0001209191-18-044547.txt : 20180731
0001209191-18-044547.hdr.sgml : 20180731
20180731161721
ACCESSION NUMBER: 0001209191-18-044547
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: SANDELL SCOTT D
CENTRAL INDEX KEY: 0001237289
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-38598
FILM NUMBER: 18981315
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
0001237289
SANDELL SCOTT D
1954 GREENSPRING DRIVE
SUITE 600
TIMONIUM
MD
21093
1
0
1
0
Class A Common Stock
2018-07-27
4
P
0
1333333
15.00
A
1333333
I
See Note 1
Series B Convertible Preferred Stock
2018-07-27
4
C
0
4527868
0.00
D
Class B Common Stock
4527868
0
I
See Note 1
Class B Common Stock
2018-07-27
4
C
0
4527868
0.00
A
Class A Common Stock
4527868
4527868
I
See Note 1
Series C Convertible Preferred Stock
2018-07-27
4
C
0
1062944
0.00
D
Class B Common Stock
1062944
0
I
See Note 1
Class B Common Stock
2018-07-27
4
C
0
1062944
0.00
A
Class A Common Stock
1062944
5590812
I
See Note 1
Series D Convertible Preferred Stock
2018-07-27
4
C
0
620155
0.00
D
Class B Common Stock
620155
0
I
See Note 1
Class B Common Stock
2018-07-27
4
C
0
620155
0.00
A
Class A Common Stock
620155
6210967
I
See Note 1
Series E Convertible Preferred Stock
2018-07-27
4
C
0
395815
0.00
D
Class B Common Stock
395815
0
I
See Note 1
Class B Common Stock
2018-07-27
4
C
0
395815
0.00
A
Class A Common Stock
395815
6606782
I
See Note 1
Series F Convertible Preferred Stock
2018-07-27
4
C
0
125989
0.00
D
Class B Common Stock
125989
0
I
See Note 1
Class B Common Stock
2018-07-27
4
C
0
125989
0.00
A
Class A Common Stock
125989
6732771
I
See Note 1
Series G Convertible Preferred Stock
2018-07-27
4
C
0
650631
0.00
D
Class B Common Stock
650631
0
I
See Note 1
Class B Common Stock
2018-07-27
4
C
0
650631
0.00
A
Class A Common Stock
650631
7383402
I
See Note 1
8% Convertible Preferred Notes
2018-07-27
4
C
0
346239
0.00
D
Series G Convertible Preferred Stock
346239
0
I
See Note 1
Class B Common Stock
2018-07-27
4
C
0
346239
0.00
A
Class A Common Stock
346239
7729641
I
See Note 1
The Reporting Person is a general partner of NEA Partners 10, Limited Partnership ("NEA Partners 10"), NEA Partners 10 is the sole general partner of New Enterprise Associates 10, Limited Partnership ("NEA 10"), the direct beneficial owner of the securities. The 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 the 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