0001659166-21-000011.txt : 20210104
0001659166-21-000011.hdr.sgml : 20210104
20210104215207
ACCESSION NUMBER: 0001659166-21-000011
CONFORMED SUBMISSION TYPE: 5
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20201231
FILED AS OF DATE: 20210104
DATE AS OF CHANGE: 20210104
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Gafinowitz Martin
CENTRAL INDEX KEY: 0001671495
FILING VALUES:
FORM TYPE: 5
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-37654
FILM NUMBER: 21503770
MAIL ADDRESS:
STREET 1: C/O FORTIVE CORPORATION
STREET 2: 6920 SEAWAY BOULEVARD
CITY: EVERETT
STATE: WA
ZIP: 98203
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: Fortive Corp
CENTRAL INDEX KEY: 0001659166
STANDARD INDUSTRIAL CLASSIFICATION: INDUSTRIAL INSTRUMENTS FOR MEASUREMENT, DISPLAY, AND CONTROL [3823]
IRS NUMBER: 000000000
STATE OF INCORPORATION: DE
FISCAL YEAR END: 1231
BUSINESS ADDRESS:
STREET 1: 6920 SEAWAY BLVD.
CITY: EVERETT
STATE: WA
ZIP: 98203
BUSINESS PHONE: (425) 446-5000
MAIL ADDRESS:
STREET 1: 6920 SEAWAY BLVD.
CITY: EVERETT
STATE: WA
ZIP: 98203
FORMER COMPANY:
FORMER CONFORMED NAME: TGA Holding Corp.
DATE OF NAME CHANGE: 20151123
5
1
wf-form5_160981511199171.xml
FORM 5
X0306
5
2020-12-31
0
0
0
0001659166
Fortive Corp
FTV
0001671495
Gafinowitz Martin
6920 SEAWAY BLVD
EVERETT
WA
98203
0
1
0
0
Senior Vice President
Common Stock
2020-03-25
5
P
0
12.50
50.47
A
46989.50
D
Executive Deferred Incentive Program - Fortive Stock Fund
2020-12-28
5
A
0
67.49
68.97
A
Common Stock
67.49
66564.86
D
Reflects shares automatically acquired through a dividend reinvestment option provided by a third party.
In connection with the spin-off of Vontier Corporation by the Issuer, outstanding Restricted Stock Units ("RSUs"), including RSUs previously granted to the Reporting Person, were subject to anti-dilution adjustments ("Anti-Dilution Adjustment"). To the extent that the outstanding RSUs granted to the Reporting Person were previously reported under Table I, the total number of shares reported include the additional RSUs held by the Reporting Person as a result of the Anti-Dilution Adjustment.
Compensation deferred or contributed into the Fortive stock fund (the "EDIP Stock Fund") included in Fortive's Executive Deferred Incentive Program (the "EDIP") is deemed to be invested in a number of unfunded, notional shares of the Issuer's common stock based on the closing price of the Issuer's common stock as reported on the NYSE on the date such compensation is credited to the EDIP Stock Fund (or the closing price for the immediately preceding business day, if such date is not a business day). The price shown in Table II, Column 8 is the closing price per share of the Issuer's common stock applicable to the respective transaction date.
The notional shares convert on a one-to-one basis.
The Reporting Person immediately vests in 100% of each voluntary contribution to the EDIP Stock Fund. The Reporting Person will vest in all contributions to the EDIP Stock Fund by the Issuer as follows: 100% upon the earlier of the Reporting Person's death, or upon retirement following at least 5 years of service with the Issuer and reaching the age of 55, or, if earlier, one-tenth per year of participation following five years of participation, in each case in accordance with the EDIP. Upon termination of employment, the vested portion of the EDIP Stock Fund is settled in the Issuer's common stock.
The total number of phantom shares reflects an anti-dilution adjustment applied as a result of the spin-off of Vontier Corporation from the Issuer.
Daniel B. Kim, as attorney-in-fact
2021-01-04