Form 4 - Statement of changes in beneficial ownership of securities
February 07 2024 - 7:02PM
Edgar (US Regulatory)
SEC Form 4
FORM 4 |
UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549
STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP
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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OMB APPROVAL |
OMB Number: |
3235-0287 |
Estimated average burden |
hours per response: |
0.5 |
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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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Check this box to indicate that a transaction was made pursuant to a contract, instruction or written plan for the purchase or sale of equity securities of the issuer that is intended to satisfy the affirmative defense conditions of Rule 10b5-1(c). See Instruction 10. |
1. Name and Address of Reporting Person*
C/O ADAPTHEALTH LLC |
220 WEST GERMANTOWN PIKE, SUITE 250 |
(Street)
PLYMOUTH MEETING |
PA |
19462 |
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2. Issuer Name and Ticker or Trading Symbol
AdaptHealth Corp.
[ AHCO ]
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5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
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Director |
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10% Owner |
X |
Officer (give title below) |
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Other (specify below) |
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Chief Operating Officer |
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3. Date of Earliest Transaction
(Month/Day/Year) 02/05/2024
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4. If Amendment, Date of Original Filed
(Month/Day/Year)
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6. Individual or Joint/Group Filing (Check Applicable Line)
X |
Form filed by One Reporting Person |
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Form filed by More than One Reporting Person |
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Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned |
1. Title of Security (Instr.
3)
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2. Transaction Date
(Month/Day/Year) |
2A. Deemed Execution Date, if any
(Month/Day/Year) |
3. Transaction 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 |
V |
Amount |
(A) or (D) |
Price |
Common Stock |
02/05/2024 |
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A |
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71,339
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A |
$0
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237,611 |
D |
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Table II - Derivative Securities Acquired, Disposed of, or Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities)
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1. Title of Derivative Security (Instr.
3)
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2. Conversion or Exercise Price of Derivative Security
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3. Transaction Date
(Month/Day/Year) |
3A. Deemed Execution Date, if any
(Month/Day/Year) |
4. Transaction Code (Instr.
8)
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5.
Number of Derivative Securities Acquired (A) or Disposed of (D) (Instr.
3, 4 and 5)
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6. Date Exercisable and Expiration Date
(Month/Day/Year) |
7. Title and Amount of Securities Underlying Derivative Security (Instr.
3 and 4)
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8. Price of Derivative Security (Instr.
5)
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9.
Number of derivative Securities Beneficially Owned Following Reported Transaction(s) (Instr.
4)
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10. Ownership Form: Direct (D) or Indirect (I) (Instr.
4)
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11. Nature of Indirect Beneficial Ownership (Instr.
4)
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Code |
V |
(A) |
(D) |
Date Exercisable |
Expiration Date |
Title |
Amount or Number of Shares |
Explanation of Responses: |
Remarks: |
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/s/ Shannone Raybon, as attorney-in-fact for Shaw Rietkerk*** |
02/07/2024 |
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** 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 Number. |
Exhibit 24
SUBSTITUTE POWER OF ATTORNEY
July 31,
2023
Reference
is made to those certain Powers of Attorney executed over a period of several years, copies of which were previously filed with the Securities
and Exchange Commission (the “Original Powers of Attorney”), by and between the undersigned, Christopher Joyce (the “Original
Attorney-in- Fact”) and each of the directors and officers of AdaptHealth
Corp. (the “Company”) set forth below (collectively, the
“Section 16 Reporting Persons”), pursuant to which
the Original Attorney-in-Fact was appointed the true and lawful attorney-in-fact, with full power of substitution, to do and perform any
and all acts which may be necessary or desirable to be done in the exercise of the rights and powers granted in the Original Powers of
Attorney:
Christine Archbold
Richard Barasch
Gregory Belinfanti
Daniel Bunting
Jason Clemens
Terence Connors
Bradley Coppens
Stephen Griggs
Josh Parnes
Albert Prast
Shaw Rietkerk
Susan Weaver
David Williams
Dale Wolf
In
accordance with the authority granted under the Original Powers of Attorney, the Original Attorney-in- Fact hereby constitutes and appoints
Shannone Raybon (the “Substitute Attorney-in-Fact”)
as a substitute attorney-in-fact, on behalf of each of the Section 16 Reporting Persons, with full power of substitution or revocation,
to exercise and execute all of the powers granted or conferred in the Original Powers of Attorney. By her signature as attorney-in-fact
to this Substitute Power of Attorney, the Substitute Attorney-in-Fact accepts such appointment and agrees to assume from the undersigned
any and all duties and responsibilities attendant to her capacity as attorney-in-fact for each of the Section 16 Reporting Persons.
In accordance with the authority granted under the Original Powers of Attorney, including the power of revocation, the undersigned hereby
revokes the Original Attorney-in-Fact’s appointment as attorney-in-fact
on behalf of each of the Section 16 Reporting Persons.
[Signature Page Follows]
IN
WITNESS WHEREOF, the parties hereto have caused this Substitute Power of Attorney to be duly executed as of the day and year
first above written.
ORIGINAL ATTORNEY-IN-FACT |
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/s/ Christopher Joyce |
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Christopher Joyce |
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I hereby accept this appointment and substitution: |
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/s/ Shannone Raybon |
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Shannone Raybon |
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[Signature Page to Substitute Power of Attorney]
Exhibit 24
SUBSTITUTE POWER OF ATTORNEY
July 31,
2023
Reference
is made to those certain Powers of Attorney executed over a period of several years, copies of which were previously filed with the Securities
and Exchange Commission (the “Original Powers of Attorney”), by and between the undersigned, Christopher Joyce (the “Original
Attorney-in- Fact”) and each of the directors and officers of AdaptHealth
Corp. (the “Company”) set forth below (collectively, the
“Section 16 Reporting Persons”), pursuant to which
the Original Attorney-in-Fact was appointed the true and lawful attorney-in-fact, with full power of substitution, to do and perform any
and all acts which may be necessary or desirable to be done in the exercise of the rights and powers granted in the Original Powers of
Attorney:
Christine Archbold
Richard Barasch
Gregory Belinfanti
Daniel Bunting
Jason Clemens
Terence Connors
Bradley Coppens
Stephen Griggs
Josh Parnes
Albert Prast
Shaw Rietkerk
Susan Weaver
David Williams
Dale Wolf
In
accordance with the authority granted under the Original Powers of Attorney, the Original Attorney-in- Fact hereby constitutes and appoints
Shannone Raybon (the “Substitute Attorney-in-Fact”)
as a substitute attorney-in-fact, on behalf of each of the Section 16 Reporting Persons, with full power of substitution or revocation,
to exercise and execute all of the powers granted or conferred in the Original Powers of Attorney. By her signature as attorney-in-fact
to this Substitute Power of Attorney, the Substitute Attorney-in-Fact accepts such appointment and agrees to assume from the undersigned
any and all duties and responsibilities attendant to her capacity as attorney-in-fact for each of the Section 16 Reporting Persons.
In accordance with the authority granted under the Original Powers of Attorney, including the power of revocation, the undersigned hereby
revokes the Original Attorney-in-Fact’s appointment as attorney-in-fact
on behalf of each of the Section 16 Reporting Persons.
[Signature Page Follows]
IN
WITNESS WHEREOF, the parties hereto have caused this Substitute Power of Attorney to be duly executed as of the day and year
first above written.
ORIGINAL ATTORNEY-IN-FACT |
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/s/ Christopher Joyce |
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Christopher Joyce |
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I hereby accept this appointment and substitution: |
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/s/ Shannone Raybon |
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Shannone Raybon |
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[Signature Page to Substitute Power of Attorney]
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