0000899243-17-027028.txt : 20171120 0000899243-17-027028.hdr.sgml : 20171120 20171120181522 ACCESSION NUMBER: 0000899243-17-027028 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20171120 FILED AS OF DATE: 20171120 DATE AS OF CHANGE: 20171120 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: NeoMed Management (Jersey) Ltd CENTRAL INDEX KEY: 0001722665 STATE OF INCORPORATION: Y9 FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-38295 FILM NUMBER: 171214996 BUSINESS ADDRESS: STREET 1: 13, CASTLE STREET CITY: ST. HELIER STATE: Y9 ZIP: JE4 5UT BUSINESS PHONE: 44 15334 722787 MAIL ADDRESS: STREET 1: 13, CASTLE STREET CITY: ST. HELIER STATE: Y9 ZIP: JE4 5UT REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: NeoMed Innovation V Ltd CENTRAL INDEX KEY: 0001722666 STATE OF INCORPORATION: Y9 FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-38295 FILM NUMBER: 171214995 BUSINESS ADDRESS: STREET 1: 13, CASTLE STREET CITY: ST. HELIER STATE: Y9 ZIP: JE4 5UT BUSINESS PHONE: 44 1534 722787 MAIL ADDRESS: STREET 1: 13, CASTLE STREET CITY: ST. HELIER STATE: Y9 ZIP: JE4 5UT REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: NeoMed Innovation V L.P. CENTRAL INDEX KEY: 0001721884 STATE OF INCORPORATION: Y9 FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-38295 FILM NUMBER: 171214997 BUSINESS ADDRESS: STREET 1: 13, CASTLE STREET CITY: ST. HELIER STATE: Y9 ZIP: JE4 5UT BUSINESS PHONE: 44-1534-722787 MAIL ADDRESS: STREET 1: 13, CASTLE STREET CITY: ST. HELIER STATE: Y9 ZIP: JE4 5UT 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 4 1 doc4.xml FORM 4 SUBMISSION X0306 4 2017-11-20 1 0001501697 Arsanis, Inc. ASNS 0001721884 NeoMed Innovation V L.P. 13 CASTLE STREET ST HELIER Y9 JE4 5UT JERSEY 0 0 1 0 0001722665 NeoMed Management (Jersey) Ltd 13 CASTLE STREET ST HELIER Y9 JERSEY 0 0 1 0 0001722666 NeoMed Innovation V Ltd 13 CASTLE STREET ST HELIER Y9 JERSEY 0 0 1 0 Common Stock 2017-11-20 4 C 0 246682 A 246682 D Common Stock 2017-11-20 4 C 0 41878 A 288560 D Common Stock 2017-11-20 4 C 0 279079 A 567639 D Common Stock 2017-11-20 4 P 0 300000 10.00 A 867639 D Series B Convertible Preferred Stock 2017-11-20 4 C 0 552487 0.00 D Common Stock 246682 0 D Series C Convertible Preferred Stock 2017-11-20 4 C 0 84040 0.00 D Common Stock 41878 0 D Series D Convertible Preferred Stock 2017-11-20 4 C 0 952497 0.00 D Common Stock 279079 0 D The Series B Convertible Preferred Stock converted into Common Stock on a 0.44650-for-one basis upon the closing of the Issuer's initial public offering without payment of consideration. The Series B Convertible Preferred Stock was convertible at any time at the holder's election and automatically upon the closing at the Issuer's initial public offering. The shares had no expiration date. The Series C Convertible Preferred Stock converted into Common Stock on a 0.49832-for-one basis upon the closing of the Issuer's initial public offering without payment of consideration. The Series C Convertible Preferred Stock was convertible at any time at the holder's election and automatically upon the closing at the Issuer's initial public offering. The shares had no expiration date. The Series D Convertible Preferred Stock converted into Common Stock on a 0.29300-for-one basis upon the closing of the Issuer's initial public offering without payment of consideration. The Series D Convertible Preferred Stock was convertible at any time at the holder's election and automatically upon the closing at the Issuer's initial public offering. The shares had no expiration date. The reported securities are held of record by NeoMed Innovation V L.P. NeoMed Management (Jersey) Limited is the Investment Manager to NeoMed Innovation V L.P. NeoMed Innovation V Limited is the general partner of Neomed Innovation V L.P. By virtue of such relationships, NeoMed Management (Jersey) Limited and NeoMed Innovation V Limited may be deemed to have voting and investment power with respect to the shares held by NeoMed Innovation V L.P. Each of NeoMed Management (Jersey) Limited and NeoMed Innovation V Limited disclaims beneficial ownership of the shares held by NeoMed Innovation V L.P., except to the extent of its or his pecuniary interest therein, if any. /s/ Mike Gray, as attorney-in-fact on behalf of NeoMed Innovation V L.P. 2017-11-20 /s/ Mike Gray, as attorney-in-fact on behalf of NeoMed Management (Jersey) Limited 2017-11-20 /s/ Mike Gray, as attorney-in-fact on behalf of NeoMed Innovation V Limited 2017-11-20