[sheet: Formation Checklist]

[sheet: Formation Checklist]
Item No. | Entity Name | Entity Short Name | Entity Type | Jurisdiction of Formation | Role in Transaction Structure | Delaware File Number | Date of Formation Filing | Filing Confirmed / Accepted | EIN | EIN Application Filed | EIN Received | Registered Agent Name | Registered Agent Address | Organizational Document Type | Organizational Document Drafted | Organizational Document Filed / Executed | Operating / Governance Agreement Required | Operating / Governance Agreement Status | Good Standing Certificate Ordered | Good Standing Certificate Received | Foreign Qualification Required | Foreign Qualification States | Responsible Attorney | Notes
1 | Ardent Healthcare Holdings LLC | Holdings / AHH | Limited Liability Company | Delaware | Top holding company; wholly owned by Ardent Capital Partners III LP and rollover participants (Dr. Raymond Carvallo, Dr. Nadia Ostrowski, Jonathan Marsh); classified as partnership for federal tax purposes (default classification; no check-the-box election filed); equity aggregator for Fund III capital ($198.5M), rollover equity ($59.54M total), and management incentive equity | 7834219 | 2024-03-05 | Yes | 93-2187445 | 2024-03-05 | 2024-03-08 | Pemberton Industries | 251 Little Falls Drive, Wilmington, DE 19808 | Certificate of Formation | 2024-03-01 | 2024-03-05 | Yes | LLC Operating Agreement — in drafting; includes Class A Units (Fund III) and Class B Units (rollover participants); tax allocation, distribution waterfall, and Section 704(b) capital account provisions under review by Calderwood & Harkness LLP | Yes | TBD | New York (business address: 600 Lexington Avenue, 38th Floor, New York, NY 10022) — NY nexus analysis pending; management fee agreements to be routed through Ardent Capital GP III LLC to mitigate Holdings-level NY nexus | Robert Jansen / Garrett Simmons (Calderwood & Harkness LLP) | Business address: 600 Lexington Avenue, 38th Floor, New York, NY 10022. Section 754 election to be made at Pinnacle level, not Holdings level. Holdings will issue Class B Units to rollover participants as tax-deferred contribution under Section 721. Mezzanine warrants (2.5% fully diluted equity) to Cascadia Mezzanine Fund IV LP also issued at this level.
2 | Ardent Healthcare Intermediate Inc. | Intermediate / AHI | C-Corporation | Delaware | Blocker entity interposed between Holdings LLC and the surviving operating subsidiary (Pinnacle); purposes: (a) block UBTI for tax-exempt Fund III LPs, (b) facilitate potential future IPO exit, (c) isolate state tax nexus; holds 100% of surviving Pinnacle entity post-merger | 7834223 | 2024-03-05 | Yes | 93-2187512 | 2024-03-05 | 2024-03-08 | Pemberton Industries | 251 Little Falls Drive, Wilmington, DE 19808 | Certificate of Incorporation | 2024-03-01 | 2024-03-05 | Yes | Bylaws — drafted; Board resolutions authorizing acquisition to be prepared prior to signing (March 15, 2024) | Yes | Yes | Pennsylvania, Virginia, Maryland, North Carolina, Georgia (operating states of Pinnacle); filings to be completed post-closing | Robert Jansen / Garrett Simmons (Calderwood & Harkness LLP) | Business address: 600 Lexington Avenue, 38th Floor, New York, NY 10022. Intermediate Inc. will be the purchasing entity receiving Section 743(b) basis step-up of $224.4M ($412.0M EV minus $187.6M Pinnacle inside basis). Authorized shares: 1,000 shares common stock, $0.01 par value. Sole shareholder: Ardent Healthcare Holdings LLC.
3 | Ardent Healthcare Merger Sub LLC | Merger Sub | Limited Liability Company | Delaware | Merger subsidiary; to merge with and into Pinnacle Health Services Group LLC in a reverse merger, with Pinnacle surviving as a wholly owned subsidiary of Ardent Healthcare Intermediate Inc. | 7834227 | 2024-03-05 | Yes | To be obtained (transitory entity; may not require separate EIN if merged out of existence at closing) | Pemberton Industries | 251 Little Falls Drive, Wilmington, DE 19808 | Certificate of Formation | 2024-03-01 | 2024-03-05 | Yes | LLC Agreement — short-form; sole member: Ardent Healthcare Intermediate Inc.; to be executed prior to signing | No | No | N/A — transitory entity; ceases to exist upon consummation of the merger at closing (May 31, 2024) | Robert Jansen / Garrett Simmons (Calderwood & Harkness LLP) | Transitory entity. Upon closing, Merger Sub merges with and into Pinnacle Health Services Group LLC (EIN 82-1947632), with Pinnacle surviving. Merger Sub will cease to exist. No foreign qualification needed.
[sheet: Formation Instructions]
Step No. | Action Item | Applicable Entity(ies) | Responsible Person | Due Date | Completed Date | Status | Notes / Instructions
1 | Draft Certificate of Formation for Holdings LLC | Ardent Healthcare Holdings LLC | Garrett Simmons | 2024-03-01 | 2024-03-01 | Complete | Delaware LLC; default partnership classification for federal tax purposes; no check-the-box election to be filed
2 | Draft Certificate of Incorporation for Intermediate Inc. | Ardent Healthcare Intermediate Inc. | Garrett Simmons | 2024-03-01 | 2024-03-01 | Complete | Delaware C-corporation; 1,000 authorized shares common stock, $0.01 par value; incorporator: Robert Jansen
3 | Draft Certificate of Formation for Merger Sub LLC | Ardent Healthcare Merger Sub LLC | Garrett Simmons | 2024-03-01 | 2024-03-01 | Complete | Delaware LLC; transitory merger subsidiary
4 | Engage Pemberton Industries as registered agent for all three entities | All | Garrett Simmons | 2024-03-01 | 2024-03-01 | Complete | Registered agent: Pemberton Industries, 251 Little Falls Drive, Wilmington, DE 19808; annual agent fee arrangements confirmed
5 | File Certificate of Formation — Holdings LLC with Delaware Secretary of State | Ardent Healthcare Holdings LLC | Garrett Simmons | 2024-03-05 | 2024-03-05 | Complete | Filed electronically; Delaware File No. 7834219; filing fee paid; confirmation received same day
6 | File Certificate of Incorporation — Intermediate Inc. with Delaware Secretary of State | Ardent Healthcare Intermediate Inc. | Garrett Simmons | 2024-03-05 | 2024-03-05 | Complete | Filed electronically; Delaware File No. 7834223; filing fee paid; confirmation received same day
7 | File Certificate of Formation — Merger Sub LLC with Delaware Secretary of State | Ardent Healthcare Merger Sub LLC | Garrett Simmons | 2024-03-05 | 2024-03-05 | Complete | Filed electronically; Delaware File No. 7834227; filing fee paid; confirmation received same day
8 | Apply for EIN — Holdings LLC (Form SS-4) | Ardent Healthcare Holdings LLC | Garrett Simmons | 2024-03-05 | 2024-03-05 | Complete | EIN 93-2187445 received; entity type: partnership; fiscal year end: December 31; responsible party: Dominic Ferrera (Co-Founder & Managing Partner, Ardent Capital Partners III LP)
9 | Apply for EIN — Intermediate Inc. (Form SS-4) | Ardent Healthcare Intermediate Inc. | Garrett Simmons | 2024-03-05 | 2024-03-05 | Complete | EIN 93-2187512 received; entity type: corporation; fiscal year end: December 31; responsible party: Dominic Ferrera
10 | Determine EIN requirement for Merger Sub LLC | Ardent Healthcare Merger Sub LLC | Robert Jansen | 2024-03-08 | 2024-03-08 | Complete | Concluded EIN not required; Merger Sub is transitory and will cease to exist upon closing merger into Pinnacle (EIN 82-1947632); if needed for bank account or signing purposes, can be obtained on expedited basis
11 | Prepare and execute LLC Agreement for Holdings LLC (Operating Agreement) | Ardent Healthcare Holdings LLC | Robert Jansen / Leonard Cross | 2024-03-15 | In Progress | Full operating agreement with Class A Units (Ardent Capital Partners III LP) and Class B Units (rollover participants: Dr. Raymond Carvallo, Dr. Nadia Ostrowski, Jonathan Marsh); includes tax provisions per Calderwood & Harkness markup (Section 704(b) capital accounts, 704(c) remedial method, minimum gain chargeback, qualified income offset, tax distributions); to be finalized and executed at or prior to signing of Merger Agreement on March 15, 2024; coordinate with Harcourt Shaw & DeVries LLP (Thomas Kundra) and Whitford & Gaines LLP (Patricia Engelman)
12 | Prepare and adopt Bylaws for Intermediate Inc. | Ardent Healthcare Intermediate Inc. | Garrett Simmons | 2024-03-10 | 2024-03-10 | Complete | Standard form Delaware corporation bylaws adopted by sole incorporator action; board of directors to be designated by Holdings LLC as sole stockholder
13 | Prepare and execute short-form LLC Agreement for Merger Sub LLC | Ardent Healthcare Merger Sub LLC | Garrett Simmons | 2024-03-10 | 2024-03-10 | Complete | Short-form LLC Agreement; sole member: Ardent Healthcare Intermediate Inc.; authorizes officers to execute merger agreement and related documents
14 | Board / Member resolutions authorizing the acquisition transaction | Ardent Healthcare Holdings LLC; Ardent Healthcare Intermediate Inc.; Ardent Healthcare Merger Sub LLC | Robert Jansen | 2024-03-14 | In Progress | Written consents / resolutions of (a) members of Holdings LLC, (b) board and sole stockholder of Intermediate Inc., and (c) sole member of Merger Sub LLC, each authorizing execution of the Merger Agreement (signing date March 15, 2024) and related transaction documents; enterprise value $412M
15 | Order certified copies and good standing certificates from Delaware Secretary of State | All | Garrett Simmons | 2024-03-06 | Pending | Good standing certificates needed for closing deliverables (closing date May 31, 2024); order updated certificates 5–10 business days prior to closing
16 | Determine foreign qualification requirements for Intermediate Inc. in Pinnacle operating states | Ardent Healthcare Intermediate Inc. | Robert Jansen | 2024-03-15 | In Progress | Pinnacle operates in PA, VA, MD, NC, GA; Intermediate Inc. will need foreign qualification in each state post-closing as the direct parent of the surviving entity; coordinate with state regulatory approval timeline (target: May 15, 2024); also evaluate NY qualification given business address at 600 Lexington Avenue
17 | Confirm no check-the-box election required for Holdings LLC | Ardent Healthcare Holdings LLC | Leonard Cross | 2024-03-01 | 2024-03-01 | Complete | Holdings LLC has two or more members and defaults to partnership classification under Treasury Reg. § 301.7701-3; no Form 8832 filing required; confirmed with Caldwell Pratt & Moorehouse LLP
18 | Confirm C-corporation default classification for Intermediate Inc. | Ardent Healthcare Intermediate Inc. | Leonard Cross | 2024-03-01 | 2024-03-01 | Complete | Incorporated under Delaware General Corporation Law; automatically classified as corporation for federal tax purposes; no Form 8832 required
19 | Coordinate with Ardent Capital GP III LLC regarding management fee agreement routing | Ardent Healthcare Holdings LLC | Leonard Cross / Robert Jansen | 2024-03-18 | Pending | Management fee agreements should be between Ardent Capital GP III LLC (already nexused in NY, EIN 87-3491520 c/o parent) and Intermediate Inc. — not directly with Holdings LLC — to mitigate NY nexus risk for Holdings; per State Tax Structuring Recommendations Letter
20 | Prepare Section 754 election statement for Pinnacle's 2024 partnership return | Pinnacle Health Services Group LLC (surviving entity) | Robert Jansen | 2024-05-31 | Pending | To be filed with Pinnacle's Form 1065 for taxable year ending December 31, 2024; permits Intermediate Inc. to receive Section 743(b) basis step-up of $224.4M; coordinate with Brewer Stanfield & Associates LLP (Pinnacle's auditors) and Caldwell Pratt & Moorehouse LLP
[sheet: Entity Summary]
Entity Name | Entity Type | Jurisdiction | Delaware File No. | EIN | Federal Tax Classification | Registered Agent | Registered Address | Business Address | Direct Parent / Owner | Ownership Interest | Purpose in Structure | Date Formed | Key Contacts
Ardent Capital Partners III LP | Limited Partnership | Delaware | N/A (pre-existing) | 87-3491520 | Partnership | N/A (pre-existing) | N/A | 600 Lexington Avenue, 38th Floor, New York, NY 10022 | Ardent Capital GP III LLC (General Partner) | N/A — Fund sponsor | Buyer / Sponsor; $3.2 billion fund (vintage 2022); committing $198.5M equity to transaction | Pre-existing | Dominic Ferrera, Claire Ashworth (Managing Partners); Marcus Pellegrino (Deal Lead)
Ardent Capital GP III LLC | LLC | Delaware | N/A (pre-existing) | N/A | Disregarded entity / Partnership | N/A (pre-existing) | N/A | c/o Ardent Capital Partners III LP, 600 Lexington Avenue, 38th Floor, New York, NY 10022 | Ferrera / Ashworth principals | General Partner of Fund III | General Partner of Ardent Capital Partners III LP; management fee agreements to be routed through this entity to mitigate NY nexus for Holdings LLC | Pre-existing | Dominic Ferrera, Claire Ashworth
Ardent Healthcare Holdings LLC | LLC | Delaware | 7834219 | 93-2187445 | Partnership (default; no Form 8832 filed) | Pemberton Industries | 251 Little Falls Drive, Wilmington, DE 19808 | 600 Lexington Avenue, 38th Floor, New York, NY 10022 | Ardent Capital Partners III LP (Class A Units); Dr. Raymond Carvallo, Dr. Nadia Ostrowski, Jonathan Marsh (Class B Units — rollover); Cascadia Mezzanine Fund IV LP (2.5% warrants) | Class A: Fund III equity ($198.5M); Class B: Rollover equity ($59.54M total — Carvallo $32.41M, Ostrowski $24.18M, Marsh $2.95M); Warrants: 2.5% fully diluted to Cascadia Mezz | Top acquisition holding company; equity aggregator; partnership for federal tax purposes; issues Class B Units as tax-deferred rollover under Section 721 | 2024-03-05 | Leonard Cross, Robert Jansen (Calderwood & Harkness LLP)
Ardent Healthcare Intermediate Inc. | C-Corporation | Delaware | 7834223 | 93-2187512 | Corporation | Pemberton Industries | 251 Little Falls Drive, Wilmington, DE 19808 | 600 Lexington Avenue, 38th Floor, New York, NY 10022 | Ardent Healthcare Holdings LLC (100%) | 100% owned by Holdings LLC | Blocker entity: Blocks UBTI for tax-exempt Fund III LPs; facilitates future IPO; isolates state tax nexus; receives Section 743(b) step-up of $224.4M through Pinnacle | 2024-03-05 | Leonard Cross, Robert Jansen (Calderwood & Harkness LLP)
Ardent Healthcare Merger Sub LLC | LLC | Delaware | 7834227 | N/A (transitory; not required) | Disregarded entity (single member: Intermediate Inc.) | Pemberton Industries | 251 Little Falls Drive, Wilmington, DE 19808 | 600 Lexington Avenue, 38th Floor, New York, NY 10022 | Ardent Healthcare Intermediate Inc. (100%) | 100% owned by Intermediate Inc. | Transitory merger subsidiary; merges with and into Pinnacle Health Services Group LLC at closing (May 31, 2024) in a reverse merger; Pinnacle survives | 2024-03-05 | Robert Jansen, Garrett Simmons (Calderwood & Harkness LLP)
Pinnacle Health Services Group LLC | LLC (partnership tax status) | Delaware | N/A (pre-existing) | 82-1947632 | Partnership | Pemberton Industries | 251 Little Falls Drive, Wilmington, DE 19808 | 2200 Renaissance Boulevard, Suite 400, King of Prussia, PA 19406 | Post-closing: Ardent Healthcare Intermediate Inc. (100%) | Pre-closing: Carvallo 38.2%, Ostrowski 28.5%, Marsh 5.8%, 14 minority physician-investors 27.5%. Post-closing: 100% Intermediate Inc. | Target; surviving entity in reverse merger; Section 754 election to be filed with 2024 Form 1065; operating agreement dated August 12, 2016 (amended March 3, 2020); 34 urgent care clinics + 8 ASCs across PA, VA, MD, NC, GA; ~1,620 employees (142 physicians) | Founded 2016 | Dr. Raymond Carvallo (CEO), Dr. Nadia Ostrowski (CMO), Jonathan Marsh (CFO)
[sheet: Key Dates & Deadlines]
Date | Event / Milestone | Entity(ies) Affected | Status | Notes
2024-01-10 | Engagement opened; engagement letter executed (Calderwood & Harkness LLP, matter 1001-00006, engagement 1001-00006) | All | Complete | Leonard Cross (Responsible Partner), Sylvia Hartwell (Billing Partner)
2024-03-01 | Entity formation drafting completed; checklist finalized | Holdings LLC, Intermediate Inc., Merger Sub LLC | Complete | All certificates of formation / incorporation drafted by Garrett Simmons
2024-03-05 | Certificates of Formation / Incorporation filed with Delaware Secretary of State | Holdings LLC (File No. 7834219), Intermediate Inc. (File No. 7834223), Merger Sub LLC (File No. 7834227) | Complete | All filings accepted same day; registered agent: Pemberton Industries
2024-03-05 | EIN applications filed (Form SS-4) | Holdings LLC (EIN 93-2187445), Intermediate Inc. (EIN 93-2187512) | Complete | EINs received March 8, 2024
2024-03-10 | Bylaws adopted — Intermediate Inc.; Short-form LLC Agreement executed — Merger Sub LLC | Intermediate Inc., Merger Sub LLC | Complete
2024-03-15 | Merger Agreement signing date | All | Pending | Enterprise value $412M; equity value $339.4M; Merger Agreement to be executed by Holdings LLC, Intermediate Inc., Merger Sub LLC, and Pinnacle
2024-04-10 | HSR Act waiting period expired (early termination granted) | All | Pending | HSR Filing No. HSR-2024-1587
2024-05-15 | State regulatory approvals obtained (PA, VA, MD, NC, GA) | Intermediate Inc. (foreign qualification target) | Pending | Foreign qualification filings for Intermediate Inc. to follow
2024-05-31 | Transaction closing date; reverse merger consummated | Merger Sub LLC merges into Pinnacle; Pinnacle survives as subsidiary of Intermediate Inc. | Pending | Merger Sub ceases to exist; Section 83(b) election property transfer date for rollover participants
2024-06-30 | Deadline for Section 83(b) elections (30 days post-closing) | Holdings LLC (Class B Units) | Pending | Elections for Dr. Carvallo, Dr. Ostrowski, and Jonathan Marsh on unvested Class B Units
2024-12-31 | Fiscal year end — Section 754 election due with Pinnacle 2024 Form 1065 | Pinnacle Health Services Group LLC | Pending | Section 743(b) step-up of $224.4M; coordinate with Caldwell Pratt & Moorehouse LLP and Brewer Stanfield & Associates LLP