0001209191-23-017567.txt : 20230309 0001209191-23-017567.hdr.sgml : 20230309 20230309165402 ACCESSION NUMBER: 0001209191-23-017567 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 2 CONFORMED PERIOD OF REPORT: 20220526 FILED AS OF DATE: 20230309 DATE AS OF CHANGE: 20230309 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Modersitzki Blake G CENTRAL INDEX KEY: 0001366065 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-40998 FILM NUMBER: 23720434 MAIL ADDRESS: STREET 1: 2755 EAST COTTONWOOD PARKWAY STREET 2: SUITE 520 CITY: SALT LAKE CITY STATE: UT ZIP: 84121 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: Weave Communications, Inc. CENTRAL INDEX KEY: 0001609151 STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-PREPACKAGED SOFTWARE [7372] IRS NUMBER: 263302902 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 1331 W POWELL WAY CITY: LEHI STATE: UT ZIP: 84043 BUSINESS PHONE: 888-579-5668 MAIL ADDRESS: STREET 1: 1331 W POWELL WAY CITY: LEHI STATE: UT ZIP: 84043 4 1 doc4.xml FORM 4 SUBMISSION X0306 4 2022-05-26 0 0001609151 Weave Communications, Inc. WEAV 0001366065 Modersitzki Blake G 2750 E. COTTONWOOD PARK SUITE 600 SALT LAKE CITY UT 84121 1 0 0 0 Common Stock 2022-05-26 4 A 0 30358 0.00 A 67358 D Common Stock 4535789 I By Pelion Ventures VI, L.P. Common Stock 310138 I By Pelion Ventures VI-A, L.P. Common Stock 530529 I By Pelion Ventures VII, L.P. Common Stock 109323 I By Pelion Ventures VII-A, L.P. Common Stock 59592 I By Pelion Ventures VII-Entrepreneurs Fund, L.P. Represents 30,358 restricted stock units (the "RSUs") granted to the Reporting Person as a director of the Issuer. Each restricted stock unit represents the right to receive one share of the Issuer's Common Stock upon vesting. The RSUs will vest in full on the earlier of (i) May 26, 2023 and (ii) the date of the first annual meeting of the Issuer's stockholders following May 26, 2022. Such grant is exempt from Section 16(b) of the Securities Exchange Act of 1934, as amended, in reliance on Rule 16b-3(d). Pelion Venture Partners VI, L.L.C. ("PVP VI") is the sole general partner of Pelion Ventures VI, L.P. ("PV VI") and Pelion Ventures VI-A, L.P. ("PV VI-A"). The Reporting Person is the managing director of PVP VI and PV VI-A and may be deemed to exercise voting and dispositive power over the shares held by PV VI and PV VI-A. The Reporting Person disclaims beneficial ownership of the shares held by PV VI and PV VI-A except to the extent of his pecuniary interest therein. Pelion Venture Partners VII, L.L.C. ("PVP VII") is the sole general partner of Pelion Ventures VII, L.P. ("PV VII"), Pelion Ventures VII-A, L.P. ("PV VII-A") and Pelion Ventures VII-Entrepreneurs Fund, L.P. ("PV VII-Entrepreneurs") . The Reporting Person is a managing director of PVP VII, PV VII-A and PV VII-Entrepreneurs and may be deemed to share voting and dispositive power over the shares held by PVP VII, PV VII-A and PV VII-Entrepreneurs. The Reporting Person disclaims beneficial ownership of the shares held by PVP VII, PV VII-A and PV VII-Entrepreneurs except to the extent of his pecuniary interest therein. /s/ Erin Goodsell, as Attorney-in-Fact 2023-03-08 EX-24 2 poa.txt POA DOCUMENT POWER OF ATTORNEY The undersigned as a Section 16 reporting person of Weave Communications, Inc. (the "Company"), hereby constitutes and appoints Brett White and Erin Goodsell, and each of them, the undersigned's true and lawful attorney-in-fact to: (1) execute, deliver and file for and on behalf of the undersigned, in the undersigned's capacity as an officer and/or director of the Company, Forms 3, 4, and 5 in accordance with Section 16(a) of the Exchange Act; (2) 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; (3) seek or obtain, as the undersigned's representative and on the undersigned's behalf, information on transactions in the Company's securities from any third party, including brokers, employee benefit plan administrators and trustees, and the undersigned hereby authorizes any such person to release any such information to the undersigned and approves and ratifies any such release of information; 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 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 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 Exchange Act. The undersigned further acknowledges and agrees that the attorney-in-fact and the Company are relying on written and oral information provided by the undersigned to complete such forms and the undersigned is responsible for reviewing the completed forms prior to their filing. The attorney-in-fact and the Company are not responsible for any errors or omissions in such filings. The attorney-in-fact and the Company are not responsible for determining whether or not the transactions reported could be matched with any other transactions for the purpose of determining liability for short-swing profits under Section 16(b). 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 foregoing attorneys-in-fact. IN WITNESS WHEREOF, the undersigned has caused this Power of Attorney to be executed as of 2/27/2023. /s/ Blake G. Modersitzki Name: Blake G Modersitzki