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U.S. SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
FORM 4
STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP
Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934,
Section 17(a) of the Public Utility Holding Company Act of 1935
or Section 30(f) of the Investment Company Act of 1940
/ / 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*
Chase Venture Capital Associates, LLC (FN 1)
(Last) (First) (Middle)
c/o Chase Capital Partners
380 Madison Avenue -- 12th Floor
(Street)
New York, New York 10017
(City) (State) (Zip)
2. Issuer Name and Ticker or Trading Symbol
Patina Oil & Gas Corporation ("POG")
3. I.R.S. Identification Number of Reporting Person, if an entity (voluntary)
4. Statement for Month/Year
December 1999
5. If Amendment, Date of Original (Month/Year)
1/10/00
6. Relationship of Reporting Person(s) to Issuer (Check all applicable)
/ / Director /X/ 10% Owner
/ / Officer (give title below) / / Other (specify below)
7. Individual or Joint/Group Reporting (Check Applicable Line)
/ / Form filed by One Reporting Person
/X/ Form filed by More than One Reporting Person
* If the form is filed by more than one reporting person, see instruction
4(b)(v).
<TABLE>
<CAPTION>
Table I -- Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned
5. Amount
of Secu-
rities
4. Securities Acquired (A) Bene- 6. Ownership
2. Trans- 3. Trans- or Disposed of (D) ficially Form:
action action (Instr. 3, 4 and 5) Owned Direct 7. Nature of
Date Code ----------------------------- at End (D) or Indirect
(Month/ (Instr. 8) (A) of Month Indirect Beneficial
1. Title of Security Day/ ------------- Amount or Price (Instr. (I) Ownership
(Instr. 3) Year) Code V (D) 3 and 4) (Instr. 4) (Instr. 4)
- ----------------------------- ---------- ------ ----- ------------ --- ---------- ----------- ------------- ---------------
<S> <C> <C> <C> <C> <C> <C> <C> <C> <C>
Common Stock 3/15/99 A 728 A 3.4379 85,481 D
- ----------------------------- ---------- ------ ----- ------------ --- ---------- ----------- ------------- ---------------
Common Stock 6/15/99 A 396 A 6.3125 85,877 D
- ----------------------------- ---------- ------ ----- ------------ --- ---------- ----------- ------------- ---------------
Common Stock 9/15/99 A 290 A 8.625 86,167 D
- ----------------------------- ---------- ------ ----- ------------ --- ---------- ----------- ------------- ---------------
Common Stock 12/15/99 A 315 A 7.9375 86,482 D
- ----------------------------- ---------- ------ ----- ------------ --- ---------- ----------- ------------- ---------------
</TABLE>
Page 1 of 7
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<TABLE>
<CAPTION>
Table II--Derivative Securities Acquired, Disposed of, or Beneficially Owned
(e.g., puts, calls, warrants, options, convertible securities)
2. Conver- 5. Number of Deriv- 6. Date Exercisable
sion or 3. Trans- ative Securities and Expiration Date
Exercise action 4. Transac- Acquired (A) or (Month/Day/Year)
Price of Date tion Code Disposed of (D) ----------------------
Deriv- (Month/ (Instr. 8) (Instr. 3, 4, and 5) Date
1. Title of Derivative Security ative Day/ ------------- -------------------------- Exercis- Expiration
(Instr. 3) Security Year) Code V (A) (D) able Date
- ---------------------------------------- ----------- ---------- ------ ----- ------------ ------------ ---------- ----------
<S> <C> <C> <C> <C> <C> <C> <C> <C>
Convertible Preferred 2.6316 P 104,888 Immed.
- ---------------------------------------- ----------- ---------- ------ ----- ------------ ------------ ---------- ----------
Non-Qualified Stock Option 2.9375 2/18/99 A 5,000 Immed.
- ---------------------------------------- ----------- ---------- ------ ----- ------------ ------------ ---------- ----------
Non-Qualified Stock Option 5.1250 5/27/99 A 5,000 Immed.
- ---------------------------------------- ----------- ---------- ------ ----- ------------ ------------ ---------- ----------
<CAPTION>
9. Number of 10. Ownership
Derivative Form of
Securities Derivative
7. Title and Amount of Underlying Benefi- Security:
Securities (Instr. 3 and 4) cially Direct 11. Nature of
---------------------------------------- 8. Price of Owned at (D) or Indirect
Amount or Derivative End of Indirect Beneficial
1. Title of Derivative Title Number of Security Month (I) Ownership
Security (Instr. 3) Shares (Instr. 5) (Instr. 4) (Instr. 4) (Instr. 4)
- --------------------------- --------------------------- ----------- ------------- ------------- -------------- ---------------
<S> <C> <C> <C> <C> <C> <C>
Convertible Preferred Common Stock 276,023 PIK (FN 2) 1,779,796 D
- --------------------------- --------------------------- ----------- ------------- ------------- -------------- ---------------
Non-Qualified Stock Option Common Stock 5,000 (FN 3) 15,000 I (FN 3)
- --------------------------- --------------------------- ----------- ------------- ------------- -------------- ---------------
Non-Qualified Stock Option Common Stock 5,000 (FN 3) 20,000 I (FN 3)
- --------------------------- --------------------------- ----------- ------------- ------------- -------------- ---------------
</TABLE>
Explanation of Response:
(1) The amounts shown in Tables I and II represent the beneficial ownership of
the Issuer's equity securities by (i) Chase Venture Capital Associates, LLC
("CVCA, LLC"), and (ii) Christopher Behrens, a general partner of Chase Capital
Partners ("CCP"), which is the managing member of CVCA, LLC. Pursuant to an
internal reorganization effective as of January 1, 2000, (i) CVCA, LLC became
the successor to Chase Venture Capital Associates, LP ("CVCA, LP") (ii) CCP-SBIC
Manager, LLC, a newly organized wholly-owned subsidiary of CCP, became the
managing member of CVCA, LLC, and (iii) CCP-CMC Consolidating, LLC
("Consolidating"), a newly-organized affiliate of CCP, became the non-managing
member of CVCA, LLC. CCP is the managing member of Consolidating, and pursuant
to a master advisory agreement with CCP-SBIC Manager, LLC and Consolidating, the
manager, by delegation, of CVCA, LLC. Prior to the internal reorganization, the
sole shareholder of Consolidating was the limited partner, of CVCA, LP. The
internal reorganization changed CVCA, LP's name and form of organization but did
not alter the proportionate interests of its ultimate security holders.
(2) Dividends on Convertible Preferred Stock were payable in kind through
October 21, 1999.
(3) Stock option grant for non-employee directors issued pursuant to the 1996
Patina Non-Employee Stock Option Plan. Exercisable as follows: 30% on first
anniversary date of transaction, 30% on second anniversary date of transaction,
and 40% on third anniversary. Christopher Behrens, a general partner of CCP, is
obligated to exercise each of the options upon the request of CVCA and to
transfer all shares received upon such exercise to CVCA.
Chase Venture Capital Associates, LLC
By: Chase Capital Partners, as Manager
By:
-----------------------------------
Title: of Chase Capital Partners 2/23/2000
--------------------- ---------
Date
Page 2 of 7
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Name and Address of Reporting Designated Statement Issuer Title Amount of Ownership Nature of Disclaims
Person Reporter1 for Name, of Securities Form: Indirect Pecuniary
month/year Ticker Security Beneficially Direct Beneficial Interest
or Owned (D) or Ownership
Trading Indirect
Symbol (I)
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<S> <C> <C> <C> <C> <C> <C> <C> <C>
Ana Carolina Aidar Chase Venture December, Patina Common 86,482 I See Explanatory Yes
c/o Chase Capital Partners Capital 1999 Oil & Gas Stock Note 2 below
Rua Verbo Divino, 1400 Associates, LLC ("POG")
Sao Paulo, Brazil, SP 04719-002
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John R. Baron Chase Venture December, Patina Common 86,482 I See Explanatory No
c/o Chase Capital Partners Capital 1999 Oil & Gas Stock Note 2 below
380 Madison Avenue 12th Floor Associates, LLC ("POG")
New York, NY 10017
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Christopher C. Behrens Chase Venture December, Patina Common 86,482 I See Explanatory No
c/o Chase Capital Partners Capital 1999 Oil & Gas Stock Note 2 below
380 Madison Avenue 12th Floor Associates, LLC ("POG")
New York, NY 10017
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Mitchell J. Blutt Chase Venture December, Patina Common 86,482 I See Explanatory No
c/o Chase Capital Partners Capital 1999 Oil & Gas Stock Note 2 below
380 Madison Avenue Associates, LLC ("POG")
12th Floor
New York, NY 10017
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David S. Britts Chase Venture December, Patina Common 86,482 I See Explanatory Yes
c/o Chase Capital Partners Capital 1999 Oil & Gas Stock Note 2 below
50 California Street Associates, LLC ("POG")
San Francisco, CA 94111
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Arnold L. Chavkin Chase Venture December, Patina Common 86,482 I See Explanatory No
c/o Chase Capital Partners Capital 1999 Oil & Gas Stock Note 2 below
380 Madison Avenue 12th Floor Associates, LLC ("POG")
New York, NY 10017
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David J. Gilbert Chase Venture December, Patina Common 86,482 I See Explanatory Yes
c/o Chase Capital Partners Capital 1999 Oil & Gas Stock Note 2 below
380 Madison Avenue Associates, LLC ("POG")
12th Floor
New York, NY 10017
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Eric A. Green Chase Venture December, Patina Common 86,482 I See Explanatory Yes
c/o Chase Capital Partners Capital 1999 Oil & Gas Stock Note 2 below
380 Madison Avenue Associates, LLC ("POG")
12th Floor
New York, NY 10017
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Michael R. Hannon Chase Venture December, Patina Common 86,482 I See Explanatory No
c/o Chase Capital Partners Capital 1999 Oil & Gas Stock Note 2 below
380 Madison Avenue 12th Floor Associates, LLC ("POG")
New York, NY 10017
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</TABLE>
Page 3 of 7
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<TABLE>
<S> <C> <C> <C> <C> <C> <C> <C> <C>
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Donald J. Hofmann Chase Venture December, Patina Common 86,482 I See Explanatory No
c/o Chase Capital Partners Capital 1999 Oil & Gas Stock Note 2 below
380 Madison Avenue 12th Floor Associates, LLC ("POG")
New York, NY 10017
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Jonathan Meggs Chase Venture December, Patina Common 86,482 I See Explanatory Yes
c/o Chase Capital Partners Capital 1999 Oil & Gas Stock Note 2 below
125 London Wall Associates, LLC ("POG")
London EC2Y 5AJ, United Kingdom
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Stephen P. Murray Chase Venture December, Patina Common 86,482 I See Explanatory No
c/o Chase Capital Partners Capital 1999 Oil & Gas Stock Note 2 below
380 Madison Avenue 12th Floor Associates, LLC ("POG")
New York, NY 10017
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John M.B. O'Connor Chase Venture December, Patina Common 86,482 I See Explanatory No
c/o Chase Capital Partners Capital 1999 Oil & Gas Stock Note 2 below
380 Madison Avenue 12th Floor Associates, LLC ("POG")
New York, NY 10017
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Bob Ruggiero Chase Venture December, Patina Common 86,482 I See Explanatory Yes
c/o Chase Capital Partners Capital 1999 Oil & Gas Stock Note 2 below
380 Madison Avenue 12th Floor Associates, LLC ("POG")
New York, NY 10017
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Susan L. Segal Chase Venture December, Patina Common 86,482 I See Explanatory Yes
c/o Chase Capital Partners Capital 1999 Oil & Gas Stock Note 2 below
380 Madison Avenue 12th Floor Associates, LLC ("POG")
New York, NY 10017
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Shahan D. Soghikian Chase Venture December, Patina Common 86,482 I See Explanatory No
c/o Chase Capital Capital 1999 Oil & Gas Stock Note 2 below
Partners Associates, LLC ("POG")
50 California Street, Suite 2940
San Francisco, CA 94111
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Lindsay Stuart Chase Venture December, Patina Common 86,482 I See Explanatory Yes
c/o Chase Capital Partners Capital 1999 Oil & Gas Stock Note 2 below
125 London Wall Associates, LLC ("POG")
London EC2Y 5AJ, United Kingdom
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Patrick Sullivan Chase Venture December, Patina Common 86,482 I See Explanatory Yes
c/o Chase Capital Partners Capital 1999 Oil & Gas Stock Note 2 below
380 Madison Avenue 12th Floor Associates, LLC ("POG")
New York, NY 10017
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Jeffrey C. Walker Chase Venture December, Patina Common 86,482 I See Explanatory No
c/o Chase Capital Partners Capital 1999 Oil & Gas Stock Note 2 below
380 Madison Avenue 12th Floor Associates, LLC ("POG")
New York, NY 10017
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Page 4 of 7
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<TABLE>
<S> <C> <C> <C> <C> <C> <C> <C> <C>
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Timothy J. Walsh Chase Venture December, Patina Common 86,482 I See Explanatory No
c/o Chase Capital Partners Capital 1999 Oil & Gas Stock Note 2 below
380 Madison Avenue 12th Floor Associates, LLC ("POG")
New York, NY 10017
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Richard D. Waters Chase Venture December, Patina Common 86,482 I See Explanatory Yes
c/o Chase Capital Partners Capital 1999 Oil & Gas Stock Note 2 below
380 Madison Avenue 12th Floor Associates, LLC ("POG")
New York, NY 10017
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Damion E. Wicker Chase Venture December, Patina Common 86,482 I See Explanatory No
c/o Chase Capital Partners Capital 1999 Oil & Gas Stock Note 2 below
380 Madison Avenue 12th Floor Associates, LLC ("POG")
New York, NY 10017
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CCP European Principals, LLC Chase Venture December, Patina Common 86,482 I See Explanatory No
c/o Chase Capital Partners Capital 1999 Oil & Gas Stock Note 2 below
380 Madison Avenue 12th Floor Associates, LLC ("POG")
New York, NY 10017
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CCP Principals, LLC Chase Venture December, Patina Common 86,482 I See Explanatory No
c/o Chase Capital Partners Capital 1999 Oil & Gas Stock Note 2 below
380 Madison Avenue 12th Floor Associates, LLC ("POG")
New York, NY 10017
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Chase Capital Corporation Chase Venture December, Patina Common 86,482 I See Explanatory No
c/o Chase Capital Partners Capital 1999 Oil & Gas Stock Note 2 below
380 Madison Avenue 12th Floor Associates, LLC ("POG")
New York, NY 10017
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The Chase Manhattan Corporation Chase Venture December, Patina Common 86,482 I See Explanatory No
270 Park Avenue Capital 1999 Oil & Gas Stock Note
35th Floor Associates, LLC ("POG") 3 below
New York, NY 10017
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Chase Capital Partners Chase Venture December, Patina Common 86,482 I See Explanatory No
380 Madison Avenue 12th Floor Capital 1999 Oil & Gas Stock Note 4 below
New York, NY 10017 Associates, LLC ("POG")
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CCP-SBIC Manager, LLC Chase Venture December, Patina Common 86,482 I See Explanatory No
c/o Chase Capital Partners Capital 1999 Oil & Gas Stock Note 5 below
380 Madison Avenue Associates, LLC ("POG")
12th Floor
New York, NY 10017
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<TABLE>
<S> <C> <C> <C> <C> <C> <C> <C> <C>
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CCP-CMC Consolidating, LLC Chase Venture December, Patina Common 86,482 I See Explanatory No
c/o Chase Capital Partners Capital 1999 Oil & Gas Stock Note 6 below
380 Madison Avenue Associates, LLC ("POG")
New York, NY 10017
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I. Robert Greene Chase Venture December, Patina Common 86,482 I See Explanatory No
c/o Flatiron Partners Capital 1999 Oil & Gas Stock Note 7 below
257 Park Avenue South Associates, LLC ("POG")
New York, NY
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Brian J. Richmand Chase Venture December, Patina Common 86,482 I See Explanatory No
c/o Chase Capital Partners Capital 1999 Oil & Gas Stock Note 8 below
380 Madison Avenue Associates, LLC ("POG")
12th Floor
New York, NY 10017
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Jonas Steinmann Chase Venture December, Patina Common 86,482 I See Explanatory No
c/o Chase Capital Partners Capital 1999 Oil & Gas Stock Note 9 below
380 Madison Avenue Associates, LLC ("POG")
12th Floor
New York, NY 10017
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</TABLE>
Explanatory Note:
1) The Designated Reporter is executing this report on behalf of all reporting
persons, each of whom has authorized it to do so.
2) The amounts shown in Tables I and II represent the beneficial ownership of
the Issuer's equity securities by CVCA, LLC, a portion of which may be deemed
attributable to the reporting person because the reporting person is a partner
of Chase Capital Partners ("CCP"), which is the sole managing member of (a)
CCP-SBIC Manager, LLC ("CCP-SBIC"), the sole managing member of CVCA, LLC and
(b) CCP-CMC Consolidating, LLC ("Consolidating"), the non-managing member of
CVCA, LLC. CCP is also the manager, by delegation, of CVCA, LLC, pursuant to an
advisory agreement with CCP-SBIC and Consolidating. The actual pro rata portion
of such beneficial ownership that may be deemed to be attributable to the
reporting person is not readily determinable because it is subject to several
variables, including internal rate of return and vesting of interests within CCP
and CVCA, LLC.
3) The amounts shown in Tables I and II represent the beneficial ownership of
the Issuer's equity securities by CVCA, LLC, a portion of which may be deemed
attributable to the reporting person because it is the sole stockholder of Chase
Capital Corporation, a general partner of CCP, the sole managing member of the
two members of CVCA, LLC and the manager, by delegation, of CVCA, LLC. The
actual pro rata portion of such beneficial ownership that may be attributable to
the reporting person is not readily determinable because it is subject to
several variables, including the internal rate of return and vesting of
interests within CCP and CVCA, LLC.
4) The amounts shown in Tables I and II represent the beneficial ownership of
the Issuer's equity securities by CVCA, LLC, a portion of which may be deemed
attributable to the reporting person because it is the sole managing member of
(a) CCP-SBIC, the sole managing member of CVCA and (b) Consolidating, the
non-managing member of CVCA, LLC. CCP is also the manager, by delegation, of
CVCA, LLC pursuant to an advisory agreement with CCP-SBIC and Consolidating. The
actual pro rata portion of such beneficial ownership that may be deemed to be
attributable to the reporting person is not readily determinable because it is
subject to several variables, including the internal rate of return and vesting
of interests within CVCA, LLC.
5) The amounts shown in Tables I and II represent the beneficial ownership of
the Issuer's equity securities by CVCA, LLC, a portion of which may be deemed
attributable to the reporting person because it is the sole managing member of
CVCA, LLC. The actual pro rata portion of such beneficial ownership that may be
deemed to be attributable to the reporting person is not readily determinable
because it is subject to several variables, including the internal rate of
return and vesting of interests within CVCA, LLC.
6) The amounts shown in Tables I and II represent the beneficial ownership of
the Issuer's equity securities by CVCA, LLC, a portion of which may be deemed
attributable to the reporting person because it is the sole non-managing member
of CVCA, LLC. The actual pro rata portion of such beneficial ownership that may
be deemed to be attributable to the reporting person is not readily determinable
because it is subject to several variables, including the internal rate of
return and vesting of interests within CVCA, LLC.
7) The amounts shown in Tables I and II represent the beneficial ownership of
the Issuer's equity securities by CVCA, LLC, a portion of which may be deemed
attributable to the reporting person because he was a general partner of CCP,
the sole managing member of the two members of CVCA, LLC and the manager, by
delegation, of CVCA, LLC, until May 31, 1999. The actual
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pro rata portion of such beneficial ownership that may be deemed to be
attributable to the reporting person is not readily determinable because it is
subject to several variables, including the internal rate of return and vesting
within CCP and CVCA, LLC.
8) The amounts shown in Tables I and II represent the beneficial ownership of
the Issuer's equity securities by CVCA, LLC, a portion of which may be deemed
attributable to the reporting person because he was a general partner of CCP,
the sole managing member of the two members of CVCA, LLC and the manager, by
delegation, of CVCA, LLC, until December 31, 1999. The actual pro rata portion
of such beneficial ownership that may be deemed to be attributable to the
reporting person is not readily determinable because it is subject to several
variables, including the internal rate of return and vesting within CCP and
CVCA, LLC.
9) The amounts shown in Tables I and II represent the beneficial ownership of
the Issuer's equity securities by CVCA, LLC, a portion of which may be deemed
attributable to the reporting person because he was a general partner of CCP,
the sole managing member of the two members of CVCA, LLC, and the manager, by
delegation, of CVCA, LLC, until July 1, 1999. The actual pro rata portion of
such beneficial ownership that may be deemed to be attributable to the reporting
person is not readily determinable because it is subject to several variables,
including the internal rate of return and vesting within CCP and CVCA, LLC.
