0001012975-14-000075.txt : 20140212
0001012975-14-000075.hdr.sgml : 20140212
20140212183528
ACCESSION NUMBER: 0001012975-14-000075
CONFORMED SUBMISSION TYPE: 3
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20140212
FILED AS OF DATE: 20140212
DATE AS OF CHANGE: 20140212
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: CONCERT PHARMACEUTICALS, INC.
CENTRAL INDEX KEY: 0001367920
STANDARD INDUSTRIAL CLASSIFICATION: PHARMACEUTICAL PREPARATIONS [2834]
IRS NUMBER: 000000000
BUSINESS ADDRESS:
STREET 1: 99 HAYDEN AVENUE
STREET 2: SUITE 500
CITY: LEXINGTON
STATE: MA
ZIP: 02421
BUSINESS PHONE: 781-860-0045
MAIL ADDRESS:
STREET 1: 99 HAYDEN AVENUE
STREET 2: SUITE 500
CITY: LEXINGTON
STATE: MA
ZIP: 02421
FORMER COMPANY:
FORMER CONFORMED NAME: CONCERT PHARMACEUTICALS INC
DATE OF NAME CHANGE: 20060628
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Ratcliffe Liam
CENTRAL INDEX KEY: 0001547100
FILING VALUES:
FORM TYPE: 3
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-36310
FILM NUMBER: 14602076
MAIL ADDRESS:
STREET 1: C/O NEW LEAF VENTURE PARTNERS
STREET 2: 7 TIMES SQUARE - SUITE 3502
CITY: NEW YORK
STATE: NY
ZIP: 10036
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Lathi Vijay K
CENTRAL INDEX KEY: 0001340806
FILING VALUES:
FORM TYPE: 3
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-36310
FILM NUMBER: 14602078
MAIL ADDRESS:
STREET 1: C/O NEW LEAF VENTURE PARTNERS
STREET 2: 2500 SAND HILL ROAD, SUITE 203
CITY: MENLO PARK
STATE: CA
ZIP: 94025
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: HUNT RONALD
CENTRAL INDEX KEY: 0001247851
FILING VALUES:
FORM TYPE: 3
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-36310
FILM NUMBER: 14602079
MAIL ADDRESS:
STREET 1: C/O CREDIT SUISSE 1ST BOSTON PRV EQY
STREET 2: 11 MADISON AVENUE
CITY: NEW YORK
STATE: NY
ZIP: 10010
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: NIEDEL JAMES
CENTRAL INDEX KEY: 0001231092
FILING VALUES:
FORM TYPE: 3
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-36310
FILM NUMBER: 14602080
MAIL ADDRESS:
STREET 1: C/O CREDIT SUISSE PRIVATE EQUITY INC
STREET 2: 11 MADISON AVE
CITY: NEW YORK
STATE: NY
ZIP: 10010
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: New Leaf Venture Management I, L.P.
CENTRAL INDEX KEY: 0001455617
STATE OF INCORPORATION: DE
FISCAL YEAR END: 1231
FILING VALUES:
FORM TYPE: 3
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-36310
FILM NUMBER: 14602083
BUSINESS ADDRESS:
STREET 1: TIMES SQUARE TOWER
STREET 2: 7 TIMES SQUARE, SUITE 3502
CITY: NEW YORK
STATE: NY
ZIP: 10036
BUSINESS PHONE: 646 871 6420
MAIL ADDRESS:
STREET 1: TIMES SQUARE TOWER
STREET 2: 7 TIMES SQUARE, SUITE 3502
CITY: NEW YORK
STATE: NY
ZIP: 10036
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: New Leaf Ventures I, L.P.
CENTRAL INDEX KEY: 0001375661
STATE OF INCORPORATION: DE
FISCAL YEAR END: 1231
FILING VALUES:
FORM TYPE: 3
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-36310
FILM NUMBER: 14602084
BUSINESS ADDRESS:
STREET 1: 7 TIMES SQUARE
STREET 2: SUITE 1603
CITY: NEW YORK
STATE: NY
ZIP: 10036
BUSINESS PHONE: 646-871-6400
MAIL ADDRESS:
STREET 1: 7 TIMES SQUARE
STREET 2: SUITE 1603
CITY: NEW YORK
STATE: NY
ZIP: 10036
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: New Leaf Venture Management I, L.L.C.
CENTRAL INDEX KEY: 0001455597
STATE OF INCORPORATION: DE
FISCAL YEAR END: 1231
FILING VALUES:
FORM TYPE: 3
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-36310
FILM NUMBER: 14602082
BUSINESS ADDRESS:
STREET 1: TIMES SQUARE TOWER
STREET 2: 7 TIMES SQUARE, SUITE 3502
CITY: NEW YORK
STATE: NY
ZIP: 10036
BUSINESS PHONE: 646 871 6420
MAIL ADDRESS:
STREET 1: TIMES SQUARE TOWER
STREET 2: 7 TIMES SQUARE, SUITE 3502
CITY: NEW YORK
STATE: NY
ZIP: 10036
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Delagardelle Jeani
CENTRAL INDEX KEY: 0001441563
FILING VALUES:
FORM TYPE: 3
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-36310
FILM NUMBER: 14602077
MAIL ADDRESS:
STREET 1: C/O NEW LEAF VENTURE PARTNERS, L.L.C.
STREET 2: 2500 SAND HILL ROAD, SUITE 203
CITY: MENLO PARK
STATE: CA
ZIP: 94025
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Chambon Philippe O.
CENTRAL INDEX KEY: 0001192212
FILING VALUES:
FORM TYPE: 3
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-36310
FILM NUMBER: 14602081
MAIL ADDRESS:
STREET 1: C/O NEW LEAF VENTURE PARTNERS
STREET 2: 7 TIMES SQUARE, SUITE 3502
CITY: NEW YORK
STATE: NY
ZIP: 10036
FORMER NAME:
FORMER CONFORMED NAME: CHAMBON PHILIPPE
DATE OF NAME CHANGE: 20020924
3
1
edgar.xml
PRIMARY DOCUMENT
X0206
3
2014-02-12
0
0001367920
CONCERT PHARMACEUTICALS, INC.
CNCE
0001375661
New Leaf Ventures I, L.P.
C/O NEW LEAF VENTURES
TIMES SQUARE TOWER, 7 TIMES SQ, STE 3502
NEW YORK
NY
10036
0
0
1
0
0001455617
New Leaf Venture Management I, L.P.
C/O NEW LEAF VENTURES
TIMES SQUARE TOWER, 7 TIMES SQ, STE 3502
NEW YORK
NY
10036
0
0
1
0
0001455597
New Leaf Venture Management I, L.L.C.
C/O NEW LEAF VENTURES
TIMES SQUARE TOWER, 7 TIMES SQ, STE 3502
NEW YORK
NY
10036
0
0
1
0
0001192212
Chambon Philippe O.
C/O NEW LEAF VENTURES
TIMES SQUARE TOWER, 7 TIMES SQ, STE 3502
NEW YORK
NY
10036
0
0
1
0
0001231092
NIEDEL JAMES
C/O NEW LEAF VENTURES
TIMES SQUARE TOWER, 7 TIMES SQ, STE 3502
NEW YORK
NY
10036
0
0
1
0
0001247851
HUNT RONALD
C/O NEW LEAF VENTURES
TIMES SQUARE TOWER, 7 TIMES SQ, STE 3502
NEW YORK
NY
10036
0
0
1
0
0001340806
Lathi Vijay K
C/O NEW LEAF VENTURES
1200 PARK PLACE, SUITE 300
SAN MATEO
CA
94043
0
0
1
0
0001441563
Delagardelle Jeani
C/O NEW LEAF VENTURES
1200 PARK PLACE, SUITE 300
SAN MATEO
CA
94043
0
0
1
0
0001547100
Ratcliffe Liam
C/O NEW LEAF VENTURES
TIMES SQUARE TOWER, 7 TIMES SQ, STE 3502
NEW YORK
NY
10036
0
0
1
0
Common Stock
15291
D
Series B Preferred Stock
Common Stock
442478
D
Series C Preferred Stock
Common Stock
77522
D
Reflects a 1-for-5.65 reverse stock split effected on January 29, 2014.
Represents shares directly beneficially owned by New Leaf Ventures II, L.P. ("NLV II"). New Leaf Venture Associates II, L.P. ("NLV Associates II") is the general partner of NLV II and New Leaf Venture Management II, L.L.C. ("NLV Management II") is the general partner of NLV Associates II. Philippe O. Chambon, Jeani Delagardelle, Ronald Hunt, Vijay Lathi, James Niedel and Liam Ratcliffe are the individual managers of NLV Management II (the "Individual Managers"). NLV Associates II and NLV Management II disclaim beneficial ownership of such shares, except to the extent of their pecuniary interest therein. As one of six individual managers, each of the Individual Managers disclaims beneficial ownership over the shares reported herein, and in all events disclaims pecuniary interest except to the extent of his economic interest.
Convertible into Common Stock on a 1-for-5.65 basis without payment of further consideration. Each share will automatically convert into 0.176991 shares of Common Stock upon the closing of the Issuer's initial public offering.
/s/ Craig L. Slutzkin, Chief Financial Officer of New Leaf Venture Management I, L.L.C., the sole general partner of New Leaf Venture Management I, L.P., the sole general partner of New Leaf Ventures I, L.P.
2014-02-12
/s/ Craig L. Slutzkin, Chief Financial Officer of New Leaf Venture Management I, L.L.C., the sole general partner of New Leaf Venture Management I, L.P.
2014-02-12
/s/ Craig L. Slutzkin, Chief Financial Officer of New Leaf Venture Management I, L.L.C.
2014-02-12
/s/ Craig L. Slutzkin, as Attorney-in-Fact for Philippe O. Chambon
2014-02-12
/s/ Craig L. Slutzkin, as Attorney-in-Fact for James Niedel
2014-02-12
/s/ Craig L. Slutzkin, as Attorney-in-Fact for Ronald Hunt
2014-02-12
/s/ Craig L. Slutzkin, as Attorney-in-Fact for Vijay Lathi
2014-02-12
/s/ Craig L. Slutzkin, as Attorney-in-Fact for Jeani Delagardelle
2014-02-12
/s/ Craig L. Slutzkin, as Attorney-in-Fact for Liam Ratcliffe
2014-02-12