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