0001209191-16-145895.txt : 20161014
0001209191-16-145895.hdr.sgml : 20161014
20161014143450
ACCESSION NUMBER: 0001209191-16-145895
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20161012
FILED AS OF DATE: 20161014
DATE AS OF CHANGE: 20161014
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: Coupa Software Inc
CENTRAL INDEX KEY: 0001385867
STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-PREPACKAGED SOFTWARE [7372]
IRS NUMBER: 204429448
STATE OF INCORPORATION: DE
BUSINESS ADDRESS:
STREET 1: 1855 S. GRANT STREET
CITY: SAN MATEO
STATE: CA
ZIP: 94402
BUSINESS PHONE: 6509313200
MAIL ADDRESS:
STREET 1: 1855 S. GRANT STREET
CITY: SAN MATEO
STATE: CA
ZIP: 94402
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Ericson William W.
CENTRAL INDEX KEY: 0001503381
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-37901
FILM NUMBER: 161936802
MAIL ADDRESS:
STREET 1: 777 MARINERS ISLAND BOULEVARD
STREET 2: SUITE 550
CITY: SAN MATEO
STATE: CA
ZIP: 94404
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: FEIBER JONATHAN D
CENTRAL INDEX KEY: 0001027621
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-37901
FILM NUMBER: 161936803
MAIL ADDRESS:
STREET 1: 3000 SAND HILL ROAD BLDG 1
CITY: MENLO PARK
STATE: CA
ZIP: 94025
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Ninth MDV Partners, L.L.C.
CENTRAL INDEX KEY: 0001573991
STATE OF INCORPORATION: DE
FISCAL YEAR END: 1231
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-37901
FILM NUMBER: 161936804
BUSINESS ADDRESS:
STREET 1: 777 MARINERS ISLAND BOULEVARD
STREET 2: SUITE 550
CITY: SAN MATEO
STATE: CA
ZIP: 94404
BUSINESS PHONE: 650-234-4840
MAIL ADDRESS:
STREET 1: 777 MARINERS ISLAND BOULEVARD
STREET 2: SUITE 550
CITY: SAN MATEO
STATE: CA
ZIP: 94404
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: MDV IX LP
CENTRAL INDEX KEY: 0001410787
STATE OF INCORPORATION: DE
FISCAL YEAR END: 1231
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-37901
FILM NUMBER: 161936805
BUSINESS ADDRESS:
STREET 1: 777 MARINERS ISLAND BOULEVARD
STREET 2: SUITE 550
CITY: SAN MATEO
STATE: CA
ZIP: 94404
BUSINESS PHONE: 650-234-4840
MAIL ADDRESS:
STREET 1: 777 MARINERS ISLAND BOULEVARD
STREET 2: SUITE 550
CITY: SAN MATEO
STATE: CA
ZIP: 94404
4
1
doc4.xml
FORM 4 SUBMISSION
X0306
4
2016-10-12
0
0001385867
Coupa Software Inc
COUP
0001410787
MDV IX LP
777 MARINERS ISLAND BLVD.
SUITE 550
SAN MATEO
CA
94404
0
0
1
0
0001573991
Ninth MDV Partners, L.L.C.
777 MARINERS ISLAND BLVD.
SUITE 550
SAN MATEO
CA
94404
0
0
1
0
0001027621
FEIBER JONATHAN D
777 MARINERS ISLAND BLVD.
SUITE 550
SAN MATEO
CA
94404
0
0
1
0
0001503381
Ericson William W.
777 MARINERS ISLAND BLVD.
SUITE 550
SAN MATEO
CA
94404
0
0
1
0
Common Stock
2016-10-12
4
C
0
6648700
A
6648700
I
MDV IX, L.P., as nominee for MDV IX, L.P., and MDV ENF IX, L.P.
Series D Convertible Preferred Stock
1.3524
2016-10-12
4
C
0
5546449
D
Common Stock
5546449
0
I
MDV IX, L.P., as nominee for MDV IX, L.P., and MDV ENF IX, L.P.
Series E Convertible Preferred Stock
3.1148
2016-10-12
4
C
0
1015725
D
Common Stock
1015725
0
I
MDV IX, L.P., as nominee for MDV IX, L.P., and MDV ENF IX, L.P.
Series F Convertible Preferred Stock
8.09
2016-10-12
4
C
0
86526
D
Common Stock
86526
0
I
MDV IX, L.P., as nominee for MDV IX, L.P., and MDV ENF IX, L.P.
Each share of Series D Convertible Preferred Stock, Series E Convertible Preferred Stock and Series F Convertible Preferred Stock automatically converted into one share of Issuer's Common Stock for no additional consideration immediately prior to the completion of the Issuer's initial public offering. The exercisability date and expiration date are not relevant to the conversion of these securities.
Ninth MDV Partners, L.L.C. is the general partner of MDV IX, L.P., as nominee for MDV IX, L.P. and MDV ENF IX, L.P. (collectively, "MDV IX"). William Ericson ("Ericson") and Jonathan Feiber ("Feiber") are Managing Members of Ninth MDV Partners, L.L.C. Ericson and Feiber may be deemed to share voting and dispositive power over the shares held by MDV IX and disclaim beneficial ownership of the shares held by MDV IX except to the extent of their pecuniary interest therein.
/s/ Brett Teele
2016-10-14