0001634122-15-000004.txt : 20150312 0001634122-15-000004.hdr.sgml : 20150312 20150312165556 ACCESSION NUMBER: 0001634122-15-000004 CONFORMED SUBMISSION TYPE: D/A PUBLIC DOCUMENT COUNT: 1 ITEM INFORMATION: Rule 504(b)(1) (not (i), (ii) or (iii)) ITEM INFORMATION: 06b FILED AS OF DATE: 20150312 DATE AS OF CHANGE: 20150312 EFFECTIVENESS DATE: 20150312 FILER: COMPANY DATA: COMPANY CONFORMED NAME: Provivi, Inc. CENTRAL INDEX KEY: 0001634122 IRS NUMBER: 454628757 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: D/A SEC ACT: 1933 Act SEC FILE NUMBER: 021-235803 FILM NUMBER: 15696590 BUSINESS ADDRESS: STREET 1: 1701 COLORADO AVENUE CITY: SANTA MONICA STATE: CA ZIP: 90404 BUSINESS PHONE: 213-683-5376 MAIL ADDRESS: STREET 1: 1701 COLORADO AVENUE CITY: SANTA MONICA STATE: CA ZIP: 90404 D/A 1 primary_doc.xml X0707 D/A LIVE 0001634122 Provivi, Inc. 1701 COLORADO AVENUE SANTA MONICA CA CALIFORNIA 90404 213-683-5376 DELAWARE None None Corporation true 2012 Pedro Coelho 1701 Colorado Avenue Santa Monica CA CALIFORNIA 90404 Executive Officer Peter Meinhold 1701 Colorado Avenue Santa Monica CA CALIFORNIA 90404 Executive Officer Frances Arnold 228 Spalding, MailCode: 210-41 California Institute of Technology Pasadena CA CALIFORNIA 91125-4100 Director Other Technology No Revenues 04 06b true 0001634122-15-000002 2013-06-11 false true false 0 1000000 1000000 0 $1,000,000 convertible preferred stock issued to one founder-investor. false 1 0 0 300000 true $150,000 annually is expected to be paid in the aggregate to the two individual founders who are officers as taxable compensation for services. false Provivi, Inc. Edwin G. Schuck, Jr. Edwin G. Schuck, Jr. power of attorney 2015-03-12