SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
Schedule 13G
(Rule 13d-102)
INFORMATION TO BE INCLUDED IN
STATEMENTS FILED PURSUANT TO RULES 13d-1 (b), (c) AND (d)
AND AMENDMENTS THERETO FILED PURSUANT TO 13d-2 (b)
(Amendment No. 1)*
VistaCare, Inc.
(Name of Issuer)
Class A Common Stock, par value $0.01 per share
(Title of Class of Securities)
92839Y109
(CUSIP Number)
December 31, 2003
(Date of Event Which Requires Filing of this Statement)
Check the appropriate box to designate the rule pursuant to which this Schedule is filed:
o |
Rule 13d-1(b) |
o |
Rule 13d-1(c) |
ý |
Rule 13d-1(d) |
*The remainder of this cover page shall be filled out for a reporting persons initial filing on this form with respect to the subject class of securities, and for any subsequent amendment containing information which would alter disclosures provided in a prior cover page.
The information required on the remainder of this cover page shall not be deemed to be filed for the purpose of Section 18 of the Securities Exchange Act of 1934 (Act) or otherwise subject to the liabilities of that section of the Act but shall be subject to all other provisions of the Act (however, see the Notes).
(Continued on following pages)
Page 1
of 14 Pages
Exhibit Index on Page 13
CUSIP NO. 92839Y109 |
13 G |
Page 2 of 14 Pages |
1 |
NAME OF
REPORTING PERSON |
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2 |
CHECK THE APPROPRIATE BOX IF A MEMBER OF A GROUP (a) o (b) ý |
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3 |
SEC USE ONLY |
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4 |
CITIZENSHIP OR PLACE OF ORGANIZATION Delaware |
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NUMBER OF |
5 |
SOLE VOTING POWER |
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6 |
SHARED VOTING
POWER |
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7 |
SOLE DISPOSITIVE
POWER |
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8 |
SHARED
DISPOSITIVE POWER |
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9 |
AGGREGATE AMOUNT BENEFICIALLY OWNED BY EACH |
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10 |
CHECK
BOX IF THE AGGREGATE AMOUNT IN ROW 9 |
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11 |
PERCENT OF CLASS REPRESENTED BY AMOUNT IN ROW 9 0% |
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12 |
TYPE OF REPORTING PERSON PN |
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CUSIP NO. 92839Y109 |
13 G |
Page 3 of 14 Pages |
1 |
NAME OF
REPORTING PERSON |
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2 |
CHECK THE APPROPRIATE BOX IF A MEMBER OF A GROUP (a) o (b) ý |
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3 |
SEC USE ONLY |
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4 |
CITIZENSHIP OR
PLACE OF ORGANIZATION |
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NUMBER OF |
5 |
SOLE VOTING
POWER |
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6 |
SHARED VOTING
POWER |
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7 |
SOLE DISPOSITIVE
POWER |
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8 |
SHARED
DISPOSITIVE POWER |
||
9 |
AGGREGATE AMOUNT BENEFICIALLY OWNED BY EACH |
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10 |
CHECK
BOX IF THE AGGREGATE AMOUNT IN ROW 9 |
||
11 |
PERCENT OF CLASS REPRESENTED BY AMOUNT IN ROW 9 0% |
||
12 |
TYPE OF REPORTING PERSON PN |
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CUSIP NO. 92839Y109 |
13 G |
Page 4 of 14 Pages |
1 |
NAME OF
REPORTING PERSON |
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2 |
CHECK THE APPROPRIATE BOX IF A MEMBER OF A GROUP |
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3 |
SEC USE ONLY |
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4 |
CITIZENSHIP OR
PLACE OF ORGANIZATION |
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NUMBER OF |
5 |
SOLE VOTING
POWER |
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6 |
SHARED VOTING
POWER |
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7 |
SOLE DISPOSITIVE
POWER |
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8 |
SHARED
DISPOSITIVE POWER |
||
9 |
AGGREGATE AMOUNT BENEFICIALLY OWNED BY EACH |
||
10 |
CHECK
BOX IF THE AGGREGATE AMOUNT IN ROW 9 |
||
11 |
PERCENT OF CLASS REPRESENTED BY AMOUNT IN ROW 9 0% |
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12 |
TYPE OF REPORTING PERSON OO |
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CUSIP NO. 92839Y109 |
13 G |
Page 5 of 14 Pages |
1 |
NAME OF
REPORTING PERSON |
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2 |
CHECK THE APPROPRIATE BOX IF A MEMBER OF A GROUP |
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3 |
SEC USE ONLY |
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4 |
CITIZENSHIP OR
PLACE OF ORGANIZATION |
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NUMBER OF |
5 |
SOLE VOTING
POWER |
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6 |
SHARED VOTING
POWER |
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7 |
SOLE DISPOSITIVE
POWER |
||
8 |
SHARED
DISPOSITIVE POWER |
||
9 |
AGGREGATE AMOUNT BENEFICIALLY OWNED BY EACH |
||
10 |
CHECK
BOX IF THE AGGREGATE AMOUNT IN ROW 9 |
||
11 |
PERCENT OF CLASS REPRESENTED BY AMOUNT IN ROW 9 0% |
||
12 |
TYPE OF REPORTING PERSON IN |
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CUSIP NO. 92839Y109 |
13 G |
Page 6 of 14 Pages |
1 |
NAME OF
REPORTING PERSON |
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2 |
CHECK THE APPROPRIATE BOX IF A MEMBER OF A GROUP |
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3 |
SEC USE ONLY |
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4 |
CITIZENSHIP OR
PLACE OF ORGANIZATION |
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NUMBER OF |
5 |
SOLE VOTING
POWER |
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6 |
SHARED VOTING
POWER |
||
7 |
SOLE DISPOSITIVE
POWER |
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8 |
SHARED
DISPOSITIVE POWER |
||
9 |
AGGREGATE AMOUNT BENEFICIALLY OWNED BY EACH |
||
10 |
CHECK
BOX IF THE AGGREGATE AMOUNT IN ROW 9 |
||
11 |
PERCENT OF CLASS REPRESENTED BY AMOUNT IN ROW 9 0.5% |
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12 |
TYPE OF REPORTING PERSON IN |
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CUSIP NO. 92839Y109 |
13 G |
Page 7 of 14 Pages |
1 |
NAME OF
REPORTING PERSON |
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2 |
CHECK THE APPROPRIATE BOX IF A MEMBER OF A GROUP |
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3 |
SEC USE ONLY |
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4 |
CITIZENSHIP OR
PLACE OF ORGANIZATION |
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NUMBER OF |
5 |
SOLE VOTING
POWER |
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6 |
SHARED VOTING
POWER |
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7 |
SOLE DISPOSITIVE
POWER |
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8 |
SHARED
DISPOSITIVE POWER |
||
9 |
AGGREGATE AMOUNT BENEFICIALLY OWNED BY EACH |
||
10 |
CHECK
BOX IF THE AGGREGATE AMOUNT IN ROW 9 |
||
11 |
PERCENT OF CLASS REPRESENTED BY AMOUNT IN ROW 9 0% |
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12 |
TYPE OF REPORTING PERSON IN |
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CUSIP NO. 92839Y109 |
13 G |
Page 8 of 14 Pages |
1 |
NAME OF
REPORTING PERSON |
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2 |
CHECK THE APPROPRIATE BOX IF A MEMBER OF A GROUP |
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3 |
SEC USE ONLY |
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4 |
CITIZENSHIP OR
PLACE OF ORGANIZATION |
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NUMBER OF |
5 |
SOLE VOTING
POWER |
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6 |
SHARED VOTING
POWER |
||
7 |
SOLE DISPOSITIVE
POWER |
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8 |
SHARED
DISPOSITIVE POWER |
||
9 |
AGGREGATE AMOUNT BENEFICIALLY OWNED BY EACH |
||
10 |
CHECK
BOX IF THE AGGREGATE AMOUNT IN ROW 9 |
||
11 |
PERCENT OF CLASS REPRESENTED BY AMOUNT IN ROW 9 0.6% |
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12 |
TYPE OF REPORTING PERSON IN |
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CUSIP NO. 92839Y109 |
13 G |
Page 9 of 14 Pages |
1 |
NAME OF
REPORTING PERSON |
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2 |
CHECK THE APPROPRIATE BOX IF A MEMBER OF A GROUP |
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3 |
SEC USE ONLY |
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4 |
CITIZENSHIP OR
PLACE OF ORGANIZATION |
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NUMBER OF |
5 |
SOLE VOTING
POWER |
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6 |
SHARED VOTING
POWER |
||
7 |
SOLE DISPOSITIVE
POWER |
||
8 |
SHARED DISPOSITIVE
POWER |
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9 |
AGGREGATE AMOUNT BENEFICIALLY OWNED BY EACH |
||
10 |
CHECK
BOX IF THE AGGREGATE AMOUNT IN ROW 9 |
||
11 |
PERCENT OF CLASS REPRESENTED BY AMOUNT IN ROW 9 0% |
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12 |
TYPE OF REPORTING PERSON IN |
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CUSIP NO. 92839Y109 |
13 G |
Page 10 of 14 Pages |
This Amendment No. 1 amends the Statement on 13(G) (the Original Statement) filed by Bessemer Venture Partners III, L.P., a Delaware limited partnership (BVP III), BVP III Special Situations, L.P., a Delaware limited partnership (BVP III SS), Robert H. Buescher, William T. Burgin, David J. Cowan, Christopher F.O. Gabrieli and G. Felda Hardymon. The foregoing entities and individuals are collectively referred to as the Reporting Persons. Only those items as to which there has been a change are included in this Amendment No. 1.
ITEM 1(b). ADDRESS OF ISSUERS PRINCIPAL EXECUTIVE OFFICES:
4800 N. Scottsdale Road, Suite 5000
Scottsdale, Arizona 85251
ITEM 4. OWNERSHIP:
Provide the following information regarding the aggregate number and percentage of the class of securities of the issuer identified in Item 1. The following information with respect to the ownership of the Class A Common Stock of the issuer by the persons filing this statement is provided as of December 31, 2003:
(i) Sole power to vote or to direct the vote:
See Row 5 of the cover page for each Reporting Person.
(ii) Shared power to vote or to direct the vote:
See Row 6 of the cover page for each Reporting Person.
(iii) Sole power to dispose or to direct the disposition of:
See Row 7 of the cover page for each Reporting Person.
(iv) Shared power to dispose or to direct the disposition of:
See Row 8 of the cover page for each Reporting Person.
ITEM
5. OWNERSHIP
OF FIVE PERCENT OR LESS OF A CLASS:
If this statement is being filed to report the fact that as of the date hereof
the reporting person has ceased to be the beneficial owner of more than five
percent of the class of securities, check the
following: ý Yes
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Page 11 of 14 Pages |
SIGNATURES
After reasonable inquiry and to the best of my knowledge and belief, I certify that the information set forth in this statement is true, complete and correct.
Date: February 13, 2004
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BESSEMER VENTURE PARTNERS III L.P. |
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By: Deer III & Co. LLC, General Partner |
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By: |
/s/ J. Edmund Colloton |
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J. Edmund Colloton |
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Authorized Officer |
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BVP III SPECIAL SITUATIONS L.P. |
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By: Deer III & Co. LLC, General Partner |
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By: |
/s/ J. Edmund Colloton |
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J. Edmund Colloton |
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Authorized Officer |
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DEER III & Co. LLC |
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By: |
/s/ J. Edmund Colloton |
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J. Edmund Colloton |
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Authorized Officer |
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ROBERT H. BUESCHER |
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By: |
* |
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J. Edmund Colloton |
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Attorney-in-Fact |
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WILLIAM T. BURGIN |
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By: |
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J. Edmund Colloton |
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Attorney-in-Fact |
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DAVID J. COWAN |
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By: |
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J. Edmund Colloton |
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Attorney-in-Fact |
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Page 12 of 14 Pages |
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CHRISTOPHER F. O. GABRIELI |
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By: |
* |
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J. Edmund Colloton |
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Attorney-in-Fact |
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G. FELDA HARDYMON |
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By: |
* |
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J. Edmund Colloton |
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Attorney-in-Fact |
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*Signed pursuant to a Statement Appointing Designated Filer and Authorized Signatories, dated February 14, 2002 (the Statement of Designation) and filed with the SEC on February 14, 2002 as an exhibit to the Form 13G for Telocity Delaware, Inc., filed by Bessemer Venture Partners IV, L.P., which Statement of Designation is incorporated by reference herein.
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Page 13 of 14 Pages |
EXHIBIT INDEX
Exhibit |
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Found on |
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Exhibit A: Agreement of Joint Filing |
14 |
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Page 14 of 14 Pages |
EXHIBIT A
Agreement of Joint Filing
The Reporting Persons hereby agree that a single Schedule 13G (or any amendment thereto) relating to the Class A Common Stock of VistaCare, Inc. shall be filed on behalf of each of the Reporting Persons. Note that copies of the applicable Agreement of Joint Filing are already on file with the appropriate agencies.