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UNITED STATES OMB Number: 3235-0145
SECURITIES AND EXCHANGE COMMISSION Expires: August 31, 1999
Washington, D.C. 20549 Estimated average burden hours
per response.............14.90
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SCHEDULE 13D/A
Under the Securities Exchange Act of 1934
(Amendment No. 2)*
MEDIQ INCORPORATED
- --------------------------------------------------------------------------------
(Name of Issuer)
SERIES A PREFERRED STOCK, PAR VALUE $.50 PER SHARE
- --------------------------------------------------------------------------------
(Title of Class of Securities)
5849061
- --------------------------------------------------------------------------------
(CUSIP Number)
John D. Iskrant
Schnader Harrison Segal & Lewis
1600 Market Street, Suite 3600
Philadelphia, PA 19103-7286
(215) 751-2205
With Copies to:
F. Douglas Raymond, III
Drinker Biddle & Reath LLP
Philadelphia National Bank Building
1345 Chestnut Street
Philadelphia, PA 19107
(215) 988-2700
- --------------------------------------------------------------------------------
(Name, Address and Telephone Number of Person
Authorized to Receive Notices and Communications)
May 29, 1998
- --------------------------------------------------------------------------------
(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 which is the subject of this Schedule 13D, and is filing this
schedule because of Rule 13d-1(b)(3) or (4), check the following box [ ]
Note: Six copies of this statement, including all exhibits, should be filed
with the Commission. See Rule 13d-1(a) for other parties to whom copies are to
be sent.
- -----------------
* The remainder of this cover page shall be filled out for a reporting
person's 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).
<PAGE>
SCHEDULE 13D/A
Page 2 of 9 Pages
- ------------------------- --------------------------
CUSIP No. 58490 61 0 Page 2 of 9 Pages
- ------------------------- --------------------------
- -------------------------------------------------------------------------------
1 | NAME OF REPORTING PERSON
| S.S. OR I.R.S. IDENTIFICATION NO. OF ABOVE PERSON
| Bessie G. Rotko, Michael J. Rotko, Judith M. Shipon, John D.
| Iskrant and PNC Bank Corp., as Trustees under an Agreement
| of trust dated November 18, 1983 I.R.S. #: 23-6764067
- -------------------------------------------------------------------------------
|
2 | CHECK THE APPROPRIATE BOX IF A MEMBER OF A GROUP* (a) |_|
| (b) |_|
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3 | SEC USE ONLY
|
- --------------------------------------------------------------------------------
4 | SOURCE OF FUNDS*
|
| Not Applicable
- --------------------------------------------------------------------------------
5 | CHECK BOX IF DISCLOSURE OF LEGAL PROCEEDINGS IS REQUIRED PURSUANT
| TO ITEMS 2(d) OR 2(e)
| |_|
- --------------------------------------------------------------------------------
6 | CITIZENSHIP OR PLACE OF ORGANIZATION
|
| Commonwealth of Pennsylvania
- --------------------------------------------------------------------------------
| 7 | SOLE VOTING POWER
| |
| | -0-
NUMBER OF SHARES |-----|--------------------------------------
BENEFICIALLY | 8 | SHARED VOTING POWER
OWNED BY EACH | |
REPORTING PERSON | | -0-
WITH |-----|--------------------------------------
| 9 | SOLE DISPOSITIVE POWER
| |
| | -0-
|-----|--------------------------------------
| 10 | SHARED DISPOSITIVE POWER
| |
| | -0-
- --------------------------------------------------------------------------------
11 | AGGREGATE AMOUNT BENEFICIALLY OWNED BY EACH REPORTING PERSON
| -0-
- --------------------------------------------------------------------------------
12 | CHECK BOX IF THE AGGREGATE AMOUNT IN ROW (11) EXCLUDES CERTAIN
| SHARES*
| |_|
- --------------------------------------------------------------------------------
13 | PERCENT OF CLASS REPRESENTED BY AMOUNT IN ROW (11)
|
| Not Applicable
- --------------------------------------------------------------------------------
14 | TYPE OF REPORTING PERSON*
| 00
|
- --------------------------------------------------------------------------------
*SEE INSTRUCTIONS BEFORE FILLING OUT!
<PAGE>
SCHEDULE 13D/A
- ------------------------- --------------------------
CUSIP No. 58490 61 0 Page 3 of 9 Pages
- ------------------------- --------------------------
- -------------------------------------------------------------------------------
1 | NAME OF REPORTING PERSON
| S.S. OR I.R.S. IDENTIFICATION NO. OF ABOVE PERSON
|
| Michael J. Rotko
|
- -------------------------------------------------------------------------------
|
2 | CHECK THE APPROPRIATE BOX IF A MEMBER OF A GROUP* (a) |_|
| (b) |_|
- --------------------------------------------------------------------------------
3 | SEC USE ONLY
|
- --------------------------------------------------------------------------------
4 | SOURCE OF FUNDS*
|
| Not Applicable
- --------------------------------------------------------------------------------
5 | CHECK BOX IF DISCLOSURE OF LEGAL PROCEEDINGS IS REQUIRED PURSUANT
| TO ITEMS 2(d) OR 2(e)
| |_|
- --------------------------------------------------------------------------------
6 | CITIZENSHIP OR PLACE OF ORGANIZATION
|
| Commonwealth of Pennsylvania
- --------------------------------------------------------------------------------
| 7 | SOLE VOTING POWER
| |
| | -0-
NUMBER OF SHARES |-----|--------------------------------------
BENEFICIALLY | 8 | SHARED VOTING POWER
OWNED BY EACH | |
REPORTING PERSON | | -0-
WITH |-----|--------------------------------------
| 9 | SOLE DISPOSITIVE POWER
| |
| | -0-
|-----|--------------------------------------
| 10 | SHARED DISPOSITIVE POWER
| |
| | -0-
- --------------------------------------------------------------------------------
11 | AGGREGATE AMOUNT BENEFICIALLY OWNED BY EACH REPORTING PERSON
| -0-
- --------------------------------------------------------------------------------
12 | CHECK BOX IF THE AGGREGATE AMOUNT IN ROW (11) EXCLUDES CERTAIN
| SHARES*
| |_|
- --------------------------------------------------------------------------------
13 | PERCENT OF CLASS REPRESENTED BY AMOUNT IN ROW (11)
|
| Not Applicable
- --------------------------------------------------------------------------------
14 | TYPE OF REPORTING PERSON*
| IN
|
- --------------------------------------------------------------------------------
*SEE INSTRUCTIONS BEFORE FILLING OUT!
<PAGE>
SCHEDULE 13D/A
- ------------------------- --------------------------
CUSIP No. 58490 61 0 Page 4 of 9 Pages
- ------------------------- --------------------------
- -------------------------------------------------------------------------------
1 | NAME OF REPORTING PERSON
| S.S. OR I.R.S. IDENTIFICATION NO. OF ABOVE PERSON
|
| Bessie G. Rotko
|
- -------------------------------------------------------------------------------
|
2 | CHECK THE APPROPRIATE BOX IF A MEMBER OF A GROUP* (a) |_|
| (b) |_|
- --------------------------------------------------------------------------------
3 | SEC USE ONLY
|
- --------------------------------------------------------------------------------
4 | SOURCE OF FUNDS*
|
| Not Applicable
- --------------------------------------------------------------------------------
5 | CHECK BOX IF DISCLOSURE OF LEGAL PROCEEDINGS IS REQUIRED PURSUANT
| TO ITEMS 2(d) OR 2(e)
| |_|
- --------------------------------------------------------------------------------
6 | CITIZENSHIP OR PLACE OF ORGANIZATION
|
| Commonwealth of Pennsylvania
- --------------------------------------------------------------------------------
| 7 | SOLE VOTING POWER
| |
| | -0-
NUMBER OF SHARES |-----|--------------------------------------
BENEFICIALLY | 8 | SHARED VOTING POWER
OWNED BY EACH | |
REPORTING PERSON | | -0-
WITH |-----|--------------------------------------
| 9 | SOLE DISPOSITIVE POWER
| |
| | -0-
|-----|--------------------------------------
| 10 | SHARED DISPOSITIVE POWER
| |
| | -0-
- --------------------------------------------------------------------------------
11 | AGGREGATE AMOUNT BENEFICIALLY OWNED BY EACH REPORTING PERSON
| -0-
- --------------------------------------------------------------------------------
12 | CHECK BOX IF THE AGGREGATE AMOUNT IN ROW (11) EXCLUDES CERTAIN
| SHARES*
| |_|
- --------------------------------------------------------------------------------
13 | PERCENT OF CLASS REPRESENTED BY AMOUNT IN ROW (11)
|
| Not Applicable
- --------------------------------------------------------------------------------
14 | TYPE OF REPORTING PERSON*
| IN
|
- --------------------------------------------------------------------------------
*SEE INSTRUCTIONS BEFORE FILLING OUT!
<PAGE>
SCHEDULE 13D/A
- ------------------------- --------------------------
CUSIP No. 58490 61 0 Page 5 of 9 Pages
- ------------------------- --------------------------
- -------------------------------------------------------------------------------
1 | NAME OF REPORTING PERSON
| S.S. OR I.R.S. IDENTIFICATION NO. OF ABOVE PERSON
|
| Judith M. Shipon
|
- -------------------------------------------------------------------------------
|
2 | CHECK THE APPROPRIATE BOX IF A MEMBER OF A GROUP* (a) |_|
| (b) |_|
- --------------------------------------------------------------------------------
3 | SEC USE ONLY
|
- --------------------------------------------------------------------------------
4 | SOURCE OF FUNDS*
|
| Not Applicable
- --------------------------------------------------------------------------------
5 | CHECK BOX IF DISCLOSURE OF LEGAL PROCEEDINGS IS REQUIRED PURSUANT
| TO ITEMS 2(d) OR 2(e)
| |_|
- --------------------------------------------------------------------------------
6 | CITIZENSHIP OR PLACE OF ORGANIZATION
|
| Commonwealth of Pennsylvania
- --------------------------------------------------------------------------------
| 7 | SOLE VOTING POWER
| |
| | -0-
NUMBER OF SHARES |-----|--------------------------------------
BENEFICIALLY | 8 | SHARED VOTING POWER
OWNED BY EACH | |
REPORTING PERSON | | -0-
WITH |-----|--------------------------------------
| 9 | SOLE DISPOSITIVE POWER
| |
| | -0-
|-----|--------------------------------------
| 10 | SHARED DISPOSITIVE POWER
| |
| | -0-
- --------------------------------------------------------------------------------
11 | AGGREGATE AMOUNT BENEFICIALLY OWNED BY EACH REPORTING PERSON
| -0-
- --------------------------------------------------------------------------------
12 | CHECK BOX IF THE AGGREGATE AMOUNT IN ROW (11) EXCLUDES CERTAIN
| SHARES*
| |_|
- --------------------------------------------------------------------------------
13 | PERCENT OF CLASS REPRESENTED BY AMOUNT IN ROW (11)
|
| Not Applicable
- --------------------------------------------------------------------------------
14 | TYPE OF REPORTING PERSON*
| IN
|
- --------------------------------------------------------------------------------
*SEE INSTRUCTIONS BEFORE FILLING OUT!
<PAGE>
AMENDMENT NO. 2
TO THE SCHEDULE 13D
The statement on Schedule 13D dated June 14, 1989, and filed with the
Securities and Exchange Commission by Bessie G. Rotko, Michael J. Rotko, Judith
M. Shipon, Lionel Felzer and Provident National Bank, as trustees under an
Agreement of Trust dated November 18, 1983, established by the late Bernard B.
Rotko (the "Trust") with respect to beneficial ownership of the Series A
Preferred Stock, par value $.50 per share (the "Preferred Stock") and the Common
Stock, par value $1.00 per share (the "Common Stock") of MEDIQ Incorporated (the
"Company" or the "Issuer"), as amended and restated by Amendment No. 1 thereto,
dated January 23, 1998, is hereby amended as provided herein.
Pursuant to Rule 13d-1(f) under the Securities Exchange Act of 1934, as
amended, the Trust, Bessie G. Rotko, Michael J. Rotko and Judith M. Shipon have
agreed to file one statement with respect to their ownership of Preferred Stock.
A Joint Filing Agreement is attached hereto as Exhibit 1. The Trust, Bessie G.
Rotko, Michael J. Rotko and Judith M. Shipon are hereinafter collectively
referred to as the "Reporting Persons."
Item 5 of this Schedule 13D is hereby amended to read in its entirety as
follows:
5. Interests in Securities of the Issuer.
(a) The Reporting Persons no longer own any shares of Preferred Stock.
(b) Not Applicable.
(c) On May 29, 1998, all shares of the Preferred Stock previously owned by
the Reporting Persons were converted into the right to receive cash and certain
securities of the Company pursuant to an Agreement and Plan of Merger dated as
of January 14, 1998, as amended as of April 27, 1998, by and between the Company
and MQ Acquisition Corporation ("MQ") which provided for the merger of MQ with
and into the Company (the "Merger"). In the Merger, each share of Preferred
Stock owned by the Reporting Persons was converted into the right to receive
$13.75 in cash, without interest, and 0.075 of a share of Series A 13%
Cumulative Compounding Preferred Stock, par value $.01 per share, of the
Company; except for, (i) 269,089 shares of Preferred Stock owned directly by
Bessie G. Rotko, which were converted into 390,186 shares of Series B 13.25%
Cumulative Compounding Perpetual Preferred Stock, par value $.01 per share, of
the Company (the "Series B Preferred Stock"), (ii) 655,187 shares of Preferred
Stock owned by the Trust, which were converted into 950,033 shares of Series B
Preferred Stock, (iii) 37,862 shares of Preferred Stock owned directly by
Michael J. Rotko, which were converted into 54,890.5 shares of Common Stock, par
value $.01 per share, of the Company, and (iv) 37,862 shares of Preferred Stock
held directly by Judith M. Shipon, which were converted into 54,890.5 shares of
Common Stock, par value $.01 per share, of the Company.
<PAGE>
(d) Not Applicable.
(e) The Reporting Persons ceased to be beneficial owners of Preferred Stock
on May 29, 1998 as a result of the Merger.
Item 7 of this Schedule 13D is hereby amended to read in its entirety as
follows:
Item 7. Material to be Filed as Exhibits.
Exhibit 1 Joint Filing Agreement, dated June 8, 1998, among the Trustees
of the Trust, signed by a majority of the Trustees.
<PAGE>
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OMB APPROVAL
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UNITED STATES OMB Number: 3235-0145
SECURITIES AND EXCHANGE COMMISSION Expires: August 31, 1999
Washington, D.C. 20549 Estimated average burden hours
per response.............14.90
-------------------------------
After due inquiry and to the best of my knowledge and belief, I certify
that the information set forth in this statement is true, complete and correct.
/s/ Bessie G. Rotko /s/ Judith M. Shipon
- ----------------------------- -----------------------------
Bessie G. Rotko Judith M. Shipon
/s/ Michael J. Rotko PNC Bank Corp.
- -----------------------------
Michael J. Rotko
By: /s/ Robert N. Tropp, Jr.
-----------------------------
Robert N. Tropp, Jr.
Vice President
/s/ John D. Iskrant
- -----------------------------
John D. Iskrant
-------------------------------
OMB APPROVAL
-------------------------------
UNITED STATES OMB Number: 3235-0145
SECURITIES AND EXCHANGE COMMISSION Expires: August 31, 1999
Washington, D.C. 20549 Estimated average burden hours
per response.............14.90
-------------------------------
Exhibit 1
JOINT FILING AGREEMENT
----------------------
In accordance with Rule 13d-1(f) under the Securities Exchange Act of 1934,
as amended, the persons named below agree to the joint filing on behalf of each
of them of a Statement on Schedule 13D (including amendments thereto) with
respect to the preferred stock, par value $.50 per share and common stock, par
value $1.00 per share, of MEDIQ Incorporated, which agreement may be executed in
any number of counterparts and further agree that this Joint Filing Agreement be
included as an exhibit to such joint filings.
Dated: June 8, 1998
/s/ Bessie G. Rotko
----------------------------------
Bessie G. Rotko
/s/ Michael J. Rotko
----------------------------------
Michael J. Rotko
T/D Bernard B. Rotko Dated
----------------------------------
November 18, 1983
By: /s/ John D. Iskrant
----------------------------------
John D. Iskrant
/s/ Judith M. Shipon
----------------------------------
Judith M. Shipon
PNC BANK
By: /s/ Robert N. Tropp, Jr.
-------------------------------
Robert N. Tropp, Jr.
Vice President
