0001209191-18-043835.txt : 20180724 0001209191-18-043835.hdr.sgml : 20180724 20180724211753 ACCESSION NUMBER: 0001209191-18-043835 CONFORMED SUBMISSION TYPE: 3 PUBLIC DOCUMENT COUNT: 2 CONFORMED PERIOD OF REPORT: 20180724 FILED AS OF DATE: 20180724 DATE AS OF CHANGE: 20180724 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: SODERBERG SHAWN MARIE CENTRAL INDEX KEY: 0001591851 FILING VALUES: FORM TYPE: 3 SEC ACT: 1934 Act SEC FILE NUMBER: 001-38598 FILM NUMBER: 18967458 MAIL ADDRESS: STREET 1: 1000 ALFRED NOBEL DRIVE CITY: HERCULES STATE: CA ZIP: 94547 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: 1299 ORLEANS DRIVE CITY: SUNNYVALE STATE: CA ZIP: 94089 BUSINESS PHONE: 408-543-1500 MAIL ADDRESS: STREET 1: 1299 ORLEANS DRIVE CITY: SUNNYVALE STATE: CA ZIP: 94089 3 1 doc3.xml FORM 3 SUBMISSION X0206 3 2018-07-24 0 0001664703 Bloom Energy Corp BE 0001591851 SODERBERG SHAWN MARIE 1299 ORLEANS DRIVE SUNNYVALE CA 94089 0 1 0 0 EVP, GC & Secretary Stock Option (Right to Buy Class B Common Stock) 30.96 2026-10-02 Class B Common Stock 20000 D Stock Option (Right to Buy Class B Common Stock) 30.89 2026-01-13 Class B Common Stock 106666 D The option vests annually over a 3 year period with 1/3rd of the total number of shares vesting on September 15, 2017, 1/3rd on September 15, 2018, and 1/3rd on September 15, 2019, subject to continued service through each vesting date. 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) any transfer except for certain permitted transfers. All the outstanding shares of our Class B common stock will convert automatically into shares of our 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 the closing of Issuer's IPO, (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 our 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. The option vests annually over 5 years with 1/5th of the total shares vesting one year from the vesting commencement date, January 13, 2016, and monthly thereafter at a rate of 1/60th per month, subject to continued service through each vesting date. Exhibit List - Exhibit 24.1 - Power of Attorney /s/Shawn Soderberg 2018-07-24 EX-24.3_802554 2 poa.txt POA DOCUMENT Exhibit 24.1 POWER OF ATTORNEY KNOW ALL BY THESE PRESENTS, that the undersigned hereby constitutes and appoints Shawn Soderberg, Randy Furr, Deon Boles and Mark Mesler, and each of them, her true and lawful attorney-in-fact to: (1) execute for and on behalf of the undersigned, in the undersigned's capacity as a representative of Bloom Energy Corporation ("Company"), any and all Form 3, 4 or 5 reports required to be filed by the undersigned in accordance with Section 16(a) of the Securities Exchange Act of 1934, as amended ("Exchange Act"), and the rules thereunder with respect to transactions in securities of the Company; (2) do and perform any and all acts for and on behalf of the undersigned which may be necessary or desirable to complete and execute any such Form 3, 4 or 5 report and timely file such report with the U.S. Securities and Exchange Commission and any stock exchange or similar authority; and (3) take any other action of any type whatsoever in connection with the foregoing which, in the opinion of such attorney in-fact, may be of benefit to, in the best interest of, or legally required by, the undersigned, it being understood that the documents executed by such attorney in-fact on behalf of the undersigned, pursuant to this Power of Attorney, shall be in such form and shall contain such terms and conditions as such attorney-in-fact may approve in her discretion. The undersigned hereby grants to each such attorney-in-fact full power and authority to do and perform each and every act and thing whatsoever requisite, necessary and proper to be done in the exercise of any of the rights and powers herein granted, as fully to all intents and purposes as the undersigned might or could do if personally present, with full power of substitution or revocation, hereby ratifying and confirming all that such attorney-in-fact, or her substitute or substitutes, shall lawfully do or cause to be done by virtue of this Power of Attorney and the rights and powers herein granted. The undersigned acknowledges that no such attorney in-fact, in serving in such capacity at the request of the undersigned, is hereby assuming, nor is the Company hereby assuming, any of the undersigned's responsibilities to comply with Section 16 of the Exchange Act. This Power of Attorney shall remain in full force and effect until the undersigned is no longer required to file Form 3, 4 or 5 reports with respect to the undersigned's holdings of and transactions in securities issued by the Company, unless earlier revoked by the undersigned in a signed writing delivered to the foregoing attorneys-in-fact. IN WITNESS WHEREOF, the undersigned has caused this Power of Attorney to be executed as of the 10th day of July, 2018. /s/Shawn M. Soderberg