AUDAX CREDIT BDC INC.
Subscription Documents
Administrator:
Audax Management Company, LLC
101 Huntington Avenue
Boston, Massachusetts 02199
EXHIBIT 10.14
AUDAX CREDIT BDC INC.
Subscription Documents
Administrator:
Audax Management Company, LLC
101 Huntington Avenue
Boston, Massachusetts 02199
DIRECTIONS FOR THE COMPLETION
OF THE SUBSCRIPTION DOCUMENTS
Prospective investors must complete the Subscription Agreement, the Investor Questionnaire (the “Investor Questionnaire”) and any necessary attachments (the Subscription Agreement, the Investor Questionnaire and all such attachments collectively, the “Subscription Documents”) contained in this package in the manner described below. Capitalized terms not defined herein are used as defined in the Confidential Private Placement Memorandum of Audax Credit BDC Inc., a Delaware corporation (as amended or supplemented from time to time) (the “Memorandum”). For purposes of these Subscription Documents, the “Investor” is the person or entity for whose account the units will be purchased and that can satisfy the representations and warranties set forth in the Subscription Documents. Another person or entity with investment authority may execute the Subscription Documents on behalf of the Investor, but should indicate the capacity in which it is doing so and the name of the Investor.
Each U.S. Investor is required to fill in and sign and date the attached Form W-9, and each non-U.S. investor is required to fill in and date the relevant Form(s) W-8 (W-8BEN, W-8BEN-E, W-8IMY, W-8ECI or W-8EXP), as applicable, in accordance with the instructions to such Form. In
the event that any applicable reduction or exemption from U.S. federal withholding tax is claimed, each Investor is required to provide all applicable attachments or addendums as required to claim such exemption or reduction.
Each Investor must provide satisfactory evidence of authorization.
For Corporations:
Generally, Investors which are corporations must submit certified corporate resolutions authorizing the subscription and identifying the corporate officer empowered to sign the Subscription Documents.
For Partnerships:
Partnerships must submit a certified copy of the partnership certificate (in the case of limited partnerships) or partnership agreement identifying the general partners.
For Limited Liability Companies:
Limited liability companies must submit a certified copy of the limited liability operating agreement or certificate of formation identifying the manager or managing member, as applicable, empowered to sign the Subscription Documents.
For Trusts:
Trusts must submit a copy of the trust agreement.
For Employee Benefit Plans:
Employee benefit plans must submit a certificate of an appropriate officer certifying that the subscription has been authorized and identifying the individual empowered to sign the Subscription Documents.
Each Investor may be required to submit further information for know your customer and anti-money laundering purposes, including, but not limited to, the information set forth in Exhibit A of this Subscription Agreement.
Two (2) original completed and executed copies of the Subscription Agreement and the Investor Questionnaire, together with the Form W-9 or W-8, (W-8BEN, W-8BEN-E, W-8IMY, W-8ECI or W-8EXP), as applicable, the appropriate acknowledgment form and any required evidence of authorization, should be delivered to the Company at the following address:
Audax Management Company, LLC
Attn: Investor Relations
101 Huntington Avenue
Boston, MA 02199
With copies via facsimile to Audax Management Company, LLC, Attention: Investor Relations at (617) 859-1600 or via electronic mail to pdlprequest@audaxgroup.com, as soon as possible.
Inquiries regarding subscription procedures (including, if the Investor Questionnaire indicates that any Investor’s response to a question requires further information) should be directed to Audax Management Company, LLC by phone at (617) 859-1500, by fax at (617) 859-1600.
6. Acceptance by the Company:
If the Investor’s subscription is accepted (in whole or in part) by the Company, a fully executed set of the Subscription Documents will be returned to the Investor. The Company may accept and countersign the Investor’s Subscription Agreement (in whole or in part) at any time.
7. Wire Instructions:
Please wire funds to: Audax Senior BDC Inc.
Bank: Wells Fargo Bank, NA
ABA #: 121-000-248
Account Number: 6355067033
Account Name: . CDO Clearing
Reference: AUDAX CREDIT BDC INC. A/C 84260000
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SUBSCRIPTION AGREEMENT
Audax Credit BDC Inc.
101 Huntington Avenue
Boston, Massachusetts 02199
Ladies and Gentlemen:
(a) The undersigned (the “Investor”) subscribes for and agrees to contribute to Audax Credit BDC Inc. or any successor thereto (the “Company”) the aggregate capital commitment in the amount set forth on the signature page hereto (“Capital Commitment”), and such Investor shall receive shares of common stock of the Company at the time of each drawdown under the Capital Commitment. The Investor understands that the Company has elected to qualify as a regulated investment company under the Internal Revenue Code of 1986, as amended (the “Code”).
The Investor acknowledges and agrees that this subscription (i) is irrevocable on the part of the Investor, (ii) is conditioned upon acceptance by or on behalf of the Company and (iii) may be accepted or rejected in whole or in part by the Company in its sole discretion at any time. The Investor agrees to be bound by all the terms and provisions of the Company’s Confidential Private Placement Memorandum, as amended, restated and/or supplemented from time to time (the “Memorandum”), the Company’s certificate of incorporation, substantially in the form attached hereto as Appendix A (as amended from time to time, the “Charter”), the Company’s bylaws, substantially in the form attached hereto as Appendix B (as amended from time to time, the “Bylaws”), the Investment Advisory Agreement by and between Audax Management Company (NY), LLC, our investment adviser (the “Adviser”), substantially in the form attached hereto as Appendix C (as amended from time to time, the “Advisory Agreement”), the Administration Agreement by and between the Company and Audax Management Company, LLC, our administrator (the “Administrator”), substantially in the form attached hereto as Appendix D (as amended from time to time, the “Administration Agreement” and, together with the Memorandum, the Charter, the Bylaws and the Advisory Agreement, collectively the “Operative Documents”), together with this subscription agreement (the “Subscription Agreement”). Capitalized terms not defined herein are used as defined in the Memorandum.
The Company has filed a registration statement on Form 10 (the “Form 10 Registration Statement”) which registered its common stock with the U.S. Securities and Exchange Commission (the “SEC”) under the Securities Exchange Act of 1934, as amended (the “Exchange Act”). The Form 10 Registration Statement is not the offering document pursuant to which the Company is conducting this offering of securities and may not include all information regarding the Company contained in the Memorandum. Accordingly, Investors should rely exclusively on information contained in the Memorandum in making their investment decisions.
(b) Payment in cleared funds for Shares must be received three business days prior to the Closing Date (as defined below). Subject to any legal or regulatory restrictions before the Closing Date, the Investor’s payment (the “Payment”) shall be held by the Company in a non-interest bearing account. If the subscription is rejected, the Payment shall be returned promptly to the Investor, and this Subscription Agreement shall have no force or effect.
2. Closings.
(a) The closing of the Offering (as defined in the Memorandum) will take place at the offices of Dechert LLP at 100 Oliver St., 40th Floor, Boston, Massachusetts 02110, on the date the Company accepts the Subscription Agreement unless otherwise agreed to by the parties (such date being the “Closing Date”). The Company may accept (in whole or in part) and countersign this Subscription Agreement at any time prior to or on the Closing Date.
(b) The Investor agrees to provide any information reasonably requested by the Company to verify the accuracy of the representations contained herein, including, without limitation, the Investor Questionnaire. Upon acceptance of this Subscription Agreement (in whole or in part), the Company shall deliver to the Investor or its representative, a countersigned copy of this Subscription Agreement and other documents and instruments necessary to reflect the Capital Commitment, including any documents and instruments to be delivered pursuant to this Subscription Agreement.
3. Drawdowns.
(a) Subject to Section 3(d), the Investor agrees to purchase Shares for an aggregate purchase price equal to its Capital Commitment, payable at such times and in such amounts as required by the Company. The Company shall deliver a notice (the “Drawdown Notice”) to the Investor at least ten calendar days prior to the Drawdown (each, a “Drawdown Date”), setting forth the amount, in U.S. dollars, of the aggregate purchase price (the “Drawdown Purchase Price”) to be paid by the Investor to purchase Shares on such Drawdown Date. Each purchase of Shares pursuant to a Drawdown Notice shall be made at a per Share price equal to the then-current net asset value per Share.
(b) Each Drawdown Purchase Price shall be payable, in U.S. dollars and in immediately available funds as set forth in wire transfer instructions included in the Drawdown Notice. In addition to the wire transfer instructions, each Drawdown Notice shall set forth (i) the Drawdown Date, (ii) the aggregate amount of the Drawdown and (iii) the Investor’s share of the Drawdown.
(c) Concurrent with any payment of all or a portion of the Drawdown Purchase Price, the Company shall issue to the Investor a number of Shares equal to the amount of the Drawdown Purchase Price funded by the Investor on the applicable Drawdown Date divided by the most recently determined net asset value per Share as of such Drawdown Date.
(d) Upon termination of the period (the “Commitment Period”) beginning on the Closing Date and ending on the completion of an initial public offering of the Shares or the listing of the Shares on a national securities exchange, the Investor shall be released from any further obligation to fund any portion of its Capital Commitment for which it has not received a Drawdown Notice prior to the termination of the Commitment Period.
(e) The Investor acknowledges and agrees that the Company intends to allocate Drawdowns on each Drawdown Date to all Investors with an undrawn Capital Commitment pro rata in proportion to the then undrawn Capital Commitments of all Investors.
(f) The Investor acknowledges that it may have capital commitments pursuant to other agreements with the Company and that the Capital Commitment pursuant to this Subscription Agreement shall in no way limit its obligations under such other agreements.
4. Dividend Reinvestment Program. As described more fully in the Memorandum, the Company generally intends to distribute, out of assets legally available for distribution, substantially all
of its available earnings, as determined by the Board of Directors in its discretion. The Company intends to reinvest all cash distributions declared by the Board of Directors on behalf of Investors who do not elect to receive their dividends in cash, crediting to each such Investor a number of Shares equal to the quotient determined by dividing the cash value of the distribution payable to such Investor by the net asset value per Share as last determined by the Board of Directors. The Investor may elect to receive any or all such distributions in cash by notifying the Administrator, in writing no later than 10 days prior to the record date for the first distribution that the Investor wishes to receive distributions in cash.
(a) This Subscription Agreement has been duly authorized, executed and delivered by the Investor and, upon due authorization, execution and delivery by the Company, shall constitute the valid and legally binding agreement of the Investor enforceable in accordance with its terms against the Investor, except as such enforceability may be limited by (i) bankruptcy, insolvency, reorganization, fraudulent conveyance, moratorium or other laws of general application relating to or affecting the enforcement of creditors’ rights and remedies, as from time to time in effect, and (ii) application of equitable principles (regardless of whether such enforceability is considered in a proceeding in equity or at law).
(d) The Investor understands that the Company has filed an election to be treated as a business development company under the Investment Company Act of 1940, as amended (the “1940 Act”), and has filed an election to be treated as a regulated investment company within the meaning of Section 851 of the Code, for U.S. federal income tax purposes; pursuant to those elections, the Investor shall be required to furnish certain information to the Company as required under Treasury Regulations § 1.852-6(a) and other regulations. If the Investor is unable or refuses to provide such information directly to the Company, the Investor understands that it shall be required to include additional information on its income tax return as provided in Treasury Regulations § 1.852-7.
(e) (i) The Investor understands that the offering and sale of the Shares are intended to be exempt from registration under the Securities Act of 1933, as amended (the “Securities Act”), applicable U.S. state securities laws and the laws of any non-U.S. jurisdictions by virtue of the private placement exemption from registration pursuant to Regulation D of the Securities Act, exemptions under applicable U.S. state securities laws and exemptions under the laws of any non-U.S. jurisdictions.
(ii) The Investor understands that a legend will be placed on any certificate or certificates evidencing the Shares stating that they have not been registered under the Securities Act and setting forth or referring to the restrictions on transfers and sales thereof.
(iii) The Investor understands that the offering and sale of the Shares in non-U.S. jurisdictions may be subject to additional restrictions and limitations and represents and warrants that it is acquiring its Shares in compliance with all applicable laws, rules, regulations and other legal requirements applicable to the Investor including, without limitation, the legal requirements of jurisdictions in which the Investor is resident and in which such acquisition is being consummated.
(i) If the Investor is not a “United States Person,” as defined below (a “non-U.S. Person”),
(a) the Investor has heretofore notified the Company in writing of such status. For this purpose, “United States Person” means a citizen or resident of the United States, a corporation, partnership or other entity created or organized in or under the laws of the United States or any political subdivision thereof, an estate the income of which is subject to U.S. federal income taxation regardless of its source, or any trust (A) the administration of which may be subject
to the primary supervision of a U.S. court and (B) the authority to control all of the substantial decisions of which is held by one or more U.S. persons.
(b) The Investor shall notify the Company immediately if the Investor becomes a United States Person.
(c) The Investor is acquiring the Shares for its own account for investment purposes only and is not subscribing on behalf of or funding its commitment with funds obtained from a United States Person.
(iv) the Plan’s investment in the Company has been duly authorized under, and conforms in all respects to, the documents governing the Plan and the Fiduciary and complies with all applicable requirements of ERISA, the Code or Similar Law;
(v) the Fiduciary is: (1) responsible for the decision to invest in the Company; (2) independent of the Company, the Adviser and their respective employees, officers, representatives and affiliates; and (3) qualified to make such investment decision;
(vi) the Adviser and the Company and their respective employees, officers, representatives and affiliates do not have investment discretion, and are not otherwise acting in a fiduciary capacity, with respect to the investment of the Plan’s assets in the Company, and, without limiting the generality of the foregoing, the Fiduciary has not relied on, and is not relying on, any investment advice or recommendation of any such person with respect to the Plan’s investment in the Company;
(vii) the Plan’s acquisition, holding and disposition of interests in the Company do not and will not constitute or result in a non-exempt prohibited transaction under Section 406 of ERISA or Section 4975 of the Code or violation of Similar Law;
(viii) the Fiduciary expressly acknowledges that the Board of Directors has the authority to require the redemption, withdrawal or other cancellation of any Shares if the Board of
Directors determines that the continued holding of such Shares, in the opinion of the Board of Directors, could result in the Company being subject to ERISA or Section 4975 of the Code;
(ix) the Fiduciary has been informed about the fee structure of the Company, including, but not limited to, any performance fee or allocation, and has concluded that such fees are reasonable and the investment in the Company otherwise constitutes a reasonable contract or arrangement; and
(x) the Fiduciary acknowledges and agrees that neither the Adviser nor any of its employees, representatives or affiliates will be a fiduciary with respect to the Plan as a result of the Plan’s investment in the Company, pursuant to the provisions of ERISA, the Code or any applicable Similar Laws, or otherwise.
“Transfer” shall mean sell, offer for sale, exchange, transfer, assign, pledge, hypothecate or otherwise dispose of.
(ii) The Investor acknowledges and understands that there are other substantial restrictions on the transferability of Shares under this Subscription Document, the Operative Documents and under applicable law including the fact that (A) there is no established market for the Shares and it is possible that no public market for the Shares will develop; (B) the Shares are not currently, and Investors have no rights to require that the Shares be, registered under the Securities Act or the securities laws of the various states or any non-U.S. jurisdiction and therefore cannot be Transferred unless subsequently registered or unless an exemption from such registration is available; and (C) the Investor may have to hold the Shares herein subscribed for and
bear the economic risk of this investment indefinitely, and it may not be possible for the Investor to liquidate its investment in the Company.
8. Compliance with Laws.
9. Credit Facilities. The Investor acknowledges and agrees that the Company may enter into one or more revolving or other credit facilities with one more syndicates of banks or otherwise incur indebtedness. In connection therewith, each Investor hereby agrees to cooperate with the Company and provide financial information and other documentation reasonably and customarily required to obtain such facilities.
10. Dividend Reinvestment. Notwithstanding anything to the contrary provided in Section 4, in the event that the Investor has not otherwise elected to receive its dividends in cash and the reinvestment of any dividend (or any portion thereof) on behalf of the Investor would cause the Investor to hold in aggregate more than three percent (3%) of the outstanding Shares, the Investor shall be deemed to have elected to receive such dividend (or any portion thereof) in cash (but only to the extent necessary to avoid the occurrence of the foregoing consequence).
12. Power of Attorney.
(a) The Investor, by its execution hereof, hereby irrevocably makes, constitutes and appoints the Company as its true and lawful agent and attorney-in-fact, with full power of substitution and full power and authority in its name, place and stead, to make, execute, sign, acknowledge, swear to, record and file:
(b) With respect to the Investor and the Company, the foregoing power of attorney:
(i) is coupled with an interest and shall be irrevocable;
(ii) may be exercised by the Company either by signing separately as attorney-in-fact for the Investor or, after listing all of the Investors, executing an instrument, by a single signature of the Company acting as attorney-in-fact for all of them;
(iii) shall survive the assignment by the Investor of the whole or any fraction of its Shares;
(iv) may not be used by the Company in any manner that is inconsistent with the terms of this Subscription Agreement and any other written agreement between the Company and the Investor.
13. Indemnity. The Investor understands that the information provided herein (including the Investor Questionnaire) shall be relied upon by the Company for the purpose of determining the eligibility of the Investor to purchase Shares in the Company. To the fullest extent permitted under applicable law, the Investor agrees to indemnify and hold harmless the Company, the Adviser, the Administrator, and their affiliates and each partner, member, officer, director, employee and agent thereof, from and against any loss, damage or liability due to or arising out of a breach of any representation, warranty or agreement of the Investor contained in this Subscription Agreement (including the Investor Questionnaire) or in any other document provided by the Investor to the Company or in any agreement executed by the Investor in connection with the Investor’s investment in Shares.
15. Confidentiality. The Investor acknowledges that the Memorandum and other information relating to the Company has been submitted to the Investor on a confidential basis for use solely in connection with the Investor’s consideration of the purchase of Shares. The Investor agrees that, without the prior written consent of the Company (which consent may be withheld at the sole discretion of
the Company), the Investor shall not (a) reproduce the Memorandum or any other information relating to the Company, in whole or in part, or (b) disclose the Memorandum or any other information relating to the Company to any person who is not an officer or employee of the Investor who is involved in its investments, or partner (general or limited) or affiliate of the Investor (it being understood and agreed that if the Investor is a pooled investment fund, it shall only be permitted to disclose the Memorandum or other information related to the Company if the Investor has required its investors to enter into confidentiality undertakings no less onerous than the provisions of this Section 15), except to the extent (1) such information is in the public domain (other than as a result of any action or omission of the Investor or any person to whom the Investor has disclosed such information) or (2) such information is required by applicable law or regulation to be disclosed; provided, however, that in the event disclosure is required pursuant to clause (2), the Investor agrees to (a) inform the Company of the full circumstances of the required disclosure, (b) consult with the Company as to the possible steps to avoid or limit the required disclosure and to take such steps where they would not result in material adverse consequences to the Investor and (c) provide the Company with an opportunity to review the contents of any such disclosure. The Investor further agrees to return the Memorandum and any other information relating to the Company if no purchase of Shares is made or upon the Company’s request therefore. The Investor acknowledges and agrees that monetary damages would not be sufficient remedy for any breach of this section by the Investor, and that in addition to any other remedies available to the Company in respect of any such breach, the Company shall be entitled to specific performance and injunctive or other equitable relief as a remedy for any such breach.
16. Necessary Acts, Further Assurances. The parties shall at their own cost and expense execute and deliver such further documents and instruments and shall take such other actions as may be reasonably required or appropriate to evidence or carry out the intent and purposes of this Subscription Agreement or to show the ability to carry out the intent and purposes of this Subscription Agreement.
17. No Joint Liability Among the Company, the Adviser, and the Administrator. The Company shall not be liable for the fulfillment of any obligation or the accuracy of any representation of the Adviser, or the Administrator under or in connection with this Subscription Agreement, the Adviser shall not be liable for the fulfillment of any obligation or the accuracy of any representation of the Company, or the Administrator under or in connection with this Subscription Agreement and the Administrator shall not be liable for the fulfillment of any obligation or the accuracy of any representation of the Company, or the Adviser under or in connection with this Subscription Agreement. There shall be no joint and several liability of the Company, the Adviser and the Administrator for any obligation under or in connection with this Subscription Agreement.
IN WITNESS WHEREOF, the undersigned has executed this Subscription Agreement as a deed on the date set forth below.
Date: December 16, 2025 Capital Commitment
USD ONLY
$15,000,000
INDIVIDUAL INVESTOR:
(Print Name)
(Signature)
(Witnessed By)
PARTNERSHIP, CORPORATION, LIMITED LIABILITY COMPANY, TRUST, CUSTODIAL ACCOUNT, OTHER INVESTOR:
Mercer Audax Credit Feeder Fund LP
(Print Name of Entity)
By:
(Signature)
Harry Leggat – VP of Mercer Investments LLC, manager of the GP
(Print Name and Title)
(Witnessed By)
Agreed and accepted:
AUDAX CREDIT BDC INC.
By:_______________________________
Name:
Title:
[Signature Page to Subscription Agreement]
INVESTOR QUESTIONNAIRE
A. General Information
1. Print Full Name of Investor:
Individual: _______________________________________
First Middle Last
Entity: Mercer Audax Credit Feeder Fund LP__
Name of Entity
To assist the Company in preparing its tax filings, please check the category into which you fall:
Partnership ■ Corporation
S-Corporation Estate
Grantor Trust
Trust-EIN (a trust with an Trust-SSN (a trust with an
EIN in this format: 12-3456789) EIN in this format: 123-45-6789)
IRA-EIN IRA-SSN
Exempt Organization
LLP LLC
Nominee-EIN Nominee-SSN
Other
Please Refer to Exhibit CName:
Address:
Telephone:
Fax:
* Investor is a Cayman Islands exempted limited partnership that has a US general partner and is beneficially owned by non-US investors. Attached is Form W-8 IMY for the Investor along with Forms W-8 from beneficial owners and a withholding statement, including tax treaty jurisdictions.
5. Residence (if an individual) or Principal Place of Business (if an entity) of the Investor (no P.O. Boxes, if any):
Principal Place of Business:
Address: c/o Mercer Investments LLC
800 Market Street, Suite 1800
Saint Louis, MO 63101
Phone: (314) 588-2500
Fax: (314) 588-2525
Email: harry.leggat@mercer.comAddress: ________
____
Telephone: __________________________________________
Fax:__________________________________________
E-mail: __________________________________________
Bank Name:
Please Refer to Exhibit DBank Location:
Account Number:
Account Name:
Bank’s Routing No.:
For further credit to:
(if any)
Reference:
SWIFT Code:
Credit securities to my brokerage account at the following firm:
Please Refer to Exhibit DFirm Name:
Address:
Account Name:
Account Number:
DTC Number:
B. Regulation D – Accredited Investor Status
The Investor represents and warrants that each equity owner of the Investor is an “accredited investor” within the meaning of Regulation D under the Securities Act, and has indicated below each category under which such equity owner qualifies as an “accredited investor.”
The Investor is:
___ (i) an individual who had an income in excess of $200,000 in each of the two most recent years (or joint income with his or her spouse in excess of $300,000 in each of those years) and has a reasonable expectation of reaching the same income level in the coming year;
___ (ii) an individual who has a net worth (or joint net worth with his or her spouse) in excess of $1,000,000. For purposes of determining the Investor’s net worth, the Investor must exclude the value of his or her primary residence and any indebtedness secured by the primary residence up to its fair market value (i.e., any indebtedness secured by the residence that is in excess of the value of the home should be considered a liability and deducted from the Investor’s net worth). The Investor must also subtract from his or her net worth any indebtedness secured by his or her primary residence that was obtained within the sixty days preceding the effective date of his or her subscription, unless such indebtedness was used to acquire the residence (in which case, the rule set forth in the preceding sentence would govern the application of such indebtedness when calculating the Investor’s net worth);
___ (iii) a broker or dealer registered pursuant to Section 15 of the Exchange Act;
___ (iv) a bank as defined in Section 3(a)(2) of the Securities Act or any savings and loan association as defined in Section 3(a)(5)(A) of the Securities Act, whether acting in its individual or fiduciary capacity;
___ (v) an insurance company as defined in Section 2(a)(13) of the Securities Act;
___ (vi) an investment company registered under the 1940 Act;
___ (vii) an Individual Retirement Account (“IRA”) or revocable trust and the individual who established the IRA or each grantor of the trust is an accredited investor on the basis of (i) or (ii) above;
___ (viii) a self-directed pension plan and the participant who directed that assets of his or her account be invested in the Company is an accredited investor on the basis of (i) or (ii) above and such participant is the only participant whose account is being invested in the Company;
___ (ix) a pension plan which is not a self-directed plan and which has total assets in excess of $5,000,000;
___ (x) a trust which consists of a single trust (a) with total assets in excess of $5,000,000, (b) which was not formed for the specific purpose of investing in the Company and (c) whose purchase is directed by a person who has such knowledge and experience in
financial and business matters that he or she is capable of evaluating the merits and risks of the prospective investment;
_X (xi) a corporation, a partnership, a limited liability company or a Massachusetts or similar business trust, that was not formed for the specific purpose of acquiring an interest in the Company, with total assets in excess of $5,000,000;
___ (xii) an organization described in Section 501(c) of the Code, and exempt from U.S. income tax pursuant to Section 501(a) of the Code with total assets in excess of $5,000,000;
___ (xiii) an entity in which all of the equity owners are accredited investors;
___ (xiv) (A) a business development company as defined in Section 2(a)(48) of the 1940 Act or (B) a Small Business Investment Fund licensed by the United States Small Business Administration under Section 301(c) or (d) of the Small Business Investment Company Act of 1958;
___ (xv) a private business development company as defined in Section 202(a)(22) of the Investment Advisers Act of 1940, as amended;
___ (xvi) a director or executive officer of the Company; or
___ (xvii) none of the above applies (further information may be required).
Check all applicable categories.
C. Qualified Purchaser Status
Qualified Purchaser Status. Please mark the appropriate box next to each description applicable to the Investor:
(1) [ ] A natural person (including any person who will hold a joint, community property, or other similar shared ownership interest in the Company with that person’s qualified purchaser spouse) who owns at least $5,000,000 in “Investments” (as defined in Rule 2a51-1 under the 1940 Act).
(2) [ ] A company1 that owns at least $5,000,000 in Investments and that is owned directly or indirectly by or for two or more natural persons who are related as siblings or spouse (including former spouses), or direct lineal descendants by birth or adoption, spouses of such persons, the estates of such persons, or foundations, charitable organizations, or trusts established by or for the benefit of such persons.
(3) [ ] A trust that is not covered by clause (2) above, and that was not formed for the specific purpose of investing in the Company, as to which the trustee or other person authorized to make decisions with respect to the trust, and each settlor or other person who has contributed assets to the trust, is a person described in clause (1), (2), or (4) below.
(4) [ X ] A person (including a company), acting for its own account or the accounts of other qualified purchasers, who in the aggregate owns and invests on a discretionary basis, not less than $25,000,000 in Investments.
(5) [ ] A natural person (including any person who will hold a joint, community property, or other similar shared ownership interest in the Company with that person’s qualified purchaser spouse) who owns at least $5,000,000 in Investments.
(6) [ ] A “Qualified Institutional Buyer” as defined in Rule 144A under the Securities Act (as that term is modified by the limitations imposed thereon by Rule 2a51-1(g)(1) under the 1940 Act).
(7) [ ] A company, regardless of the amount of its Investments, where each of the beneficial owners of securities issued by such company is a person described in clause (1), (2), (3), (4), or (5). (If this item is checked, please contact the Company. Additional requirements may apply.)
* For purposes of this Question, “company” includes a corporation, a partnership, an association, a joint-stock company, a trust or a fund. In order to be a “qualified purchaser” any company that both (i) would, but for an exception provided in Sections 3(c)(1) or 3(c)(7) of the 1940 Act, be an investment company and (ii) was in existence prior to May 1, 1996, must have complied with the consent provisions of Section 2(a)(51)(C) of the 1940 Act.
D. Required Supplemental Data
Yes ■ No
A “Benefit Plan Investor” is as defined in 29 C.F.R. Section 2510.3-101, as modified by Section 3(42) of the U.S. Employee Retirement Income Security Act of 1974, as amended (“ERISA”) (the “Plan Asset Regulation”) and includes (i) an “employee benefit plan” subject to Part 4, Subtitle B of Title I of ERISA, (ii) a “plan” subject to Section 4975 of the Code, and (iii) any entity whose underlying assets include “plan assets” by reason of such employee benefit plan’s or other plan’s investment in the entity or otherwise. A Benefit Plan Investor can also include an insurance company general account the assets of which are considered for purposes of ERISA or Section 4975 of the Code to be assets of a Benefit Plan Investor.
(a) an “employee benefit plan” or trust that is subject to Part 4, Subtitle B of Title I of ERISA;
(b) a “plan” to which Section 4975 of the Code applies;
(c) an entity (other than an insurance company general account) whose underlying
assets include “plan assets” by reason of an employee benefit plan’s or other plan’s investment in the entity or otherwise for purposes of ERISA or Section 4975 of the Code;
If Item 2(c) above is applicable, insert the maximum percentage of the assets of the entity that constitutes or may in the future constitute “plan assets” during the period of its investment in the Company:
_________%
If Item 2(d) above is applicable, insert the maximum percentage of the general account as a whole that constitutes or may in the future constitute “plan assets” during the period of its investment in the Company:
_________%
Without limiting the remedies available in the event of a breach, the Investor agrees promptly to notify the Adviser in writing if there is a change in the percentage set forth above, or any other response above, at such time or times as the Adviser may request.
Yes ■ No
Section 3(c)(1) thereof? Yes ■ No
Section 3(c)(7) thereof? ■ Yes No
F. Controlling Persons:
Is the undersigned or will the undersigned be a person (including an entity) that has discretionary authority or control with respect to the assets of the Company or a person who provides investment advice with respect to the assets of the Company or an “affiliate” of such a person? For purposes of this representation and agreement, an “affiliate” is any person controlling, controlled by or under common control with any such person, including by reason of having the power to exercise a controlling influence over the management or policies of such person.
Yes ■ No
G. Related Parties/Other Beneficial Interests:
Yes ■ No
If the question above was answered “Yes,” please indicate the name of such other investor in the space below:
____________________________________
Yes ■ No
If either question above was answered “Yes,” please contact the Administrator for additional information that will be required.
H. BHC Investor Status:
Is the Investor a “BHC Investor”?2
Yes ■ No
[remainder of page intentionally left blank]
2 A “BHC Investor” is defined as an Investor that is a bank holding company, as defined in Section 2(a) of the Bank Holding Company Act of 1956, as amended (the “BHC Act”), a non-bank subsidiary (for purposes of the BHC Act) of a bank holding company, a foreign banking organization, as defined in Regulation K of the Board of Governors of the Federal Reserve System (12 C.F.R. § 211.23) or any successor regulation, or a non-bank subsidiary (for purposes of the BHC Act) of a foreign banking organization which subsidiary is engaged, directly or indirectly in business in the United States and which in any case holds Shares for its own account.
Signatures:
INDIVIDUAL:
(Signature)
(Print Name)
PARTNERSHIP, CORPORATION, LIMITED LIABILITY COMPANY, TRUST, CUSTODIAL ACCOUNT, OTHER:
Mercer Audax Credit Feeder Fund LP_________
(Name of Entity)
By:
(Signature)
(Print Name and Title)
APPENDIX A
[CERTIFICATE OF INCORPORATION]
APPENDIX B
[BYLAWS]
APPENDIX C
[FORM OF ADVISORY AGREEMENT]
APPENDIX D
[FORM OF ADMINISTRATION AGREEMENT]
APPENDIX E
TRANSFER RESTRICTIONS
No Transfer of the Investor’s Capital Commitment or all or any fraction of the Investor’s Shares may be made without (i) registration of the Transfer on the Company books and (ii) the prior written consent of the Administrator. In any event, the consent of the Company may be withheld (x) if the creditworthiness of the proposed transferee, as determined by the Company in its sole discretion, is not sufficient to satisfy all obligations under the Subscription Agreement or (y) unless, in the opinion of counsel (who may be counsel for the Company or the Investor) satisfactory in form and substance to the Company:
The Investor agrees that it shall pay all reasonable expenses, including attorneys’ fees, incurred by the Company in connection with any Transfer of all or any fraction of its Shares, prior to the consummation of such Transfer.
Any person that acquires all or any fraction of the Shares of the Investor in a Transfer permitted under this Appendix E shall be obligated to pay to the Company the appropriate portion of any amounts thereafter becoming due in respect of the Capital Commitment committed to be made by its predecessor in interest. The Investor agrees that, notwithstanding the Transfer of all or any fraction of its Shares, as between it and the Company it shall remain liable for its Capital Commitment prior to the time, if any, when the purchaser, assignee or transferee of such Shares, or fraction thereof, becomes a holder of such Shares.
The Company shall not recognize for any purpose any purported Transfer of all or any fraction of the Shares and shall be entitled to treat the transferor of Shares as the absolute owner thereof in all respects, and shall incur no liability for distributions or dividends made in good faith to it, unless the Company shall have given its prior written consent thereto and there shall have been filed with the Company a dated notice of such Transfer, in form satisfactory to the Company, executed and acknowledged by both the seller, assignor or transferor and the purchaser, assignee or transferee, and such notice (i) contains the acceptance by the purchaser, assignee or transferee of all of the terms and provisions of this Subscription Agreement and its agreement to be bound thereby, and (ii) represents that such Transfer was made in accordance with this Subscription Agreement, the provisions of the Memorandum and all applicable laws and regulations applicable to the transferee and the transferor.
EXHIBIT A
CIP MATRIX
To help the government fight the funding of terrorism and money laundering activities, U.S. federal law requires certain financial institutions to obtain, verify, and record information that identifies each person who opens an account.
The Company may reject your subscription if the required identifying information is not provided.
Each Investor must provide the following information and documents to the Administrator in order to satisfy its anti-money laundering program:
Non-U.S. Persons: |
In addition to the specific requirements listed below, Non-U.S. Investors must also: 1. Provide a translation for any documents not in English. 2. (Other than individual Non-U.S. Persons) Provide a statement of account purpose, including: (a). Nature of the customer’s business and the market it serves; (b) Account purpose/Is the account being established on behalf of the customers’ customers? (c) Anticipated account activity |
(Note: If an asterisk (*) appears next to an item listed below, the item is optional.)
Type of Investor |
Identification Information |
Verification Information |
Individual
Individuals include owners of individual accounts, both individual owners of joint accounts and power of attorney |
1. Name of investor 2. Physical address and mailing address (if different) 3. Date of Birth 4. Social Security Number 5. Signed subscription document 6. List of authorized signers (other than investor, if any) 7. Source of Wealth* 8. Telephone number* 9. Occupation * 10. Employer * 11. Email address/website *
|
Copy of either: 1. Passport OR 2. Photo Drivers license OR 3. Other government–issued photo ID
Note: Non-Documentary methods (i.e., PA compliance) may also be utilized for verification.
|
Type of Investor |
Identification Information |
Verification Information |
Private Corporation
Private Corporation includes Limited Liability Companies (LLC) |
1. Name of corporation 2. Beneficial Owners with more than 20% interest 3. Physical address & mailing address (if different) 4. U.S. TIN or other government ID number (accompanied by a description of the type of identification and the name of the issuing government body) 5. Signed subscription document 6. List of Authorized Signers 7. Nature of business 8. Source of Wealth* 9. Telephone number* 10. Email address/website *
|
Copy of either: 1. Certificate of Incorporation OR 2. Certificate of good standing OR 3. Government issued business license
Note: Non-Documentary methods (i.e. PA compliance) may also be utilized for verification.
Foreign Banks: a Shell Bank certification must be supplied
|
U.S. Public Corporation |
1. Name of corporation 2. Physical address & mailing address (if different) 3. U.S. TIN or other government ID number 4. Signed subscription document 5. List of Authorized Signers 6. Source of Wealth* 7. Telephone number* 8. Email address/website *
|
Obtain: Ticker Symbol
|
Partnerships
Partnerships include Limited Partnership (LP) |
1. Name of partnership 2. Partners with more than 20% interest 3. Physical address & mailing address (if different) 4. U.S. TIN or other government ID number 5. Signed subscription document 6. List of Authorized Signers 7. Nature of business 8. Source of Wealth* 9. Telephone number* 10. Email address/website *
|
Copy of: 1. Partnership/Membership Agreement
Note: Non-Documentary methods (i.e. PA compliance) may also be utilized for verification.
Non-U.S.-Based Partnerships: Copy of: 1. An unexpired government-issued photo drivers license or other government-issued ID for all managing or general partner(s) 2. If the GP/managing partner is a business entity, U.S. TIN or other government ID number with a description of the type of the identification and the name of the issuing body
|
Type of Investor |
Identification Information |
Verification Information |
U.S. Non-Profit |
1. Name of entity 2. Physical address & mailing address (if different) 3. U.S. TIN or other government ID number 4. Signed subscription document 5. List of Authorized Signers 6. Nature of business 7. Source of Wealth* 8. Telephone number* 9. Email address/website *
|
Copy of: 1. IRS Determination Letter
Note: Non-Documentary methods are not an acceptable backup for Non-Profits; IRS Determination Letter must be obtained.
|
Trust |
1. Name of trust 2. List of Trustee(s) 3. Physical address & mailing address (if different) 4. U.S. TIN or other government ID number 5. Signed subscription document 6. Name of maker of trust (grantor/trustor) 7. List of principal beneficiaries 8. Source of Wealth* 9. Telephone number of Trust* 10. Successor Trustee* 11. Email address/website *
|
Copy of: 1. Trust deed
Note: Non-Documentary methods are not an acceptable backup for Trusts; Trust deed must be obtained.
|
Investor declared as exempt from CIP
(ERISA Plan, Governmental Agency, Financial Institution subject to Section 352 of the USA PATRIOT Act or Publicly Traded Companies listed on the New York Stock Exchange & Nasdaq) |
1. Name of entity 2. Physical address & mailing address (if different) 3. U.S. TIN or other government ID number 4. Signed subscription document 5. List of authorized signers 6. Telephone number * 7. Email address/website *
|
Copy of: 1. If ERISA – copy of IRS letter or IRS form 5500 or plan document 2. If Governmental Agency – website research or alternative informational source If Financial Institution subject to Section 352 of the USA PATRIOT Act certificate # for bank on FDIC website or look up CRD# for a Broker Dealer on the FINRA.org website 4. If publicly traded company listed on the New York Stock Exchange or Nasdaq – Ticker symbol in order to research in Bloomberg |
Individuals Associated with U.S. Entities
In addition to the identification verification performed on the entity (i.e. LLC, LP, trust), verification of the identities of the individuals listed below must also be performed, where applicable, as specified in the table.
Identification Information |
Verification Information |
1. Name 2. Physical address & mailing address (if different) 3. Date of birth 4. U.S. TIN or other government ID number |
Copy of: 1. Passport OR 2. Photo drivers license OR 3. Other government-issued photo ID
Note: Non-Documentary methods (i.e. PA compliance) may also be utilized for verification. |
Exhibit C
Contact Information Sheet for Mercer Audax Credit Feeder Fund, LP
For all correspondence, including statements, tax forms, legal documents, audits, performance letters, etc.
David Scopelliti
Mercer Investments LLC
501 Merritt Suite 7; Norwalk, CT 06856
Phone: (203) 970-9365
Email: david.scopelliti@mercer.com
Harry Leggat
Mercer Investments LLC
800 Market Street, Suite 1800, St. Louis, MO 63101
Phone: (314) 588-2500
Email: harry.leggat@mercer.com
Mercer US PIP Operations Team: Kristin Ferrer, Zoya Filippova, Geraldine Arnold, Maxwell
Bauer, David Greenberg, David Kowalczyk, Phil Stobie, Troy Tallman, Emily O’Meara,
Keta Patel, Casey Betz, Nicole Hughes, Chali Cero, Ian Hessler, Chen Yang, Sabour
Moumouni, Rebeca Lee and Maryam Busi
800 Market Street, Suite 1800, St. Louis, MO 63101
Phone: (314) 588-2500
MercerUSPIPFunds@mercer.com
Mercer Alternatives Document Management Team: Stephanie Perry, Bryan Garland and
Samantha Mitchell
10850 Gold Center Drive, Suite 375, Rancho Cordova, CA 95670
Phone: (916) 231-3900
MercerAlts_DocMgmt@mercer.com
MercerAltsFOF-PM@mercer.com
Mercer Private Debt Team: Noreen Cahill, Joe Abrams, Philip Bauer, Tasmin Coleman,
Michael Forestner, Jordan Kitchen, Nicholas Kocus, Jimmy Luong, Chris Martinaz, Vincent
Mu, Derek Mullane, David Scopelliti, Adam Skinner, Emily Sun, Max Twyman, Scott
Wilkinson, Jane Xu
Email: #MercerGlobalPrivateDebtTeam@mercer.com
Mercer Private Equity Team: Eric Rudy, Justin Straatman, Shannon Turner
800 Market Street, Suite 1800, St. Louis, MO 63101
Phone: (314) 588-2500
Email: SLH-PrivateEquity@mercer.com
IFS, A State Street Company
Attn: IFS NAV & IFS Pricing
1 Iron Street, Boston, MA 02110
Phone: (212) 848-3971
Email: MercerNAV@statestreet.com
IFSPricingTeam@statestreet.com
Private Market Connect (S&P)
Email: monitor@privatemarketconnect.com
EXHIBIT D
WIRE INSTRUCTIONS FOR MERCER AUDAX CREDIT FEEDER FUND, LP
Please update your records with the following wire instructions for Mercer Audax Credit Feeder Fund, LP
USD Cash Instructions State Street Bank and Trust Company, Boston One Lincoln Street Boston, MA, USA 02111
ABA#: 011000028 DDA#: 10631877 Acct Name: Mercer Audax Credit Feeder Fund, LP Ref: MEP2 |
DTC Settlement Instructions State Street Bank Participant #: 997 Agent Bank #: 26022 FINS ID#: 58873 FFC: SSC Fund MEP2 |