0001140361-21-033143.txt : 20210930 0001140361-21-033143.hdr.sgml : 20210930 20210930173546 ACCESSION NUMBER: 0001140361-21-033143 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20210928 FILED AS OF DATE: 20210930 DATE AS OF CHANGE: 20210930 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Sherpa Ventures Fund, LP CENTRAL INDEX KEY: 0001580437 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-40824 FILM NUMBER: 211296012 BUSINESS ADDRESS: STREET 1: 555 MISSION STREET, SUITE 1850 CITY: SAN FRANCISCO STATE: CA ZIP: 94105-0937 BUSINESS PHONE: (415) 655 9887 MAIL ADDRESS: STREET 1: 555 MISSION STREET, SUITE 1850 CITY: SAN FRANCISCO STATE: CA ZIP: 94105-0937 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Sherpa Ventures Fund GP, LLC CENTRAL INDEX KEY: 0001580438 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-40824 FILM NUMBER: 211296010 BUSINESS ADDRESS: STREET 1: 555 MISSION STREET, SUITE 1850 CITY: SAN FRANCISCO STATE: CA ZIP: 94105-0937 BUSINESS PHONE: (415) 655 9887 MAIL ADDRESS: STREET 1: 555 MISSION STREET, SUITE 1850 CITY: SAN FRANCISCO STATE: CA ZIP: 94105-0937 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: SherpaVentures Fund II GP, LLC CENTRAL INDEX KEY: 0001640277 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-40824 FILM NUMBER: 211296009 BUSINESS ADDRESS: STREET 1: 800 MARKET STREET, SUITE 800 CITY: SAN FRANCISCO STATE: CA ZIP: 94102 BUSINESS PHONE: 415 805 8500 MAIL ADDRESS: STREET 1: 800 MARKET STREET, SUITE 800 CITY: SAN FRANCISCO STATE: CA ZIP: 94102 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: SherpaVentures Fund II, LP CENTRAL INDEX KEY: 0001640276 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-40824 FILM NUMBER: 211296011 BUSINESS ADDRESS: STREET 1: 800 MARKET STREET, SUITE 800 CITY: SAN FRANCISCO STATE: CA ZIP: 94102 BUSINESS PHONE: 415 805 8500 MAIL ADDRESS: STREET 1: 800 MARKET STREET, SUITE 800 CITY: SAN FRANCISCO STATE: CA ZIP: 94102 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: Cue Health Inc. CENTRAL INDEX KEY: 0001628945 STANDARD INDUSTRIAL CLASSIFICATION: LABORATORY ANALYTICAL INSTRUMENTS [3826] IRS NUMBER: 000000000 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 4980 CARROLL CANYON ROAD STREET 2: SUITE 100 CITY: SAN DIEGO STATE: CA ZIP: 92121 BUSINESS PHONE: (858) 412-8151 MAIL ADDRESS: STREET 1: 4980 CARROLL CANYON ROAD STREET 2: SUITE 100 CITY: SAN DIEGO STATE: CA ZIP: 92121 FORMER COMPANY: FORMER CONFORMED NAME: Cue Inc. DATE OF NAME CHANGE: 20141223 FORMER COMPANY: FORMER CONFORMED NAME: Cue, Inc. DATE OF NAME CHANGE: 20141222 4 1 form4.xml FORM 4 X0306 4 2021-09-28 0001628945 Cue Health Inc. HLTH 0001580437 Sherpa Ventures Fund, LP 800 MARKET STREET, 8TH FLOOR SAN FRANCISCO CA 94102 true 0001640276 SherpaVentures Fund II, LP 800 MARKET STREET, 8TH FLOOR SAN FRANCISCO CA 94102 true 0001580438 Sherpa Ventures Fund GP, LLC 800 MARKET STREET, 8TH FLOOR SAN FRANCISCO CA 94102 true 0001640277 SherpaVentures Fund II GP, LLC 800 MARKET STREET, 8TH FLOOR SAN FRANCISCO CA 94102 true Common Stock 2021-09-28 4 C 0 9619451 A 9748805 I See footnote. Common Stock 2021-09-28 4 C 0 4926417 A 5120448 I See footnote. Common Stock 2021-09-28 4 J 0 371293 12.8 A 5491741 I See footnote. Series A Preferred Stock 2021-09-28 4 C 0 5450898 0 D Common Stock 5450898 0 I See footnote. Series B Preferred Stock 2021-09-28 4 C 0 3076224 0 D Common Stock 3076224 0 I See footnote. Series C-1 Preferred Stock 2021-09-28 4 C 0 1092329 0 D Common Stock 1092329 0 I See footnote. Series B Preferred Stock 2021-09-28 4 C 0 3834088 0 D Common Stock 3834088 0 I See footnote. Series C-1 Preferred Stock 2021-09-28 4 C 0 1092329 0 D Common Stock 1092329 0 I See footnote. On September 28, 2021, the Series A Preferred Stock automatically converted into Common Stock on a one-to-one basis without payment of further consideration upon the closing of the initial public offering of the Issuer's common stock. The shares had no expiration date. On September 28, 2021, the Series B Preferred Stock automatically converted into Common Stock on a one-to-one basis without payment of further consideration upon the closing of the initial public offering of the Issuer's common stock. The shares had no expiration date. On September 28, 2021, the Series C-1 Preferred Stock automatically converted into Common Stock on a one-to-one basis without payment of further consideration upon the closing of the initial public offering of the Issuer's common stock. The shares had no expiration date. The shares are held directly by Sherpa Ventures Fund, LP ("ACME I"). Sherpa Ventures Fund GP, LLC ("ACME GP I") is the general partner of ACME I. Each of the reporting persons disclaims beneficial ownership of the shares reported herein except to the extent of its respective pecuniary interest therein. The shares are held directly by Sherpa Ventures Fund II, LP ("ACME II"). Sherpa Ventures Fund II GP, LLC ("ACME GP II") is the general partner of ACME II. Each of the reporting persons disclaims beneficial ownership of the shares reported herein except to the extent of its respective pecuniary interest therein. On September 28, 2021, outstanding principal and accrued interest underlying a convertible note automatically converted into Common Stock upon the closing of the initial public offering of the Issuer's common stock at a conversion price equal to 80% of the initial public offering price per share. SHERPA VENTURES FUND, LP By: Sherpa Ventures Fund GP, LLC, its general partner By: /s/ Scott Stanford, Manager 2021-09-30 SHERPA VENTURES FUND II, LP By: Sherpa Ventures Fund II GP, LLC, its general partner By: /s/ Scott Stanford, Manager 2021-09-30 SHERPA VENTURES FUND GP, LLC By: /s/ Scott Stanford, Manager 2021-09-30 SHERPA VENTURES FUND II GP, LLC By: /s/ Scott Stanford, Manager 2021-09-30