SEC FORM
3
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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| OMB APPROVAL |
| OMB Number: |
3235-0104 |
| Estimated average burden |
| hours per response: |
0.5 |
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1. Name and Address of Reporting Person*
| 14651 NORTH DALLAS PARKWAY, SUITE 500 |
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(Street)
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2. Date of Event Requiring Statement
(Month/Day/Year)
04/15/2021
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3. Issuer Name and Ticker or Trading Symbol
CECO ENVIRONMENTAL CORP
[ CECE ]
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4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
|
Director |
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10% Owner |
| X |
Officer (give title below) |
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Other (specify below) |
| See Remarks |
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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)
| X |
Form filed by One Reporting Person |
|
Form filed by More than One Reporting Person |
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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)
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3. Ownership Form: Direct (D) or Indirect (I) (Instr.
5)
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4. Nature of Indirect Beneficial Ownership (Instr.
5)
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| Common Stock |
41,757 |
D |
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Table II - Derivative Securities Beneficially Owned
(e.g., puts, calls, warrants, options, convertible securities)
|
|---|
| 1. Title of Derivative Security (Instr.
4)
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2. Date Exercisable and Expiration Date
(Month/Day/Year) |
3. Title and Amount of Securities Underlying Derivative Security (Instr.
4)
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4. Conversion or Exercise Price of Derivative Security
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5. Ownership Form: Direct (D) or Indirect (I) (Instr.
5)
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6. Nature of Indirect Beneficial Ownership (Instr.
5)
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| Date Exercisable |
Expiration Date |
Title |
Amount or Number of Shares |
| Explanation of Responses: |
| Remarks: |
|
|
/s/ Paul M. Gohr, as Attorney-in-Fact for Chasity Henry |
04/21/2021 |
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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
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. |
POWER OF ATTORNEY
KNOW ALL MEN BY THESE PRESENTS, that the undersigned hereby constitutes
and appoints Matthew Eckl and Paul M. Gohr, and each of them, as the true and
lawful attorney or attorneys-in-fact, with full power of substitution and
revocation, for the undersigned and in the name, place and stead of the
undersigned, in any and all capacities, to execute, on behalf of the
undersigned, (1) any and all notices pursuant to Rule l44 under the Securities
Act of 1933 with respect to sales of shares of common stock, par value $0.01 per
share, or other securities, of CECO Environmental Corp., including, without
limitation, all notices of proposed sale on Form 144, and (2) any and all
statements or reports under Section 16 of the Securities Exchange Act of 1934
with respect to the beneficial ownership of common stock, par value $0.01 per
share, or other securities, of CECO Environmental Corp., including, without
limitation, all initial statements of beneficial ownership on Form 3, all
statements of changes in beneficial ownership on Form 4, all annual statements
of beneficial ownership on Form 5 and all successor or similar forms, to be
filed with the Securities and Exchange Commission, to execute any and all
amendments or supplements to any such notices, statements or reports, and to
file the same, with all exhibits thereto, and other documents in connection
therewith, with the Securities and Exchange Commission, granting to said
attorney or attorneys-in-fact, and each of them, full power and authority to do
so and perform each and every act and thing requisite and necessary to be done
in and about the premises (including, without limitation, completing, executing,
delivering and filing a Form ID to apply for electronic filing codes), as fully
and to all intents and purposes as the undersigned might or could do in person,
and hereby ratifying and confirming all that said attorney or attorneys-in-
fact, or any of them, or their substitute or substitutes, may lawfully do or
cause to be done by virtue hereof. The undersigned acknowledges that the
foregoing attorneys-in-fact, and each of them, in serving in such capacity at
the request of the undersigned, are not assuming any of the responsibilities of
the undersigned to comply with Section 16 of the Securities Exchange Act of 1934
or any other legal requirement. This Power of Attorney shall remain in effect
until revoked in writing by the undersigned.
/s/ Chasity Henry
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Name: Chasity Henry
Date: April 1, 2021
