0001209191-16-117474.txt : 20160504 0001209191-16-117474.hdr.sgml : 20160504 20160504172124 ACCESSION NUMBER: 0001209191-16-117474 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20160502 FILED AS OF DATE: 20160504 DATE AS OF CHANGE: 20160504 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: Envision Healthcare Holdings, Inc. CENTRAL INDEX KEY: 0001578318 STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-GENERAL MEDICAL & SURGICAL HOSPITALS, NEC [8062] IRS NUMBER: 450832318 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 6200 S. SYRACUSE WAY, SUITE 200 CITY: GREENWOOD VILLAGE STATE: CO ZIP: 80111 BUSINESS PHONE: (303) 495-1200 MAIL ADDRESS: STREET 1: 6200 S. SYRACUSE WAY, SUITE 200 CITY: GREENWOOD VILLAGE STATE: CO ZIP: 80111 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: SMITH MICHAEL L CENTRAL INDEX KEY: 0001194201 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-36048 FILM NUMBER: 161620584 MAIL ADDRESS: STREET 1: ANTHEM INC STREET 2: 120 MONUMENT CIRCLE CITY: INDIANAPOLIS STATE: IN ZIP: 46204 4 1 doc4.xml FORM 4 SUBMISSION X0306 4 2016-05-02 0 0001578318 Envision Healthcare Holdings, Inc. EVHC 0001194201 SMITH MICHAEL L 6200 S. SYRACUSE WAY STE 200 GREENWOOD VILLAGE CO 80111 1 0 0 0 Common Stock 2016-05-02 4 A 0 4420 0.00 A 29506 D Common Stock 27689 I By trust Represents restricted stock units granted as director fees. The restricted stock units vest on the earlier of (i) the one year anniversary of the grant date or (ii) the date of the Company's next annual shareholders meeting, in each case subject to Mr. Smith's continued service on the Company's board of directors. Pursuant to Mr. Smith's election, once vested, the settlement of these stock units will be deferred until the earlier of Mr. Smith's termination of board service and a change in control of the Issuer. These shares of common stock are held in the Michael L. Smith 2013 GRAT I. /s/ Craig A. Wilson, Attorney-in-Fact for Michael L. Smith 2016-05-04