0000899243-19-006849.txt : 20190308 0000899243-19-006849.hdr.sgml : 20190308 20190308122459 ACCESSION NUMBER: 0000899243-19-006849 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20181219 FILED AS OF DATE: 20190308 DATE AS OF CHANGE: 20190308 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Torgerson Family Trust CENTRAL INDEX KEY: 0001735990 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-36246 FILM NUMBER: 19668370 BUSINESS ADDRESS: STREET 1: 596 MCCLURE ROAD CITY: KELOWNA STATE: A1 ZIP: V1W 1H3 BUSINESS PHONE: 250-869-9913 MAIL ADDRESS: STREET 1: 596 MCCLURE ROAD CITY: KELOWNA STATE: A1 ZIP: V1W 1H3 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: Civeo Corp CENTRAL INDEX KEY: 0001590584 STANDARD INDUSTRIAL CLASSIFICATION: HOTELS, ROOMING HOUSE, CAMPS & OTHER LODGING PLACES [7000] IRS NUMBER: 463831207 STATE OF INCORPORATION: A1 FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: THREE ALLEN CENTER STREET 2: 333 CLAY STREET, SUITE 4980 CITY: HOUSTON STATE: TX ZIP: 77002 BUSINESS PHONE: (713) 510-2400 MAIL ADDRESS: STREET 1: THREE ALLEN CENTER STREET 2: 333 CLAY STREET, SUITE 4980 CITY: HOUSTON STATE: TX ZIP: 77002 FORMER COMPANY: FORMER CONFORMED NAME: OIS Accommodations SpinCo Inc. DATE OF NAME CHANGE: 20131030 4 1 doc4.xml FORM 4 SUBMISSION X0306 4 2018-12-19 0 0001590584 Civeo Corp CVEO 0001735990 Torgerson Family Trust 596 MCCLURE ROAD KELOWNA A1 V1W 1H3 BRITISH COLUMBIA, CANADA 0 0 1 0 Class A Series 1 Preferred Shares 3.30 2018-12-19 4 J 0 637 9448.33 D Common Stock 1930303.011 9042 D Forfeiture of shares pursuant to escrow agreement entered into on April 2, 2018 in connection with the acquisition of Noralta Lodge Ltd. by the Issuer. The shares were forfeited in connection with a post-closing purchase price adjustment. The Preferred Shares can be converted by the issuer at any time if the 15-day volume weighted average price of the Common Shares is equal to or exceeds the Conversion Price; the holders of the Preferred Shares will have the right to convert the Preferred Shares into Common Shares at any time after April 2, 2020. The Preferred Shares mandatorily convert after five years from the date of issuance. The Preferred Shares are convertible into the number of Common Shares at a rate of 3,030.3030 Common Shares per each $10,000 of Liquidation Preference. The Preferred Shares have an initial Liquidation Preference of $10,000 per share, which amount may be increased in connection with the accrual of dividends or the payment of in-kind dividends. Pursuant to the escrow agreement, the shares were to be valued at CAD$12,708 for purposes of the purchase price adjustment. $9,448.33 represents the the USD equivalent of CAD$12,708 based on the exchange rate on December 19, 2018. /s/ Lance Torgerson, Trustee 2019-03-08