0001104659-17-044115.txt : 20170707 0001104659-17-044115.hdr.sgml : 20170707 20170707180443 ACCESSION NUMBER: 0001104659-17-044115 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20170705 FILED AS OF DATE: 20170707 DATE AS OF CHANGE: 20170707 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: Blue Apron Holdings, Inc. CENTRAL INDEX KEY: 0001701114 STANDARD INDUSTRIAL CLASSIFICATION: RETAIL-CATALOG & MAIL-ORDER HOUSES [5961] IRS NUMBER: 814777373 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 5 CROSBY STREET CITY: NEW YORK STATE: NY ZIP: 10013 BUSINESS PHONE: 347-719-4312 MAIL ADDRESS: STREET 1: 5 CROSBY STREET CITY: NEW YORK STATE: NY ZIP: 10013 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: First Round Capital IV, L.P. CENTRAL INDEX KEY: 0001547069 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-38134 FILM NUMBER: 17955998 BUSINESS ADDRESS: STREET 1: 4040 LOCUST STREET CITY: PHILADELPHIA STATE: PA ZIP: 19104 BUSINESS PHONE: 610-834-1461 MAIL ADDRESS: STREET 1: 4040 LOCUST STREET CITY: PHILADELPHIA STATE: PA ZIP: 19104 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Kopelman Joshua CENTRAL INDEX KEY: 0001512421 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-38134 FILM NUMBER: 17956000 MAIL ADDRESS: STREET 1: 4040 LOCUST STREET CITY: PHILADELPHIA STATE: PA ZIP: 19104 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Hayes Robert CENTRAL INDEX KEY: 0001710113 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-38134 FILM NUMBER: 17956001 MAIL ADDRESS: STREET 1: 4040 LOCUST STREET CITY: PHILADELPHIA STATE: PA ZIP: 19104 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Fralic Christopher CENTRAL INDEX KEY: 0001701579 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-38134 FILM NUMBER: 17956002 MAIL ADDRESS: STREET 1: 4040 LOCUST STREET CITY: PHILADELPHIA STATE: PA ZIP: 19104 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Barnes Phineas CENTRAL INDEX KEY: 0001710157 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-38134 FILM NUMBER: 17956003 MAIL ADDRESS: STREET 1: 4040 LOCUST STREET CITY: PHILADELPHIA STATE: PA ZIP: 19104 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: First Round Capital IV Partners Fund, L.P. CENTRAL INDEX KEY: 0001547073 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-38134 FILM NUMBER: 17956004 BUSINESS ADDRESS: STREET 1: 4040 LOCUST STREET CITY: PHILADELPHIA STATE: PA ZIP: 19104 BUSINESS PHONE: 610-834-1461 MAIL ADDRESS: STREET 1: 4040 LOCUST STREET CITY: PHILADELPHIA STATE: PA ZIP: 19104 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: First Round Capital Management IV, LLC CENTRAL INDEX KEY: 0001710037 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-38134 FILM NUMBER: 17956005 BUSINESS ADDRESS: STREET 1: 4040 LOCUST STREET CITY: PHILADELPHIA STATE: PA ZIP: 19104 BUSINESS PHONE: (610) 834-1461 MAIL ADDRESS: STREET 1: 4040 LOCUST STREET CITY: PHILADELPHIA STATE: PA ZIP: 19104 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Trenchard William CENTRAL INDEX KEY: 0001710102 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-38134 FILM NUMBER: 17955999 MAIL ADDRESS: STREET 1: 4040 LOCUST STREET CITY: PHILADELPHIA STATE: PA ZIP: 19104 4 1 a4.xml 4 X0306 4 2017-07-05 0 0001701114 Blue Apron Holdings, Inc. APRN 0001547069 First Round Capital IV, L.P. 4040 LOCUST STREET PHILADELPHIA PA 19104 0 0 1 0 0001710037 First Round Capital Management IV, LLC 4040 LOCUST STREET PHILADELPHIA PA 19104 0 0 1 0 0001547073 First Round Capital IV Partners Fund, L.P. 4040 LOCUST STREET PHILADELPHIA PA 19104 0 0 1 0 0001710157 Barnes Phineas 4040 LOCUST STREET PHILADELPHIA PA 19104 0 0 1 0 0001701579 Fralic Christopher 4040 LOCUST STREET PHILADELPHIA PA 19104 0 0 1 0 0001710113 Hayes Robert 4040 LOCUST STREET PHILADELPHIA PA 19104 0 0 1 0 0001512421 Kopelman Joshua 4040 LOCUST STREET PHILADELPHIA PA 19104 0 0 1 0 0001710102 Trenchard William 4040 LOCUST STREET PHILADELPHIA PA 19104 0 0 1 0 Series A Preferred Stock 2017-07-05 4 C 0 195901 0 D Class B Common Stock 9795071 0 I See Footnote Series A Preferred Stock 2017-07-05 4 C 0 3422 0 D Class B Common Stock 171079 0 I See Footnote Series B Preferred Stock 2017-07-05 4 C 0 86035 0 D Class B Common Stock 4301765 0 I See Footnote Series B Preferred Stock 2017-07-05 4 C 0 1503 0 D Class B Common Stock 75135 0 I See Footnote Series C Preferred Stock 2017-07-05 4 C 0 320723 0 D Class B Common Stock 1603615 0 I See Footnote Series C Preferred Stock 2017-07-05 4 C 0 5602 0 D Class B Common Stock 28010 0 I See Footnote Series D Preferred Stock 2017-07-05 4 C 0 7375 0 D Class B Common Stock 7375 0 I See Footnote Series D Preferred Stock 2017-07-05 4 C 0 129 0 D Class B Common Stock 129 0 I See Footnote Class B Common Stock 2017-07-05 4 C 0 15707826 0 A Class A Common Stock 15707826 15707826 I See Footnote Class B Common Stock 2017-07-05 4 C 0 274353 0 A Class A Common 274353 274353 I See Footnote The Series A Preferred Stock automatically converted into Class B Common Stock on a 50:1 basis upon the closing of the Issuer's initial public offering of its Class A Common Stock and had no expiration date. The Class B Common Stock is convertible into the Issuer's Class A Common Stock on a one-for-one basis upon certain transfers of such shares and at the holder's election and has no expiration date. The reported shares are directly owned by First Round Capital IV, LP. ("FRC IV LP"). First Round Capital Management IV, L.P., the general partner of FRC IV LP, and First Round Capital Management IV, LLC, the general partner of First Round Capital Management IV, L.P., have sole dispositive and voting power of the shares directly owned by FRC IV LP, and Phineas Barnes, Christopher Fralic, Robert Hayes, Joshua Kopelman and William Trenchard may be deemed to have shared dispositive and voting power over such shares. Such persons and entities disclaim beneficial ownership over the shares held FRC IV LP except to the extent of any pecuniary interest therein. The reported shares are owned directly by First Round Capital IV Partners Fund, L.P. First Round Capital Management IV, L.P. the general partner of FRC IV LP, and First Round Capital Management IV, LLC, the general partner of First Round Capital Management IV, L.P., have sole dispositive and voting power of the shares directly owned by FRC IV LP, and Phineas Barnes, Christopher Fralic, Robert Hayes, Joshua Kopelman and William Trenchard may be deemed to have shared dispositive and voting power over such shares. Such persons and entities disclaim beneficial ownership over the shares held FRC IV LP except to the extent of any pecuniary interest therein. The Series B Preferred Stock automatically converted into Class B Common Stock on a 50:1 basis upon the closing of the Issuer's initial public offering of its Class A Common Stock and had no expiration date. The Series C Preferred Stock automatically converted into Class B Common Stock on a 5:1 basis upon the closing of the Issuer's initial public offering of its Class A Common Stock and had no expiration date. The Series D Preferred Stock automatically converted into Class B Common Stock on a 1:1 basis upon the closing of the Issuer's initial public offering of its Class A Common Stock and had no expiration date. /s/ Jeffrey Donnon, Attorney-in-Fact for First Round Capital IV, L.P. 2017-07-05 /s/ Jeffrey Donnon, Attorney-in-Fact for First Round Capital Management IV, L.P. 2017-07-05 /s/ Jeffrey Donnon, Attorney-in-Fact for First Round Capital Management IV, LLC 2017-07-05 /s/ Jeffrey Donnon, Attorney-in-Fact for Phineas Barnes 2017-07-05 /s/ Jeffrey Donnon, Attorney-in-Fact for Christopher Fralic 2017-07-05 /s/ Jeffrey Donnon, Attorney-in-Fact for Robert Hayes 2017-07-05 /s/ Jeffrey Donnon, Attorney-in-Fact for Joshua Kopelman 2017-07-05 /s/ Jeffrey Donnon, Attorney-in-Fact for William Trenchard 2017-07-05