-----BEGIN PRIVACY-ENHANCED MESSAGE----- Proc-Type: 2001,MIC-CLEAR Originator-Name: webmaster@www.sec.gov Originator-Key-Asymmetric: MFgwCgYEVQgBAQICAf8DSgAwRwJAW2sNKK9AVtBzYZmr6aGjlWyK3XmZv3dTINen TWSM7vrzLADbmYQaionwg5sDW3P6oaM5D3tdezXMm7z1T+B+twIDAQAB MIC-Info: RSA-MD5,RSA, NuiEy62CE/Mlgc8E+Zpl6meoQvQ0sS26dyCLGSUg5ds37Ps15CQ23vI4WTE5yfOl yBNjZni48PD48xR0pYSzsA== 0000914121-10-000557.txt : 20100203 0000914121-10-000557.hdr.sgml : 20100203 20100203173237 ACCESSION NUMBER: 0000914121-10-000557 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20100201 FILED AS OF DATE: 20100203 DATE AS OF CHANGE: 20100203 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: KOZIEL WILLIAM E CENTRAL INDEX KEY: 0001304540 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-50052 FILM NUMBER: 10571719 MAIL ADDRESS: STREET 1: C/O COSI INC STREET 2: 1751 LAKE COOK ROAD 6TH FLOOR CITY: DEERFIELD STATE: IL ZIP: 60015 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: COSI INC CENTRAL INDEX KEY: 0001171014 STANDARD INDUSTRIAL CLASSIFICATION: RETAIL-EATING PLACES [5812] IRS NUMBER: 061393745 STATE OF INCORPORATION: DE FISCAL YEAR END: 0101 BUSINESS ADDRESS: STREET 1: COSI INC STREET 2: 1751 LAKE COOK ROAD SUITE 650 CITY: DEERFIELD STATE: IL ZIP: 60015 BUSINESS PHONE: 847-597-3200 MAIL ADDRESS: STREET 1: 1751 LAKE COOK ROAD STREET 2: SUITE 650 CITY: DEERFIELD STATE: IL ZIP: 60015 4 1 p18303213-4koziel_ex.xml X0303 4 2010-02-01 0 0001171014 COSI INC COSI 0001304540 KOZIEL WILLIAM E C/O COSI INC 1751 LAKE COOK ROAD 6TH FLOOR DEERFIELD IL 60015 0 1 0 0 Chief Financial Officer Common Stock, $0.01 par value per share 2010-02-01 4 P 0 47694 0.50 A 148000 D These shares were issued pursuant to a private placement in connection with the Company's rights offering completed January 6, 2010. /s/ WILLIAM E. KOZIEL 2010-02-03 -----END PRIVACY-ENHANCED MESSAGE-----