0001628908-16-000068.txt : 20161018 0001628908-16-000068.hdr.sgml : 20161018 20161018160151 ACCESSION NUMBER: 0001628908-16-000068 CONFORMED SUBMISSION TYPE: D PUBLIC DOCUMENT COUNT: 1 ITEM INFORMATION: 06b FILED AS OF DATE: 20161018 DATE AS OF CHANGE: 20161018 EFFECTIVENESS DATE: 20161018 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: 021-272779 FILM NUMBER: 161940939 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 D 1 primary_doc.xml X0707 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 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 Michael Kirshbaum 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 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 Steve Wigginton 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 Other Decline to Disclose 06b false 2016-10-03 false true true Offering is in connection with Issuer's acquisition of Valence Health, Inc. by merger. 0 181480000 169100000 12380000 Total offering amount consists of $169.1 million of Class A common stock issued at closing of merger and up to $12.38 million of Class A stock to be issued pursuant to earn-out arrangement based on achievement of new business activity through end of 2016 false 95 0 0 0 false Evolent Health, Inc. /s/ Jonathan Weinberg Jonathan Weinberg General Counsel and Secretary 2016-10-18