0001192482-19-000420.txt : 20191113 0001192482-19-000420.hdr.sgml : 20191113 20191113204829 ACCESSION NUMBER: 0001192482-19-000420 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20191108 FILED AS OF DATE: 20191113 DATE AS OF CHANGE: 20191113 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Oliva Adele C CENTRAL INDEX KEY: 0001339379 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-39130 FILM NUMBER: 191215971 MAIL ADDRESS: STREET 1: C/O QUAKER PARTNERS STREET 2: 150 MONUMENT ROAD, SUITE 207 CITY: BALA CYNWYD STATE: PA ZIP: 19004 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: TELA Bio, Inc. CENTRAL INDEX KEY: 0001561921 STANDARD INDUSTRIAL CLASSIFICATION: SURGICAL & MEDICAL INSTRUMENTS & APPARATUS [3841] IRS NUMBER: 455320061 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 1 GREAT VALLEY PARKWAY, SUITE 24 CITY: MALVERN STATE: PA ZIP: 19355 BUSINESS PHONE: 484-320-2930 MAIL ADDRESS: STREET 1: 1 GREAT VALLEY PARKWAY, SUITE 24 CITY: MALVERN STATE: PA ZIP: 19355 4 1 edgar.xml PRIMARY DOCUMENT X0306 4 2019-11-08 0001561921 TELA Bio, Inc. TELA 0001339379 Oliva Adele C C/O QUAKER BIOVENTURES CAPITAL II, L.P. 150 MONUMENT ROAD, SUITE 207 BALA CYNWYD PA 19004 1 0 1 0 Common Stock 2019-11-08 4 P 0 153846 13.00 A 888664 I By Quaker Bioventures II, L.P. Common Stock 2019-11-13 4 C 0 345489 A 1234153 I By Quaker Bioventures II, L.P. Common Stock 2019-11-13 4 C 0 516947 A 1751100 I By Quaker Bioventures II, L.P. Series A Preferred Stock 2019-11-13 4 C 0 8530145 0 D Common Stock 345489 0 I By Quaker Bioventures II, L.P. Series B Preferred Stock 2019-11-13 4 C 0 12763434 0 D Common Stock 516947 0 I By Quaker Bioventures II, L.P. Warrant (right to buy) 1.16 2019-11-13 4 C 0 446813 0 D 2017-01-18 2027-01-18 Series B Preferred Stock 446813 0 I By Quaker Bioventures II, L.P. Warrant (right to buy) 28.65 2019-11-13 4 C 0 446813 0 A 2019-11-13 2027-01-18 Common Stock 18096 446813 I By Quaker Bioventures II, L.P. Reflects 705,530 shares of common stock received as a payment-in-kind dividend on Series A Preferred Stock and Series B Preferred Stock exempt from reporting under Rule 16a-9(a). The reporting person disclaims beneficial ownership of these securities except to the extent of her pecuniary interest therein, and the inclusion of these securities in this report shall not be deemed an admission of beneficial ownership of all of the reported securities for the purposes of Section 16 or otherwise. Shares of Series A Preferred Stock automatically converted into shares of Common Stock at a 1-for-1 conversion rate upon the closing of the Issuer's initial public offering and had no expiration date. Shares of Series B Preferred Stock automatically converted into shares of Common Stock at a 1-for-1 conversion rate upon the closing of the Issuer's initial public offering and had no expiration date. Reflects 1-for-24.69 reverse stock split which became effective on October 28, 2019. Warrants exercisable for shares of Series B Preferred Stock automatically converted into warrants exercisable for shares of Common Stock upon the closing of the Issuer's initial public offering. /s/ Nora Brennan as attorney-in-fact for Adele C. Oliva 2019-11-13