0001209191-18-044626.txt : 20180731 0001209191-18-044626.hdr.sgml : 20180731 20180731201357 ACCESSION NUMBER: 0001209191-18-044626 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: DOERR L JOHN CENTRAL INDEX KEY: 0001032455 STATE OF INCORPORATION: CA FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-38598 FILM NUMBER: 18982599 MAIL ADDRESS: STREET 1: C/O KLEINER PERKINS CAUFIELD & BYERS STREET 2: 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: 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 0001032455 DOERR L JOHN 1299 ORLEANS DRIVE SUNNYVALE CA 94089 1 0 0 0 Class A Common Stock 2018-07-27 4 P 0 1333333 15.00 A 1333333 I Vallejo Ventures Trust Series A Convertible Preferred Stock 2018-07-27 4 C 0 8423073 0.00 D Class B Common Stock 8423073 0 I KPCB Holdings, Inc., as nominee Class B Common Stock 2018-07-27 4 C 0 8423073 0.00 A Class A Common Stock 8423073 8423073 I KPCB Holdings, Inc., as Nominee Series B Convertible Preferred Stock 2018-07-27 4 C 0 3120525 0.00 D Class B Common Stock 3120525 0 I KPCB Holdings, Inc., as Nominee Class B Common Stock 2018-07-27 4 C 0 3120525 0.00 A Class A Common Stock 3120525 11543598 I KPCB Holdings, Inc., as Nominee Series C Convertible Preferred Stock 2018-07-27 4 C 0 632293 0.00 D Class B Common Stock 632293 0 I KPCB Holdings, Inc., as Nominee Class B Common Stock 2018-07-27 4 C 0 632293 0.00 A Class A Common Stock 632293 12175891 I KPCB Holdings, Inc., as Nominee Series D Convertible Preferred Stock 2018-07-27 4 C 0 177071 0.00 D Class B Common Stock 177071 0 I KPCB Holdings, Inc., as Nominee Class B Common Stock 2018-07-27 4 C 0 177071 0.00 A Class A Common Stock 177071 12352962 I KPCB Holdings, Inc., as Nominee Series E Convertible Preferred Stock 2018-07-27 4 C 0 262164 0.00 D Class B Common Stock 262164 0 I KPCB Holdings, Inc. as Nominee Class B Common Stock 2018-07-27 4 C 0 262164 0.00 A Class A Common Stock 262164 12615126 I KPCB Holdings, Inc., as nominee Series F Convertible Preferred Stock 2018-07-27 4 C 0 119911 0.00 D Classs B Common Stock 119911 0 I KPCB Holdings, Inc., as nominee Class B Common Stock 2018-07-27 4 C 0 119911 0.00 A Class A Common Stock 119911 12735037 I KPCB Holdings, Inc., as nominee Series. G Convertible Preferred Stock 2018-07-27 4 C 0 247967 0.00 D Class B Common Stock 247967 0 I KPCB Holdings, Inc., as nominee Class B Common Stock 2018-07-27 4 C 0 247967 0.00 A Class A Common Stock 247967 12983004 I KPCB Holdings, Inc., as nominee 8% Convertible Preferred Note (Series G) 2018-07-27 4 C 0 329536 0.00 D Class B Common Stock 329536 0 I KPCB Holdings, Inc., as nominee Class B Common Stock 2018-07-27 4 C 0 329536 0.00 A Class A Common Stock 329536 13312540 I KPCB Holdings, Inc., as nominee Series A Convertible Preferred Stock 2018-07-27 4 C 0 426927 0.00 D Class B Common Stock 426927 0 I Vallejo Ventures Trust Class B Common Stock 2018-07-27 4 C 0 426927 0.00 A Class A Common Stock 426927 426927 I Vallejo Ventures Trust Series B Convertible Preferred Stock 2018-07-27 4 C 0 158165 0.00 D Class B Common Stock 158165 0 I Vallejo Ventures Trust Class B Common Stock 2018-07-27 4 C 0 158165 0.00 A Class A Common Stock 158165 585092 I Vallejo Ventures Trust Series C Convertible Preferred Stock 2018-07-27 4 C 0 32048 0.00 D Class B Common Stock 32048 0 I Vallejo Ventures Trust Class B Common Stock 2018-07-27 4 C 0 32048 0.00 A Class A Common Stock 32048 617140 I Vallejo Ventures Trust Series D Convertible Preferred Stoc 2018-07-27 4 C 0 8975 0.00 D Class B Common Stock 8975 0 I Vallejo Ventures Trust Class B Common Stock 2018-07-27 4 C 0 8975 0.00 A Class A Common Stock 8975 626115 I Vallejo Ventures Trust Series E Convertible Preferred Stock 2018-07-27 4 C 0 13288 0.00 D Class B Common Stock 13288 0 I Vallejo Ventures Trust Class B Common Stock 2018-07-27 4 C 0 13288 0.00 A Class A Common Stock 13288 639403 I Vallejo Ventures Trust Series F Convertible Preferred Stock 2018-07-27 4 C 0 6078 0.00 D Class B Common Stock 6078 0 I Vallejo Ventures Trust Class B Common Stock 2018-07-27 4 C 0 6078 0.00 A Class A Common Stock 6078 645481 I Vallejo Ventures Trust Series G Convertible Preferred Stock 2018-07-27 4 C 0 12569 0.00 D Class B Common Stock 12569 0 I Vallejo Ventures Trust Class B Common Stock 2018-07-27 4 C 0 12569 0.00 A Class A Common Stock 12569 658050 I Vallejo Ventures Trust L. John Doerr and Ann Doerr, Trustees of the Vallejo Ventures Trust. The shares of Series A Convertible Preferred Stock, 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 on a 1-for-1 basis into shares of Class B Common Stock in connection with the closing of the Issuer's initial public offering on July 27, 2018 ("IPO"). 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. 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. 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 Issuer's outstanding preferred stock in connection with the Issuer's IPO. The number of shares reflect both the principal and the interest accrued on the 8% Notes through July 27, 2018, the date of the automatic conversion in connection with the Issuer's IPO. One of two Forms 4 being filed to report transactions by the reporting person occurring on July 27, 2018. /s/Shawn Soderberg, attorney-in-fact 2018-07-31