0001209191-21-007838.txt : 20210204 0001209191-21-007838.hdr.sgml : 20210204 20210204175518 ACCESSION NUMBER: 0001209191-21-007838 CONFORMED SUBMISSION TYPE: 3 PUBLIC DOCUMENT COUNT: 2 CONFORMED PERIOD OF REPORT: 20210204 FILED AS OF DATE: 20210204 DATE AS OF CHANGE: 20210204 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: ENGLEMAN EDGAR CENTRAL INDEX KEY: 0001227162 FILING VALUES: FORM TYPE: 3 SEC ACT: 1934 Act SEC FILE NUMBER: 001-39988 FILM NUMBER: 21592496 MAIL ADDRESS: STREET 1: 575 HIGH STREET STREET 2: STE 201 CITY: PALO ALTO STATE: CA ZIP: 94301 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: Bolt Biotherapeutics, Inc. CENTRAL INDEX KEY: 0001641281 STANDARD INDUSTRIAL CLASSIFICATION: PHARMACEUTICAL PREPARATIONS [2834] IRS NUMBER: 472804636 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 900 CHESAPEAKE DRIVE CITY: REDWOOD CITY STATE: CA ZIP: 94063 BUSINESS PHONE: 650-665-9295 MAIL ADDRESS: STREET 1: 900 CHESAPEAKE DRIVE CITY: REDWOOD CITY STATE: CA ZIP: 94063 FORMER COMPANY: FORMER CONFORMED NAME: Bolt Therapeutics, Inc. DATE OF NAME CHANGE: 20150504 3 1 doc3.xml FORM 3 SUBMISSION X0206 3 2021-02-04 0 0001641281 Bolt Biotherapeutics, Inc. BOLT 0001227162 ENGLEMAN EDGAR C/O BOLT BIOTHERAPEUTICS, INC. 900 CHESAPEAKE DRIVE REDWOOD CITY CA 94063 1 0 1 0 Common Stock 577425 I By Engleman Family Trust Common Stock 321428 I By The Erik Nathan Engleman Irrevocable Trust dated December 06, 2012 Common Stock 321428 I By The Jason Engleman Irrevocable GST Trust dated December 06, 2012 Common Stock 25104 I By Vivo Capital Fund VIII, L.P. Common Stock 3466 I By Vivo Capital Surplus Fund VIII, L.P. Series Seed Preferred Stock 0.00 Common Stock 57946 I By Engleman Family Trust Series B Preferred Stock 0.00 Common Stock 1092080 I By Vivo Capital Fund VIII, L.P. Series C-1 Preferred Stock 0.00 Common Stock 317922 I By Vivo Capital Fund VIII, L.P. Series C-2 Preferred Stock 0.00 Common Stock 345568 I By Vivo Capital Fund VIII, L.P. Warrant (Right to Buy) 0.00 2028-07-26 Common Stock 40953 I By Vivo Capital Fund VIII, L.P. Series B Preferred Stock 0.00 Common Stock 150802 I By Vivo Capital Surplus Fund VIII, L.P. Series C-1 Preferred Stock 0.00 Common Stock 43901 I By Vivo Capital Surplus Fund VIII, L.P. Series C-2 Preferred Stock 0.00 Common Stock 47718 I By Vivo Capital Surplus Fund VIII, L.P. Warrant (Right to Buy) 0.00 2028-07-26 Common Stock 5655 I By Vivo Capital Surplus Fund VIII, L.P. The Reporting Person is trustee of the Engleman Family Trust. The Reporting Person's spouse is trustee of The Erik Nathan Engleman Irrevocable Trust dated December 06, 2012. The Reporting Person's spouse is trustee of The Jason Engleman Irrevocable GST Trust dated December 06, 2012. The securities reported herein are held of record by Vivo Capital Fund VIII, L.P. Vivo Capital VIII, LLC is the general partner of Vivo Capital Fund VIII, L.P. The Reporting Person is one of three voting members of Vivo Capital VIII, LLC and may be deemed to have shared voting and dispositive power over the shares held by Vivo Capital Fund VIII, L.P. The Reporting Person disclaims beneficial ownership over such shares except to the extent of his pecuniary interest therein. The securities reported herein are held of record by Vivo Capital Surplus Fund VIII, L.P. Vivo Capital VIII, LLC is the general partner of Vivo Capital Surplus Fund VIII, L.P. The Reporting Person is one of three voting members of Vivo Capital VIII, LLC and may be deemed to have shared voting and dispositive power over the shares held by Vivo Capital Surplus Fund VIII, L.P. The Reporting Person disclaims beneficial ownership over such shares except to the extent of his pecuniary interest therein. The Series Seed Preferred Stock has no expiration date and is convertible into shares of Common Stock of the Issuer at the option of the holder. The shares of Series Seed Preferred Stock will automatically convert into shares of Common Stock of the Issuer on a 1-to-1 basis upon closing of the initial public offering of the Issuer (the "IPO"). The Series B Preferred Stock has no expiration date and is convertible into shares of Common Stock of the Issuer at the option of the holder. The shares of Series B Preferred Stock will automatically convert into shares of Common Stock of the Issuer on a 1-to-1 basis upon closing of the IPO. The Series C-1 Preferred Stock has no expiration date and is convertible into shares of Common Stock of the Issuer at the option of the holder. The shares of Series C-1 Preferred Stock will automatically convert into shares of Common Stock of the Issuer on a 1-to-1 basis upon closing of the IPO. The Series C-2 Preferred Stock has no expiration date and is convertible into shares of Common Stock of the Issuer at the option of the holder. The shares of Series C-2 Preferred Stock will automatically convert into shares of Common Stock of the Issuer on a 1-to-1 basis upon closing of the IPO. The shares subject to this warrant are fully vested. This warrant will automatically be net exercised upon closing of the IPO if it is not exercised on or before such date. Exhibit 24 - Power of Attorney /s/ Brian Woodard, Attorney-in-Fact 2021-02-04 EX-24 2 attachment1.htm EX-24 DOCUMENT

POWER OF ATTORNEY
Know all by these presents that the undersigned hereby constitutes and appoints
each of William Quinn of Bolt Biotherapeutics, Inc. (the "Company") and John
McKenna, Julia Stark, Colleen Badgley, Michael Perretta, Tess Morgan and Brian
Woodard of Cooley LLP, signing individually, the undersigned's true and lawful
attorneys-in fact and agents to:
(1) prepare, execute in the undersigned's name and on the undersigned's behalf,
and submit to the Securities and Exchange Commission (the "SEC") a Form ID,
including amendments thereto, and any other documents necessary or appropriate
to obtain 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 or any rule or regulation thereunder;

(2) prepare, execute in the undersigned's name and on the undersigned's behalf,
and submit to the SEC Forms 3, 4 and 5 (including amendments thereto and joint
filing agreements in connection therewith) in accordance with Section 16(a) of
the Securities Exchange Act of 1934 and the rules thereunder;

(3) do and perform any and all acts for and on behalf of the undersigned that
may be necessary or desirable to prepare and execute any such Form 3, 4 or 5
(including amendments thereto and joint filing agreements in connection
therewith) and file such Forms with the SEC and any stock exchange,
self-regulatory association or any other authority; and

(4) take any other action of any type whatsoever in connection with the
foregoing that, in the opinion of such attorney-in-fact, may be of benefit to,
in the best interest of, or legally required of the undersigned, it being
understood that the documents executed by the 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 the attorney-in-fact may approve in the
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 or revocation,
hereby ratifying and confirming all that such attorney-in-fact, or such
attorney-in-fact's 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 attorney-in-fact, and
their substitutes, 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.

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 the Company,
unless earlier revoked by the undersigned in a signed writing delivered to the
Company and the attorneys-in-fact.

IN WITNESS WHEREOF, the undersigned has caused this Power of Attorney to be
executed as of the date written below.

Dated: January 15, 2021


By: /s/ Edgar G. Engleman 		Edgar G. Engleman
	Signature 			Printed Name