0000920527-12-000013.txt : 20120130 0000920527-12-000013.hdr.sgml : 20120130 20120130143724 ACCESSION NUMBER: 0000920527-12-000013 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20120130 FILED AS OF DATE: 20120130 DATE AS OF CHANGE: 20120130 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: ADAIR CHARLES E CENTRAL INDEX KEY: 0001183732 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-23832 FILM NUMBER: 12555051 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: PSS WORLD MEDICAL INC CENTRAL INDEX KEY: 0000920527 STANDARD INDUSTRIAL CLASSIFICATION: WHOLESALE-MEDICAL, DENTAL & HOSPITAL EQUIPMENT & SUPPLIES [5047] IRS NUMBER: 592280364 STATE OF INCORPORATION: FL FISCAL YEAR END: 0327 BUSINESS ADDRESS: STREET 1: 4345 SOUTHPOINT BLVD STREET 2: STE 250 CITY: JACKSONVILLE STATE: FL ZIP: 32216 BUSINESS PHONE: 9043323000 MAIL ADDRESS: STREET 1: 4345 SOUTHPOINT BLVD STREET 2: STE 250 CITY: JACKSONVILLE STATE: FL ZIP: 32216 FORMER COMPANY: FORMER CONFORMED NAME: PHYSICIAN SALES & SERVICE INC /FL/ DATE OF NAME CHANGE: 19940318 4 1 edgar.xml PRIMARY DOCUMENT X0304 4 2012-01-30 0000920527 PSS WORLD MEDICAL INC PSSI 0001183732 ADAIR CHARLES E 4345 SOUTHPOINT BLVD JACKSONVILLE FL 32216 1 0 0 0 Common Stock 2012-01-30 4 M 0 17991 6.84 A 34971 D Common Stock 2012-01-30 4 S 0 17991 24.3069 D 16980 D Non Qualified Stock Option (right to buy) 6.84 2012-01-30 4 M 0 17991 0 D 2003-01-02 2013-01-02 Common Stock 17991 0 D This transaction was executed in multiple trades at prices ranging from $24.25 to $24.55. The price reported above reflects the weighted average sale price. The reporting person hereby undertakes to provide upon request to the SEC staff, the issuer or a security holder of the issuer full information regarding the number of shares and prices at which the transaction was effected. The option became 100% exercisable on the date of grant. Mark Rotondaro, attorney-in-fact 2012-01-30