0001104659-23-036522.txt : 20230324 0001104659-23-036522.hdr.sgml : 20230324 20230324125430 ACCESSION NUMBER: 0001104659-23-036522 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20221210 FILED AS OF DATE: 20230324 DATE AS OF CHANGE: 20230324 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: McColgan Matthew J. CENTRAL INDEX KEY: 0001959297 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-40147 FILM NUMBER: 23758999 MAIL ADDRESS: STREET 1: 475 SENTRY PARKWAY E, STE 200 CITY: BLUE BELL STATE: PA ZIP: 19422 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: QualTek Services Inc. CENTRAL INDEX KEY: 0001839412 STANDARD INDUSTRIAL CLASSIFICATION: WATER, SEWER, PIPELINE, COMM AND POWER LINE CONSTRUCTION [1623] IRS NUMBER: 000000000 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 888 SAN CLEMENTE DRIVE, SUITE 400 CITY: NEWPORT BEACH STATE: CA ZIP: 92660 BUSINESS PHONE: 949-887-0331 MAIL ADDRESS: STREET 1: 888 SAN CLEMENTE DRIVE, SUITE 400 CITY: NEWPORT BEACH STATE: CA ZIP: 92660 FORMER COMPANY: FORMER CONFORMED NAME: Roth CH Acquisition III Co DATE OF NAME CHANGE: 20210107 4 1 tm2310296-2_4seq1.xml OWNERSHIP DOCUMENT X0407 4 2022-12-10 0 0001839412 QualTek Services Inc. QTEK 0001959297 McColgan Matthew J. C/O QUALTEK SERVICES, INC. 475 SENTRY PARKWAY E, SUITE 200 BLUE BELL PA 19422 0 1 0 0 Chief Financial Officer 0 Employee Stock Option 1 2022-12-10 4 A 0 100000 0 A 2032-12-10 Common Stock 100000 100000 D The option vests as follows: 25% on each of December 10, 2023, December 10, 2024, December 10, 2025 and December 10, 2026. /s/ Matthew McColgan 2023-03-24