Statement of Changes in Beneficial Ownership (4)
May 16 2023 - 06:22PM
Edgar (US Regulatory)
FORM 4
☐ Check this
box if no longer subject to Section 16. Form 4 or Form 5
obligations may continue. See Instruction 1(b).
|
UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
STATEMENT OF CHANGES IN BENEFICIAL
OWNERSHIP OF SECURITIES
|
OMB
APPROVAL
OMB Number: 3235-0287
Estimated average burden
hours per response... 0.5 |
|
Filed pursuant to Section 16(a) of the
Securities Exchange Act of 1934 or Section 30(h) of the Investment
Company Act of 1940
|
|
1. Name
and Address of Reporting Person * Bienstock
Lee |
2. Issuer Name and Ticker or Trading
Symbol DocGo Inc. [ DCGO ] |
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)_____
Director _____
10% Owner
__X__ Officer (give title
below) _____ Other
(specify below)
Chief Operating Officer |
(Last)
(First)
(Middle)
C/O DOCGO INC, 35 WEST 35TH STREET, FLOOR 6 |
3. Date of Earliest Transaction (MM/DD/YYYY)
5/12/2023
|
(Street)
NEW YORK, NY 10001 |
4. If Amendment, Date Original Filed
(MM/DD/YYYY)
|
6. Individual or Joint/Group Filing
(Check Applicable Line) _X _ Form filed by One Reporting Person
___ Form filed by More than One Reporting Person |
(City)
(State)
(Zip)
|
Rule 10b5-1(c) Transaction Indication
☐ Check this box to indicate
that a transaction was made pursuant to a contract, instruction or
written plan that is intended to satisfy the affirmative defense
conditions of Rule 10b5-1(c). See Instruction 10. |
Table I - Non-Derivative Securities Acquired, Disposed of, or
Beneficially Owned
|
1.Title of Security
(Instr. 3) |
2. Trans. Date |
2A. Deemed Execution Date, if any |
3. Trans. Code
(Instr. 8) |
4. Securities Acquired (A) or Disposed of (D)
(Instr. 3, 4 and 5) |
5. Amount of Securities Beneficially Owned Following
Reported Transaction(s)
(Instr. 3 and 4) |
6. Ownership Form: Direct (D) or Indirect (I)
(Instr. 4) |
7. Nature of Indirect Beneficial Ownership (Instr.
4) |
Code |
V |
Amount |
(A) or (D) |
Price |
Common Stock |
5/12/2023 |
|
A |
|
1066 (1) |
A |
$0.00 |
182087 |
D |
|
Restricted Stock Unit |
5/12/2023 |
|
A |
|
121951 (2) |
A |
$0.00 |
304038 |
D |
|
Table II - Derivative Securities Beneficially Owned
(e.g., puts, calls, warrants, options, convertible
securities)
|
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 |
Options to purchase Common
Stock |
$8.61 |
5/12/2023 |
|
A |
|
210843 (3) |
|
(4) |
5/12/2033 |
Common Stock |
210843 |
$0.00 |
210843 |
D |
|
Explanation of
Responses: |
(1) |
These shares reflect fully
vested shares of common stock of the Issuer granted in lieu of
making Mr. Bienstock's 2023 base salary increase retroactive to
January 1, 2023, net of shares withheld for taxes and other payroll
withholdings. |
(2) |
Represents restricted stock
units granted pursuant to the Issuer's 2021 Stock Incentive Plan
(the "Plan"), vesting in four equal annual installments on each of
the first four anniversaries of May 12, 2023, in each case, subject
to the terms of the Plan. Each restricted stock unit represents the
right to receive, upon vesting, one share of Common
Stock. |
(3) |
Represents stock options
granted pursuant to the Plan. Each option represents the right to
acquire one share of Common Stock. |
(4) |
The shares subject to the
stock options vest and become exercisable in four equal annual
installments on each of the first four anniversaries of May 12,
2023, in each case, subject to the terms of the Plan. |
Reporting
Owners
|
Reporting Owner Name / Address |
Relationships
|
Director |
10% Owner |
Officer |
Other |
Bienstock Lee
C/O DOCGO INC
35 WEST 35TH STREET, FLOOR 6
NEW YORK, NY 10001 |
|
|
Chief Operating Officer |
|
Signatures
|
/s/ Andre Oberholzer, Attorney-in-Fact for Lee
Bienstock |
|
5/16/2023 |
**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. |
DocGo (NASDAQ:DCGO)
Historical Stock Chart
From Sep 2023 to Oct 2023
DocGo (NASDAQ:DCGO)
Historical Stock Chart
From Oct 2022 to Oct 2023