SEC Info - Qualys, Inc. - IPO: ‘S-1/A’ on 9/11/12

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Qualys, Inc. – IPO: ‘S-1/A’ on 9/11/12 – ‘EX-4.1’

On: Tuesday, 9/11/12, at 9:46pm ET · As of: 9/12/12 · Private-to-Public: Document/Exhibit `¶` – Release Delayed · Accession #: 1193125-12-388433 · File #: 333-182027

  As Of                Filer                Filing    For·On·As Docs:Size              Issuer               Agent

 9/12/12  Qualys, Inc.                      S-1/A¶                15:6.8M                                   Donnelley … Solutions/FA

Initial Public Offering (IPO): Pre-Effective Amendment to Registration Statement (General Form) — Form S-1
Filing Table of Contents

Document/Exhibit                   Description                      Pages   Size 

 1: S-1/A       Amendment No.4 to Form S-1                          HTML   2.19M 
15: CORRESP   ¶ Comment-Response or Other Letter to the SEC         HTML     16K 
 2: EX-1.1      Form of Underwriting Agreement                      HTML    195K 
 3: EX-3.3      Form of Amended and Restated Certificate of         HTML     33K 
                Incorporation                                                    
 4: EX-3.5      Form of Amended and Restated Bylaws of Qualys       HTML    163K 
 5: EX-3.6      Amendment No. 8 to Amended and Restated             HTML     16K 
                Certificate of Incorporation                                     
 6: EX-4.1      Form of Common Stock Certificate                    HTML     34K 
 7: EX-5.1      Opinion of Wilson Sonsini Goodrich & Rosati, P.C.   HTML     14K 
10: EX-10.14    Master Services Agreement - Savvis Communications   HTML     43K 
                Corporation                                                      
11: EX-10.15    Master Agreement - Interoute Communications         HTML    249K 
                Limited                                                          
12: EX-10.16    Manufacturing Services Agreement - Synnex           HTML     73K 
                Corporation                                                      
 8: EX-10.2     2012 Equity Incentive Plan and Forms of Agreements  HTML    257K 
                Thereunder                                                       
 9: EX-10.6     Offer Letter - Donald C. McCauley                   HTML     29K 
13: EX-23.1     Consent of Grant Thornton LLP                       HTML      8K 
14: EX-23.2     Consent of Grant Thornton LLP                       HTML      8K

‘EX-4.1’ — Form of Common Stock Certificate

This Exhibit is an HTML Document rendered as filed. [ Alternative Formats ]

Form of common stock certificate

Exhibit 4.1

016570| 003590|127C|RESTRICTED||4|057-423

COMMON STOCK

PAR VALUE $0.001

COMMON STOCK

THIS CERTIFICATE IS TRANSFERABLE IN CANTON, MA AND NEW YORK, NY

Certificate Number ZQ 000000

* * 0 0 0 0 0 0 * * * * * *

* * * 0 0 0 0 0 0 * * * * *

* * * * 0 0 0 0 0 0 * * * *

* * * * * 0 0 0 0 0 0 * * *

* * * * * * 0 0 0 0 0 0 * *

QUALYS, INC.

INCORPORATED UNDER THE LAWS OF THE STATE OF DELAWARE

THIS CERTIFIES THAT MR. SAMPLE & MRS. SAMPLE & MR. SAMPLE & MRS. SAMPLE

CUSIP 74758T 30 3

SEE REVERSE FOR CERTAIN DEFINITIONS

** Mr. Alexander David Sample **** Mr. Alexander David Sample **** Mr. Alexander David Sample **** Mr. Alexander David Sample **** Mr. Alexander David Sample **** Mr. Alexander David Sample **** Mr. Alexander David Sample **** Mr. Alexander David Sample **** Mr. Alexander David Sample **** Mr. Alexander David Sample **** Mr. Alexander David Sample **** Mr. Alexander David Sample **** Mr. Alexander David Sample **** Mr. Alexander David Sample **** Mr. Alexander David Sample **** Mr. Alexander David Sample **** Mr. Alexander David Sample **** Mr. Alexander David Sample **** Mr. Alexander David Sample **** Mr. Alexander David Sample **** Mr. Alexander David Sample **** Mr. Alexander David Sample **** Mr. Alexander David Sample **** Mr. Alexander David Sample **** Mr. Alexander David Sample **** Mr. Alexander David Sample **** Mr. Alexander David Sample **** Mr. Alexander David Sample **** Mr. Alexander David Sample **** Mr. Alexander David Sample **** Mr. Alexander David Sample **** Mr. Alexander David Sample **** Mr. Alexander David Sample **** Mr. Alexander David Sample **** Mr. Alexander David Sample **** Mr. Alexander David Sample **** Mr. Alexander David Sample **** Mr. Alexander David Sample **** Mr. Alexander David Sample **** Mr. Alexander David Sample **** Mr. Alexander David Sample **** Mr. Alexander David Sample **** Mr. Alexander David Sample **** Mr. Alexander David Sample **** Mr. Alexander David Sample **** Mr. Alexander David Sample **** Mr. Alexander David Sample **** Mr. Alexander David Sample **** Mr. Alexander David Sample **** Mr. Alexander David Sample **** Mr. Alexander David Sample **** Mr. Alexander David Sample **** Mr. Sample **** Mr. Sample

is the owner of

***ZERO HUNDRED THOUSAND ZERO HUNDRED AND ZERO***

**000000**Shares****000000**Shares****000000**Shares****000000**Shares****000000**Shares****000000**Shares****00

0000**Shares****000000**Shares****000000**Shares****000000**Shares****000000**Shares****000000**Shares****000000

**Shares****000000**Shares****000000**Shares****000000**Shares****000000**Shares****000000**Shares****000000**

Shares****000000**Shares****000000**Shares****000000**Shares****000000**Shares****000000**Shares****000000**

Shares****000000**Shares****000000**Shares****000000**Shares****000000**S

FULLY-PAID AND NON-ASSESSABLE SHARES OF THE COMMON STOCK OF

Qualys, Inc. (hereinafter called the “Company”), transferable on the books of the Company in person or by duly authorized attorney, upon surrender of this Certificate properly endorsed. This Certificate and the shares represented hereby, are issued and shall be held subject to all of the provisions of the Certificate of Incorporation, as amended, and the By-Laws, as amended, of the Company (copies of which are on file with the Company and with the Transfer Agent), to all of which each holder, by acceptance hereof, assents. This Certificate is not valid unless countersigned and registered by the Transfer Agent and Registrar.

Witness the facsimile seal of the Company and the facsimile signatures of its duly authorized officers.

Chief Financial Officer

Vice President, General Counsel and Corporate Secretary

QUALYS, INC.

CORPORATE

SEAL

1999

DELAWARE

DATED <<Month Day, Year>>

COUNTERSIGNED AND REGISTERED:

COMPUTERSHARE TRUST COMPANY, N.A.

TRANSFER AGENT AND REGISTRAR,

AUTHORIZED SIGNATURE

SECURITY INSTRUCTIONS ON REVERSE

1234567

Qualys, Inc.

PO BOX 43004, Providence, RI 02940-3004

MR A SAMPLE DESIGNATION (IF ANY) ADD 1 ADD 2 ADD 3 ADD 4

CUSIP XXXXXX XX X

Holder ID XXXXXXXXXX

Insurance Value 1,000,000.00

Number of Shares 123456

DTC 12345678 123456789012345

Certificate Numbers

1234567890/1234567890

Num/No. 1 2 3 4 5 6

Denom. 1 2 3 4 5 6

Total 1 2 3 4 5 6

Total Transaction 7

QUALYS, INC.

THE COMPANY WILL FURNISH WITHOUT CHARGE TO EACH SHAREHOLDER WHO SO REQUESTS, A SUMMARY OF THE POWERS, DESIGNATIONS, PREFERENCES AND RELATIVE, PARTICIPATING, OPTIONAL OR OTHER SPECIAL RIGHTS OF EACH CLASS OF STOCK OF THE COMPANY AND THE QUALIFICATIONS, LIMITATIONS OR RESTRICTIONS OF SUCH PREFERENCES AND RIGHTS, AND THE VARIATIONS IN RIGHTS, PREFERENCES AND LIMITATIONS DETERMINED FOR EACH SERIES, WHICH ARE FIXED BY THE CERTIFICATE OF INCORPORATION OF THE COMPANY, AS AMENDED, AND THE RESOLUTIONS OF THE BOARD OF DIRECTORS OF THE COMPANY, AND THE AUTHORITY OF THE BOARD OF DIRECTORS TO DETERMINE VARIATIONS FOR FUTURE SERIES. SUCH REQUEST MAY BE MADE TO THE OFFICE OF THE SECRETARY OF THE COMPANY OR TO THE TRANSFER AGENT. THE BOARD OF DIRECTORS MAY REQUIRE THE OWNER OF A LOST OR DESTROYED STOCK CERTIFICATE, OR HIS LEGAL REPRESENTATIVES, TO GIVE THE COMPANY A BOND TO INDEMNIFY IT AND ITS TRANSFER AGENTS AND REGISTRARS AGAINST ANY CLAIM THAT MAY BE MADE AGAINST THEM ON ACCOUNT OF THE ALLEGED LOSS OR DESTRUCTION OF ANY SUCH CERTIFICATE.


The following abbreviations, when used in the inscription on the face of this certificate, shall be construed as though they were written out in full according to applicable laws or regulations:
TEN COM	- as tenants in common	UNIF GIFT MIN ACT -	Custodian
		(Cust)	(Minor)
TEN ENT	- as tenants by the entireties	under Uniform Gifts to Minors Act
		(State)
JT TEN	- as joint tenants with right of survivorship	UNIF TRF MIN ACT -	Custodian (until age )
	and not as tenants in common	(Cust)
			under Uniform Transfers to Minors Act
		(Minor)	(State)
Additional abbreviations may also be used though not in the above list.


For value received, hereby sell, assign and transfer unto		PLEASE INSERT SOCIAL SECURITY OR OTHER IDENTIFYING NUMBER OF ASSIGNEE
For value received, hereby sell, assign and transfer unto

(PLEASE PRINT OR TYPEWRITE NAME AND ADDRESS, INCLUDING POSTAL ZIP CODE, OF ASSIGNEE)


		Shares
of the common stock represented by the within Certificate, and do hereby irrevocably constitute and appoint
		Attorney
to transfer the said stock on the books of the within-named Company with full power of substitution in the premises.

Dated:

Signature(s) Guaranteed: Medallion Guarantee Stamp

THE SIGNATURE(S) SHOULD BE GUARANTEED BY AN ELIGIBLE GUARANTOR INSTITUTION (Banks, Stockbrokers, Savings and Loan Associations and Credit Unions) WITH MEMBERSHIP IN AN APPROVED SIGNATURE GUARANTEE MEDALLION PROGRAM, PURSUANT TO S.E.C. RULE 17Ad-15.

Signature:

Notice:

The signature to this assignment must correspond with the name as written upon the face of the certificate, in every particular, without alteration or enlargement, or any change whatever.

The IRS requires that we report the cost basis of certain shares acquired after January 1, 2011. If your shares were covered by the legislation and you have sold or transferred the shares and requested a specific cost basis calculation method, we have processed as requested. If you did not specify a cost basis calculation method, we have defaulted to the first in, first out (FIFO) method. Please visit our website or consult your tax advisor if you need additional information about cost basis.

If you do not keep in contact with us or do not have any activity in your account for the time periods specified by state law, your property could become subject to state unclaimed property laws and transferred to the appropriate state.

Dates Referenced Herein

This ‘S-1/A’ Filing	Date	Other Filings

Filed as of:	9/12/12	None on these Dates
Filed on:	9/11/12
	1/1/11
		List all Filings

7 Subsequent Filings that Reference this Filing

  As Of               Filer                 Filing    For·On·As Docs:Size             Issuer                      Filing Agent

 2/22/24  Qualys, Inc.                      10-K       12/31/23  103:11M
 2/23/23  Qualys, Inc.                      10-K       12/31/22   97:11M                                    RDG Filings/FA
 2/22/22  Qualys, Inc.                      10-K       12/31/21   98:10M                                    RDG Filings/FA
 2/22/22  Qualys, Inc.                      S-8         2/22/22    4:85K                                    Donnelley … Solutions/FA
 7/02/21  Qualys, Inc.                      S-8         7/02/21    3:81K                                    RDG Filings/FA
 2/22/21  Qualys, Inc.                      10-K       12/31/20  101:11M                                    RDG Filings/FA
 2/22/21  Qualys, Inc.                      S-8         2/22/21    3:69K                                    Donnelley … Solutions/FA

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Filing Submission 0001193125-12-388433 – Alternative Formats (Word / Rich Text, HTML, Plain Text, et al.)

Qualys, Inc. – IPO: ‘S-1/A’ on 9/11/12 – ‘EX-4.1’

On: Tuesday, 9/11/12, at 9:46pm ET · As of: 9/12/12 · Private-to-Public: Document/Exhibit ¶ – Release Delayed · Accession #: 1193125-12-388433 · File #: 333-182027

Initial Public Offering (IPO): Pre-Effective Amendment to Registration Statement (General Form) — Form S-1Filing Table of Contents

‘EX-4.1’ — Form of Common Stock Certificate

This Exhibit is an HTML Document rendered as filed. [ Alternative Formats ]

Dates Referenced Herein

7 Subsequent Filings that Reference this Filing

On: Tuesday, 9/11/12, at 9:46pm ET · As of: 9/12/12 · Private-to-Public: Document/Exhibit `¶` – Release Delayed · Accession #: 1193125-12-388433 · File #: 333-182027

Initial Public Offering (IPO): Pre-Effective Amendment to Registration Statement (General Form) — Form S-1
Filing Table of Contents