0001104659-19-067772.txt : 20191126
0001104659-19-067772.hdr.sgml : 20191126
20191126204141
ACCESSION NUMBER: 0001104659-19-067772
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20191122
FILED AS OF DATE: 20191126
DATE AS OF CHANGE: 20191126
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: 191252897
BUSINESS ADDRESS:
STREET 1: 2750 SAND HILL ROAD
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: 191252898
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 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: 191252899
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 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: 191252900
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: 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: 191252901
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: 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: 191252902
MAIL ADDRESS:
STREET 1: 2750 DANS 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
tm1923989d1_form4.xml
FORM 4
X0306
4
2019-11-22
1
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 RD
MENLO PARK
CA
94025
0
0
1
0
0001093461
KLEINER PERKINS CAUFIELD & BYERS IX B LP
2750 SAND HILL RD
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
2019-11-22
4
C
0
1029791
0
A
7029791
I
See footnote
Class A Common Stock
2019-11-22
4
J
0
7029791
0
D
0
I
See footnote
Class A Common Stock
2019-11-22
4
J
0
4884244
0
A
4884244
I
See footnote
Class A Common Stock
2019-11-22
4
J
0
4884244
0
D
0
I
See footnote
Class B Common Stock
2019-11-22
4
C
0
1029791
0
D
Class A Common Stock
1029791
7573804
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) 5,915,974 shares of Class A Common Stock held by KPCB IX-A; (b) 182,638 shares of Class A Common Stock held by KPCB IX-B; and (c) 931,179 shares of Class A Common Stock held by individuals and entities associated with Kleiner Perkins Caufield & Byers.
Represents a pro-rata in-kind distribution of Class A Common Stock of the Issuer by KPCB IX-A and KPCB IX-B without consideration to their partners (the "Fund Distribution") and a change in the form of beneficial ownership for individuals and entities associated with Kleiner Perkins Caufield & Byers.
Represents a change in the form of ownership from indirect to direct by virtue of the receipt of shares in the Fund Distribution.
Consists of 4,884,244 shares of Class A Common Stock held by KPCB IX Associates.
Represents a pro-rata in-kind distribution of Class A Common Stock of the Issuer by KPCB IX Associates without consideration to its members.
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) 4,785,752 shares of Class B Common Stock held by KPCB X-A; (b) 134,977 shares of Class B Common Stock held by KPCB X-B; and (c) 2,653,075 shares of Class B Common Stock held by individuals and entities associated with Kleiner Perkins Caufield & Byers, including 721,730 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 IX Associates, LLC
2019-11-26
/s/ Susan Biglieri, Chief Financial Officer of KPCB IX Associates, LLC, General Partner of Kleiner Perkins Caufield & Byers IX-A, L.P.
2019-11-26
/s/ Susan Biglieri, Chief Financial Officer of KPCB IX Associates, LLC, General Partner of Kleiner Perkins Caufield & Byers IX-B, L.P.
2019-11-26
/s/ Susan Biglieri, Chief Financial Officer of KPCB X Associates, LLC
2019-11-26
/s/ Susan Biglieri, Chief Financial Officer of KPCB X Associates, LLC, General Partner of Kleiner Perkins Caufield & Byers X-A, L.P.
2019-11-26
/s/ Susan Biglieri, Chief Financial Officer of KPCB X Associates, LLC, General Partner of Kleiner Perkins Caufield & Byers X-B, L.P.
2019-11-26