0000906344-14-000024.txt : 20140424
0000906344-14-000024.hdr.sgml : 20140424
20140424160430
ACCESSION NUMBER: 0000906344-14-000024
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20140422
FILED AS OF DATE: 20140424
DATE AS OF CHANGE: 20140424
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: TriVascular Technologies, Inc.
CENTRAL INDEX KEY: 0001432732
STANDARD INDUSTRIAL CLASSIFICATION: SURGICAL & MEDICAL INSTRUMENTS & APPARATUS [3841]
IRS NUMBER: 000000000
STATE OF INCORPORATION: DE
FISCAL YEAR END: 1231
BUSINESS ADDRESS:
STREET 1: 3910 BRICKWAY BOULEVARD
CITY: SANTA ROSA
STATE: CA
ZIP: 95403
BUSINESS PHONE: 707-543-8800
MAIL ADDRESS:
STREET 1: 3910 BRICKWAY BOULEVARD
CITY: SANTA ROSA
STATE: CA
ZIP: 95403
FORMER COMPANY:
FORMER CONFORMED NAME: TV2 HOLDING Co
DATE OF NAME CHANGE: 20091116
FORMER COMPANY:
FORMER CONFORMED NAME: TV2 HOLDING CO
DATE OF NAME CHANGE: 20080417
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: DOUGLASS DAVID L
CENTRAL INDEX KEY: 0001271389
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-36419
FILM NUMBER: 14781771
MAIL ADDRESS:
STREET 1: 3000 SAND HILL RD
STREET 2: BUILDING 1, SUITE 135
CITY: MENLO PARK
STATE: CA
ZIP: 94025
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: ROEDER DOUGLAS A
CENTRAL INDEX KEY: 0001270735
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-36419
FILM NUMBER: 14781772
MAIL ADDRESS:
STREET 1: 3000 DAND HILL RD, BLDG 1, STE 135
STREET 2: C/O DELPHI VENTURES
CITY: MENLO PARK
STATE: CA
ZIP: 94025
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: BOCHNOWSKI JAMES J
CENTRAL INDEX KEY: 0001255743
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-36419
FILM NUMBER: 14781773
MAIL ADDRESS:
STREET 1: C/O DELPHI VENTURES
STREET 2: 3000 SAND HILL ROAD STE 135
CITY: MENLO PARK
STATE: CA
ZIP: 94025
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: DELPHI BIOINVESTMENTS VII LP
CENTRAL INDEX KEY: 0001346198
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-36419
FILM NUMBER: 14781775
BUSINESS ADDRESS:
STREET 1: 3000 SAND HILL ROAD
STREET 2: BUILDING 1 STE 135
CITY: MENLO PARK
STATE: CA
ZIP: 94025
MAIL ADDRESS:
STREET 1: 3000 SAND HILL ROAD
STREET 2: BUILDING 1 STE 135
CITY: MENLO PARK
STATE: CA
ZIP: 94025
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: DELPHI VENTURES VII L P
CENTRAL INDEX KEY: 0001336922
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-36419
FILM NUMBER: 14781777
BUSINESS ADDRESS:
STREET 1: 3000 SAND HILL RD
STREET 2: BUILDING 1 SUITE 135
CITY: MENLO PARK
STATE: CA
ZIP: 94025
BUSINESS PHONE: 650-854-9650
MAIL ADDRESS:
STREET 1: 3000 SAND HILL RD
STREET 2: BUILDING 1 SUITE 135
CITY: MENLO PARK
STATE: CA
ZIP: 94025
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Delphi Management Partners VIII, L.L.C.
CENTRAL INDEX KEY: 0001457494
STATE OF INCORPORATION: DE
FISCAL YEAR END: 1231
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-36419
FILM NUMBER: 14781779
BUSINESS ADDRESS:
STREET 1: 3000 SAND HILL ROAD, 1-135
CITY: MENLO PARK
STATE: CA
ZIP: 94025
BUSINESS PHONE: 650-854-9650
MAIL ADDRESS:
STREET 1: 3000 SAND HILL ROAD, 1-135
CITY: MENLO PARK
STATE: CA
ZIP: 94025
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: DELPHI VENTURES VIII LP
CENTRAL INDEX KEY: 0001436285
STATE OF INCORPORATION: DE
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-36419
FILM NUMBER: 14781776
BUSINESS ADDRESS:
STREET 1: 3000 SAND HILL ROAD
STREET 2: BUILDING 1, SUITE 135
CITY: MENLO PARK
STATE: CA
ZIP: 94025
BUSINESS PHONE: 650-854-9657
MAIL ADDRESS:
STREET 1: 3000 SAND HILL ROAD
STREET 2: BUILDING 1, SUITE 135
CITY: MENLO PARK
STATE: CA
ZIP: 94025
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: PAKIANATHAN DEEPIKA
CENTRAL INDEX KEY: 0001270734
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-36419
FILM NUMBER: 14781770
MAIL ADDRESS:
STREET 1: 3000 SAND HILL RD, BLDG 1, STE 135
STREET 2: C/O DELPHI VENTURES
CITY: MENLO PARK
STATE: CA
ZIP: 94025
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Delphi BioInvestments VIII LP
CENTRAL INDEX KEY: 0001451526
STATE OF INCORPORATION: DE
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-36419
FILM NUMBER: 14781774
BUSINESS ADDRESS:
STREET 1: 300 Sand Hill Rd
STREET 2: Building 1 Suite 135
CITY: Menlo Park
STATE: CA
ZIP: 94025
BUSINESS PHONE: 650 854 9650
MAIL ADDRESS:
STREET 1: 300 Sand Hill rd
STREET 2: Building 1 Suite 135
CITY: Menlo pARK
STATE: ca
ZIP: 94025
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Delphi Management Partners VII, L.L.C.
CENTRAL INDEX KEY: 0001457493
STATE OF INCORPORATION: DE
FISCAL YEAR END: 1231
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-36419
FILM NUMBER: 14781778
BUSINESS ADDRESS:
STREET 1: 3000 SAND HILL ROAD, 1-135
CITY: MENLO PARK
STATE: CA
ZIP: 94025
BUSINESS PHONE: 650-854-9650
MAIL ADDRESS:
STREET 1: 3000 SAND HILL ROAD, 1-135
CITY: MENLO PARK
STATE: CA
ZIP: 94025
4
1
edgar.xml
PRIMARY DOCUMENT
X0306
4
2014-04-22
0001432732
TriVascular Technologies, Inc.
TRIV
0001457494
Delphi Management Partners VIII, L.L.C.
3000 SAND HILL ROAD, BLDG.1, SUITE 135
MENLO PARK
CA
94025
0
0
1
0
0001457493
Delphi Management Partners VII, L.L.C.
3000 SAND HILL ROAD, BLDG.1, SUITE 135
MENLO PARK
CA
94025
0
0
1
0
0001336922
DELPHI VENTURES VII L P
C/O DELPHI VENTURES
3000 SAND HILL ROAD, BLDG.1, SUITE 135
MENLO PARK
CA
94025
0
0
1
0
0001436285
DELPHI VENTURES VIII LP
C/O DELPHI VENTURES
3000 SAND HILL ROAD, BLDG.1, SUITE 135
MENLO PARK
CA
94025
0
0
1
0
0001346198
DELPHI BIOINVESTMENTS VII LP
C/O DELPHI VENTURES
3000 SAND HILL ROAD, BLDG.1, SUITE 135
MENLO PARK
CA
94025
0
0
1
0
0001451526
Delphi BioInvestments VIII LP
C/O DELPHI VENTURES
3000 SAND HILL ROAD, BLDG.1, SUITE 135
MENLO PARK
CA
94025
0
0
1
0
0001270735
ROEDER DOUGLAS A
C/O DELPHI VENTURES
3000 SAND HILL ROAD, BLDG.1, SUITE 135
MENLO PARK
CA
94025
1
0
1
0
0001255743
BOCHNOWSKI JAMES J
C/O DELPHI VENTURES
3000 SAND HILL ROAD, BLDG.1, SUITE 135
MENLO PARK
CA
94025
0
0
1
0
0001271389
DOUGLASS DAVID L
C/O DELPHI VENTURES
3000 SAND HILL ROAD, BLDG.1, SUITE 135
MENLO PARK
CA
94025
0
0
1
0
0001270734
PAKIANATHAN DEEPIKA
C/O DELPHI VENTURES
3000 SAND HILL ROAD, BLDG.1, SUITE 135
MENLO PARK
CA
94025
0
0
1
0
Common Stock
2014-04-22
4
P
0
833333
12.00
A
833333
I
See Footnotes
Common Stock
2014-04-22
4
C
0
574933
0
A
1408266
I
See Footnotes
Common Stock
2014-04-22
4
C
0
384594
0
A
1792860
I
See Footnotes
Common Stock
2014-04-22
4
C
0
424918
0
A
2217778
I
See Footnotes
Common Stock
2014-04-22
4
C
0
970167
0
A
3187945
I
See Footnotes
Common Stock
2014-04-22
4
C
0
347965
0
A
3535910
I
See Footnotes
Series A Preferred Stock
2014-04-22
4
C
0
574933
D
Common Stock
574933
0
I
See Footnote
Series B Preferred Stock
2014-04-22
4
C
0
384594
D
Common Stock
384594
0
I
See Footnote
Series C Preferred Stock
2014-04-22
4
C
0
424918
D
Common Stock
424918
0
I
See Footnote
Series D Preferred Stock
2014-04-22
4
C
0
970167
D
Common Stock
970167
0
I
See Footnote
Series E Preferred Stock
2013-11-01
4
A
0
347965
A
Common Stock
347965
347965
I
See Footnote
Series E Preferred Stock
2014-04-22
4
C
0
347965
D
Common Stock
347965
0
I
See Footnote
Warrant to Purchase Series D Preferred Stock (right to buy)
2014-04-22
4
C
0
45094
15.8061
D
2012-02-02
2019-02-02
Series D Preferred Stock
45094
0
I
See Footnote
Warrant to Purchase Common Stock (right to buy)
15.8061
2014-04-22
4
C
0
45094
0
A
2012-02-02
2019-02-02
Common Stock
45094
45094
I
See Footnote
These securities are directly held as follows: 247,525 shares by Delphi Ventures VII, L.P. ("Ventures VII"), 2,475 shares by Delphi BioInvestments VII, L.P. ("BioInvestments VII" and together with Ventures VII, the "Delphi VII Funds"), 577,692 shares by Delphi Ventures VIII, L.P. ("Ventures VIII") and 5,641 shares by Delphi BioInvestments VIII, L.P. ("BioInvestments VIII" and together with Ventures VIII, the "Delphi VIII Funds" and collectively with the Delphi VII Funds, the "Delphi Funds"). Delphi Management Partners VII, L.L.C. ("DMP VII") is the general partner of each of Ventures VII and BioInvestments VII and may be deemed to have sole voting and dispositive power over the securities held by the Delphi VII Funds. Delphi Management Partners VIII, L.L.C. ("DMP VIII") is the general partner of each of Ventures VIII and BioInvestments VIII and may be deemed to have sole voting and dispositive power over the securities held by the Delphi VIII Funds.
Douglas A. Roeder, James J. Bochnowski, David L. Douglass and Deepika R. Pakianathan, Ph.D. are the managing members of each of DMP VII and DMP VIII and may be deemed to share voting and dispositive power over the securities held by the Delphi Funds. Such persons and entities disclaim beneficial ownership of the securities held by the Delphi Funds, except to the extent of any pecuniary interest therein.
These securities are directly held as follows: 569,241 shares by Ventures VII and 5,692 shares by BioInvestments VII. DMP VII is the general partner of each of Ventures VII and BioInvestments VII and may be deemed to have sole voting and dispositive power over the securities held by the Delphi VII Funds. Douglas A. Roeder, James J. Bochnowski, David L. Douglass and Deepika R. Pakianathan, Ph.D. are the managing members of DMP VII and may be deemed to share voting and dispositive power over the securities held by the Delphi Funds. Such persons and entities disclaim beneficial ownership of the securities held by the Delphi Funds, except to the extent of any pecuniary interest therein.
These securities are directly held as follows: 114,236 shares by Ventures VII, 1,142 shares by BioInvestments VII, 266,613 shares by Ventures VIII and 2,603 shares by BioInvestments VIII. DMP VII is the general partner of each of Ventures VII and BioInvestments VII and may be deemed to have sole voting and dispositive power over the securities held by the Delphi VII Funds. DMP VIII is the general partner of each of Ventures VIII and BioInvestments VIII and may be deemed to have sole voting and dispositive power over the securities held by the Delphi VIII Funds. Douglas A. Roeder, James J. Bochnowski, David L. Douglass and Deepika R. Pakianathan, Ph.D. are the managing members of each of DMP VII and DMP VIII and may be deemed to share voting and dispositive power over the securities held by the Delphi Funds. Such persons and entities disclaim beneficial ownership of the securities held by the Delphi Funds, except to the extent of any pecuniary interest therein.
These securities are directly held as follows: 105,298 shares by Ventures VII, 1,052 shares by BioInvestments VII, 315,489 shares by Ventures VIII and 3,079 shares by BioInvestments VIII. DMP VII is the general partner of each of Ventures VII and BioInvestments VII and may be deemed to have sole voting and dispositive power over the securities held by the Delphi VII Funds. DMP VIII is the general partner of each of Ventures VIII and BioInvestments VIII and may be deemed to have sole voting and dispositive power over the securities held by the Delphi VIII Funds. The Reporting Person is a managing member of each of DMP VII and DMP VIII and may be deemed to share voting and dispositive power over the securities held by the Delphi Funds. The Reporting Person disclaims beneficial ownership of the securities held by the Delphi Funds, except to the extent of any pecuniary interest therein.
These securities are directly held as follows: 270,867 shares by Ventures VII, 2,707 shares by BioInvestments VII, 689,858 shares by Ventures VIII and 6,735 shares by BioInvestments VIII. DMP VII is the general partner of each of Ventures VII and BioInvestments VII and may be deemed to have sole voting and dispositive power over the securities held by the Delphi VII Funds. DMP VIII is the general partner of each of Ventures VIII and BioInvestments VIII and may be deemed to have sole voting and dispositive power over the securities held by the Delphi VIII Funds. Douglas A. Roeder, James J. Bochnowski, David L. Douglass and Deepika R. Pakianathan, Ph.D. are the managing members of each of DMP VII and DMP VIII and may be deemed to share voting and dispositive power over the securities held by the Delphi Funds. Such persons and entities disclaim beneficial ownership of the securities held by the Delphi Funds, except to the extent of any pecuniary interest therein.
These securities are directly held as follows: 157,386 shares by Ventures VII, 1,573 shares by BioInvestments VII, 187,179 shares by Ventures VIII and 1,827 shares by BioInvestments VIII. DMP VII is the general partner of each of Ventures VII and BioInvestments VII and may be deemed to have sole voting and dispositive power over the securities held by the Delphi VII Funds. DMP VIII is the general partner of each of Ventures VIII and BioInvestments VIII and may be deemed to have sole voting and dispositive power over the securities held by the Delphi VIII Funds. Douglas A. Roeder, James J. Bochnowski, David L. Douglass and Deepika R. Pakianathan, Ph.D. are the managing members of each of DMP VII and DMP VIII and may be deemed to share voting and dispositive power over the securities held by the Delphi Funds. Such persons and entities disclaim beneficial ownership of the securities held by the Delphi Funds, except to the extent of any pecuniary interest therein.
Each share of Series A Preferred Stock and each share of Series B Preferred Stock converted into 0.03845959625192770 of a share of Common Stock upon the closing of the Issuer's initial public offering without payment of further consideration. The number of securities reported in Table II is shown on an as converted basis. The shares have no expiration date.
Each share of Series C Preferred Stock converted into 0.03899558573514530 of a share of Common Stock upon the closing of the Issuer's initial public offering without payment of further consideration. The number of securities reported in Table II is shown on an as converted basis. The shares have no expiration date.
Each share of Series D Preferred Stock and each share of Series E Preferred Stock converted into 0.02464875523786050 of a share of Common Stock upon the closing of the Issuer's initial public offering without payment of further consideration. The number of securities reported in Table II is shown on an as converted basis. The shares have no expiration date.
These securities are directly held as follows: 25,754 shares by Ventures VII, 257 shares by BioInvestments VII, 18,899 shares by Ventures VIII and 184 shares by BioInvestments VIII. DMP VII is the general partner of each of Ventures VII and BioInvestments VII and may be deemed to have sole voting and dispositive power over the securities held by the Delphi VII Funds. DMP VIII is the general partner of each of Ventures VIII and BioInvestments VIII and may be deemed to have sole voting and dispositive power over the securities held by the Delphi VIII Funds. Douglas A. Roeder, James J. Bochnowski, David L. Douglass and Deepika R. Pakianathan, Ph.D. are the managing members of each of DMP VII and DMP VIII and may be deemed to share voting and dispositive power over the securities held by the Delphi Funds. Such persons and entities disclaim beneficial ownership of the securities held by the Delphi Funds, except to the extent of any pecuniary interest therein.
/s/ Matthew T. Potter, Attorney-In-Fact for Delphi Management Partners VIII, L.L.C.
2014-04-24
/s/ Matthew T. Potter, Attorney-In-Fact for Delphi Management Partners VII, L.L.C.
2014-04-24
/s/ Matthew T. Potter, Attorney-In-Fact for Delphi Ventures VII, L.P.
2014-04-24
/s/ Matthew T. Potter, Attorney-In-Fact for Delphi Ventures VIII, L.P.
2014-04-24
/s/ Matthew T. Potter, Attorney-In-Fact for Delphi BioInvestments VII, L.P.
2014-04-24
/s/ Matthew T. Potter, Attorney-In-Fact for Delphi BioInvestments VIII, L.P.
2014-04-24
/s/ Matthew T. Potter, Attorney-In-Fact for Douglas A. Roeder
2014-04-24
/s/ Matthew T. Potter, Attorney-In-Fact for James J. Bochnowski
2014-04-24
/s/ Matthew T. Potter, Attorney-In-Fact for David L. Douglass
2014-04-24
/s/ Matthew T. Potter, Attorney-In-Fact for Deepika R. Pakianathan
2014-04-24