Saexploration Holdings Inc. (NASDAQ:SAEX): Andrew Feldstein And Stephen Siderow’s Blue Mountain Capital filed an amended 13D.
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You can access the original SEC filing by clicking here.
Ownership Summary Table
Name | Sole Voting Power | Shared Voting Power | Sole Dispositive Power | Shared Dispositive Power | Aggregate Amount Owned Power | Percent of Class |
---|---|---|---|---|---|---|
BlueMountain Capital Management | 0 | 2,409,106 | 0 | 2,409,106 | 2,409,106 | 25.6% |
BlueMountain GP Holdings | 0 | 1,976,336 | 0 | 1,976,336 | 1,976,336 | 21.0% |
BlueMountain Long Short Credit GP | 0 | 80,647 | 0 | 80,647 | 80,647 | 0.9% |
BlueMountain Guadalupe Peak Fund | 0 | 80,647 | 0 | 80,647 | 80,647 | 0.9% |
BlueMountain Kicking Horse Fund GP | 0 | 61,411 | 0 | 61,411 | 61,411 | 0.7% |
BlueMountain Kicking Horse Fund | 0 | 61,411 | 0 | 61,411 | 61,411 | 0.7% |
BlueMountain Timberline Ltd | 0 | 59,405 | 0 | 59,405 | 59,405 | 0.6% |
BlueMountain Summit Opportunities GP II | 0 | 160,171 | 0 | 160,171 | 160,171 | 1.7% |
BlueMountain Summit Trading | 0 | 160,171 | 0 | 160,171 | 160,171 | 1.7% |
BlueMountain Montenvers GP S. r.l | 0 | 373,365 | 0 | 373,365 | 373,365 | 4.0% |
BlueMountain Montenvers Master Fund SCA SICAV-SIF | 0 | 373,365 | 0 | 373,365 | 373,365 | 4.0% |
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Page 1 of 15 – SEC Filing
SECURITIES AND EXCHANGE COMMISSION
WASHINGTON, D.C. 20549
SCHEDULE 13D
UNDER THE SECURITIES EXCHANGE ACT OF 1934
(Amendment No. 2)*
SAEXPLORATION
HOLDINGS, INC.
(Name of Issuer)
Common Stock, par value $0.0001 per share
(Title of Class of Securities)
78636X204
(CUSIP Number)
Eric M. Albert
BlueMountain Capital Management, LLC
280 Park Avenue, 12th Floor
New York, New York 10017
212-905-5647
(Name, Address and Telephone Number of Person Authorized to Receive Notices and Communications)
December 21, 2017
(Date
of Event which Requires Filing of this Statement)
If the filing person has
previously filed a statement on Schedule 13G to report the acquisition that is the subject of this Schedule 13D, and is filing this schedule because of §§ 240.13d-1(e),
240.13d-1(f) or 240.13d-1(g), check the following box. ☐
Note: Schedules filed in paper format shall
include a signed original and five copies of the schedule, including all exhibits. See § 240.13d-7 for other parties to whom copies are to be sent.
* | 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).
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Page 2 of 15 – SEC Filing
CUSIP No. 78636X204
1 | NAMES OF BlueMountain Capital Management, LLC | |||||
2 | CHECK THE APPROPRIATE BOX IF A MEMBER (a) ☒ (b) ☐ | |||||
3 | SEC USE ONLY | |||||
4 | SOURCE OF FUNDS (See WC | |||||
5 | CHECK IF DISCLOSURE OF LEGAL ☐ | |||||
6 | CITIZENSHIP OR PLACE OF Delaware, United States of America | |||||
NUMBER OF SHARES BENEFICIALLY OWNED BY EACH REPORTING PERSON WITH | 7 | SOLE VOTING POWER 0 | ||||
8 | SHARED VOTING POWER 2,409,106 | |||||
9 | SOLE DISPOSITIVE POWER 0 | |||||
10 | SHARED DISPOSITIVE POWER 2,409,106 | |||||
11 | AGGREGATE AMOUNT BENEFICIALLY OWNED BY EACH REPORTING PERSON 2,409,106 | |||||
12 | CHECK IF THE AGGREGATE AMOUNT IN ROW ☐ | |||||
13 | PERCENT OF CLASS REPRESENTED BY AMOUNT 25.6% (1) | |||||
14 | TYPE OF REPORTING PERSON (See IA |
(1) | The percentage set forth in Row 13 of this Cover Page is based on the 9,424,534 shares of Common Stock (as defined in Item 1) outstanding as of November 1, 2017, as reported on Form 10-Q (as defined in Item 5). |
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Page 3 of 15 – SEC Filing
CUSIP No. 78636X204
1 | NAMES OF BlueMountain GP Holdings, LLC | |||||
2 | CHECK THE APPROPRIATE BOX IF A MEMBER (a) ☒ (b) ☐ | |||||
3 | SEC USE ONLY | |||||
4 | SOURCE OF FUNDS (See WC | |||||
5 | CHECK IF DISCLOSURE OF LEGAL ☐ | |||||
6 | CITIZENSHIP OR PLACE OF Delaware, United States of America | |||||
NUMBER OF SHARES BENEFICIALLY OWNED BY EACH REPORTING PERSON WITH | 7 | SOLE VOTING POWER 0 | ||||
8 | SHARED VOTING POWER 1,976,336 | |||||
9 | SOLE DISPOSITIVE POWER 0 | |||||
10 | SHARED DISPOSITIVE POWER 1,976,336 | |||||
11 | AGGREGATE AMOUNT BENEFICIALLY OWNED BY EACH REPORTING PERSON 1,976,336 | |||||
12 | CHECK IF THE AGGREGATE AMOUNT IN ROW ☐ | |||||
13 | PERCENT OF CLASS REPRESENTED BY AMOUNT 21.0% (1) | |||||
14 | TYPE OF REPORTING PERSON (See OO |
(1) | The percentage set forth in Row 13 of this Cover Page is based on the 9,424,534 shares of Common Stock outstanding as of November 1, 2017, as reported on Form 10-Q. |
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Page 4 of 15 – SEC Filing
CUSIP No. 78636X204
1 | NAMES OF BlueMountain Long/Short Credit GP, LLC | |||||
2 | CHECK THE APPROPRIATE BOX IF A MEMBER (a) ☒ (b) ☐ | |||||
3 | SEC USE ONLY | |||||
4 | SOURCE OF FUNDS (See WC | |||||
5 | CHECK IF DISCLOSURE OF LEGAL ☐ | |||||
6 | CITIZENSHIP OR PLACE OF Delaware, United States of America | |||||
NUMBER OF SHARES BENEFICIALLY OWNED BY EACH REPORTING PERSON WITH | 7 | SOLE VOTING POWER 0 | ||||
8 | SHARED VOTING POWER 80,647 | |||||
9 | SOLE DISPOSITIVE POWER 0 | |||||
10 | SHARED DISPOSITIVE POWER 80,647 | |||||
11 | AGGREGATE AMOUNT BENEFICIALLY OWNED BY EACH REPORTING PERSON 80,647 | |||||
12 | CHECK IF THE AGGREGATE AMOUNT IN ROW ☐ | |||||
13 | PERCENT OF CLASS REPRESENTED BY AMOUNT 0.9% (1) | |||||
14 | TYPE OF REPORTING PERSON (See OO |
(1) | The percentage set forth in Row 13 of this Cover Page is based on the 9,424,534 shares of Common Stock outstanding as of November 1, 2017, as reported on Form 10-Q. |
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Page 5 of 15 – SEC Filing
CUSIP No. 78636X204
1 | NAMES OF BlueMountain Guadalupe Peak Fund L.P. | |||||
2 | CHECK THE APPROPRIATE BOX IF A MEMBER (a) ☒ (b) ☐ | |||||
3 | SEC USE ONLY | |||||
4 | SOURCE OF FUNDS (See WC | |||||
5 | CHECK IF DISCLOSURE OF LEGAL ☐ | |||||
6 | CITIZENSHIP OR PLACE OF Delaware, United States of America | |||||
NUMBER OF SHARES BENEFICIALLY OWNED BY EACH REPORTING PERSON WITH | 7 | SOLE VOTING POWER 0 | ||||
8 | SHARED VOTING POWER 80,647 | |||||
9 | SOLE DISPOSITIVE POWER 0 | |||||
10 | SHARED DISPOSITIVE POWER 80,647 | |||||
11 | AGGREGATE AMOUNT BENEFICIALLY OWNED BY EACH REPORTING PERSON 80,647 | |||||
12 | CHECK IF THE AGGREGATE AMOUNT IN ROW ☐ | |||||
13 | PERCENT OF CLASS REPRESENTED BY AMOUNT 0.9% (1) | |||||
14 | TYPE OF REPORTING PERSON (See PN |
(1) | The percentage set forth in Row 13 of this Cover Page is based on the 9,424,534 shares of Common Stock outstanding as of November 1, 2017, as reported on Form 10-Q. |
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Page 6 of 15 – SEC Filing
CUSIP No. 78636X204
1 | NAMES OF BlueMountain Kicking Horse Fund GP, LLC | |||||
2 | CHECK THE APPROPRIATE BOX IF A MEMBER (a) ☒ (b) ☐ | |||||
3 | SEC USE ONLY | |||||
4 | SOURCE OF FUNDS (See WC | |||||
5 | CHECK IF DISCLOSURE OF LEGAL ☐ | |||||
6 | CITIZENSHIP OR PLACE OF Delaware, United States of America | |||||
NUMBER OF SHARES BENEFICIALLY OWNED BY EACH REPORTING PERSON WITH | 7 | SOLE VOTING POWER 0 | ||||
8 | SHARED VOTING POWER 61,411 | |||||
9 | SOLE DISPOSITIVE POWER 0 | |||||
10 | SHARED DISPOSITIVE POWER 61,411 | |||||
11 | AGGREGATE AMOUNT BENEFICIALLY OWNED BY EACH REPORTING PERSON 61,411 | |||||
12 | CHECK IF THE AGGREGATE AMOUNT IN ROW ☐ | |||||
13 | PERCENT OF CLASS REPRESENTED BY AMOUNT 0.7% (1) | |||||
14 | TYPE OF REPORTING PERSON (See OO |
(1) | The percentage set forth in Row 13 of this Cover Page is based on the 9,424,534 shares of Common Stock outstanding as of November 1, 2017, as reported on Form 10-Q. |
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Page 7 of 15 – SEC Filing
CUSIP No. 78636X204
1 | NAMES OF BlueMountain Kicking Horse Fund L.P. | |||||
2 | CHECK THE APPROPRIATE BOX IF A MEMBER (a) ☒ (b) ☐ | |||||
3 | SEC USE ONLY | |||||
4 | SOURCE OF FUNDS (See WC | |||||
5 | CHECK IF DISCLOSURE OF LEGAL ☐ | |||||
6 | CITIZENSHIP OR PLACE OF Cayman Islands | |||||
NUMBER OF SHARES BENEFICIALLY OWNED BY EACH REPORTING PERSON WITH | 7 | SOLE VOTING POWER 0 | ||||
8 | SHARED VOTING POWER 61,411 | |||||
9 | SOLE DISPOSITIVE POWER 0 | |||||
10 | SHARED DISPOSITIVE POWER 61,411 | |||||
11 | AGGREGATE AMOUNT BENEFICIALLY OWNED BY EACH REPORTING PERSON 61,411 | |||||
12 | CHECK IF THE AGGREGATE AMOUNT IN ROW ☐ | |||||
13 | PERCENT OF CLASS REPRESENTED BY AMOUNT 0.7% (1) | |||||
14 | TYPE OF REPORTING PERSON (See PN |
(1) | The percentage set forth in Row 13 of this Cover Page is based on the 9,424,534 shares of Common Stock outstanding as of November 1, 2017, as reported on Form 10-Q. |
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Page 8 of 15 – SEC Filing
CUSIP No. 78636X204
1 | NAMES OF BlueMountain Timberline Ltd. | |||||
2 | CHECK THE APPROPRIATE BOX IF A MEMBER (a) ☒ (b) ☐ | |||||
3 | SEC USE ONLY | |||||
4 | SOURCE OF FUNDS (See WC | |||||
5 | CHECK IF DISCLOSURE OF LEGAL ☐ | |||||
6 | CITIZENSHIP OR PLACE OF Cayman Islands | |||||
NUMBER OF SHARES BENEFICIALLY OWNED BY EACH REPORTING PERSON WITH | 7 | SOLE VOTING POWER 0 | ||||
8 | SHARED VOTING POWER 59,405 | |||||
9 | SOLE DISPOSITIVE POWER 0 | |||||
10 | SHARED DISPOSITIVE POWER 59,405 | |||||
11 | AGGREGATE AMOUNT BENEFICIALLY OWNED BY EACH REPORTING PERSON 59,405 | |||||
12 | CHECK IF THE AGGREGATE AMOUNT IN ROW ☐ | |||||
13 | PERCENT OF CLASS REPRESENTED BY AMOUNT 0.6% (1) | |||||
14 | TYPE OF REPORTING PERSON (See CO |
(1) | The percentage set forth in Row 13 of this Cover Page is based on the 9,424,534 shares of Common Stock outstanding as of November 1, 2017, as reported on Form 10-Q. |
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Page 9 of 15 – SEC Filing
CUSIP No. 78636X204
1 | NAMES OF BlueMountain Summit Opportunities GP II, LLC | |||||
2 | CHECK THE APPROPRIATE BOX IF A MEMBER (a) ☒ (b) ☐ | |||||
3 | SEC USE ONLY | |||||
4 | SOURCE OF FUNDS (See WC | |||||
5 | CHECK IF DISCLOSURE OF LEGAL ☐ | |||||
6 | CITIZENSHIP OR PLACE OF Delaware, United States of America | |||||
NUMBER OF SHARES BENEFICIALLY OWNED BY EACH REPORTING PERSON WITH | 7 | SOLE VOTING POWER 0 | ||||
8 | SHARED VOTING POWER 160,171 | |||||
9 | SOLE DISPOSITIVE POWER 0 | |||||
10 | SHARED DISPOSITIVE POWER 160,171 | |||||
11 | AGGREGATE AMOUNT BENEFICIALLY OWNED BY EACH REPORTING PERSON 160,171 | |||||
12 | CHECK IF THE AGGREGATE AMOUNT IN ROW ☐ | |||||
13 | PERCENT OF CLASS REPRESENTED BY AMOUNT 1.7% (1) | |||||
14 | TYPE OF REPORTING PERSON (See OO |
(1) | The percentage set forth in Row 13 of this Cover Page is based on the 9,424,534 shares of Common Stock outstanding as of November 1, 2017, as reported on Form 10-Q. |
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Page 10 of 15 – SEC Filing
CUSIP No. 78636X204
1 | NAMES OF BlueMountain Summit Trading L.P. | |||||
2 | CHECK THE APPROPRIATE BOX IF A MEMBER (a) ☒ (b) ☐ | |||||
3 | SEC USE ONLY | |||||
4 | SOURCE OF FUNDS (See WC | |||||
5 | CHECK IF DISCLOSURE OF LEGAL ☐ | |||||
6 | CITIZENSHIP OR PLACE OF Delaware, United States of America | |||||
NUMBER OF SHARES BENEFICIALLY OWNED BY EACH REPORTING PERSON WITH | 7 | SOLE VOTING POWER 0 | ||||
8 | SHARED VOTING POWER 160,171 | |||||
9 | SOLE DISPOSITIVE POWER 0 | |||||
10 | SHARED DISPOSITIVE POWER 160,171 | |||||
11 | AGGREGATE AMOUNT BENEFICIALLY OWNED BY EACH REPORTING PERSON 160,171 | |||||
12 | CHECK IF THE AGGREGATE AMOUNT IN ROW ☐ | |||||
13 | PERCENT OF CLASS REPRESENTED BY AMOUNT 1.7% (1) | |||||
14 | TYPE OF REPORTING PERSON (See PN |
(1) | The percentage set forth in Row 13 of this Cover Page is based on the 9,424,534 shares of Common Stock outstanding as of November 1, 2017, as reported on Form 10-Q. |
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Page 11 of 15 – SEC Filing
CUSIP No. 78636X204
1 | NAMES OF BlueMountain Montenvers GP S.à r.l. | |||||
2 | CHECK THE APPROPRIATE BOX IF A MEMBER (a) ☒ (b) ☐ | |||||
3 | SEC USE ONLY | |||||
4 | SOURCE OF FUNDS (See WC | |||||
5 | CHECK IF DISCLOSURE OF LEGAL ☐ | |||||
6 | CITIZENSHIP OR PLACE OF Luxembourg | |||||
NUMBER OF SHARES BENEFICIALLY OWNED BY EACH REPORTING PERSON WITH | 7 | SOLE VOTING POWER 0 | ||||
8 | SHARED VOTING POWER 373,365 | |||||
9 | SOLE DISPOSITIVE POWER 0 | |||||
10 | SHARED DISPOSITIVE POWER 373,365 | |||||
11 | AGGREGATE AMOUNT BENEFICIALLY OWNED BY EACH REPORTING PERSON 373,365 | |||||
12 | CHECK IF THE AGGREGATE AMOUNT IN ROW ☐ | |||||
13 | PERCENT OF CLASS REPRESENTED BY AMOUNT 4.0% (1) | |||||
14 | TYPE OF REPORTING PERSON (See CO |
(1) | The percentage set forth in Row 13 of this Cover Page is based on the 9,424,534 shares of Common Stock outstanding as of November 1, 2017, as reported on Form 10-Q. |
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Page 12 of 15 – SEC Filing
CUSIP No. 78636X204
1 | NAMES OF BlueMountain Montenvers Master Fund SCA SICAV-SIF | |||||
2 | CHECK THE APPROPRIATE BOX IF A MEMBER (a) ☒ (b) ☐ | |||||
3 | SEC USE ONLY | |||||
4 | SOURCE OF FUNDS (See WC | |||||
5 | CHECK IF DISCLOSURE OF LEGAL ☐ | |||||
6 | CITIZENSHIP OR PLACE OF Luxembourg | |||||
NUMBER OF SHARES BENEFICIALLY OWNED BY EACH REPORTING PERSON WITH | 7 | SOLE VOTING POWER 0 | ||||
8 | SHARED VOTING POWER 373,365 | |||||
9 | SOLE DISPOSITIVE POWER 0 | |||||
10 | SHARED DISPOSITIVE POWER 373,365 | |||||
11 | AGGREGATE AMOUNT BENEFICIALLY OWNED BY EACH REPORTING PERSON 373,365 | |||||
12 | CHECK IF THE AGGREGATE AMOUNT IN ROW ☐ | |||||
13 | PERCENT OF CLASS REPRESENTED BY AMOUNT 4.0% (1) | |||||
14 | TYPE OF REPORTING PERSON (See PN |
(1) | The percentage set forth in Row 13 of this Cover Page is based on the 9,424,534 shares of Common Stock outstanding as of November 1, 2017, as reported on Form 10-Q. |
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Page 13 of 15 – SEC Filing
CUSIP No. 78636X204
Item 1. Security of the Issuer.
This Amendment No. 2 amends the Schedule 13D filed with the Securities Exchange Commission (the SEC) on August 8, 2016 (as amended
by Amendment No. 1 thereto filed on December 21, 2017, the Schedule 13D), relating to the shares of Common Stock, par value $0.0001 per share (the Common Stock), of SAExploration Holdings, Inc., a
Delaware corporation (the Issuer). The Issuers principal executive office is located at 1160 Dairy Ashford Rd., Suite 160, Houston, Texas 77079. Unless specifically amended hereby, the disclosures set forth in the Schedule
13D remain unchanged.
Item 6. Contracts, Arrangements, Understandings or Relationships With Respect to Securities of the Issuer.
Item 6 of the Schedule 13D is hereby amended by adding the following:
(iv) Waiver and Consent to Term Loan and Security Agreement
On
December 21, 2017, the Issuer entered into a Waiver and Consent to Term Loan and Security Agreement (the Term Loan Consent) with the lenders, including the 2017 Supporting Holders, under the New Senior Loan Facility, pursuant to
which the 2017 Supporting Holders (A) consented to, and waived compliance with any provision in the agreement governing the New Senior Loan Facility that might prohibit, the Restructuring Transaction and (B) consented to increase the
amount of aggregate principal amount of obligations secured by liens that are senior to the liens securing the Obligations (as such term is defined in the Term Loan Consent) from $16 million to $20 million under the Specified Letter
Agreement (as such term is defined in the Term Loan Consent).
The summary of the Term Loan Consent set forth above does not purport to be complete and is
qualified in its entirety by reference to such agreement, a copy of which is being filed as Exhibit 10 hereto and is incorporated herein by reference.
Item 7. Material to be Filed as Exhibits.
Item 7 of
the Schedule 13D is hereby amended by adding the following:
9. Joint Filing Agreement dated December 22, 2017, attached as Exhibit 7 hereto.
10. Waiver and Consent to Term Loan and Security Agreement, dated as of December 21, 2017, by and among the Issuer, the Guarantors, the lenders identified
therein and the New Senior Loan Facility Agent.
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Page 14 of 15 – SEC Filing
SIGNATURES
After reasonable inquiry and to the best knowledge and belief of the undersigned, the undersigned certifies that the information set forth in this statement
with respect to the undersigned is true, complete and correct.
Date: December 22, 2017
BLUEMOUNTAIN CAPITAL MANAGEMENT, LLC | ||
By: | /s/ ERIC M. ALBERT | |
Name: | Eric M. Albert, Chief Compliance Officer | |
BLUEMOUNTAIN GP HOLDINGS, LLC | ||
By: | /s/ ERIC M. ALBERT | |
Name: | Eric M. Albert, Chief Compliance Officer | |
BLUEMOUNTAIN LONG/SHORT CREDIT GP, LLC | ||
BY: BLUEMOUNTAIN GP HOLDINGS, LLC | ||
By: | /s/ ERIC M. ALBERT | |
Name: | Eric M. Albert, Chief Compliance Officer | |
BLUEMOUNTAIN GUADALUPE PEAK FUND L.P. | ||
BY: BLUEMOUNTAIN LONG/SHORT CREDIT GP, LLC | ||
BY: BLUEMOUNTAIN GP HOLDINGS, LLC | ||
By: | /s/ ERIC M. ALBERT | |
Name: | Eric M. Albert, Chief Compliance Officer | |
BLUEMOUNTAIN KICKING HORSE FUND GP, LLC | ||
BY: BLUEMOUNTAIN GP HOLDINGS, LLC | ||
By: | /s/ ERIC M. ALBERT | |
Name: | Eric M. Albert, Chief Compliance Officer | |
BLUEMOUNTAIN KICKING HORSE FUND L.P. | ||
BY: BLUEMOUNTAIN KICKING HORSE FUND GP, LLC | ||
BY: BLUEMOUNTAIN GP HOLDINGS, LLC | ||
By: | /s/ ERIC M. ALBERT | |
Name: | Eric M. Albert, Chief Compliance Officer | |
BLUEMOUNTAIN TIMBERLINE LTD. | ||
By: | /s/ ANDREW FELDSTEIN | |
Name: | Andrew Feldstein, Director |
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Page 15 of 15 – SEC Filing
BLUEMOUNTAIN SUMMIT OPPORTUNITIES GP II, LLC | ||
BY: BLUEMOUNTAIN GP HOLDINGS, LLC | ||
By: | /s/ ERIC M. ALBERT | |
Name: | Eric M. Albert, Chief Compliance Officer | |
BLUEMOUNTAIN SUMMIT TRADING L.P. | ||
BY: BLUEMOUNTAIN SUMMIT OPPORTUNITIES GP II, LLC | ||
BY: BLUEMOUNTAIN GP HOLDINGS, LLC | ||
By: | /s/ ERIC M. ALBERT | |
Name: | Eric M. Albert, Chief Compliance Officer | |
BLUEMOUNTAIN MONTENVERS GP S.à r.l. | ||
By: | /s/ PAUL FRIEDMAN | |
Name: | Paul Friedman, Authorized Person | |
BLUEMOUNTAIN MONTENVERS MASTER FUND SCA SICAV-SIF | ||
BY: BLUEMOUNTAIN MONTENVERS GP S.à r.l. | ||
By: | /s/ PAUL FRIEDMAN | |
Name: | Paul Friedman, Authorized Person |
The original statement shall be signed by each person on whose behalf the statement is filed or his authorized
representative. If the statement is signed on behalf of a person by his authorized representative (other than an executive officer or general partner of the filing person), evidence of the representatives authority to sign on behalf of such
person shall be filed with the statement; provided, however, that a power of attorney for this purpose which is already on file with the Commission may be incorporated by reference. The name and any title of each person who signs the
statement shall be typed or printed beneath his signature.
ATTENTION: INTENTIONAL MISSTATEMENTS OR OMISSIONS OF FACT CONSTITUTE FEDERAL CRIMINAL
VIOLATIONS (SEE 18 U.S.C. 1001)