0001209191-12-014715.txt : 20120301
0001209191-12-014715.hdr.sgml : 20120301
20120301193657
ACCESSION NUMBER: 0001209191-12-014715
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20120229
FILED AS OF DATE: 20120301
DATE AS OF CHANGE: 20120301
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: KINGSLEY DOUGLAS A
CENTRAL INDEX KEY: 0001197537
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-35435
FILM NUMBER: 12659735
MAIL ADDRESS:
STREET 1: C/O ADVENT INTERNATIONAL CORP
STREET 2: 75 STATE ST 29TH FLOOR
CITY: BOSTON
STATE: MA
ZIP: 02104
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: DAMORE RICHARD A
CENTRAL INDEX KEY: 0001206641
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-35435
FILM NUMBER: 12659736
MAIL ADDRESS:
STREET 1: C/O NORTHBRIDGE VENTURE PARTNERS
STREET 2: 950 WINTER ST STE 4600
CITY: WALTHAM
STATE: MA
ZIP: 02451
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: ANDERSON EDWARD T
CENTRAL INDEX KEY: 0001218581
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-35435
FILM NUMBER: 12659737
MAIL ADDRESS:
STREET 1: 950 WINTER ST SUITE 4600
CITY: WATHAM
STATE: MA
ZIP: 02451
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: Proto Labs Inc
CENTRAL INDEX KEY: 0001443669
STANDARD INDUSTRIAL CLASSIFICATION: FABRICATED STRUCTURAL METAL PRODUCTS [3440]
IRS NUMBER: 000000000
BUSINESS ADDRESS:
STREET 1: 5540 Pioneer Creek
CITY: Maple Plain
STATE: MN
ZIP: 55359
BUSINESS PHONE: 763-479-7474
MAIL ADDRESS:
STREET 1: 5540 Pioneer Creek
CITY: Maple Plain
STATE: MN
ZIP: 55359
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: NORTH BRIDGE GROWTH EQUITY I LP
CENTRAL INDEX KEY: 0001390657
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-35435
FILM NUMBER: 12659733
BUSINESS ADDRESS:
STREET 1: 950 WINTER STREET
STREET 2: SUITE 4600
CITY: WALTHAM
STATE: MA
ZIP: 02451
BUSINESS PHONE: 7812900004
MAIL ADDRESS:
STREET 1: 950 WINTER STREET
STREET 2: SUITE 4600
CITY: WALTHAM
STATE: MA
ZIP: 02451
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: NBGE Manager, LLC
CENTRAL INDEX KEY: 0001542779
STATE OF INCORPORATION: DE
FISCAL YEAR END: 1231
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-35435
FILM NUMBER: 12659738
BUSINESS ADDRESS:
STREET 1: 950 WINTER STREET
STREET 2: SUITE 4600
CITY: WALTHAM
STATE: MA
ZIP: 02454
BUSINESS PHONE: 781-290-0004
MAIL ADDRESS:
STREET 1: 950 WINTER STREET
STREET 2: SUITE 4600
CITY: WALTHAM
STATE: MA
ZIP: 02454
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: NBGE GP, LLC
CENTRAL INDEX KEY: 0001542781
STATE OF INCORPORATION: DE
FISCAL YEAR END: 1231
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-35435
FILM NUMBER: 12659734
BUSINESS ADDRESS:
STREET 1: 950 WINTER STREET
STREET 2: SUITE 4600
CITY: WALTHAM
STATE: MA
ZIP: 02454
BUSINESS PHONE: 781-290-0004
MAIL ADDRESS:
STREET 1: 950 WINTER STREET
STREET 2: SUITE 4600
CITY: WALTHAM
STATE: MA
ZIP: 02454
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: North Bridge Growth Management, L.P.
CENTRAL INDEX KEY: 0001542785
STATE OF INCORPORATION: DE
FISCAL YEAR END: 1231
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-35435
FILM NUMBER: 12659732
BUSINESS ADDRESS:
STREET 1: 950 WINTER STREET
STREET 2: SUITE 4600
CITY: WALTHAM
STATE: MA
ZIP: 02454
BUSINESS PHONE: 781-290-0004
MAIL ADDRESS:
STREET 1: 950 WINTER STREET
STREET 2: SUITE 4600
CITY: WALTHAM
STATE: MA
ZIP: 02454
4
1
doc4.xml
FORM 4 SUBMISSION
X0304
4
2012-02-29
0
0001443669
Proto Labs Inc
PRLB
0001542779
NBGE Manager, LLC
C/O NORTH BRIDGE GROWTH EQUITY
950 WINTER STREET, SUITE 4600
WALTHAM
MA
02454
1
0
1
0
0001218581
ANDERSON EDWARD T
C/O NORTH BRIDGE GROWTH EQUITY
950 WINTER STREET, SUITE 4600
WALTHAM
MA
02454
0
0
1
0
0001206641
DAMORE RICHARD A
C/O NORTH BRIDGE GROWTH EQUITY
950 WINTER STREET, SUITE 4600
WALTHAM
MA
02454
0
0
1
0
0001197537
KINGSLEY DOUGLAS A
C/O NORTH BRIDGE GROWTH EQUITY
950 WINTER STREET, SUITE 4600
WALTHAM
MA
02454
1
0
0
0
0001542781
NBGE GP, LLC
C/O NORTH BRIDGE GROWTH EQUITY
950 WINTER STREET, SUITE 4600
WALTHAM
MA
02454
0
0
1
0
0001390657
NORTH BRIDGE GROWTH EQUITY I LP
C/O NORTH BRIDGE GROWTH EQUITY
950 WINTER STREET, SUITE 4600
WALTHAM
MA
02454
0
0
1
0
0001542785
North Bridge Growth Management, L.P.
C/O NORTH BRIDGE GROWTH EQUITY
950 WINTER STREET, SUITE 4600
WALTHAM
MA
02454
0
0
1
0
Common Stock
2012-02-29
4
C
0
5991790
A
5991790
I
By North Bridge Growth Equity I, L.P.
Common Stock
2012-02-29
4
P
0
430000
16.00
A
6421790
I
By North Bridge Growth Equity I, L.P.
Series A Preferred Stock
2012-02-29
4
C
0
427985
0.00
D
Common Stock
5991790
0
I
By North Bridge Growth Equity I, L.P.
Upon the closing of the Issuer's initial public offering, each of the 427,985 shares of Series A Preferred Stock automatically converted into shares of the Issuer's Common Stock on a 14-for-1 basis.
Represents shares held directly by North Bridge Growth Equity I, L.P. NBGE Manager, LLC ("NBGE") is the managing manager of NBGE GP, LLC, which is the sole general partner of North Bridge Growth Management, L.P., which is the sole general partner of North Bridge Growth Equity I, L.P. NBGE has sole vesting and dispositive power over such shares. Douglas Kingsley, a director of the Issuer, is a founding managing director of NBGE GP, LLC. Shared voting and investment power over such shares is vested in the managers of NBGE, Edward Anderson and Richard D'Amore. Mr. Kingsley, Mr. Anderson and Mr. D'Amore each disclaim any beneficial ownership of such shares, except to the extent of any pecuniary interest therein. This report shall not be deemed an admission that any of the reporting persons is the beneficial owner of such securities for purposes of Section 16 or for any other purpose.
The security does not have an expiration date.
/c/ Catherine M. Verschelden, Attorney-in-Fact for NBGE Manager, LLC
2012-03-01
/s/ Catherine M. Verschelden, Attorney-in-Fact for Edward Anderson
2012-03-01
/s/ Catherine M. Verschelden, Attorney-in-Fact for Richard D'Amore
2012-03-01
/s/ Catherine M. Verschelden, Attorney-in-Fact for Douglas Kingsley
2012-03-01
/s/ Catherine M. Verschelden, Attorney-in-Fact for NBGE GP, LLC
2012-03-01
/s/ Catherine M. Verschelden, Attorney-in-Fact for North Bridge Growth Equity I, L.P.
2012-03-01
/s/ Catherine M. Verschelden, Attorney-in-Fact for North Bridge Growth Management, L.P.
2012-03-01