-----BEGIN PRIVACY-ENHANCED MESSAGE----- Proc-Type: 2001,MIC-CLEAR Originator-Name: webmaster@www.sec.gov Originator-Key-Asymmetric: MFgwCgYEVQgBAQICAf8DSgAwRwJAW2sNKK9AVtBzYZmr6aGjlWyK3XmZv3dTINen TWSM7vrzLADbmYQaionwg5sDW3P6oaM5D3tdezXMm7z1T+B+twIDAQAB MIC-Info: RSA-MD5,RSA, BtvYwFNjx/fgzkFqPpGqQTxu2BTusPwsSNuOG8QvW7kyhETwrt1j2ou8n3yZZFP5 VJxT8FTXi6ISVWE+Y9ht8g== 0001072613-06-000301.txt : 20060210 0001072613-06-000301.hdr.sgml : 20060210 20060210121642 ACCESSION NUMBER: 0001072613-06-000301 CONFORMED SUBMISSION TYPE: SC 13G/A PUBLIC DOCUMENT COUNT: 1 FILED AS OF DATE: 20060210 DATE AS OF CHANGE: 20060210 GROUP MEMBERS: ALLIANCE TECHNOLOGY VENTURES III, LIMITED PARTNERSHIP GROUP MEMBERS: ATV III AFFILIATES FUND, LIMITED PARTNERSHIP GROUP MEMBERS: ATV III PARTNERS, LLC GROUP MEMBERS: J. CONNOR SEABROOK GROUP MEMBERS: MICHAEL A. HENOS GROUP MEMBERS: MICHAEL R. SLAWSON SUBJECT COMPANY: COMPANY DATA: COMPANY CONFORMED NAME: ADEZA BIOMEDICAL CORP CENTRAL INDEX KEY: 0000902482 STANDARD INDUSTRIAL CLASSIFICATION: INSTRUMENTS FOR MEAS & TESTING OF ELECTRICITY & ELEC SIGNALS [3825] IRS NUMBER: 770054952 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: SC 13G/A SEC ACT: 1934 Act SEC FILE NUMBER: 005-46611 FILM NUMBER: 06596516 BUSINESS ADDRESS: STREET 1: 1240 ELKO DR CITY: SUNNYVALE STATE: CA ZIP: 94089 FILED BY: COMPANY DATA: COMPANY CONFORMED NAME: ALLIANCE TECHNOLOGY VENTURES LIMITED PARTNERSHIP CENTRAL INDEX KEY: 0000916911 IRS NUMBER: 582081073 STATE OF INCORPORATION: DE FILING VALUES: FORM TYPE: SC 13G/A BUSINESS ADDRESS: STREET 1: 8995 WESTSIDE PARKWAY, SUITE 200 CITY: ALPHARETTA STATE: GA ZIP: 30004 BUSINESS PHONE: 6783362000 SC 13G/A 1 schedule-13ga_14152.txt AMENDMENT #1 TO SCHEDULE 13G ================================================================================ SECURITIES AND EXCHANGE COMMISSION WASHINGTON, D.C. 20549 SCHEDULE 13G UNDER THE SECURITIES EXCHANGE ACT OF 1934 (AMENDMENT NO. 1)* ADEZA BIOMEDICAL CORPORATION - -------------------------------------------------------------------------------- (NAME OF ISSUER) COMMON STOCK, $0.001 PAR VALUE - -------------------------------------------------------------------------------- (TITLE OF CLASS OF SECURITIES) 006864102 - -------------------------------------------------------------------------------- (CUSIP NUMBER) DECEMBER 31, 2005 - -------------------------------------------------------------------------------- (DATE OF EVENT WHICH REQUIRES FILING OF THIS STATEMENT) - -------------------------------------------------------------------------------- CHECK THE APPROPRIATE BOX TO DESIGNATE THE RULE PURSUANT TO WHICH THIS SCHEDULE IS FILED: [ ] RULE 13D-1(B) [ ] RULE 13D-1(C) [X] RULE 13D-1(D) *The remainder of this cover page shall be filled out for a reporting person's initial filing on this form with respect to the subject class of securities, and for any subsequent amendment containing information which would alter the disclosures provided in a prior cover page. The information required in the remainder of this cover page shall not be deemed to be "filed" for the purpose of Section 18 of the Securities Exchange Act of 1934 ("Act") or otherwise subject to the liabilities of that section of the Act but shall be subject to all other provisions of the Act (however, see the Notes). ================================================================================ =================== ================== CUSIP No. 006864102 SCHEDULE 13G Page 2 of 12 Pages =================== ================== ================================================================================ 1 NAMES OF REPORTING PERSON: I.R.S. IDENTIFICATION NO. OF ABOVE PERSON (ENTITIES ONLY) Alliance Technology Ventures III, L.P. - -------------------------------------------------------------------------------- 2 CHECK THE APPROPRIATE BOX IF A MEMBER OF A GROUP* (a)[_] (b)[_] - -------------------------------------------------------------------------------- 3 SEC USE ONLY - -------------------------------------------------------------------------------- 4 CITIZENSHIP OR PLACE OF ORGANIZATION Delaware - -------------------------------------------------------------------------------- 5 SOLE VOTING POWER NUMBER OF ----------------------------------------------------- SHARES 6 SHARED VOTING POWER BENEFICIALLY OWNED BY EACH ----------------------------------------------------- REPORTING 7 SOLE DISPOSITIVE POWER PERSON WITH ----------------------------------------------------- 8 SHARED DISPOSITIVE POWER - -------------------------------------------------------------------------------- 9 AGGREGATE AMOUNT BENEFICIALLY OWNED BY EACH REPORTING PERSON - -------------------------------------------------------------------------------- 10 CHECK BOX IF THE AGGREGATE AMOUNT IN ROW (9) EXCLUDES CERTAIN SHARES* [_] - -------------------------------------------------------------------------------- 11 PERCENT OF CLASS REPRESENTED BY AMOUNT IN ROW 9 - -------------------------------------------------------------------------------- 12 TYPE OF REPORTING PERSON* PN ================================================================================ *SEE INSTRUCTIONS BEFORE FILLING OUT! =================== ================== CUSIP No. 006864102 SCHEDULE 13G Page 3 of 12 Pages =================== ================== ================================================================================ 1 NAMES OF REPORTING PERSON: I.R.S. IDENTIFICATION NO. OF ABOVE PERSON (ENTITIES ONLY) ATV III Affiliates Fund, L.P. - -------------------------------------------------------------------------------- 2 CHECK THE APPROPRIATE BOX IF A MEMBER OF A GROUP* (a)[_] (b)[_] - -------------------------------------------------------------------------------- 3 SEC USE ONLY - -------------------------------------------------------------------------------- 4 CITIZENSHIP OR PLACE OF ORGANIZATION Delaware - -------------------------------------------------------------------------------- 5 SOLE VOTING POWER NUMBER OF ----------------------------------------------------- SHARES 6 SHARED VOTING POWER BENEFICIALLY OWNED BY EACH ----------------------------------------------------- REPORTING 7 SOLE DISPOSITIVE POWER PERSON WITH ----------------------------------------------------- 8 SHARED DISPOSITIVE POWER - -------------------------------------------------------------------------------- 9 AGGREGATE AMOUNT BENEFICIALLY OWNED BY EACH REPORTING PERSON - -------------------------------------------------------------------------------- 10 CHECK BOX IF THE AGGREGATE AMOUNT IN ROW (9) EXCLUDES CERTAIN SHARES* [_] - -------------------------------------------------------------------------------- 11 PERCENT OF CLASS REPRESENTED BY AMOUNT IN ROW 9 - -------------------------------------------------------------------------------- 12 TYPE OF REPORTING PERSON* PN ================================================================================ *SEE INSTRUCTIONS BEFORE FILLING OUT! =================== ================== CUSIP No. 006864102 SCHEDULE 13G Page 4 of 12 Pages =================== ================== ================================================================================ 1 NAMES OF REPORTING PERSON: I.R.S. IDENTIFICATION NO. OF ABOVE PERSON (ENTITIES ONLY) ATV III Partners, LLC - -------------------------------------------------------------------------------- 2 CHECK THE APPROPRIATE BOX IF A MEMBER OF A GROUP* (a)[_] (b)[_] - -------------------------------------------------------------------------------- 3 SEC USE ONLY - -------------------------------------------------------------------------------- 4 CITIZENSHIP OR PLACE OF ORGANIZATION Delaware - -------------------------------------------------------------------------------- 5 SOLE VOTING POWER NUMBER OF ----------------------------------------------------- SHARES 6 SHARED VOTING POWER BENEFICIALLY OWNED BY EACH ----------------------------------------------------- REPORTING 7 SOLE DISPOSITIVE POWER PERSON WITH ----------------------------------------------------- 8 SHARED DISPOSITIVE POWER - -------------------------------------------------------------------------------- 9 AGGREGATE AMOUNT BENEFICIALLY OWNED BY EACH REPORTING PERSON - -------------------------------------------------------------------------------- 10 CHECK BOX IF THE AGGREGATE AMOUNT IN ROW (9) EXCLUDES CERTAIN SHARES* [_] - -------------------------------------------------------------------------------- 11 PERCENT OF CLASS REPRESENTED BY AMOUNT IN ROW 9 - -------------------------------------------------------------------------------- 12 TYPE OF REPORTING PERSON* OO ================================================================================ *SEE INSTRUCTIONS BEFORE FILLING OUT! =================== ================== CUSIP No. 006864102 SCHEDULE 13G Page 5 of 12 Pages =================== ================== ================================================================================ 1 NAMES OF REPORTING PERSON: I.R.S. IDENTIFICATION NO. OF ABOVE PERSON (ENTITIES ONLY) Michael A. Henos - -------------------------------------------------------------------------------- 2 CHECK THE APPROPRIATE BOX IF A MEMBER OF A GROUP* (a)[_] (b)[_] - -------------------------------------------------------------------------------- 3 SEC USE ONLY - -------------------------------------------------------------------------------- 4 CITIZENSHIP OR PLACE OF ORGANIZATION United States - -------------------------------------------------------------------------------- 5 SOLE VOTING POWER NUMBER OF ----------------------------------------------------- SHARES 6 SHARED VOTING POWER BENEFICIALLY OWNED BY EACH ----------------------------------------------------- REPORTING 7 SOLE DISPOSITIVE POWER PERSON WITH ----------------------------------------------------- 8 SHARED DISPOSITIVE POWER - -------------------------------------------------------------------------------- 9 AGGREGATE AMOUNT BENEFICIALLY OWNED BY EACH REPORTING PERSON - -------------------------------------------------------------------------------- 10 CHECK BOX IF THE AGGREGATE AMOUNT IN ROW (9) EXCLUDES CERTAIN SHARES* [_] - -------------------------------------------------------------------------------- 11 PERCENT OF CLASS REPRESENTED BY AMOUNT IN ROW 9 - -------------------------------------------------------------------------------- 12 TYPE OF REPORTING PERSON* IN ================================================================================ *SEE INSTRUCTIONS BEFORE FILLING OUT! =================== ================== CUSIP No. 006864102 SCHEDULE 13G Page 6 of 12 Pages =================== ================== ================================================================================ 1 NAMES OF REPORTING PERSON: I.R.S. IDENTIFICATION NO. OF ABOVE PERSON (ENTITIES ONLY) J. Connor Seabrook - -------------------------------------------------------------------------------- 2 CHECK THE APPROPRIATE BOX IF A MEMBER OF A GROUP* (a)[_] (b)[_] - -------------------------------------------------------------------------------- 3 SEC USE ONLY - -------------------------------------------------------------------------------- 4 CITIZENSHIP OR PLACE OF ORGANIZATION United States - -------------------------------------------------------------------------------- 5 SOLE VOTING POWER NUMBER OF ----------------------------------------------------- SHARES 6 SHARED VOTING POWER BENEFICIALLY OWNED BY EACH ----------------------------------------------------- REPORTING 7 SOLE DISPOSITIVE POWER PERSON WITH ----------------------------------------------------- 8 SHARED DISPOSITIVE POWER - -------------------------------------------------------------------------------- 9 AGGREGATE AMOUNT BENEFICIALLY OWNED BY EACH REPORTING PERSON - -------------------------------------------------------------------------------- 10 CHECK BOX IF THE AGGREGATE AMOUNT IN ROW (9) EXCLUDES CERTAIN SHARES* [_] - -------------------------------------------------------------------------------- 11 PERCENT OF CLASS REPRESENTED BY AMOUNT IN ROW 9 - -------------------------------------------------------------------------------- 12 TYPE OF REPORTING PERSON* IN ================================================================================ *SEE INSTRUCTIONS BEFORE FILLING OUT! =================== ================== CUSIP No. 006864102 SCHEDULE 13G Page 7 of 12 Pages =================== ================== ================================================================================ 1 NAMES OF REPORTING PERSON: I.R.S. IDENTIFICATION NO. OF ABOVE PERSON (ENTITIES ONLY) J. Connor Seabrook - -------------------------------------------------------------------------------- 2 CHECK THE APPROPRIATE BOX IF A MEMBER OF A GROUP* (a)[_] (b)[_] - -------------------------------------------------------------------------------- 3 SEC USE ONLY - -------------------------------------------------------------------------------- 4 CITIZENSHIP OR PLACE OF ORGANIZATION United States - -------------------------------------------------------------------------------- 5 SOLE VOTING POWER NUMBER OF ----------------------------------------------------- SHARES 6 SHARED VOTING POWER BENEFICIALLY OWNED BY EACH ----------------------------------------------------- REPORTING 7 SOLE DISPOSITIVE POWER PERSON WITH ----------------------------------------------------- 8 SHARED DISPOSITIVE POWER - -------------------------------------------------------------------------------- 9 AGGREGATE AMOUNT BENEFICIALLY OWNED BY EACH REPORTING PERSON - -------------------------------------------------------------------------------- 10 CHECK BOX IF THE AGGREGATE AMOUNT IN ROW (9) EXCLUDES CERTAIN SHARES* [_] - -------------------------------------------------------------------------------- 11 PERCENT OF CLASS REPRESENTED BY AMOUNT IN ROW 9 - -------------------------------------------------------------------------------- 12 TYPE OF REPORTING PERSON* IN ================================================================================ *SEE INSTRUCTIONS BEFORE FILLING OUT! =================== ================== CUSIP No. 006864102 SCHEDULE 13G Page 8 of 12 Pages =================== ================== ITEM 1. (a) Name of Issuer: Adeza Biomedical Corporation (b) Address of Issuer's Principal Executive Offices: 1240 Elko Drive, Sunnyvale, CA 94089 ITEM 2. (a) Name of Person Filing: (1) Alliance Technology Ventures III, L.P. ("ATV"); (2) ATV III Partners, LLC ("ATV/GP"); (3) ATV III Affiliates Fund, L.P. ("ATV/AF"); (4) Michael A. Henos ("Henos"); (5) J. Connor Seabrook ("Seabrook"); and (6) Michael R. Slawson ("Slawson"). Henos, Seabrook and Slawson are the individual managers of ATV/GP. The entities and persons named in this paragraph are referred to individually herein as a "Reporting Person" and collectively as the "Reporting Persons." (b) Address of Principal Business Office or, if none, Residence: The address of the principal business office of each of ATV, ATV/GP, ATV/AF, Henos, Seabrook and Slawson is: 2400 Lakeview Parkway, Suite 675, Alpharetta, GA 30004 (c) Citizenship: ATV and ATV/AF are limited partnerships organized under the laws of the State of Delaware. ATV/GP is a limited liability company organized under the laws of the State of Delaware. Each of Henos, Seabrook and Slawson is a United States citizen. (d) Title of Class of Securities: Common Stock (e) CUSIP Number: 006864102 ITEM 3. IF THIS STATEMENT IS FILED PURSUANT TO SS.SS.240.13D-1(B) OR 240.13D-2(B) OR (C), CHECK WHETHER THE PERSON FILING IS A: NOT APPLICABLE (a) |_| Broker or dealer registered under section 15 of the Act (b) |_| Bank as defined in section 3(a)(6) of the Act (c) |_| Insurance company as defined in section 3(a)(19) of the Act (d) |_| Investment company registered under section 8 of the Investment Company Act of 1940 (e) |_| An investment adviser in accordance with ss.240.13d-1(b) (1(ii)(E) (f) |_| An employee benefit plan or endowment fund in accordance with ss.240.13d-1(b)(1)(ii)(F) (g) |_| A parent holding company or control person in accordance with ss.240.13d-1(b)(1)(ii)(G) (h) |_| A savings association as defined in section 3(b) of the Federal Deposit Insurance Act (i) |_| A church plan that is excluded from the definition of an investment company under section 3(c)(14) of the Investment Company Act of 1940 (j) |_| Group, in accordance with ss.240.13d-1(b)-1(ii)(J) =================== ================== CUSIP No. 006864102 SCHEDULE 13G Page 9 of 12 Pages =================== ================== ITEM 4. OWNERSHIP N/A ITEM 5. OWNERSHIP OF FIVE PERCENT OR LESS OF A CLASS If this statement is being filed to report the fact that as of the date hereof the reporting person has ceased to be the beneficial owner of more than five percent of the class of securities, check the following |X|. ITEM 6. OWNERSHIP OF MORE THAN FIVE PERCENT ON BEHALF OF ANOTHER PERSON N/A ITEM 7. IDENTIFICATION AND CLASSIFICATION OF THE SUBSIDIARY WHICH ACQUIRED THE SECURITY BEING REPORTED ON BY THE PARENT HOLDING COMPANY N/A ITEM 8. IDENTIFICATION AND CLASSIFICATION OF MEMBERS OF THE GROUP N/A ITEM 9. NOTICE OF DISSOLUTION OF GROUP N/A ITEM 10. CERTIFICATION N/A =================== =================== CUSIP No. 006864102 SCHEDULE 13G Page 10 of 12 Pages =================== =================== SIGNATURE After reasonable inquiry and to the best of its knowledge and belief, each of the undersigned certifies that the information set forth in this statement is true, complete and correct. Each of the undersigned has previously agreed to file this statement jointly pursuant to the Agreement listed on Exhibit 1 which has been previously filed with the Securities and Exchange Commission and is hereby incorporated herein by reference. Date: February 9, 2006 ALLIANCE TECHNOLOGY VENTURES III, L.P. By: ATV III PARTNERS, LLC By: /s/ Michael A. Henos --------------------------------- Michael A. Henos Manager ATV III AFFILIATES FUND, L.P. By: ATV III PARTNERS, LLC By: /s/ Michael A. Henos --------------------------------- Michael A. Henos Manager ATV III PARTNERS, LLC By: ATV III PARTNERS, LLC By: /s/ Michael A. Henos --------------------------------- Michael A. Henos Manager * ------------------------ MICHAEL R. SLAWSON * ------------------------ J. CONNOR SEABROOK * The undersigned attorney-in-fact, by signing his name below, does hereby sign this statement on behalf of the above indicated filers pursuant to the Power of Attorney attached hereto as Exhibit 2 which has been previously filed with the Securities and Exchange Commission and is hereby incorporated herein by reference. /s/ Michael A. Henos - ------------------------ Michael A. Henos Individually and as Attorney-in-Fact =================== =================== CUSIP No. 006864102 SCHEDULE 13G Page 11 of 12 Pages =================== =================== EXHIBIT 1 --------- AGREEMENT Pursuant to Rule 13d-1(k)(1) under the Securities Exchange Act of 1934, the undersigned hereby agree that only one statement containing the information required by Schedule 13G need be filed with respect to the ownership by each of the undersigned of shares of stock of Adeza Biomedical Corporation. EXECUTED this 10th day of February, 2005. ALLIANCE TECHNOLOGY VENTURES III, L.P. By: ATV III PARTNERS, LLC By: /s/ Michael A. Henos ---------------------------------------- Michael A. Henos Manager ATV III AFFILIATES FUND, L.P. By: ATV III PARTNERS, LLC By: /s/ Michael A. Henos ---------------------------------------- Michael A. Henos Manager ATV III PARTNERS, LLC By: /s/ Michael A. Henos --------------------------------------- Michael A. Henos Manager * - ------------------------------------------- MICHAEL R. SLAWSON * - ------------------------------------------- WILLIAM L. LYMAN * - ------------------------------------------- J. CONNOR SEABROOK /s/ Michael A. Henos - ------------------------------------------- Michael A. Henos Individually and as Attorney-in-Fact This Schedule 13G was executed by Michael A. Henos on behalf of the individuals listed above pursuant to a Power of Attorney which is being filed with the Securities and Exchange Commission with this Schedule 13G filing for Adeza Biomedical Corporation and said Power of Attorney is incorporated herein by reference and a copy of which is attached as Exhibit 2. =================== =================== CUSIP No. 006864102 SCHEDULE 13G Page 12 of 12 Pages =================== =================== EXHIBIT 2 --------- POWER OF ATTORNEY KNOW ALL MEN BY THESE PRESENTS, that each person whose signature appears below hereby constitutes and appoints Michael A. Henos with full power to act without the other, his true and lawful attorney-in-fact, with full power of substitution, to sign any and all instruments, certificates and documents that may be necessary, desirable or appropriate to be executed on behalf of himself as an individual or in his capacity as general partner of any partnership, pursuant to section 13 or 16 of the Securities Exchange Act of 1934, as amended (the "Exchange Act"), and any and all regulations promulgated thereunder, and to file the same, with all exhibits thereto, and any other documents in connection therewith, with the Securities and Exchange Commission, and with any other entity when and if such is mandated by the Exchange Act or by the By-laws of the National Association of Securities Dealers, Inc., granting unto said attorney-in-fact full power and authority to do and perform each and every act and thing necessary, desirable or appropriate, fully to all intents and purposes as he might or could do in person, thereby ratifying and confirming all that said attorney-in-fact, or his substitutes, may lawfully do or cause to be done by virtue hereof. IN WITNESS WHEREOF, this Power of Attorney has been signed as of the 14th day of June, 2004. /s/ Michael R. Slawson ---------------------------- Michael R. Slawson /s/ William L. Lyman ---------------------------- William L. Lyman /s/ J. Connor Seabrook ---------------------------- J. Connor Seabrook -----END PRIVACY-ENHANCED MESSAGE-----