0001590503-17-000006.txt : 20170110
0001590503-17-000006.hdr.sgml : 20170110
20170110153401
ACCESSION NUMBER: 0001590503-17-000006
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20170109
FILED AS OF DATE: 20170110
DATE AS OF CHANGE: 20170110
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: Surgical Care Affiliates, Inc.
CENTRAL INDEX KEY: 0001411574
STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-SPECIALTY OUTPATIENT FACILITIES, NEC [8093]
IRS NUMBER: 000000000
STATE OF INCORPORATION: DE
FISCAL YEAR END: 1231
BUSINESS ADDRESS:
STREET 1: 510 LAKE COOK ROAD
STREET 2: SUITE 400
CITY: DEERFIELD
STATE: IL
ZIP: 60015
BUSINESS PHONE: 847-236-0921
MAIL ADDRESS:
STREET 1: 510 LAKE COOK ROAD
STREET 2: SUITE 400
CITY: DEERFIELD
STATE: IL
ZIP: 60015
FORMER COMPANY:
FORMER CONFORMED NAME: ASC Acquisition LLC
DATE OF NAME CHANGE: 20070905
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: HAYEK ANDREW P
CENTRAL INDEX KEY: 0001248908
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-36154
FILM NUMBER: 17520501
MAIL ADDRESS:
STREET 1: C/O SURGICAL CARE AFFILIATES, INC.
STREET 2: 520 LAKE COOK ROAD, SUITE 250
CITY: DEERFIELD
STATE: IL
ZIP: 60015
4
1
edgar.xml
PRIMARY DOCUMENT
X0306
4
2017-01-09
0001411574
Surgical Care Affiliates, Inc.
SCAI
0001248908
HAYEK ANDREW P
C/O SURGICAL CARE AFFILIATES, INC.
510 LAKE COOK ROAD, SUITE 400
DEERFIELD
IL
60015
1
1
0
0
Chief Executive Officer
Common Stock
2017-01-09
4
M
0
3124
11.18
A
278660
I
See Explanation of Responses
Common Stock
2017-01-09
4
S
0
3124
56.55
D
275536
I
See Explanation of Responses
Common Stock
22556
I
By Spouse of Reporting Person
Options to Purchase Common Stock
11.18
2017-01-09
4
M
0
3124
0
D
2020-03-24
Common Stock
3124
123721
I
See Explanation of Responses
Options to Purchase Common Stock
8.72
2020-03-24
Common Stock
43902
43902
I
See Explanation of Responses
Options to Purchase Common Stock
12.41
2023-05-06
Common Stock
182926
182926
I
See Explanation of Responses
Options to Purchase Common Stock
29.02
2024-09-17
Common Stock
135682
135682
I
See Explanation of Responses
Options to Purchase Common Stock
38.35
2025-06-04
Common Stock
102113
102113
I
See Explanation of Responses
Includes 230,436 shares of Common Stock underlying restricted stock units ("RSUs") of the issuer, all of which are subject to time-based vesting. As of the date hereof, 68,292 of the RSUs were vested and are settled on the earlier of the individual's termination of employment (as defined in the Surgical Care Affiliates, Inc. 2013 Omnibus Long-Term Incentive Plan, as amended) or a change in control of the issuer. The remaining RSUs vest on the following schedule and are settled on each applicable vesting date: 13,637 RSUs vesting on March 2, 2017, 19,068 RSUs vesting on June 4, 2017, 25,198 RSUs vesting on September 17, 2017, 13,636 RSUs vesting on March 2, 2018, 19,068 RSUs vesting on June 4, 2018, 25,198 RSUs vesting on September 17, 2018, 13,636 RSUs vesting on March 2, 2019, 19,067 RSUs vesting on June 4, 2019 and 13,636 RSUs vesting on March 2, 2020.
Mr. Hayek is the sole trustee of the Andrew Hayek 2008 Living Trust, which directly owns all of the securities reported on this line.
The sales reported in this Form 4 were effected pursuant to a Rule 10b5-1 trading plan.
This price represents the weighted average sale price (rounded to the nearest cent) for multiple transactions reported on this line. The prices of the transactions reported on this line ranged from $56.44 to $56.65. Upon request by the Commission staff, the issuer or a security holder of the issuer, the reporting person will undertake to provide full information regarding the number of shares sold at each separate price.
This line contains a combination of both time-based and performance-based options which, as of September 16, 2013, were fully vested.
All of the options are time-based options which, as of March 24, 2015, were fully vested.
The option provides for vesting in equal annual installments on May 6, 2014, May 6, 2015, May 6, 2016 and May 6, 2017.
The option provides for vesting in equal annual installments on September 17, 2015, September 17, 2016, September 17, 2017 and September 17, 2018.
The option provides for vesting in equal annual installments on June 4, 2016, June 4, 2017, June 4, 2018 and June 4, 2019.
/s/ Richard L. Sharff, Jr., by power of attorney
2017-01-10