Filing Details

 

 

SECURITIES AND EXCHANGE COMMISSION

Washington, D.C. 20549

 

Schedule 13G

 

INFORMATION TO BE INCLUDED IN STATEMENTS FILED PURSUANT TO RULES 13d-1 (b), (c) AND (d) AND AMENDMENTS THERETO FILED PURSUANT TO 13d-2 (b)

(Amendment No. _____)*

 

Inspire Medical Systems, Inc.

(Name of Issuer)

Common Stock

(Title of Class of Securities)

45773010

(CUSIP Number)

December 31, 2018

(Date of Event Which Requires Filing of this Statement)

 

Check the appropriate box to designate the rule pursuant to which this Schedule is filed:

 

¨

Rule 13d-1(b)

 

¨

Rule 13d-1(c)

 

x

Rule 13d-1(d)

 

*The remainder of this cover page shall be filled out for a reporting person’s initial filing on this form with respect to the subject class of securities, and for any subsequent amendment containing information which would alter disclosures provided in a prior cover page.

 

The information required on the remainder of this cover page shall not be deemed to be “filed” for the purpose of Section 18 of the Securities Exchange Act of 1934 (“Act”) or otherwise subject to the liabilities of that section of the Act but shall be subject to all other provisions of the Act (however, see the Notes).

 

(Continued on following pages)

 

Page 1 of 9

Exhibit Index on Page 8

 

 

CUSIP #45773010

Page 2 of 9

 

1	NAME OF REPORTING PERSONS      Kleiner Perkins Caufield & Byers XII, LLC (“KPCB XII”)
2	CHECK THE APPROPRIATE BOX IF A MEMBER OF A GROUP (a)          ¨           (b)          x
3	SEC USE ONLY
4	CITIZENSHIP OR PLACE OF ORGANIZATION Delaware

NUMBER OF SHARES BENEFICIALLY OWNED BY EACH REPORTING PERSON WITH	5	SOLE VOTING POWER 1,732,200 shares, except that KPCB XII Associates, LLC (“Associates”), the managing member of KPCB XII, may be deemed to have sole power to vote these shares.
	6	SHARED VOTING POWER See response to row 5.
	7	SOLE DISPOSITIVE POWER 1,732,200 shares, except that Associates, the managing member of KPCB XII, may be deemed to have sole power to dispose of these shares.
	8	SHARED DISPOSITIVE POWER See response to row 7.

9	AGGREGATE AMOUNT BENEFICIALLY OWNED BY EACH REPORTING PERSON	1,732,200
10	CHECK BOX IF THE AGGREGATE AMOUNT IN ROW (9) EXCLUDES CERTAIN SHARES	¨
11	PERCENT OF CLASS REPRESENTED BY AMOUNT IN ROW 9	8.1%
12	TYPE OF REPORTING PERSON	OO

 

 

CUSIP #45773010

Page 3 of 9

 

1	NAME OF REPORTING PERSONS        KPCB XII Founders Fund, LLC (“KPCB XII Founders”)
2	CHECK THE APPROPRIATE BOX IF A MEMBER OF A GROUP (a)          ¨           (b)          x
3	SEC USE ONLY
4	CITIZENSHIP OR PLACE OF ORGANIZATION Delaware

NUMBER OF SHARES BENEFICIALLY OWNED BY EACH REPORTING PERSON WITH	5	SOLE VOTING POWER 24,106 shares, except that Associates, the managing member of KPCB XII Founders, may be deemed to have sole power to vote these shares.
	6	SHARED VOTING POWER See response to row 5.
	7	SOLE DISPOSITIVE POWER 24,106 shares, except that Associates, the managing member of KPCB XII Founders, may be deemed to have sole power to dispose of these shares.
	8	SHARED DISPOSITIVE POWER See response to row 7.

9	AGGREGATE AMOUNT BENEFICIALLY OWNED BY EACH REPORTING PERSON	24,106
10	CHECK BOX IF THE AGGREGATE AMOUNT IN ROW (9) EXCLUDES CERTAIN SHARES	¨
11	PERCENT OF CLASS REPRESENTED BY AMOUNT IN ROW 9	0.1%
12	TYPE OF REPORTING PERSON	OO

  

 

CUSIP #45773010

Page 4 of 9

 

1	NAME OF REPORTING PERSONS        KPCB XII Associates, LLC
2	CHECK THE APPROPRIATE BOX IF A MEMBER OF A GROUP (a)          ¨           (b)          x
3	SEC USE ONLY
4	CITIZENSHIP OR PLACE OF ORGANIZATION Delaware

NUMBER OF SHARES BENEFICIALLY OWNED BY EACH REPORTING PERSON WITH	5	SOLE VOTING POWER 1,756,306 shares, of which 1,732,200 are directly owned by KPCB XII and 24,106 are directly owned by KPCB XII Founders. Associates, the managing member of KPCB XII and KPCB XII Founders, may be deemed to have sole power to vote these shares.
	6	SHARED VOTING POWER See response to row 5.
	7	SOLE DISPOSITIVE POWER 1,756,306 shares, of which 1,732,200 are directly owned by KPCB XII and 24,106 are directly owned by KPCB XII Founders. Associates, the managing member of KPCB XII and KPCB XII Founders, may be deemed to have sole power to dispose of these shares.
	8	SHARED DISPOSITIVE POWER See response to row 7.

9	AGGREGATE AMOUNT BENEFICIALLY OWNED BY EACH REPORTING PERSON	1,756,306
10	CHECK BOX IF THE AGGREGATE AMOUNT IN ROW (9) EXCLUDES CERTAIN SHARES	¨
11	PERCENT OF CLASS REPRESENTED BY AMOUNT IN ROW 9	8.2%
12	TYPE OF REPORTING PERSON	OO

 

 

CUSIP #45773010

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ITEM 1(A).	NAME OF ISSUER
	Inspire Medical Systems, Inc. (the “Issuer”)
ITEM 1(B).	ADDRESS OF ISSUER’S PRINCIPAL EXECUTIVE OFFICES
	9700 63rd Ave. N., Suite 200
	Maple Grove, MN 55369
ITEM 2(A).	NAME OF PERSONS FILING
	This Schedule 13G is filed by Kleiner Perkins Caufield & Byers XII, LLC, a Delaware limited liability company, KPCB XII Founders Fund, LLC, a Delaware limited liability company, and KPCB XII Associates, LLC, a Delaware limited liability company. The foregoing entities are collectively referred to as the “Reporting Persons.”
ITEM 2(B).	ADDRESS OF PRINCIPAL OFFICE
	The address for each of the Reporting Persons is:
	c/o Kleiner Perkins Caufield & Byers
	2750 Sand Hill Road
	Menlo Park, California 94025
ITEM 2(C).	CITIZENSHIP
	See Row 4 of cover page for each Reporting Person.
ITEM 2(D).	TITLE OF CLASS OF SECURITIES
	Common Stock, $.001 par value
ITEM 2(E).	CUSIP NUMBER
	45773010
ITEM 3.	If this statement is filed pursuant to Rule 13d-1(b), or 13d-2(b) or (c), check whether the person filing is a:
	Not applicable.
ITEM 4.	OWNERSHIP
	The following information with respect to the ownership of the ordinary shares of the Issuer by the persons filing this Statement is provided as of December 31, 2018:

 

 

CUSIP #45773010

Page 6 of 9

 

(a)

Amount beneficially owned:

 

See

Row 9 of cover page for each Reporting Person.

 

(b)

Percent of Class:

 

See

Row 11 of cover page for each Reporting Person.

 

(c)

Number of shares as to which such person has:

 

(i)

Sole power to vote or to direct the vote:

 

See

Row 5 of cover page for each Reporting Person.

 

(ii)

Shared power to vote or to direct the vote:

 

See

Row 6 of cover page for each Reporting Person.

 

(iii)

Sole power to dispose or to direct the disposition of:

 

See

Row 7 of cover page for each Reporting Person.

 

(iv)

Shared power to dispose or to direct the disposition of:

 

See

Row 8 of cover page for each Reporting Person.

 

ITEM 5.	OWNERSHIP OF FIVE PERCENT OR LESS OF A CLASS
	Not applicable.
ITEM 6.	OWNERSHIP OF MORE THAN FIVE PERCENT ON BEHALF OF ANOTHER PERSON.
	Under certain circumstances set forth in the limited liability company agreements of the Reporting Persons, the members of such entities may be deemed to have the right to receive dividends from, or the proceeds from, the sale of shares of the Issuer owned by each such entity of which they are a member.
ITEM 7.	IDENTIFICATION AND CLASSIFICATION OF THE SUBSIDIARY WHICH ACQUIRED THE SECURITY BEING REPORTED ON BY THE PARENT HOLDING COMPANY
	Not applicable.
ITEM 8.	IDENTIFICATION AND CLASSIFICATION OF MEMBERS OF THE GROUP.
	Not applicable.
ITEM 9.	NOTICE OF DISSOLUTION OF GROUP.
	Not applicable.
ITEM 10.	CERTIFICATION.
	Not applicable.

 

CUSIP #45773010

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SIGNATURES

 

After reasonable inquiry and to the best of my knowledge and belief, I certify that the information set forth in this statement is true, complete and correct.

 

Date: February 13, 2019

 

	KLEINER PERKINS CAUFIELD & BYERS XII, LLC, a Delaware limited liability company
	KPCB XII ASSOCIATES, LLC, a Delaware limited liability company, its managing member
	By:	/s/ Susan Biglieri
		Susan Biglieri
		Chief Financial Officer

 

	KPCB XII FOUNDERS FUND, LLC, a Delaware limited liability company
	KPCB XII ASSOCIATES, LLC, a Delaware limited liability company, its managing member
	By:	/s/ Susan Biglieri
		Susan Biglieri
		Chief Financial Officer

 

	KPCB XII ASSOCIATES, LLC, a Delaware limited liability company
	By:	/s/ Susan Biglieri
		Susan Biglieri
		Chief Financial Officer

  

 

CUSIP #45773010

Page 8 of 9

 

EXHIBIT INDEX

 

		Found on Sequentially
Exhibit		Numbered Page
Exhibit A:  Agreement of Joint Filing		9

 

 

CUSIP #45773010

Page 9 of 9

 

 exhibit A

 

Agreement of Joint Filing

 

The undersigned hereby agree that a single Schedule 13G (or any amendment thereto) relating to the common stock of the Issuer shall be filed on behalf of each of the undersigned and that this Agreement shall be filed as an exhibit to such Schedule 13G.

 

Date: February 13, 2019

 

	KLEINER PERKINS CAUFIELD & BYERS XII, LLC, a Delaware limited liability company
	KPCB XII ASSOCIATES, LLC, a Delaware limited liability company, its managing member
	By:	/s/ Susan Biglieri
		Susan Biglieri
		Chief Financial Officer

 

	KPCB XII FOUNDERS FUND, LLC, a Delaware limited liability company
	KPCB XII ASSOCIATES, LLC, a Delaware limited liability company, its managing member
	By:	/s/ Susan Biglieri
		Susan Biglieri
		Chief Financial Officer

 

	KPCB XII ASSOCIATES, LLC, a Delaware limited liability company
	By:	/s/ Susan Biglieri
		Susan Biglieri
		Chief Financial Officer