SEC FORM 4 SEC Form 4
FORM 4 UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549

STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP

Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934
or Section 30(h) of the Investment Company Act of 1940
 
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Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b).
1. Name and Address of Reporting Person*
Kouzelos Michael P

(Last) (First) (Middle)
C/O CBIZ, INC.
6050 OAK TREE BOULEVARD SOUTH

(Street)
CLEVELAND OH 44131

(City) (State) (Zip)
2. Issuer Name and Ticker or Trading Symbol
CBIZ, Inc. [ CBZ ]
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
Director 10% Owner
X Officer (give title below) Other (specify below)
President, Employee Services
3. Date of Earliest Transaction (Month/Day/Year)
03/09/2022
4. If Amendment, Date of Original Filed (Month/Day/Year)
6. Individual or Joint/Group Filing (Check Applicable Line)
X Form filed by One Reporting Person
Form filed by More than One Reporting Person
Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned
1. Title of Security (Instr. 3) 2. Transaction Date (Month/Day/Year) 2A. Deemed Execution Date, if any (Month/Day/Year) 3. Transaction Code (Instr. 8) 4. Securities Acquired (A) or Disposed Of (D) (Instr. 3, 4 and 5) 5. Amount of Securities Beneficially Owned Following Reported Transaction(s) (Instr. 3 and 4) 6. Ownership Form: Direct (D) or Indirect (I) (Instr. 4) 7. Nature of Indirect Beneficial Ownership (Instr. 4)
Code V Amount (A) or (D) Price
Common Stock 03/09/2022 M 5,000 A $15.55 302,703 D
Common Stock 03/09/2022 S 5,000 D $39.3265(1) 297,703 D
Common Stock 03/10/2022 M 7,505 A $15.55 305,208 D
Common Stock 03/10/2022 S 7,505 D $39.1114(2) 297,703 D
Table II - Derivative Securities Acquired, Disposed of, or Beneficially Owned
(e.g., puts, calls, warrants, options, convertible securities)
1. Title of Derivative Security (Instr. 3) 2. Conversion or Exercise Price of Derivative Security 3. Transaction Date (Month/Day/Year) 3A. Deemed Execution Date, if any (Month/Day/Year) 4. Transaction Code (Instr. 8) 5. Number of Derivative Securities Acquired (A) or Disposed of (D) (Instr. 3, 4 and 5) 6. Date Exercisable and Expiration Date (Month/Day/Year) 7. Title and Amount of Securities Underlying Derivative Security (Instr. 3 and 4) 8. Price of Derivative Security (Instr. 5) 9. Number of derivative Securities Beneficially Owned Following Reported Transaction(s) (Instr. 4) 10. Ownership Form: Direct (D) or Indirect (I) (Instr. 4) 11. Nature of Indirect Beneficial Ownership (Instr. 4)
Code V (A) (D) Date Exercisable Expiration Date Title Amount or Number of Shares
Employee Stock Option $15.55 03/09/2022 M(3) 5,000 05/10/2018 05/10/2023 Common Stock 5,000 $0 52,100 D
Employee Stock Option $15.55 03/10/2022 M(3) 7,505 05/10/2018 05/10/2023 Common Stock 7,505 $0 44,595 D
Explanation of Responses:
1. Weighted average sale price of price range between $38.94 and $39.56. Will provide upon request number of shares sold at each separate price.
2. Weighted average sale price of price range between $38.76 and $39.59. Will provide upon request number of shares sold at each separate price.
3. Consists of Options granted on 5/10/2017 vesting in 25% increments each year beginning 05/10/2018 and expiring on 05/10/2023.
/s/ Michael W Gleespen, attorney-in-fact for Michael P Kouzelos 03/11/2022
** Signature of Reporting Person Date
Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly.
* If the form is filed by more than one reporting person, see Instruction 4 (b)(v).
** Intentional misstatements or omissions of facts constitute Federal Criminal Violations See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a).
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