0001628908-22-000105.txt : 20220811
0001628908-22-000105.hdr.sgml : 20220811
20220811113801
ACCESSION NUMBER: 0001628908-22-000105
CONFORMED SUBMISSION TYPE: D
PUBLIC DOCUMENT COUNT: 1
ITEM INFORMATION: 06b
FILED AS OF DATE: 20220811
DATE AS OF CHANGE: 20220811
EFFECTIVENESS DATE: 20220811
FILER:
COMPANY DATA:
COMPANY CONFORMED NAME: Evolent Health, Inc.
CENTRAL INDEX KEY: 0001628908
STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-MANAGEMENT SERVICES [8741]
IRS NUMBER: 320454912
STATE OF INCORPORATION: DE
FISCAL YEAR END: 1231
FILING VALUES:
FORM TYPE: D
SEC ACT: 1933 Act
SEC FILE NUMBER: 021-455638
FILM NUMBER: 221154452
BUSINESS ADDRESS:
STREET 1: 800 NORTH GLEBE RD, SUITE 500
CITY: ARLINGTON
STATE: VA
ZIP: 22203
BUSINESS PHONE: 571-389-6000
MAIL ADDRESS:
STREET 1: 800 NORTH GLEBE RD, SUITE 500
CITY: ARLINGTON
STATE: VA
ZIP: 22203
D
1
primary_doc.xml
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0001628908
Evolent Health, Inc.
800 NORTH GLEBE RD, SUITE 500
ARLINGTON
VA
VIRGINIA
22203
571-389-6000
DELAWARE
None
None
Corporation
true
JONATHAN
WEINBERG
800 NORTH GLEBE ROAD
SUITE 500
ARLINGTON
VA
VIRGINIA
22203
Executive Officer
FRANK
WILLIAMS
800 NORTH GLEBE ROAD
SUITE 500
ARLINGTON
VA
VIRGINIA
22203
Director
TUNDE
SOTUNDE
800 NORTH GLEBE ROAD
SUITE 500
ARLINGTON
VA
VIRGINIA
22203
Director
DAVID
FARNER
800 NORTH GLEBE ROAD
SUITE 500
ARLINGTON
VA
VIRGINIA
22203
Director
CRAIG
BARBAROSH
800 NORTH GLEBE ROAD
SUITE 500
ARLINGTON
VA
VIRGINIA
22203
Director
BRIDGET
DUFFY
800 NORTH GLEBE ROAD
SUITE 500
ARLINGTON
VA
VIRGINIA
22203
Director
PETER
GRUA
800 NORTH GLEBE ROAD
SUITE 500
ARLINGTON
VA
VIRGINIA
22203
Director
DIANE
HOLDER
800 NORTH GLEBE ROAD
SUITE 500
ARLINGTON
VA
VIRGINIA
22203
Director
KIM
KECK
800 NORTH GLEBE ROAD
SUITE 500
ARLINGTON
VA
VIRGINIA
22203
Director
CHERYL
SCOTT
800 NORTH GLEBE ROAD
SUITE 500
ARLINGTON
VA
VIRGINIA
22203
Director
SETH
BLACKLEY
800 NORTH GLEBE ROAD
SUITE 500
ARLINGTON
VA
VIRGINIA
22203
Executive Officer
Director
JOHN
JOHNSON
800 NORTH GLEBE ROAD
SUITE 500
ARLINGTON
VA
VIRGINIA
22203
Executive Officer
STEVE
TUTEWOHL
800 NORTH GLEBE ROAD
SUITE 500
ARLINGTON
VA
VIRGINIA
22203
Executive Officer
AAMMAAD
SHAMS
800 NORTH GLEBE ROAD
SUITE 500
ARLINGTON
VA
VIRGINIA
22203
Executive Officer
Other
Decline to Disclose
- 06b
false
2022-08-01
true
true
true
Offering is in connection with a transaction with TPG Growth Iceman Parent, Inc.
0
181999816
124999816
57000000
Total consists of $124,999,815.90 of Class A Common Stock issued at Closing and up to $57,000,000 of Class A Common Stock to be issued pursuant to an earn-out arrangement through the end of 2023.
false
6
0
0
0
false
Evolent Health, Inc.
/s/ JONATHAN WEINBERG
JONATHAN WEINBERG
GENERAL COUNSEL AND SECRETARY
2022-08-11