0001567619-20-013524.txt : 20200721 0001567619-20-013524.hdr.sgml : 20200721 20200721102744 ACCESSION NUMBER: 0001567619-20-013524 CONFORMED SUBMISSION TYPE: D PUBLIC DOCUMENT COUNT: 1 ITEM INFORMATION: 06b FILED AS OF DATE: 20200721 DATE AS OF CHANGE: 20200721 EFFECTIVENESS DATE: 20200721 FILER: COMPANY DATA: COMPANY CONFORMED NAME: ACTIV Surgical, Inc. CENTRAL INDEX KEY: 0001710426 IRS NUMBER: 472924761 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: D SEC ACT: 1933 Act SEC FILE NUMBER: 021-371448 FILM NUMBER: 201037907 BUSINESS ADDRESS: STREET 1: 840 SUMMER STREET, SUITE 108 CITY: BOSTON STATE: MA ZIP: 02127 BUSINESS PHONE: (646) 312-9611 MAIL ADDRESS: STREET 1: 840 SUMMER STREET, SUITE 108 CITY: BOSTON STATE: MA ZIP: 02127 FORMER COMPANY: FORMER CONFORMED NAME: Omniboros Inc. DATE OF NAME CHANGE: 20170627 D 1 primary_doc.xml X0708 D LIVE 0001710426 ACTIV Surgical, Inc. 840 Summer Street - Ste. 108 Boston MA MASSACHUSETTS 02127 617-333-8162 DELAWARE None Omniboros Inc. Corporation true Todd Usen c/o Activ Surgical, Inc. 840 Summer Street - Ste. 108 Boston MA MASSACHUSETTS 02127 Executive Officer Director Peter Kim c/o Activ Surgical, Inc. 840 Summer Street - Ste. 108 Boston MA MASSACHUSETTS 02127 Executive Officer Director Sub Datta c/o Activ Surgical, Inc. 840 Summer Street - Ste. 108 Boston MA MASSACHUSETTS 02127 Executive Officer Tom Calef c/o Activ Surgical, Inc. 840 Summer Street - Ste. 108 Boston MA MASSACHUSETTS 02127 Executive Officer Paul Meister c/o Activ Surgical, Inc. 840 Summer Street - Ste. 108 Boston MA MASSACHUSETTS 02127 Director Emily Casey c/o Activ Surgical, Inc. 840 Summer Street - Ste. 108 Boston MA MASSACHUSETTS 02127 Director Ashok Krishnamurthi c/o Activ Surgical, Inc. 840 Summer Street - Ste. 108 Boston MA MASSACHUSETTS 02127 Director Ameena El-Bibany c/o Activ Surgical, Inc. 840 Summer Street - Ste. 108 Boston MA MASSACHUSETTS 02127 Director Will Cowen c/o Activ Surgical, Inc. 840 Summer Street - Ste. 108 Boston MA MASSACHUSETTS 02127 Director Michael Ruehlman c/o Activ Surgical, Inc. 840 Summer Street - Ste. 108 Boston MA MASSACHUSETTS 02127 Executive Officer Other Health Care Decline to Disclose 06b false 2020-07-06 false true false 0 14999999 14999999 0 false 10 0 0 0 false ACTIV Surgical, Inc. /s/ Todd Usen Todd Usen President and Chief Executive Officer 2020-07-21