0001094891-16-000501.txt : 20160527 0001094891-16-000501.hdr.sgml : 20160527 20160527135419 ACCESSION NUMBER: 0001094891-16-000501 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20160525 FILED AS OF DATE: 20160527 DATE AS OF CHANGE: 20160527 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: PAVmed Inc. CENTRAL INDEX KEY: 0001624326 STANDARD INDUSTRIAL CLASSIFICATION: SURGICAL & MEDICAL INSTRUMENTS & APPARATUS [3841] IRS NUMBER: 471214177 STATE OF INCORPORATION: DE FISCAL YEAR END: 0930 BUSINESS ADDRESS: STREET 1: ONE GRAND CENTRAL PLACE STREET 2: SUITE 4600 CITY: NEW YORK STATE: NY ZIP: 10165 BUSINESS PHONE: 212-949-4319 MAIL ADDRESS: STREET 1: ONE GRAND CENTRAL PLACE STREET 2: SUITE 4600 CITY: NEW YORK STATE: NY ZIP: 10165 FORMER COMPANY: FORMER CONFORMED NAME: PAXmed Inc. DATE OF NAME CHANGE: 20141105 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Aklog Lishan CENTRAL INDEX KEY: 0001665074 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-37685 FILM NUMBER: 161681561 MAIL ADDRESS: STREET 1: 420 LEXINGTON AVENUE STREET 2: SUITE 300 CITY: NEW YORK STATE: NY ZIP: 10171 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: HCFP/Capital Partners III LLC CENTRAL INDEX KEY: 0001665111 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-37685 FILM NUMBER: 161681560 BUSINESS ADDRESS: STREET 1: 420 LEXINGTON AVENUE STREET 2: SUITE 300 CITY: NEW YORK STATE: NY ZIP: 10170 BUSINESS PHONE: 2124011951 MAIL ADDRESS: STREET 1: 420 LEXINGTON AVENUE STREET 2: SUITE 300 CITY: NEW YORK STATE: NY ZIP: 10170 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Pavilion Venture Partners LLC CENTRAL INDEX KEY: 0001665114 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-37685 FILM NUMBER: 161681559 BUSINESS ADDRESS: STREET 1: 420 LEXINGTON AVENUE STREET 2: SUITE 300 CITY: NEW YORK STATE: NY ZIP: 10170 BUSINESS PHONE: 2124011951 MAIL ADDRESS: STREET 1: 420 LEXINGTON AVENUE STREET 2: SUITE 300 CITY: NEW YORK STATE: NY ZIP: 10170 4 1 edgar.xml PRIMARY DOCUMENT X0306 4 2016-05-25 0001624326 PAVmed Inc. PAVM 0001665074 Aklog Lishan ONE GRAND CENTRAL PLACE SUITE 4600 NEW YORK NY 10165 1 1 1 0 Chairman and CEO 0001665111 HCFP/Capital Partners III LLC ONE GRAND CENTRAL PLACE SUITE 4600 NEW YORK NY 10165 0 0 1 0 0001665114 Pavilion Venture Partners LLC ONE GRAND CENTRAL PLACE SUITE 4600 NEW YORK NY 10165 0 0 1 0 Common Stock 2016-05-25 4 P 0 2500 A 12500 D Common Stock 2016-05-26 4 P 0 1500 A 14000 D Common Stock 5713879 I By HCFP/Capital Partners III LLC Common Stock 2520532 I By Pavilion Venture Partners LLC Common Stock 87020 I By HCFP Inc. Common Stock 125000 I By HCFP/Capital Partners IIIB LLC Common Stock 20000 I By HCFP/AG LLC Warrants 5.00 2016-05-25 4 P 0 2500 A 2016-10-28 2022-01-29 Common Stock 2500 12500 D Warrants 5.00 2016-05-26 4 P 0 1500 A 2016-10-28 2022-01-29 Common Stock 1500 14000 D Warrants 5.00 2016-10-28 2022-01-29 Common Stock 5713879 5713879 I By HCFP/Capital Partners III LLC Warrants 5.00 2016-10-28 2022-01-29 Common Stock 12000 2220532 I By Pavilion Venture Parnters LLC Warrants 5.00 2016-10-28 2022-01-29 Common Stock 87020 387020 I By HCFP Inc. Warrants 5.00 2016-10-28 2022-01-29 Common Stock 125000 125000 I By HCFP/Capital Partners IIIB LLC Warrants 5.00 2016-10-28 2022-01-29 Common Stock 20000 20000 I By HCFP/AG LLC The reporting person purchased units, each unit consisting of one share of the issuer's common stock and one warrant. Each warrant entitles the holder to purchase one share of the issuer's common stock at an exercise price of $5.00 per share, subject to adjustment.The units were purchased at an weighted average price of approximately $9.737188 per unit. These units were purchased in multiple transactions at prices ranging from $9.52 to $9.75, inclusive. The reporting person undertakes to provide to PAVmed Inc., any security holder of PAVmed Inc., or the staff of the Securities and Exchange Commission, upon request, full information regarding the number of units sold at each separate price within the ranges set forth this footnote to this Form 4. The reporting person purchased units, each unit consisting of one share of the issuer's common stock and one warrant. Each warrant entitles the holder to purchase one share of the issuer's common stock at an exercise price of $5.00 per share, subject to adjustment.The units were purchased at an weighted average price of approximately $10.45186 per unit. These units were purchased in multiple transactions at prices ranging from $9.9632 to $11.1874, inclusive. The reporting person undertakes to provide to PAVmed Inc., any security holder of PAVmed Inc., or the staff of the Securities and Exchange Commission, upon request, full information regarding the number of units sold at each separate price within the ranges set forth in Footnote 1 and 3 to this Form 4. Dr. Aklog is a member and a co-manager of HCFP/Capital Partners III LLC, and shares joint voting and dispositive power over the shares held by this entity. Dr. Aklog disclaims beneficial ownership of shares held by this entity, except to the extent of his proportionate pecuniary interest therein. Dr. Aklog is a member and sole manager of Pavilion Venture Partners LLC, and has sole voting and dispositive power over the shares held by this entity. Dr. Aklog disclaims beneficial ownership of shares held by this entity, except to the extent of his proportionate pecuniary interest therein. Dr. Aklog is a controlling shareholder of HCFP Inc., and shares joint voting and dispositive power over the shares held by this entity. Dr. Aklog disclaims beneficial ownership of shares held by this entity, except to the extent of his proportionate pecuniary interest therein. Dr. Aklog is a member and a co-manager of the entity that acts as sole manager of HCFP/Capital Partners IIIB LLC, and shares joint voting and dispositive power over the shares held by this entity. Dr. Aklog disclaims beneficial ownership of shares held by this entity, except to the extent of his pecuniary interest therein. Dr. Aklog is a co-manager of HCFP/AG LLC, and shares joint voting and dispositive power over the shares held by this entity. Dr. Aklog disclaims beneficial ownership of shares held by this entity, except to the extent of his pecuniary interest therein. /s/ Dr. Lishan Aklog 2016-05-27 /s/ Dr. Lishan Aklog, as manager of HCFP/Capital Partners III LLC 2016-05-27 /s/ Dr. Lishan Aklog, as manager of Pavilion Venture Partners LLC 2016-05-27