| 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*
(Street)
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2. Date of Event Requiring Statement
(Month/Day/Year) 02/14/2022 |
3. Issuer Name and Ticker or Trading Symbol
Columbia Care Inc. [ CCHW ] |
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4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
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5. If Amendment, Date of Original Filed
(Month/Day/Year) |
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6. Individual or Joint/Group Filing (Check Applicable Line)
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| 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 Shares | 321,151 | D | |
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Table II - Derivative Securities Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities) | |||||||
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| 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 | ||||
| Restricted Stock Units | (1) | (1) | Common Shares | 217,673 | (2) | D | |
| Restricted Stock Units | (3) | (3) | Common Shares | 102,478 | (2) | D | |
| Restricted Stock Units | (4) | (4) | Common Shares | 479,284 | (2) | D | |
| Restricted Stock Units | (5) | (5) | Common Shares | 225,320 | (2) | D | |
| Performance Stock Units | (6) | 04/29/2022 | Common Shares | 870,691 | (6) | D | |
| Performance Stock Units | (6) | 04/29/2024 | Common Shares | 870,691 | (6) | D | |
| Explanation of Responses: |
| 1. 870,691 restricted stock units ("RSUs") were granted on April 29, 2019, with 653,018 vesting prior to the date of this Form 3. The remaining 217,673 RSUs vest on October 29, 2022. Settlement of vested RSUs will occur within 60 days of the applicable vesting date. |
| 2. Each restricted stock unit represents a contingent right to receive one share of the Issuer's common stock. |
| 3. 204,955 restricted stock units ("RSUs") were granted on September 30, 2019, with 102,477 vesting prior to the date of this Form 3. The remaining 102,478 RSUs vest as follows: 51,239 on April 29, 2022 and April 29, 2023. Settlement of vested RSUs will occur within 60 days of the applicable vesting date. |
| 4. 639,045 restricted stock units ("RSUs") were granted on March 31, 2020, with 159,761 vesting prior to the date of this Form 3. The remaining RSUs will vest as follows: 159,761 on March 31, 2022 and March 31, 2023, and 159,762 on March 31, 2024. Settlement of vested RSUs will occur within 60 days of the applicable vesting date. |
| 5. The restricted stock units ("RSUs") were granted on March 23, 2021, and vest as follows: 56,330 on March 23, 2022, March 23, 2023, March 23, 2024, and March 23, 2025. Settlement of vested RSUs will occur within 60 days of the applicable vesting date. |
| 6. The performance stock units ("PSUs") were granted on April 29, 2019. Each PSU represents a contingent right to receive one share of the Issuer's common stock. The PSUs vest upon the Issuer's common stock achieving a specified price per share. |
| Remarks: |
| Exhibit 24.1 Power of Attorney |
| /s/ David Sirolly as attorney-in-fact for Michael Abbott | 03/30/2022 | |
| ** 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. | ||