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