SEC Form 4 · accession 0001209191-18-044626

Bloom Energy Corp · BE

Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗

Reporting owner

L John Doerr

Director

Period of report

Jul 27, 2018

Accepted (ET)

Jul 31, 2018 · 8:13 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 Stock^F1	Jul 27, 2018	P	1,333,333	$15.00	A	1,333,333	I	Vallejo Ventures Trust

Table II — derivative securities

Security	Conv. / exercise price	Date	Code	Shares	A/D	Exercisable	Expires	Underlying	Underlying shares	Owned after	D/I
Series A Convertible Preferred Stock^F4,F5,F2,F3	—	Jul 27, 2018	C	8,423,073	D	—	—	Class B Common Stock	8,423,073	0	I
Class B Common Stock^F4,F5,F3	—	Jul 27, 2018	C	8,423,073	A	—	—	Class A Common Stock	8,423,073	8,423,073	I
Series B Convertible Preferred Stock^F4,F5,F2,F3	—	Jul 27, 2018	C	3,120,525	D	—	—	Class B Common Stock	3,120,525	0	I
Class B Common Stock^F4,F5,F3	—	Jul 27, 2018	C	3,120,525	A	—	—	Class A Common Stock	3,120,525	11,543,598	I
Series C Convertible Preferred Stock^F4,F5,F2,F3	—	Jul 27, 2018	C	632,293	D	—	—	Class B Common Stock	632,293	0	I
Class B Common Stock^F4,F5,F3	—	Jul 27, 2018	C	632,293	A	—	—	Class A Common Stock	632,293	12,175,891	I
Series D Convertible Preferred Stock^F4,F5,F2,F3	—	Jul 27, 2018	C	177,071	D	—	—	Class B Common Stock	177,071	0	I
Class B Common Stock^F4,F5,F3	—	Jul 27, 2018	C	177,071	A	—	—	Class A Common Stock	177,071	12,352,962	I
Series E Convertible Preferred Stock^F4,F5,F2,F3	—	Jul 27, 2018	C	262,164	D	—	—	Class B Common Stock	262,164	0	I
Class B Common Stock^F4,F5,F3	—	Jul 27, 2018	C	262,164	A	—	—	Class A Common Stock	262,164	12,615,126	I
Series F Convertible Preferred Stock^F4,F5,F2,F3	—	Jul 27, 2018	C	119,911	D	—	—	Classs B Common Stock	119,911	0	I
Class B Common Stock^F4,F5,F3	—	Jul 27, 2018	C	119,911	A	—	—	Class A Common Stock	119,911	12,735,037	I
Series. G Convertible Preferred Stock^F4,F5,F2,F3	—	Jul 27, 2018	C	247,967	D	—	—	Class B Common Stock	247,967	0	I
Class B Common Stock^F4,F5,F3	—	Jul 27, 2018	C	247,967	A	—	—	Class A Common Stock	247,967	12,983,004	I
8% Convertible Preferred Note (Series G)^{F7,F4,F5,F6,F3}	—	Jul 27, 2018	C	329,536	D	—	—	Class B Common Stock	329,536	0	I
Class B Common Stock^F7,F4,F5,F3	—	Jul 27, 2018	C	329,536	A	—	—	Class A Common Stock	329,536	13,312,540	I
Series A Convertible Preferred Stock^F1,F2,F3	—	Jul 27, 2018	C	426,927	D	—	—	Class B Common Stock	426,927	0	I
Class B Common Stock^F1,F3	—	Jul 27, 2018	C	426,927	A	—	—	Class A Common Stock	426,927	426,927	I
Series B Convertible Preferred Stock^F1,F2,F3	—	Jul 27, 2018	C	158,165	D	—	—	Class B Common Stock	158,165	0	I
Class B Common Stock^F1,F3	—	Jul 27, 2018	C	158,165	A	—	—	Class A Common Stock	158,165	585,092	I
Series C Convertible Preferred Stock^F1,F2,F3	—	Jul 27, 2018	C	32,048	D	—	—	Class B Common Stock	32,048	0	I
Class B Common Stock^F1,F3	—	Jul 27, 2018	C	32,048	A	—	—	Class A Common Stock	32,048	617,140	I
Series D Convertible Preferred Stoc^F1,F2,F3	—	Jul 27, 2018	C	8,975	D	—	—	Class B Common Stock	8,975	0	I
Class B Common Stock^F1,F3	—	Jul 27, 2018	C	8,975	A	—	—	Class A Common Stock	8,975	626,115	I
Series E Convertible Preferred Stock^F1,F2,F3	—	Jul 27, 2018	C	13,288	D	—	—	Class B Common Stock	13,288	0	I
Class B Common Stock^F1,F3	—	Jul 27, 2018	C	13,288	A	—	—	Class A Common Stock	13,288	639,403	I
Series F Convertible Preferred Stock^F1,F2,F3	—	Jul 27, 2018	C	6,078	D	—	—	Class B Common Stock	6,078	0	I
Class B Common Stock^F1,F3	—	Jul 27, 2018	C	6,078	A	—	—	Class A Common Stock	6,078	645,481	I
Series G Convertible Preferred Stock^F1,F2,F3	—	Jul 27, 2018	C	12,569	D	—	—	Class B Common Stock	12,569	0	I
Class B Common Stock^F1,F3	—	Jul 27, 2018	C	12,569	A	—	—	Class A Common Stock	12,569	658,050	I

Explanation of responses

F1L. John Doerr and Ann Doerr, Trustees of the Vallejo Ventures Trust.
F2The 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").
F3The 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.
F4All 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.
F5KPCB 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.
F6The 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.
F7The 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.

Remarks

One of two Forms 4 being filed to report transactions by the reporting person occurring on July 27, 2018.