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SEC Form 3
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*
Mounts Gonzales David

(Last) (First) (Middle)
1 W 4TH STREET
SUITE 740

(Street)
WINSTON-SALEM NC 27101

(City) (State) (Zip)
2. Date of Event Requiring Statement (Month/Day/Year)
03/07/2025
3. Issuer Name and Ticker or Trading Symbol
ModivCare Inc [ MODV ]
4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
X Director X 10% Owner
Officer (give title below) Other (specify below)
5. If Amendment, Date of Original Filed (Month/Day/Year)
6. Individual or Joint/Group Filing (Check Applicable Line)
Form filed by One Reporting Person
X Form filed by More than One Reporting Person
Table I - Non-Derivative Securities Beneficially Owned
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)
Common Stock, par value $0.001 per share(1) 2,130,000 I By: AI Catalyst Fund, LP(2)
Table II - Derivative Securities Beneficially Owned
(e.g., puts, calls, warrants, options, convertible securities)
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
1. Name and Address of Reporting Person*
Mounts Gonzales David

(Last) (First) (Middle)
1 W 4TH STREET
SUITE 740

(Street)
WINSTON-SALEM NC 27101

(City) (State) (Zip)

Relationship of Reporting Person(s) to Issuer
X Director X 10% Owner
Officer (give title below) Other (specify below)
1. Name and Address of Reporting Person*
AI Catalyst Fund GP, LLC

(Last) (First) (Middle)
1 W 4TH STREET
SUITE 740

(Street)
WINSTON-SALEM NC 27101

(City) (State) (Zip)

Relationship of Reporting Person(s) to Issuer
X Director X 10% Owner
Officer (give title below) Other (specify below)
Explanation of Responses:
1. This Form 3 is filed jointly by AI Catalyst Fund GP, LLC ("AICF GP") and David Mounts Gonzales (collectively, the "Reporting Persons"). Each Reporting Person disclaims beneficial ownership of the securities reported herein except to the extent of his or its pecuniary interest therein, and this report shall not be deemed to be an admission that any Reporting Person is the beneficial owner of such securities for purposes of Section 16 or for any other purpose.
2. Securities owned directly by AI Catalyst Fund, LP ("AICF"). AICF GP is the general partner of AICF. Mr. Mounts Gonzales is the President and Sole Managing Member of AICF GP. As a result of these relationships, each of AICF GP and Mr. Mounts Gonzales may be deemed to beneficially own the securities owned directly by AICF.
Remarks:
David Mounts Gonzales is a director of the Issuer. For purposes of Section 16 of the Securities Exchange Act of 1934, as amended, each AICF and AICF GP may be deemed a director by deputization by virtue of its representation on the Board of Directors of the Issuer.
/s/ David Mounts Gonzales 03/17/2025
AI Catalyst Fund GP, LLC, By: /s/ David Mounts Gonzales, President and Sole Managing Member 03/17/2025
** 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.