-----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, Rd37uGpLZ0cwyCoXK1kcXGVQNAbiZEbLcOdzJWE7vU8u1q3k3DfAWgqvxo9GkVAn vmDZO5RQiSVUpdg0TTRH0w== 0001188112-10-002883.txt : 20101027 0001188112-10-002883.hdr.sgml : 20101027 20101027192827 ACCESSION NUMBER: 0001188112-10-002883 CONFORMED SUBMISSION TYPE: 3 PUBLIC DOCUMENT COUNT: 2 CONFORMED PERIOD OF REPORT: 20101027 FILED AS OF DATE: 20101027 DATE AS OF CHANGE: 20101027 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Arguedas Clare CENTRAL INDEX KEY: 0001501276 FILING VALUES: FORM TYPE: 3 SEC ACT: 1934 Act SEC FILE NUMBER: 001-34930 FILM NUMBER: 101146001 MAIL ADDRESS: STREET 1: 3280 PEACHTREE ROAD STREET 2: SUITE 2625 CITY: ATLANTA STATE: GA ZIP: 30305 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: ExamWorks Group, Inc. CENTRAL INDEX KEY: 0001498021 STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-HEALTH SERVICES [8000] IRS NUMBER: 272909425 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 3280 PEACHTREE ROAD STREET 2: SUITE 2625 CITY: ATLANTA STATE: GA ZIP: 30305 BUSINESS PHONE: 404-952-2400 MAIL ADDRESS: STREET 1: 3280 PEACHTREE ROAD STREET 2: SUITE 2625 CITY: ATLANTA STATE: GA ZIP: 30305 3 1 edgar.xml PRIMARY DOCUMENT X0203 3 2010-10-27 0 0001498021 ExamWorks Group, Inc. EXAM 0001501276 Arguedas Clare 3280 PEACHTREE ROAD, N.E., SUITE 2625 ATLANTA GA 30305 0 1 0 0 VP, GC & Assistant Secretary Series A Convertible Preferred Stock Common Stock 11310 D Employee Stock Option (right to buy) 4.86 2020-02-15 Common Stock 38558 D Employee Stock Option (right to buy) 11.67 2020-10-06 Common Stock 25705 D Each share of Series A Convertible Preferred Stock will automatically convert into one share of common stock simultaneously upon the completion of the Issuer's initial public offering and has no expiration date. The shares subject to the option vest in three equal annual installments beginning on February 15, 2011. The shares subject to the option vest in three equal annual installments beginning on October 1, 2011. /s/ J. Miguel Fernandez de Castro, Attorney-in-Fact 2010-10-27 EX-24 2 arguedas_poa.htm EXHIBIT 24 Unassociated Document
Exhibit 24
 
POWER OF ATTORNEY
 
FOR
 
EXAMWORKS GROUP, INC.

SECTION 16(a) FILINGS

Know all by these presents that the undersigned hereby constitutes and appoints J. Miguel Fernandez de Castro, signing singly, the undersigned’s true and lawful attorney-in-fact to:

 
(1)
Prepare, execute in the undersigned’s name and on the undersigned’s behalf, and submit to the U.S. Securities and Exchange Commission (the “SEC”) a Form ID, including amendments thereto, and any other documents necessary or appropriate to obtain codes and passwords enabling the undersigned to make electronic filings with the SEC of reports required by Section 16(a) of the Securities and Exchange Act of 1934 or any rule or regulations of the SEC;
 
 
(2)
Execute for and on behalf of the undersigned, in the undersigned’s capacity as an officer and/or director of ExamWorks Group, Inc. (the “Company”), Forms 3, 4, and 5 and amendments thereto in accordance with Section 16(a) of the Securities Exchange Act of 1934 and the rules thereunder, and any other forms or reports the undersigned may be required to file in connection with the undersigned’s ownership, acquisition, or disposition of securities of the Company;
 
 
(3)
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 IDs and Form 3, 4, or 5, or other form or report, or amendment thereto and timely file such forms or reports with the SEC and any stock exchange or similar authority; and
 
 
(4)
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 such attorney-in-fact’s discretion.
 
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 or revocation, hereby ratifying and confirming all that such attorney-in-fact, or such attorney-in-fact’s 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 acknowledges that the foregoing 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.
 
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 with respect to the undersigned’s holdings of and transaction in securities issued by the Company, unless earlier revoked by the undersigned in a signed writing delivered to the foregoing attorneys-in-fact.  This Power of Attorney may be filed with the SEC as a confirming statement of the authority granted herein.
 
IN WITNESS WHEREOF, the undersigned has caused this Power of Attorney to be executed as of this 13th day of September 2010.
 
 
 
 
 /s/ Clare Arguedas  
    Clare Arguedas  
 
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