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| FORM 3 | UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
INITIAL STATEMENT OF BENEFICIAL OWNERSHIP OF SECURITIES
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(h) of the Investment Company Act of 1940 | | OMB APPROVAL | | OMB Number: | 3235-0104 | | Expires: | February 28, 2011 | | Estimated average burden | | hours per response | 0.5 |
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1. Name and Address of Reporting Person*
| C/O AIRGAS, INC., 259 N. RADNOR-CHESTER ROAD, SUITE 100 | |
(Street)
| 2. Date of Event Requiring Statement (Month/Day/Year)
07/16/2008 | 3. Issuer Name and Ticker or Trading Symbol
AIRGAS INC
[ARG]
| 4. Relationship of Reporting Person(s) to Issuer
(Check all applicable) | Director | | 10% Owner | | X | Officer (give title below) | | Other (specify below) | | Division President |
| 5. 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 |
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| Table I - Non-Derivative Securities Beneficially Owned |
|---|
| 1. Title of Security (Instr.
4)
| 2.
Amount of Securities Owned (Instr.
4)
| 3. Ownership Form: Direct (D) or Indirect (I) (Instr.
5)
| 4. Nature of Indirect Beneficial Ownership (Instr.
5)
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|---|
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Common Stock
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51,959
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D
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Table II - Derivative Securities Beneficially Owned
(e.g., puts, calls, warrants, options, convertible securities) |
|---|
| 1. Title of Derivative Security (Instr. 4) | 2. Date Exercisable and Expiration Date (Month/Day/Year)
| 3. Title and Amount of Securities Underlying Derivative Security (Instr. 4) | 4. Conversion or Excercise Price of Derivative Security
| 5. Ownership Form: Direct (D) or Indirect (I) (Instr. 5)
| 6. Nature of Indirect Beneficial Ownership (Instr. 5)
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|---|
| Date Exercisable | Expiration Date | Title | Amount or Number of Shares |
|---|
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Stock Option (Right to Buy)
| | 03/04/2009 |
Common Stock
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7,500
|
$
8.5
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D
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| |
Stock Option (Right to Buy)
| | 05/18/2009 |
Common Stock
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21,000
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$
11.5
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D
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Stock Option (Right to Buy)
| | 05/16/2010 |
Common Stock
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23,500
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$
5.5
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D
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Stock Option (Right to Buy)
| | 05/08/2011 |
Common Stock
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33,000
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$
8.99
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D
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Stock Option (Right to Buy)
| | 05/06/2012 |
Common Stock
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17,200
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$
16.52
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D
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Stock Option (Right to Buy)
| | 05/12/2013 |
Common Stock
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15,900
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$
19.22
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D
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Stock Option (Right to Buy)
| | 05/25/2014 |
Common Stock
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9,900
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$
21.15
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D
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Stock Option (Right to Buy)
| | 05/24/2015 |
Common Stock
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9,400
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$
24.09
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D
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Stock Option (Right to Buy)
| | 05/23/2014 |
Common Stock
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9,400
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$
36.17
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D
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Stock Option (Right to Buy)
| | 05/08/2015 |
Common Stock
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11,000
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$
43.62
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D
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Stock Option (Right to Buy)
| | 05/20/2016 |
Common Stock
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14,500
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$
60.84
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D
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| Explanation of Responses: | |
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| Andrew R. Cichocki | 07/22/2008 | | ** 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 5(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. |
LIMITED POWER OF ATTORNEY
For Airgas, Inc. Section 16(a) Filings
Know all men by these presents, that the undersigned hereby constitutes
and appoints each of Robert H. Young, Jr. and Todd R. Craun or either of them,
his true and lawful attorney-in-fact to:
(1) prepare, execute and file with the United States Securities and
Exchange Commission, any stock exchange and Airgas, Inc. (the
"Company") for and on behalf of the undersigned, in the undersigned's
capacity as an officer and/or director of the Company, Forms 3, 4 and
5 and amendments thereto in accordance with Section 16(a) of the
Securities Exchange Act of 1934 and the rules thereunder (the
"Exchange Act");
(2) obtain, for and on behalf of the undersigned, information from the
undersigned's brokers regarding transactions by the undersigned in the
Company's securities as may be necessary or desirable to prepare Forms
3, 4 and 5 on behalf of the undersigned; and
(3) perform any and all other acts which, in the discretion of such
attorney-in-fact, may be necessary or desirable in connection with
the foregoing authority, it being understood that the documents
executed by such attorney-in-fact on behalf of the undersigned pursuant
to this Limited Power of Attorney shall be in such form and shall
contain such terms and conditions as such attorney-in-fact may approve
in his discretion.
The undersigned hereby grants to each such attorney-in-fact full power
and authority to do and perform any and every act and thing whatsoever
requisite, necessary or appropriate to be done in the exercise of any
of the rights and powers herein granted, as fully to all intents and
purposes as the undersigned might or could do if personally present,
hereby ratifying and confirming all that such attorney-in-fact shall
lawfully do or cause to be done by virtue of this Limited Power of
Attorney. The undersigned acknowledges that: (i) this Limited Power
of Attorney authorizes each of the foregoing attorneys-in-fact to act
in his discretion in preparing Forms 3, 4 and 5 on information
provided to such attorney-in-fact without independent verification of
such information; (ii) the foregoing attorneys-in-fact, in serving in
such capacity at the request of the undersigned, are not assuming, nor
is the Company assuming, any of the undersigned's responsibilities
under the Exchange Act, including to comply with Section 16 of the
Exchange Act; and (iii) neither the attorneys-in-fact nor the Company
is assuming any liability for the undersigned's responsibility to
comply with the requirements of the Exchange Act or any obligation or
liability of the undersigned for profit disgorgement under
Section 16(b) of the Exchange Act.
This Power of Attorney shall remain in full force and effect until the
undersigned is no longer required to file Forms 3, 4 and 5 with respect
to the undersigned's holdings of and transactions in securities issued
by the Company, unless earlier revoked by the undersigned in a signed
writing delivered to the foregoing attorneys-in-fact.
IN WITNESS WHEREOF, the undersigned has caused this Limited Power of
Attorney to be executed as of this 22nd day of July, 2008.
/s/ Andrew R. Cichocki
___________________________
Andrew R. Cichocki
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