0001209191-20-037736.txt : 20200618
0001209191-20-037736.hdr.sgml : 20200618
20200618212518
ACCESSION NUMBER: 0001209191-20-037736
CONFORMED SUBMISSION TYPE: 3
PUBLIC DOCUMENT COUNT: 2
CONFORMED PERIOD OF REPORT: 20200618
FILED AS OF DATE: 20200618
DATE AS OF CHANGE: 20200618
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Jerel Davis
CENTRAL INDEX KEY: 0001745958
FILING VALUES:
FORM TYPE: 3
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-39335
FILM NUMBER: 20974064
BUSINESS ADDRESS:
STREET 1: ONE SANSOME STREET, SUITE 3630
CITY: SAN FRANCISCO
STATE: CA
ZIP: 94104
BUSINESS PHONE: 415-801-8100
MAIL ADDRESS:
STREET 1: ONE SANSOME STREET, SUITE 3630
CITY: SAN FRANCISCO
STATE: CA
ZIP: 94104
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: Repare Therapeutics Inc.
CENTRAL INDEX KEY: 0001808158
STANDARD INDUSTRIAL CLASSIFICATION: PHARMACEUTICAL PREPARATIONS [2834]
IRS NUMBER: 000000000
STATE OF INCORPORATION: Z4
FISCAL YEAR END: 1231
BUSINESS ADDRESS:
STREET 1: 7210 FREDERICK-BANTING, SUITE 100
CITY: ST-LAURENT
STATE: A8
ZIP: H4S 2A1
BUSINESS PHONE: (857) 412-7018
MAIL ADDRESS:
STREET 1: 7210 FREDERICK-BANTING, SUITE 100
CITY: ST-LAURENT
STATE: A8
ZIP: H4S 2A1
3
1
doc3.xml
FORM 3 SUBMISSION
X0206
3
2020-06-18
0
0001808158
Repare Therapeutics Inc.
RPTX
0001745958
Jerel Davis
C/O REPARE THERAPEUTICS INC.
7210 FREDERICK-BANTING, SUITE 100
ST-LAURENT
A8
QUEBEC, CANADA
1
0
0
0
Common Shares
651462
I
See Footnote
Common Shares
49580
I
See Footnote
Common Shares
21692
I
See Footnote
Common Shares
19596
I
See Footnote
Class A Preferred Shares
Common Shares
2054198
I
See Footnote
Class A Preferred Shares
Common Shares
156335
I
See Footnote
Class A Preferred Shares
Common Shares
68398
I
See Footnote
Class A Preferred Shares
Common Shares
61791
I
See Footnote
Class A Preferred Shares
Common Shares
2443883
I
See Footnote
Class B Preferred Shares
Common Shares
111361
I
See Footnote
Class B Preferred Shares
Common Shares
8475
I
See Footnote
Class B Preferred Shares
Common Shares
3708
I
See Footnote
Class B Preferred Shares
Common Shares
3350
I
See Footnote
Class B Preferred Shares
Common Shares
875568
I
See Footnote
Class B Preferred Shares
Common Shares
458282
I
See Footnote
The securities are held by Versant Venture Capital V, L.P. ("VVC V"). The Reporting Person is a managing member of the general partner of VVC V, but
disclaims beneficial ownership of such securities, except to the extent of his pecuniary interest therein, if any.
The securities are held by Versant Venture Capital V (Canada) LP ("VVC V (Canada)"). The Reporting Person is a director of the ultimate general partner of VVC V (Canada), but disclaims beneficial ownership of such securities, except to the extent of his pecuniary interest therein, if any.
The securities are held by Versant Ophthalmic Affiliates Fund I, L.P. ("VOAF I"). The Reporting Person is a managing member of the general partner of VOAF I, but disclaims beneficial ownership of such securities, except to the extent of his pecuniary interest therein, if any.
The securities are held by Versant Affiliates Fund V, L.P. ("VAF V"). The Reporting Person is a managing member of the general partner of VAF V, but disclaims beneficial ownership of such securities, except to the extent of his pecuniary interest therein, if any.
Each Class A Preferred Share and Class B Preferred Share is convertible at any time, at the holder's election, into Common Shares, on a one-for-one basis, has no expiration date and will convert into Common Shares upon the closing of the Issuer's initial public offering.
The securities are held by Versant Venture Capital VI, L.P. ("VVC VI"). The Reporting Person is a managing member of the ultimate general partner of VVC VI, but disclaims beneficial ownership of such securities, except to the extent of his pecuniary interest therein, if any.
The securities are held by Versant Vantage I, L.P. ("VV I"). The Reporting Person is a managing member of the ultimate general partner of VV I, but disclaims beneficial ownership of such securities, except to the extent of his pecuniary interest therein, if any.
/s/ Steve Forte, Attorney-in-Fact
2020-06-18
EX-24.3_923402
2
poa.txt
POA DOCUMENT
Exhibit 24
POWER OF ATTORNEY
(For Executing Form ID and Forms 3, 4 and 5)
Know all by these presents, that the undersigned hereby constitutes and
appoints each of Lloyd M. Segal and Steve Forte of Repare Therapeutics Inc. (the
"Company") and Divakar Gupta, Courtney Thorne, Trey Reilly and Jason Minio of
Cooley LLP, signing individually, the undersigned's true and lawful attorneys-in
fact and agents to:
(1) Prepare, execute in the undersigned's name and on the undersigned's behalf,
and submit to the Securities and Exchange Commission (the "SEC"), a Form ID and
Forms 3, 4 and 5 (including amendments thereto and joint filing agreements in
connection therewith) in accordance with Section 16 of the Securities Exchange
Act of 1934, as amended (the "Exchange Act"), and the rules thereunder, in the
undersigned's capacity as an officer, director or beneficial owner of more than
10% of a registered class of securities of the Company;
(2) Do and perform any and all acts for and on behalf of the undersigned that
may be necessary or desirable to prepare and execute any such Form ID and Forms
3, 4 or 5 (including amendments thereto and joint filing agreements in
connection therewith) and file such forms with the SEC and any stock exchange,
self-regulatory association or any similar authority; and
(3) Take any other action of any type whatsoever in connection with the
foregoing that, in the opinion of such attorney-in-fact, may be of benefit to,
in the best interest of, or legally required of the undersigned, it being
understood that the documents executed by the attorney-in-fact on behalf of the
undersigned pursuant to this Power of Attorney shall be in such form and shall
contain such terms and conditions as the attorney-in-fact may approve in the
attorney-in-fact's discretion.
The undersigned hereby grants to each such attorney in fact full power and
authority to do and perform any and every act and thing whatsoever requisite,
necessary, or proper to be done in the exercise of any of the rights and powers
herein granted, as fully to all intents and purposes as the undersigned might or
could do if personally present, with full power of substitution or revocation,
hereby ratifying and confirming all that such attorney in fact, or such attorney
in fact's substitute or substitutes, shall lawfully do or cause to be done by
virtue of this power of attorney and the rights and powers herein granted. The
undersigned acknowledges that the foregoing attorneys-in-fact, and their
substitutes, in serving in such capacity at the request of the undersigned, are
not assuming (nor is the Company assuming) any of the undersigned's
responsibilities to comply with Section 16 of the Exchange Act.
This Power of Attorney shall remain in full force and effect until the earliest
to occur of (a) the undersigned is no longer required to file Forms 3, 4 and 5
with respect to the undersigned's holdings of and transactions in securities
issued by the Company, (b) revocation by the undersigned in a signed writing
delivered to the Company and the foregoing attorneys-in fact or (c) as to any
attorney-in-fact individually, until such attorney-in-fact is no longer employed
by the Company or employed by or a partner at Cooley LLP or another law firm
representing the Company, as applicable.
IN WITNESS WHEREOF, the undersigned has caused this Power of Attorney to be
executed as of the date written below.
Date: 6/15/2020
Jerel Davis, Ph.D.