0000899243-19-020582.txt : 20190730 0000899243-19-020582.hdr.sgml : 20190730 20190730163259 ACCESSION NUMBER: 0000899243-19-020582 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20190729 FILED AS OF DATE: 20190730 DATE AS OF CHANGE: 20190730 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: SHAPIRO LEE CENTRAL INDEX KEY: 0001213350 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-38983 FILM NUMBER: 19985886 MAIL ADDRESS: STREET 1: C/O ALLSCRIPTS HEALTCHARE SOLUTIONS STREET 2: 2401 COMMERCE DR CITY: LIBERTYVILLE STATE: IL ZIP: 60048 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: Livongo Health, Inc. CENTRAL INDEX KEY: 0001639225 STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-MISC HEALTH & ALLIED SERVICES, NEC [8090] IRS NUMBER: 263542036 STATE OF INCORPORATION: DE BUSINESS ADDRESS: STREET 1: 150 W. EVELYN AVE. CITY: MOUNTAIN VIEW STATE: CA ZIP: 94041 BUSINESS PHONE: 1(866)435-5643 MAIL ADDRESS: STREET 1: 150 W. EVELYN AVE. CITY: MOUNTAIN VIEW STATE: CA ZIP: 94041 4 1 doc4.xml FORM 4 SUBMISSION X0306 4 2019-07-29 0 0001639225 Livongo Health, Inc. LVGO 0001213350 SHAPIRO LEE C/O LIVONGO HEALTH, INC. 150 WEST EVELYN AVENUE, SUITE 150 MOUNTAIN VIEW CA 94041 0 1 0 0 Chief Financial Officer Common Stock 2019-07-29 4 C 0 745093 A 1159901 I See footnote. Common Stock 2019-07-29 4 C 0 285131 A 285131 I See footnote. Common Stock 2019-07-29 4 C 0 361718 A 361718 I See footnote. Common Stock 2019-07-29 4 C 0 400528 A 400528 I See footnote. Common Stock 2019-07-29 4 C 0 60000 A 60000 I See footnote. Common Stock 1984865 D Common Stock 3373987 I See footnote. Series A Convertible Preferred Stock 2019-07-29 4 C 0 3506 D Common Stock 3506 0 I See footnote. Series C Convertible Preferred Stock 2019-07-29 4 C 0 2104 D Common Stock 2104 0 I See footnote. Series C Convertible Preferred Stock 2019-07-29 4 C 0 285131 D Common Stock 285131 0 I See footnote. Series D Convertible Preferred Stock 2019-07-29 4 C 0 250800 D Common Stock 250800 0 I See footnote. Series D Convertible Preferred Stock 2019-07-29 4 C 0 361718 D Common Stock 361718 0 I See footnote. Series E Convertible Preferred Stock 2019-07-29 4 C 0 488683 D Common Stock 488683 0 I See footnote. Series E Convertible Preferred Stock 2019-07-29 4 C 0 400528 D Common Stock 400528 0 I See footnote. Series E Convertible Preferred Stock 2019-07-29 4 C 0 60000 D Common Stock 60000 0 I See footnote. Each share of Series A Convertible Preferred Stock automatically converted into Common Stock on a 1:1 basis immediately prior to the closing of the Issuer's initial public offering of Common Stock and had no expiration date. The shares are held of record by 7Wire Ventures Fund, L.P., or 7Wire LP. The reporting person serves as a Manager of 7Wire Management, LLC, or 7Wire Management, the Manager of 7Wire LP. The reporting person disclaims beneficial ownership of these securities, and this report shall not be deemed an admission that the reporting person is the beneficial owner of the securities for purposes of Section 16 or for any other purpose. Each share of Series C Convertible Preferred Stock automatically converted into Common Stock on a 1:1 basis immediately prior to the closing of the Issuer's initial public offering of Common Stock and had no expiration date. The shares are held of record by 7Wire Ventures LLC - Series Livongo C. The reporting person serves as a Manager of 7Wire Management, the Manager of 7Wire Ventures LLC - Series Livongo C. The reporting person disclaims beneficial ownership of these securities, and this report shall not be deemed an admission that the reporting person is the beneficial owner of the securities for purposes of Section 16 or for any other purpose. Each share of Series D Convertible Preferred Stock automatically converted into Common Stock on a 1:1 basis immediately prior to the closing of the Issuer's initial public offering of Common Stock and had no expiration date. The shares are held of record by 7Wire Ventures LLC - Series Livongo D. The reporting person serves as a Manager of 7Wire Management, the Manager of 7Wire Ventures LLC - Series Livongo D. The reporting person disclaims beneficial ownership of these securities, and this report shall not be deemed an admission that the reporting person is the beneficial owner of the securities for purposes of Section 16 or for any other purpose. Each share of Series E Convertible Preferred Stock automatically converted into Common Stock on a 1:1 basis immediately prior to the closing of the Issuer's initial public offering of Common Stock and had no expiration date. The shares are held of record by 7Wire Ventures LLC - Series Livongo E. The reporting person serves as a Manager of 7Wire Management, the Manager of 7Wire Ventures LLC - Series Livongo E. The reporting person disclaims beneficial ownership of these securities, and this report shall not be deemed an admission that the reporting person is the beneficial owner of the securities for purposes of Section 16 or for any other purpose. The shares are held of record by 7Wire Ventures Wanxiang Strategic Fund I, LLC, or 7Wire Wanxiang. The reporting person serves as a Manager of 7Wire Management, the Manager of 7Wire Wanxiang. The reporting person disclaims beneficial ownership of these securities, and this report shall not be deemed an admission that the reporting person is the beneficial owner of the securities for purposes of Section 16 or for any other purpose. The shares are held of record by 7Wire Ventures LLC-Series EosHealth. The reporting person serves as a Manager of 7Wire Management, the Manager of 7Wire Ventures LLC-Series EosHealth. The reporting person disclaims beneficial ownership of these securities, and this report shall not be deemed an admission that the reporting person is the beneficial owner of the securities for purposes of Section 16 or for any other purpose. /s/ Erica Palsis, by power of attorney 2019-07-30