0001104659-18-060328.txt : 20181003
0001104659-18-060328.hdr.sgml : 20181003
20181003162443
ACCESSION NUMBER: 0001104659-18-060328
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20181001
FILED AS OF DATE: 20181003
DATE AS OF CHANGE: 20181003
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: 5AM VENTURES III, L.P.
CENTRAL INDEX KEY: 0001456890
STATE OF INCORPORATION: DE
FISCAL YEAR END: 1231
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-38672
FILM NUMBER: 181105303
BUSINESS ADDRESS:
STREET 1: 2200 SAND HILL ROAD
STREET 2: SUITE 110
CITY: MENLO PARK
STATE: CA
ZIP: 94025
BUSINESS PHONE: 650-233-8600
MAIL ADDRESS:
STREET 1: 2200 SAND HILL ROAD
STREET 2: SUITE 110
CITY: MENLO PARK
STATE: CA
ZIP: 94025
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: 5AM Co-Investors III, L.P.
CENTRAL INDEX KEY: 0001478660
STATE OF INCORPORATION: DE
FISCAL YEAR END: 1231
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-38672
FILM NUMBER: 181105304
BUSINESS ADDRESS:
STREET 1: 2200 SAND HILL ROAD, SUITE 110
CITY: MENLO PARK
STATE: CA
ZIP: 94025
BUSINESS PHONE: 650-233-8600
MAIL ADDRESS:
STREET 1: 2200 SAND HILL ROAD, SUITE 110
CITY: MENLO PARK
STATE: CA
ZIP: 94025
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: 5AM Partners III, LLC
CENTRAL INDEX KEY: 0001555953
STATE OF INCORPORATION: DE
FISCAL YEAR END: 1231
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-38672
FILM NUMBER: 181105305
BUSINESS ADDRESS:
STREET 1: 2200 SAND HILL ROAD STE 110
CITY: MENLO PARK
STATE: CA
ZIP: 94025
BUSINESS PHONE: 650.233.8600
MAIL ADDRESS:
STREET 1: 2200 SAND HILL ROAD STE 110
CITY: MENLO PARK
STATE: CA
ZIP: 94025
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: ROCKLAGE SCOTT M
CENTRAL INDEX KEY: 0001219014
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-38672
FILM NUMBER: 181105306
MAIL ADDRESS:
STREET 1: 179 SANDY POND ROAD
CITY: LINCOLN
STATE: MA
ZIP: 01773
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: DIEKMAN JOHN D
CENTRAL INDEX KEY: 0001240357
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-38672
FILM NUMBER: 181105307
MAIL ADDRESS:
STREET 1: C/O 5 AM VENTURES
STREET 2: 3000 SAND HILL RD
CITY: MENLO PARK
STATE: CA
ZIP: 94025
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Schwab Andrew J.
CENTRAL INDEX KEY: 0001598549
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-38672
FILM NUMBER: 181105308
MAIL ADDRESS:
STREET 1: C/O 5AM VENTURES, 2200 SAND HILL ROAD
STREET 2: SUITE 110
CITY: MENLO PARK
STATE: CA
ZIP: 94025
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: ARVINAS INC.
CENTRAL INDEX KEY: 0001655759
STANDARD INDUSTRIAL CLASSIFICATION: PHARMACEUTICAL PREPARATIONS [2834]
IRS NUMBER: 472566120
STATE OF INCORPORATION: DE
FISCAL YEAR END: 1231
BUSINESS ADDRESS:
STREET 1: 395 WINCHESTER COMPANY, LLC
STREET 2: 5 SCIENCE PARK
CITY: NEW HAVEN
STATE: CT
ZIP: 06511
BUSINESS PHONE: 203-535-1456
MAIL ADDRESS:
STREET 1: 395 WINCHESTER COMPANY, LLC
STREET 2: 5 SCIENCE PARK
CITY: NEW HAVEN
STATE: CT
ZIP: 06511
FORMER COMPANY:
FORMER CONFORMED NAME: ARVINAS HOLDING COMPANY, LLC
DATE OF NAME CHANGE: 20151015
4
1
a4.xml
4
X0306
4
2018-10-01
0
0001655759
ARVINAS INC.
ARVN
0001456890
5AM VENTURES III, L.P.
501 2ND STREET, SUITE 350
SAN FRANCISCO
CA
94107
0
0
1
0
0001478660
5AM Co-Investors III, L.P.
501 2ND STREET, SUITE 350
SAN FRANCISCO
CA
94107
0
0
1
0
0001555953
5AM Partners III, LLC
501 2ND STREET, SUITE 350
SAN FRANCISCO
CA
94107
0
0
1
0
0001219014
ROCKLAGE SCOTT M
501 2ND STREET, SUITE 350
SAN FRANCISCO
CA
94107
0
0
1
0
0001240357
DIEKMAN JOHN D
501 2ND STREET, SUITE 350
SAN FRANCISCO
CA
94107
0
0
1
0
0001598549
Schwab Andrew J.
501 2ND STREET, SUITE 350
SAN FRANCISCO
CA
94107
0
0
1
0
Common Stock
2018-10-01
4
C
0
2862649
A
2862649
I
See footnotes
Common Stock
2018-10-01
4
C
0
1338679
A
4201328
I
See footnotes
Common Stock
2018-10-01
4
C
0
662864
A
4864192
I
See footnotes
Common Stock
2018-10-01
4
C
0
73777
A
73777
I
See footnotes
Common Stock
2018-10-01
4
C
0
34500
A
108277
I
See footnotes
Common Stock
2018-10-01
4
C
0
17083
A
125360
I
See footnotes
Series A Preferred Stock
2018-10-01
4
C
0
9303611
0.00
D
Common Stock
2862649
0
I
See Footnotes
Series A Preferred Stock
2018-10-01
4
C
0
239776
0.00
D
Common Stock
73777
0
I
See Footnotes
Series B Preferred Stock
2018-10-01
4
C
0
4350709
0.00
D
Common Stock
1338679
0
I
See Footnotes
Series B Preferred Stock
2018-10-01
4
C
0
112128
0.00
D
Common Stock
34500
0
I
See Footnotes
Series C Preferred Stock
2018-10-01
4
C
0
2154311
0.00
D
Common Stock
662864
0
I
See Footnotes
Series C Preferred Stock
2018-10-01
4
C
0
55522
0.00
D
Common Stock
17083
0
I
See Footnotes
These Secruties are held of record by 5AM Ventures III, L.P. ("Ventures III").
These Securities are held of record by 5AM Co-Investors III, L.P. ("Co-Investors III").
On October 1, 2018, the Series A Preferred Stock, Series B Preferred Stock and Series C Preferred Stock converted into Common Stock on a 3.25-for-one basis, upon the closing of the Issuer's initial public offering without payment of consideration. The Series A Preferred Stock, Series B Preferred Stock and Series C Preferred Stock were convertible at any time at the holder's election and automatically upon the closing of the Issuer's initial public offering. The shares had no expiration date.
5AM Partners III, LLC ("Partners III") is the sole general partner of Ventures III and Co-Investors III. Dr. John D. Diekman, Andrew J. Schwab and Dr. Scott M. Rocklage, are the managing members of Partners III, and may be deemed to have shared voting and investment power over the shares beneficially owned by Ventures III and Co-Investors III. Each of Partners III, Dr. Diekman, Mr. Schwab and Dr. Rocklage disclaim beneficial ownership of such shares except to the extent of its or his pecuniary interest therein.
5AM VENTURES III, L.P. By: 5AM Partners III, LLC, its General Partner /s/ Andrew J. Schwab
2018-10-03
5AM CO-INVESTORS III, L.P. By: 5AM Partners III, LLC, its General Partners /s/ Andrew J. Schwab
2018-10-03
5AM PARTNERS III, LLC /s/ Andrew J. Schwab
2018-10-03
/s/ Scott Rocklage
2018-10-03
/s/ John D. Diekman
2018-10-03
/s/ Andrew J. Schwab
2018-10-03