# EDGAR Filing Document

**Accession Number:** 0001385867
**File Stem:** 0000899243-23-006435
**Filing Date:** 2023-2
**Character Count:** 12889
**Document Hash:** b593f2266e9ec83cd4e07772deb48284
**Contains OCR:** False
**Source Format:** 

## Filing Content

## Filing Summary
**0000899243-23-006435.hdr.sgml**: 20230228

**ACCESSION NUMBER**: 0000899243-23-006435

**CONFORMED SUBMISSION TYPE**: 4

**PUBLIC DOCUMENT COUNT**: 1

**CONFORMED PERIOD OF REPORT**: 20230228

**FILED AS OF DATE**: 20230228

**DATE AS OF CHANGE**: 20230228

**REPORTING-OWNER**: 

**OWNER DATA:**
- **COMPANY CONFORMED NAME:** BERNSHTEYN ROBERT
- **CENTRAL INDEX KEY:** 0001436655

**FILING VALUES:**
- **FORM TYPE:** 4
- **SEC ACT:** 1934 Act
- **SEC FILE NUMBER:** 001-37901
- **FILM NUMBER:** 23687833

**MAIL ADDRESS:**
- **STREET 1:** C/O SUCCESSFACTORS, INC., 1500 FASHION
- **STREET 2:** ISLAND BLVD., SUITE 300
- **CITY:** SAN MATEO
- **STATE:** CA
- **ZIP:** 94404

**FORMER NAME:**
- **FORMER CONFORMED NAME:** BERNSHTYEN ROBERT
- **DATE OF NAME CHANGE:** 20080603
**ISSUER**: 

**COMPANY DATA:**
- **COMPANY CONFORMED NAME:** Coupa Software Inc
- **CENTRAL INDEX KEY:** 0001385867
- **STANDARD INDUSTRIAL CLASSIFICATION:** SERVICES-PREPACKAGED SOFTWARE [7372]
- **IRS NUMBER:** 204429448
- **STATE OF INCORPORATION:** DE
- **FISCAL YEAR END:** 0131

**BUSINESS ADDRESS:**
- **STREET 1:** 1855 S. GRANT STREET
- **CITY:** SAN MATEO
- **STATE:** CA
- **ZIP:** 94402
- **BUSINESS PHONE:** 6509313200

**MAIL ADDRESS:**
- **STREET 1:** 1855 S. GRANT STREET
- **CITY:** SAN MATEO
- **STATE:** CA
- **ZIP:** 94402

### UNITED STATES SECURITIES AND EXCHANGE COMMISSION
**Washington, D.C. 20549**

## FORM 4

### STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP

[x] Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b).

[ ] Check this box to indicate that a transaction was made pursuant to a contract, instruction or written plan for the purchase or sale of equity securities of the issuer that is intended to satisfy the affirmative defense conditions of Rule 10b5-1(c). See Instruction 10.

---

| | | |
|:---|:---|:---|
| **1. Name and Address of Reporting Person**<sup>*</sup><br>BERNSHTEYN ROBERT<br><sub>(Last) (First) (Middle)</sub><br>C/O COUPA SOFTWARE INCORPORATED<br>1855 S. GRANT STREET<br><sub>(Street)</sub><br>SAN MATEO, CA 94402<br><sub>(City) (State) (Zip)</sub> | **3. Date of Earliest Transaction (Month/Day/Year)**<br>2023-02-28 | **5. Relationship of Reporting Person(s) to Issuer**<br>(Check all applicable)<br>[X] Director [ ] 10% Owner<br>[X] Officer (give title below) [ ] Other (specify below)<br>_Chief Executive Officer_ |
| **2. Issuer Name and Ticker or Trading Symbol**<br>Coupa Software Inc [ COUP ] | **4. If Amendment, Date of Original Filed (Month/Day/Year)**<br>  | **6. Individual or Joint/Group Filing (Check Applicable Line)**<br>[X] Form filed by One Reporting Person<br>[ ] Form filed by More than One Reporting Person |

---

## Table I - Non-Derivative Securities

---

|  |  |  |  |  |  |  |  |  |  |  |
| --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- |
| 1. Title of Security | 2. Transaction Date | 2A. Deemed Execution Date | 3. Transaction Code (V) | 3. Transaction Code (V) | 4. Securities Acquired (A) or Disposed of (D) | 4. Securities Acquired (A) or Disposed of (D) | 4. Securities Acquired (A) or Disposed of (D) | 5. Amount of Securities Beneficially Owned | 6. Ownership Form | 7. Nature of Indirect Beneficial Ownership |
| 1. Title of Security | 2. Transaction Date | 2A. Deemed Execution Date | Code | V | Amount | (A) or (D) | Price | 5. Amount of Securities Beneficially Owned | 6. Ownership Form | 7. Nature of Indirect Beneficial Ownership |
| Common Stock | 2023-02-28 |  | D |  | 259300 | D | <sup>(1)</sup> | 0 | D |  |

---

## Table II - Derivative Securities

---

|  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |
| --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- |
| 1. Title of Derivative Security | 2. Conversion or Exercise Price | 3. Transaction Date | 3A. Deemed Execution Date | 4. Transaction Code (V) | 4. Transaction Code (V) | 5. Number of Derivative Securities Acquired (A) or Disposed of (D) | 5. Number of Derivative Securities Acquired (A) or Disposed of (D) | 6. Date Exercisable and Expiration Date | 6. Date Exercisable and Expiration Date | 7. Title and Amount of Underlying Securities | 7. Title and Amount of Underlying Securities | 8. Price of Derivative Security | 9. Number of Derivative Securities Beneficially Owned | 10. Ownership Form | 11. Nature of Indirect Beneficial Ownership |
| 1. Title of Derivative Security | 2. Conversion or Exercise Price | 3. Transaction Date | 3A. Deemed Execution Date | Code | V | (A) | (D) | Date Exercisable | Expiration Date | Title | Amount or Number of Shares | 8. Price of Derivative Security | 9. Number of Derivative Securities Beneficially Owned | 10. Ownership Form | 11. Nature of Indirect Beneficial Ownership |
| Restricted Stock Units | <sup>(2)(3)(4)</sup> | 2023-02-28 |  | D |  |  | 4731 | <sup>(3)(4)</sup> | <sup>(3)(4)</sup> | Common Stock | 4731 | $81.00 | 0 | D |  |
| Restricted Stock Units | <sup>(2)(3)(4)</sup> | 2023-02-28 |  | D |  |  | 13259 | <sup>(3)(4)</sup> | <sup>(3)(4)</sup> | Common Stock | 13259 | $81.00 | 0 | D |  |
| Restricted Stock Units | <sup>(2)(3)(4)</sup> | 2023-02-28 |  | D |  |  | 14926 | <sup>(3)(4)</sup> | <sup>(3)(4)</sup> | Common Stock | 14926 | $81.00 | 0 | D |  |
| Restricted Stock Units | <sup>(2)(3)(4)</sup> | 2023-02-28 |  | D |  |  | 73938 | <sup>(3)(4)</sup> | <sup>(3)(4)</sup> | Common Stock | 73938 | $81.00 | 0 | D |  |
| Restricted Stock Units | <sup>(2)(3)(4)</sup> | 2023-02-28 |  | D |  |  | 390000 | <sup>(3)(4)</sup> | <sup>(3)(4)</sup> | Common Stock | 390000 | $81.00 | 0 | D |  |
| Performance Stock Units | <sup>(2)(5)</sup> | 2023-02-28 |  | D |  |  | 49406 | <sup>(5)</sup> | <sup>(5)</sup> | Common Stock | 49406 | $81.00 | 0 | D |  |
| Performance Stock Units | <sup>(2)(5)</sup> | 2023-02-28 |  | D |  |  | 40584 | <sup>(5)</sup> | <sup>(5)</sup> | Common Stock | 40584 | $81.00 | 0 | D |  |
| Performance Stock Units | <sup>(2)(5)</sup> | 2023-02-28 |  | D |  |  | 91000 | <sup>(5)</sup> | <sup>(5)</sup> | Common Stock | 91000 | $81.00 | 0 | D |  |
| Performance Stock Units | <sup>(2)(6)</sup> | 2023-02-28 |  | D |  |  | 585000 | <sup>(6)</sup> | <sup>(6)</sup> | Common Stock | 585000 | $0.00 | 0 | D |  |
| Stock Option (right to buy) | $13.04 | 2023-02-28 |  | D |  |  | 50621 | <sup>(7)(8)</sup> | <sup>(7)(8)</sup> | Common Stock | 50621 | 67.96<sup>(7)(8)</sup> | 0 | D |  |
| Stock Option (right to buy) | $13.04 | 2023-02-28 |  | D |  |  | 163238 | <sup>(7)(8)</sup> | <sup>(7)(8)</sup> | Common Stock | 163238 | 67.96<sup>(7)(8)</sup> | 0 | D |  |
| Stock Option (right to buy) | $13.04 | 2023-02-28 |  | D |  |  | 163238 | <sup>(7)(8)</sup> | <sup>(7)(8)</sup> | Common Stock | 163238 | 67.96<sup>(7)(8)</sup> | 0 | D |  |
| Stock Option (right to buy) | $23.70 | 2023-02-28 |  | D |  |  | 158462 | <sup>(7)(8)</sup> | <sup>(7)(8)</sup> | Common Stock | 158462 | 57.30<sup>(7)(8)</sup> | 0 | D |  |
| Stock Option (right to buy) | $48.47 | 2023-02-28 |  | D |  |  | 334742 | <sup>(7)(8)</sup> | <sup>(7)(8)</sup> | Common Stock | 334742 | 32.53<sup>(7)</sup> | 0 | D |  |
| Stock Option (right to buy) | $94.47 | 2023-02-28 |  | D |  |  | 56521 | <sup>(7)(8)</sup> | <sup>(7)(8)</sup> | Common Stock | 56521 | $0.00 | 0 | D |  |

---

### Footnotes:

(1) The shares were disposed of pursuant to the Agreement and Plan of Merger, dated as of December 11, 2022 (the "Merger Agreement"), by and among Coupa Holdings, LLC (f/k/a Project CS Parent, LLC) ("Parent"), Project CS Merger Sub, Inc. ("Merger Sub"), and Coupa Software Incorporated (the "Company"). Pursuant to the Merger Agreement, Merger Sub merged with and into the Company (the "Merger"), with the Company surviving the Merger as a wholly owned subsidiary of Parent. At the effective time of the Merger (the "Effective Time"), each share of the Company's common stock, par value $0.0001 per share ("Common Stock"), was canceled and automatically converted into the right to receive $81.00 in cash, without interest, less any applicable withholding taxes (the "Merger Consideration").

(2) Restricted stock units ("RSUs") and performance stock units ("PSUs") represent a contingent right to receive one share of Common Stock for each RSU or PSU, as applicable.

(3) Pursuant to the Merger Agreement, at the Effective Time, each RSU that was subject to time-based vesting conditions that was unexpired, unsettled and vested as of immediately prior to the Effective Time (including any RSU that vested automatically as a result of the Merger) (each a "Vested RSU") and a portion of certain RSUs that would have vested on or prior to January 31, 2024 (each a "Deemed Vested RSU") was canceled and converted into the right to receive a cash payment equal to the number of shares of Common Stock subject to such Vested RSU or Deemed Vested RSU as of immediately prior to the Effective Time, multiplied by the Merger Consideration. (Continued in Footnote 4)

(4) (Continued from Footnote 3) Pursuant to the Merger Agreement, at the Effective Time, each RSU that remained unexpired, unvested and outstanding as of immediately prior to the Effective Time (other than any Deemed Vested RSU) (each an "Unvested RSU") was canceled and automatically converted into the right to receive a cash payment equal to the number of shares of Common Stock subject to such Unvested RSU as of immediately prior to the Effective Time, multiplied by the Merger Consideration, with such amount to vest and become payable on substantially the same terms and conditions that applied to the Unvested RSU, subject to the Reporting Person's continued service with Parent and its affiliates through the applicable vesting date.

(5) Pursuant to the Merger Agreement, at the Effective Time, each PSU, whether vested or unvested, that was outstanding immediately prior to the Effective Time was canceled and automatically converted into the right to receive a cash payment equal to the number of shares of Common Stock subject to such PSU as of immediately prior to the Effective time (with the number of PSUs determined based on deemed achievement at 100% of target) multiplied by the Merger Consideration.

(6) Pursuant to the Merger Agreement, at the Effective Time, this PSU was canceled for no consideration in accordance with its terms.

(7) Pursuant to the Merger Agreement, at the Effective Time, each option to purchase shares of Common Stock (an "Option") that was unexpired, unexercised, vested and outstanding as of immediately prior to the Effective Time (including any Option that vested automatically as a result of the Merger) (each a "Vested Option") was canceled and automatically converted into the right to receive a cash payment, without interest, equal to (x) the number of shares of Common Stock for which such option had not then been exercised multiplied by (y) the excess, if any, of the Merger Consideration over the per share exercise price of such Vested Option, except that each Vested Option with a per share exercise price equal to or greater than the Merger Consideration was canceled for no consideration. (Continued in Footnote 8)

(8) (Continued from Footnote 7) Pursuant to the Merger Agreement, at the Effective Time, each Option that was unexpired, unexercised, unvested and outstanding as of immediately prior to the Effective Time (each an "Unvested Option") was canceled and automatically converted into the right to receive a cash payment, without interest, equal to the number of shares of Common Stock for which such Unvested Option had not then been exercised multiplied by the excess, if any, of the Merger Consideration over the per share exercise price of such Unvested Option, with such amount to vest and become payable on substantially the same terms and conditions that applied to the Unvested Option, subject to the Reporting Person's continued service with Parent and its affiliates through the applicable vesting date, except that each Unvested Option with a per share exercise price equal to or greater than the Merger Consideration was canceled for no consideration.

**Signature:** /s/ Jon Stueve, Authorized Signatory for: Robert Bernshteyn  
**Date:** 2023-02-28

### Remarks:

Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly.

* If the form is filed by more than one reporting person, see Instruction 4 (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).

Note: File three copies of this Form, one of which must be manually signed. If space is insufficient, see Instruction 6 for procedure.

**Persons who respond to the collection of information contained in this form are not required to respond unless the form displays a currently valid OMB Number.**