SEC FORM
4
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 Number: |
3235-0287 |
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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). |
1. Name and Address of Reporting Person*
| 2300 YONGE STREET, SUITE 1710 |
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(Street)
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2. Issuer Name and Ticker or Trading Symbol
CECO ENVIRONMENTAL CORP
[ CECE ]
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5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
| X |
Director |
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10% Owner |
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Officer (give title below) |
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Other (specify below) |
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3. Date of Earliest Transaction
(Month/Day/Year)
05/16/2017
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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 |
05/16/2017 |
|
A |
|
7,642 |
A |
$0.00
|
26,146 |
D |
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| Common Stock |
|
|
|
|
|
|
|
2,300 |
I |
By Spouse |
| Common Stock |
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|
|
|
|
|
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49,500 |
I |
See footnote
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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/ Paul M. Gohr, as Attorney-in-Fact for Jonathan Pollack |
05/18/2017 |
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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. |
POWER OF ATTORNEY
KNOW ALL MEN BY THESE PRESENTS, that the undersigned hereby constitutes and
appoints Matthew Eckl, Paul M. Gohr, and Michael Burmaster, 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/ Jonathan Pollack
---------------------------------
Name: Jonathan Pollack
Date: May 18, 2017
