0001634122-19-000001.txt : 20190705 0001634122-19-000001.hdr.sgml : 20190705 20190705102154 ACCESSION NUMBER: 0001634122-19-000001 CONFORMED SUBMISSION TYPE: D PUBLIC DOCUMENT COUNT: 1 ITEM INFORMATION: 06b FILED AS OF DATE: 20190705 DATE AS OF CHANGE: 20190705 EFFECTIVENESS DATE: 20190705 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 SEC ACT: 1933 Act SEC FILE NUMBER: 021-343556 FILM NUMBER: 19943323 BUSINESS ADDRESS: STREET 1: 1701 COLORADO AVENUE CITY: SANTA MONICA STATE: CA ZIP: 90404 BUSINESS PHONE: 626-390-0484 MAIL ADDRESS: STREET 1: 1701 COLORADO AVENUE CITY: SANTA MONICA STATE: CA ZIP: 90404 D 1 primary_doc.xml X0708 D LIVE 0001634122 Provivi, Inc. 1701 COLORADO AVENUE SANTA MONICA CA CALIFORNIA 90404 626-390-0484 DELAWARE None None Corporation true Pedro Coelho 1701 Colorado Avenue Santa Monica CA CALIFORNIA 90404 Executive Officer Director James Demetriades 1499 Blueridge Drive Beverly Hills CA CALIFORNIA 90210 Director Ganesh Kishore 100 Montgomery Street Suite 2190 San Francisco CA CALIFORNIA 94104 Director 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 Paul Kuc 1701 Colorado Avenue Santa Monica CA CALIFORNIA 90404 Executive Officer Ronald Olson 350 South Grand Avenue 50th Floor Los Angeles CA CALIFORNIA 90071 Director Other Technology Decline to Disclose 06b false 2019-06-20 false true false 0 65000000 34181624 30818376 false 15 0 0 0 false Provivi, Inc. /s/ Paul Kuc Paul Kuc Chief Financial Officer 2019-07-05