0001209191-18-040039.txt : 20180629 0001209191-18-040039.hdr.sgml : 20180629 20180629163657 ACCESSION NUMBER: 0001209191-18-040039 CONFORMED SUBMISSION TYPE: 3 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20180601 FILED AS OF DATE: 20180629 DATE AS OF CHANGE: 20180629 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Makhzoumi Mohamad CENTRAL INDEX KEY: 0001630226 FILING VALUES: FORM TYPE: 3 SEC ACT: 1934 Act SEC FILE NUMBER: 001-36323 FILM NUMBER: 18929732 MAIL ADDRESS: STREET 1: 2855 SAND HILL ROAD CITY: MENLO PARK STATE: CA ZIP: 94025 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: Achaogen Inc CENTRAL INDEX KEY: 0001301501 STANDARD INDUSTRIAL CLASSIFICATION: PHARMACEUTICAL PREPARATIONS [2834] IRS NUMBER: 680533693 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 7000 SHORELINE COURT STREET 2: SUITE 371 CITY: SOUTH SAN FRANCISCO STATE: CA ZIP: 94080 BUSINESS PHONE: 650-800-3636 MAIL ADDRESS: STREET 1: 7000 SHORELINE COURT STREET 2: SUITE 371 CITY: SOUTH SAN FRANCISCO STATE: CA ZIP: 94080 3 1 doc3.xml FORM 3 SUBMISSION X0206 3 2018-06-01 0 0001301501 Achaogen Inc AKAO 0001630226 Makhzoumi Mohamad 2855 SAND HILL ROAD MENLO PARK CA 94025 0 0 1 0 Common Stock 5215128 I See Note 1 Common Stock Warrants (right to buy) 3.66 2021-06-03 Common Stock 1178782 I See Note 1 The Reporting Person is a manager of NEA 15 GP, LLC, ("NEA 15 GP") which is the sole general partner of NEA Partners 15, L.P. ("NEA Partners 15"). NEA Partners 15 is the sole general partner of New Enterprise Associates 15, L. P. ("NEA 15"). NEA 15 is the sole member of Growth Equity Opportunities Fund IV, LLC ("GEO IV"), which is the direct beneficial owner of the shares. The Reporting Person disclaims beneficial ownership within the meaning of Section 16 of the Securities Exchange Act of 1934, as amended, or otherwise of such portion of the shares held by GEO IV in which the Reporting Person has no pecuniary interest. The Warrants are immediately exercisable upon issuance, however the Warrants may not be exercised to the extent such exercise would cause the holder of such Warrants (together with the holder's affiliates, and any other persons acting as a group together with the holder or any of the holder's affiliates) to beneficially own more than 19.99% of the Common Stock of the Issuer then outstanding. /s/ Sasha Keough, attorney-in-fact 2018-06-29