0000899243-18-028795.txt : 20181113 0000899243-18-028795.hdr.sgml : 20181113 20181113181135 ACCESSION NUMBER: 0000899243-18-028795 CONFORMED SUBMISSION TYPE: 3 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20181113 FILED AS OF DATE: 20181113 DATE AS OF CHANGE: 20181113 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: 3x5 Special Opportunity Fund, L.P. CENTRAL INDEX KEY: 0001529594 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 3 SEC ACT: 1934 Act SEC FILE NUMBER: 001-38740 FILM NUMBER: 181179617 BUSINESS ADDRESS: STREET 1: 7733 FORSYTH BOULEVARD CITY: ST. LOUIS STATE: MO ZIP: 63105 BUSINESS PHONE: 314-726-6700 MAIL ADDRESS: STREET 1: 7733 FORSYTH BOULEVARD CITY: ST. LOUIS STATE: MO ZIP: 63105 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: VAPOTHERM INC CENTRAL INDEX KEY: 0001253176 STANDARD INDUSTRIAL CLASSIFICATION: SURGICAL & MEDICAL INSTRUMENTS & APPARATUS [3841] IRS NUMBER: 000000000 STATE OF INCORPORATION: DE BUSINESS ADDRESS: STREET 1: 100 DOMAIN DRIVE CITY: EXETER STATE: NH ZIP: 03833 BUSINESS PHONE: 603-658-0411 MAIL ADDRESS: STREET 1: 100 DOMAIN DRIVE CITY: EXETER STATE: NH ZIP: 03833 3 1 doc3.xml FORM 3 SUBMISSION X0206 3 2018-11-13 0 0001253176 VAPOTHERM INC VAPO 0001529594 3x5 Special Opportunity Fund, L.P. 101 S. HANLEY ROAD, SUITE 1850 ST. LOUIS MO 63105 0 0 1 0 Series A Convertible Preferred Stock Common Stock 500000 D Series B Convertible Preferred Stock Common Stock 285714 D Series C Convertible Preferred Stock Common Stock 264244 D Series A Convertible Preferred Stock is convertible into shares of common stock at any time at the holder's election and automatically upon the consummation of a qualified public offering of the registrant. There is no expiration date for the Series A Convertible Preferred Stock. Series B Convertible Preferred Stock is convertible into shares of common stock at any time at the holder's election and automatically upon the consummation of a qualified public offering of the registrant. There is no expiration date for the Series B Convertible Preferred Stock. Series C Convertible Preferred Stock is convertible into shares of common stock at any time at the holder's election and automatically upon the consummation of a qualified public offering of the registrant. There is no expiration date for the Series C Convertible Preferred Stock. /s/ Nicholas Walrod 2018-11-13