0001209191-23-052381.txt : 20231006 0001209191-23-052381.hdr.sgml : 20231006 20231006194851 ACCESSION NUMBER: 0001209191-23-052381 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20231004 FILED AS OF DATE: 20231006 DATE AS OF CHANGE: 20231006 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: LEVIN RICHARD C CENTRAL INDEX KEY: 0001255200 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-39744 FILM NUMBER: 231315255 MAIL ADDRESS: STREET 1: C/O C3.AI, INC. STREET 2: 1400 SEAPORT BLVD CITY: REDWOOD CITY STATE: CA ZIP: 94063 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: C3.ai, Inc. CENTRAL INDEX KEY: 0001577526 STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-PREPACKAGED SOFTWARE [7372] IRS NUMBER: 263999357 STATE OF INCORPORATION: DE FISCAL YEAR END: 0430 BUSINESS ADDRESS: STREET 1: 1400 SEAPORT BLVD CITY: REDWOOD CITY STATE: CA ZIP: 94063 BUSINESS PHONE: 650-503-2200 MAIL ADDRESS: STREET 1: 1400 SEAPORT BLVD CITY: REDWOOD CITY STATE: CA ZIP: 94063 FORMER COMPANY: FORMER CONFORMED NAME: C3 IoT, Inc. DATE OF NAME CHANGE: 20180123 FORMER COMPANY: FORMER CONFORMED NAME: C3, Inc. DATE OF NAME CHANGE: 20130522 4 1 doc4.xml FORM 4 SUBMISSION X0508 4 2023-10-04 0 0001577526 C3.ai, Inc. AI 0001255200 LEVIN RICHARD C C/O C3.AI, INC. 1400 SEAPORT BLVD REDWOOD CITY CA 94063 1 0 0 0 0 Stock Option (Right to Buy) 24.11 2023-10-04 4 A 0 22795 0.00 A 2033-10-03 Class A Common Stock 22795 22795 D Provided the Reporting Person remains a director of the Company and attends in person the regularly scheduled meeting of the Board during each fiscal quarter, commencing on October 4, 2023 (the "Vesting Commencement Date"), then 5% of the shares subject to the option shall vest on the last day of such fiscal quarter (the "Quarterly Shares") during the term of the option, provided, however, if the Reporting Person fails to attend any such regularly scheduled meeting, then vesting for the Quarterly Shares shall not occur and will be suspended (any such suspended Quarterly Shares being referred to collectively as the "Suspended Shares"). For any Suspended Shares, if any, equal to 5% of the shares subject to the option shall vest only following the fifth anniversary of the effective grant date, if the Reporting Person satisfies the attendance requirements in subsequent periods. /s/ Eric Jensen, Attorney-in-Fact 2023-10-06