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