Delaware
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68-0533453
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(State or other jurisdiction of incorporation or organization)
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(I.R.S. Employer Identification No.)
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12988 Valley View Road
Eden Prairie, Minnesota
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55344
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(Address of Principal Executive Offices)
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(Zip Code)
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CHF Solutions, Inc. 2017 Equity Incentive Plan
CHF Solutions, Inc. 2013 Non-Employee Directors’ Equity Incentive Plan
CHF Solutions, Inc. New-Hire Equity Incentive Plan
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(Full title of the plan)
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John L. Erb
Chief Executive Officer
CHF Solutions, Inc.
12988 Valley View Road
Eden Prairie, MN 55344
(952) 345-4200
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(Name, address and telephone number, including area code, of agent for service)
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Copies to:
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Phillip D. Torrence, Esq.
Meredith Ervine, Esq.
Honigman LLP
650 Trade Center Way, Ste 200
Kalamazoo, MI 49002
(269) 337-7700
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Thomas P. Lynch
General Counsel
CHF Solutions, Inc.
12988 Valley View Road
Eden Prairie, MN 55344
(952) 345-4200
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Title of securities to be registered
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Amount to be
Registered (1)
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Proposed maximum
offering price
per share (2)
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Proposed maximum
aggregate offering
price (2)
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Amount of
registration
fee
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||||||||||||
Common Stock, par value $0.0001 per share
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318,141
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$
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2.60
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$
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827,166.60
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$
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100.25
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(1) |
Pursuant to Rule 416(a) under the Securities Act of 1933, as amended (the “Securities Act”), this Registration Statement shall also cover any
additional shares of the Registrant’s common stock (“Common Stock”) that become issuable under the Plans (as defined below) by reason of any stock dividend, stock split,
recapitalization or any other similar transaction without receipt of consideration that results in an increase in the number of shares of the Registrant’s outstanding Common Stock.
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(2) |
Estimated solely for the purpose of calculating the registration fee pursuant to paragraphs (c) and (h) of Rule 457 under the Securities Act. The offering price per share and aggregate offering price are
based upon the average of the high and low prices of the Common Stock as reported on the NASDAQ Capital Market on August 5, 2019, a date within five business days prior to the date of filing of this Registration Statement, for: (i) shares
reserved for grant pursuant to the Registrant’s 2017 Equity Incentive Plan (the “2017 EIP”); (ii) shares reserved for grant pursuant to the Registrant’s 2013 Non-Employee
Directors’ Equity Incentive Plan (the “Directors’ EIP”); and (iii) shares reserved for grant pursuant to the Registrant’s New-Hire Equity Incentive Plan (the “New-Hire Plan”; and collectively, with the 2017 EIP and the Directors’ EIP, the “Plans”).
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Securities
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Number of Shares
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Offering Price
Per Share
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Aggregate Offering Price
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|||||||||
Shares reserved for grant under the 2017 EIP
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42,711
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(3)
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$
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2.60
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$
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111,048.60
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||||||
Shares reserved for grant under the Directors’ EIP
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25,430
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(4)
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$
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2.60 |
$
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66,118.00
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||||||
Shares reserved for grant under the New-Hire Plan
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250,000
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(5)
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$
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2.60 |
$
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650,000
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||||||
Proposed Maximum Offering Price
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$
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827,166.60
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(3) |
Consists of shares that were automatically added to the shares authorized for issuance under the 2017 EIP on January 1, 2019 pursuant to an “evergreen” provision contained in the 2017 EIP. Pursuant to the
2017 EIP, the share reserve will automatically increase on January 1st of each year, for a period of not more than ten years, commencing on January 1, 2018 and ending on (and including) January 1, 2027, to an amount equal to thirteen
percent (13%) of the fully diluted shares outstanding on December 31st of the preceding calendar year; provided that the Board of Directors may act prior to January 1st of a given year to provide that there will be no January 1st increase
in the share reserve for such year or that the increase in the share reserve for such year will be a lesser number of shares than would otherwise occur.
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(4) |
Consists of shares that were automatically added to the shares authorized for issuance under the Directors’ EIP on January 1, 2019 pursuant to an “evergreen” provision contained in the Directors’ EIP.
Pursuant to the Directors’ EIP, the share reserve will automatically increase on January 1st of each year, for a period of not more than ten years, commencing on January 1, 2014 and ending on (and including) January 1, 2023, by an amount
equal to two percent (2%) of the fully diluted shares outstanding on December 31st of the preceding calendar year; provided that the Board of Directors may act prior to January 1st of a given year to provide that there will be no January
1st increase in the share reserve for such year or that the increase in the share reserve for such year will be a lesser number of shares than would otherwise occur.
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(5) |
Consists of shares reserved for grant under the New-Hire Plan pursuant to a Sixth Amendment to the New-Hire Plan that was approved by the Registrant’s Board of Directors on May 23, 2019.
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Item 3. |
Incorporation of Documents by Reference.
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Item 4.
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Description of Securities.
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Item 5.
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Interests of Named Experts and Counsel.
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Item 6.
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Indemnification of Directors and Officers.
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•
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breach of their duty of loyalty to the Registrant or the Registrant’s stockholders;
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•
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act or omission not in good faith or that involves intentional misconduct or a knowing violation of law;
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•
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unlawful payment of dividends or redemption of shares as provided in Section 174 of the Delaware General Corporation Law; or
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•
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transaction from which the directors derived an improper personal benefit.
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Item 7.
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Exemption from Registration Claimed.
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Item 8. |
Exhibits.
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Incorporated By Reference
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||||||||||||
Exhibit
Number
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Exhibit
Description
|
Form
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File
Number
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Date of First
Filing
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Exhibit
Number
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Filed
Herewith
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||||||
Fourth Amended and Restated Certificate of Incorporation
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10
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001-35312
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February 1, 2012
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3.1
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||||||||
Certificate of Amendment to the Fourth Amended and Restated Certificate of Incorporation
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8-K
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001-35312
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January 13, 2017
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3.1
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||||||||
Certificate of Amendment to Fourth Amended and Restated Certificate of Incorporation
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8-K
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001-35312
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May 23, 2017
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3.1
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||||||||
Certificate of Amendment to Fourth Amended and Restated Certificate of Incorporation
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8-K
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001-35312
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October 12, 2017
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3.1
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||||||||
Certificate of Amendment to Fourth Amended and Restated Certificate of Incorporation
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8-K
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001-35312
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January 2, 2019
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3.1
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||||||||
Second Amended and Restated Bylaws
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8-K
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001-35312
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May 23, 2017
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3.2
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||||||||
Form of Certificate of Designation of Series A Junior Participating Preferred Stock
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8-K
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001-35312
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June 14, 2013
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3.1
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||||||||
Form of Certificate of Designation of Preferences, Rights and Limitations of Series F Convertible Preferred Stock
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S-1/A
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333-221010
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November 17, 2017
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3.7
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||||||||
Certificate of Designation of Preferences, Rights and Limitations of Series G Convertible Preferred Stock
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8-K
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001-35312
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March 13, 2019
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3.1
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||||||||
Warrant to Purchase Stock, dated February 18, 2015, issued to Silicon Valley Bank
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8-K
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001-35312
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February 19, 2015
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4.1
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Incorporated By Reference
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||||||||||||
Exhibit
Number
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Exhibit
Description
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Form
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File
Number
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Date of First
Filing
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Exhibit
Number
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Filed
Herewith
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||||||
Warrant to Purchase Stock, dated February 18, 2015, issued to Life Science Loans, LLC
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8-K
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001-35312
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February 19, 2015
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4.2
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||||||||
Form of common stock Purchase Warrant issued pursuant to the Securities Purchase Agreement, dated July 20, 2016, among the Company and the purchasers signatory thereto
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8-K
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001-35312
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July 22, 2016
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4.2
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||||||||
Form of common stock Purchase Warrant issued to Northland Securities, Inc.
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8-K
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001-35312
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July 22, 2016
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4.3
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||||||||
Registration Rights Agreement between Sunshine Heart, Inc. and Gambro UF Solutions, Inc. dated August 5, 2016
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8-K
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001-35312
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August 8, 2016
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4.1
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||||||||
Form of common stock Purchase Warrant issued pursuant to the Securities Purchase Agreement, dated October 30, 2016, among the Company and the purchasers signatory thereto
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8-K
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001-35312
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October 31, 2016
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4.1
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||||||||
Form of common stock Purchase Warrant issued pursuant to the Letter Agreement between the Company and the purchasers signatory thereto, dated February 15, 2017
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8-K
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001-35312
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February 16, 2017
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4.1
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||||||||
Form of common stock Purchase Warrant issued pursuant to the Underwriting Agreement between the Company and Ladenburg Thalmann & Co. Inc., dated April 19, 2017
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S-1/A
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333-216841
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April 4, 2017
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4.8
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||||||||
Form of Warrant to purchase shares of common stock
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S-1/A
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333-221010
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November 17, 2017
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4.9
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||||||||
Form of Series 1 and Series 2 Warrant to purchase shares of common stock
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S-1/A
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333-229102
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February 25, 2019
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4.10
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||||||||
Warrant Agency Agreement, dated as of March 12, 2019, between CHF Solutions, Inc. and American Stock Transfer & Trust Company, LLC
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8-K
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001-35312
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March 13, 2019
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4.2
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||||||||
Warrant, dated May 30, 2019 between CHF Solutions, Inc. and Redington, Inc.
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10-Q
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001-35312
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August 8, 2019
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4.1
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Incorporated By Reference
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||||||||||||
Exhibit
Number
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Exhibit
Description
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Form
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File
Number
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Date of First
Filing
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Exhibit
Number
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Filed
Herewith
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||||||
Opinion of Honigman LLP
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X
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|||||||||||
Consent of Baker Tilly Virchow Krause, LLP
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X
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|||||||||||
Consent of Honigman LLP (included in its opinion filed as Exhibit 5.1 to this Registration Statement)
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X
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|||||||||||
Power of Attorney (included on signature page)
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X
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|||||||||||
99.1 | Sixth Amendment to New-Hire Equity Incentive Plan† | 10-Q | 001-35312 |
August 8, 2019 |
10.2 |
Item 9. |
Undertakings.
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CHF SOLUTIONS, INC.
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By:
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/s/ John L. Erb
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Name:
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John L. Erb
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Title:
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Chief Executive Officer
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SIGNATURE
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TITLE
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DATE
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/s/ John L. Erb
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President, CEO and Chairman
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August 8, 2019
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John L. Erb
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(principal executive officer)
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/s/ Claudia Drayton
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Chief Financial Officer
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August 8, 2019
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Claudia Drayton
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(principal financial and accounting officer)
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/s/ Steve Brandt
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Director
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August 8, 2019
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Steve Brandt
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/s/ Matthew Likens
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Director
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August 8, 2019
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Matthew Likens
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/s/ Jon W. Salveson
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Director
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August 8, 2019
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Jon W. Salveson
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/s/ Gregory D. Waller
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Director
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August 8, 2019
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Gregory D. Waller
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/s/ Warren S. Watson
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Director
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August 8, 2019
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Warren S. Watson
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HONIGMAN
Honigman LLP
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(269) 337-7700
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Attorneys and Counselors
|
Fax: (269) 337-7701
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Honigman LLP • 650 Trade Centre Way • Suite 200 • Kalamazoo, Michigan
49002-0402
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/s/ BAKER TILLY VIRCHOW KRAUSE, LLP
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Minneapolis, Minnesota
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August 8, 2019
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