-----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, GzXRTebZgqL5sh4yDxDa+Z2N+J0KtBrik6f+nrhLyjyu5+MFb9I5Lgt1HuzCvgbG av40n0Vee8R6cDENI0jzXQ== 0000096313-04-000068.txt : 20040330 0000096313-04-000068.hdr.sgml : 20040330 20040330190721 ACCESSION NUMBER: 0000096313-04-000068 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 3 CONFORMED PERIOD OF REPORT: 20030623 FILED AS OF DATE: 20040330 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: LEWIS C RICHARD GST EXEMPT MARTIAL SUB TRUST CENTRAL INDEX KEY: 0001285143 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-25428 FILM NUMBER: 04703317 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: MARSHALL LEWIS KIM CENTRAL INDEX KEY: 0001285116 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-25428 FILM NUMBER: 04703315 MAIL ADDRESS: STREET 1: PO BOX 284 CITY: PROSPECT STATE: OR ZIP: 97536 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: MEADOW VALLEY CORP CENTRAL INDEX KEY: 0000934749 STANDARD INDUSTRIAL CLASSIFICATION: WATER, SEWER, PIPELINE, COMM AND POWER LINE CONSTRUCTION [1623] IRS NUMBER: 880328443 STATE OF INCORPORATION: NV FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 4411 S 40TH ST STREET 2: STE D-11 CITY: PHOENIX STATE: AZ ZIP: 85040 BUSINESS PHONE: 6024375400 MAIL ADDRESS: STREET 1: 4411 S 40TH ST STREET 2: STE D-11 CITY: PHOENIX STATE: AZ ZIP: 85040 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: LEWIS KIM A SURVIVORS TRUST UTA 09 24 1991 CENTRAL INDEX KEY: 0001282843 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-25428 FILM NUMBER: 04703316 BUSINESS ADDRESS: STREET 1: PO BOX 284 CITY: PROSPECT STATE: OR ZIP: 97536 BUSINESS PHONE: 5415603500 MAIL ADDRESS: STREET 1: PO BOX 284 CITY: PROSPECT STATE: OR ZIP: 97536 4 1 lewis304107_ex.xml X0201 4 2003-06-23 0 0000934749 MEADOW VALLEY CORP (MVCO) 0001282843 LEWIS KIM A SURVIVORS TRUST UTA 09 24 1991 PO BOX 284 PROSPECT OR 97536 0 0 1 0 0001285143 LEWIS C RICHARD GST EXEMPT MARTIAL SUB TRUST RICHARD C. LEWIS GST EXEMPT MARITAL SUB 630 BUTTE FALLS HIGHWAY PROSPECT OR 97536 0 0 0 1 Beneficial owner less than 10% 0001285116 MARSHALL LEWIS KIM KIM LEWIS MARSHALL 630 BUTTE FALLS HIGHWAY PROSPECT OR 97536 0 0 0 1 Beneficial owner less than 10% Common Stock, par value $0.001 2003-06-23 4 S 0 2000 1.12 D 411034 I by Trust These securities are owned solely by the Kim A. Lewis Survivors Trust, u/t/a dated 9/24/1991 ("Survivors Trust"), of which Kim Lewis Marshall is Trustee. The Survivors Trust may be deemed to be a member of a "group" with Kim Lewis Marshall and the Marital Trust (referred to below) for purposes of Section 13(d) of the Exchange Act. The Trustee may be deemed to be a beneficial owner of the shares because members of her family are the beneficiaries of the Survivors Trust. The Trustee disclaims beneficial ownership of all of the shares owned by the Survivors Trust in excess of her pecuniary interest, if any, in said Trust. (Continued Below) (Footnote 1 Continued) Does not include 66,666 shares owned solely by the Richard C. Lewis GST Exempt Marital Sub Trust, u/t/a dated 4/5/1994 ("Marital Trust"), of which Kim Lewis Marshall is Trustee. The Marital Trust may be deemed to be a member of a "group" with Kim Lewis Marshall and the Survivors Trust for purposes of Section 13(d) of the Exchange Act. The Trustee may be deemed to be a beneficial owner of the shares because members of her family are the beneficiaries of the Marital Trust. The Trustee disclaims beneficial ownership of all of the shares owned by the Marital Trust in excess of her pecuniary interest, if any, in said Trust. /s/Kim Lewis Marshall, Individually 2004-03-25 EX-99 3 lewis304107exh991.txt Exhibit 99.1 ------------ Form 4 Joint Filer Information Name: Kim A. Lewis Survivors Trust, u/t/a dated 9/24/1991 Address: 630 Butte Falls Highway Prospect, OR 97536 Designated Filer: Kim Lewis Marshall Issuer & Ticker Symbol: Meadow Valley Corp (MVCO) Date of Event: 06/23/03 Signature: /s/ Kim Lewis Marshall, as Trustee ----------------------------------- EX-99 4 lewis304107exh992.txt Exhibit 99.2 ------------ Form 4 Joint Filer Information Name: Richard C. Lewis GST Exempt Marital Sub Trust, u/t/a dated 4/5/94 Address: 630 Butte Falls Highway Prospect, OR 97536 Designated Filer: Kim Lewis Marshall Issuer & Ticker Symbol: Meadow Valley Corp (MVCO) Date of Event: 06/23/03 Signature: /s/ Kim Lewis Marshall, as Trustee ----------------------------------- -----END PRIVACY-ENHANCED MESSAGE-----