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