0001235802-18-000155.txt : 20181015
0001235802-18-000155.hdr.sgml : 20181015
20181015160808
ACCESSION NUMBER: 0001235802-18-000155
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 2
CONFORMED PERIOD OF REPORT: 20181015
FILED AS OF DATE: 20181015
DATE AS OF CHANGE: 20181015
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Mainelli Michael
CENTRAL INDEX KEY: 0001315983
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-34951
FILM NUMBER: 181122321
MAIL ADDRESS:
STREET 1: C/O ORTHOFIX INTERNATIONAL N. V.
STREET 2: 3451 PLANO PARKWAY
CITY: LEWISVILLE
STATE: TX
ZIP: 75056
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: Xtant Medical Holdings, Inc.
CENTRAL INDEX KEY: 0001453593
STANDARD INDUSTRIAL CLASSIFICATION: BIOLOGICAL PRODUCTS (NO DIAGNOSTIC SUBSTANCES) [2836]
IRS NUMBER: 205313323
STATE OF INCORPORATION: DE
FISCAL YEAR END: 1231
BUSINESS ADDRESS:
STREET 1: 664 CRUISER LANE
CITY: BELGRADE
STATE: MT
ZIP: 59714
BUSINESS PHONE: 406-388-0480
MAIL ADDRESS:
STREET 1: 664 CRUISER LANE
CITY: BELGRADE
STATE: MT
ZIP: 59714
FORMER COMPANY:
FORMER CONFORMED NAME: Bacterin International Holdings, Inc.
DATE OF NAME CHANGE: 20100615
FORMER COMPANY:
FORMER CONFORMED NAME: K KITZ INC
DATE OF NAME CHANGE: 20090108
4
1
primary_doc.xml
PRIMARY DOCUMENT
X0306
4
2018-10-15
0
0001453593
Xtant Medical Holdings, Inc.
XTNT
0001315983
Mainelli Michael
664 CRUISER LANE
BELGRADE
MT
59714
1
1
0
0
Interim CEO
Common Stock, $0.000001 par value
20833
D
Stock Option (right to buy)
3.22
2018-10-15
4
A
0
240000
0
A
2028-10-15
Common Stock
240000
240000
D
These shares are subject to vesting pursuant to a restricted stock award granted under the Amended and Restated Xtant Medical Equity Incentive Plan.
This option vests with respect to 10,000 of the shares subject to the option on the 15th day of each of the twenty-four (24) months commencing on November 15, 2018, subject to such Reporting Person's continued employment as Chief Executive Officer of Xtant Medical Holdings, Inc.
/s/ Amy Culbert, attorney-in-fact
2018-10-15
EX-24
2
poa-mainelli.txt
POWER OF ATTORNEY
POWER OF ATTORNEY
MICHAEL MAINELLI
With respect to holdings of and transactions in
securities issued by Xtant Medical Holdings, Inc.
(the Company), the undersigned hereby constitutes
and appoints the officers of the Company listed on
Schedule A attached hereto and as may be amended
from time to time, or any of them signing singly,
with full power of substitution and resubstitution,
to act as the undersigned's true and lawful
attorney-in-fact to:
1. execute for and on behalf of the undersigned,
Forms 3, 4, and 5 in accordance with Section 16 of
the Securities Exchange Act of 1934, as amended, any
Form 144 in accordance with Rule 144 under the
Securities Act of 1933, as amended, and the rules
and regulations thereunder;
2. do and perform any and all acts for and on
behalf of the undersigned which may be necessary
or desirable to complete and execute any such
Form 3, 4, or 5 or Form 144 or complete and execute
any amendment or amendments thereto, and timely file
such forms with the United States Securities and
Exchange Commission (the SEC) and any stock exchange
or similar authority; and
3. take any other action of any type
whatsoever in connection with the foregoing which,
in the opinion of such attorney-in-fact, may be
of benefit to, in the best interest of, or legally
required by, the undersigned, it being understood
that the documents executed by such attorney-in-fact
on behalf of the undersigned pursuant to this Power
of Attorney shall be in such form and shall contain
such terms and conditions as such attorney-in-fact
may approve in the discretion of such attorney-in-
fact.
The undersigned hereby grants to each such attorney-
in-fact full power and authority to do and perform
any and every act and thing whatsoever requisite,
necessary, or proper to be done in the exercise of
any of the rights and powers herein granted, as fully
to all intents and purposes as the undersigned might
or could do if personally present, with full power of
substitution and resubstitution or revocation, hereby
ratifying and confirming all that such attorney-in-
fact, or such attorney-in-facts substitute or
substitutes, shall lawfully do or cause to be done
by virtue of this Power of Attorney and the rights
and powers herein granted.
The undersigned hereby acknowledges that the attorneys-
in-fact, in serving in such capacity at the request
of the undersigned, are not assuming, nor is the
Company assuming, any of the undersigned's
responsibilities to comply with Section 16 of the
Securities Exchange Act of 1934, as amended, or Rule
144 of the Securities Act of 1933, as amended, and
any similar law, rule or regulation.
This Power of Attorney shall remain in full force
and effect until the undersigned is no longer
required to file Forms 3, 4, and 5 and Forms 144
with respect to the undersigned's holdings of and
transactions in securities issued by the Company,
unless earlier revoked by the undersigned in a signed
writing delivered to the foregoing attorneys-in-fact.
IN WITNESS WHEREOF, the undersigned has caused
this Power of Attorney to be executed as of this
1st day of August, 2018.
/s/ Michael Mainelli
Michael Mainelli
Schedule A
Individuals Appointed as Attorney-in-Fact with
Full Power of Substitution and Resubstitution
1. Carl O'Connell, Chief Executive Officer
2. Jeffrey Peters, Chairman of the Board
3. Amy Culbert, Secretary
4. Thomas Letscher, Assistant Secretary