0000899243-18-011978.txt : 20180508 0000899243-18-011978.hdr.sgml : 20180508 20180508202305 ACCESSION NUMBER: 0000899243-18-011978 CONFORMED SUBMISSION TYPE: 3 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20180508 FILED AS OF DATE: 20180508 DATE AS OF CHANGE: 20180508 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: AFEYAN NOUBAR CENTRAL INDEX KEY: 0001222012 FILING VALUES: FORM TYPE: 3 SEC ACT: 1934 Act SEC FILE NUMBER: 001-38473 FILM NUMBER: 18816391 MAIL ADDRESS: STREET 1: 1 SUNSET RIDGE CITY: LEXINGTON STATE: MA ZIP: 02173 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: KANIA EDWIN M JR CENTRAL INDEX KEY: 0001255927 FILING VALUES: FORM TYPE: 3 SEC ACT: 1934 Act SEC FILE NUMBER: 001-38473 FILM NUMBER: 18816390 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Flagship V VentureLabs Rx Fund, L.P. CENTRAL INDEX KEY: 0001724939 FILING VALUES: FORM TYPE: 3 SEC ACT: 1934 Act SEC FILE NUMBER: 001-38473 FILM NUMBER: 18816396 BUSINESS ADDRESS: STREET 1: 55 CAMBRIDGE PARKWAY STREET 2: SUITE 800E CITY: CAMBRIDGE STATE: MA ZIP: 02142 BUSINESS PHONE: 617-868-1888 MAIL ADDRESS: STREET 1: 55 CAMBRIDGE PARKWAY STREET 2: SUITE 800E CITY: CAMBRIDGE STATE: MA ZIP: 02142 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Flagship Ventures Opportunities Fund I General Partner LLC CENTRAL INDEX KEY: 0001725004 FILING VALUES: FORM TYPE: 3 SEC ACT: 1934 Act SEC FILE NUMBER: 001-38473 FILM NUMBER: 18816392 BUSINESS ADDRESS: STREET 1: 55 CAMBRIDGE PARKWAY STREET 2: SUITE 800E CITY: CAMBRIDGE STATE: MA ZIP: 02142 BUSINESS PHONE: 617-868-1888 MAIL ADDRESS: STREET 1: 55 CAMBRIDGE PARKWAY STREET 2: SUITE 800E CITY: CAMBRIDGE STATE: MA ZIP: 02142 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Nutritional Health Disruptive Innovation Fund, L.P. CENTRAL INDEX KEY: 0001725001 FILING VALUES: FORM TYPE: 3 SEC ACT: 1934 Act SEC FILE NUMBER: 001-38473 FILM NUMBER: 18816395 BUSINESS ADDRESS: STREET 1: 55 CAMBRIDGE PARKWAY STREET 2: SUITE 800E CITY: CAMBRIDGE STATE: MA ZIP: 02142 BUSINESS PHONE: 617-868-1888 MAIL ADDRESS: STREET 1: 55 CAMBRIDGE PARKWAY STREET 2: SUITE 800E CITY: CAMBRIDGE STATE: MA ZIP: 02142 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Nutritional Health Side Fund, L.P. CENTRAL INDEX KEY: 0001725000 FILING VALUES: FORM TYPE: 3 SEC ACT: 1934 Act SEC FILE NUMBER: 001-38473 FILM NUMBER: 18816394 BUSINESS ADDRESS: STREET 1: 55 CAMBRIDGE PARKWAY STREET 2: SUITE 800E CITY: CAMBRIDGE STATE: MA ZIP: 02142 BUSINESS PHONE: 617-868-1888 MAIL ADDRESS: STREET 1: 55 CAMBRIDGE PARKWAY STREET 2: SUITE 800E CITY: CAMBRIDGE STATE: MA ZIP: 02142 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Flagship VentureLabs V LLC CENTRAL INDEX KEY: 0001724959 STATE OF INCORPORATION: DE FILING VALUES: FORM TYPE: 3 SEC ACT: 1934 Act SEC FILE NUMBER: 001-38473 FILM NUMBER: 18816398 BUSINESS ADDRESS: STREET 1: 55 CAMBRIDGE PARKWAY STREET 2: SUITE 800E CITY: CAMBRIDGE STATE: MA ZIP: 02142 BUSINESS PHONE: 617-868-1888 MAIL ADDRESS: STREET 1: 55 CAMBRIDGE PARKWAY STREET 2: SUITE 800E CITY: CAMBRIDGE STATE: MA ZIP: 02142 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Flagship Ventures Fund V General Partner LLC CENTRAL INDEX KEY: 0001724575 STATE OF INCORPORATION: DE FILING VALUES: FORM TYPE: 3 SEC ACT: 1934 Act SEC FILE NUMBER: 001-38473 FILM NUMBER: 18816399 BUSINESS ADDRESS: STREET 1: 55 CAMBRIDGE PARKWAY STREET 2: SUITE 800E CITY: CAMBRIDGE STATE: MA ZIP: 02142 BUSINESS PHONE: 617-868-1888 MAIL ADDRESS: STREET 1: 55 CAMBRIDGE PARKWAY STREET 2: SUITE 800E CITY: CAMBRIDGE STATE: MA ZIP: 02142 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Flagship Ventures Opportunities Fund I, L.P. CENTRAL INDEX KEY: 0001677345 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 3 SEC ACT: 1934 Act SEC FILE NUMBER: 001-38473 FILM NUMBER: 18816393 BUSINESS ADDRESS: STREET 1: ONE MEMORIAL DRIVE STREET 2: 7TH FLOOR CITY: CAMBRIDGE STATE: MA ZIP: 02142 BUSINESS PHONE: 617-868-1888 MAIL ADDRESS: STREET 1: ONE MEMORIAL DRIVE STREET 2: 7TH FLOOR CITY: CAMBRIDGE STATE: MA ZIP: 02142 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Flagship Ventures Fund V, L.P. CENTRAL INDEX KEY: 0001627639 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 3 SEC ACT: 1934 Act SEC FILE NUMBER: 001-38473 FILM NUMBER: 18816397 BUSINESS ADDRESS: STREET 1: ONE MEMORIAL DRIVE, 7TH FLOOR CITY: CAMBRIDGE STATE: MA ZIP: 02142 BUSINESS PHONE: 617-868-1888 MAIL ADDRESS: STREET 1: ONE MEMORIAL DRIVE, 7TH FLOOR CITY: CAMBRIDGE STATE: MA ZIP: 02142 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: Evelo Biosciences, Inc. CENTRAL INDEX KEY: 0001694665 STANDARD INDUSTRIAL CLASSIFICATION: PHARMACEUTICAL PREPARATIONS [2834] IRS NUMBER: 465594527 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 620 MEMORIAL DRIVE STREET 2: SUITE 200 WEST CITY: CAMBRIDGE STATE: MA ZIP: 02139 BUSINESS PHONE: 617 870 8281 MAIL ADDRESS: STREET 1: 620 MEMORIAL DRIVE STREET 2: SUITE 200 WEST CITY: CAMBRIDGE STATE: MA ZIP: 02139 3 1 doc3.xml FORM 3 SUBMISSION X0206 3 2018-05-08 0 0001694665 Evelo Biosciences, Inc. EVLO 0001724575 Flagship Ventures Fund V General Partner LLC 55 CAMBRIDGE PARKWAY, SUITE 800E CAMBRIDGE MA 02142 0 0 1 0 0001724959 Flagship VentureLabs V LLC 55 CAMBRIDGE PARKWAY, SUITE 800E CAMBRIDGE MA 02142 0 0 1 0 0001627639 Flagship Ventures Fund V, L.P. 55 CAMBRIDGE PARKWAY, SUITE 800E CAMBRIDGE MA 02142 0 0 1 0 0001724939 Flagship V VentureLabs Rx Fund, L.P. 55 CAMBRIDGE PARKWAY, SUITE 800E CAMBRIDGE MA 02142 0 0 1 0 0001725001 Nutritional Health Disruptive Innovation Fund, L.P. 55 CAMBRIDGE PARKWAY, SUITE 800E CAMBRIDGE MA 02142 0 0 1 0 0001725000 Nutritional Health Side Fund, L.P. 55 CAMBRIDGE PARKWAY, SUITE 800E CAMBRIDGE MA 02142 0 0 1 0 0001677345 Flagship Ventures Opportunities Fund I, L.P. 55 CAMBRIDGE PARKWAY, SUITE 800E CAMBRIDGE MA 02142 0 0 1 0 0001725004 Flagship Ventures Opportunities Fund I General Partner LLC 55 CAMBRIDGE PARKWAY, SUITE 800E CAMBRIDGE MA 02142 0 0 1 0 0001222012 AFEYAN NOUBAR 55 CAMBRIDGE PARKWAY, SUITE 800E CAMBRIDGE MA 02142 1 0 1 0 0001255927 KANIA EDWIN M JR 55 CAMBRIDGE PARKWAY, SUITE 800E CAMBRIDGE MA 02142 0 0 1 0 Common Stock 3330009 I See footnotes Series A Preferred Stock Common Stock 3073533 I See footnotes Series A-1 Preferred Stock Common Stock 2476600 I See footnotes Series A-2 Preferred Stock Common Stock 1327939 I See footnotes Series A-3 Preferred Stock Common Stock 2042902 I See footnotes Series B Preferred Stock Common Stock 4562664 I See footnotes Series C Preferred Stock Common Stock 1138505 I See footnotes Includes 684,372 shares held by Flagship VentureLabs IV LLC ("VentureLabs IV") and 2,645,637 shares held by Flagship VentureLabs V LLC ("VentureLabs V"). The preferred stock is convertible into the Issuer's common stock on a 0.2452-for-one basis at the holder's election and has no expiration date. The preferred stock will automatically convert into common stock upon the closing of the Issuer's initial public offering. Includes Series A Preferred Stock convertible into 2,554,616 shares of common stock by Flagship Ventures Fund V, L.P. ("Flagship Fund V"), 314,619 shares of common stock by Flagship V VentureLabs Rx Fund, L.P. ("VentureLabs Rx V") and 204,298 shares of common stock by Nutritional Health Side Fund, L.P. ("Nutritional Health Side Fund"). Includes Series A-1 Preferred Stock convertible into 1,019,675 shares of common stock by Flagship Ventures Fund IV L.P. ("Flagship Fund IV"), 244,621 shares of common stock by Flagship Ventures Fund IV-Rx, L.P. ("Flagship Fund IV-Rx" and, together with VentureLabs IV and Flagship Fund IV, the "Flagship Fund IV Funds"), 303,076 shares of common stock by Flagship Fund V and 909,228 shares of common stock by Nutritional Health Disruptive Innovation Fund, L.P. ("Nutritional Innovation Fund" and, together with VentureLabs V, Flagship Fund V, VentureLabs Rx V and Nutritional Health Side Fund, the "Flagship Fund V Funds"). Includes Series A-2 Preferred Stock convertible into 747,732 shares of common stock by Flagship Fund V, 478,058 shares of common stock by VentureLabs Rx V and 102,149 shares of common stock by Nutritional Health Side Fund. Includes Series A-3 Preferred Stock convertible into 817,161 shares of common stock by Flagship Fund IV, 204,290 shares of common stock by Flagship Fund IV-Rx, 255,362 shares of common stock by Flagship Fund V and 766,089 shares of common stock by Nutritional Innovation Fund. Includes Series B Preferred Stock convertible into 340,497 shares of common stock by Flagship Fund V, 817,194 shares of common stock by VentureLabs Rx V, 1,361,989 shares of common stock by Nutritional Innovation Fund, 1,702,487 shares of common stock by Flagship Ventures Opportunities Fund I, L.P. ("Flagship Opportunities I" and, together with the Flagship Fund IV Funds and Flagship Fund V Funds, the "Flagship Funds") and 340,497 shares of common stock by Nutritional Health Side Fund. Includes Series C Preferred Stock convertible into 569,253 shares of common stock by Flagship Opportunities I, 455,402 shares of common stock by Nutritional Innovation Fund and 113,850 shares of common stock by Nutritional Health Side Fund. Flagship Fund IV is a member of Flagship VentureLabs IV and also serves as its manager. Flagship Fund V is a member of Flagship VentureLabs V and also serves as its manager. The general partner of each of Flagship Fund IV and Flagship Fund IV-Rx is Flagship Ventures Fund IV General Partner LLC ("Flagship Fund IV GP"). The general partner of Flagship Fund V, Flagship VentureLabs V-Rx, Nutritional Innovation Fund and Nutritional Health Side Fund is Flagship Ventures Fund V General Partner LLC ("Flagship Fund V GP"). The general partner of Flagship Opportunities Fund I is Flagship Ventures Opportunities Fund I General Partner LLC ("Flagship Opportunities GP," and together with Flagship Fund IV GP and Flagship Fund V GP, the "Flagship General Partners"). Noubar B. Afeyan, Ph.D. and Edwin M. Kania, Jr. are the managers of Flagship Fund IV GP and each of these individuals may be deemed to share voting and investment power with respect to all shares held by Flagship Fund IV Funds. Dr. Afeyan also serves as the managing member of the Flagship Fund V GP and Flagship Opportunities Fund GP and may be deemed to possess sole voting and investment control over the shares held by the Flagship Fund V Funds and Flagship Opportunities Fund I. Each of the Flagship General Partners, Dr. Afeyan and Mr. Kania disclaims beneficial ownership of any shares beneficially owned by the Flagship Funds except to the extent of its or his pecuniary interest therein. Exhibit 24 - Power of Attorney. Due to the limitations of the electronic filing system each of Flagship Ventures Fund IV General Partner LLC, Flagship VentureLabs IV LLC, Flagship Ventures Fund IV, L.P. and Flagship Ventures Fund IV-Rx, L.P. are filing a separate Form 3. Flagship Ventures Fund V General Partner LLC, By: /s/ Noubar B. Afeyan, Name: Noubar B. Afeyan, Ph.D., Title: Manager 2018-05-08 Flagship VentureLabs V LLC, By: Flagship Ventures Fund V, L.P., its manager, By: Flagship Ventures Fund V General Partner LLC, its general partner, By: /s/ Noubar B. Afeyan, Ph.D., Name: Noubar B. Afeyan, Ph.D., Title: Manager 2018-05-08 Flagship Ventures Fund V, L.P., By: Flagship Ventures Fund V General Partner LLC, its general partner, By: /s/ Noubar B. Afeyan, Name: Noubar B. Afeyan, Ph.D., Title: Manager 2018-05-08 Flagship V VentureLabs Rx Fund, L.P., By: Flagship Ventures Fund V General Partner LLC, its general partner, By: /s/ Noubar B. Afeyan, Name: Noubar B. Afeyan, Ph.D., Title: Manager 2018-05-08 Nutritional Health Disruptive Innovation Fund, L.P., By: Flagship Ventures Fund V General Partner LLC, its general partner, By: /s/ Noubar B. Afeyan, Name: Noubar B. Afeyan, Ph.D., Title: Manager 2018-05-08 Nutritional Health Side Fund, L.P., By: Flagship Ventures Fund V General Partner LLC, its general partner, By: /s/ Noubar B. Afeyan, Name: Noubar B. Afeyan, Ph.D., Title: Manager 2018-05-08 Flagship Ventures Opportunities Fund I, L.P., By: Flagship Ventures Opportunities Fund I General Partner LLC, its general partner, By: /s/ Noubar B. Afeyan, Name: Noubar B. Afeyan, Ph.D., Title: Manager 2018-05-08 Flagship Ventures Opportunities Fund I General Partner LLC, By: /s/ Noubar B. Afeyan, Name: Noubar B. Afeyan, Ph.D., Title: Manager 2018-05-08 /s/ Noubar B. Afeyan, Noubar B. Afeyan, Ph.D. 2018-05-08 /s/ Edwin M. Kania, Jr., Edwin M. Kania, Jr. 2018-05-08