0001104659-19-065976.txt : 20191120 0001104659-19-065976.hdr.sgml : 20191120 20191120210333 ACCESSION NUMBER: 0001104659-19-065976 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20191118 FILED AS OF DATE: 20191120 DATE AS OF CHANGE: 20191120 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: KPCB X ASSOCIATES LLC CENTRAL INDEX KEY: 0001242712 STATE OF INCORPORATION: CA FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-38598 FILM NUMBER: 191235546 MAIL ADDRESS: STREET 1: 2750 DANS HILL ROAD CITY: MENLO PARK STATE: CA ZIP: 94025 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: KPCB IX ASSOCIATES LLC CENTRAL INDEX KEY: 0001111392 STATE OF INCORPORATION: CA FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-38598 FILM NUMBER: 191235547 BUSINESS ADDRESS: STREET 1: 2750 SAND HILL RD CITY: MENLO PARK STATE: CA ZIP: 94025 BUSINESS PHONE: 6502332750 MAIL ADDRESS: STREET 1: 2750 SAND HILL RD CITY: MENLO PARK STATE: CA ZIP: 94025 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: KLEINER PERKINS CAUFIELD & BYERS IX A LP CENTRAL INDEX KEY: 0001093460 STATE OF INCORPORATION: CA FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-38598 FILM NUMBER: 191235548 BUSINESS ADDRESS: STREET 1: 2750 SAND HILL ROAD CITY: MENLO PARK STATE: CA ZIP: 94025 BUSINESS PHONE: 6502332750 MAIL ADDRESS: STREET 1: 2750 SAND HILL RD CITY: MENLO PARK STATE: CA ZIP: 94025 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: KLEINER PERKINS CAUFIELD & BYERS IX B LP CENTRAL INDEX KEY: 0001093461 STATE OF INCORPORATION: CA FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-38598 FILM NUMBER: 191235549 BUSINESS ADDRESS: STREET 1: 2750 SAND HILL ROAD CITY: MENLO PARK STATE: CA ZIP: 94025 BUSINESS PHONE: 6502332750 MAIL ADDRESS: STREET 1: 2750 SAND HILL RD CITY: MENLO PARK STATE: CA ZIP: 94025 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: KLEINER PERKINS CAUFIELD & BYERS X A LP CENTRAL INDEX KEY: 0001118829 STATE OF INCORPORATION: CA FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-38598 FILM NUMBER: 191235550 BUSINESS ADDRESS: STREET 1: 2750 SAND HILL RD CITY: MENLO PARK STATE: CA ZIP: 94025 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: KLEINER PERKINS CAUFIELD & BYERS X B LP CENTRAL INDEX KEY: 0001128699 STATE OF INCORPORATION: CA FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-38598 FILM NUMBER: 191235551 BUSINESS ADDRESS: STREET 1: 2750 SAND HILL ROAD CITY: MENLO PARK STATE: CA ZIP: 94025 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: Bloom Energy Corp CENTRAL INDEX KEY: 0001664703 STANDARD INDUSTRIAL CLASSIFICATION: ELECTRICAL INDUSTRIAL APPARATUS [3620] IRS NUMBER: 770565408 STATE OF INCORPORATION: DE BUSINESS ADDRESS: STREET 1: 4353 NORTH FIRST STREET CITY: SAN JOSE STATE: CA ZIP: 95134 BUSINESS PHONE: 408-543-1500 MAIL ADDRESS: STREET 1: 4353 NORTH FIRST STREET CITY: SAN JOSE STATE: CA ZIP: 95134 4 1 tm1923580d1_4.xml OWNERSHIP DOCUMENT X0306 4 2019-11-18 0 0001664703 Bloom Energy Corp BE 0001242712 KPCB X ASSOCIATES LLC 2750 SAND HILL ROAD MENLO PARK CA 94025 0 0 1 0 0001111392 KPCB IX ASSOCIATES LLC 2750 SAND HILL ROAD MENLO PARK CA 94025 0 0 1 0 0001093460 KLEINER PERKINS CAUFIELD & BYERS IX A LP 2750 SAND HILL ROAD MENLO PARK CA 94025 0 0 1 0 0001093461 KLEINER PERKINS CAUFIELD & BYERS IX B LP 2750 SAND HILL ROAD MENLO PARK CA 94025 0 0 1 0 0001118829 KLEINER PERKINS CAUFIELD & BYERS X A LP 2750 SAND HILL ROAD MENLO PARK CA 94025 0 0 1 0 0001128699 KLEINER PERKINS CAUFIELD & BYERS X B LP 2750 SAND HILL ROAD MENLO PARK CA 94025 0 0 1 0 Class A Common Stock 2019-11-18 4 C 0 5500000 0 A 5500000 I See footnote Class B Common Stock 2019-11-18 4 C 0 5500000 0 D Class A Common Stock 5500000 8487293 I See footnote Conversion of a derivative security in accordance with its terms. All shares are held for convenience in the name of KPCB Holdings, Inc., as nominee, for the accounts of such individuals and entities who each exercise their own voting and dispositive control over such shares. KPCB IX Associates, LLC ("KPCB IX Associates"), is the general partner of Kleiner Perkins Caufield & Byers IX-A, L.P. ("KPCB IX-A") and Kleiner Perkins Caufield & Byers IX-B, L.P. ("KPCB IX-B"). KPCB X Associates, LLC ("KPCB X Associates"), is the general partner of Kleiner Perkins Caufield & Byers X-A, L.P. ("KPCB X-A") and Kleiner Perkins Caufield & Byers X-B, L.P. ("KPCB X-B"). Brook Byers, L. John Doerr, Kevin Compton, Doug Mackenzie, Raymond Lane and Theodore Schlein, the managers of KPCB IX Associates, share voting and dispositive control over the shares held by KPCB IX-A and KPCB IX-B. Brook Byers, L. John Doerr, Kevin Compton, Doug Mackenzie, Raymond Lane and Theodore Schlein, the managers of KPCB X Associates, share voting and dispositive control over the shares held by KPCB X-A and KPCB X-B. Each manager of KPCB IX Associates and KPCB X Associates disclaims beneficial ownership of the shares held by KPCB IX-A, KPCB IX-B, KPCB X-A and KPCB X-B. Consists of (a) 4,501,272 shares of Class A Common Stock held by KPCB IX-A; (b) 142,966 shares of Class A Common Stock held by KPCB IX-B; and (c) 855,762 shares of Class A Common Stock held by individuals and entities associated with Kleiner Perkins Caufield & Byers. The Class B Common Stock is convertible into the Issuer's Class A Common Stock on a 1-for-1 basis (a) at the holder's option; or (b) upon any transfer except certain permitted transfers. All the outstanding shares of Class B Common Stock will convert automatically into shares of Class A common stock upon the date that is the earliest to occur of (i) immediately prior to the close of business on the fifth anniversary of July 27, 2018, (ii) immediately prior to the close of business on the date on which the outstanding shares of Class B Common Stock represent less than five percent (5%) of the aggregate number of shares of Class A Common Stock and Class B Common Stock then outstanding, (iii) the date and time, or the occurrence of an event, specified in a written conversion election delivered by KR Sridhar to the Secretary or Chairman of the Board to so convert all shares of Class B Common Stock, or (iv) immediately following the date of the death of KR Sridhar. Consists of (a) 935,589 shares of Class B Common Stock held by KPCB IX-A; (b) 24,881 shares of Class B Common Stock held by KPCB IX-B; (c) 4,785,752 shares of Class B Common Stock held by KPCB X-A; (d) 134,977 shares of Class B Common Stock held by KPCB X-B; and (e) 2,606,094 shares of Class B Common Stock held by individuals and entities associated with Kleiner Perkins Caufield & Byers, including 674,749 shares of Class B Common Stock held by L. John and Ann Doerr, Trustees of the Vallejo Ventures Trust. /s/Susan Biglieri, Chief Financial Officer of KPCB X Associates, LLC 2019-11-20 /s/Susan Biglieri, Chief Financial Officer of KPCB IX Associates, LLC 2019-11-20 /s/Susan Biglieri, Chief Financial Officer of KPCB IX Associates, LLC, General Partner of Kleiner Perkins Caufield & Byers IX-A, L.P. 2019-11-20 /s/Susan Biglieri, Chief Financial Officer of KPCB IX Associates, LLC, General Partner of Kleiner Perkins Caufield & Byers IX-B, L.P. 2019-11-20 /s/Susan Biglieri, Chief Financial Officer of KPCB X Associates, LLC, General Partner of Kleiner Perkins Caufield & Byers X-A, L.P. 2019-11-20 /s/Susan Biglieri, Chief Financial Officer of KPCB X Associates, LLC, General Partner of Kleiner Perkins Caufield & Byers X-B, L.P. 2019-11-20