0000899243-21-016904.txt : 20210423 0000899243-21-016904.hdr.sgml : 20210423 20210423181722 ACCESSION NUMBER: 0000899243-21-016904 CONFORMED SUBMISSION TYPE: 3 PUBLIC DOCUMENT COUNT: 2 CONFORMED PERIOD OF REPORT: 20210423 FILED AS OF DATE: 20210423 DATE AS OF CHANGE: 20210423 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: FRIEDMAN DARREN M. CENTRAL INDEX KEY: 0001526095 FILING VALUES: FORM TYPE: 3 SEC ACT: 1934 Act SEC FILE NUMBER: 001-40361 FILM NUMBER: 21850924 MAIL ADDRESS: STREET 1: C/O STEPSTONE GROUP LP STREET 2: 885 THIRD AVENUE, 17TH FLOOR CITY: NEW YORK STATE: NY ZIP: 10022 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: AGILITI, INC. \DE CENTRAL INDEX KEY: 0001749704 STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-MISCELLANEOUS EQUIPMENT RENTAL & LEASING [7350] IRS NUMBER: 000000000 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 100 FEDERAL STREET, 35TH FLOOR CITY: BOSTON STATE: MA ZIP: 02110 BUSINESS PHONE: 617-227-1050 MAIL ADDRESS: STREET 1: 100 FEDERAL STREET, 35TH FLOOR CITY: BOSTON STATE: MA ZIP: 02110 3 1 doc3.xml FORM 3 SUBMISSION X0206 3 2021-04-23 0 0001749704 AGILITI, INC. \DE AGTI 0001526095 FRIEDMAN DARREN M. C/O AGILITI, INC. 6625 WEST 78TH STREET, SUITE 300 MINNEAPOLIS MN 55439 1 0 0 0 Options (Right to Buy) 6.27 2029-03-06 Common Stock, $0.0001 par value 55703 D Options (Right to Buy) 8.25 2030-03-06 Common Stock, $0.0001 par value 50909 D These options were granted under Agiliti, Inc.'s 2018 Omnibus Incentive Plan on March 6, 2019. These options fully vested on March 6, 2020. These options were granted under Agiliti, Inc.'s 2018 Omnibus Incentive Plan on March 6, 2020. These options fully vested on March 6, 2021. Exhibit List: Exhibit 24 - Power of Attorney /s/ Lee M. Neumann, by power of attorney 2021-04-23 EX-24 2 attachment1.htm EX-24 DOCUMENT
                               POWER OF ATTORNEY

                      FOR SECTION 16 REPORTING OBLIGATIONS

                                 April 23, 2021

KNOW ALL BY THESE PRESENTS, that the undersigned hereby constitutes and appoints
each of Scott A. Christensen, Matthew E. McCabe and Lee M. Neumann, signing
singly, the undersigned's true and lawful attorney-in-fact to: (i) execute for
and on behalf of the undersigned, in the undersigned's capacity as an officer
and/or director and/or owner of greater than 10% of the outstanding common stock
of Agiliti, Inc., a Delaware corporation (the "Company"), Forms 3, 4 and 5
(including any amendments, supplements or exhibits thereto) in accordance with
Section 16(a) of the Securities Exchange Act of 1934 and the rules thereunder;
(ii) 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
(including any amendments, supplements or exhibits thereto) and timely file such
form with the United States Securities and Exchange Commission (the "SEC") and
any stock exchange or similar authority, including without limitation the filing
of a Form ID or any other documents necessary or appropriate to enable the
undersigned to file the Form 3, 4 and 5 electronically with the SEC; (iii) seek
or obtain, as the undersigned's representative and on the undersigned's behalf,
information on transactions in the Company's securities from any third party,
including brokers, employee benefit plan administrators and trustees, and the
undersigned hereby authorizes any such person to release any such information to
each of the undersigned's attorneys-in-fact appointed by this Power of Attorney
and ratifies any such release of information; and (iv) 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 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 the date first written above.

                                        Signed and acknowledged:

                                        /s/ Darren M. Friedman
                                        ---------------------------------
                                        Darren M. Friedman