0001628908-18-000074.txt : 20181016 0001628908-18-000074.hdr.sgml : 20181016 20181016121016 ACCESSION NUMBER: 0001628908-18-000074 CONFORMED SUBMISSION TYPE: D PUBLIC DOCUMENT COUNT: 1 ITEM INFORMATION: 06b FILED AS OF DATE: 20181016 DATE AS OF CHANGE: 20181016 EFFECTIVENESS DATE: 20181016 FILER: COMPANY DATA: COMPANY CONFORMED NAME: Evolent Health, Inc. CENTRAL INDEX KEY: 0001628908 STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-MANAGEMENT SERVICES [8741] IRS NUMBER: 320454912 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: D SEC ACT: 1933 Act SEC FILE NUMBER: 021-323629 FILM NUMBER: 181123957 BUSINESS ADDRESS: STREET 1: 800 NORTH GLEBE RD, SUITE 500 CITY: ARLINGTON STATE: VA ZIP: 22203 BUSINESS PHONE: 571-389-6000 MAIL ADDRESS: STREET 1: 800 NORTH GLEBE RD, SUITE 500 CITY: ARLINGTON STATE: VA ZIP: 22203 FILER: COMPANY DATA: COMPANY CONFORMED NAME: Evolent Health LLC CENTRAL INDEX KEY: 0001530865 IRS NUMBER: 454084136 STATE OF INCORPORATION: DE FISCAL YEAR END: 0331 FILING VALUES: FORM TYPE: D SEC ACT: 1933 Act SEC FILE NUMBER: 021-323629-01 FILM NUMBER: 181123956 BUSINESS ADDRESS: STREET 1: 800 N. GLEBE ROAD STREET 2: SUITE 500 CITY: ARLINGTON STATE: VA ZIP: 22203 BUSINESS PHONE: 571-389-6000 MAIL ADDRESS: STREET 1: 800 N. GLEBE ROAD STREET 2: SUITE 500 CITY: ARLINGTON STATE: VA ZIP: 22203 FORMER COMPANY: FORMER CONFORMED NAME: VPHealth, Inc. DATE OF NAME CHANGE: 20110921 D 1 primary_doc.xml X0708 D LIVE 0001628908 Evolent Health, Inc. 800 NORTH GLEBE RD, SUITE 500 ARLINGTON VA VIRGINIA 22203 571-389-6000 DELAWARE None None Corporation true 2014 0001530865 Evolent Health LLC 800 N. GLEBE ROAD SUITE 500 ARLINGTON VA VIRGINIA 22203 571-389-6000 DELAWARE VPHealth, Inc. Limited Liability Company true Jonathan Weinberg 800 N. Glebe Road Suite 500 Arlington VA VIRGINIA 22203 Executive Officer Frank Williams 800 N. Glebe Road Suite 500 Arlington VA VIRGINIA 22203 Executive Officer Director Michael D'Amato 800 N. Glebe Road Suite 500 Arlington VA VIRGINIA 22203 Director David Farner 800 N. Glebe Road Suite 500 Arlington VA VIRGINIA 22203 Director Bruce Felt 800 N. Glebe Road Suite 500 Arlington VA VIRGINIA 22203 Director Matt Hobart 800 N. Glebe Road Suite 500 Arlington VA VIRGINIA 22203 Director Diane Holder 800 N. Glebe Road Suite 500 Arlington VA VIRGINIA 22203 Director Norman Payson 800 N. Glebe Road Suite 500 Arlington VA VIRGINIA 22203 Director Kenneth Samet 800 N. Glebe Road Suite 500 Arlington VA VIRGINIA 22203 Director Cheryl Scott 800 N. Glebe Road Suite 500 Arlington VA VIRGINIA 22203 Director Seth Blackley 800 N. Glebe Road Suite 500 Arlington VA VIRGINIA 22203 Executive Officer Director Nicholas McGrane 800 N. Glebe Road Suite 500 Arlington VA VIRGINIA 22203 Executive Officer Tom Peterson 800 N. Glebe Road Suite 500 Arlington VA VIRGINIA 22203 Executive Officer Chad Pomeroy 800 N. Glebe Road Suite 500 Arlington VA VIRGINIA 22203 Executive Officer David Thornton 800 N. Glebe Road Suite 500 Arlington VA VIRGINIA 22203 Executive Officer Lydia Stone 800 N. Glebe Road Suite 500 Arlington VA VIRGINIA 22203 Executive Officer Bridget Duffy 800 N. Glebe Road Suite 500 Arlington VA VIRGINIA 22203 Director Other Decline to Disclose 06b false 2018-10-01 false true true Offering is in connection with Issuers' acquisition of NCIS Holdings, Inc. 0 88878443 83173120 5705323 Total consists of $83,173,120 of Class B Common Stock and Class B Common Units issued at closing and up to $5,705,323 of Class B Common Stock and Class B Common Units to be issued pursuant to an earn-out arrangement through the end of 2019. false 18 0 0 0 false Evolent Health, Inc. Jonathan Weinberg Jonathan Weinberg General Counsel and Secretary 2018-10-16 Evolent Health LLC Jonathan Weinberg Jonathan Weinberg General Counsel and Secretary 2018-10-16