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