0001209191-21-062087.txt : 20211029 0001209191-21-062087.hdr.sgml : 20211029 20211029165929 ACCESSION NUMBER: 0001209191-21-062087 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20211029 FILED AS OF DATE: 20211029 DATE AS OF CHANGE: 20211029 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: CD&R Investment Associates IX, Ltd. CENTRAL INDEX KEY: 0001624514 STATE OF INCORPORATION: E9 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-50924 FILM NUMBER: 211364011 BUSINESS ADDRESS: STREET 1: MAPLES CORPORATE SERVICES LIMITED STREET 2: UGLAND HOUSE CITY: GRAND CAYMAN STATE: E9 ZIP: KY101194 BUSINESS PHONE: 345-949-8066 MAIL ADDRESS: STREET 1: MAPLES CORPORATE SERVICES LIMITED STREET 2: UGLAND HOUSE CITY: GRAND CAYMAN STATE: E9 ZIP: KY101194 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: CD&R Boulder Holdings, L.P. CENTRAL INDEX KEY: 0001726960 FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-50924 FILM NUMBER: 211364010 BUSINESS ADDRESS: STREET 1: UGLAND HOUSE STREET 2: SOUTH CHURCH STREET CITY: GRAND CAYMAN STATE: E9 ZIP: KY1-1104 BUSINESS PHONE: 212-407-5200 MAIL ADDRESS: STREET 1: C/O CLAYTON, DUBILIER & RICE, LLC STREET 2: 375 PARK AVENUE, 18TH FLR CITY: NEW YORK STATE: NY ZIP: 10152 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: BEACON ROOFING SUPPLY INC CENTRAL INDEX KEY: 0001124941 STANDARD INDUSTRIAL CLASSIFICATION: WHOLESALE-LUMBER & OTHER CONSTRUCTION MATERIALS [5030] IRS NUMBER: 364173371 STATE OF INCORPORATION: DE FISCAL YEAR END: 0930 BUSINESS ADDRESS: STREET 1: 505 HUNTMAR PARK DRIVE STREET 2: SUITE 300 CITY: HERNDON STATE: VA ZIP: 20170 BUSINESS PHONE: 571-323-3939 MAIL ADDRESS: STREET 1: 505 HUNTMAR PARK DRIVE STREET 2: SUITE 300 CITY: HERNDON STATE: VA ZIP: 20170 4 1 doc4.xml FORM 4 SUBMISSION X0306 4 2021-10-29 0 0001124941 BEACON ROOFING SUPPLY INC BECN 0001624514 CD&R Investment Associates IX, Ltd. C/O CLAYTON, DUBILIER & RICE, LLC 375 PARK AVENUE NEW YORK NY 10152 0 0 1 0 0001726960 CD&R Boulder Holdings, L.P. C/O CLAYTON, DUBILIER & RICE, LLC 375 PARK AVENUE NEW YORK NY 10152 0 0 1 0 Common Stock 2021-10-29 4 P 0 116945 51.306 A 14545973 I By affiliate These securities are owned directly by CD&R Boulder Holdings, L.P. ("CD&R Stockholder"). CD&R Associates IX, Ltd., as the general partner of CD&R Stockholder, may be deemed to beneficially own the shares of common stock held by CD&R Stockholder. CD&R Investment Associates IX, Ltd. expressly disclaims beneficial ownership of the shares of common stock held by CD&R Stockholder, except to the extent of its pecuniary interest therein. CD&R Investment Associates IX, Ltd., By: /s/ Rima Simson, Vice President, Treasurer and Secretary 2021-10-29 CD&R Boulder Holdings, L.P., By: CD&R Investment Associates IX, Ltd, general partner; By: /s/ Rima Simson, Vice President, Treasurer and Secretary 2021-10-29