0001445866-17-001762.txt : 20171214 0001445866-17-001762.hdr.sgml : 20171214 20171214183550 ACCESSION NUMBER: 0001445866-17-001762 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20171212 FILED AS OF DATE: 20171214 DATE AS OF CHANGE: 20171214 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: BlueLine Partners, L.L.C. CENTRAL INDEX KEY: 0001311443 FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-35020 FILM NUMBER: 171257266 BUSINESS ADDRESS: STREET 1: 3480 BUSKIRK AVENUE STREET 2: SUITE 214 CITY: PLEASANT HILL STATE: CA ZIP: 94523 BUSINESS PHONE: 925-648-2085 MAIL ADDRESS: STREET 1: 3480 BUSKIRK AVENUE STREET 2: SUITE 214 CITY: PLEASANT HILL STATE: CA ZIP: 94523 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: TSV Investment Partners, LLC CENTRAL INDEX KEY: 0001603326 STATE OF INCORPORATION: CT FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-35020 FILM NUMBER: 171257268 BUSINESS ADDRESS: STREET 1: 405 WEED STREET CITY: NEW CANAAN STATE: CT ZIP: 06840 BUSINESS PHONE: 203-643-9300 MAIL ADDRESS: STREET 1: 405 WEED STREET CITY: NEW CANAAN STATE: CT ZIP: 06840 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: BlueLine Capital Partners II, L.P. CENTRAL INDEX KEY: 0001460781 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-35020 FILM NUMBER: 171257267 BUSINESS ADDRESS: STREET 1: 3480 BUSKIRK AVENUE STREET 2: SUITE 214 CITY: PLEASANT HILL STATE: CA ZIP: 94523 BUSINESS PHONE: 925-236-9790 MAIL ADDRESS: STREET 1: 3480 BUSKIRK AVENUE STREET 2: SUITE 214 CITY: PLEASANT HILL STATE: CA ZIP: 94523 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Meridian TSV II, LP CENTRAL INDEX KEY: 0001601536 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-35020 FILM NUMBER: 171257264 BUSINESS ADDRESS: STREET 1: 405 WEED STREET CITY: NEW CANAAN STATE: CT ZIP: 06840 BUSINESS PHONE: 203-643-9300 MAIL ADDRESS: STREET 1: 405 WEED STREET CITY: NEW CANAAN STATE: CT ZIP: 06840 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Meridian OHC Partners, LP CENTRAL INDEX KEY: 0001601397 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-35020 FILM NUMBER: 171257265 BUSINESS ADDRESS: STREET 1: 405 WEED STREET CITY: NEW CANAAN STATE: CT ZIP: 06840 BUSINESS PHONE: 203-643-9300 MAIL ADDRESS: STREET 1: 405 WEED STREET CITY: NEW CANAAN STATE: CT ZIP: 06840 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: InfuSystem Holdings, Inc CENTRAL INDEX KEY: 0001337013 STANDARD INDUSTRIAL CLASSIFICATION: SURGICAL & MEDICAL INSTRUMENTS & APPARATUS [3841] IRS NUMBER: 203341405 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 31700 RESEARCH PARK DRIVE CITY: MADISON HEIGHTS STATE: MI ZIP: 48071 BUSINESS PHONE: (248) 291-1210 MAIL ADDRESS: STREET 1: 31700 RESEARCH PARK DRIVE CITY: MADISON HEIGHTS STATE: MI ZIP: 48071 FORMER COMPANY: FORMER CONFORMED NAME: HAPC, Inc. DATE OF NAME CHANGE: 20060425 FORMER COMPANY: FORMER CONFORMED NAME: Healthcare Acquisition Partners Corp. DATE OF NAME CHANGE: 20050824 4 1 form4.xml OWNERSHIP DOCUMENT X0306 4 2017-12-12 0 0001337013 InfuSystem Holdings, Inc INFU 0001601397 Meridian OHC Partners, LP 425 WEED STREET NEW CANAAN CT 06840 1 0 1 0 0001601536 Meridian TSV II, LP 425 WEED STREET NEW CANAAN CT 06840 1 0 1 0 0001603326 TSV Investment Partners, LLC 425 WEED STREET NEW CANAAN CT 06840 1 0 1 0 0001460781 BlueLine Capital Partners II, L.P. 3480 BUSKIRK AVENUE SUITE 214 PLEASANT HILL CA 94523 1 0 1 0 0001311443 BlueLine Partners, L.L.C. 3480 BUSKIRK AVENUE SUITE 214 PLEASANT HILL CA 94523 1 0 1 0 Common Stock 2017-12-12 4 P 0 12000 2.32 A 3063652 D Common Stock 2017-12-12 4 P 0 3233 2.35 A 3066885 D Common Stock 2017-12-13 4 P 0 4767 2.30 A 3071652 D Common Stock 2017-12-13 4 P 0 24000 2.30 A 3095652 D Common Stock 2017-12-13 4 P 0 20000 2.35 A 3115652 D These securities are owned by Meridian OHC Partners, LP. The price reported in Column 4 is a weighted average price. These shares reported herein were purchased in multiple transactions. The reporting persons undertake to provide to InfuSystem Holdings, Inc., any security holder of InfuSystem Holdings, Inc., or the staff of the Securities and Exchange Commission, upon request, full information regarding the number of shares purchased at each separate price. These securities are owned by BlueLine Capital Partners II, LP. These shares reported herein were purchased in multiple transactions. The reporting persons undertake to provide to InfuSystem Holdings, Inc., any security holder of InfuSystem Holdings, Inc., or the staff of the Securities and Exchange Commission, upon request, full information regarding the number of shares purchased at each separate price. As described in the Schedule 13D filing made on February 12, 2016 with respect to the Common Stock owned by Meridian OHC Partners, LP, Meridian TSV II, LP, TSV Investment Partners, LLC, BlueLine Capital Partners II, L.P. and BlueLine Partners, L.L.C., the Reporting Entities may have been deemed to be a "group" under Section 13(d) of the Securities Exchange Act and accordingly each Reporting Person may have been deemed to have beneficial ownership of 10% or more of the Common Stock. /s/ Scott A. Shuda 2017-12-14