0001628280-20-014064.txt : 20200930 0001628280-20-014064.hdr.sgml : 20200930 20200930184250 ACCESSION NUMBER: 0001628280-20-014064 CONFORMED SUBMISSION TYPE: 3 PUBLIC DOCUMENT COUNT: 2 CONFORMED PERIOD OF REPORT: 20200930 FILED AS OF DATE: 20200930 DATE AS OF CHANGE: 20200930 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Mead Dana G Jr. CENTRAL INDEX KEY: 0001222358 FILING VALUES: FORM TYPE: 3 SEC ACT: 1934 Act SEC FILE NUMBER: 001-39562 FILM NUMBER: 201213724 MAIL ADDRESS: STREET 1: 2750 SAND HILL ROAD CITY: MENLO PARK STATE: CA ZIP: 94025 FORMER NAME: FORMER CONFORMED NAME: MEAD DANA G JR DATE OF NAME CHANGE: 20030310 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: Pulmonx Corp CENTRAL INDEX KEY: 0001127537 STANDARD INDUSTRIAL CLASSIFICATION: SURGICAL & MEDICAL INSTRUMENTS & APPARATUS [3841] IRS NUMBER: 000000000 STATE OF INCORPORATION: DE BUSINESS ADDRESS: STREET 1: 700 CHESAPEAKE DRIVE CITY: REDWOOD CITY STATE: CA ZIP: 94063 BUSINESS PHONE: 650-364-0400 MAIL ADDRESS: STREET 1: 700 CHESAPEAKE DRIVE CITY: REDWOOD CITY STATE: CA ZIP: 94063 FORMER COMPANY: FORMER CONFORMED NAME: PULMONX DATE OF NAME CHANGE: 20001031 3 1 wf-form3_160150574338046.xml FORM 3 X0206 3 2020-09-30 0 0001127537 Pulmonx Corp LUNG 0001222358 Mead Dana G Jr. C/O KLEINER PERKINS CAUFIELD & BYERS 2750 SAND HILL ROAD MENLO PARK CA 94025 1 0 0 0 Employee Stock Option (right to buy) 2.1 2029-10-20 Common Stock 6000.0 D Series C-1 Preferred Stock Common Stock 1268411.0 I See Footnote Series D-1 Preferred Stock Common Stock 168223.0 I See Footnote Series E-1 Preferred Stock Common Stock 87475.0 I See Footnote The shares subject to the option are immediately exercisable and vest in 12 equal consecutive monthly installments commencing on October 24, 2019, subject to the Reporting Person's continuous service through each such vesting date. Each share of Preferred Stock automatically converts on a one-for-one basis into Common Stock at any time at the holder's election and automatically upon the closing of the Issuer's initial public offering, for no additional consideration. The Preferred Stock has no expiration date. The shares are directly held by Kleiner Perkins Caufield & Byers XIII, LLC ("KPCB XIII"). All shares are held for convenience in the name of "KPCB Holdings, Inc., as nominee". The managing member of KPCB XIII is KPCB XIII Associates, LLC ("XIII Associates"). The voting and dispositive control over the shares is shared by individual managing directors of XIII Associates, none of whom has veto power. Excludes 102,725 shares of Common Stock beneficially owned by individuals and entities associated with Kleiner Perkins Caufield & Byers and 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. The Reporting Person disclaims beneficial ownership of these securities, and this report shall not be deemed an admission that the reporting person is the beneficial owner of the securities for purposes of Section 16 or for any other purpose. /s/ Mark Weeks, Attorney-In-Fact 2020-09-30 EX-24 2 ex-24.htm MEAD JR. POA

POWER OF ATTORNEY

Know all by these presents, that the undersigned hereby constitutes and appoints each of (i) Seth J. Gottlieb, (ii) Mark B. Weeks, (iii) Glendon E. French, (iv) Derrick Sung, Ph.D., and (v) Lauren Cristina, or any of them signing singly, and with full power of substitution, the undersigned's true and lawful attorney in fact to:

(1)    prepare, execute in the undersigned's name and on the undersigned's behalf, and submit to the U.S. Securities and Exchange Commission (the "SEC") a Form ID, including amendments thereto, and any other documents necessary or appropriate to obtain codes and passwords enabling the undersigned to make electronic filings with the SEC of reports required by Section 16(a) of the Securities Exchange Act of 1934 or any rule or regulation of the SEC;

(2)    execute for and on behalf of the undersigned, in the undersigned's capacity as an officer, director or holder of 10% or more of a class of securities of Pulmonx Corporation (the "Company"), Forms 3, 4, and 5 in accordance with Section 16(a) of the Securities Exchange Act of 1934 and the rules thereunder;

(3)    do and perform any and all acts for and on behalf of the undersigned which may be necessary or desirable to complete and execute any such Form 3, 4, or 5, complete and execute any amendment or amendments thereto, and timely file such form with the SEC and any stock exchange or similar authority; and

(4)    take any other action of any type whatsoever in connection with the foregoing which, in the opinion of such attorney in fact, may be of benefit to, in the best interest of, or legally required by, the undersigned, it being understood that the documents executed by such attorney in fact on behalf of the undersigned pursuant to this Power of Attorney shall be in such form and shall contain such terms and conditions as such attorney in fact may approve in such attorney in fact's discretion.

The undersigned hereby grants to each such attorney in fact full power and authority to do and perform any and every act and thing whatsoever requisite, necessary, or proper to be done in the exercise of any of the rights and powers herein granted, as fully to all intents and purposes as the undersigned might or could do if personally present, with full power of substitution or revocation, hereby ratifying and confirming all that such attorney in fact, or such attorney in fact's substitute or substitutes, shall lawfully do or cause to be done by virtue of this power of attorney and the rights and powers herein granted.  The undersigned acknowledges that the foregoing attorneys in fact, in serving in such capacity at the request of the undersigned, are not assuming, nor is the Company assuming, any of the undersigned's responsibilities to comply with Section 16 of the Securities Exchange Act of 1934.

This Power of Attorney shall remain in full force and effect until the earliest to occur of (a) the undersigned is no longer required to file Forms 3, 4, and 5 with respect to the undersigned's holdings of and transactions in securities issued by the Company, (b) revocation by the undersigned in a signed writing delivered to the foregoing attorney-in-fact or (c) as to any attorney-in-fact individually, until such attorney-in-fact shall no longer be employed by the Company or Cooley LLP.

IN WITNESS WHEREOF, the undersigned has caused this Power of Attorney to be executed as of this 1st day of October, 2020.

/s/ Dana G. Mead Jr.
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Dana G. Mead Jr.