1. Title of Derivative Security (Instr. 4) |
2. Date Exercisable and Expiration Date (Month/Day/Year) |
3. Title and Amount of Securities Underlying Derivative Security (Instr. 4) |
4. Conversion or Exercise Price of Derivative Security |
5. Ownership Form of Derivative Security: Direct (D) or Indirect (I) (Instr. 5) |
6. Nature of Indirect Beneficial Ownership (Instr. 5) |
Date Exercisable |
Expiration Date |
Title |
Amount or Number of Shares |
See Footnote
(1)
|
09/02/2011 |
Â
(2)
|
Common Stock, $0.001 par value per share
|
50,000
(3)
|
$
7
(4)
|
I
|
See Footnote
(5)
|
Warrants
|
09/02/2011 |
09/02/2021 |
Common Stock, $0.001 par value per share
|
50,000
(6)
|
$
7
(7)
|
I
|
See Footnote
(5)
|
* |
If the form is filed by more than one reporting person, see Instruction 5(b)(v). |
** |
Intentional misstatements or omissions of facts constitute Federal Criminal Violations. See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a). |
(1) |
Series A Convertible Perpetual Preferred Stock, $0.001 par value per share |
(2) |
The Series A Convertible Perpetual Preferred Stock has no expiration date. |
(3) |
Represents 50,000 shares of Common Stock initially issuable upon conversion of 350 shares of Series A Convertible Perpetual Preferred Stock, subject to adjustment as set forth in the Certificate of Designation of Series A Convertible Perpetual Preferred Stock, filed as Exhibit 4.1 to the Issuer's Current Report on Form 8-K filed with the SEC on September 6, 2011 (the "Certificate of Designation"). |
(4) |
The initial conversion price of the Series A Convertible Perpetual Preferred Stock is $7 per share of Common Stock, subject to adjustment as set forth in the Certificate of Designation. |
(5) |
XPO Partners LLC is the direct beneficial owner of these securities. G. Chris Andersen is the Managing Member of XPO Partners LLC. |
(6) |
Represents 50,000 shares of Common Stock initially issuable upon the exercise of 50,000 Warrants, subject to adjustment as set forth in the Form of Warrant Certificate, filed as Exhibit 4.2 to the Issuer's Current Report on Form 8-K filed with the SEC on September 6, 2011 (the "Warrant Certificate"). |
(7) |
The initial exercise price of the Warrants is $7 per share of Common Stock, subject to adjustment as set forth in the Warrant Certificate. |