0001513965-15-000105.txt : 20150915 0001513965-15-000105.hdr.sgml : 20150915 20150915162834 ACCESSION NUMBER: 0001513965-15-000105 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20150915 FILED AS OF DATE: 20150915 DATE AS OF CHANGE: 20150915 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: American Midstream Partners, LP CENTRAL INDEX KEY: 0001513965 STANDARD INDUSTRIAL CLASSIFICATION: NATURAL GAS TRANSMISSION [4922] IRS NUMBER: 270855785 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 1400 16TH STREET STREET 2: SUITE 310 CITY: DENVER STATE: CO ZIP: 80202 BUSINESS PHONE: (720) 457-6060 MAIL ADDRESS: STREET 1: 1400 16TH STREET STREET 2: SUITE 310 CITY: DENVER STATE: CO ZIP: 80202 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Sullivan Kevin J. CENTRAL INDEX KEY: 0001625982 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-35257 FILM NUMBER: 151108005 MAIL ADDRESS: STREET 1: 1400 16TH STREET STREET 2: SUITE 310 CITY: DENVER STATE: CO ZIP: 80202 4 1 wf-form4_144234890420959.xml FORM 4 X0306 4 2015-09-15 0 0001513965 American Midstream Partners, LP AMID 0001625982 Sullivan Kevin J. 1400 16TH STREET SUITE 310 DENVER CO 80202 0 1 0 0 Executive Vice President Common Units (limited partner interests) 2015-09-15 4 P 0 10000 11.31 A 10000 D Common Units (limited partner interests) 661743 I Units held by Costar Midstream Energy LLC Of the 661,743 units held by Costar Midstream Energy LLC, 237,341 are currently being held in escrow and a subject to forfeiture to satisfy claims arising as a result of breaches of certain representations and warranties contained in that certain Purchase and Sale Agreement, dated as of October 13, 2014, by and between Costar Midstream Energy LLC, Energy Spectrum Partners VI LP and American Midstream, LLC. Mr. Sullivan is a member of Costar Midstream Energy LLC but disclaims beneficial ownership of such units except to the extent of his pecuniary interest therein. /s/ William B. Mathews, Attorney-in-Fact for Kevin J. Sullivan 2015-09-15