0001104659-16-128656.txt : 20160621 0001104659-16-128656.hdr.sgml : 20160621 20160621181853 ACCESSION NUMBER: 0001104659-16-128656 CONFORMED SUBMISSION TYPE: 3 PUBLIC DOCUMENT COUNT: 2 CONFORMED PERIOD OF REPORT: 20160621 FILED AS OF DATE: 20160621 DATE AS OF CHANGE: 20160621 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: SELECTA BIOSCIENCES INC CENTRAL INDEX KEY: 0001453687 STANDARD INDUSTRIAL CLASSIFICATION: PHARMACEUTICAL PREPARATIONS [2834] IRS NUMBER: 000000000 STATE OF INCORPORATION: DE BUSINESS ADDRESS: STREET 1: 480 ARSENAL STREET STREET 2: BUILDING ONE CITY: WATERTOWN STATE: MA ZIP: 02472 BUSINESS PHONE: 617-923-1400 MAIL ADDRESS: STREET 1: 480 ARSENAL STREET STREET 2: BUILDING ONE CITY: WATERTOWN STATE: MA ZIP: 02472 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: KANIA EDWIN M JR CENTRAL INDEX KEY: 0001255927 FILING VALUES: FORM TYPE: 3 SEC ACT: 1934 Act SEC FILE NUMBER: 001-37798 FILM NUMBER: 161725246 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: AFEYAN NOUBAR CENTRAL INDEX KEY: 0001222012 FILING VALUES: FORM TYPE: 3 SEC ACT: 1934 Act SEC FILE NUMBER: 001-37798 FILM NUMBER: 161725247 MAIL ADDRESS: STREET 1: 1 SUNSET RIDGE CITY: LEXINGTON STATE: MA ZIP: 02173 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Flagship Ventures 2007 General Partner LLC CENTRAL INDEX KEY: 0001508053 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 3 SEC ACT: 1934 Act SEC FILE NUMBER: 001-37798 FILM NUMBER: 161725248 BUSINESS ADDRESS: STREET 1: ONE MEMORIAL DRIVE STREET 2: 7TH FLOOR CITY: CAMBRIDGE STATE: MA ZIP: 02142 BUSINESS PHONE: 617-868-1888 MAIL ADDRESS: STREET 1: ONE MEMORIAL DRIVE STREET 2: 7TH FLOOR CITY: CAMBRIDGE STATE: MA ZIP: 02142 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Flagship Ventures Fund 2007, L.P. CENTRAL INDEX KEY: 0001508052 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 3 SEC ACT: 1934 Act SEC FILE NUMBER: 001-37798 FILM NUMBER: 161725249 BUSINESS ADDRESS: STREET 1: ONE MEMORIAL DRIVE STREET 2: 7TH FLOOR CITY: CAMBRIDGE STATE: MA ZIP: 02142 BUSINESS PHONE: 617-868-1888 MAIL ADDRESS: STREET 1: ONE MEMORIAL DRIVE STREET 2: 7TH FLOOR CITY: CAMBRIDGE STATE: MA ZIP: 02142 3 1 a3.xml 3 X0206 3 2016-06-21 0 0001453687 SELECTA BIOSCIENCES INC SELB 0001508052 Flagship Ventures Fund 2007, L.P. ONE MEMORIAL DRIVE, 7TH FLOOR CAMBRIDGE MA 02142 1 0 1 0 0001508053 Flagship Ventures 2007 General Partner LLC ONE MEMORIAL DRIVE, 7TH FLOOR CAMBRIDGE MA 02142 1 0 1 0 0001222012 AFEYAN NOUBAR ONE MEMORIAL DRIVE, 7TH FLOOR CAMBRIDGE MA 02142 1 0 1 0 0001255927 KANIA EDWIN M JR ONE MEMORIAL DRIVE, 7TH FLOOR CAMBRIDGE MA 02142 1 0 1 0 Common Stock 31115 I See Footnote Series A Convertible Preferred Stock Common Stock 318752 I See Footnote Series B Convertible Preferred Stock Common Stock 631458 I See Footnote Series C Convertible Preferred Stock Common Stock 235042 I See Footnote Series D Convertible Preferred Stock Common Stock 241718 I See Footnote Series E Convertible Preferred Stock Common Stock 125008 I See Footnote Common Warrants 17.55 2015-07-24 2018-07-24 Common Stock 20262 I See Footnote Held by Flagship Ventures Fund 2007, L.P. ("Flagship 2007"). Flagship Ventures 2007 General Partner LLC ("Flagship 2007 LLC") is the general partner of Flagship 2007. Noubar B. Afeyan, Ph.D. and Edwin M. Kania, Jr. are the managers of Flagship 2007 LLC. Flagship 2007 LLC and each of these individuals may be deemed to share voting and investment power with respect to all shares held by Flagship 2007. Each of the filing persons disclaims beneficial ownership of such shares except to the extent of his or its pecuniary interest therein. The preferred stock is convertible at any time, at the holder's election and has no expiration date. The preferred stock will automatically convert into common stock upon the closing of the Issuer's initial public offering. Exhibit 24 - Power of Attorney Flagship Ventures Fund 2007, L.P., Flagship Ventures 2007 General Partner LLC and Noubar B. Afeyan are directors by deputization based on Edwin M. Kania, Jr.'s position on the Issuer's Board of Directors. FLAGSHIP VENTURES FUND 2007, L.P. By: Flagship Ventures 2007 General Partner LLC By: /s/ Noubar B. Afeyan, Ph.D., Manager 2016-06-21 FLAGSHIP VENTURES 2007 GENERAL PARTNER LLC By: /s/ Noubar B. Afeyan, Ph.D., Manager 2016-06-21 s/ Noubar B. Afeyan, Ph.D. 2016-06-21 /s/ Edwin M. Kania Jr. 2016-06-21 EX-24 2 ex-24.htm EX-24

Ex. 24

 

POWER OF ATTORNEY

 

With respect to holdings of and transactions in securities issued by Selecta Biosciences, Inc. (the “Company”), the undersigned hereby constitutes and appoints the individuals named on Schedule A attached hereto and as may be amended from time to time, or any of them signing singly, with full power of substitution and resubstitution, to act as the undersigned’s true and lawful attorney-in-fact to:

 

1.                                   prepare, execute in the undersigned’s name and on the undersigned’s behalf, and submit    to the United States Securities and Exchange Commission (the “SEC”) a Form ID, including amendments thereto, and any other documents necessary or appropriate to obtain and/or regenerate codes and passwords enabling the undersigned to make electronic filings with the SEC of reports required by Section 16(a) of the Securities Exchange Act of 1934, as amended, or any rule or regulation of the SEC;

 

2.                                   execute for and on behalf of the undersigned, Forms 3, 4, and 5 in accordance with Section 16 of the Securities Exchange Act of 1934, as amended, and the rules thereunder;

 

3.                                   do and perform any and all acts for and on behalf of the undersigned which may be necessary or desirable to complete and execute any such Form 3, 4, or 5, complete and execute any amendment or amendments thereto, and timely file such form with the SEC and any stock exchange or similar authority; and

 

4.                                   take any other action of any type whatsoever in connection with the foregoing which, in the opinion of such attorney-in-fact, may be of benefit to, in the best interest of, or legally required by, the undersigned, it being understood that the documents executed by such attorney-in-fact on behalf of the undersigned 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.

 

The undersigned hereby grants 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 the undersigned might or could do if personally present, with full power of substitution and resubstitution or revocation, hereby ratifying and confirming all that such attorney-in-fact, or such attorneys-in-fact 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.

 

The undersigned acknowledges that the foregoing attorneys-in-fact, in serving in such capacity at the request of the undersigned, are not assuming, nor is the Company assuming, any of the undersigned’s responsibilities to comply with Section 16 of the Securities Exchange Act of 1934, as amended.

 

This Power of Attorney shall remain in full force and effect until the undersigned is no longer required to file Forms 3, 4, and 5 with respect to the undersigned’s holdings of and transactions in securities issued by Selecta Biosciences, Inc., unless earlier revoked by the undersigned in a signed writing delivered to the foregoing attorneys-in-fact..

 


 

IN WITNESS WHEREOF, the undersigned has caused this Power of Attorney to be executed as of this 5th day of June, 2016.

 

 

/s/ Edwin M. Kania, Jr.

 

Signature

 

 

 

Edwin M. Kania, Jr.

 

Printed Name

 

Schedule A

 

Individuals Appointed as Attorney-in-Fact with Full Power of Substitution and Resubstitution

 

David Abraham

 

David Siewers