0001209191-18-044546.txt : 20180731
0001209191-18-044546.hdr.sgml : 20180731
20180731161645
ACCESSION NUMBER: 0001209191-18-044546
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20180727
FILED AS OF DATE: 20180731
DATE AS OF CHANGE: 20180731
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: NEW ENTERPRISE ASSOCIATES 10 L P
CENTRAL INDEX KEY: 0001132326
STATE OF INCORPORATION: DE
FISCAL YEAR END: 1231
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-38598
FILM NUMBER: 18981296
BUSINESS ADDRESS:
STREET 1: 1119 ST PAUL STREET
CITY: BALTIMORE
STATE: MD
ZIP: 21202
BUSINESS PHONE: 4102440115
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: NEA PARTNERS 10 L P
CENTRAL INDEX KEY: 0001236049
STATE OF INCORPORATION: DE
FISCAL YEAR END: 1231
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-38598
FILM NUMBER: 18981297
BUSINESS ADDRESS:
STREET 1: 1119 ST PAUL STREET
CITY: BALTIMORE
STATE: MD
ZIP: 21202
BUSINESS PHONE: 4102440115
MAIL ADDRESS:
STREET 1: 1119 ST PAUL STREET
CITY: BALTIMORE
STATE: MD
ZIP: 21202
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: BARRIS PETER J
CENTRAL INDEX KEY: 0001005561
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-38598
FILM NUMBER: 18981298
MAIL ADDRESS:
STREET 1: 1119 ST PAUL STREET
CITY: BALTIMORE
STATE: MD
ZIP: 21202
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: BARRETT M JAMES
CENTRAL INDEX KEY: 0001219855
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-38598
FILM NUMBER: 18981299
MAIL ADDRESS:
STREET 1: 1119 ST PAUL STREET
CITY: BALTIMORE
STATE: MD
ZIP: 21202
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
4
1
doc4.xml
FORM 4 SUBMISSION
X0306
4
2018-07-27
0
0001664703
Bloom Energy Corp
BE
0001132326
NEW ENTERPRISE ASSOCIATES 10 L P
1954 GREENSPRING DRIVE
SUITE 600
TIMONIUM
MD
21093
0
0
1
0
0001236049
NEA PARTNERS 10 L P
1954 GREENSPRING DRIVE
SUITE 600
TIMONIUM
MD
21093
0
0
1
0
0001005561
BARRIS PETER J
1954 GREENSPRING DRIVE
SUITE 600
TIMONIUM
MD
21093
0
0
1
0
0001219855
BARRETT M JAMES
1954 GREENSPRING DRIVE
SUITE 600
TIMONIUM
MD
21093
0
0
1
0
Class A Common Stock
2018-07-27
4
P
0
1333333
15.00
A
1333333
D
Series B Convertible Preferred Stock
2018-07-27
4
C
0
4527868
0.00
D
Class B Common Stock
4527868
0
D
Class B Common Stock
2018-07-27
4
C
0
4527868
0.00
A
Class A Common Stock
4527868
4527868
D
Series C Convertible Preferred Stock
2018-07-27
4
C
0
1062944
0.00
D
Class B Common Stock
1062944
0
D
Class B Common Stock
2018-07-27
4
C
0
1062944
0.00
A
Class A Common Stock
1062944
5590812
D
Series D Convertible Preferred Stock
2018-07-27
4
C
0
620155
0.00
D
Class B Common Stock
620155
0
D
Class B Common Stock
2018-07-27
4
C
0
620155
0.00
A
Class A Common Stock
620155
6210967
D
Series E Convertible Preferred Stock
2018-07-27
4
C
0
395815
0.00
D
Class B Common Stock
395815
0
D
Class B Common Stock
2018-07-27
4
C
0
395815
0.00
A
Class A Common Stock
395815
6606782
D
Series F Convertible Preferred Stock
2018-07-27
4
C
0
125989
0.00
D
Class B Common Stock
125989
0
D
Class B Common Stock
2018-07-27
4
C
0
125989
0.00
A
Class A Common Stock
125989
6732771
D
Series G Convertible Preferred Stock
2018-07-27
4
C
0
650631
0.00
D
Class B Common Stock
650631
0
D
Class B Common Stock
2018-07-27
4
C
0
650631
0.00
A
Class A Common Stock
650631
7383402
D
8% Convertible Preferred Notes
2018-07-27
4
C
0
346239
0.00
D
Series G Convertible Preferred Stock
346239
0
D
Class B Common Stock
2018-07-27
4
C
0
346239
0.00
A
Class A Common Stock
346239
7729641
D
The securities are directly held by New Enterprise Associates 10, Limited Partnership ("NEA 10") and indirectly held by NEA Partners 10, Limited Partnership ("NEA Partners 10"), the sole general partner of NEA 10, and the individual general partners of NEA Partners 10 (NEA Partners 10 and its individual general partners together, the "Indirect Reporting Persons"). The individual general partners of NEA Partners 10 are Peter J. Barris, M. James Barrett and Scott D. Sandell. Each Indirect Reporting Person disclaims beneficial ownership within the meaning of Section 16 of the Securities Exchange Act of 1934, as amended, or otherwise of such portion of the NEA 10 securities in which such Indirect Reporting Person has no pecuniary interest.
Each share of Series B Convertible Preferred Stock, Series C Convertible Preferred Stock, Series D Convertible Preferred Stock, Series E Convertible Preferred Stock, Series F Convertible Preferred Stock and Series G Convertible Preferred Stock automatically converted into the Issuer's Class B Common Stock, on a 1 for 1 basis, immediately prior to the Closing of the Issuer's initial public offering on July 27, 2018 ("IPO") and had no expiration date.
The Class B Common Stock is convertible into the issuer's Class A Common Stock on a 1-for-1 basis at the holder's option or upon 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 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 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 principal amount and accrued interest of the 8% Convertible Preferred Notes ("8% Notes") automatically converted into the specified number of shares of Class B Common Stock as a result of the automatic conversion of the Issuer's outstanding preferred stock in connection with the Issuer's IPO.
The number of shares reflect both the principle and the interest accrued through July 27, 2018, the date of the automatic conversion.
/s/ Sasha Keough, attorney-in-fact
2018-07-31