-----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, OZJPjUTqE9oNrUzmMUYpobd+hdSUu/2L/YH/T9ctBSm6wy4ce36vAfCT7fmKaYgM 9wMsZPxI7SUeEhK623aZKA== 0000904454-04-000358.txt : 20040520 0000904454-04-000358.hdr.sgml : 20040520 20040520144135 ACCESSION NUMBER: 0000904454-04-000358 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20040518 FILED AS OF DATE: 20040520 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: NUVASIVE INC CENTRAL INDEX KEY: 0001142596 STANDARD INDUSTRIAL CLASSIFICATION: SURGICAL & MEDICAL INSTRUMENTS & APPARATUS [3841] IRS NUMBER: 330768598 STATE OF INCORPORATION: DE BUSINESS ADDRESS: STREET 1: 10065 OLD GROVE RD CITY: SAN DIEGO STATE: CA ZIP: 92131 BUSINESS PHONE: 8582717070 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: BLAIR JAMES C CENTRAL INDEX KEY: 0001024000 STANDARD INDUSTRIAL CLASSIFICATION: PHARMACEUTICAL PREPARATIONS [2834] STATE OF INCORPORATION: CA FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-50744 FILM NUMBER: 04821061 BUSINESS ADDRESS: STREET 1: 5880 PACIFIC CENTER BLVD CITY: SAN DIEGO STATE: CA ZIP: 92121-4204 BUSINESS PHONE: 6194572553 MAIL ADDRESS: STREET 1: 5880 PACIFIC CENTER BLVD CITY: SAN DIEGO STATE: CA ZIP: 92121-4204 4 1 edgar.xml PRIMARY DOCUMENT X0202 4 2004-05-18 0001142596 NUVASIVE INC NUVA 0001024000 BLAIR JAMES C C/O DOMAIN ASSOCIATES, LLC ONE PALMER SQUARE PRINCETON NJ 08542 1 0 1 0 Common Stock 2004-05-18 4 C 0 1617798 A 1617798 I By Domain Partners IV, L.P. Common Stock 2004-05-18 4 X 0 133818 .625 A 1751616 I By Domain Partners IV, L.P. Common Stock 2004-05-18 4 J 0 7603 11.00 D 1744013 I By Domain Partners IV, L.P. Common Stock 2004-05-18 4 C 0 8442 A 1752455 I By Domain Partners IV, L.P. Common Stock 2004-05-18 4 C 0 31001 A 31001 I By DP IV Associates, L.P. Common Stock 2004-05-18 4 C 0 203 A 31204 I By DP IV Associates, L.P. Series B Preferred Stock 2004-05-18 4 C 0 2204872 0 D Common Stock 881949 0 I By Domain Partners IV, L.P. Series C Preferred Stock 2004-05-18 4 C 0 257332 0 D Common Stock 102933 0 I By Domain Partners IV, L.P. Series D Preferred Stock 2004-05-18 4 C 0 772013 0 D Common Stock 308805 0 I By Domain Partners IV, L.P. Series D-1 Preferred Stock 2004-05-18 4 C 0 810277 0 D Common Stock 324111 0 I By Domain Partners IV, L.P. Warrants (right-to-buy) .625 2004-05-18 4 X 0 133818 0 D Common Stock 133818 0 I By Domain Partners IV, L.P. Warrants (right-to-buy) 6.325 2004-05-18 4 X 0 49655 0 D Series D Preferred Stock 49655 0 I By Domain Partners IV, L.P. Series D Preferred Stock 2004-05-18 4 X 0 49655 6.325 A Common Stock 19862 49655 I By Domain Partners IV, L.P. Series D Preferred Stock 2004-05-18 4 J 0 28552 4.40 D Common Stock 11420 21103 I By Domain Partners IV, L.P. Series D Preferred Stock 2004-05-18 4 C 0 21103 0 D Common Stock 8442 0 I By Domain Partners IV, L.P. Series B Preferred Stock 2004-05-18 4 C 0 52835 0 D Common Stock 21134 0 I By DP IV Associates, L.P. Series C Preferred Stock 2004-05-18 4 C 0 6167 0 D Common Stock 2467 0 I By DP IV Associates, L.P. Series D Preferred Stock 2004-05-18 4 C 0 18501 0 D Common Stock 7400 0 I By DP IV Associates, L.P. Warrants (right-to-buy) 6.325 2004-05-18 4 X 0 1191 0 D Series D Preferred Stock 1191 0 I By DP IV Associates, L.P. Series D Preferred Stock 2004-05-18 4 X 0 1191 6.325 A Common Stock 477 1191 I By DP IV Associates, L.P. Series D Preferred Stock 2004-05-18 4 J 0 685 4.40 D Common Stock 274 506 I By DP IV Associates, L.P. Series D Preferred Stock 2004-05-18 4 C 0 506 0 D Common Stock 203 0 I By DP IV Associates, L.P. All of the Preferred Stock automatically converted into Common Stock immediately upon the closing of the Issuer's initial public offering, for no additional consideration. All of the Warrants were fully vested and were exercised in full immediately upon the closing of the Issuer's initial public offering. Deemed disposition of shares in connection with the cashless exercise of the Warrants. The Reporting Person also indirectly beneficially owns 8,000 shares of Common Stock held by Domain Associates, L.L.C. The Reporting Person is a managing member of Domain Associates, L.L.C. and a managing member of One Palmer Square Associates IV, L.L.C., the sole general partner of Domain Partners IV, L.P. and DP IV Associates, L.P. Pursuant to Instruction 4(b)(iv) of Form 4, the Reporting Person has elected to report as indirectly beneficially owned the entire number of securities beneficially owned by each such entity. The Reporting Person disclaims beneficial ownership of any securities, and any proceeds thereof, that exceed his or her pecuniary interest therein and/or that are not actually distributed to him or her. Kathleen K. Schoemaker, Attorney-in-Fact 2004-05-20 -----END PRIVACY-ENHANCED MESSAGE-----