0000899243-21-041314.txt : 20211022 0000899243-21-041314.hdr.sgml : 20211022 20211022173708 ACCESSION NUMBER: 0000899243-21-041314 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20211021 FILED AS OF DATE: 20211022 DATE AS OF CHANGE: 20211022 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Moiz Nadeem CENTRAL INDEX KEY: 0001711261 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-38632 FILM NUMBER: 211341627 MAIL ADDRESS: STREET 1: 26600 TELEGRAPH ROAD, SUITE 400 CITY: SOUTHFIELD STATE: MI ZIP: 48033 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: Select Interior Concepts, Inc. CENTRAL INDEX KEY: 0001723866 STANDARD INDUSTRIAL CLASSIFICATION: GEN BUILDING CONTRACTORS - RESIDENTIAL BUILDINGS [1520] IRS NUMBER: 474640296 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 400 GALLERIA PARKWAY STREET 2: SUITE 1760 CITY: ATLANTA STATE: GA ZIP: 30339 BUSINESS PHONE: (888)701-4737 MAIL ADDRESS: STREET 1: 400 GALLERIA PARKWAY STREET 2: SUITE 1760 CITY: ATLANTA STATE: GA ZIP: 30339 4 1 doc4.xml FORM 4 SUBMISSION X0306 4 2021-10-21 1 0001723866 Select Interior Concepts, Inc. SIC 0001711261 Moiz Nadeem 400 GALLERIA PARKWAY, SUITE 1760 ATLANTA GA 30339 0 1 0 0 See Remarks Class A Common Stock 2021-10-21 4 D 0 275987 14.50 D 0 D Restricted Sock Units 2021-10-21 4 D 0 175000 14.50 D Common Stock 125000 0 D Includes time-vesting restricted stock units (RSUs) convertible into shares of Class A Common Stock. Disposed of pursuant to merger agreement between issuer and Astro Stone Intermediate holding, LLC in exchange for a cash payment equal to the per share merger consideration ($14.50). Reflects performance-based RSUs that each represented a contingent right to receive one share of Class A Common Stock based on the closing price of the Issuer's common stock exceeding specific hurdles for 20 consecutive trading days, and subject to the reporting person's continued employment with the Issuer. Chief Financial Officer; Chief Operating Officer /s/ Scott Jarvis, attorney-in-fact 2021-10-22