0001104659-18-031866.txt : 20180509 0001104659-18-031866.hdr.sgml : 20180509 20180509211958 ACCESSION NUMBER: 0001104659-18-031866 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20180507 FILED AS OF DATE: 20180509 DATE AS OF CHANGE: 20180509 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: LIDDLE DAVID E CENTRAL INDEX KEY: 0001212726 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-38468 FILM NUMBER: 18820230 MAIL ADDRESS: STREET 1: C/O THE NEW YORK TIMES CO STREET 2: 229 WEST 43RD ST CITY: NEW YORK STATE: NY ZIP: 10036 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Matteucci Paul A CENTRAL INDEX KEY: 0001370817 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-38468 FILM NUMBER: 18820229 MAIL ADDRESS: STREET 1: 2735 SAND HILL ROAD CITY: MENLO PARK STATE: CA ZIP: 94025 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: FEDERMAN IRWIN CENTRAL INDEX KEY: 0001192391 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-38468 FILM NUMBER: 18820232 MAIL ADDRESS: STREET 1: 2735 SAND HILL ROAD CITY: MENLO PARK STATE: CA ZIP: 94025 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: KRAUSZ STEVEN M CENTRAL INDEX KEY: 0001190636 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-38468 FILM NUMBER: 18820231 MAIL ADDRESS: STREET 1: 2735 SAND HILL ROAD CITY: MENLO PARK STATE: CA ZIP: 94025 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: ROOT JONATHAN D CENTRAL INDEX KEY: 0001225480 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-38468 FILM NUMBER: 18820228 MAIL ADDRESS: STREET 1: 2735 SAND HILL ROAD CITY: MENLO PARK STATE: CA ZIP: 94025 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: YOUNG PHILIP M CENTRAL INDEX KEY: 0001048637 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-38468 FILM NUMBER: 18820227 MAIL ADDRESS: STREET 1: 2735 SAND HILL ROAD CITY: MENLO PARK STATE: CA ZIP: 94025 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: U S Venture Partners IX L P CENTRAL INDEX KEY: 0001309185 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-38468 FILM NUMBER: 18820233 BUSINESS ADDRESS: STREET 1: 2735 SAND HILL RD CITY: MENLO PARK STATE: CA ZIP: 94025 BUSINESS PHONE: 650-854-9080 MAIL ADDRESS: STREET 1: 2735 SAND HILL RD CITY: MENLO PARK STATE: CA ZIP: 94025 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Presidio Management Group IX, L.L.C. CENTRAL INDEX KEY: 0001527715 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-38468 FILM NUMBER: 18820234 BUSINESS ADDRESS: STREET 1: 2735 SAND HILL ROAD CITY: MENLO PARK STATE: CA ZIP: 94025 BUSINESS PHONE: 650-854-9080 MAIL ADDRESS: STREET 1: 2735 SAND HILL ROAD CITY: MENLO PARK STATE: CA ZIP: 94025 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: Inspire Medical Systems, Inc. CENTRAL INDEX KEY: 0001609550 STANDARD INDUSTRIAL CLASSIFICATION: SURGICAL & MEDICAL INSTRUMENTS & APPARATUS [3841] IRS NUMBER: 261377674 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 9700 63RD AVENUE N STREET 2: SUITE 200 CITY: MAPLE GROVE STATE: X1 ZIP: 55369 BUSINESS PHONE: 763-205-7970 MAIL ADDRESS: STREET 1: 9700 63RD AVENUE N STREET 2: SUITE 200 CITY: MAPLE GROVE STATE: X1 ZIP: 55369 4 1 a4.xml 4 X0306 4 2018-05-07 0 0001609550 Inspire Medical Systems, Inc. INSP 0001527715 Presidio Management Group IX, L.L.C. 1460 EL CAMINO REAL, #100 MENLO PARK CA 94025 0 0 1 0 0001309185 U S Venture Partners IX L P 1460 EL CAMINO REAL, #100 MENLO PARK CA 94025 0 0 1 0 0001192391 FEDERMAN IRWIN 1460 EL CAMINO REAL, #100 MENLO PARK CA 94025 0 0 1 0 0001190636 KRAUSZ STEVEN M 1460 EL CAMINO REAL, #100 MENLO PARK CA 94025 0 0 1 0 0001212726 LIDDLE DAVID E 1460 EL CAMINO REAL, #100 MENLO PARK CA 94025 0 0 1 0 0001370817 Matteucci Paul A 1460 EL CAMINO REAL, #100 MENLO PARK CA 94025 0 0 1 0 0001225480 ROOT JONATHAN D 1460 EL CAMINO REAL, #100 MENLO PARK CA 94025 0 0 1 0 0001048637 YOUNG PHILIP M 1460 EL CAMINO REAL, #100 MENLO PARK CA 94025 0 0 1 0 Common Stock 2018-05-07 4 C 0 360902 A 360902 I See Footnote Common Stock 2018-05-07 4 C 0 389893 A 750795 I See Footnote Common Stock 2018-05-07 4 C 0 472581 A 1223376 I See Footnote Common Stock 2018-05-07 4 C 0 210147 A 1433523 I See Footnote Common Stock 2018-05-07 4 C 0 163962 A 1597485 I See Footnote Common Stock 2018-05-07 4 C 0 570769 A 2168254 I See Footnote Series A Convertible Preferred Stock 2018-05-07 4 C 0 2400000 0 D Common Stock 360902 0 I See Footnote Series B Convertible Preferred Stock 2018-05-07 4 C 0 2102315 0 D Common Stock 389893 0 I See Footnote Series C Convertible Preferred Stock 2018-05-07 4 C 0 3142670 0 D Common Stock 472581 0 I See Footnote Series D Convertible Preferred Stock 2018-05-07 4 C 0 1397478 0 D Common Stock 210147 0 I See Footnote Series E Convertible Preferred Stock 2018-05-07 4 C 0 948855 0 D Common Stock 163962 0 I See Footnote Series F Convertible Preferred Stock 2018-05-07 4 C 0 3795620 0 D Common Stock 570769 0 I See Footnote Shares of Series A, Series C, Series D and Series F Convertible Preferred Stock automatically converted into shares of the Issuer's Common Stock at a 1-for-0.1504 conversion rate immediately prior to the closing of the Issuer's initial public offering ("IPO") for no additional consideration (subject to the payment of cash in lieu of any fractional shares in accordance with the Issuer's Sixth Amended and Restated Certificate of Incorporation (as amended, the "Certificate of Incorporation")). These shares had no expiration date. Shares of Series B Convertible Preferred Stock automatically converted into shares of the Issuer's Common Stock at a 1-for-0.1855 conversion rate immediately prior to the closing of the Issuer's IPO for no additional consideration (subject to the payment of cash in lieu of any fractional shares in accordance with the Issuer's Certificate of Incorporation). These shares had no expiration date. Shares of Series E Convertible Preferred Stock automatically converted into shares of the Issuer's Common Stock at a 1-for-0.1728 conversion rate immediately prior to the closing of the Issuer's IPO for no additional consideration (subject to the payment of cash in lieu of any fractional shares in accordance with the Issuer's Certificate of Incorporation). These shares had no expiration date. The shares are held of record by U.S. Venture Partners IX, L.P. ("USVP IX"). Presidio Management Group IX, LLC ("PMG IX") is the general partner of USVP IX and may be deemed to have sole voting and dispositive power over the shares held by USVP IX. Casey Tansey, a director of the Issuer, and each of Irwin Federman, Steven M. Krausz, David E. Liddle, Paul A. Matteucci, Jonathan D. Root, and Philip M. Young, are managing members of PMG IX, and may be deemed to share voting and dispositive power over the shares held by USVP IX. Such persons and entities disclaim beneficial ownership of shares held by USVP IX, except to the extent of any proportionate pecuniary interest therein. /s/ Richard Buchholz, as Attorney-in-Fact for Presidio Management Group IX, L.L.C. 2018-05-09 /s/ Richard Buchholz, as Attorney-in-Fact for U.S. Venture Partners IX, L.P. 2018-05-09 /s/ Richard Buchholz, as Attorney-in-Fact for Irwin Federman 2018-05-09 /s/ Richard Buchholz, as Attorney-in-Fact for Steven M. Krausz 2018-05-09 /s/ Richard Buchholz, as Attorney-in-Fact for David E. Liddle 2018-05-09 /s/ Richard Buchholz, as Attorney-in-Fact for Paul E. Matteucci 2018-05-09 /s/ Richard Buchholz, as Attorney-in-Fact for Jonathon D. Root 2018-05-09 /s/ Richard Buchholz, as Attorney-in-Fact for Philip M. Young 2018-05-09