0001437749-15-017267.txt : 20150914 0001437749-15-017267.hdr.sgml : 20150914 20150914195728 ACCESSION NUMBER: 0001437749-15-017267 CONFORMED SUBMISSION TYPE: 3 PUBLIC DOCUMENT COUNT: 2 CONFORMED PERIOD OF REPORT: 20150904 FILED AS OF DATE: 20150914 DATE AS OF CHANGE: 20150914 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: Sun BioPharma, Inc. CENTRAL INDEX KEY: 0001029125 STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-COMPUTER INTEGRATED SYSTEMS DESIGN [7373] IRS NUMBER: 870543922 STATE OF INCORPORATION: UT FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 712 VISTA BLVD #305 CITY: WACONIA STATE: MN ZIP: 55387 BUSINESS PHONE: 352-745-7665 MAIL ADDRESS: STREET 1: 712 VISTA BLVD #305 CITY: WACONIA STATE: MN ZIP: 55387 FORMER COMPANY: FORMER CONFORMED NAME: Cimarron Medical, Inc. DATE OF NAME CHANGE: 20150602 FORMER COMPANY: FORMER CONFORMED NAME: CIMARRON SOFTWARE INC DATE OF NAME CHANGE: 19961217 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: GILBERTSON RYAN RANDALL CENTRAL INDEX KEY: 0001394821 FILING VALUES: FORM TYPE: 3 SEC ACT: 1934 Act SEC FILE NUMBER: 000-55242 FILM NUMBER: 151106555 MAIL ADDRESS: STREET 1: 130 LAKE ST. WEST CITY: WAYZATA STATE: MN ZIP: 55391 3 1 rdgdoc.xml FORM 3 X0206 3 2015-09-04 0 0001029125 Sun BioPharma, Inc. SNBP 0001394821 GILBERTSON RYAN RANDALL 1000 PARKER'S LAKE ROAD WAYZATA MN 55391 1 Common Stock 4170508 D Stock Option (right to buy) 0.2750 2015-09-04 2023-12-27 Common Stock 1523208 D Stock Option (right to buy) 0.3175 2015-09-04 2025-03-05 Common Stock 400000 D Warrants (right to buy) 0.1875 2015-09-04 2023-06-04 Common Stock 800000 D Convertible Promissory Note (right to buy) 1.1250 2015-09-04 Common Stock 444444 D Convertible Promissory Note (right to buy) 1.1250 2015-09-04 Common Stock 177776 I By Total Depth Foundation Unless earlier terminated pursuant to its terms, the warrants terminate upon the earliest of June 2023, upon a closing of a change of control of Issuer, or immediately prior to a closing of a firm commitment underwritten initial public offering pursuant to an effective registration statement filed under the Securities Act covering the offering and sale of Issuer common stock. The convertible promissory notes are scheduled to mature and become due and payable on December 27, 2018. The conversion right thereunder has no expiration date. /s/ Joshua L. Colburn, attorney-in-fact for Ryan R. Gilbertson 2015-09-14 EX-24 2 poagilbertson.txt POWER OF ATTORNEY I, Ryan R. Gilbertson, hereby authorize and designate each of W. Morgan Burns, Joshua L. Colburn and Andrew E. Gustafson signing singly, as my true and lawful attorney-in-fact to: (1) execute for and on my behalf, in my capacity as an officer and/or director of Sun BioPharma, Inc. (the "Company"), Form ID or Forms 3, 4 and 5 in accordance with Section 16(a) of the Securities Exchange Act of 1934 (the "Exchange Act") and the rules and regulations promulgated thereunder and other forms or reports on my behalf as may be required to be filed in connection with my ownership, acquisition, or disposition of securities of the Company, including Form 144 and Schedule 13D or Schedule 13G; (2) do and perform any and all acts for and on my behalf which may be necessary or desirable to complete and execute any such Form ID, Forms 3, 4 or 5, Form 144, Schedule 13D or Schedule 13G and timely file such form with the Securities and Exchange Commission and any stock exchange or similar authority; and (3) take any other action of any type whatsoever in connection with the foregoing which, in the opinion of such attorney-in-fact, may be to my benefit, in my best interest, or legally required of me, it being understood that the statements executed by such attorney-in-fact on my behalf pursuant to this Power of Attorney shall be in such form and shall contain such terms and conditions as such attorney-in-fact may approve in such attorney-in-fact's discretion. I hereby further grant to each such attorney-in-fact full power and authority to do and perform any and every act and thing whatsoever requisite, necessary, or proper to be done in the exercise of any of the rights and powers herein granted, as fully to all intents and purposes as I might or could do if personally present, with full power of substitution or revocation, hereby ratifying and confirming all that such attorney-in-fact, or such attorney-in-fact's substitute or substitutes, shall lawfully do or cause to be done by virtue of this Power of Attorney and the rights and powers herein granted. I hereby acknowledge that the foregoing attorneys-in-fact, in serving in such capacity at my request, are not assuming, nor is the Company assuming, any of my responsibilities to comply with Section 16 of the Exchange Act. This Power of Attorney shall remain in full force and effect until I am no longer required to file Form ID or Forms 3, 4 and 5 with respect to my holdings of and transactions in securities issued by the Company, unless earlier revoked by me in a signed writing delivered to the foregoing attorneys-in-fact. Notwithstanding the foregoing, if any such attorney-in- fact hereafter ceases to be at least one of the following: (i) a partner of Faegre Baker Daniels LLP or (ii) an employee of Faegre Baker Daniels LLP, then this Power of Attorney shall be automatically revoked solely as to such individual, immediately upon such cessation, without any further action on my part. I hereby revoke all previous Powers of Attorney that have been granted by me in connection with my reporting obligations under Section 16 of the Exchange Act with respect to my holdings of and transactions in securities issued by the Company. IN WITNESS WHEREOF, I have caused this Power of Attorney to be duly executed as of this 11th day of September, 2015. /s/ Ryan R. Gilbertson