0001209191-21-001461.txt : 20210105 0001209191-21-001461.hdr.sgml : 20210105 20210105180037 ACCESSION NUMBER: 0001209191-21-001461 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20200331 FILED AS OF DATE: 20210105 DATE AS OF CHANGE: 20210105 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: 21507624 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 FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 4353 NORTH FIRST STREET CITY: SAN JOSE STATE: CA ZIP: 95134 BUSINESS PHONE: 408-543-1500 MAIL ADDRESS: STREET 1: 4353 NORTH FIRST STREET CITY: SAN JOSE STATE: CA ZIP: 95134 4 1 doc4.xml FORM 4 SUBMISSION X0306 4 2020-03-31 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 2020-03-31 4 A 0 4063 5.23 A 36610 D Class A Common Stock 2020-06-30 4 A 0 1953 10.88 A 38563 D Class A Common Stock 2020-09-30 4 A 0 1182 17.97 A 39745 D Class A Common Stock 2020-12-31 4 A 0 741 28.66 A 40486 D Class A Common Stock 1333333 I See Note 6 Represents Deferred Stock Units ("DSUs") credited to the Reporting Person's deferral account under the Bloom Energy Corporation 2020 Non-Employee Director Deferred Compensation Plan (the "Plan") for the quarter ending March 31, 2020, issuable to the Reporting Person on January 1, 2021 pursuant to the terms of the Plan. Amount of securities includes the grant of 19,813 Restricted Stock Units on May 12, 2020, as reported on a Form 4 filed on May 14, 2020. Represents DSUs credited to the Reporting Person's deferral account under the Plan for the quarter ending June 30, 2020, issuable to the Reporting Person on January 1, 2021 pursuant to the terms of the Plan. Represents DSUs credited to the Reporting Person's deferral account under the Plan for the quarter ending September 30, 2020, issuable to the Reporting Person on January 1, 2021 pursuant to the terms of the Plan. Represents DSUs credited to the Reporting Person's deferral account under the Plan for the quarter ending December 31, 2020, issuable to the Reporting Person on January 1, 2021 pursuant to the terms of the Plan. The Reporting Person is the 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 securities held by NEA 10 in which the Reporting Person has no pecuniary interest. /s/ Sasha Keough, attorney-in-fact 2021-01-05