0001209191-17-020716.txt : 20170315
0001209191-17-020716.hdr.sgml : 20170315
20170315121152
ACCESSION NUMBER: 0001209191-17-020716
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20170313
FILED AS OF DATE: 20170315
DATE AS OF CHANGE: 20170315
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: Cotiviti Holdings, Inc.
CENTRAL INDEX KEY: 0001657197
STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-BUSINESS SERVICES, NEC [7389]
IRS NUMBER: 460595918
STATE OF INCORPORATION: DE
FISCAL YEAR END: 1231
BUSINESS ADDRESS:
STREET 1: 115 PERIMETER CENTER PLACE
STREET 2: SUITE 700
CITY: ATLANTA
STATE: GA
ZIP: 30346
BUSINESS PHONE: 770 379-2800
MAIL ADDRESS:
STREET 1: 115 PERIMETER CENTER PLACE
STREET 2: SUITE 700
CITY: ATLANTA
STATE: GA
ZIP: 30346
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Advent-Cotiviti GP Corp
CENTRAL INDEX KEY: 0001675037
STATE OF INCORPORATION: DE
FISCAL YEAR END: 1231
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-37787
FILM NUMBER: 17690420
BUSINESS ADDRESS:
STREET 1: 75 STATE STREET
CITY: BOSTON
STATE: MA
ZIP: 02129
BUSINESS PHONE: 617-951-9400
MAIL ADDRESS:
STREET 1: 75 STATE STREET
CITY: BOSTON
STATE: MA
ZIP: 02129
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Advent-Cotiviti Acquisition II Limited Partnership
CENTRAL INDEX KEY: 0001675440
STATE OF INCORPORATION: DE
FISCAL YEAR END: 1231
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-37787
FILM NUMBER: 17690421
BUSINESS ADDRESS:
STREET 1: 75 STATE STREET
CITY: BOSTON
STATE: MA
ZIP: 02109
BUSINESS PHONE: 617-951-9400
MAIL ADDRESS:
STREET 1: 75 STATE STREET
CITY: BOSTON
STATE: MA
ZIP: 02109
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Advent-Cotiviti Acquisition Limited Partnership
CENTRAL INDEX KEY: 0001675002
STATE OF INCORPORATION: DE
FISCAL YEAR END: 1231
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-37787
FILM NUMBER: 17690422
BUSINESS ADDRESS:
STREET 1: 75 STATE STREET
CITY: BOSTON
STATE: MA
ZIP: 02129
BUSINESS PHONE: 617-951-9400
MAIL ADDRESS:
STREET 1: 75 STATE STREET
CITY: BOSTON
STATE: MA
ZIP: 02129
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: ADVENT INTERNATIONAL CORP/MA
CENTRAL INDEX KEY: 0001034196
STATE OF INCORPORATION: DE
FISCAL YEAR END: 1231
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-37787
FILM NUMBER: 17690423
BUSINESS ADDRESS:
STREET 1: 75 STATE STREET
CITY: BOSTON
STATE: MA
ZIP: 02109
BUSINESS PHONE: 6179510555
MAIL ADDRESS:
STREET 1: 75 STATE STREET
CITY: BOSTON
STATE: MA
ZIP: 02109
4
1
doc4.xml
FORM 4 SUBMISSION
X0306
4
2017-03-13
0
0001657197
Cotiviti Holdings, Inc.
COTV
0001034196
ADVENT INTERNATIONAL CORP/MA
C/O ADVENT INTERNATIONAL CORPORATION
75 STATE STREET, 29TH FLOOR
BOSTON
MA
02109
0
0
1
0
0001675002
Advent-Cotiviti Acquisition Limited Partnership
C/O ADVENT INTERNATIONAL CORPORATION
75 STATE STREET, 29TH FLOOR
BOSTON
MA
02109
0
0
1
0
0001675440
Advent-Cotiviti Acquisition II Limited Partnership
C/O ADVENT INTERNATIONAL CORPORATION
75 STATE STREET, 29TH FLOOR
BOSTON
MA
02109
0
0
1
0
0001675037
Advent-Cotiviti GP Corp
C/O ADVENT INTERNATIONAL CORPORATION
75 STATE STREET, 29TH FLOOR
BOSTON
MA
02109
0
0
1
0
Common Stock
2017-03-13
4
S
0
8011580
34.38
D
50691350
I
See Footnotes
Represents 21,750,944 shares held directly by Advent-Cotiviti Acquisition Limited Partnership ("ACA LP"), 23,022,463 shares held directly by Advent-Cotiviti Acquisition II Limited Partnership ("ACA II LP"), 1,123,367 shares directly owned by Advent International GPE VI-C Limited Partnership ("AI GPE VI-C"), 1,071,561 shares directly owned by Advent International GPE VI-D Limited Partnership ("AI GPE VI-D"), 2,710,467 shares directly owned by Advent International GPE VI-E Limited Partnership ("AI GPE VI-E"), 797,009 shares directly owned by Advent Partners GPE VI 2008 Limited Partnership ("AP GPE VI 2008"), TO BE CONTINUED IN NEXT FOOTNOTE
CONTINUTED FROM PREVIOUS FOOTNOTE:
24,178 directly owned by Advent Partners GPE VI 2009 Limited Partnership ("AP GPE VI 2009"), 57,022 shares directly owned by Advent Partners GPE VI 2010 Limited Partnership ("AP GPE VI 2010"), 63,327 shares directly owned by Advent Partners GPE VI-A 2010 Limited Partnership ("AP GPE VI-A 2010") and 71,012 shares directly owned by Advent Partners GPE VI-A Limited Partnership ("AP GPE VI-A").
Advent International Corporation ("AIC") is the manager of Advent International LLC ("AILLC"), which is the general partner of each of GPE VI GP Limited Partnership ("GPE VI GP"), GPE VI GP (Delaware) Limited Partnership ("GPE VI (DE) GP"), AP GPE VI 2008, AP GPE VI 2009, AP GPE VI 2010, AP GPE VI-A and AP GPE VI-A 2010 (AP GPE VI 2008, AP GPE VI 2009, AP GPE VI 2010, AP GPE VI-A and AP GPE VI-A 2010 are collectively the "AP Funds").
Advent-Cotiviti GP Corporation ("AC GP") is the general partner of ACA LP and ACA II LP. Advent International GPE VI Limited Partnership ("AI GPE VI"), Advent International GPE VI-A Limited Partnership ("AI GPE VI-A"), Advent International GPE VI-B Limited Partnership ("AI GPE VI-B"), Advent International GPE VI-F Limited Partnership ("AI GPE VI-F") and Advent International GPE VI-G Limited Partnership ("AI GPE VI-G" and, together with AI GPE VI, AI GPE VI-A, AI GPE VI-B and AI GPE VI-F, the "GPE VI GP Funds") collectively own 100% of AC GP. AI GPE VI owns 100% of the limited partnership interests in ACA LP and the other GPE VI GP Funds collectively own 100% of the limited partnership interests in ACA II LP.
GPE VI GP is the general partner of the GPE VI GP Funds. GPE VI (DE) GP is the general partner of AI GPE VI-C, AI GPE VI-D and AI GPE VI-E (collectively, the "GPE VI (DE) GP Funds" and together with the GPE VI GP Funds and the AP Funds, the "Advent Funds").
Each of AIC, AILLC, GPE VI GP, GPE VI (DE) GP, ACA LP, ACA II LP, AC GP and the Advent Funds are referred to herein as the "Reporting Persons". Each Reporting Person disclaims Section 16 beneficial ownership of the shares reported herein except to the extent of its respective pecuniary interest therein, if any, and the inclusion of these shares in their report shall not be deemed an admission of beneficial ownership of all of the reported shares for purposes of Section 16 or any other purpose.
This Form 4 is the third and final of three Forms 4 being filed relating to the same event. The Form 4 has been split into three filings because there are more than 10 Reporting Persons in total, and the SEC's EDGAR filing system limits a single Form 4 to a maximum of 10 Reporting Persons. Each Form 4 will be filed by Designated Filer Advent International Corporation.
/s/ Richard Terranova, Attorney-in-Fact for Advent International Corp
2016-03-15
/s/ Richard Terranova, Attorney-in-Fact for Advent-Cotiviti Acquisition Limited Partnership
2017-03-15
/s/ Richard Terranova, Attorney-in-Fact for Advent-Cotiviti Acquisition II Limited Partnership
2017-03-15
/s/ Richard Terranova, Attorney-in-Fact for Advent-Cotiviti GP Corporation
2017-03-15