SECURITIES AND EXCHANGE COMMISSION
WASHINGTON, DC 20549
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SCHEDULE 13G
UNDER THE SECURITIES EXCHANGE ACT OF 1934
(Amendment No: ______)*
POLYAIR INTER PACK INC.
(Name of Issuer)
COMMON STOCK, NO PAR VALUE
(Title of Class of Securities)
731 912 101
(CUSIP Number)
Victor H. Boyajian, Esq.
Sills Cummis Epstein & Gross, P.C.
One Riverfront Plaza
Newark, New Jersey 07102
(973) 643-7000
(Name, address and telephone number of person
authorized to receive notices and communications)
March 31, 2004
(Date of Event Which Requires Filing of This Statement)
Check the appropriate box to designate the rule pursuant to which this schedule
is filed:
[ ] Rule 13d-1(b)
[X] Rule 13d-1(c)
[ ] Rule 13d-1(d)
* 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 reminder of this cover page shall not be deemed
to be "filed" for the purpose of Section 18 of the Securities Exchange Act of
1934 (the "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).
(Continued on following pages)
Page 2 of 7 Pages
SCHEDULE 13G
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CUSIP NO. 731 912 101
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1 NAME OF REPORTING PERSON
S.S. OR I.R.S. IDENTIFICATION NO. OF ABOVE PERSON
Jacuzzi Brands, Inc.
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2 CHECK THE APPROPRIATE BOX IF A MEMBER OF A GROUP*
(a) [ ]
(b) [ ]
--------------------------------------------------------------------------------
3 SEC USE ONLY
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4 CITIZENSHIP OR PLACE OF ORGANIZATION
Delaware, United States of America
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5 SOLE VOTING POWER
NUMBER OF 0
--------------------------------------------------------
SHARES 6 SHARED VOTING POWER
BENEFICIALLY
OWNED BY 598,802*
--------------------------------------------------------
REPORTING 7 SOLE DISPOSITIVE POWER
PERSON
WITH: 0
--------------------------------------------------------------------------------
8 SHARED DISPOSITIVE POWER
598,802*
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9 AGGREGATE AMOUNT BENEFICIALLY OWNED BY EACH REPORTING PERSON
598,802*
--------------------------------------------------------------------------------
10 CHECK BOX IF THE AGGREGATE AMOUNT IN
ROW (9) EXCLUDES CERTAIN SHARES*
--------------------------------------------------------------------------------
11 PERCENT OF CLASS REPRESENTED BY AMOUNT IN ROW (9)
9.3%
--------------------------------------------------------------------------------
12 TYPE OF REPORTING PERSON*
CO
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*Represents shares of common stock, no par value, of Polyair Inter Pack, Inc.
issuable to Jacuzzi Inc. ("JI"), a wholly-owned subsidiary of Jacuzzi Brands,
Inc., upon conversion of a promissory note (the "Note") currently held by JI.
While the Note is outstanding, it is convertible at JI's option from time to
time after March 31, 2004.
Page 3 of 7 Pages
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CUSIP NO. 731 912 101
--------------------------------------------------------------------------------
1 NAME OF REPORTING PERSON
S.S. OR I.R.S. IDENTIFICATION NO. OF ABOVE PERSON
Jacuzzi Inc., a wholly-owned subsidiary of Jacuzzi Brands, Inc.
--------------------------------------------------------------------------------
2 CHECK THE APPROPRIATE BOX IF A MEMBER OF A GROUP*
(a) [ ]
(b) [ ]
--------------------------------------------------------------------------------
3 SEC USE ONLY
--------------------------------------------------------------------------------
4 CITIZENSHIP OR PLACE OF ORGANIZATION
Delaware, United States of America
--------------------------------------------------------------------------------
5 SOLE VOTING POWER
NUMBER OF 0
--------------------------------------------------------
SHARES 6 SHARED VOTING POWER
BENEFICIALLY
OWNED BY 598,802*
--------------------------------------------------------
REPORTING 7 SOLE DISPOSITIVE POWER
PERSON
WITH: 0
--------------------------------------------------------------------------------
8 SHARED DISPOSITIVE POWER
598,802*
--------------------------------------------------------------------------------
9 AGGREGATE AMOUNT BENEFICIALLY OWNED BY EACH REPORTING PERSON
598,802*
--------------------------------------------------------------------------------
10 CHECK BOX IF THE AGGREGATE AMOUNT IN
ROW (9) EXCLUDES CERTAIN SHARES*
--------------------------------------------------------------------------------
11 PERCENT OF CLASS REPRESENTED BY AMOUNT IN ROW (9)
9.3%
--------------------------------------------------------------------------------
12 TYPE OF REPORTING PERSON*
CO
--------------------------------------------------------------------------------
*Represents shares of common stock, no par value, of Polyair Inter Pack, Inc.
issuable to Jacuzzi Inc. ("JI"), a wholly-owned subsidiary of Jacuzzi Brands,
Inc., upon conversion of a promissory note (the "Note") currently held by JI.
While the Note is outstanding, it is convertible at JI's option from time to
time after March 31, 2004.
Page 4 of 7 Pages
Schedule 13G
This Schedule 13G is filed by the undersigned to provide information
regarding the common stock, no par value, of Polyair Inter Pack, Inc. issuable
to Jacuzzi Inc. ("JI"), a wholly-owned subsidiary of Jacuzzi Brands, Inc., upon
conversion of a promissory note (the "Note") currently held by JI. While the
Note is outstanding, it is convertible at JI's option from time to time after
March 31, 2004.
Item 1. (a) Name of Issuer
Polyair Inter Pack, Inc.
(b) Address of Issuer's Principal Executive Offices
258 Attwell Drive
Toronto, Ontario M9W 5B2
Item 2. (a) Names of Persons Filing
Jacuzzi Brands, Inc.
Jacuzzi Inc., a wholly-owned subsidiary of Jacuzzi
Brands, Inc.
(b) Address of Principal Business Office
The address of the principal business office of each of Jacuzzi
Brands, Inc. and Jacuzzi Inc. is:
c/o Jacuzzi Brands, Inc.
Phillips Point - West Tower
777 S. Flagler Drive
Suite 1100
West Palm Beach, FL 33401
(c) Citizenship
Jacuzzi Brands, Inc. - Delaware, United States of America
Jacuzzi Inc. - Delaware, United States of America
(d) Title of Class of Securities
Common Stock, no par value (the "Shares")
(e) CUSIP Number
731 912 101
Item 3. If this Statement is filed pursuant to Rules 13d-1(b) or 13d-2(b)
or (c), check whether the person filing is a:
Not applicable
(a) [ ] Broker or dealer registered under Section 15 of the Act
(15 U.S.C.78o).
(b) [ ] Bank as defined in Section 3(a)(6) of the Act (15 U.S.C.
78c).
(c) [ ] Insurance company as defined in Section 3(a)(19) of the
Act (15 U.S.C. 78c).
Page 5 of 7 Pages
(d) [ ] Investment company registered under Section 8 of the
Investment Company Act of 1940 (15 U.S.C, 80a-8).
(e) [ ] An investment adviser in accordance with Section
240.13d-1(b)(1)(ii)(E).
(f) [ ] An employee benefit plan or endowment fund in accordance
with Section 240-13d-1(b)(1)(ii)(F).
(g) [ ] A parent holding company or control person in accordance
with Section 240.13d-1(b)(1)(ii)(G).
(h) [ ] A savings association as defined in Section 3(b) of the
Federal Deposit Insurance Act (12 U.S.C. 1813).
(i) [ ] A church plan that is excluded from the definition of an
investment company under Section 3(C)(14) of the Investment
Company Act of 1940 (15 U.S.C. 80a-3).
(j) [ ] Group, in accordance with Section 240.13d-1(b)(1)(ii)(J).
Item 4. Ownership
Provide the following information regarding the aggregate number
and percentage of the class of securities of the Issuer
identified in Item 1.
(a) Amount beneficially owned: 598,802
(b) Percent of class: 9.3%
(c) Number of shares as to which the person has:
(i) sole power to vote or direct the vote: 0
(ii) shared power to vote or to direct the vote: 598,802
(iii) sole power to dispose or to direct the disposition of: 0
(iv) shared power to dispose or to direct the disposition
of: 598,802
Item 5. Ownership of Five Percent or Less of a Class
Not applicable.
Item 6. Ownership of More than Five Percent on Behalf of Another Person
Not applicable.
Item 7. Identification and Classification of Subsidiary Which Acquired
the Security Being Reported on By the Parent Holding Company
Jacuzzi Inc. is an indirect, wholly-owned subsidiary of Jacuzzi
Brands, Inc.
Jacuzzi Inc. ("JI") is the holder of a convertible promissory
note issued by Polyair Inter Pack, Inc. ("Polyair"), which note
is convertible, at JI's option from time to time after March 31,
2004, into 598,802 share of Polyair common stock, no par value.
Item 8. Identification and Classification of Members of the Group
Not applicable.
Page 6 of 7 Pages
Item 9. Notice of Dissolution of Group
Not applicable.
Item 10. Certification
Not applicable
SIGNATURES
After reasonable 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.
Dated: March 10, 2004
JACUZZI BRANDS, INC.
By: /s/ Steven C. Barre
----------------------------------------
Name: Steven C. Barre
Title: Senior Vice President, General
Counsel and Secretary
JACUZZI INC.
By: /s/ Steven C. Barre
----------------------------------------
Name: Steven C. Barre
Title: Vice President
Page 7 of 7 Pages
JOINT FILING AGREEMENT
In accordance with Rule 13d-1(k)(1) 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 13G (including amendments thereto) with
respect to the common stock of Polyair Inter Pack, Inc. and further agree that
this Joint Filing Agreement be included as an Exhibit to such joint filings. In
evidence thereof, the undersigned, being duly authorized, hereby execute this
Agreement as of March 10, 2004.
JACUZZI BRANDS, INC.
By: /s/ Steven C. Barre
----------------------------------------
Name: Steven C. Barre
Title: Senior Vice President, General
Counsel and Secretary
JACUZZI INC.
By: /s/ Steven C. Barre
----------------------------------------
Name: Steven C. Barre
Title: Vice President