SEC Form 4 · accession 0001209191-18-044546
Bloom Energy Corp · BE
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owners
Peter J Barris
10% Owner
NEW ENTERPRISE ASSOCIATES 10 L P
10% Owner
M James Barrett
10% Owner
NEA PARTNERS 10 L P
10% Owner
Period of report
Jul 27, 2018
Accepted (ET)
Jul 31, 2018 · 4:16 pm EDT
Rule 10b5-1 plan
unknown — predates the checkbox
Issuer CIK
0001664703
Table I — non-derivative securities
| Security | Date | Code | Shares | Price | A/D | Owned after | D/I | Nature of ownership |
|---|---|---|---|---|---|---|---|---|
| Class A Common StockF1 | Jul 27, 2018 | P | 1,333,333 | $15.00 | A | 1,333,333 | D |
Table II — derivative securities
| Security | Conv. / exercise price | Date | Code | Shares | A/D | Exercisable | Expires | Underlying | Underlying shares | Owned after | D/I |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Series B Convertible Preferred StockF1,F2,F3 | — | Jul 27, 2018 | C | 4,527,868 | D | — | — | Class B Common Stock | 4,527,868 | 0 | D |
| Class B Common StockF1,F3 | — | Jul 27, 2018 | C | 4,527,868 | A | — | — | Class A Common Stock | 4,527,868 | 4,527,868 | D |
| Series C Convertible Preferred StockF1,F2,F3 | — | Jul 27, 2018 | C | 1,062,944 | D | — | — | Class B Common Stock | 1,062,944 | 0 | D |
| Class B Common StockF1,F3 | — | Jul 27, 2018 | C | 1,062,944 | A | — | — | Class A Common Stock | 1,062,944 | 5,590,812 | D |
| Series D Convertible Preferred StockF1,F2,F3 | — | Jul 27, 2018 | C | 620,155 | D | — | — | Class B Common Stock | 620,155 | 0 | D |
| Class B Common StockF1,F3 | — | Jul 27, 2018 | C | 620,155 | A | — | — | Class A Common Stock | 620,155 | 6,210,967 | D |
| Series E Convertible Preferred StockF1,F2,F3 | — | Jul 27, 2018 | C | 395,815 | D | — | — | Class B Common Stock | 395,815 | 0 | D |
| Class B Common StockF1,F3 | — | Jul 27, 2018 | C | 395,815 | A | — | — | Class A Common Stock | 395,815 | 6,606,782 | D |
| Series F Convertible Preferred StockF1,F2,F3 | — | Jul 27, 2018 | C | 125,989 | D | — | — | Class B Common Stock | 125,989 | 0 | D |
| Class B Common StockF1,F3 | — | Jul 27, 2018 | C | 125,989 | A | — | — | Class A Common Stock | 125,989 | 6,732,771 | D |
| Series G Convertible Preferred StockF1,F2,F3 | — | Jul 27, 2018 | C | 650,631 | D | — | — | Class B Common Stock | 650,631 | 0 | D |
| Class B Common StockF1,F3 | — | Jul 27, 2018 | C | 650,631 | A | — | — | Class A Common Stock | 650,631 | 7,383,402 | D |
| 8% Convertible Preferred NotesF5,F1,F4 | — | Jul 27, 2018 | C | 346,239 | D | — | — | Series G Convertible Preferred Stock | 346,239 | 0 | D |
| Class B Common StockF5,F1,F4 | — | Jul 27, 2018 | C | 346,239 | A | — | — | Class A Common Stock | 346,239 | 7,729,641 | D |
Explanation of responses
- F1The 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.
- F2Each 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.
- F3The 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.
- F4The 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.
- F5The number of shares reflect both the principle and the interest accrued through July 27, 2018, the date of the automatic conversion.