0001628908-21-000133.txt : 20211015 0001628908-21-000133.hdr.sgml : 20211015 20211015123733 ACCESSION NUMBER: 0001628908-21-000133 CONFORMED SUBMISSION TYPE: D PUBLIC DOCUMENT COUNT: 1 ITEM INFORMATION: 06b FILED AS OF DATE: 20211015 DATE AS OF CHANGE: 20211015 EFFECTIVENESS DATE: 20211015 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: 021-417135 FILM NUMBER: 211325517 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 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 JONATHAN WEINBERG 800 NORTH GLEBE ROAD SUITE 500 ARLINGTON VA VIRGINIA 22203 Executive Officer FRANK WILLIAMS 800 NORTH GLEBE ROAD SUITE 500 ARLINGTON VA VIRGINIA 22203 Executive Officer Director MICHAEL D'AMATO 800 NORTH GLEBE ROAD SUITE 500 ARLINGTON VA VIRGINIA 22203 Director DAVID FARNER 800 NORTH GLEBE ROAD SUITE 500 ARLINGTON VA VIRGINIA 22203 Director CRAIG BARBAROSH 800 NORTH GLEBE ROAD SUITE 500 ARLINGTON VA VIRGINIA 22203 Director BRIDGET DUFFY 800 NORTH GLEBE ROAD SUITE 500 ARLINGTON VA VIRGINIA 22203 Director PETER GRUA 800 NORTH GLEBE ROAD SUITE 500 ARLINGTON VA VIRGINIA 22203 Director DIANE HOLDER 800 NORTH GLEBE ROAD SUITE 500 ARLINGTON VA VIRGINIA 22203 Director KIM KECK 800 NORTH GLEBE ROAD SUITE 500 ARLINGTON VA VIRGINIA 22203 Director CHERYL SCOTT 800 NORTH GLEBE ROAD SUITE 500 ARLINGTON VA VIRGINIA 22203 Director SETH BLACKLEY 800 NORTH GLEBE ROAD SUITE 500 ARLINGTON VA VIRGINIA 22203 Executive Officer JOHN JOHNSON 800 NORTH GLEBE ROAD SUITE 500 ARLINGTON VA VIRGINIA 22203 Executive Officer STEVE TUTEWOHL 800 NORTH GLEBE ROAD SUITE 500 ARLINGTON VA VIRGINIA 22203 Executive Officer AAMMAAD SHAMS 800 NORTH GLEBE ROAD SUITE 500 ARLINGTON VA VIRGINIA 22203 Executive Officer Other Decline to Disclose 06b false 2021-10-01 true true true Offering is in connection with acquisition of Vital Decisions Acquisition, LLC and MTS III Vital Decisions Blocker Corp. 0 65000000 42500000 22500000 Total offering consists of $42,500,000 of Class A Common Stock issued at closing and up to $22,500,000 of Class A Common Stock issuable pursuant to an earn-out arrangement based on operating results in the fourth quarter of 2022 false 15 0 0 0 false Evolent Health, Inc. /s/ Jonathan Weinberg JONATHAN WEINBERG GENERAL COUNSEL AND SECRETARY 2021-10-15