0000899243-17-026399.txt : 20171115 0000899243-17-026399.hdr.sgml : 20171115 20171115172523 ACCESSION NUMBER: 0000899243-17-026399 CONFORMED SUBMISSION TYPE: 3 PUBLIC DOCUMENT COUNT: 2 CONFORMED PERIOD OF REPORT: 20171115 FILED AS OF DATE: 20171115 DATE AS OF CHANGE: 20171115 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Gerngross Tillman U. CENTRAL INDEX KEY: 0001722061 FILING VALUES: FORM TYPE: 3 SEC ACT: 1934 Act SEC FILE NUMBER: 001-38295 FILM NUMBER: 171206052 MAIL ADDRESS: STREET 1: C/O ARSANIS, INC. STREET 2: 890 WINTER STREET, SUITE 230 CITY: WALTHAM STATE: MA ZIP: 02451 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: Arsanis, Inc. CENTRAL INDEX KEY: 0001501697 STANDARD INDUSTRIAL CLASSIFICATION: BIOLOGICAL PRODUCTS (NO DIAGNOSTIC SUBSTANCES) [2836] IRS NUMBER: 273181608 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 890 WINTER STREET, SUITE 230 CITY: WALTHAM STATE: MA ZIP: 02451 BUSINESS PHONE: 781-819-5704 MAIL ADDRESS: STREET 1: 890 WINTER STREET, SUITE 230 CITY: WALTHAM STATE: MA ZIP: 02451 3 1 doc3.xml FORM 3 SUBMISSION X0206 3 2017-11-15 0 0001501697 Arsanis, Inc. ASNS 0001722061 Gerngross Tillman U. C/O ARSANIS, INC. 890 WINTER STREET, SUITE 230 WALTHAM MA 02451 1 0 1 0 Common Stock 102549 D Stock Option (right to buy) 1.85 2023-04-18 Common Stock 26809 D Stock Option (right to buy) 9.39 2026-07-19 Common Stock 38675 D Series D Convertible Preferred Stock Common Stock 90272 D This option fully vested on September 1, 2014. This option was granted on July 20, 2016, and vests over four years, with 25% of the original 38,675 shares underlying the option having vested on July 20, 2017 and 2.0833% of the original 38,675 shares vesting monthly thereafter, subject to continued service. The Series D Convertible Preferred Stock is convertible into Common Stock on a 0.29300-for-one basis into the number of shares of Common Stock shown in column 3 at any time at the holder's election and automatically upon the closing of the Issuer's initial public offering without payment of further consideration. The shares have no expiration date. Exhibit Index: 24.1 Power of Attorney /s/ Mike Gray, attorney-in-fact 2017-11-15 EX-24.1 2 attachment1.htm EX-24.1 DOCUMENT

                                                                    EXHIBIT 24.1

         LIMITED POWER OF ATTORNEY FOR SECTION 16 REPORTING OBLIGATIONS

     Know all by these presents, that the undersigned hereby makes, constitutes
and appoints each of Rene Russo and Mike Gray, signing singly and each acting
individually, as the undersigned's true and lawful attorney-in-fact with full
power and authority as hereinafter described to:

     (1)  execute for and on behalf of the undersigned, in the undersigned's
capacity as an officer and/or director of Arsanis, Inc. (the "Company"), Forms
3, 4, and 5 (including any amendments thereto) in accordance with Section 16(a)
of the Securities Exchange Act of 1934 and the rules thereunder (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 prepare, complete and execute any such
Form 3, 4, or 5, prepare, complete and execute any amendment or amendments
thereto, and timely deliver and file such form with the United States Securities
and Exchange Commission (the "SEC") and any stock exchange or similar authority,
including without limitation the filing of a Form ID or any other application
materials to enable the undersigned to gain or maintain access to the Electronic
Data Gathering, Analysis and Retrieval system of the SEC;

     (3)  seek or obtain, as the undersigned's representative and on the
undersigned's behalf, information regarding 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 such attorney-in-fact 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
relieving, nor is the Company assuming nor relieving, any of the undersigned's
responsibilities to comply with Section 16 of the Exchange Act. The undersigned
acknowledges that neither the Company nor the foregoing attorneys-in-fact assume
(i) any liability for the undersigned's responsibility to comply with the
requirement of the Exchange Act, (ii) any liability of the undersigned for any
failure to comply with such requirements, or (iii) any obligation or liability
of the undersigned for profit disgorgement under Section 16(b) of the Exchange
Act.

     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
foregoing attorneys-in-fact.

     IN WITNESS WHEREOF, the undersigned has caused this Power of Attorney to be
executed as of this 27th day of October, 2017.

                                        /s/ Tillman U. Gerngross
                                        --------------------------------
                                        Signature

                                        Tillman U. Gerngross
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