0001104659-21-094472.txt : 20210721
0001104659-21-094472.hdr.sgml : 20210721
20210721170448
ACCESSION NUMBER: 0001104659-21-094472
CONFORMED SUBMISSION TYPE: 3
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20210714
FILED AS OF DATE: 20210721
DATE AS OF CHANGE: 20210721
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: BXHCP SP II, LLC
CENTRAL INDEX KEY: 0001804589
STATE OF INCORPORATION: DE
FISCAL YEAR END: 1231
FILING VALUES:
FORM TYPE: 3
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-40606
FILM NUMBER: 211105174
BUSINESS ADDRESS:
STREET 1: 135 E 57TH STREET
STREET 2: 23RD FLOOR
CITY: NEW YORK
STATE: NY
ZIP: 10022
BUSINESS PHONE: (646) 688-1617
MAIL ADDRESS:
STREET 1: 135 E 57TH STREET
STREET 2: 23RD FLOOR
CITY: NEW YORK
STATE: NY
ZIP: 10022
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Blue Ox Healthcare Partners SP, LLC
CENTRAL INDEX KEY: 0001785138
STATE OF INCORPORATION: DE
FISCAL YEAR END: 1231
FILING VALUES:
FORM TYPE: 3
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-40606
FILM NUMBER: 211105172
BUSINESS ADDRESS:
STREET 1: 135 E. 57TH STREET, 23RD FLOOR
CITY: NEW YORK
STATE: NY
ZIP: 10022
BUSINESS PHONE: 646.688.1617
MAIL ADDRESS:
STREET 1: 135 E. 57TH STREET, 23RD FLOOR
CITY: NEW YORK
STATE: NY
ZIP: 10022
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Blue Ox Healthcare Partners, LLC
CENTRAL INDEX KEY: 0001873840
STATE OF INCORPORATION: DE
FISCAL YEAR END: 1231
FILING VALUES:
FORM TYPE: 3
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-40606
FILM NUMBER: 211105175
BUSINESS ADDRESS:
STREET 1: 239 DAWSON ROAD
CITY: HILLSIDE
STATE: NY
ZIP: 12529
BUSINESS PHONE: 646.688.1617
MAIL ADDRESS:
STREET 1: 239 DAWSON ROAD
CITY: HILLSIDE
STATE: NY
ZIP: 12529
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: BXHCP SP III, LLC
CENTRAL INDEX KEY: 0001862000
STATE OF INCORPORATION: DE
FISCAL YEAR END: 1231
FILING VALUES:
FORM TYPE: 3
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-40606
FILM NUMBER: 211105173
BUSINESS ADDRESS:
STREET 1: 229 DAWSON ROAD
CITY: HILLSDALE
STATE: NY
ZIP: 12529
BUSINESS PHONE: (646) 688-1617
MAIL ADDRESS:
STREET 1: 229 DAWSON ROAD
CITY: HILLSDALE
STATE: NY
ZIP: 12529
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: SERA PROGNOSTICS, INC.
CENTRAL INDEX KEY: 0001534969
STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-MEDICAL LABORATORIES [8071]
IRS NUMBER: 261911522
STATE OF INCORPORATION: DE
FISCAL YEAR END: 1231
BUSINESS ADDRESS:
STREET 1: 2749 E. PARLEYS WAY
STREET 2: SUITE 200
CITY: SALT LAKE CITY
STATE: UT
ZIP: 84109
BUSINESS PHONE: (801) 990-0520
MAIL ADDRESS:
STREET 1: 2749 E. PARLEYS WAY
STREET 2: SUITE 200
CITY: SALT LAKE CITY
STATE: UT
ZIP: 84109
3
1
tm2122872-1_3seq1.xml
OWNERSHIP DOCUMENT
X0206
3
2021-07-14
0
0001534969
SERA PROGNOSTICS, INC.
SERA
0001873840
Blue Ox Healthcare Partners, LLC
C/O SERA PROGNOSTICS, INC.
2749 EAST PARLEYS WAY, SUITE 200
SALT LAKE CITY
UT
84109
0
0
1
0
0001804589
BXHCP SP II, LLC
C/O SERA PROGNOSTICS, INC.
2749 EAST PARLEYS WAY, SUITE 200
SALT LAKE CITY
UT
84109
0
0
1
0
0001862000
BXHCP SP III, LLC
C/O SERA PROGNOSTICS, INC.
2749 EAST PARLEYS WAY, SUITE 200
SALT LAKE CITY
UT
84109
0
0
1
0
0001785138
Blue Ox Healthcare Partners SP, LLC
C/O SERA PROGNOSTICS, INC.
2749 EAST PARLEYS WAY, SUITE 200
SALT LAKE CITY
UT
84109
0
0
1
0
Series D Preferred Stock
9.02
Class A Common Stock
1515595
I
By Blue Ox Healthcare Partners SP, LLC
Series D Preferred Stock
9.02
Class A Common Stock
1075047
I
By BXHCP SP II, LLC
Series E Preferred Stock
12.45
Class A Common Stock
1204508
I
By BXHCP SP III, LLC
Warrant (right to buy)
9.02
2029-07-31
Class A Common Stock
378897
I
By Blue Ox Healthcare Partners SP, LLC
Warrant (right to buy)
10.83
2029-07-31
Class A Common Stock
378897
I
By Blue Ox Healthcare Partners SP, LLC
The shares of preferred stock will automatically convert into the Issuer's Class A Common Stock in accordance with the Issuer's Restated Certificate of Incorporation, as amended, immediately upon completion of the Issuer's initial public offering.
Not applicable
The Issuer's Series D Preferred Stock is convertible at the option of a holder at any time into shares of the Issuer's Class A Common Stock at a conversion price, as adjusted to reflect the Issuer's recent 1-for-0.481 reverse stock split, of $9.02 per share. The Series D Preferred Stock has no expiration date.
Blue Ox Healthcare Partners, LLC is the manager of each of Blue Ox Healthcare Partners SP, LLC, BXHCP SP II, LLC, and BXHCP SP III, LLC, and may be deemed to have voting, investment and dispositive power with respect to the shares held by Blue Ox Healthcare Partners SP, LLC, BXHCP SP II, LLC, and BXHCP SP III, LLC. Charles D. Kennedy MD, Oded Levy, and John A. Neczesny, managing partners of Blue Ox Healthcare Partners, LLC, each may be deemed to share voting, investment and dispositive power with respect to these shares.
The Issuer's Series E Preferred Stock is convertible at the option of a holder at any time into shares of the Issuer's Class A Common Stock at a conversion price, as adjusted to reflect the Issuer's recent 1-for-0.481 reverse stock split, of $12.45 per share. The Series E Preferred Stock has no expiration date.
Immediately exercisable.
Blue Ox Healthcare Partners, LLC /s/ John A. Neczesny, Secretary John A. Neczesny, Secretary
2021-07-21
Blue Ox Healthcare Partners SP, LLC /s/ John A. Neczesny, Secretary John A. Neczesny, Secretary
2021-07-21
BXHCP SP II, LLC /s/ John A. Neczesny, Secretary John A. Neczesny, Secretary
2021-07-21
BXHCP SP III, LLC /s/ John A. Neczesny, Secretary John A. Neczesny, Secretary
2021-07-21