0000895930-16-000282.txt : 20161201 0000895930-16-000282.hdr.sgml : 20161201 20161201163337 ACCESSION NUMBER: 0000895930-16-000282 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20161201 FILED AS OF DATE: 20161201 DATE AS OF CHANGE: 20161201 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: AMSURG CORP CENTRAL INDEX KEY: 0000895930 STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-OFFICES & CLINICS OF DOCTORS OF MEDICINE [8011] IRS NUMBER: 621493316 STATE OF INCORPORATION: TN FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 1A BURTON HILLS BLVD. CITY: NASHVILLE STATE: TN ZIP: 37215 BUSINESS PHONE: 615-665-1283 MAIL ADDRESS: STREET 1: 1A BURTON HILLS BLVD. CITY: NASHVILLE STATE: TN ZIP: 37215 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Clendenin Phillip A CENTRAL INDEX KEY: 0001459541 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-36531 FILM NUMBER: 162028690 MAIL ADDRESS: STREET 1: 20 BURTON HILLS BOULEVARD CITY: NASHVILLE STATE: TN ZIP: 37215 4 1 wf-form4_148062800403886.xml FORM 4 X0306 4 2016-12-01 1 0000895930 AMSURG CORP AMSG 0001459541 Clendenin Phillip A 1A BURTON HILLS BLVD NASHVILLE TN 37215 0 1 0 0 President Ambulatory Services Common stock 2016-12-01 4 M 0 5018 0 A 52342 D Common stock 2016-12-01 4 D 0 52342 D 0 D Restricted stock units 2016-12-01 4 D 0 5018 0 D Common stock 5018.0 0 D Pursuant to the terms of the Agreement and Plan of Merger, dated as of June 15, 2016, by and among Envision Healthcare Holdings,Inc., New Amethyst Corp. and AmSurg Corp. (the "Merger Agreement"), at the Merger 1 Effective Time, a Change of Control, as defined in the AmSurg Corp. 2014 Equity and Incentive Plan (the "Plan") of AmSurg Corp. (the "Company"), occurred under the Plan. Under the Company's Performance Share Unit Award Agreement (the "Agreement") issued under the Plan, upon the occurrence of a Change of Control, the Performance Awards eligible to vest settle into shares of restricted stock at the Target Award, as defined in the Agreement. The Change of Control eliminates the performance aspect of the Performance Awards and such awards convert to restricted stock. Disposition pursuant to the terms of the Merger Agreement, exempt under Rule 16b-3. Pursuant to the terms of the Merger Agreement, at the Merger 1 Effective Time (as defined in the Merger Agreement), each share of common stock held by the reporting person immediately prior to the Merger 1 Effective Time was assumed by New Amethyst and converted into a New Amethyst share of common stock having the same terms and conditions, taking into account any changes thereto by reason of the Mergers (as defined in the Merger Agreement). /s/ Phillip A. Clendenin 2016-12-01