0001439789-13-000004.txt : 20130205 0001439789-13-000004.hdr.sgml : 20130205 20130205170849 ACCESSION NUMBER: 0001439789-13-000004 CONFORMED SUBMISSION TYPE: D PUBLIC DOCUMENT COUNT: 1 ITEM INFORMATION: Rule 506 FILED AS OF DATE: 20130205 DATE AS OF CHANGE: 20130205 EFFECTIVENESS DATE: 20130205 FILER: COMPANY DATA: COMPANY CONFORMED NAME: COVENANT SURGICAL PARTNERS INC CENTRAL INDEX KEY: 0001439789 IRS NUMBER: 000000000 STATE OF INCORPORATION: DE FILING VALUES: FORM TYPE: D SEC ACT: 1933 Act SEC FILE NUMBER: 021-191378 FILM NUMBER: 13574884 BUSINESS ADDRESS: STREET 1: 401 COMMERCE STREET STREET 2: SUITE 740 CITY: NASHVILLE STATE: TN ZIP: 37219 BUSINESS PHONE: 615-345-6902 MAIL ADDRESS: STREET 1: 401 COMMERCE STREET STREET 2: SUITE 740 CITY: NASHVILLE STATE: TN ZIP: 37219 D 1 primary_doc.xml X0706 D LIVE 0001439789 COVENANT SURGICAL PARTNERS INC 401 COMMERCE STREET SUITE 740 NASHVILLE TN TENNESSEE 37219 615-345-6902 DELAWARE None None Corporation true 2008 Michael A. Koban 401 Commerce Street, Suite 740 Nashville TN TENNESSEE 37219 Executive Officer Director Mr. Koban was chairman of the board and a director at the time of the offering. At the time of this filing,Mr. Koban is no longer chairman of the board. Marnix E. Heersink 401 Commerce Street, Suite 740 Nashville TN TENNESSEE 37219 Executive Officer Director Dr. Heersink was vice-chairman of the board, chief medical officer and a director at the time of the offering. At the time of this filing, Dr. Heersink is no longer vice-chairman of the board or a director. Richard K. Jacques 401 Commerce Street, Suite 740 Nashville TN TENNESSEE 37219 Executive Officer Director Morton A. Pierce 401 Commerce Street, Suite 740 Nashville TN TENNESSEE 37219 Director Mr. Pierce was a director at the time of the offering. At the time of this filing, Mr. Pierce is no longer a director. Lucius E. Burch III 401 Commerce Street, Suite 740 Nashville TN TENNESSEE 37219 Director Mr. Burch was a director at the time of the offering. At the time of this filing, Mr. Burch is no longer a director. John F. Jacques 401 Commerce Street, Suite 740 Nashville TN TENNESSEE 37219 Director James E. Vann 401 Commerce Street, Suite 740 Nashville TN TENNESSEE 37219 Director Mr. Vann was director at the time of the offering. At the time of this filing, Mr. Vann is no longer a director. David A. Holst 401 Commerce Street, Suite 740 Nashville TN TENNESSEE 37219 Executive Officer Jack F. King 1200 One Nashville Place 150 4th Avenue North Nashville TN TENNESSEE 37219 Executive Officer Barry D. Wesson 401 Commerce Street, Suite 740 Nashville TN TENNESSEE 37219 Executive Officer D. Whitcomb Polley 401 Commerce Street, Suite 740 Nashville TN TENNESSEE 37219 Executive Officer Keith W. Pennell 401 Commerce Street, Suite 740 Nashville TN TENNESSEE 37219 Director Mr. Pennell is a director of the company at the time of this filing. Mr. Pennell was not a director at the time of the offering. Brian C. Tilley 401 Commerce Street, Suite 740 Nashville TN TENNESSEE 37219 Director Mr. Tilley is a director of the company at the time of this filing. Mr. Tilley was not a director at the time of the offering. F. T. Chong 401 Commerce Street, Suite 740 Nashville TN TENNESSEE 37219 Director Mr. Chong is a director of the company at the time of this filing. Mr. Chong was not a director at the time of the offering. Scott M. Gallin 401 Commerce Street, Suite 740 Nashville TN TENNESSEE 37219 Director Mr. Gallin is a director of the company at the time of this filing. Mr. Gallin was not a director at the time of the offering. Other Health Care $25,000,001 - $100,000,000 06 false 2013-01-22 false true false 35000 Iroquois Capital Advisors, LLC 145235 Richard T. Gernert 1392896 401 Commerce Street, Suite 740 Nashville TN TENNESSEE 37219 NJ NEW JERSEY false 35000000 35000000 0 false 11 2100000 0 0 false COVENANT SURGICAL PARTNERS INC Richard K. Jacques Richard K. Jacques President and Chief Executive Officer 2013-02-05