0000899243-20-013356.txt : 20200515 0000899243-20-013356.hdr.sgml : 20200515 20200515214259 ACCESSION NUMBER: 0000899243-20-013356 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20200513 FILED AS OF DATE: 20200515 DATE AS OF CHANGE: 20200515 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Bortner Andrea Renee CENTRAL INDEX KEY: 0001808260 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-38950 FILM NUMBER: 20887601 MAIL ADDRESS: STREET 1: C/O GROCERY OUTLET HOLDING CORP. STREET 2: 5650 HOLLIS STREET CITY: EMERYVILLE STATE: CA ZIP: 94608 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: Grocery Outlet Holding Corp. CENTRAL INDEX KEY: 0001771515 STANDARD INDUSTRIAL CLASSIFICATION: RETAIL-GROCERY STORES [5411] IRS NUMBER: 471874201 STATE OF INCORPORATION: DE FISCAL YEAR END: 1228 BUSINESS ADDRESS: STREET 1: 5650 HOLLIS STREET CITY: EMERYVILLE STATE: CA ZIP: 94608 BUSINESS PHONE: (510) 845-1999 MAIL ADDRESS: STREET 1: 5650 HOLLIS STREET CITY: EMERYVILLE STATE: CA ZIP: 94608 4 1 doc4.xml FORM 4 SUBMISSION X0306 4 2020-05-13 0 0001771515 Grocery Outlet Holding Corp. GO 0001808260 Bortner Andrea Renee C/O GROCERY OUTLET HOLDING CORP. 5650 HOLLIS STREET EMERYVILLE CA 94608 0 1 0 0 Chief Human Resources Officer Common Stock 2020-05-13 4 A 0 14100 0.00 A 14100 D Represents 14,100 restricted stock units ("RSUs") granted to the reporting person, of which 2,892 RSUs are scheduled to vest on March 1, 2021, 2,892 RSUs are scheduled to vest on March 1, 2022, 2,893 RSUs are scheduled to vest on March 1, 2023 and 5,423 RSUs are scheduled to vest on June 19, 2023, in each case, subject to the continued service of the reporting person through such vesting dates. Does not include up to an additional 13,016 unvested performance stock units at target achievement (or up to an additional 26,032 unvested performance stock units at maximum achievement) which are eligible to vest upon the achievement of certain performance-based vesting conditions. /s/ Pamela B. Burke, Pamela B. Burke, as Attorney-In-Fact 2020-05-15