Statement of Changes in Beneficial Ownership (4)
March 13 2023 - 4:13PM
Edgar (US Regulatory)
FORM 4
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Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b).
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UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP OF SECURITIES
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OMB APPROVAL
OMB Number:
3235-0287
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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
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WCAS XII CARBON ANALYTICS ACQUISITION, L.P. |
2. Issuer Name and Ticker or Trading Symbol
Clearwater Analytics Holdings, Inc.
[
CWAN
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5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
_____ Director __X__ 10% Owner _____ Officer (give title below) _____ Other (specify below)
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(Last)
(First)
(Middle)
C/O WELSH, CARSON, ANDERSON AND STOWE, 599 LEXINGTON AVENUE, SUITE 1800 |
3. Date of Earliest Transaction
(MM/DD/YYYY)
3/9/2023 |
(Street)
NEW YORK, NY 10022
(City)
(State)
(Zip)
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4. If Amendment, Date Original Filed
(MM/DD/YYYY)
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6. Individual or Joint/Group Filing
(Check Applicable Line)
___ Form filed by One Reporting Person
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X
_ Form filed by More than One Reporting Person
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Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned
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1.Title of Security (Instr. 3)
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2. Trans. Date
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2A. Deemed Execution Date, if any
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3. Trans. Code (Instr. 8)
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4. Securities Acquired (A) or Disposed of (D) (Instr. 3, 4 and 5)
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5. Amount of Securities Beneficially Owned Following Reported Transaction(s) (Instr. 3 and 4)
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6. Ownership Form: Direct (D) or Indirect (I) (Instr. 4)
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7. Nature of Indirect Beneficial Ownership (Instr. 4)
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Code
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V
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Amount
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(A) or (D)
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Price
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Class C Common Stock (1) | 3/9/2023 | | C | | 4194343 | D | (1)(2) | 43183244 | I | See Footnotes (3)(4)(5) |
Class D Common Stock (3) | 3/9/2023 | | C | | 8805657 | D | (1)(2) | 54832446 | I | See Footnotes (3)(4)(5) |
Class A Common Stock | 3/9/2023 | | C | | 13000000 | A | (1)(2) | 13000000 | I | See Footnotes (3)(4)(5) |
Class A Common Stock | 3/13/2023 | | S | | 13000000 | D | $14.50 (6) | 0 | I | See Footnotes (3)(4)(5) |
Table II - Derivative Securities Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities)
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1. Title of Derivate Security (Instr. 3) | 2. Conversion or Exercise Price of Derivative Security | 3. Trans. Date | 3A. Deemed Execution Date, if any | 4. Trans. Code (Instr. 8) | 5. Number of Derivative Securities Acquired (A) or Disposed of (D) (Instr. 3, 4 and 5) | 6. Date Exercisable and Expiration Date | 7. Title and Amount of Securities Underlying Derivative Security (Instr. 3 and 4) | 8. Price of Derivative Security (Instr. 5) | 9. Number of derivative Securities Beneficially Owned Following Reported Transaction(s) (Instr. 4) | 10. Ownership Form of Derivative Security: Direct (D) or Indirect (I) (Instr. 4) | 11. Nature of Indirect Beneficial Ownership (Instr. 4) |
Code | V | (A) | (D) | Date Exercisable | Expiration Date | Title | Amount or Number of Shares |
CWAN Holdings LLC Interests (1) | (1)(2) | 3/9/2023 | | C | | | 4194343 | (1)(2) | (1)(2) | Class A or Class D Common Stock (2) | 4194343 | (1)(2) | 43183244 (7) | I | See Footnotes (3)(4)(5) |
Explanation of Responses: |
(1) | Shares of Class C Common Stock do not represent economic interests in the Issuer. Except as provided in the Issuer's certificate of incorporation or as required by applicable law, holders of Class C Common Stock will be initially entitled to 10 votes per share on all matters to be voted on by the Issuer's stockholders generally. The Reporting Person may exchange all or a portion of such person's CWAN Holdings LLC Interests ("LLC Interests") (together with the delivery for no consideration of an equal number of shares of Class C Common Stock) for an equal number of newly issued shares of Class D Common Stock or Class A Common Stock from time to time, subject to customary adjustments, or, at the election of the Issuer, a cash payment equal to the 20 day volume weighted average price of shares of Class A Common Stock immediately prior to the applicable exchange date. |
(2) | Upon the earlier of (i) the date that affiliates of Welsh Carson own less than 5% of the Issuer's common stock and (ii) the seventh anniversary of the closing of the Issuer's initial public offering, each share of Class D Common Stock will automatically convert into a share of Class A Common Stock and each share of Class C Common Stock will automatically convert into a share of Class B Common Stock of the Issuer, each of which is entitled to one vote per share. Thereafter, an exchange of the Reporting Person's LLC Interests will be for Class A Common Stock and the surrender for no consideration of non-economic voting stock in connection with such exchange will be with respect to Class B Common Stock held by the Reporting Person. |
(3) | Includes 16,995,584 shares of Class C Common Stock held by WCAS XII Carbon Analytics Acquisition, L.P., 24,572,711 shares of Class C Common Stock held by WCAS XIII Carbon Analytics Acquisition, L.P., 1,614,949 shares of Class C Common Stock held by WCAS GP CW LLC, 12,114,292 shares of Class D Common Stock held by Welsh, Carson, Anderson & Stowe XII, L.P., 5,231,009 shares of Class D Common Stock held by Welsh, Carson, Anderson & Stowe XII Delaware, L.P., 757,934 shares of Class D Common Stock held by Welsh, Carson, Anderson & Stowe XII Delaware II, L.P., 5,263,125 shares of Class D Common Stock held by Welsh, Carson, Anderson & Stowe XII Cayman, L.P., 11,627,713 shares of Class D Common Stock held by WCAS XII Carbon Investors, L.P. and 19,838,373 shares of Class D Common Stock held by WCAS XIII Carbon Investors, L.P. (together, the "WCAS Entities"). |
(4) | The general partner of Welsh, Carson, Anderson & Stowe XII Delaware, L.P. and Welsh, Carson, Anderson & Stowe XII Cayman, L.P. is WCAS XII Associates Cayman, L.P. The general partner of WCAS XII Carbon Analytics Acquisition, L.P., Welsh, Carson, Anderson & Stowe XII, L.P., WCAS XII Associates Cayman, L.P. and Welsh, Carson, Anderson & Stowe XII Delaware II, L.P. is WCAS XII Associates LLC. The general partner of WCAS XIII Carbon Analytics Acquisition, L.P. and the managing member of WCAS GP CW LLC is WCAS XIII Associates LLC. Investment and voting decisions with respect to the shares held by the WCAS Entities are made by a committee comprised of three or more individuals and all members of such committee disclaim beneficial ownership of the shares. |
(5) | Each of the Reporting Persons disclaims beneficial ownership except to the extent of their pecuniary interest therein, and the filing of this Form 4 shall not be construed as an admission that any Reporting Person is the beneficial owner of any or all of the reported securities for the purposes of Section 16 or for any other purpose. |
(6) | This amount represents a public offering price of $15.00 per share of Class A Common Stock less an underwriting discount of $0.50 per share for shares sold in an underwritten public offering. |
(7) | The Form 3 filed by the Reporting Persons inadvertently overstated the amount of LLC Interests held by the Reporting Persons, which, at the time of such filing, was 47,377,587 LLC Interests. The reported amount corrects such overstatement after giving effect to the conversion of LLC Interests reported herein. |
Reporting Owners
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Reporting Owner Name / Address | Relationships |
Director | 10% Owner | Officer | Other |
WCAS XII CARBON ANALYTICS ACQUISITION, L.P. C/O WELSH, CARSON, ANDERSON AND STOWE 599 LEXINGTON AVENUE, SUITE 1800 NEW YORK, NY 10022 |
| X |
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WCAS XII ASSOCIATES LLC C/O WELSH, CARSON, ANDERSON AND STOWE 599 LEXINGTON AVENUE, SUITE 1800 NEW YORK, NY 10022 |
| X |
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WCAS XIII Associates LLC C/O WELSH, CARSON, ANDERSON AND STOWE 599 LEXINGTON AVENUE, SUITE 1800 NEW YORK, NY 10022 |
| X |
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Signatures
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WCAS XII CARBON ANALYTICS ACQUISITION, L.P., By: WCAS XII Associates LLC, its general partner /s/ Jonathan Rather, Managing Member | | 3/13/2023 |
**Signature of Reporting Person | Date |
WCAS XII ASSOCIATES LLC, By: /s/ Jonathan Rather, Managing Member | | 3/13/2023 |
**Signature of Reporting Person | Date |
WCAS XIII ASSOCIATES LLC, By: /s/ Jonathan Rather, Managing Member | | 3/13/2023 |
**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 4(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 control number. |
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