0001181431-14-006104.txt : 20140210
0001181431-14-006104.hdr.sgml : 20140210
20140210200832
ACCESSION NUMBER: 0001181431-14-006104
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20140206
FILED AS OF DATE: 20140210
DATE AS OF CHANGE: 20140210
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: Van Horne Edward
CENTRAL INDEX KEY: 0001584200
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-36048
FILM NUMBER: 14591060
MAIL ADDRESS:
STREET 1: 6200 S. SYRACUSE WAY
STREET 2: STE 200
CITY: GREENWOOD VILLAGE
STATE: CO
ZIP: 80111
4
1
rrd402078.xml
FORM 4
X0306
4
2014-02-06
0
0001578318
Envision Healthcare Holdings, Inc.
EVHC
0001584200
Van Horne Edward
6200 S. SYRACUSE WAY
STE 200
GREENWOOD VILLAGE
CO
80111
0
1
0
0
President of AMR
Common Stock
2014-02-06
4
M
0
13075
3.19
A
24474
D
Common Stock
2014-02-06
4
M
0
4000
4.29
A
28474
D
Common Stock
2014-02-06
4
F
0
6206
29.509
D
22268
D
Options (Rights to Buy)
3.19
2014-02-06
4
M
0
13075
0
D
2019-03-12
Common Stock
13075
0
D
Options (Rights to Buy)
4.29
2014-02-06
4
M
0
4000
0
D
2017-06-14
Common Stock
4000
30875
D
These options were originally granted on March 12, 2009 as options to purchase common stock of Envision Healthcare Corporation ("EVHC"), formerly known as Emergency Medical Services Corporation, and were scheduled to vest ratably on the first four anniversaries of the grant date. In connection with the merger of an indirect subsidiary of the Issuer with and into EVHC, with EVHC as the surviving corporation and an indirect wholly owned subsidiary of the Issuer (the "Merger"), the options converted to fully vested options to purchase common stock of the Issuer pursuant to a rollover agreement between the reporting person and the Issuer (the "Rollover Agreement").
These options were originally granted on June 14, 2007 as options to purchase common stock of EVHC, which were scheduled to vest on the first four anniversaries of the grant date, subject to continued employment. In connection with the Merger, the options converted to fully vested options to purchase common stock of the Issuer pursuant to the Rollover Agreement.
/s/ Craig A. Wilson, Attorney-in-Fact for Edward Van Horne
2014-02-10