0001247524-15-000137.txt : 20150403 0001247524-15-000137.hdr.sgml : 20150403 20150403171417 ACCESSION NUMBER: 0001247524-15-000137 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20150401 FILED AS OF DATE: 20150403 DATE AS OF CHANGE: 20150403 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: 520 LAKE COOK ROAD STREET 2: SUITE 250 CITY: DEERFIELD STATE: IL ZIP: 60015 BUSINESS PHONE: 847-236-0921 MAIL ADDRESS: STREET 1: 520 LAKE COOK ROAD STREET 2: SUITE 250 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: Mansukani Sharad CENTRAL INDEX KEY: 0001402190 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-36154 FILM NUMBER: 15751912 BUSINESS ADDRESS: BUSINESS PHONE: (847) 236-0921 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 2015-04-01 0001411574 Surgical Care Affiliates, Inc. SCAI 0001402190 Mansukani Sharad C/O SURGICAL CARE AFFILIATES, INC., 520 LAKE COOK ROAD, SUITE 250 DEERFIELD IL 60015 1 0 0 0 Common Stock 2015-04-01 4 M 0 70496 10.25 A 76868 D Common Stock 2015-04-01 4 S 0 70496 32.0031 D 6372 D Options to Purchase Common Stock 10.25 2015-04-01 4 M 0 70496 0 D 2015-06-24 Common Stock 70496 0 D Options to Purchase Common Stock 12.10 2021-08-01 Common Stock 9921 9921 D Includes 6,372 shares of Common Stock underlying Restricted Stock Units ("RSUs") of the issuer. All of the RSUs are subject to time-based vesting. As of April 1, 2015, 3,027 of the RSUs were vested, with the remaining RSUs vesting on the following schedule: 1,168 RSUs vesting on June 30, 2015, 1,009 RSUs vesting on July 1, 2015, and 1,168 RSUs vesting on June 30, 2016. Each vested RSU is settled on the earlier of the individual's termination of employment or a change in control. The price of $32.003125 represents the public offering price of $33.25 per share of Common Stock less the underwriters' discount of $1.246875 per share of Common Stock. The options became vested as to all of the shares of Common Stock underlying such options on June 29, 2010 and became exercisable on September 16, 2013. The options became vested as to all of the shares of Common Stock underlying such options on June 29, 2012 and became exercisable on September 16, 2013. /s/ Peter J. Clemens, IV, by power of attorney 2015-04-03