SEC Form 4 · accession 0001209191-18-044627
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 · 8:14 pm EDT
Rule 10b5-1 plan
unknown — predates the checkbox
Issuer CIK
0001664703
Table I — non-derivative securities
No Table I lines on this filing.
Table II — derivative securities
| Security | Conv. / exercise price | Date | Code | Shares | A/D | Exercisable | Expires | Underlying | Underlying shares | Owned after | D/I |
|---|---|---|---|---|---|---|---|---|---|---|---|
| 8% Convertible Preferred Note (Series G)F2,F4,F1,F3 | — | Jul 27, 2018 | C | 16,703 | D | — | — | Class B Common Stock | 16,703 | 0 | I |
| Class B Common StockF2,F4,F3 | — | Jul 27, 2018 | C | 16,703 | A | — | — | Class A Common Stock | 16,703 | 674,753 | I |
Explanation of responses
- F1The 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.
- F2The 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.
- 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.
- F4L. John Doerr and Ann Doerr, Trustees of the Vallejo Ventures Trust.
Remarks
Two of two Forms 4 being filed to report transactions by the reporting person occurring on July 27, 2018. The holdings for KPCB Holdings, Inc., as nominee are reported on Form 1 of 2.