0001209191-15-034081.txt : 20150414
0001209191-15-034081.hdr.sgml : 20150414
20150414182024
ACCESSION NUMBER: 0001209191-15-034081
CONFORMED SUBMISSION TYPE: 3
PUBLIC DOCUMENT COUNT: 2
CONFORMED PERIOD OF REPORT: 20150407
FILED AS OF DATE: 20150414
DATE AS OF CHANGE: 20150414
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: Foundation Medicine, Inc.
CENTRAL INDEX KEY: 0001488613
STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-MEDICAL LABORATORIES [8071]
IRS NUMBER: 271316416
STATE OF INCORPORATION: DE
FISCAL YEAR END: 1231
BUSINESS ADDRESS:
STREET 1: 150 SECOND STREET
CITY: CAMBRIDGE
STATE: MA
ZIP: 02141
BUSINESS PHONE: 617-418-2200
MAIL ADDRESS:
STREET 1: 150 SECOND STREET
CITY: CAMBRIDGE
STATE: MA
ZIP: 02141
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: O'Day Daniel Patrick
CENTRAL INDEX KEY: 0001638643
FILING VALUES:
FORM TYPE: 3
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-36086
FILM NUMBER: 15770171
MAIL ADDRESS:
STREET 1: F. HOFFMANN LA ROCHE AG
STREET 2: GRENZACHERSTRASSE 124
CITY: 4070 BASEL
STATE: V8
ZIP: 00000
3
1
doc3.xml
FORM 3 SUBMISSION
X0206
3
2015-04-07
1
0001488613
Foundation Medicine, Inc.
FMI
0001638643
O'Day Daniel Patrick
C/O FOUNDATION MEDICINE, INC.
150 SECOND STREET
CAMBRIDGE
MA
02141
1
0
0
0
/s/ Robert W. Hesslein, as Attorney-in-Fact for Daniel Patrick O'Day
2015-04-14
EX-24.3_576366
2
poa.txt
POA DOCUMENT
LIMITED POWER OF ATTORNEY FOR SECTION 16 REPORTING OBLIGATIONS
The undersigned hereby constitutes and appoints each of Michael J. Pellini,
M.D., Jason Ryan and Robert W. Hesslein, signing singly, and with full power of
substitution, the undersigned's true and lawful attorney-in-fact to:
(1) execute for and on behalf of the undersigned, in the undersigned's capacity
as an officer and/or director of Foundation Medicine, Inc. (the "Company"), from
time to time the following U.S. Securities and Exchange Commission ("SEC")
forms: (i) Form ID, including any attached documents, to effect the assignment
of codes to the undersigned to be used in the transmission of information to the
SEC using the EDGAR System; (ii) Form 3, Initial Statement of Beneficial
Ownership of Securities, including any attached documents; (iii) Form 4,
Statement of Changes in Beneficial Ownership of Securities, including any
attached documents; (iv) Form 5, Annual Statement of Beneficial Ownership of
Securities in accordance with Section 16(a) of the Securities Exchange Act of
1934, as amended, and the rules thereunder, including any attached documents;
(v) Schedule 13D and (vi) amendments of each thereof, in accordance with the
Securities Exchange Act of 1934, as amended, and the rules thereunder, including
any attached documents;
(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,
Schedule 13D or any amendment(s) thereto, and timely file such form(s) with the
SEC and any securities exchange, national association or similar authority; and
(3) 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 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, in
serving in such capacity at the request of the undersigned, is not assuming, nor
is the Company assuming, any of the undersigned's responsibilities to comply
with Section 16 or Regulation 13D-G of the Securities Exchange Act of 1934, as
amended. The undersigned hereby agrees to indemnify the attorney in fact and
the Company from and against any demand, damage, loss, cost or expense arising
from any false or misleading information provided by the undersigned to the
attorney-in fact.
This Power of Attorney shall remain in full force and effect until the
undersigned is no longer required to file such forms 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
foregoing attorney-in-fact.
IN WITNESS WHEREOF, the undersigned has caused this Power of Attorney to be
executed as of April 1, 2015.
/s/ Daniel Patrick O'Day