SEC Info - Baker Hughes Holdings LLC, et al. - ‘3’ for 12/8/20 re: C3.ai, Inc.

FORM 3

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

INITIAL STATEMENT OF BENEFICIAL OWNERSHIP OF SECURITIES

Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934
or Section 30(h) of the Investment Company Act of 1940

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1. Name and Address of Reporting Person^*

Baker Hughes Holdings LLC

(Last)

(First)

(Middle)

17021 ALDINE WESTFIELD

(Street)

HOUSTON

77073

(City)

(State)

(Zip)

2. Date of Event Requiring Statement (Month/Day/Year)
12/8/20

3. Issuer Name and Ticker or Trading Symbol
C3.ai, Inc. [ AI ]

4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)

X	Director	X	10% Owner
	Officer (give title below)		Other (specify below)

5. If Amendment, Date of Original Filed (Month/Day/Year)

6. Individual or Joint/Group Filing (Check Applicable Line)

	Form filed by One Reporting Person
X	Form filed by More than One Reporting Person

Table I - Non-Derivative Securities Beneficially Owned
1. Title of Security (Instr. 4)	2. Amount of Securities Beneficially Owned (Instr. 4)	3. Ownership Form: Direct (D) or Indirect (I) (Instr. 5)	4. Nature of Indirect Beneficial Ownership (Instr. 5)
Class A Common Stock	9,529,762	D ⁽¹⁾

Table II - Derivative Securities Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities)
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: Direct (D) or Indirect (I) (Instr. 5)	6. Nature of Indirect Beneficial Ownership (Instr. 5)
1. Title of Derivative Security (Instr. 4)	Date Exercisable	Expiration Date	Title	Amount or Number of Shares	4. Conversion or Exercise Price of Derivative Security	5. Ownership Form: Direct (D) or Indirect (I) (Instr. 5)	6. Nature of Indirect Beneficial Ownership (Instr. 5)
Series G Preferred Stock	⁽²⁾	⁽²⁾	Class A Common Stock	1,283,333	⁽²⁾	D ⁽¹⁾

1. Name and Address of Reporting Person^*

Baker Hughes Holdings LLC

(Last)

(First)

(Middle)

17021 ALDINE WESTFIELD

(Street)

HOUSTON

77073

(City)

(State)

(Zip)

1. Name and Address of Reporting Person^*

Baker Hughes Co

(Last)

(First)

(Middle)

17021 ALDINE WESTFIELD

(Street)

HOUSTON

77073

(City)

(State)

(Zip)

1. Name and Address of Reporting Person^*

Simonelli Lorenzo

(Last)

(First)

(Middle)

C/O BAKER HUGHES COMPANY

17021 ALDINE WESTFIELD

(Street)

HOUSTON

77073

(City)

(State)

(Zip)

Explanation of Responses:

(1) The reported securities are owned directly by Baker Hughes Holdings LLC ("Holdings"). Holdings is a controlled subsidiary of Baker Hughes Company ("Baker Hughes") and may be deemed to have beneficial ownership of the Class A Common Stock and Series G Preferred Stock held directly by Holdings. Baker Hughes disclaims beneficial ownership of the reported securities except to the extent of their pecuniary interest therein.

(2) The Series G Preferred Stock will convert to Class A Common Stock on a 1 for 1 basis upon the closing of the initial public offering of the Issuer.

	/s/ Lee Whitley, as Authorized Signatory for Baker Hughes Holdings LLC	12/8/20
	/s/ Lee Whitley, as Authorized Signatory for Baker Hughes Company	12/8/20
	/s/ Lee Whitley, as Attorney-in-Fact for Lorenzo Simonelli	12/8/20
	** Signature of Reporting Person	Date
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 5 (b)(v).
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Baker Hughes Holdings LLC, et al. – ‘3’ for 12/8/20 re: C3.ai, Inc.

On: Tuesday, 12/8/20, at 8:13pm ET · For: 12/8/20 · Accession #: 950103-20-23987 · File #: 1-39744

Previous ‘3’: ‘3’ on 5/20/98 for 5/10/98 · Latest ‘3’: This Filing

Initial Statement of Beneficial Ownership of Securities by an Insider — Form 3 — SEA’34
Filing Table of Contents

‘3’ — Initial Statement of Beneficial Ownership of Securities by an Insider — dp142680_3-bhh.xml/2.6

This ‘3’ Document is an XML Data File that may be rendered in various formats:

Baker Hughes Holdings LLC, et al. – ‘3’ for 12/8/20 re: C3.ai, Inc.

On: Tuesday, 12/8/20, at 8:13pm ET · For: 12/8/20 · Accession #: 950103-20-23987 · File #: 1-39744

Previous ‘3’: ‘3’ on 5/20/98 for 5/10/98 · Latest ‘3’: This Filing

Initial Statement of Beneficial Ownership of Securities by an Insider — Form 3 — SEA’34Filing Table of Contents

‘3’ — Initial Statement of Beneficial Ownership of Securities by an Insider — dp142680_3-bhh.xml/2.6

This ‘3’ Document is an XML Data File that may be rendered in various formats:

Initial Statement of Beneficial Ownership of Securities by an Insider — Form 3 — SEA’34
Filing Table of Contents