0000899243-18-026148.txt : 20181003
0000899243-18-026148.hdr.sgml : 20181003
20181003205017
ACCESSION NUMBER: 0000899243-18-026148
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20181001
FILED AS OF DATE: 20181003
DATE AS OF CHANGE: 20181003
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Goff Gregory James
CENTRAL INDEX KEY: 0001490987
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-03473
FILM NUMBER: 181106777
MAIL ADDRESS:
STREET 1: 19100 RIDGEWOOD PARKWAY
CITY: SAN ANTONIO
STATE: TX
ZIP: 78259
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: ANDEAVOR
CENTRAL INDEX KEY: 0000050104
STANDARD INDUSTRIAL CLASSIFICATION: PETROLEUM REFINING [2911]
IRS NUMBER: 950862768
STATE OF INCORPORATION: DE
FISCAL YEAR END: 1231
BUSINESS ADDRESS:
STREET 1: 19100 RIDGEWOOD PKWY
CITY: SAN ANTONIO
STATE: TX
ZIP: 78259-1828
BUSINESS PHONE: 210 626-6000
MAIL ADDRESS:
STREET 1: 19100 RIDGEWOOD PKWY
CITY: SAN ANTONIO
STATE: TX
ZIP: 78259-1828
FORMER COMPANY:
FORMER CONFORMED NAME: TESORO CORP /NEW/
DATE OF NAME CHANGE: 20041108
FORMER COMPANY:
FORMER CONFORMED NAME: TESORO PETROLEUM CORP /NEW/
DATE OF NAME CHANGE: 19920703
4
1
doc4.xml
FORM 4 SUBMISSION
X0306
4
2018-10-01
1
0000050104
ANDEAVOR
ANDV
0001490987
Goff Gregory James
19100 RIDGEWOOD PARKWAY
SAN ANTONIO
78259-1828
1
1
0
0
President and CEO
Common Stock
2018-10-01
4
A
0
160906
A
773568.71
D
Common Stock
2018-10-01
4
D
0
773568.71
D
0
D
Market Stock Units
2018-10-01
4
D
0
120035
D
Common Stock
120035
0
D
Stock Options
2018-10-01
4
D
0
33513
D
2020-05-03
Common Stock
33513
0
D
Stock Options
2018-10-01
4
D
0
118000
D
2020-05-05
Common Stock
118000
0
D
Vesting of Total Shareholder Return ("TSR")-based performance share award previously granted under the Issuer's Amended and Restated 2011 Long-Term Incentive Plan. The performance share award was accelerated upon the change of control of the Issuer pursuant to the Agreement and Plan of Merger, dated as of April 29, 2018, by and among the Issuer, Marathon Petroleum Corporation ("MPC"), Mahi Inc. and Mahi LLC (as amended, the "Merger Agreement"), and performance was certified by the Compensation Committee.
Includes 625.717 shares held through the Andeavor 401(k) plan (based upon a statement dated September 18, 2018). Also includes 23,844 shares gifted on August 29, 2018 by the reporting person from existing holdings to a trust of which the reporting person is a trustee and the beneficiaries are members of the reporting person's immediate family.
Pursuant to the Merger Agreement, at the effective time, each outstanding share of the Issuer's common stock was cancelled and became exchangeable for, at the holder's election, either $152.27 in cash or 1.87 shares of MPC common stock, subject to an allocation and proration whereby the outstanding shares of Issuer's common stock would be exchanged for approximately $3.5 billion in cash with the balance of shares exchanged for MPC shares. The TSR-based performance share award referenced above was assumed by MPC and converted into a time-based restricted stock unit award denominated in a number of MPC shares equal to the number of shares certified by the Compensation Committee as to performance for such award multiplied by 1.87.
Pursuant to the Merger Agreement, at the effective time, each outstanding market stock unit award was assumed by MPC and converted into a time-based restricted stock unit award denominated in a number of MPC shares equal to the number of shares certified by the Compensation Committee as to performance for such award multiplied by 1.87.
Pursuant to the Merger Agreement, at the effective time, this exercisable stock option was assumed by MPC and converted into an exercisable stock option to purchase 62,669 shares of MPC common stock at an exercise price of $7.31 per share.
Pursuant to the Merger Agreement, at the effective time, this exercisable stock option was assumed by MPC and converted into an exercisable stock option to purchase 220,660 shares of MPC common stock at an exercise price of $6.92 per share..
/s/ Elisa D. Watts, Attorney-in-Fact for Gregory James Goff
2018-10-03