Form D Raw Data - Electronic Filing Depository

EFDID: 91799EFD: Raw Data

Issuer: Colibri Heart Valve LLC (0001471637) - D

Accession: 0001471637-14-000002 () (EDGAR Files) (Form D)

Edgar Posted: Mar. 18, 2014
EFD Posted: Aug. 7, 2014

- < edgarSubmission >

< schemaVersion > X0707 </ schemaVersion >

< submissionType > D </ submissionType >

< testOrLive > LIVE </ testOrLive >

- < primaryIssuer >

< cik > 0001471637 </ cik >

< entityName > Colibri Heart Valve LLC </ entityName >

- < issuerAddress >

< street1 > 2150 W. 6TH AVE. </ street1 >

< street2 > UNIT M </ street2 >

< city > BROOMFIELD </ city >

< stateOrCountry > CO </ stateOrCountry >

< stateOrCountryDescription > COLORADO </ stateOrCountryDescription >

< zipCode > 80020 </ zipCode >

</ issuerAddress >

< issuerPhoneNumber > 303-460-8667 </ issuerPhoneNumber >

< jurisdictionOfInc > DELAWARE </ jurisdictionOfInc >

- < edgarPreviousNameList >

< previousName > EndoLumix Technology LLC </ previousName >

</ edgarPreviousNameList >

< entityType > Limited Liability Company </ entityType >

- < yearOfInc >

< withinFiveYears > true </ withinFiveYears >

< value > 2010 </ value >

</ yearOfInc >

</ primaryIssuer >

- < relatedPersonsList >

- < relatedPersonInfo >

- < relatedPersonName >

< firstName > Joseph </ firstName >

< middleName > B. </ middleName >

< lastName > Horn </ lastName >

</ relatedPersonName >

- < relatedPersonAddress >

< street1 > c/o Colibri Heart Valve LLC </ street1 >

< street2 > 2150 West 6th Avenue, Unit M </ street2 >

< city > Broomfield </ city >

< stateOrCountry > CO </ stateOrCountry >

< stateOrCountryDescription > COLORADO </ stateOrCountryDescription >

< zipCode > 80020 </ zipCode >

</ relatedPersonAddress >

- < relatedPersonRelationshipList >

< relationship > Executive Officer </ relationship >

< relationship > Director </ relationship >

</ relatedPersonRelationshipList >

< relationshipClarification > President and CEO </ relationshipClarification >

</ relatedPersonInfo >

- < relatedPersonInfo >

- < relatedPersonName >

< firstName > Eric </ firstName >

< lastName > Schauble </ lastName >

</ relatedPersonName >

- < relatedPersonAddress >

< street1 > c/o Colibri Heart Valve LLC </ street1 >

< street2 > 2150 West 6th Avenue, Unit M </ street2 >

< city > Broomfield </ city >

< stateOrCountry > CO </ stateOrCountry >

< stateOrCountryDescription > COLORADO </ stateOrCountryDescription >

< zipCode > 80020 </ zipCode >

</ relatedPersonAddress >

- < relatedPersonRelationshipList >

< relationship > Executive Officer </ relationship >

</ relatedPersonRelationshipList >

< relationshipClarification > Vice President, Corporate Development </ relationshipClarification >

</ relatedPersonInfo >

- < relatedPersonInfo >

- < relatedPersonName >

< firstName > Thomas </ firstName >

< middleName > P. </ middleName >

< lastName > Reagan </ lastName >

</ relatedPersonName >

- < relatedPersonAddress >

< street1 > c/o Colibri Heart Valve LLC </ street1 >

< street2 > 2150 West 6th Avenue, Unit M </ street2 >

< city > Broomfield </ city >

< stateOrCountry > CO </ stateOrCountry >

< stateOrCountryDescription > COLORADO </ stateOrCountryDescription >

< zipCode > 80020 </ zipCode >

</ relatedPersonAddress >

- < relatedPersonRelationshipList >

< relationship > Director </ relationship >

</ relatedPersonRelationshipList >

< relationshipClarification > Corporate and Financial Advisor </ relationshipClarification >

</ relatedPersonInfo >

- < relatedPersonInfo >

- < relatedPersonName >

< firstName > R. </ firstName >

< middleName > David </ middleName >

< lastName > Fish </ lastName >

</ relatedPersonName >

- < relatedPersonAddress >

< street1 > c/o Colibri Heart Valve LLC </ street1 >

< street2 > 2150 West 6th Avenue, Unit M </ street2 >

< city > Broomfield </ city >

< stateOrCountry > CO </ stateOrCountry >

< stateOrCountryDescription > COLORADO </ stateOrCountryDescription >

< zipCode > 80020 </ zipCode >

</ relatedPersonAddress >

- < relatedPersonRelationshipList >

< relationship > Director </ relationship >

</ relatedPersonRelationshipList >

< relationshipClarification />

</ relatedPersonInfo >

- < relatedPersonInfo >

- < relatedPersonName >

< firstName > David </ firstName >

< lastName > Paniagua </ lastName >

</ relatedPersonName >

- < relatedPersonAddress >

< street1 > c/o Colibri Heart Valve LLC </ street1 >

< street2 > 2150 West 6th Avenue, Unit M </ street2 >

< city > Broomfield </ city >

< stateOrCountry > CO </ stateOrCountry >

< stateOrCountryDescription > COLORADO </ stateOrCountryDescription >

< zipCode > 80020 </ zipCode >

</ relatedPersonAddress >

- < relatedPersonRelationshipList >

< relationship > Director </ relationship >

</ relatedPersonRelationshipList >

< relationshipClarification />

</ relatedPersonInfo >

- < relatedPersonInfo >

- < relatedPersonName >

< firstName > James </ firstName >

< lastName > Gleason </ lastName >

</ relatedPersonName >

- < relatedPersonAddress >

< street1 > c/o Colibri Heart Valve LLC </ street1 >

< street2 > 2150 West 6th Avenue, Unit M </ street2 >

< city > Broomfield </ city >

< stateOrCountry > CO </ stateOrCountry >

< stateOrCountryDescription > COLORADO </ stateOrCountryDescription >

< zipCode > 80020 </ zipCode >

</ relatedPersonAddress >

- < relatedPersonRelationshipList >

< relationship > Director </ relationship >

</ relatedPersonRelationshipList >

< relationshipClarification />

</ relatedPersonInfo >

</ relatedPersonsList >

- < offeringData >

- < industryGroup >

< industryGroupType > Other Technology </ industryGroupType >

</ industryGroup >

- < issuerSize >

< revenueRange > Decline to Disclose </ revenueRange >

</ issuerSize >

- < federalExemptionsExclusions >

< item > 06b </ item >

</ federalExemptionsExclusions >

- < typeOfFiling >

- < newOrAmendment >

< isAmendment > false </ isAmendment >

</ newOrAmendment >

- < dateOfFirstSale >

< value > 2014-03-05 </ value >

</ dateOfFirstSale >

</ typeOfFiling >

- < durationOfOffering >

< moreThanOneYear > false </ moreThanOneYear >

</ durationOfOffering >

- < typesOfSecuritiesOffered >

< isEquityType > true </ isEquityType >

< isDebtType > true </ isDebtType >

</ typesOfSecuritiesOffered >

- < businessCombinationTransaction >

< isBusinessCombinationTransaction > false </ isBusinessCombinationTransaction >

< clarificationOfResponse />

</ businessCombinationTransaction >

< minimumInvestmentAccepted > 50000 </ minimumInvestmentAccepted >

< salesCompensationList />

- < offeringSalesAmounts >

< totalOfferingAmount > 3000000 </ totalOfferingAmount >

< totalAmountSold > 750000 </ totalAmountSold >

< totalRemaining > 2250000 </ totalRemaining >

< clarificationOfResponse > Senior Secured Convertible Promissory Notes and the Units issuable thereunder </ clarificationOfResponse >

</ offeringSalesAmounts >

- < investors >

< hasNonAccreditedInvestors > false </ hasNonAccreditedInvestors >

< totalNumberAlreadyInvested > 2 </ totalNumberAlreadyInvested >

</ investors >

- < salesCommissionsFindersFees >

- < salesCommissions >

< dollarAmount > 0 </ dollarAmount >

</ salesCommissions >

- < findersFees >

< dollarAmount > 0 </ dollarAmount >

</ findersFees >

< clarificationOfResponse />

</ salesCommissionsFindersFees >

- < useOfProceeds >

- < grossProceedsUsed >

< dollarAmount > 0 </ dollarAmount >

</ grossProceedsUsed >

< clarificationOfResponse />

</ useOfProceeds >

- < signatureBlock >

< authorizedRepresentative > false </ authorizedRepresentative >

- < signature >

< issuerName > Colibri Heart Valve LLC </ issuerName >

< signatureName > Eric Schauble </ signatureName >

< nameOfSigner > Eric Schauble </ nameOfSigner >

< signatureTitle > VP, Corporate Development </ signatureTitle >

< signatureDate > 2014-03-18 </ signatureDate >

</ signature >

</ signatureBlock >

</ offeringData >

</ edgarSubmission >