0001104659-19-029735.txt : 20190515
0001104659-19-029735.hdr.sgml : 20190515
20190515161859
ACCESSION NUMBER: 0001104659-19-029735
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20190513
FILED AS OF DATE: 20190515
DATE AS OF CHANGE: 20190515
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Flagship Ventures Fund IV General Partner LLC
CENTRAL INDEX KEY: 0001508051
STATE OF INCORPORATION: DE
FISCAL YEAR END: 1231
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-38901
FILM NUMBER: 19828468
BUSINESS ADDRESS:
STREET 1: 55 CAMBRIDGE PARKWAY, SUITE 800E
CITY: CAMBRIDGE
STATE: MA
ZIP: 02142
BUSINESS PHONE: 617-868-1888
MAIL ADDRESS:
STREET 1: 55 CAMBRIDGE PARKWAY, SUITE 800E
CITY: CAMBRIDGE
STATE: MA
ZIP: 02142
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Flagship Ventures Fund IV, L.P.
CENTRAL INDEX KEY: 0001503559
STATE OF INCORPORATION: DE
FISCAL YEAR END: 1231
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-38901
FILM NUMBER: 19828469
BUSINESS ADDRESS:
STREET 1: 55 CAMBRIDGE PARKWAY, 8TH FLOOR
CITY: CAMBRIDGE
STATE: MA
ZIP: 02142
BUSINESS PHONE: 617-868-1888
MAIL ADDRESS:
STREET 1: 55 CAMBRIDGE PARKWAY, 8TH FLOOR
CITY: CAMBRIDGE
STATE: MA
ZIP: 02142
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Flagship Ventures Fund IV-Rx, L.P.
CENTRAL INDEX KEY: 0001590973
STATE OF INCORPORATION: DE
FISCAL YEAR END: 1231
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-38901
FILM NUMBER: 19828470
BUSINESS ADDRESS:
STREET 1: 55 CAMBRIDGE PARKWAY, 8TH FLOOR
CITY: CAMBRIDGE
STATE: MA
ZIP: 02142
BUSINESS PHONE: 617-868-1888
MAIL ADDRESS:
STREET 1: 55 CAMBRIDGE PARKWAY, 8TH FLOOR
CITY: CAMBRIDGE
STATE: MA
ZIP: 02142
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Flagship VentureLabs IV, LLC
CENTRAL INDEX KEY: 0001642578
STATE OF INCORPORATION: DE
FISCAL YEAR END: 1231
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-38901
FILM NUMBER: 19828471
BUSINESS ADDRESS:
STREET 1: 55 CAMBRIDGE PARKWAY, 8TH FLOOR
CITY: CAMBRIDGE
STATE: MA
ZIP: 02143
BUSINESS PHONE: 617-868-1888
MAIL ADDRESS:
STREET 1: 55 CAMBRIDGE PARKWAY, 8TH FLOOR
CITY: CAMBRIDGE
STATE: MA
ZIP: 02143
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: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-38901
FILM NUMBER: 19828472
BUSINESS ADDRESS:
STREET 1: 55 CAMBRIDGE PARKWAY, SUITE 800E
CITY: CAMBRIDGE
STATE: MA
ZIP: 02142
BUSINESS PHONE: 617-868-1888
MAIL ADDRESS:
STREET 1: 55 CAMBRIDGE PARKWAY, SUITE 800E
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: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-38901
FILM NUMBER: 19828473
BUSINESS ADDRESS:
STREET 1: 55 CAMBRIDGE PARKWAY, 8TH FLOOR
CITY: CAMBRIDGE
STATE: MA
ZIP: 02142
BUSINESS PHONE: 617-868-1888
MAIL ADDRESS:
STREET 1: 55 CAMBRIDGE PARKWAY, 8TH FLOOR
CITY: CAMBRIDGE
STATE: MA
ZIP: 02142
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Flagship Ventures Opportunities Fund I General Partner LLC
CENTRAL INDEX KEY: 0001725004
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-38901
FILM NUMBER: 19828474
BUSINESS ADDRESS:
STREET 1: 55 CAMBRIDGE PARKWAY
STREET 2: SUITE 800E
CITY: CAMBRIDGE
STATE: MA
ZIP: 02142
BUSINESS PHONE: 617-868-1888
MAIL ADDRESS:
STREET 1: 55 CAMBRIDGE PARKWAY
STREET 2: SUITE 800E
CITY: CAMBRIDGE
STATE: MA
ZIP: 02142
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Flagship Ventures Opportunities Fund I, L.P.
CENTRAL INDEX KEY: 0001677345
STATE OF INCORPORATION: DE
FISCAL YEAR END: 1231
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-38901
FILM NUMBER: 19828475
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: AFEYAN NOUBAR
CENTRAL INDEX KEY: 0001222012
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-38901
FILM NUMBER: 19828476
MAIL ADDRESS:
STREET 1: 1 SUNSET RIDGE
CITY: LEXINGTON
STATE: MA
ZIP: 02173
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: KANIA EDWIN M JR
CENTRAL INDEX KEY: 0001255927
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-38901
FILM NUMBER: 19828477
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: Axcella Health Inc.
CENTRAL INDEX KEY: 0001633070
STANDARD INDUSTRIAL CLASSIFICATION: BIOLOGICAL PRODUCTS (NO DIAGNOSTIC SUBSTANCES) [2836]
IRS NUMBER: 000000000
STATE OF INCORPORATION: DE
FISCAL YEAR END: 1231
BUSINESS ADDRESS:
STREET 1: 840 MEMORIAL DRIVE
STREET 2: THIRD FLOOR
CITY: CAMBRIDGE
STATE: MA
ZIP: 02139
BUSINESS PHONE: 617-868-0949
MAIL ADDRESS:
STREET 1: 840 MEMORIAL DRIVE
STREET 2: THIRD FLOOR
CITY: CAMBRIDGE
STATE: MA
ZIP: 02139
FORMER COMPANY:
FORMER CONFORMED NAME: Pronutria Biosciences, Inc.
DATE OF NAME CHANGE: 20150206
4
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a4.xml
4
X0306
4
2019-05-13
0
0001633070
Axcella Health Inc.
AXLA
0001508051
Flagship Ventures Fund IV General Partner LLC
55 CAMBRIDGE PARKWAY, SUITE 800E
CAMBRIDGE
MA
02142
0
0
1
0
0001503559
Flagship Ventures Fund IV, L.P.
55 CAMBRIDGE PARKWAY, SUITE 800E
CAMBRIDGE
MA
02142
0
0
1
0
0001590973
Flagship Ventures Fund IV-Rx, L.P.
55 CAMBRIDGE PARKWAY, SUITE 800E
CAMBRIDGE
MA
02142
0
0
1
0
0001642578
Flagship VentureLabs IV, LLC
55 CAMBRIDGE PARKWAY, SUITE 800E
CAMBRIDGE
MA
02142
0
0
1
0
0001508053
Flagship Ventures 2007 General Partner LLC
55 CAMBRIDGE PARKWAY, SUITE 800E
CAMBRIDGE
MA
02142
0
0
1
0
0001508052
Flagship Ventures Fund 2007, L.P.
55 CAMBRIDGE PARKWAY, SUITE 800E
CAMBRIDGE
MA
02142
0
0
1
0
0001725004
Flagship Ventures Opportunities Fund I General Partner LLC
55 CAMBRIDGE PARKWAY, SUITE 800E
CAMBRIDGE
MA
02142
0
0
1
0
0001677345
Flagship Ventures Opportunities Fund I, L.P.
55 CAMBRIDGE PARKWAY, SUITE 800E
CAMBRIDGE
MA
02142
0
0
1
0
0001222012
AFEYAN NOUBAR
55 CAMBRIDGE PARKWAY, SUITE 800E
CAMBRIDGE
MA
02142
0
0
1
0
0001255927
KANIA EDWIN M JR
55 CAMBRIDGE PARKWAY, SUITE 800E
CAMBRIDGE
MA
02142
0
0
1
0
Common Stock
678610
I
See Footnote
Common Stock
2035830
I
See Footnote
Common Stock
2019-05-13
4
C
0
751691
A
1430301
I
See Footnote
Common Stock
2019-05-13
4
C
0
2255074
A
2255074
I
See Footnote
Common Stock
2019-05-13
4
C
0
209933
A
1640234
I
See Footnote
Common Stock
2019-05-13
4
C
0
503840
A
2758914
I
See Footnote
Common Stock
2019-05-13
4
C
0
545826
A
545826
I
See Footnote
Common Stock
2019-05-13
4
C
0
120795
A
1761029
I
See Footnote
Common Stock
2019-05-13
4
C
0
335457
A
3094371
I
See Footnote
Common Stock
2019-05-13
4
C
0
82324
A
628150
I
See Footnote
Common Stock
2019-05-13
4
C
0
194409
A
3288780
I
See Footnote
Common Stock
2019-05-13
4
C
0
48602
A
676752
I
See Footnote
Common Stock
2019-05-13
4
C
0
486023
A
486023
I
See Footnote
Common Stock
2019-05-13
4
P
0
500000
20
A
986023
I
See Footnote
Series A Preferred Stock
2019-05-13
4
C
0
1384615
D
Common Stock
751691
0
I
See Footnote
Series A Preferred Stock
2019-05-13
4
C
0
4153847
D
Common Stock
2255074
0
I
See Footnote
Series B Preferred Stock
2019-05-13
4
C
0
386697
D
Common Stock
209933
0
I
See Footnote
Series B Preferred Stock
2019-05-13
4
C
0
928074
D
Common Stock
503840
0
I
See Footnote
Series B Preferred Stock
2019-05-13
4
C
0
1005413
D
Common Stock
545826
0
I
See Footnote
Series C Preferred Stock
2019-05-13
4
C
0
222506
D
Common Stock
120795
0
I
See Footnote
Series C Preferred Stock
2019-05-13
4
C
0
617914
D
Common Stock
335457
0
I
See Footnote
Series C Preferred Stock
2019-05-13
4
C
0
151643
D
Common Stock
82324
0
I
See Footnote
Series E Preferred Stock
2019-05-13
4
C
0
358102
D
Common Stock
194409
0
I
See Footnote
Series E Preferred Stock
2019-05-13
4
C
0
89525
D
Common Stock
48602
0
I
See Footnote
Series E Preferred Stock
2019-05-13
4
C
0
895255
D
Common Stock
486023
0
I
See Footnote
Shares held by Flagship Ventures Fund 2007, L.P. ("Flagship Fund 2007"). Flagship Ventures 2007 General Partner LLC ("Fund 2007 GP") is the general partner of Flagship Fund 2007. Noubar B. Afeyan, Ph.D. and Edwin M. Kania, Jr. are the managers of Fund 2007 GP. While Mr. Kania is retired from Flagship Pioneering, Inc., he continues to serve as a manager of Flagship 2007 GP. Each of these individuals and entities may be deemed to share voting and investment power with respect to all shares held by Flagship Fund 2007. Each of the reporting persons disclaims beneficial ownership of the shares except to the extent of his or its pecuniary interest therein.
Shares held by Flagship VentureLabs IV, LLC ("VentureLabs IV"). Flagship Ventures Fund IV, L.P. ("Flagship Fund IV") is a member of VentureLabs IV and also serves as its manager. Flagship Ventures Fund IV General Partner LLC ("Flagship Fund IV GP") is the general partner of Flagship Fund IV. Noubar B. Afeyan, Ph.D. and Edwin M. Kania, Jr. are the managers of Flagship Fund IV GP. While Mr. Kania is retired from Flagship Pioneering, Inc., he continues to serve as a manager of Flagship Fund IV GP. Each of these individuals and entities may be deemed to share voting and investment power with respect to all shares held by VentureLabs IV. Each of the filing persons disclaims beneficial ownership of the shares except to the extent of his or its pecuniary interest therein.
Each share of Series A Preferred Stock converted into shares of the Issuer's common stock, par value $0.0001 per share ("Common Stock") on a one-for-1.842 basis upon the closing of the Issuer's initial public offering.
Shares held by Flagship Fund IV. Flagship Fund IV GP is the general partner of Flagship Fund IV. Noubar B. Afeyan, Ph.D. and Edwin M. Kania, Jr. are the managers of Flagship Fund IV GP. While Mr. Kania is retired from Flagship Pioneering, Inc., he continues to serve as a manager of Flagship Fund IV GP. Each of these individuals and entities may be deemed to share voting and investment power with respect to all shares held by Flagship Fund IV. Each of the reporting persons disclaims beneficial ownership of such shares except to the extent of his or its pecuniary interest therein.
Each share of Series B Preferred Stock converted into shares of the Issuer's Common Stock on a one-for-1.842 basis upon the closing of the Issuer's initial public offering.
Shares held by Flagship Ventures Fund IV-Rx, L.P. ("Flagship Fund IV-Rx"). Flagship Fund IV GP is the general partner of Flagship Fund IV-Rx. Noubar B. Afeyan, Ph.D. and Edwin M. Kania, Jr. are the managers of Flagship Fund IV GP. While Mr. Kania is retired from Flagship Pioneering, Inc., he continues to serve as a manager of Flagship Fund IV GP. Each of these individuals and entities may be deemed to share voting and investment power with respect to all shares held by Flagship Fund IV-Rx. Each of the reporting persons disclaims beneficial ownership of such shares except to the extent of his or its pecuniary interest therein.
Each share of Series C Preferred Stock converted into shares of the Issuer's Common Stock on a one-for-1.842 basis upon the closing of the Issuer's initial public offering.
Each share of Series E Preferred Stock converted into shares of the Issuer's Common Stock on a one-for-1.842 basis upon the closing of the Issuer's initial public offering.
Shares held by Flagship Ventures Opportunities Fund I, L.P. ("Flagship Opportunities I"). Flagship Ventures Opportunities Fund I General Partner LLC ("Flagship Opportunities GP") is the general partner of Flagship Opportunities I. Noubar B. Afeyan, Ph.D. serves as sole manager of Flagship Opportunities GP and may be deemed to possess sole voting and investment power with respect to all shares held by Flagship Opportunities I. Each of the reporting persons disclaims beneficial ownership of the shares except to the extent of his or its pecuniary interest therein.
Flagship Ventures Fund IV General Partner LLC, By: /s/ Noubar B. Afeyan, Ph.D., Name: Noubar B. Afeyan, Ph.D., Title: Manager
2019-05-15
Flagship Ventures Fund IV, L.P., By: Flagship Ventures Fund IV General Partner LLC, its general partner, By: /s/ Noubar B. Afeyan, Ph.D., Name: Noubar B. Afeyan, Ph.D., Title: Manager
2019-05-15
Flagship Ventures Fund IV-Rx, L.P., By: Flagship Ventures Fund IV General Partner LLC, its general partner, By: /s/ Noubar B. Afeyan, Ph.D., Name: Noubar B. Afeyan, Ph.D., Title: Manager
2019-05-15
Flagship VentureLabs IV LLC, By: Flagship Ventures Fund IV, L.P., its manager, By: Flagship Ventures Fund IV General Partner LLC, its general partner, By: /s/ Noubar B. Afeyan, Ph.D., Name: Noubar B. Afeyan, Ph.D., Title: Manager
2019-05-15
Flagship Ventures 2007 General Partner LLC, By: /s/ Noubar B. Afeyan, Ph.D., Name: Noubar B. Afeyan, Ph.D., Title: Manager
2019-05-15
Flagship Ventures Fund 2007, L.P., By: Flagship Ventures 2007 General Partner LLC, its general partner, By: /s/ Noubar B. Afeyan, Ph.D., Name: Noubar B. Afeyan, Ph.D., Title: Manager
2019-05-15
Flagship Ventures Opportunities Fund I General Partner LLC, By: /s/ Noubar B. Afeyan, Ph.D., Name: Noubar B. Afeyan, Ph.D., Title: Manager
2019-05-15
Flagship Ventures Opportunities Fund I, L.P. By: Flagship Ventures Opportunities Fund I General Partner LLC, its general partner, By: /s/ Noubar B. Afeyan, Ph.D., Name: Noubar B. Afeyan, Ph.D., Title: Manager
2019-05-15
Noubar B. Afeyan, Ph.D. By: /s/ Noubar B. Afeyan, Ph.D.
2019-05-15
Edwin M. Kania, Jr. By: /s/ Edwin M. Kania, Jr.
2019-05-15