# EDGAR Filing Document

**Accession Number:** 0001492125
**File Stem:** 0001209191-23-021752
**Filing Date:** 2023-3
**Character Count:** 7678
**Document Hash:** fb0e1b76ee6700725055ac5f40e3daf5
**Contains OCR:** False
**Source Format:** 

## Filing Content

## Filing Summary
**0001209191-23-021752.hdr.sgml**: 20230331

**ACCESSION NUMBER**: 0001209191-23-021752

**CONFORMED SUBMISSION TYPE**: 4

**PUBLIC DOCUMENT COUNT**: 1

**CONFORMED PERIOD OF REPORT**: 20230330

**FILED AS OF DATE**: 20230331

**DATE AS OF CHANGE**: 20230331

**REPORTING-OWNER**: 

**OWNER DATA:**
- **COMPANY CONFORMED NAME:** Pelzer Francis J.
- **CENTRAL INDEX KEY:** 0001492125

**FILING VALUES:**
- **FORM TYPE:** 4
- **SEC ACT:** 1934 Act
- **SEC FILE NUMBER:** 001-39449
- **FILM NUMBER:** 23783463

**MAIL ADDRESS:**
- **STREET 1:** CONCUR TECHNOLOGIES, INC.
- **STREET 2:** 18400 NE UNION HILL RD.
- **CITY:** REDMOND
- **STATE:** WA
- **ZIP:** 98052
**ISSUER**: 

**COMPANY DATA:**
- **COMPANY CONFORMED NAME:** DUCK CREEK TECHNOLOGIES, INC.
- **CENTRAL INDEX KEY:** 0001160951
- **STANDARD INDUSTRIAL CLASSIFICATION:** SERVICES-PREPACKAGED SOFTWARE [7372]
- **IRS NUMBER:** 843723837
- **FISCAL YEAR END:** 0831

**BUSINESS ADDRESS:**
- **STREET 1:** 22 BOSTON WHARF ROAD, FLOOR 10
- **CITY:** BOSTON
- **STATE:** MA
- **ZIP:** 02210
- **BUSINESS PHONE:** (833) 798-7789

**MAIL ADDRESS:**
- **STREET 1:** 22 BOSTON WHARF ROAD, FLOOR 10
- **CITY:** BOSTON
- **STATE:** MA
- **ZIP:** 02210

**FORMER COMPANY:**
- **FORMER CONFORMED NAME:** DUCK CREEK TECHNOLOGIES INC
- **DATE OF NAME CHANGE:** 20011016

### UNITED STATES SECURITIES AND EXCHANGE COMMISSION
**Washington, D.C. 20549**

## FORM 4

### STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP

[x] Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b).

[ ] Check this box to indicate that a transaction was made pursuant to a contract, instruction or written plan for the purchase or sale of equity securities of the issuer that is intended to satisfy the affirmative defense conditions of Rule 10b5-1(c). See Instruction 10.

---

| | | |
|:---|:---|:---|
| **1. Name and Address of Reporting Person**<sup>*</sup><br>Pelzer Francis J.<br><sub>(Last) (First) (Middle)</sub><br>C/O DUCK CREEK TECHNOLOGIES, INC.<br>22 BOSTON WHARF ROAD<br><sub>(Street)</sub><br>BOSTON, MA 02210<br><sub>(City) (State) (Zip)</sub> | **3. Date of Earliest Transaction (Month/Day/Year)**<br>2023-03-30 | **5. Relationship of Reporting Person(s) to Issuer**<br>(Check all applicable)<br>[X] Director [ ] 10% Owner<br>[ ] Officer (give title below) [ ] Other (specify below)<br>_ _ |
| **2. Issuer Name and Ticker or Trading Symbol**<br>DUCK CREEK TECHNOLOGIES, INC. [ DCT ] | **4. If Amendment, Date of Original Filed (Month/Day/Year)**<br>  | **6. Individual or Joint/Group Filing (Check Applicable Line)**<br>[X] Form filed by One Reporting Person<br>[ ] Form filed by More than One Reporting Person |

---

## Table I - Non-Derivative Securities

---

|  |  |  |  |  |  |  |  |  |  |  |
| --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- |
| 1. Title of Security | 2. Transaction Date | 2A. Deemed Execution Date | 3. Transaction Code (V) | 3. Transaction Code (V) | 4. Securities Acquired (A) or Disposed of (D) | 4. Securities Acquired (A) or Disposed of (D) | 4. Securities Acquired (A) or Disposed of (D) | 5. Amount of Securities Beneficially Owned | 6. Ownership Form | 7. Nature of Indirect Beneficial Ownership |
| 1. Title of Security | 2. Transaction Date | 2A. Deemed Execution Date | Code | V | Amount | (A) or (D) | Price | 5. Amount of Securities Beneficially Owned | 6. Ownership Form | 7. Nature of Indirect Beneficial Ownership |
| Common Stock, par value $0.01 per share | 2023-03-30 |  | D<sup>(1)</sup> |  | 127028 | D | <sup>(1)</sup> | 0 | D |  |
| Common Stock, par value $0.01 per share | 2023-03-30 |  | D<sup>(2)</sup> |  | 14380 | D | <sup>(2)</sup> | 0 | D |  |

---

## Table II - Derivative Securities

---

|  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |
| --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- |
| 1. Title of Derivative Security | 2. Conversion or Exercise Price | 3. Transaction Date | 3A. Deemed Execution Date | 4. Transaction Code (V) | 4. Transaction Code (V) | 5. Number of Derivative Securities Acquired (A) or Disposed of (D) | 5. Number of Derivative Securities Acquired (A) or Disposed of (D) | 6. Date Exercisable and Expiration Date | 6. Date Exercisable and Expiration Date | 7. Title and Amount of Underlying Securities | 7. Title and Amount of Underlying Securities | 8. Price of Derivative Security | 9. Number of Derivative Securities Beneficially Owned | 10. Ownership Form | 11. Nature of Indirect Beneficial Ownership |
| 1. Title of Derivative Security | 2. Conversion or Exercise Price | 3. Transaction Date | 3A. Deemed Execution Date | Code | V | (A) | (D) | Date Exercisable | Expiration Date | Title | Amount or Number of Shares | 8. Price of Derivative Security | 9. Number of Derivative Securities Beneficially Owned | 10. Ownership Form | 11. Nature of Indirect Beneficial Ownership |
| Option | $27.00 | 2023-03-30 |  | D<sup>(3)</sup> |  |  | 30246 | <sup>(4)</sup> | 2030-08-14 | Common Stock, par value $0.01 per share | 30246 | <sup>(3)</sup> | 0 | D |  |

---

### Footnotes:

(1) The shares were disposed of pursuant to the Agreement and Plan of Merger (the "Merger Agreement"), dated as of January 8, 2023, by and among the Issuer, Disco Parent, LLC, a Delaware limited liability company, and Disco Merger Sub, Inc., a Delaware corporation, whereby, at the effective time of the merger contemplated therein (the "Effective Time"), all shares of Issuer common stock issued and outstanding immediately prior to the Effective time (other than certain excluded shares) were cancelled, extinguished and automatically converted into the right to receive $19.00 per share in cash, without interest.

(2) Reflects unvested awards of stock ("RSAs") held by the Reporting Person. Pursuant to the Merger Agreement, each unvested RSA that was outstanding immediately prior to the Effective Time was fully vested, cancelled and automatically converted into the right to receive an amount in cash equal to the product of (a) the aggregate number of shares subject to such unvested RSAs, multiplied by (b) $19.00, subject to any required withholding of taxes.

(3) Pursuant to the Merger Agreement, each option, whether vested or unvested, that was unexpired, unexercised, and outstanding as of immediately prior to the Effective Time was fully vested, cancelled and automatically converted into the right to receive an amount in cash equal to the product of (a) the aggregate number of shares subject to such option, multiplied by (b) the excess, if any, of $19.00 over the applicable per share exercise price under such option, subject to any required withholding of taxes. As the per share exercise price of each option exceeds $19.00, each option will be cancelled immediately upon the Effective Time without payment or consideration.

(4) These options were fully vested.

**Signature:** /s/ Christopher R. Stone as Attorney-in-Fact  
**Date:** 2023-03-31

### Remarks:

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).

Note: File three copies of this Form, one of which must be manually signed. If space is insufficient, see Instruction 6 for procedure.

**Persons who respond to the collection of information contained in this form are not required to respond unless the form displays a currently valid OMB Number.**