FORM 3 |
UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549 INITIAL STATEMENT OF BENEFICIAL OWNERSHIP OF SECURITIES Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934 or Section 30(h) of the Investment Company Act of 1940 |
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1. Name and Address of Reporting Person*
(Street)
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2. Date of Event Requiring Statement
(Month/Day/Year) 02/02/2021 |
3. Issuer Name and Ticker or Trading Symbol
AdaptHealth Corp. [ AHCO ] |
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4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
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5. If Amendment, Date of Original Filed
(Month/Day/Year) |
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6. Individual or Joint/Group Filing (Check Applicable Line)
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Table I - Non-Derivative Securities Beneficially Owned | |||
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1. Title of Security (Instr. 4) | 2. Amount of Securities Beneficially Owned (Instr. 4) | 3. Ownership Form: Direct (D) or Indirect (I) (Instr. 5) | 4. Nature of Indirect Beneficial Ownership (Instr. 5) |
Class A Common Stock | 2,930,374(1) | D(2) | |
Class A Common Stock | 1,255,874(1) | I | See Footnote(3) |
Table II - Derivative Securities Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities) | |||||||
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1. Title of Derivative Security (Instr. 4) | 2. Date Exercisable and Expiration Date (Month/Day/Year) | 3. Title and Amount of Securities Underlying Derivative Security (Instr. 4) | 4. Conversion or Exercise Price of Derivative Security | 5. Ownership Form: Direct (D) or Indirect (I) (Instr. 5) | 6. Nature of Indirect Beneficial Ownership (Instr. 5) | ||
Date Exercisable | Expiration Date | Title | Amount or Number of Shares | ||||
Series C Preferred Stock | (4) | (4) | Class A Common Stock | 2,732,440(1) | (4) | D(2) | |
Series C Preferred Stock | (4) | (4) | Class A Common Stock | 1,171,045(1) | (4) | I | See Footnote(3) |
1. Name and Address of Reporting Person*
(Street)
Relationship of Reporting Person(s) to Issuer
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1. Name and Address of Reporting Person*
(Street)
Relationship of Reporting Person(s) to Issuer
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1. Name and Address of Reporting Person*
(Street)
Relationship of Reporting Person(s) to Issuer
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1. Name and Address of Reporting Person*
(Street)
Relationship of Reporting Person(s) to Issuer
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1. Name and Address of Reporting Person*
(Street)
Relationship of Reporting Person(s) to Issuer
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1. Name and Address of Reporting Person*
(Street)
Relationship of Reporting Person(s) to Issuer
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Explanation of Responses: |
1. On December 1, 2020, the Issuer entered into Agreement and Plan of Merger (the "Merger Agreement") with AH Apollo Merger Sub Inc. ("Merger Sub I"), AH Apollo Merger Sub II Inc. ("Merger Sub II"), Peloton Equity, LLC (the "Stockholder Representative") and AeroCare Holdings, Inc. ("AeroCare"). The effective time of the merger occurred on February 1, 2021, at which time the outstanding shares of the Common Stock and Series C Preferred Stock of AeroCare were converted into the right to receive, among other things, shares of the Issuer's Class A Common Stock and Series C Preferred Stock, respectively, pursuant to the Merger Agreement. |
2. Shares held by SkyKnight Aero Holdings, LLC ("SkyKnight Aero Holdings"). SkyKnight Capital, L.P. ("SkyKnight Capital") is the manager of SkyKnight Aero Holdings. SkyKnight Capital Management, LLC ("SkyKnight Capital Management") is the general partner of SkyKnight Capital. Matthew Ebbel is the managing member of SkyKnight Capital Management. Each of the Reporting Persons disclaims beneficial ownership of such shares except to the extent of his or its pecuniary interest therein, if any. |
3. Shares held by SkyKnight Capital Fund II, L.P. ("SkyKnight Fund II"). SkyKnight Capital II GP, LLC ("SkyKnight II GP") is the general partner of SkyKnight Fund II. Matthew Ebbel is the managing member of SkyKnight II GP. Each of the Reporting Persons disclaims beneficial ownership of such shares except to the extent of his or its pecuniary interest therein, if any. |
4. Upon approval by the stockholders of the Issuer pursuant to the terms of the Merger Agreement, each share of Series C Preferred Stock will be convertible on a 100-for-one basis into the number of shares of the Issuer's Class A Common Stock shown in Column 3, subject to adjustments as set forth in the Certificate of Designation, Preferences and Rights of Series C Convertible Preferred Stock, Par Value $0.0001, of AdaptHealth Corp. dated as of January 29, 2021. The Series C Preferred Stock has no expiration date. |
Remarks: |
Theodore B. Lundberg was appointed to the board of directors of the Issuer on February 2, 2021 and has been deputized to represent the Reporting Persons on the board of directors of the Issuer. By virtue of Mr. Lundberg's representation, for purposes of Section 16 of the Securities Exchange Act of 1934 (the "Exchange Act"), each of the Reporting Persons may be deemed directors by deputization of the Issuer. This filing shall not be deemed an admission that any Reporting Person is a beneficial owner of the securities reported in this filing for purposes of Section 16 of the Exchange Act or otherwise, or is subject to Section 16 of the Exchange Act, and each Reporting Person disclaims beneficial ownership of these securities, except to the extent of such Reporting Person's pecuniary interest therein, if any. |
SkyKnight Aero Holdings, LLC, By: SkyKnight Capital, L.P., its manager, By: SkyKnight Capital Management, LLC, its general partner, By: /s/ Matthew Ebbel, Title: Managing Member | 02/04/2021 | |
SkyKnight Capital, L.P., By: SkyKnight Capital Management, LLC, its general partner, By: /s/ Matthew Ebbel, Title: Managing Member | 02/04/2021 | |
SkyKnight Capital Management, LLC, By: /s/ Matthew Ebbel, Title: Managing Member | 02/04/2021 | |
SkyKnight Capital Fund II, L.P, By: SkyKnight Capital II GP, LLC, its manager, By: /s/ Matthew Ebbel, Title: Managing Member | 02/04/2021 | |
SkyKnight Capital II GP, LLC, By: /s/ Matthew Ebbel, Title: Managing Member | 02/04/2021 | |
/s/ Matthew Ebbel | 02/04/2021 | |
** Signature of Reporting Person | Date | |
Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly. | ||
* If the form is filed by more than one reporting person, see Instruction 5 (b)(v). | ||
** Intentional misstatements or omissions of facts constitute Federal Criminal Violations See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a). | ||
Note: File three copies of this Form, one of which must be manually signed. If space is insufficient, see Instruction 6 for procedure. | ||
Persons who respond to the collection of information contained in this form are not required to respond unless the form displays a currently valid OMB Number. |