0000903423-15-000444.txt : 20150708
0000903423-15-000444.hdr.sgml : 20150708
20150708190035
ACCESSION NUMBER: 0000903423-15-000444
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20150707
FILED AS OF DATE: 20150708
DATE AS OF CHANGE: 20150708
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: ConforMIS Inc
CENTRAL INDEX KEY: 0001305773
STANDARD INDUSTRIAL CLASSIFICATION: ORTHOPEDIC, PROSTHETIC & SURGICAL APPLIANCES & SUPPLIES [3842]
IRS NUMBER: 000000000
STATE OF INCORPORATION: DE
FISCAL YEAR END: 1231
BUSINESS ADDRESS:
STREET 1: 28 CROSBY DR.
CITY: BEDFORD
STATE: MA
ZIP: 01730
BUSINESS PHONE: (781) 345-9001
MAIL ADDRESS:
STREET 1: 28 CROSBY DR.
CITY: BEDFORD
STATE: MA
ZIP: 01730
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Procific
CENTRAL INDEX KEY: 0001362557
STATE OF INCORPORATION: E9
FISCAL YEAR END: 1231
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-37474
FILM NUMBER: 15980167
BUSINESS ADDRESS:
STREET 1: P.O. BOX 7106
CITY: EMIRATE OF ABU DHABI
STATE: C0
ZIP: 00000
BUSINESS PHONE: (202) 457-6325
MAIL ADDRESS:
STREET 1: P.O. BOX 7106
CITY: EMIRATE OF ABU DHABI
STATE: C0
ZIP: 00000
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Abu Dhabi Investment Authority
CENTRAL INDEX KEY: 0001362558
STATE OF INCORPORATION: C0
FISCAL YEAR END: 1231
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-37474
FILM NUMBER: 15980168
BUSINESS ADDRESS:
STREET 1: 211 CORNICHE
STREET 2: PO BOX 3600
CITY: ABU DHABI
STATE: C0
ZIP: 0000
BUSINESS PHONE: 971 2 4154242
MAIL ADDRESS:
STREET 1: P.O. BOX 3600
CITY: ABU DHABI
STATE: C0
ZIP: 0000
4
1
adiaprocific.xml
OWNERSHIP DOCUMENT
X0306
4
2015-07-07
0
0001305773
ConforMIS Inc
CFMS
0001362558
Abu Dhabi Investment Authority
211 CORNICHE STREET
ABU DHABI, PO BOX 3600
C0
3600
UNITED ARAB EMIRATES
1
0
0
0
0001362557
Procific
122 MARY STREET,
P.O. BOX 709
GRAND CAYMAN
E9
KY1-1107
CAYMAN ISLANDS
1
0
0
0
Common Stock
2015-07-07
4
C
0
3125000
A
3125000
D
Series E 1 Preferred Stock
2015-07-07
4
C
0
3125000
0
D
Common stock
1562500
0
D
Series E 2 Preferred Stock
2015-07-07
4
C
0
3125000
0
D
Common Stock
1562500
0
D
The Series E-1 Preferred Stock and Series E-2 Preferred Stock converted into common stock, par value of $0.00001 per share (the "Common Stock"), on a two-for-one basis upon the closing of the Issuer's initial public offering on July 7, 2015, and had no expiration.
Procific directly holds 3,125,000 shares of Common Stock (the "Procific Shares"), which it acquired upon the automatic conversion of the Series E-1 Preferred Stock and Series E-2 Preferred Stock upon the closing of the Issuer's initial public offering. The Abu Dhabi Investment Authority ("ADIA" and, together with Procific, the "Reporting Persons") is the sole owner of Procific and therefore may also be deemed to beneficially own the Procific Shares.
Pursuant to Rule 16a-1(a)(4) under the Securities Exchange Act of 1934, as amended (the "Exchange Act"), this filing shall not be deemed an admission that the Reporting Persons are, for purposes of Section 16 of the Exchange Act or otherwise, the beneficial owners of any equity securities in excess of their respective pecuniary interests
The Reporting Persons are no longer 10% owners; however, solely for the purposes of Section 16 of the Exchange Act, each of the Reporting Persons may be deemed a "deputized director" by virtue of Colm Lanigan, an employee of ADIA, serving as a member of the board of directors of the Issuer.
/s/ Hamad Shahwan AlDhaheri, Authorized Signatory of Abu Dhabi Investment Authority
2015-07-08
/s/ Saeed AlMazrouei, Authorized Signatory of Abu Dhabi Investment Authority
2015-07-08
/s/ Khalifa AlFalasi,Authorized Signatory of Procific
2015-07-08
/s/ Ahmed Al Mosa, Authorized Signatory of Procific
2015-07-08