0001209191-21-019683.txt : 20210310 0001209191-21-019683.hdr.sgml : 20210310 20210310211832 ACCESSION NUMBER: 0001209191-21-019683 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20210308 FILED AS OF DATE: 20210310 DATE AS OF CHANGE: 20210310 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: SIEBEL THOMAS M CENTRAL INDEX KEY: 0001031530 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-39744 FILM NUMBER: 21731584 MAIL ADDRESS: STREET 1: SIEBEL SYSTEMS INC STREET 2: 2207 BRIDGEPOINTE PARKWAY CITY: SAN MATEO STATE: CA ZIP: 94404 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Siebel Living Trust u/a/d 7/27/93, as amended CENTRAL INDEX KEY: 0001834425 STATE OF INCORPORATION: CA FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-39744 FILM NUMBER: 21731583 BUSINESS ADDRESS: STREET 1: C/O C3.AI, INC. STREET 2: 1300 SEAPORT BLVD., SUITE 500 CITY: REDWOOD CITY STATE: CA ZIP: 94063 BUSINESS PHONE: 650-503-2200 MAIL ADDRESS: STREET 1: C/O C3.AI, INC. STREET 2: 1300 SEAPORT BLVD., SUITE 500 CITY: REDWOOD CITY STATE: CA ZIP: 94063 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: C3.ai, Inc. CENTRAL INDEX KEY: 0001577526 STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-PREPACKAGED SOFTWARE [7372] IRS NUMBER: 263999357 STATE OF INCORPORATION: DE FISCAL YEAR END: 0430 BUSINESS ADDRESS: STREET 1: 1300 SEAPORT BLVD STREET 2: SUITE 500 CITY: REDWOOD CITY STATE: CA ZIP: 94063 BUSINESS PHONE: 650-503-2218 MAIL ADDRESS: STREET 1: 1300 SEAPORT BLVD STREET 2: SUITE 500 CITY: REDWOOD CITY STATE: CA ZIP: 94063 FORMER COMPANY: FORMER CONFORMED NAME: C3 IoT, Inc. DATE OF NAME CHANGE: 20180123 FORMER COMPANY: FORMER CONFORMED NAME: C3, Inc. DATE OF NAME CHANGE: 20130522 4 1 doc4.xml FORM 4 SUBMISSION X0306 4 2021-03-08 0 0001577526 C3.ai, Inc. AI 0001031530 SIEBEL THOMAS M C/O C3.AI, INC. 1300 SEAPORT BLVD, SUITE 500 REDWOOD CITY CA 94603 1 1 1 0 Chief Executive Officer 0001834425 Siebel Living Trust u/a/d 7/27/93, as amended C/O C3.AI, INC. 1300 SEAPORT BLVD, SUITE 500 REDWOOD CITY CA 94063 0 0 1 0 Class A Common Stock 2021-03-08 4 S 0 423534 82.80 D 11633993 I See Footnote Class A Common Stock 2021-03-08 4 S 0 268880 85.40 D 11365113 I See Footnote Class A Common Stock 2021-03-08 4 S 0 88246 86.55 D 11276867 I See Footnote Class A Common Stock 2021-03-08 4 S 0 89554 87.49 D 11187313 I See Footnote Class A Common Stock 2021-03-08 4 S 0 43037 88.31 D 11144276 I See Footnote Class A Common Stock 2021-03-08 4 S 0 20220 89.48 D 11124056 I See Footnote Class A Common Stock 2021-03-08 4 S 0 31287 90.64 D 11092769 I See Footnote Class A Common Stock 2021-03-08 4 S 0 30365 91.36 D 11062404 I See Footnote Class A Common Stock 2021-03-08 4 S 0 4877 92.23 D 11057527 I See Footnote Class A Common Stock 2021-03-09 4 S 0 617519 83.99 D 10440008 I See Footnote Class A Common Stock 2021-03-09 4 S 0 211235 85.20 D 10228773 I See Footnote Class A Common Stock 2021-03-09 4 S 0 57936 86.26 D 10170837 I See Footnote Class A Common Stock 2021-03-09 4 S 0 31693 87.12 D 10139144 I See Footnote Class A Common Stock 2021-03-09 4 S 0 3700 88.05 D 10135444 I See Footnote Class A Common Stock 2021-03-10 4 S 0 83817 83.68 D 10051627 I See Footnote Class A Common Stock 2021-03-10 4 S 0 195261 84.46 D 9856366 I See Footnote Class A Common Stock 2021-03-10 4 S 0 31162 85.21 D 9825204 I See Footnote Class A Common Stock 2021-03-10 4 S 0 27503 86.41 D 9797701 I See Footnote Class A Common Stock 2021-03-10 4 S 0 3400 87.67 D 9794301 I See Footnote Class A Common Stock 2021-03-10 4 S 0 15 88.15 D 9794286 I See Footnote Class A Common Stock 2175666 D Class A Common Stock 9216 I See Footnote Class A Common Stock 170294 I See Footnote Class A Common Stock 72695 I See Footnote Class A Common Stock 1237115 I See Footnote Class B Common Stock 2021-01-15 5 G 0 E 331 0.00 D Class A Common Stock 331 43047 I See Footnote Class B Common Stock 2021-01-15 5 G 0 E 331 0.00 D Class A Common Stock 331 43047 I See Footnote Class B Common Stock 2021-01-15 5 G 0 E 473 0.00 D Class A Common Stock 473 82109 I See Footnote Class B Common Stock 2021-01-15 5 G 0 E 473 0.00 D Class A Common Stock 473 82109 I See Footnote Class B Common Stock 2021-01-15 5 G 0 E 156 0.00 D Class A Common Stock 156 23758 I See Footnote Class B Common Stock 2021-01-15 5 G 0 E 156 0.00 D Class A Common Stock 156 23758 I See Footnote Class B Common Stock 2021-01-15 5 G 0 E 270 0.00 D Class A Common Stock 270 18353 I See Footnote Class B Common Stock 2021-01-15 5 G 0 E 270 0.00 D Class A Common Stock 270 328353 I See Footnote Class B Common Stock 2021-01-15 5 G 0 E 2460 0.00 A Class A Common Stock 2460 2032748 I See Footnote Class B Common Stock Class A Common Stock 500000 500000 I See Footnote Class B Common Stock Class A Common Stock 19009 19009 I See Footnote Class B Common Stock Class A Common Stock 19009 19009 I See Footnote Class B Common Stock Class A Common Stock 10250 10250 I See Footnote Class B Common Stock Class A Common Stock 10250 10250 I See Footnote The shares are held by The Siebel Living Trust u/a/d 7/27/93, a amended, of which the Reporting Person is trustee. Represents weighted average sales price. The shares were sold at prices ranging from $85.00 to $85.99. The Reporting Person will provide upon request, to the SEC, the Issuer or security holder of the Issuer, full information regarding the number of shares sold at each separate price. Represents weighted average sales price. The shares were sold at prices ranging from $86.00 to $86.99. The Reporting Person will provide upon request, to the SEC, the Issuer or security holder of the Issuer, full information regarding the number of shares sold at each separate price. Represents weighted average sales price. The shares were sold at prices ranging from $87.00 to $87.99. The Reporting Person will provide upon request, to the SEC, the Issuer or security holder of the Issuer, full information regarding the number of shares sold at each separate price. Represents weighted average sales price. The shares were sold at prices ranging from $88.00 to $88.81. The Reporting Person will provide upon request, to the SEC, the Issuer or security holder of the Issuer, full information regarding the number of shares sold at each separate price. Represents weighted average sales price. The shares were sold at prices ranging from $89.00 to $89.92. The Reporting Person will provide upon request, to the SEC, the Issuer or security holder of the Issuer, full information regarding the number of shares sold at each separate price. Represents weighted average sales price. The shares were sold at prices ranging from $90.00 to $90.99. The Reporting Person will provide upon request, to the SEC, the Issuer or security holder of the Issuer, full information regarding the number of shares sold at each separate price. Represents weighted average sales price. The shares were sold at prices ranging from $91.00 to $91.98. The Reporting Person will provide upon request, to the SEC, the Issuer or security holder of the Issuer, full information regarding the number of shares sold at each separate price. Represents weighted average sales price. The shares were sold at prices ranging from $92.00 to $92.50. The Reporting Person will provide upon request, to the SEC, the Issuer or security holder of the Issuer, full information regarding the number of shares sold at each separate price. Represents weighted average sales price. The shares were sold at prices ranging from $83.70 to $84.69. The Reporting Person will provide upon request, to the SEC, the Issuer or security holder of the Issuer, full information regarding the number of shares sold at each separate price. Represents weighted average sales price. The shares were sold at prices ranging from $84.70 to $85.69. The Reporting Person will provide upon request, to the SEC, the Issuer or security holder of the Issuer, full information regarding the number of shares sold at each separate price. Represents weighted average sales price. The shares were sold at prices ranging from $85.70 to $86.68. The Reporting Person will provide upon request, to the SEC, the Issuer or security holder of the Issuer, full information regarding the number of shares sold at each separate price. Represents weighted average sales price. The shares were sold at prices ranging from $86.70 to $87.62. The Reporting Person will provide upon request, to the SEC, the Issuer or security holder of the Issuer, full information regarding the number of shares sold at each separate price. Represents weighted average sales price. The shares were sold at prices ranging from $87.75 to $88.30. The Reporting Person will provide upon request, to the SEC, the Issuer or security holder of the Issuer, full information regarding the number of shares sold at each separate price. Represents weighted average sales price. The shares were sold at prices ranging from $83.00 to $83.99. The Reporting Person will provide upon request, to the SEC, the Issuer or security holder of the Issuer, full information regarding the number of shares sold at each separate price. Represents weighted average sales price. The shares were sold at prices ranging from $84.00 to $84.99. The Reporting Person will provide upon request, to the SEC, the Issuer or security holder of the Issuer, full information regarding the number of shares sold at each separate price. Represents weighted average sales price. The shares were sold at prices ranging from $85.00 to $85.98. The Reporting Person will provide upon request, to the SEC, the Issuer or security holder of the Issuer, full information regarding the number of shares sold at each separate price. Represents weighted average sales price. The shares were sold at prices ranging from $86.00 to $86.86. The Reporting Person will provide upon request, to the SEC, the Issuer or security holder of the Issuer, full information regarding the number of shares sold at each separate price. Represents weighted average sales price. The shares were sold at prices ranging from $87.02 to $87.96. The Reporting Person will provide upon request, to the SEC, the Issuer or security holder of the Issuer, full information regarding the number of shares sold at each separate price. The shares are held by First Virtual Holdings, LLC, of which the Reporting Person is Chairman. The shares are held by Siebel Asset Management, L.P., of which the Reporting Person is the general partner. The shares are held by Siebel Asset Management III, L.P., of which the Reporting Person is the general partner. The shares are held by The Siebel 2011 Irrevocable Children's Trust, of which the Reporting Person is co-trustee. Immediately upon the closing of the Issuer's initial public offering, all shares of Series A* Convertible Preferred Stock automatically converted into shares of Class B Common Stock and had no expiration date. On January 25, 2021, shares held by the annuity trust were transferred to The Siebel Living Trust u/a/d 7/27/1983 to satisfy annuity payments. The shares are held by The Siebel 2013 Annuity Trust I u/a/d 10/8/2013, of which the Reporting Person is the trustee. The shares are held by The Siebel 2013 Annuity Trust II u/a/d 10/8/2013, of which the Reporting Person is the trustee. The shares are held by The Siebel 2014 Annuity Trust I u/a/d 10/22/2014, of which the Reporting Person is the trustee. The shares are held by The Siebel 2014 Annuity Trust II u/a/d 10/22/2014, of which the Reporting Person is the trustee. The shares are held by The Siebel 2017 Annuity Trust I u/a/d 11/28/2017, of which the Reporting Person is the trustee. The shares are held by The Siebel 2017 Annuity Trust II u/a/d 11/28/2017, of which the Reporting Person is the trustee. The shares are held by The Siebel 2018 Annuity Trust I u/a/d 12/13/2018, of which the Reporting Person is the trustee. The shares are held by The Siebel 2018 Annuity Trust II u/a/d 12/18/2018, of which the Reporting Person is the trustee. On January 25, 2021, these shares that were held by related annuity trusts were transferred to The Siebel Living Trust u/a/d 7/27/1983 to satisfy annuity payments. The shares are held by The Siebel 2020 Annuity Trust I u/a/d 3/4/2020, of which the Reporting Person is the trustee. The shares are held by The Siebel 2020 Annuity Trust II u/a/d 3/4/2020, of which the Reporting Person is the trustee. The shares are held by The Siebel 2020 Annuity Trust III u/a/d 12/3/2020, of which the Reporting Person is the trustee. The shares are held by The Siebel 2020 Annuity Trust IV u/a/d 12/3/2020, of which the Reporting Person is the trustee. /s/ Brady Mickelsen, Attorney-in-Fact 2021-03-10 /s/ Brady Mickelsen, Attorney-in-Fact 2021-03-10