0001209191-23-060013.txt : 20231229 0001209191-23-060013.hdr.sgml : 20231229 20231229165809 ACCESSION NUMBER: 0001209191-23-060013 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20231227 FILED AS OF DATE: 20231229 DATE AS OF CHANGE: 20231229 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Davis Lisa Ann CENTRAL INDEX KEY: 0001706496 ORGANIZATION NAME: FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-39744 FILM NUMBER: 231528356 MAIL ADDRESS: STREET 1: 2555 TELEGRAPH RD CITY: BLOOMFIELD HILLS STATE: MI ZIP: 48302 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: C3.ai, Inc. CENTRAL INDEX KEY: 0001577526 STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-PREPACKAGED SOFTWARE [7372] ORGANIZATION NAME: 06 Technology IRS NUMBER: 263999357 STATE OF INCORPORATION: DE FISCAL YEAR END: 0430 BUSINESS ADDRESS: STREET 1: 1400 SEAPORT BLVD CITY: REDWOOD CITY STATE: CA ZIP: 94063 BUSINESS PHONE: 650-503-2200 MAIL ADDRESS: STREET 1: 1400 SEAPORT BLVD CITY: REDWOOD CITY STATE: CA ZIP: 94063 FORMER COMPANY: FORMER CONFORMED NAME: C3 IoT, Inc. DATE OF NAME CHANGE: 20180123 FORMER COMPANY: FORMER CONFORMED NAME: C3, Inc. DATE OF NAME CHANGE: 20130522 4 1 doc4.xml FORM 4 SUBMISSION X0508 4 2023-12-27 0 0001577526 C3.ai, Inc. AI 0001706496 Davis Lisa Ann C/O C3.AI, INC. 1400 SEAPORT BLVD REDWOOD CITY CA 94063 1 0 0 0 0 Class A Common Stock 2023-12-27 4 M 0 2000 13.49 A 27945 D Class A Common Stock 2023-12-27 4 F 0 915 29.975 D 27030 D Stock Option (Right to Buy) 13.49 2023-12-27 4 M 0 2000 0.00 D 2032-10-04 Class A Common Stock 2000 48349 D Provided the Reporting Person remains a director of the Company and attends in person the regularly scheduled meeting of the Board during each fiscal quarter, commencing on October 5, 2022 (the "Vesting Commencement Date"), then 5% of the shares subject to the option shall vest on the last day of such fiscal quarter (the "Quarterly Shares") during the term of the option, provided, however, if the Reporting Person fails to attend any such regularly scheduled meeting, then vesting for the Quarterly Shares shall not occur and will be suspended (any such suspended Quarterly Shares being referred to collectively as the "Suspended Shares"). For any Suspended Shares, such shares shall vest only following the fifth anniversary of the applicable Vesting Commencement Date, if the Reporting Person satisfies the attendance requirements in subsequent periods. /s/ Eric Jensen, Attorney-in-Fact 2023-12-29