-----BEGIN PRIVACY-ENHANCED MESSAGE----- Proc-Type: 2001,MIC-CLEAR Originator-Name: webmaster@www.sec.gov Originator-Key-Asymmetric: MFgwCgYEVQgBAQICAf8DSgAwRwJAW2sNKK9AVtBzYZmr6aGjlWyK3XmZv3dTINen TWSM7vrzLADbmYQaionwg5sDW3P6oaM5D3tdezXMm7z1T+B+twIDAQAB MIC-Info: RSA-MD5,RSA, G1w/hxFtDAZm/gMkdjGW+vKn/myybQ26/vN3xcwVglKqKoReKA/WrVwwvyAgUOXb YLoMIQvMOu9OvnruBAoRkA== 0001104659-11-007342.txt : 20110214 0001104659-11-007342.hdr.sgml : 20110214 20110214152253 ACCESSION NUMBER: 0001104659-11-007342 CONFORMED SUBMISSION TYPE: SC 13G/A PUBLIC DOCUMENT COUNT: 1 FILED AS OF DATE: 20110214 DATE AS OF CHANGE: 20110214 GROUP MEMBERS: BARBARA N. LUBASH GROUP MEMBERS: BRIAN G. ATWOOD GROUP MEMBERS: DONALD B. MILDER GROUP MEMBERS: REBECCA B. ROBERTSON GROUP MEMBERS: ROSS A. JAFFE, M.D. GROUP MEMBERS: SAMUEL D. COLELLA GROUP MEMBERS: VERSANT AFFILIATES FUND I-A, L.P. GROUP MEMBERS: VERSANT AFFILIATES FUND I-B, L.P. GROUP MEMBERS: VERSANT SIDE FUND I, L.P. GROUP MEMBERS: VERSANT VENTURE CAPITAL I, L.P. GROUP MEMBERS: WILLIAM J. LINK, PH.D. SUBJECT COMPANY: COMPANY DATA: COMPANY CONFORMED NAME: INSULET CORP CENTRAL INDEX KEY: 0001145197 STANDARD INDUSTRIAL CLASSIFICATION: SURGICAL & MEDICAL INSTRUMENTS & APPARATUS [3841] IRS NUMBER: 043523891 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: SC 13G/A SEC ACT: 1934 Act SEC FILE NUMBER: 005-83352 FILM NUMBER: 11606927 BUSINESS ADDRESS: STREET 1: 9 OAK PARK DRIVE CITY: BEDFORD STATE: MA ZIP: 01730 BUSINESS PHONE: (781) 457-5000 MAIL ADDRESS: STREET 1: 9 OAK PARK DRIVE CITY: BEDFORD STATE: MA ZIP: 01730 FILED BY: COMPANY DATA: COMPANY CONFORMED NAME: VERSANT VENTURES I LLC CENTRAL INDEX KEY: 0001279905 IRS NUMBER: 954767936 FILING VALUES: FORM TYPE: SC 13G/A BUSINESS ADDRESS: STREET 1: 3000 SAND HILL RD., #4-210 CITY: MENLO PARK STATE: CA ZIP: 94025 BUSINESS PHONE: 650-233-7877 MAIL ADDRESS: STREET 1: 3000 SAND HILL ROAD, #4-210 CITY: MENLO PARK STATE: CA ZIP: 94025 SC 13G/A 1 a11-5856_5sc13ga.htm SC 13G

 

 

UNITED STATES

 

 

SECURITIES AND EXCHANGE COMMISSION

 

 

Washington, D.C. 20549

 

 

 

 

SCHEDULE 13G

 

Under the Securities Exchange Act of 1934
(Amendment No. 1)*

 

Insulet Corporation

(Name of Issuer)

Common Stock

(Title of Class of Securities)

45784P101

(CUSIP Number)

December 31, 2010

(Date of Event Which Requires Filing of this Statement)

Check the appropriate box to designate the rule pursuant to which this Schedule is filed:

o

Rule 13d-1(b)

o

Rule 13d-1(c)

x

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 the disclosures provided in a prior cover page.

 

The information required in 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).

 



 

 

1.

Names of Reporting Persons
Versant Venture Capital I, L.P.

 

 

2.

Check the Appropriate Box if a Member of a Group (See Instructions)

 

 

(a)

o

 

 

(b)

x (1)

 

 

3.

SEC Use Only

 

 

4.

Citizenship or Place of Organization
Delaware, United States of America

 

 

 

Number of
Shares
Beneficially
Owned by
Each
Reporting
Person With:

5.

Sole Voting Power
1,813,273 (2)

 

6.

Shared Voting Power
0

 

7.

Sole Dispositive Power
1,813,273 (2)

 

8.

Shared Dispositive Power
0

 

 

9.

Aggregate Amount Beneficially Owned by Each Reporting Person
1,813,273 (2)

 

 

10.

Check if the Aggregate Amount in Row (9) Excludes Certain Shares (See Instructions)  o

 

 

11.

Percent of Class Represented by Amount in Row 9
4.52% (3)

 

 

12.

Type of Reporting Person (See Instructions)
PN

 


(1)          This Schedule 13G is filed by Versant Venture Capital I, L.P. (“VVC- I”), Versant Side Fund I, L.P. (“VSF-I), Versant Affiliates Fund I-A, L.P. (“VAF-I-A”), Versant Affiliates Fund I-B, L.P. (“VAF-I-B”), Versant Ventures I, LLC (“VVI-LLC”), Brian G. Atwood (“BGA”), Samuel D. Colella (“SDC”), Ross A. Jaffe (“RAJ”), William J. Link (“WJL”), Donald B. Milder (“DBM”), Barbara N. Lubash (“BNL”) and Rebecca B. Robertson (“RBR”) (collectively, the “Versant Entities”).  The Versant Entities expressly disclaim status as a “group” for purposes of this Schedule 13G.

 

(2)          VVI-LLC serves as the general partner of VVC- I and owns no securities of the Issuer directly.  BGA, SDC, RAJ , WJL, DBM, BNL and RBR are directors and/or members of VVI-LLC and share voting and dispositive power over the shares held by VVC-I.  The information with respect to the ownership of the Common Stock of the Issuer by the persons filing this statement on Schedule 13G is provided as of December 31, 2010.

 

(3)          This percentage is calculated based upon 40,143,138 shares of the Issuer’s common stock outstanding as of August 4, 2010 as set forth in the Issuer’s most recent 10-Q filed with the Securities and Exchange Commissions on November 19, 2010.

 

2



 

 

1.

Names of Reporting Persons
Versant Side Fund I, L.P.

 

 

2.

Check the Appropriate Box if a Member of a Group (See Instructions)

 

 

(a)

o

 

 

(b)

x (1)

 

 

3.

SEC Use Only

 

 

4.

Citizenship or Place of Organization
Delaware, United States of America

 

 

 

Number of
Shares
Beneficially
Owned by
Each
Reporting
Person With:

5.

Sole Voting Power
35,475 (2)

 

6.

Shared Voting Power
0

 

7.

Sole Dispositive Power
35,475 (2)

 

8.

Shared Dispositive Power
0

 

 

9.

Aggregate Amount Beneficially Owned by Each Reporting Person
35,475 (2)

 

 

10.

Check if the Aggregate Amount in Row (9) Excludes Certain Shares (See Instructions)  o

 

 

11.

Percent of Class Represented by Amount in Row 9
0.08% (3)

 

 

12.

Type of Reporting Person (See Instructions)
PN

 


(1)          This Schedule 13G is filed by Versant Venture Capital I, L.P. (“VVC- I”), Versant Side Fund I, L.P. (“VSF-I), Versant Affiliates Fund I-A, L.P. (“VAF-I-A”), Versant Affiliates Fund I-B, L.P. (“VAF-I-B”), Versant Ventures I, LLC (“VVI-LLC”), Brian G. Atwood (“BGA”), Samuel D. Colella (“SDC”), Ross A. Jaffe (“RAJ”), William J. Link (“WJL”), Donald B. Milder (“DBM”), Barbara N. Lubash (“BNL”) and Rebecca B. Robertson (“RBR”) (collectively, the “Versant Entities”).  The Versant Entities expressly disclaim status as a “group” for purposes of this Schedule 13G.

 

(2)          VVI-LLC serves as the general partner of VSF-I and owns no securities of the Issuer directly.  BGA, SDC, RAJ , WJL, DBM, BNL and RBR are directors and/or members of VVI-LLC and share voting and dispositive power over the shares held by VSF-I.  The information with respect to the ownership of the Common Stock of the Issuer by the persons filing this statement on Schedule 13G is provided as of December 31, 2010.

 

(3)          This percentage is calculated based upon 40,143,138 shares of the Issuer’s common stock outstanding as of August 4, 2010 as set forth in the Issuer’s most recent 10-Q filed with the Securities and Exchange Commissions on November 19, 2010.

 

3



 

 

1.

Names of Reporting Persons
Versant Affiliates Fund I-A, L.P.

 

 

2.

Check the Appropriate Box if a Member of a Group (See Instructions)

 

 

(a)

o

 

 

(b)

x (1)

 

 

3.

SEC Use Only

 

 

4.

Citizenship or Place of Organization
Delaware, United States of America

 

 

 

Number of
Shares
Beneficially
Owned by
Each
Reporting
Person With:

5.

Sole Voting Power
39,417 (2)

 

6.

Shared Voting Power
0

 

7.

Sole Dispositive Power
39,417 (2)

 

8.

Shared Dispositive Power
0

 

 

9.

Aggregate Amount Beneficially Owned by Each Reporting Person
39,417 (2)

 

 

10.

Check if the Aggregate Amount in Row (9) Excludes Certain Shares (See Instructions)  o

 

 

11.

Percent of Class Represented by Amount in Row 9
0.09% (3)

 

 

12.

Type of Reporting Person (See Instructions)
PN

 


(1)          This Schedule 13G is filed by Versant Venture Capital I, L.P. (“VVC- I”), Versant Side Fund I, L.P. (“VSF-I), Versant Affiliates Fund I-A, L.P. (“VAF-I-A”), Versant Affiliates Fund I-B, L.P. (“VAF-I-B”), Versant Ventures I, LLC (“VVI-LLC”), Brian G. Atwood (“BGA”), Samuel D. Colella (“SDC”), Ross A. Jaffe (“RAJ”), William J. Link (“WJL”), Donald B. Milder (“DBM”), Barbara N. Lubash (“BNL”) and Rebecca B. Robertson (“RBR”) (collectively, the “Versant Entities”).  The Versant Entities expressly disclaim status as a “group” for purposes of this Schedule 13G.

 

(2)          VVI-LLC serves as the general partner of VAF-I-A and owns no securities of the Issuer directly.  BGA, SDC, RAJ , WJL, DBM, BNL and RBR are directors and/or members of VVI-LLC and share voting and dispositive power over the shares held by VAF-I-A.  The information with respect to the ownership of the Common Stock of the Issuer by the persons filing this statement on Schedule 13G is provided as of December 31, 2010.

 

(3)          This percentage is calculated based upon 40,143,138 shares of the Issuer’s common stock outstanding as of August 4, 2010 as set forth in the Issuer’s most recent 10-Q filed with the Securities and Exchange Commissions on November 19, 2010.

 

4



 

 

1.

Names of Reporting Persons
Versant Affiliates Fund I-B, L.P.

 

 

2.

Check the Appropriate Box if a Member of a Group (See Instructions)

 

 

(a)

o

 

 

(b)

x (1)

 

 

3.

SEC Use Only

 

 

4.

Citizenship or Place of Organization
Delaware, United States of America

 

 

 

Number of
Shares
Beneficially
Owned by
Each
Reporting
Person With:

5.

Sole Voting Power
82,778 (2)

 

6.

Shared Voting Power
0

 

7.

Sole Dispositive Power
82,778 (2)

 

8.

Shared Dispositive Power
0

 

 

9.

Aggregate Amount Beneficially Owned by Each Reporting Person
82,778 (2)

 

 

10.

Check if the Aggregate Amount in Row (9) Excludes Certain Shares (See Instructions)  o

 

 

11.

Percent of Class Represented by Amount in Row 9
0.20% (3)

 

 

12.

Type of Reporting Person (See Instructions)
PN

 


(1)          This Schedule 13G is filed by Versant Venture Capital I, L.P. (“VVC- I”), Versant Side Fund I, L.P. (“VSF-I), Versant Affiliates Fund I-A, L.P. (“VAF-I-A”), Versant Affiliates Fund I-B, L.P. (“VAF-I-B”), Versant Ventures I, LLC (“VVI-LLC”), Brian G. Atwood (“BGA”), Samuel D. Colella (“SDC”), Ross A. Jaffe (“RAJ”), William J. Link (“WJL”), Donald B. Milder (“DBM”), Barbara N. Lubash (“BNL”) and Rebecca B. Robertson (“RBR”) (collectively, the “Versant Entities”).  The Versant Entities expressly disclaim status as a “group” for purposes of this Schedule 13G.

 

(2)          VVI-LLC serves as the general partner of VAF-I-B and owns no securities of the Issuer directly.  BGA, SDC, RAJ , WJL, DBM, BNL and RBR are directors and/or members of VVI-LLC and share voting and dispositive power over the shares held by VAF-I-B.  The information with respect to the ownership of the Common Stock of the Issuer by the persons filing this statement on Schedule 13G is provided as of December 31, 2010.

 

(3)          This percentage is calculated based upon 40,143,138 shares of the Issuer’s common stock outstanding as of August 4, 2010 as set forth in the Issuer’s most recent 10-Q filed with the Securities and Exchange Commissions on November 19, 2010.

 

5



 

 

1.

Names of Reporting Persons
Versant Ventures I, LLC

 

 

2.

Check the Appropriate Box if a Member of a Group (See Instructions)

 

 

(a)

o

 

 

(b)

x (1)

 

 

3.

SEC Use Only

 

 

4.

Citizenship or Place of Organization
Delaware, United States of America

 

 

 

Number of
Shares
Beneficially
Owned by
Each
Reporting
Person With:

5.

Sole Voting Power
0

 

6.

Shared Voting Power
1,970,943 (2)

 

7.

Sole Dispositive Power
0

 

8.

Shared Dispositive Power
1,970,943 (2)

 

 

9.

Aggregate Amount Beneficially Owned by Each Reporting Person
1,970,943 (2)

 

 

10.

Check if the Aggregate Amount in Row (9) Excludes Certain Shares (See Instructions)  o

 

 

11.

Percent of Class Represented by Amount in Row 9
4.91% (3)

 

 

12.

Type of Reporting Person (See Instructions)
OO

 


(1)          This Schedule 13G is filed by Versant Venture Capital I, L.P. (“VVC- I”), Versant Side Fund I, L.P. (“VSF-I), Versant Affiliates Fund I-A, L.P. (“VAF-I-A”), Versant Affiliates Fund I-B, L.P. (“VAF-I-B”), Versant Ventures I, LLC (“VVI-LLC”), Brian G. Atwood (“BGA”), Samuel D. Colella (“SDC”), Ross A. Jaffe (“RAJ”), William J. Link (“WJL”), Donald B. Milder (“DBM”), Barbara N. Lubash (“BNL”) and Rebecca B. Robertson (“RBR”) (collectively, the “Versant Entities”).  The Versant Entities expressly disclaim status as a “group” for purposes of this Schedule 13G.

 

(2)          Includes: (i) 1,813,273 shares held by VVC-I.; (ii) 35,475 shares held by VSF-1; (iii) 39,417 shares held by VAF-I-A; and (iv) 82,778 shares held by VAF-I-B.   VVI-LLC serves as the general partner of VVC- I, VSF-I, VAF-I-A, and VAF-I-B and owns no securities of the Issuer directly.  BGA, SDC, RAJ , WJL, DBM, BNL and RBR are directors and/or members of VVI-LLC and share voting and dispositive power over the shares held by VVC- I, VSF-I, VAF-I-A and VAF-I-B.  The information with respect to the ownership of the Common Stock of the Issuer by the persons filing this statement on Schedule 13G is provided as of December 31, 2010.

 

(3)          This percentage is calculated based upon 40,143,138 shares of the Issuer’s common stock outstanding as of August 4, 2010 as set forth in the Issuer’s most recent 10-Q filed with the Securities and Exchange Commissions on November 19, 2010.

 

6



 

 

1.

Names of Reporting Persons
BRIAN G. ATWOOD

 

 

2.

Check the Appropriate Box if a Member of a Group (See Instructions)

 

 

(a)

o

 

 

(b)

x (1)

 

 

3.

SEC Use Only

 

 

4.

Citizenship or Place of Organization
United States of America

 

 

 

Number of
Shares
Beneficially
Owned by
Each
Reporting
Person With:

5.

Sole Voting Power
0

 

6.

Shared Voting Power
1,970,943 (2)

 

7.

Sole Dispositive Power
0

 

8.

Shared Dispositive Power
1,970,943 (2)

 

 

9.

Aggregate Amount Beneficially Owned by Each Reporting Person
1,970,943 (2)

 

 

10.

Check if the Aggregate Amount in Row (9) Excludes Certain Shares (See Instructions)  o

 

 

11.

Percent of Class Represented by Amount in Row 9
4.91% (3)

 

 

12.

Type of Reporting Person (See Instructions)
IN

 


(1)          This Schedule 13G is filed by Versant Venture Capital I, L.P. (“VVC- I”), Versant Side Fund I, L.P. (“VSF-I), Versant Affiliates Fund I-A, L.P. (“VAF-I-A”), Versant Affiliates Fund I-B, L.P. (“VAF-I-B”), Versant Ventures I, LLC (“VVI-LLC”), Brian G. Atwood (“BGA”), Samuel D. Colella (“SDC”), Ross A. Jaffe (“RAJ”), William J. Link (“WJL”), Donald B. Milder (“DBM”), Barbara N. Lubash (“BNL”) and Rebecca B. Robertson (“RBR”) (collectively, the “Versant Entities”).  The Versant Entities expressly disclaim status as a “group” for purposes of this Schedule 13G.

 

(2)          Includes: (i) 1,813,273 shares held by VVC-I.; (ii) 35,475 shares held by VSF-1; (iii) 39,417 shares held by VAF-I-A; and (iv) 82,778 shares held by VAF-I-B.   VVI-LLC serves as the general partner of VVC- I, VSF-I, VAF-I-A, and VAF-I-B and owns no securities of the Issuer directly.  BGA, SDC, RAJ , WJL, DBM, BNL and RBR are directors and/or members of VVI-LLC and share voting and dispositive power over the shares held by VVC- I, VSF-I, VAF-I-A and VAF-I-B.  The information with respect to the ownership of the Common Stock of the Issuer by the persons filing this statement on Schedule 13G is provided as of December 31, 2010. 

 

(3)          This percentage is calculated based upon 40,143,138 shares of the Issuer’s common stock outstanding as of August 4, 2010 as set forth in the Issuer’s most recent 10-Q filed with the Securities and Exchange Commissions on November 19, 2010.

 

7



 

 

1.

Names of Reporting Persons
SAMUEL D. COLELLA

 

 

2.

Check the Appropriate Box if a Member of a Group (See Instructions)

 

 

(a)

o

 

 

(b)

x (1)

 

 

3.

SEC Use Only

 

 

4.

Citizenship or Place of Organization
United States of America

 

 

 

Number of
Shares
Beneficially
Owned by
Each
Reporting
Person With:

5.

Sole Voting Power
0

 

6.

Shared Voting Power
1,970,943 (2)

 

7.

Sole Dispositive Power
0

 

8.

Shared Dispositive Power
1,970,943 (2)

 

 

9.

Aggregate Amount Beneficially Owned by Each Reporting Person
1,970,943 (2)

 

 

10.

Check if the Aggregate Amount in Row (9) Excludes Certain Shares (See Instructions)  o

 

 

11.

Percent of Class Represented by Amount in Row 9
4.91% (3)

 

 

12.

Type of Reporting Person (See Instructions)
IN

 


(1)          This Schedule 13G is filed by Versant Venture Capital I, L.P. (“VVC- I”), Versant Side Fund I, L.P. (“VSF-I), Versant Affiliates Fund I-A, L.P. (“VAF-I-A”), Versant Affiliates Fund I-B, L.P. (“VAF-I-B”), Versant Ventures I, LLC (“VVI-LLC”), Brian G. Atwood (“BGA”), Samuel D. Colella (“SDC”), Ross A. Jaffe (“RAJ”), William J. Link (“WJL”), Donald B. Milder (“DBM”), Barbara N. Lubash (“BNL”) and Rebecca B. Robertson (“RBR”) (collectively, the “Versant Entities”).  The Versant Entities expressly disclaim status as a “group” for purposes of this Schedule 13G.

 

(2)          Includes: (i) 1,813,273 shares held by VVC-I.; (ii) 35,475 shares held by VSF-1; (iii) 39,417 shares held by VAF-I-A; and (iv) 82,778 shares held by VAF-I-B.   VVI-LLC serves as the general partner of VVC- I, VSF-I, VAF-I-A, and VAF-I-B and owns no securities of the Issuer directly.  BGA, SDC, RAJ , WJL, DBM, BNL and RBR are directors and/or members of VVI-LLC and share voting and dispositive power over the shares held by VVC- I, VSF-I, VAF-I-A and VAF-I-B.  The information with respect to the ownership of the Common Stock of the Issuer by the persons filing this statement on Schedule 13G is provided as of December 31, 2010.

 

(3)          This percentage is calculated based upon 40,143,138 shares of the Issuer’s common stock outstanding as of August 4, 2010 as set forth in the Issuer’s most recent 10-Q filed with the Securities and Exchange Commissions on November 19, 2010.

 

8



 

 

1.

Names of Reporting Persons
ROSS A. JAFFE, M.D.

 

 

2.

Check the Appropriate Box if a Member of a Group (See Instructions)

 

 

(a)

o

 

 

(b)

x (1)

 

 

3.

SEC Use Only

 

 

4.

Citizenship or Place of Organization
United States of America

 

 

 

Number of
Shares
Beneficially
Owned by
Each
Reporting
Person With:

5.

Sole Voting Power
19,810 (2)

 

6.

Shared Voting Power
1,970,943 (3)

 

7.

Sole Dispositive Power
19,810 (2)

 

8.

Shared Dispositive Power
1,970,943 (3)

 

 

9.

Aggregate Amount Beneficially Owned by Each Reporting Person
1,990,753 (2)(3)

 

 

10.

Check if the Aggregate Amount in Row (9) Excludes Certain Shares (See Instructions)  o

 

 

11.

Percent of Class Represented by Amount in Row 9
4.96% (4)

 

 

12.

Type of Reporting Person (See Instructions)
IN

 


(1)          This Schedule 13G is filed by Versant Venture Capital I, L.P. (“VVC- I”), Versant Side Fund I, L.P. (“VSF-I), Versant Affiliates Fund I-A, L.P. (“VAF-I-A”), Versant Affiliates Fund I-B, L.P. (“VAF-I-B”), Versant Ventures I, LLC (“VVI-LLC”), Brian G. Atwood (“BGA”), Samuel D. Colella (“SDC”), Ross A. Jaffe (“RAJ”), William J. Link (“WJL”), Donald B. Milder (“DBM”), Barbara N. Lubash (“BNL”) and Rebecca B. Robertson (“RBR”) (collectively, the “Versant Entities”).  The Versant Entities expressly disclaim status as a “group” for purposes of this Schedule 13G.

 

(2)          Consists of options to acquire 19,810 shares of Common Stock held by RAJ for the benefit of VVI-LLC.

 

(3)          Includes: (i) 1,813,273 shares held by VVC-I.; (ii) 35,475 shares held by VSF-1; (iii) 39,417 shares held by VAF-I-A; and (iv) 82,778 shares held by VAF-I-B.   VVI-LLC serves as the general partner of VVC- I, VSF-I, VAF-I-A, and VAF-I-B and owns no securities of the Issuer directly.  BGA, SDC, RAJ , WJL, DBM, BNL and RBR are directors and/or members of VVI-LLC and share voting and dispositive power over the shares held by VVC- I, VSF-I, VAF-I-A and VAF-I-B.  The information with respect to the ownership of the Common Stock of the Issuer by the persons filing this statement on Schedule 13G is provided as of December 31, 2010. 

 

(4)          This percentage is calculated based upon 40,143,138 shares of the Issuer’s common stock outstanding as of August 4, 2010 as set forth in the Issuer’s most recent 10-Q filed with the Securities and Exchange Commissions on November 19, 2010.

 

9



 

 

1.

Names of Reporting Persons
WILLIAM J. LINK, Ph.D.

 

 

2.

Check the Appropriate Box if a Member of a Group (See Instructions)

 

 

(a)

o

 

 

(b)

x (1)

 

 

3.

SEC Use Only

 

 

4.

Citizenship or Place of Organization
United States of America

 

 

 

Number of
Shares
Beneficially
Owned by
Each
Reporting
Person With:

5.

Sole Voting Power
0

 

6.

Shared Voting Power
1,970,943 (2)

 

7.

Sole Dispositive Power
0

 

8.

Shared Dispositive Power
1,970,943 (2)

 

 

9.

Aggregate Amount Beneficially Owned by Each Reporting Person
1,970,943 (2)

 

 

10.

Check if the Aggregate Amount in Row (9) Excludes Certain Shares (See Instructions)  o

 

 

11.

Percent of Class Represented by Amount in Row 9
4.91% (3)

 

 

12.

Type of Reporting Person (See Instructions)
IN

 


(1)          This Schedule 13G is filed by Versant Venture Capital I, L.P. (“VVC- I”), Versant Side Fund I, L.P. (“VSF-I), Versant Affiliates Fund I-A, L.P. (“VAF-I-A”), Versant Affiliates Fund I-B, L.P. (“VAF-I-B”), Versant Ventures I, LLC (“VVI-LLC”), Brian G. Atwood (“BGA”), Samuel D. Colella (“SDC”), Ross A. Jaffe (“RAJ”), William J. Link (“WJL”), Donald B. Milder (“DBM”), Barbara N. Lubash (“BNL”) and Rebecca B. Robertson (“RBR”) (collectively, the “Versant Entities”).  The Versant Entities expressly disclaim status as a “group” for purposes of this Schedule 13G.

 

(2)          Includes: (i) 1,813,273 shares held by VVC-I.; (ii) 35,475 shares held by VSF-1; (iii) 39,417 shares held by VAF-I-A; and (iv) 82,778 shares held by VAF-I-B.   VVI-LLC serves as the general partner of VVC- I, VSF-I, VAF-I-A, and VAF-I-B and owns no securities of the Issuer directly.  BGA, SDC, RAJ , WJL, DBM, BNL and RBR are directors and/or members of VVI-LLC and share voting and dispositive power over the shares held by VVC- I, VSF-I, VAF-I-A and VAF-I-B.  The information with respect to the ownership of the Common Stock of the Issuer by the persons filing this statement on Schedule 13G is provided as of December 31, 2010.

 

(3)          This percentage is calculated based upon 40,143,138 shares of the Issuer’s common stock outstanding as of August 4, 2010 as set forth in the Issuer’s most recent 10-Q filed with the Securities and Exchange Commissions on November 19, 2010.

 

10



 

 

1.

Names of Reporting Persons
DONALD B. MILDER

 

 

2.

Check the Appropriate Box if a Member of a Group (See Instructions)

 

 

(a)

o

 

 

(b)

x (1)

 

 

3.

SEC Use Only

 

 

4.

Citizenship or Place of Organization
United States of America

 

 

 

Number of
Shares
Beneficially
Owned by
Each
Reporting
Person With:

5.

Sole Voting Power
0

 

6.

Shared Voting Power
1,970,943 (2)

 

7.

Sole Dispositive Power
0

 

8.

Shared Dispositive Power
1,970,943 (2)

 

 

9.

Aggregate Amount Beneficially Owned by Each Reporting Person
1,970,943 (2)

 

 

10.

Check if the Aggregate Amount in Row (9) Excludes Certain Shares  (See Instructions) o

 

 

11.

Percent of Class Represented by Amount in Row 9
4.91% (3)

 

 

12.

Type of Reporting Person (See Instructions)
IN

 


(1)   This Schedule 13G is filed by Versant Venture Capital I, L.P. (“VVC- I”), Versant Side Fund I, L.P. (“VSF-I), Versant Affiliates Fund I-A, L.P. (“VAF-I-A”), Versant Affiliates Fund I-B, L.P. (“VAF-I-B”), Versant Ventures I, LLC (“VVI-LLC”), Brian G. Atwood (“BGA”), Samuel D. Colella (“SDC”), Ross A. Jaffe (“RAJ”), William J. Link (“WJL”), Donald B. Milder (“DBM”), Barbara N. Lubash (“BNL”) and Rebecca B. Robertson (“RBR”) (collectively, the “Versant Entities”).  The Versant Entities expressly disclaim status as a “group” for purposes of this Schedule 13G.

 

(2)   Includes: (i) 1,813,273 shares held by VVC-I.; (ii) 35,475 shares held by VSF-1; (iii) 39,417 shares held by VAF-I-A; and (iv) 82,778 shares held by VAF-I-B.   VVI-LLC serves as the general partner of VVC- I, VSF-I, VAF-I-A, and VAF-I-B and owns no securities of the Issuer directly.  BGA, SDC, RAJ , WJL, DBM, BNL and RBR are directors and/or members of VVI-LLC and share voting and dispositive power over the shares held by VVC- I, VSF-I, VAF-I-A and VAF-I-B.  The information with respect to the ownership of the Common Stock of the Issuer by the persons filing this statement on Schedule 13G is provided as of December 31, 2010.

 

(3)   This percentage is calculated based upon 40,143,138 shares of the Issuer’s common stock outstanding as of August 4, 2010 as set forth in the Issuer’s most recent 10-Q filed with the Securities and Exchange Commissions on November 19, 2010.

 

11



 

 

1.

Names of Reporting Persons
BARBARA N. LUBASH

 

 

2.

Check the Appropriate Box if a Member of a Group (See Instructions)

 

 

(a)

o

 

 

(b)

x (1)

 

 

3.

SEC Use Only

 

 

4.

Citizenship or Place of Organization
United States of America

 

 

 

Number of
Shares
Beneficially
Owned by
Each
Reporting
Person With:

5.

Sole Voting Power
0

 

6.

Shared Voting Power
1,970,943 (2)

 

7.

Sole Dispositive Power
0

 

8.

Shared Dispositive Power
1,970,943 (2)

 

 

9.

Aggregate Amount Beneficially Owned by Each Reporting Person
1,970,943 (2)

 

 

10.

Check  if the Aggregate Amount in Row (9) Excludes Certain Shares (See Instructions) o

 

 

11.

Percent of Class Represented by Amount in Row 9
4.91% (3)

 

 

12.

Type of Reporting Person (See Instructions)
IN

 


(1)   This Schedule 13G is filed by Versant Venture Capital I, L.P. (“VVC- I”), Versant Side Fund I, L.P. (“VSF-I), Versant Affiliates Fund I-A, L.P. (“VAF-I-A”), Versant Affiliates Fund I-B, L.P. (“VAF-I-B”), Versant Ventures I, LLC (“VVI-LLC”), Brian G. Atwood (“BGA”), Samuel D. Colella (“SDC”), Ross A. Jaffe (“RAJ”), William J. Link (“WJL”), Donald B. Milder (“DBM”), Barbara N. Lubash (“BNL”) and Rebecca B. Robertson (“RBR”) (collectively, the “Versant Entities”).  The Versant Entities expressly disclaim status as a “group” for purposes of this Schedule 13G.

 

(2)   Includes: (i) 1,813,273 shares held by VVC-I.; (ii) 35,475 shares held by VSF-1; (iii) 39,417 shares held by VAF-I-A; and (iv) 82,778 shares held by VAF-I-B.   VVI-LLC serves as the general partner of VVC- I, VSF-I, VAF-I-A, and VAF-I-B and owns no securities of the Issuer directly.  BGA, SDC, RAJ , WJL, DBM, BNL and RBR are directors and/or members of VVI-LLC and share voting and dispositive power over the shares held by VVC- I, VSF-I, VAF-I-A and VAF-I-B.  The information with respect to the ownership of the Common Stock of the Issuer by the persons filing this statement on Schedule 13G is provided as of December 31, 2010.

 

(3)   This percentage is calculated based upon 40,143,138 shares of the Issuer’s common stock outstanding as of August 4, 2010 as set forth in the Issuer’s most recent 10-Q filed with the Securities and Exchange Commissions on November 19, 2010.

 

12



 

 

1.

Names of Reporting Persons
REBECCA B. ROBERTSON

 

 

2.

Check the Appropriate Box if a Member of a Group (See Instructions)

 

 

(a)

o

 

 

(b)

x (1)

 

 

3.

SEC Use Only

 

 

4.

Citizenship or Place of Organization
United States of America

 

 

 

Number of
Shares
Beneficially
Owned by
Each
Reporting
Person With:

5.

Sole Voting Power
0

 

6.

Shared Voting Power
1,970,943 (2)

 

7.

Sole Dispositive Power
0

 

8.

Shared Dispositive Power
1,970,943 (2)

 

 

9.

Aggregate Amount Beneficially Owned by Each Reporting Person
1,970,943 (2)

 

 

10.

Check  if the Aggregate Amount in Row (9) Excludes Certain Shares  (See Instructions) o

 

 

11.

Percent of Class Represented by Amount in Row 9
4.91% (3)

 

 

12.

Type of Reporting Person (See Instructions)
IN

 


(1)   This Schedule 13G is filed by Versant Venture Capital I, L.P. (“VVC- I”), Versant Side Fund I, L.P. (“VSF-I), Versant Affiliates Fund I-A, L.P. (“VAF-I-A”), Versant Affiliates Fund I-B, L.P. (“VAF-I-B”), Versant Ventures I, LLC (“VVI-LLC”), Brian G. Atwood (“BGA”), Samuel D. Colella (“SDC”), Ross A. Jaffe (“RAJ”), William J. Link (“WJL”), Donald B. Milder (“DBM”), Barbara N. Lubash (“BNL”) and Rebecca B. Robertson (“RBR”) (collectively, the “Versant Entities”).  The Versant Entities expressly disclaim status as a “group” for purposes of this Schedule 13G.

 

(2)   Includes: (i) 1,813,273 shares held by VVC-I.; (ii) 35,475 shares held by VSF-1; (iii) 39,417 shares held by VAF-I-A; and (iv) 82,778 shares held by VAF-I-B.   VVI-LLC serves as the general partner of VVC- I, VSF-I, VAF-I-A, and VAF-I-B and owns no securities of the Issuer directly.  BGA, SDC, RAJ , WJL, DBM, BNL and RBR are directors and/or members of VVI-LLC and share voting and dispositive power over the shares held by VVC- I, VSF-I, VAF-I-A and VAF-I-B.  The information with respect to the ownership of the Common Stock of the Issuer by the persons filing this statement on Schedule 13G is provided as of December 31, 2010.

 

(3)   This percentage is calculated based upon 40,143,138 shares of the Issuer’s common stock outstanding as of August 4, 2010 as set forth in the Issuer’s most recent 10-Q filed with the Securities and Exchange Commissions on November 19, 2010.

 

13



 

Item 1 (a).

Name of Issuer:
INSULET CORPORATION

Item 1 (b).

Address of Issuer’s Principal Executive Offices
9 Oak Park Drive

Bedford, MA 01730

 

Item 2 (a).

Name of Person Filing:


Versant Venture Capital I, L.P. (“VVC-I”)

Versant Side Fund I, L.P. (“VSF-I”)

Versant Affiliates Fund I-A, L.P. (“VAF-I-A”)

Versant Affiliates Fund I-B, L.P. (“VAF-I-B”)

Versant Ventures I, LLC (“VVI-LLC”)

Brian G. Atwood (“BGA”)

Samuel D. Colella (“SDC”)

Ross A. Jaffe (“RAJ”)

William J. Link (“WJL”)

Donald B. Milder (“DBM”)

Barbara N. Lubash (“BNL”)

Rebecca B. Robertson (“RBR”)

Item 2 (b).

Address of Principal Business Office or, if none, Residence:


Versant Ventures

3000 Sand Hill Road, #4-210

Menlo Park, CA 94025

Item 2 (c).

Citizenship:

 

Entities:

 

VVC-I

 

-

 

Delaware, United States of America

 

 

 

VSF-1

 

-

 

Delaware, United States of America

 

 

 

VAF-1-A

 

-

 

Delaware, United States of America

 

 

 

VAF-1-B

 

-

 

Delaware, United States of America

 

 

 

VVI-LLC

 

-

 

Delaware, United States of America

 

 

 

 

 

 

 

 

 

Individuals:

 

BGA

 

-

 

United States of America

 

 

 

SDC

 

-

 

United States of America

 

 

 

RAJ

 

-

 

United States of America

 

 

 

WJL

 

-

 

United States of America

 

 

 

DBM

 

-

 

United States of America

 

 

 

BNL

 

-

 

United States of America

 

 

 

RBR

 

-

 

United States of America

 

 

 

 

 

 

 

 

Item 2 (d).

Title of Class of Securities:
Common Stock

Item 2 (e).

CUSIP Number:
45784P101

 

Item 3.

If this statement is filed pursuant to §§240.13d-1(b), or 240.13d-2(b) or (c), check whether the person filing is a:

 

Not Applicable

 

14



 

Item 1.

Ownership

Provide the following information regarding the aggregate number and percentage of the class of securities of the issuer identified in Item 1.

 

Versant
Entities

 

Shares Held
Directly

 

Sole Voting
Power

 

Shared Voting
Power

 

Sole Dispositive
Power

 

Shared Dispositive
Power

 

Beneficial
Ownership

 

Percentage of Class 
(2)

 

VVC-1

 

1,813,273

 

1,813,273

 

0

 

1,813,273

 

0

 

1,813,273

 

4.52

%

VSF-1

 

35,475

 

35,475

 

0

 

35,475

 

0

 

35,475

 

0.08

%

VAF-I-A

 

39,417

 

39,417

 

0

 

39,417

 

0

 

39,417

 

0.09

%

VAF-I-B

 

82,778

 

82,778

 

0

 

82,778

 

0

 

82,778

 

0.20

%

VVI-LLC

 

0

 

0

 

1,970,943

 

0

 

1,970,943

 

1,970,943

 

4.91

%

BGA

 

0

 

0

 

1,970,943

 

0

 

1,970,943

 

1,970,943

 

4.91

%

SDC

 

0

 

0

 

1,970,943

 

0

 

1,970,943

 

1,970,943

 

4.91

%

RAJ

 

19,810

 

19,810

 

1,970,943

 

19,810

 

1,970,943

 

1,990,753

 

4.96

%

WJL

 

0

 

0

 

1,970,943

 

0

 

1,970,943

 

1,970,943

 

4.91

%

DBM

 

0

 

0

 

1,970,943

 

0

 

1,970,943

 

1,970,943

 

4.91

%

BNL

 

0

 

0

 

1,970,943

 

0

 

1,970,943

 

1,970,943

 

4.91

%

RBR

 

0

 

0

 

1,970,943

 

0

 

1,970,943

 

1,970,943

 

4.91

%

 


(1)   VVI-LLC serves as the general partner of VVC-I, VSF-I, VAF-I-A, and VAF-I-B and owns no securities of the Issuer directly.  BGA, SDC, RAJ, WJL, DBM, BNL and RBR are directors and/or members of VVI-LLC.  None of BGA, SDC, RAJ, WJL, DBM, BNL and RBR owns no securities of the Issuer directly.

 

(2)   This percentage is calculated based upon 40,143,138 shares of the Issuer’s common stock outstanding as of August 4, 2010 as set forth in the Issuer’s most recent 10-Q filed with the Securities and Exchange Commissions on November 19, 2010.

 

Item 2.

Ownership of 5 Percent or Less of a Class

If this statement is being filed to report the fact that as of the date hereof the reporting person has ceased to be the beneficial owner of more than 5 percent of the class of securities, check the following. x

 

Item 3.

Ownership of More than 5 Percent on Behalf of Another Person

Not applicable

 

Item 4.

Identification and Classification of the Subsidiary Which Acquired the Security Being Reported on By the Parent Holding Company or Control Person.

Not applicable

 

Item 5.

Identification and Classification of Members of the Group

Not applicable

 

Item 6.

Notice of Dissolution of a Group

Not applicable

 

15



 

Item 7.

Certification

Not applicable

 

SIGNATURE

 

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: February       , 2011

 

 

 

Versant Affiliates Fund I-A, L.P.

 

 

 

By:

Versant Ventures I, LLC

 

Its:

General Partner

 

 

 

By:

/s/ Robin L. Praeger

 

 

Authorized Representative

 

 

 

Versant Affiliates Fund I-B, L.P.

 

 

 

By:

Versant Ventures I, LLC

 

Its:

General Partner

 

 

 

By:

/s/ Robin L. Praeger

 

 

Authorized Representative

 

 

 

Versant Side Fund I, L.P.

 

 

 

By:

Versant Ventures I, LLC

 

Its:

General Partner

 

 

 

By:

/s/ Robin L. Praeger

 

 

Authorized Representative

 

 

 

Versant Venture Capital I, L.P.

 

 

 

By:

Versant Ventures I, LLC

 

Its:

General Partner

 

 

 

By:

/s/ Robin L. Praeger

 

 

Authorized Representative

 

 

 

Versant Ventures I, LLC

 

 

 

By:

/s/ Robin L. Praeger

 

 

Managing Member

 

 

 

 

 

/s/ Robin L. Praeger as attorney in fact

 

Brian G. Atwood

 

 

 

/s/ Robin L. Praeger as attorney in fact

 

Samuel D. Colella

 

 

 

/s/ Robin L. Praeger as attorney in fact

 

Ross A. Jaffe

 

 

 

/s/ Robin L. Praeger as attorney in fact

 

William J. Link

 

 

 

/s/ Robin L. Praeger as attorney in fact

 

Donald B. Milder

 

 

 

/s/ Robin L. Praeger as attorney in fact

 

Barbara N. Lubash

 

 

 

/s/ Robin L. Praeger as attorney in fact

 

Rebecca B. Robertson

 

 

16



 

EXHIBIT A

JOINT FILING STATEMENT

 

We, the undersigned, hereby express our agreement that the attached Schedule 13G (or any amendments thereto) related to the Common Stock of Insulet Corporation is filed on behalf of each of us.

Dated: February 14, 2011

 

 

 

Versant Affiliates Fund I-A, L.P.

 

 

 

By:

Versant Ventures I, LLC

 

Its:

General Partner

 

 

 

By:

/s/ Robin L. Praeger

 

 

Authorized Representative

 

 

 

Versant Affiliates Fund I-B, L.P.

 

 

 

By:

Versant Ventures I, LLC

 

Its:

General Partner

 

 

 

By:

/s/ Robin L. Praeger

 

 

Authorized Representative

 

 

 

Versant Side Fund I, L.P.

 

 

 

By:

Versant Ventures I, LLC

 

Its:

General Partner

 

 

 

By:

/s/ Robin L. Praeger

 

 

Authorized Representative

 

 

 

Versant Venture Capital I, L.P.

 

 

 

By:

Versant Ventures I, LLC

 

Its:

General Partner

 

 

 

By:

/s/ Robin L. Praeger

 

 

Authorized Representative

 

 

 

Versant Ventures I, LLC

 

 

 

By:

/s/ Robin L. Praeger

 

 

Managing Member

 

 

 

 

 

/s/ Robin L. Praeger as attorney in fact

 

Brian G. Atwood

 

 

 

/s/ Robin L. Praeger as attorney in fact

 

Samuel D. Colella

 

 

 

/s/ Robin L. Praeger as attorney in fact

 

Ross A. Jaffe

 

 

 

/s/ Robin L. Praeger as attorney in fact

 

William J. Link

 

 

 

/s/ Robin L. Praeger as attorney in fact

 

Donald B. Milder

 

 

 

/s/ Robin L. Praeger as attorney in fact

 

Barbara N. Lubash

 

 

 

/s/ Robin L. Praeger as attorney in fact

 

Rebecca B. Robertson

 

 

17


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