred Shares, Series I (7) Common 479,602 I(4)(6) - ------------------------------------------------------------------------------------------------------------------------------------ Convertible Participating Voting Second Preferred Shares, Series I (7) Common 133,397 I(5)(6) - ------------------------------------------------------------------------------------------------------------------------------------ ==================================================================================================================================== Explanation of Responses:
(1) The actual exercise price of option is $Cdn 23.15/share. The United States dollar equivalent exercise price per share was calculated assuming an exchange ratio of $0.6263 United States dollars per Canadian dollar, the exchange ratio quoted in the Wall Street Journal on February 5, 2002. (2) Represents shares owned by Thomas H. Lee Equity Fund IV, L.P. While the number of shares of Convertible Participating Voting Second Preferred Shares, Series I owned by such entity has not changed, the number of shares of Common Stock into which such shares of Convertible Participating Voting Second Preferred Shares, Series I are convertible has increased with the passage of time and will continue to do so until July 2002. (3) Represents shares owned by Thomas H. Lee Foreign Fund IV, L.P. While the number of shares of Convertible Participating Voting Second Preferred Shares, Series I owned by such entity has not changed, the number of shares of Common Stock into which such shares of Convertible Participating Voting Second Preferred Shares, Series I are convertible has increased with the passage of time and will continue to do so until July 2002. (4) Represents shares owned by Thomas H. Lee Foreign Fund IV-B, L.P. While the number of shares of Convertible Participating Voting Second Preferred Shares, Series I owned by such entity has not changed, the number of shares of Common Stock into which such shares of Convertible Participating Voting Second Preferred Shares, Series I are convertible has increased with the passage of time and will continue to do so until July 2002. (5) Represents shares owned by Thomas H. Lee THL-Coinvestors III-B, LLC. While the number of shares of Convertible Participating Voting Second Preferred Shares, Series I owned by such entity has not changed, the number of shares of Common Stock into which such shares of Convertible Participating Voting Second Preferred Shares, Series I are convertible has increased with the passage of time and will continue to do so until July 2002. (6) The Reporting Person disclaims beneficial ownership of such shares except to the extent of his pecuniary interest in the entity. (7) Subject to anti-dilution and other adjustments, including an increase in the number of shares of Common Stock into which each share of Convertible Participating Voting Second Preferred Shares, Series I is convertible with the passage of time. Each share of Convertible Participating Voting Second Preferred Shares, Series I is currently convertible into approximately 1.54 shares of Common Stock. /s/ Thomas M. Hagerty Feb. 8, 2002 - --------------------------------------------- ----------------------- **Signature of Reporting Person Date ** _____ Intentional misstatements or omissions of facts constitute Federal Criminal Violations. See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a). Note: File three copies of this Form, one of which must be manually signed. If space provided is insufficient, see Instruction 6 for procedure. -----END PRIVACY-ENHANCED MESSAGE-----