0001181431-11-053701.txt : 20111028 0001181431-11-053701.hdr.sgml : 20111028 20111028112452 ACCESSION NUMBER: 0001181431-11-053701 CONFORMED SUBMISSION TYPE: D PUBLIC DOCUMENT COUNT: 1 ITEM INFORMATION: Rule 506 FILED AS OF DATE: 20111028 DATE AS OF CHANGE: 20111028 EFFECTIVENESS DATE: 20111028 FILER: COMPANY DATA: COMPANY CONFORMED NAME: Kips Bay Medical, Inc. CENTRAL INDEX KEY: 0001460198 STANDARD INDUSTRIAL CLASSIFICATION: SURGICAL & MEDICAL INSTRUMENTS & APPARATUS [3841] IRS NUMBER: 208947689 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: D SEC ACT: 1933 Act SEC FILE NUMBER: 021-167954 FILM NUMBER: 111163932 BUSINESS ADDRESS: STREET 1: 3405 ANNAPOLIS LANE CITY: MINNEAPOLIS STATE: MN ZIP: 55447 BUSINESS PHONE: 763-235-3540 MAIL ADDRESS: STREET 1: 3405 ANNAPOLIS LANE CITY: MINNEAPOLIS STATE: MN ZIP: 55447 D 1 primary_doc.xml X0704 D LIVE 0001460198 Kips Bay Medical, Inc. 3405 Annapolis Lane North Suite 200 Minneapolis MN MINNESOTA 55447 763-235-3540 DELAWARE None None Corporation true 2007 Manny Villafana 3405 Annapolis Lane Suite 200 Minneapolis MN MINNESOTA 55447 Executive Officer Director Scott Kellen 3405 Annapolis Lane Suite 200 Minneapolis MN MINNESOTA 55447 Executive Officer Arch C. Smith 3405 Annapolis Lane Suite 200 Minneapolis MN MINNESOTA 55447 Director Robert E. Munzenrider 3405 Annapolis Lane Suite 200 Minneapolis MN MINNESOTA 55447 Director Robert J. Sheehy 3405 Annapolis Lane Suite 200 Minneapolis MN MINNESOTA 55447 Director Randall K. LaBounty 3405 Annapolis Lane Suite 200 Minneapolis MN MINNESOTA 55447 Executive Officer Michael E. Reinhardt 3405 Annapolis Lane Suite 200 Minneapolis MN MINNESOTA 55447 Executive Officer Biotechnology $1 - $1,000,000 06 false 2011-10-24 true true false 0 Cohen & Company Capital Markets, LLC 144981 Cohen & Company Capital Markets, LLC 144981 1633 Broadway 28th Floor New York NY NEW YORK 10019 All States false 20600000 600000 20000000 The total amount sold represents the value of the amount of common stock (i) issued to the investor for payment of the commitment fee payable by the Issuer pursuant to the terms of the subject financing and (ii) sold to the investor as of the date hereof. false 1 600000 0 Assumes Aspire Capital Fund, LLC purchases $20 million of Kips Bay common stock during the term of this offering. 0 false Kips Bay Medical, Inc. /s/ Scott Kellen Scott Kellen Chief Financial Officer 2011-10-28