Delaware
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87-0442441
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(State or Other Jurisdiction
of
Incorporation or Organization)
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(I.R.S. Employer
Identification
Number)
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Title Of Shares
To Be
Registered
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Amount
To Be Registered
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Proposed Maximum
Offering
Price Per Share(1)
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Proposed Maximum
Aggregate
Offering Price(1)
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Amount Of Registration Fee
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Common stock, $0.001 par value per share (including associated preferred stock purchase rights)
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944,100 shares
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$
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5.02
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$
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4,739,382
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$
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436.02
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(1)
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Estimated based upon the average of the high and low sales prices of the Registrants common stock on May 28, 2002, as reported by the Nasdaq National
Market, solely for the purpose of calculating the registration fee pursuant to Rule 457(c) promulgated under the Securities Act of 1933, as amended.
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Page
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2
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2
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9
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10
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10
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12
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13
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13
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15
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15
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the evolving and varying demand for dental and medical lasers;
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our ability to develop, introduce, market and gain market acceptance of new products and product enhancements in a timely manner;
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our ability to control costs;
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the size, timing, rescheduling or cancellation of significant customer orders;
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the introduction of new products by competitors;
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the availability and reliability of components used to manufacture our products;
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changes in our pricing policies or those of our suppliers and competitors, as well as increased price competition in general;
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the mix of our domestic and international sales, and the risks and uncertainties associated with our international business;
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costs associated with any future acquisitions of technologies and businesses; and
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general global economic and political conditions, including international conflicts and acts of terrorism.
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political, social and economic instability and increased security concerns;
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fluctuations in currency exchange rates;
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exposure to different legal standards;
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reduced protection for our intellectual property in some countries;
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burdens of complying with a variety of foreign laws;
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import and export license requirements and restrictions of the United States and each other country in which we operate;
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trade restrictions;
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the imposition of governmental controls;
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unexpected changes in regulatory or certification requirements;
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changes in tariffs;
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difficulties in staffing and managing international operations;
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longer collection periods and difficulties in collecting receivables from foreign entities; and
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potentially adverse tax consequences.
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entering into service agreements for devices sold in Europe;
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retraining existing employees in our operations, and hiring additional employees for the facility;
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integrating the facilitys operations with our existing operations; and
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generating German facility revenue and achieving profitability.
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We may encounter difficulties in assimilating and integrating the operations, products and workforce of the acquired companies;
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Acquisitions may materially and adversely affect our results of operations because they may require large one-time charges or could result in increased debt or
contingent liabilities, adverse tax consequences, substantial depreciation or deferred compensation charges, or the amortization of amounts related to deferred compensation, goodwill and other intangible assets;
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Acquisitions may be dilutive to our existing stockholders;
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Acquisitions may disrupt our ongoing business and distract our management; and
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Key personnel of the acquired company may decide not to work for us.
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Uncertainties relating to worldwide political stability, general economic conditions and trade policies;
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Uncertainties relating to government and regulatory policies;
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Unforeseen technological developments by competitors;
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The entry of new, well-capitalized competitors;
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The availability and pricing of materials used in the manufacture of our products;
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Uncertainties relating to the development, ownership and enforcement of intellectual property rights;
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Adverse changes in the financing of commercial health and dental plans;
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Adverse changes in the financial markets affecting the availability and cost of capital;
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The impact of natural disasters, including a major earthquake, on our operations; or
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The ability to attract and retain qualified personnel to grow and compete effectively.
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Number of Shares Beneficially Owned Prior to Offering
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Number of Shares Being Offered in Offering
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Beneficially Owned
After
Offering
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Name of Selling Stockholder
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Number of Shares
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Percent of Outstanding Shares
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CBG Compagnie Bancaire Geneve(1)
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480,000
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160,000
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320,000
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1.6
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%
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Corner Bank Ltd.(2)
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360,000
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360,000
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Corner Banque S.A.(3)
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105,000
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105,000
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GEM Holdings Corp.(4)
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566,400
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256,600
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309,800
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1.5
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%
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Triglova Finance S.A.(5)
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62,500
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62,500
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Total
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1,573,900
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944,100
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629,800
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3.0
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%
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(1)
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Includes 160,000 shares of common stock subject to warrants which are immediately exercisable.
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(2)
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Includes 260,000 shares of common stock subject to warrants which are immediately exercisable.
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(3)
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Includes 40,000 shares of common stock subject to warrants which are immediately exercisable.
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(4)
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Includes 200,000 shares of common stock subject to warrants which are immediately exercisable.
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(5)
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Includes 62,500 shares of common stock subject to warrants which are immediately exercisable for our common stock at a price per share of $2.50 and which expire
in September 2002. The warrants were originally issued to Eurocapital Limited, which acted as our agent for the private placement completed in March 2000, but were subsequently transferred by Eurocapital Limited to Triglova Finance S.A. in May 2001.
Our Chairman of the Board, Federico Pignatelli, has in the past acted as an agent of Eurocapital Limited, but has no current relationship, financial or otherwise, with Eurocapital Limited. Mr. Pignatelli disclaims beneficial ownership of the shares
that were transferred by Eurocapital Limited and that are being offered by Triglova Finance S.A.
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a block trade in which the broker-dealer so engaged will attempt to sell the shares as agent but may position and resell a portion of the block as principal to
facilitate the transaction;
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purchases by a broker-dealer as principal and resale by such broker-dealer for its account under this prospectus;
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an exchange distribution in accordance with the rules of such exchange;
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ordinary brokerage transactions and transactions in which the broker solicits purchasers; or
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privately negotiated transactions.
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the name of each such selling stockholder and of the participating broker-dealer(s),
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the number of shares involved,
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the price at which such shares were sold,
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the commissions paid or discounts or concessions allowed to such broker-dealer(s), where applicable,
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that such broker-dealer(s) did not conduct any investigation to verify the information set out or incorporated by reference in this prospectus, and
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other facts material to the transaction.
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SEC Registration Fee
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$
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436.02
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Printing Expenses
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6,000.00
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Legal Fees and Expenses
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10,500.00
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Accounting Fees and Expenses
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5,000.00
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Transfer Agent Fees and Expenses
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700.00
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Total
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$
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22,636.02
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Exhibit Number
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4.1
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Specimen of common stock certificate.
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4.2
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Form of Common Stock Purchase Warrant for private placement investors.
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4.3
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Form of Common Stock Purchase Warrant for GEM Holdings Corp.
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4.4
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Form of rights certificate for preferred stock purchase rights (incorporated by reference to Exhibit A to Exhibit 1
to the Registrants Registration Statement on Form 8-A as filed with the SEC on December 29, 1998).
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4.5
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Restated Certificate of Incorporation, as Amended (incorporated by reference to the Registrants Annual Report
on Form 10-K filed with the SEC on April 14, 1994).
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4.6
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Amended and Restated Bylaws (incorporated by reference to the Registrants Quarterly Report on Form 10-QSB filed
with the SEC on September 15, 1995).
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5.1
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Opinion of Brobeck, Phleger & Harrison LLP.
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23.1
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Consent of Independent Accountants.
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23.2
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Consent of Brobeck, Phleger & Harrison LLP (included in Exhibit 5.1).
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24.1
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Power of Attorney (included in signature page).
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B
IOLASE
T
ECHNOLOGY
, I
NC
.
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By:
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/s/ J
EFFREY
W. J
ONES
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Jeffrey W. Jones
President,
Chief Executive Officer
and Director
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Signature
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Title
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Date
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/s/ J
EFFREY
W. J
ONES
Jeffrey W. Jones
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President and Chief Executive Officer and Director (principal executive officer)
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June 3, 2002
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/
S
/ E
DSON
J.
R
OOD
Edson J. Rood
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Vice President and Chief Financial Officer (principal financial and accounting officer)
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June 3, 2002
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/s/ F
EDERICO
P
IGNATELLI
Federico Pignatelli
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Director and Chairman of the Board
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June 3, 2002
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/s/ W
ILLIAM
A. O
WENS
William A. Owens
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Director
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June 3, 2002
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/s/ G
EORGE
V.
D
A
RBELOFF
George V.
dArbeloff
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Director
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June 3, 2002
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Exhibit Number
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4.1
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Specimen of common stock certificate.
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4.2
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Form of Common Stock Purchase Warrant for private placement investors.
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4.3
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Form of Common Stock Purchase Warrant for GEM Holdings Corp.
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4.4
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Form of rights certificate for preferred stock purchase rights (incorporated by reference to Exhibit A to Exhibit 1
to the Registrants Registration Statement on Form 8-A as filed with the SEC on December 29, 1998).
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4.5
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Restated Certificate of Incorporation, as Amended (incorporated by reference to the Registrants Annual Report
on Form 10-K filed with the SEC on April 14, 1994).
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4.6
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Amended and Restated Bylaws (incorporated by reference to the Registrants Quarterly Report on Form 10-QSB filed
with the SEC on September 15, 1995).
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5.1
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Opinion of Brobeck, Phleger & Harrison LLP.
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23.1
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Consent of Independent Accountants.
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23.2
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Consent of Brobeck, Phleger & Harrison LLP (included in Exhibit 5.1).
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24.1
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Power of Attorney (included in signature page).
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EXHIBIT 4.1
SPECIMEN OF COMMON STOCK CERTIFICATE
BIOLASE
TECHNOLOGY, INC.
INCORPORATED UNDER THE LAWS OF THE STATE OF DELAWARE
COMMON STOCK COMMON STOCK NUMBER SHARES This Certifies that: CUSIP 090911 10 8 |
SEE REVERSE FOR
CERTAIN DEFINITIONS
SPECIMEN
is the record holder of
Fully paid and Non-Assessable Shares of Common Stock Par Value $.001 Per Share
of
BIOLASE TECHNOLOGY, INC.
transferable only on the books of the Company by the holder hereof in person or
by duly authorized attorney, upon surrender of this Certificate duly endorsed.
This Certificate is not valid until countersigned by the Transfer Agent and
Registrar.
IN WITNESS WHEREOF the Corporation has caused this Certificate to be signed
in facsimile by its duly authorized officers and a facsimile of its corporate
seal to be impressed hereon. Dated:
/s/ EDSON J. ROOD [SEAL] /s/ JEFFREY W. JONES SECRETARY PRESIDENT |
Countersigned and Registered:
U.S. STOCK TRANSFER CORPORATION
(Glendale, California)
Transfer Agent and Registrar
By
Authorized Officer
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 JT TEN ---as joint tenants with right Act......................... of survivorship and not as (State) tenants in common. |
Additional abbreviations may also be used though not in the above list.
For Value received_________hereby sell assigns and transfer unto
_______________________________________________________________________Shares represented by the within Certificate and do hereby irrevocably constitute and appoint
_______________________________________________________________________Attorney to transfer the said Shares on the share register of the within named Corporation with full power of substitution in the premises.
Dated______________________
Signature Guaranteed:
By__________________________________________________________
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 17 Ad-15.
This certificate also evidences and entitles the holder hereof to certain Rights as set forth in a Rights Agreement dated as of December 31, 1998 by and between BioLase Technology, Inc. and U.S. Stock Transfer Corporation, as Rights Agent (the "Rights Agreement"), as amended to date, the terms and conditions of which are hereby incorporated herein by reference and a copy of which is on file at the principle executive offices of BioLase Technology, Inc. Under certain circumstances specified in the Rights Agreement, such Rights will be represented by separate certificates and no longer be represented by this certificate. Under certain circumstances specified in the Rights Agreement, Rights beneficially owned by certain persons may become null and void. BioLase Technology, Inc. will mail to the holder of this certificate a copy of the Rights Agreement without charge promptly following receipt of a written request therefor. As described in the Rights Agreement, Rights issued to any Person who becomes a 15% stockholder (as defined in the Rights Agreement) shall become null and void.
EXHIBIT 4.2
THE WARRANTS REPRESENTED HEREBY AND THE COMMON STOCK ISSUABLE UPON EXERCISE OF THE WARRANTS HAVE NOT BEEN REGISTERED UNDER THE SECURITIES ACT OF 1933, AS AMENDED (THE "SECURITIES ACT"), OR REGISTERED OR QUALIFIED UNDER SECURITIES LAWS OF ANY STATE OR JURISDICTION AND ARE BEING OFFERED AND SOLD IN RELIANCE UPON EXEMPTIONS FROM THE REGISTRATION REQUIREMENTS OF THE SECURITIES ACT AND SUCH
LAWS. THE WARRANTS REPRESENTED HEREBY AND THE COMMON STOCK ISSUABLE UPON EXERCISE OF THE WARRANTS MAY NOT BE OFFERED, SOLD, HYPOTHECATED OR OTHERWISE TRANSFERRED UNLESS REGISTERED UNDER THE SECURITIES ACT OR AN EXEMPTION FROM THE REGISTRATION REQUIREMENTS OF THE SECURITIES ACT IS APPLICABLE (IN WHICH CASE THE ISSUER SHALL HAVE RECEIVED AN OPINION OF COUNSEL IN FORM AND SUBSTANCE REASONABLY SATISFACTORY TO THE ISSUER TO SUCH EFFECT) AND THE PROVISIONS OF ALL OTHER APPLICABLE SECURITIES LAWS ARE OBSERVED.
BIOLASE TECHNOLOGY, INC.
Incorporated Under the Laws of the State of Delaware
No._________ ________Common Stock Purchase Warrants CERTIFICATE FOR COMMON STOCK PURCHASE WARRANTS |
The Warrants represented by this Warrant Certificate were originally issued as part of a unit consisting of ten thousand shares of the Company's Common Stock and five thousand (5,000) Warrants, issued by the Company in a private placement during 2000.
THE SHARES REPRESENTED BY THIS CERTIFICATE HAVE NOT BEEN REGISTERED UNDER THE SECURITIES ACT OF 1933, AS AMENDED (THE "ACT") OR REGISTERED OR QUALIFIED UNDER THE SECURITIES LAWS OF ANY STATE OR OTHER JURISDICTION IN RELIANCE UPON EXEMPTIONS AFFORDED UNDER THE ACT AND APPLICABLE LAWS OF OTHER JURISDICTIONS. THE SHARES REPRESENTED HEREBY MAY NOT BE OFFERED, SOLD, HYPOTHECATED OR OTHERWISE TRANSFERRED UNLESS REGISTERED UNDER THE ACT OR AN EXEMPTION FROM THE ACT'S REGISTRATION REQUIREMENTS IS APPLICABLE (IN WHICH CASE THE ISSUER SHALL HAVE RECEIVED AN OPINION OF COUNSEL, IN FORM AND SUBSTANCE REASONABLY SATISFACTORY TO THE ISSUER, TO SUCH EFFECT) AND ALL OTHER APPLICABLE SECURITIES LAWS ARE OBSERVED.
A Warrant shall be deemed to have been exercised immediately prior to the close of business on the date (the "Exercise Date") of the surrender to the Company during the Exercise Period at its principal executive offices of this Warrant Certificate with the exercise form attached hereto duly completed and executed by the Registered Holder and accompanied by payment to the Company, in cash or by official bank or certified check, of an amount equal to the aggregate Exercise Price for the Shares being acquired through exercise of Warrants, in lawful money of the United States of America.
The person entitled to receive the Shares issuable upon exercise of a Warrant or Warrants ("Warrant Shares") shall be treated for all purposes as the holder of such Warrant Shares as of the close of business on the Exercise Date. The Company shall not issue any fractional share interests in Warrant Shares issuable or deliverable on the exercise of any Warrant, but the Company will instead pay a cash adjustment in respect of any fraction of a Warrant Share which would otherwise be issuable in an amount equal to the same fraction of the market price of a Share on the date of
exercise, such market price to be determined in good faith by the Board of Directors of the Company. If Warrants represented by more than one Warrant Certificate shall be exercised at one time by the same Registered Holder, the number of full Shares which shall be issuable on exercise thereof shall be computed on the basis of the aggregate number of full shares issuable on such exercise.
Promptly, and in any event within ten business days after the Exercise Date, the Company shall cause to be issued and delivered to the person or persons entitled to receive the same a certificate or certificates for the number of Warrant Shares deliverable on such exercise.
The Company may deem and treat the Registered Holder of the Warrants at any time as the absolute owner thereof for all purposes, and the Company shall not be affected by any notice to the contrary. The Warrants shall not entitle the Registered Holder thereof to any of the rights of shareholders or to any dividend declared on the Shares unless the Registered Holder shall have exercised the Warrants and thereby purchased the Warrant Shares prior to the record date for the determination of holders of Shares entitled to such dividend or other right.
The Registered Holder shall pay all documentary, stamp or similar taxes and other government charges that may be imposed with respect to the issuance, transfer or delivery of any Warrant Shares on exercise of the Warrants. In the event the Warrant Shares are to be delivered in a name other than the name of the Registered Holder of the Warrant Certificate, no such delivery shall be made unless the person requesting the same has paid the amount of any such taxes or charges incident thereto.
thereof. On due presentment at such office of any Warrant Certificate for registration of a transfer permitted hereunder, the Company shall execute, issue and deliver to the transferee a new Warrant Certificate representing an equal aggregate number of Warrants. All Warrant Certificates presented for registration of transfer or exercise shall be duly endorsed or be accompanied by a written instrument or instruments of transfer in form satisfactory to the Company and shall be accompanied by documentary evidence, reasonably satisfactory to the Company, demonstrating the entitlement of the transferee to the requested transfer. The Company may require payment of a sum sufficient to cover any tax or other government charge that may be imposed in connection therewith.
All Warrant Certificates so surrendered, or surrendered for exercise, or for exchange in case of mutilated Warrant Certificates, shall be promptly canceled by the Company and thereafter retained by the Company until the Expiration Date. Prior to due presentment for registration of transfer thereof, the Company may treat the Registered Holder of any Warrant Certificate as the absolute owner thereof (notwithstanding any notations of ownership or writing thereon made by anyone other than the Company), and the Company shall not be affected by any notice to the contrary.
Warrants in accordance with the provisions of Section 3 hereof. Said notice of redemption shall require the Registered Holder to surrender to the Company, on the Redemption Date, at the principal executive offices of the Company, the certificate or certificates representing the Warrants to be redeemed. Notwithstanding the fact that any Warrants called for redemption have not been surrendered for redemption and cancellation on the Redemption Date, after the Redemption Date such Warrants shall be deemed to be expired and all rights of the Registered Holder of such unsurrendered Warrants shall cease and terminate, other than the right to receive the redemption price of $.01 per Warrant for such Warrants, without interest.
In connection with any call hereunder, the Company shall have no obligation to call any other stock purchase warrant or warrants, whether or not having similar terms, and no call made pursuant to any other stock purchase warrant shall obligate the Company to exercise its right and option to make a call hereunder, except that the Company shall not call any redeemable stock purchase warrants expiring ______________ (including the Warrants evidenced hereby) having terms substantially identical to the Warrants evidenced hereby unless the Company concurrently calls all such Warrants.
(a) If the Company shall, at any time prior to the complete exercise of the Warrants evidenced hereby, declare or pay to the holders of its outstanding Shares, a dividend payable in any kind of shares of stock or other securities of the Company, or in property, or otherwise than in cash, the Registered Holder when thereafter exercising the Warrants evidenced hereby as herein provided shall be entitled to receive for the Exercise Price, in addition to one Warrant Share, such additional share or shares of stock or scrip representing fractions of a share or other securities or property as the Registered Holder would have received in the form of such dividend if he had been the holder of record of such Warrant Share on the record date for the determination of the holders of Shares entitled to receive such dividend.
(b) If the Company shall, while any Warrants evidenced hereby remain in force, effect a stock split, reverse stock split or other recapitalization of such character that the Shares for which the Warrants are exercisable shall be changed into or become exchangeable for a larger or smaller number of Shares, then thereafter the number of Shares which the Registered Holder shall be entitled to purchase hereunder shall be increased or decreased, as the case may be, in direct proportion to the increase or decrease in the number of outstanding Shares of the Company arising solely by reason of such recapitalization, and the Exercise Price (per Share) shall in the case of an increase in the number of Shares be proportionately reduced, and in the case of
a decrease in the number of shares be proportionately increased, so that the aggregate exercise price shall remain the same.
(c) In case of any reorganization of the Company (or any other corporation the stock or other securities of which are at the time receivable upon exercise of a Warrant) or in case the Company (or any such other corporation) shall merge into or with or consolidate with another corporation or convey all or substantially all of its assets to another corporation or enter into a business combination of any form as a result of which the Shares or other securities receivable upon exercise of a Warrant are converted into other stock or securities of the same or another corporation, then and in each such case, the Registered Holder of a Warrant, upon exercise of the purchase right at any time after the consummation of such reorganization, consolidation, merger, conveyance or combination, shall be entitled to receive, in lieu of the Shares or other securities to which such Registered Holder would have been entitled had he exercised the purchase right immediately prior thereto, such stock and securities which such Registered Holder would have owned immediately after such event with respect to the Shares and other securities for which a Warrant may have been exercised immediately before such event had the Registered Holder exercised the Warrant immediately prior to such event.
(d) In case the Company shall at any time prior to the exercise of a Warrant evidenced hereby make any distribution of its assets to holders of its Shares by liquidating or partial liquidating dividend or by way of return of capital, or other than as a dividend payable out of earnings or any surplus legally available for dividends under the laws of the state of its incorporation, then the Registered Holder when thereafter exercising such Warrant as herein provided after the date of record for the determination of those holders of Shares entitled to such distribution of assets, shall be entitled to receive for the Exercise Price, in addition to a Warrant Share, the amount of such assets (or at the option of the Company, a sum equal to the value thereof at the time of such distribution to holders of Shares as such value is determined by the Board of Directors of the Company in good faith) which would have been payable to the Registered Holder had such Registered Holder been the holder of record of such Warrant Share receivable upon exercise of such Warrant on the record date for the determination of those entitled to such distribution.
In each case of an adjustment in the Shares or other securities receivable upon the exercise of a Warrant, the Company shall promptly notify the Registered Holder of such adjustment. Such notice shall set forth the facts upon which such adjustment is based.
effect at any time either for the life of the Warrants or any shorter period of time determined by the Company's Board of Directors. The Company shall promptly notify the Registered Holders of any such reduction in the Exercise Price.
IN WITNESS WHEREOF, the Company has caused this Warrant Certificate to be duly executed as of the ________ day of ________________.
BioLase Technology, Inc.
By____________________________
BIOLASE TECHNOLOGY, INC.
The following abbreviations, when used in the inscription on the face of this instrument, shall be construed as though they were written out in full according to applicable laws or regulations:
TEN COM - as tenants in common
TEN ENT - as tenants by the entireties
JR TEN - as joint tenants with right of survivorship and not as tenants in
common
CUST UNIF GIFT MIN ACT - Custodian under Uniform Gift to Minors Act
Additional abbreviations may also be used though not in the above list.
FORM OF ASSIGNMENT
(To be Executed by the Registered Holder if He Desires to Assign Warrants Evidenced by the Within Warrant Certificate)
FOR VALUE RECEIVED ____________________________________________ hereby sells, assigns and transfers unto ________________________________________ ________________________________ (_______) Warrants, evidenced by the within Warrant Certificate, and does hereby irrevocably constitute and appoint ___________________ __________________ Attorney to transfer the said Warrants evidenced by the within Warrant Certificates on the books of the Company, with full power of substitution.
Dated:____________________ _____________________________ Signature Notice: The above signature must correspond with the name as written upon the face of the Warrant Certificate in every particular, without alteration or enlargement or any change whatsoever. |
Signature Guaranteed: ________________________________________________
SIGNATURE MUST BE GUARANTEED BY AN "ELIGIBLE GUARANTOR INSTITUTION", AS DEFINED IN RULE 17Ad-15 PROMULGATED UNDER THE SECURITIES EXCHANGE ACT OF 1934, AS AMENDED.
FORM OF ELECTION TO PURCHASE
(To be Executed by the Holder to Exercise Warrants)
To BioLase Technology, Inc.:
The undersigned hereby irrevocably elects to exercise _________________ _______________________ (______) Warrants evidenced by the within Warrant Certificate for, and to purchase thereunder, ________________________ (______) full shares of Common Stock issuable upon exercise of said Warrants and delivery of $___________ and any applicable taxes.
The undersigned hereby:
(i) either [check one]
[_] certifies that the undersigned is an accredited investor, as defined in Rule 501 under the Securities Exchange Act of 1934, as amended, and will be the record and beneficial owner of the shares of Common Stock to be issued upon exercise of these Warrants; or
[_] is supplying an opinion of counsel for the undersigned, which shall be reasonably satisfactory in form and substance to BioLase Technology, Inc., to the effect that the issuance of shares of Common Stock pursuant to this exercise is exempt from the registration requirements of the Securities Act of 1933, as amended; and
(ii) agrees that the undersigned will not offer, sell, hypothecate or otherwise transfer such shares of Common Stock unless such shares are registered under said Securities Act or an exemption from the registration requirements of such Act is applicable (in which case the undersigned shall supply an opinion of counsel in form and substance reasonably satisfactory to BioLase Technology, Inc. to such effect) and the provisions of all other applicable securities laws are observed.
Please register the certificates for such shares as follows:
Taxpayer identification or social security number:
(FORM OF ELECTION TO PURCHASE CONTINUES ON FOLLOWING PAGE)
If said number of Warrants shall not be all the Warrants evidenced by the within Warrant Certificate, the undersigned requests that a new Warrant Certificate evidencing the Warrants not so exercised be registered in the name of the undersigned at the following address and delivered to that address:
Dated: _______________________ Signature:______________________________
NOTICE: The above signature must correspond with the name as written upon the face of the within Warrant Certificate in every particular, without alteration or enlargement or any change whatsoever. If the certificate representing the shares is to be registered in a name other than that in which the within Warrant Certificate is registered, the signature of the holder hereof must be guaranteed. |
Signature Guaranteed: ___________________________________________________
SIGNATURE MUST BE GUARANTEED BY AN "ELIGIBLE GUARANTOR INSTITUTION", AS DEFINED IN RULE 17Ad-15 PROMULGATED UNDER THE SECURITIES EXCHANGE ACT OF 1934, AS AMENDED.
EXHIBIT 4.3
THE WARRANTS REPRESENTED HEREBY AND THE COMMON STOCK ISSUABLE UPON EXERCISE OF THE WARRANTS HAVE NOT BEEN REGISTERED UNDER THE SECURITIES ACT OF 1933, AS AMENDED (THE "SECURITIES ACT"), OR REGISTERED OR QUALIFIED UNDER SECURITIES LAWS OF ANY STATE AND ARE BEING OFFERED AND SOLD IN RELIANCE UPON EXEMPTIONS FROM THE REGISTRATION REQUIREMENTS OF THE SECURITIES ACT AND SUCH LAWS. THE WARRANTS
REPRESENTED HEREBY AND THE COMMON STOCK ISSUABLE UPON EXERCISE OF THE WARRANTS MAY NOT BE OFFERED, SOLD, HYPOTHECATED OR OTHERWISE TRANSFERRED UNLESS REGISTERED UNDER THE SECURITIES ACT OR AN EXEMPTION FROM THE REGISTRATION REQUIREMENTS OF THE SECURITIES ACT IS APPLICABLE (IN WHICH CASE, IF REQUESTED, THE ISSUER SHALL HAVE RECEIVED AN OPINION OF COUNSEL IN FORM AND SUBSTANCE REASONABLY SATISFACTORY TO THE ISSUER TO SUCH EFFECT) AND THE PROVISIONS OF ALL OTHER APPLICABLE SECURITIES LAWS ARE OBSERVED.
BIOLASE TECHNOLOGY, INC.
Incorporated Under the Laws of the State of Delaware
No. _______ ________ Common Stock Purchase Warrants CERTIFICATE FOR COMMON STOCK PURCHASE WARRANTS |
"THE SHARES REPRESENTED BY THIS CERTIFICATE HAVE NOT BEEN REGISTERED UNDER THE SECURITIES ACT OF 1933, AS AMENDED (THE "SECURITIES ACT") OR REGISTERED OR QUALIFIED UNDER THE SECURITIES LAWS OF ANY OTHER JURISDICTION IN RELIANCE UPON EXEMPTIONS AFFORDED UNDER THE SECURITIES ACT AND APPLICABLE LAWS OF OTHER JURISDICTIONS. THE SHARES REPRESENTED HEREBY MAY NOT BE OFFERED, SOLD, HYPOTHECATED OR OTHERWISE TRANSFERRED UNLESS REGISTERED UNDER THE SECURITIES ACT OR AN EXEMPTION FROM THE REGISTRATION REQUIREMENTS UNDER THE SECURITIES ACT IS APPLICABLE (IN WHICH CASE, IF REQUESTED, THE ISSUER SHALL HAVE RECEIVED AN OPINION OF COUNSEL IN FORM AND SUBSTANCE REASONABLY SATISFACTORY TO THE ISSUER TO SUCH EFFECT) AND THE PROVISIONS OF ALL OTHER APPLICABLE SECURITIES LAWS ARE OBSERVED."
A Warrant shall be deemed to have been exercised immediately prior to the close of business on the date (the "Exercise Date") of the surrender to the Company prior to the Expiration Date at its principal executive offices of this Warrant Certificate with the exercise form attached hereto duly completed and executed by the Registered Holder and accompanied by payment to the Company, in cash or by official bank or certified check, of an amount equal to the aggregate Exercise Price for the Shares being acquired through exercise of Warrants, in lawful money of the United States of America.
The person entitled to receive the Shares issuable upon exercise of a Warrant or Warrants ("Warrant Shares") shall be treated for all purposes as the holder of such Warrant Shares as of the close of business on the Exercise Date. The Company shall not issue any fractional share interests in Warrant Shares issuable or deliverable on the exercise of any Warrant, but the Company will instead pay a cash adjustment in respect of any fraction of a Warrant Share which would otherwise be issuable in an amount equal to the same fraction of the market price of a Share on the Exercise Date, such market price to be determined in good faith by the Board of Directors of the Company. If Warrants represented by more than one Warrant Certificate shall be exercised at one time by the same Registered Holder, the number of full Shares which shall be issuable on exercise thereof shall be computed on the basis of the aggregate number of full shares issuable on such exercise.
Promptly, and in any event within ten business days after the Exercise Date, the Company shall cause to be issued and delivered to the person or persons entitled to
receive the same a certificate or certificates for the number of Warrant Shares deliverable on such exercise.
The Company may deem and treat the Registered Holder of the Warrants at any time as the absolute owner thereof for all purposes, and the Company shall not be affected by any notice to the contrary. The Warrants shall not entitle the Registered Holder thereof to any of the rights of shareholders or to any dividend declared on the Shares unless the Registered Holder shall have exercised the Warrants and thereby purchased the Warrant Shares prior to the record date for the determination of holders of Shares entitled to such dividend or other right.
The Registered Holder shall pay all documentary, stamp or similar taxes and other government charges that may be imposed with respect to the issuance, transfer or delivery of any Warrant Shares on exercise of the Warrants.
All Warrant Certificates surrendered for transfer, or surrendered for exercise or for exchange in case of mutilated Warrant Certificates, shall be promptly canceled by the Company and thereafter retained by the Company until the Expiration Date. Prior to due presentment for registration of transfer thereof, the Company may treat the Registered Holder of any Warrant Certificate as the absolute owner thereof (notwithstanding any notations of ownership or writing thereon made by anyone other than the Company), and the Company shall not be affected by any notice to the contrary.
(a) If the Company shall, at any time prior to the complete exercise of the Warrants evidenced hereby, declare or pay to the holders of its outstanding Shares, a dividend payable in any kind of shares of stock or other securities of the Company, the Registered Holder when thereafter exercising the Warrants evidenced hereby as herein provided shall be entitled to receive for the Exercise Price, in addition to one Warrant Share, such additional share or shares of stock, or scrip representing fractions of a share, or other securities as the Registered Holder would have received in the form of such dividend if he had been the holder of record of such Warrant Share on the record date for the determination of the holders of Shares entitled to receive such dividend.
(b) If the Company shall, at any time prior to the complete exercise of the Warrants evidenced hereby, effect a stock split, reverse stock split or other recapitalization of such character that the Warrant Shares for which the Warrants are exercisable shall be changed into or become exchangeable for a larger or smaller number of Shares, then thereafter the number of Shares which the Registered Holder shall be entitled to purchase hereunder shall be increased or decreased, as the case may be, in direct proportion to the increase or decrease in the number of outstanding Shares of the Company arising solely by reason of such stock split, reverse stock split or recapitalization, and the Exercise Price (per Share) shall in the case of an increase in the number of Shares be proportionately reduced and in the case of a decrease in the number of shares be proportionately increased, so that the aggregate exercise price shall remain the same and the Registered Holder shall receive upon payment thereof the same number of Shares he would have received upon such stock split, reverse stock split or recapitalization in exchange for Warrant Shares issuable upon exercise hereof if he had been the holder of record of such Warrant Shares on the record date for the determination of the holders of Shares with respect to such stock split, reverse stock split or recapitalization.
(c) In case of any reorganization of the Company (or any other corporation the stock or other securities of which are at the time receivable upon exercise of a Warrant) or in case the Company (or any such other corporation) shall merge into or with or consolidate with another corporation or convey all or substantially all of its assets to another corporation or enter into a business combination of any form as a result of which the Shares or other securities receivable upon exercise of a Warrant are converted into other stock or securities of the same or another corporation at any time prior to the complete exercise of the Warrants evidenced hereby, then and in each such case, the Registered Holder of a Warrant, upon exercise of the purchase right at any time after the consummation of such reorganization, consolidation, merger, conveyance or combination, shall be entitled to receive, in lieu of the Shares or other securities to which such Registered Holder would have been entitled had he exercised the purchase right immediately prior thereto, such stock and securities which such Registered Holder would have owned immediately after such event with respect to the Shares and other securities for which a Warrant may have been exercised immediately before such event had the Registered Holder exercised the Warrant immediately prior to such event.
(d) In case the Company shall at any time prior to the exercise of a Warrant evidenced hereby make any distribution of its assets to holders of its Shares by liquidating or partial liquidating dividend or by way of return of capital, or other than as a dividend payable out of earnings or any surplus legally available for dividends under the laws of the state of its incorporation, then the Registered Holder when thereafter exercises such Warrant as herein provided after the date of record for the determination of those holders of Shares entitled to such distribution of assets, shall be entitled to receive for the Exercise Price, in addition to a Warrant Share, the amount of such assets (or at the option of the Company, a sum equal to the value thereof at the time of such distribution to holders of Shares as such value is determined by the Board of Directors of the Company in good faith) which would have been payable to the Registered Holder had he been the holder of record of such Warrant Share receivable upon exercise of such Warrant on the record date for the determination of those entitled to such distribution.
In each case of an adjustment in the Shares or other securities receivable upon the exercise of a Warrant, the Company shall promptly notify the Registered Holder of such adjustment. Such notice shall set forth the facts upon which such adjustment is based.
return receipt requested and postage prepaid, to the Company, at its principal executive office, and to the Registered Holder, at the address of such holder as set forth on the records relating to the Warrants maintained by the Company.
IN WITNESS WHEREOF, the Company has caused this Warrant Certificate to be duly executed as of the ___________ day of ____________________.
BioLase Technology, Inc.
By ________________________
BIOLASE TECHNOLOGY, INC.
The following abbreviations, when used in the inscription on the face of this instrument, 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 - TEN ENT - as tenants by the entireties Custodian -------------------- JR TEN - as joint tenants with right (Cust) (Minor) of survivorship and not as under Uniform Gifts tenants in common to Minors Act _____ (State) |
Additional abbreviations may also be used though not in the above list.
FORM OF ASSIGNMENT
(To be Executed by the Registered Holder if He Desires to Assign Warrants Evidenced by the Within Warrant Certificate)
FOR VALUE RECEIVED _______________________________________ hereby sells, assigns and transfers unto ______________________ ___________________ ______________________________ (_________) Warrants, evidenced by the within Warrant Certificate, and does hereby irrevocably constitute and appoint ____________________________ __________________ Attorney to transfer the said Warrants evidenced by the within Warrant Certificates on the books of the Company, with full power of substitution.
Dated:____________________ _____________________________ Signature Notice: The above signature must correspond with the name as written upon the face of the Warrant Certificate in every particular, without alteration or enlargement or any change whatsoever. |
Signature Guaranteed: __________________________________________
SIGNATURE MUST BE GUARANTEED BY AN "ELIGIBLE GUARANTOR INSTITUTION", AS DEFINED IN RULE 17Ad-15 PROMULGATED UNDER THE SECURITIES EXCHANGE ACT OF 1934, AS AMENDED.
FORM OF ELECTION TO PURCHASE
(To be Executed by the Holder to Exercise Warrants)
To BioLase Technology, Inc.:
The undersigned hereby irrevocably elects to exercise ____________________________ (_______) Warrants evidenced by the within Warrant Certificate for, and to purchase thereunder, ____________________________ (_______) full shares of Common Stock issuable upon exercise of said Warrants and delivery of $___________ and any applicable taxes.
The undersigned hereby:
(i) either [check one]
[_] certifies that the undersigned is an accredited investor, as defined in Rule 501 under the Securities Exchange Act of 1934, as amended, and will be the record and beneficial owner of the shares of Common Stock to be issued upon exercise of these Warrants; or
[_] is supplying an opinion of counsel for the undersigned, which shall be reasonably satisfactory in form and substance to BioLase Technology, Inc., to the effect that the issuance of shares of Common Stock pursuant to this exercise is exempt from the registration requirements of the Securities Act of 1933, as amended; and
(ii) agrees that the undersigned will not offer, sell, hypothecate or otherwise transfer such shares of Common Stock unless such shares are registered under said Securities Act or an exemption from the registration requirements of such Act is applicable (in which case the undersigned shall supply an opinion of counsel in form and substance reasonably satisfactory to BioLase Technology, Inc. to such effect) and the provisions of all other applicable securities laws are observed.
Please register the certificates for such shares as follows:
(FORM OF ELECTION TO PURCHASE CONTINUES ON FOLLOWING PAGE)
If said number of Warrants shall not be all the Warrants evidenced by the within Warrant Certificate, the undersigned requests that a new Warrant Certificate evidencing the Warrants not so exercised be registered in the name of the undersigned at the following address and delivered to that address:
Dated: __________________
Signature:______________________________
NOTICE: The above signature must correspond with the name as written upon the face of the within Warrant Certificate in every particular, without alteration or enlargement or any change whatsoever. If the certificate representing the shares is to be registered in a name other than that in which the within Warrant Certificate is registered, the signature of the holder hereof must be guaranteed. |
Signature Guaranteed: ________________________________
SIGNATURE MUST BE GUARANTEED BY AN "ELIGIBLE GUARANTOR INSTITUTION", AS DEFINED IN RULE 17Ad-15 PROMULGATED UNDER THE SECURITIES EXCHANGE ACT OF 1934, AS AMENDED.
EXHIBIT 5.1
Opinion of Brobeck, Phleger & Harrison LLP
June 3, 2002
BioLase Technology, Inc.
981 Calle Amanecer
San Clemente, California 92673
Ladies and Gentlemen:
We have acted as counsel to BioLase Technology, Inc., a Delaware corporation (the "Company"), in connection with the registration for resale of up to an aggregate of 221,600 shares of the Company's common stock (the "Shares") and 722,500 shares of the Company's common stock issuable upon the exercise of certain warrants dated March 22, 2000, December 1, 2000 and May 1, 2001 (the "Warrant Shares"), pursuant to the Company's Registration Statement on Form S-3 (the "Registration Statement") filed with the Securities and Exchange Commission under the Securities Act of 1933, as amended (the "Act").
This opinion is being furnished in accordance with the requirements of Item 16 of Form S-3 and Item 601(b)(5)(i) of Regulation S-K.
We have reviewed the Company's charter documents, the corporate proceedings taken by the Company in connection with the original issuance and sale of the Shares and a certificate of a Company officer regarding, among other things, the Company's receipt of consideration upon the original issuance and sale of the Shares. Based on such review, we are of the opinion that the Shares are duly authorized, validly issued, nonassessable and, to our knowledge, fully paid, and that if, as and when the Warrant Shares are issued and sold (and the consideration therefor received) pursuant to the provisions of the underlying warrants, such Warrant Shares will be duly authorized, validly issued, fully paid and nonassessable.
We consent to the filing of this opinion letter as Exhibit 5.1 to the Registration Statement and to the reference to this firm under the caption "Legal Matters" in the prospectus which is part of the Registration Statement. In giving this consent, we do not thereby admit that we are within the category of persons whose consent is required under Section 7 of the Act, the rules and regulations of the Securities and Exchange Commission promulgated thereunder or Item 509 of Regulation S-K.
This opinion letter is rendered as of the date first written above and we disclaim any obligation to advise you of facts, circumstances, events or developments which hereafter may be brought to our attention and which may alter, affect or modify the opinion expressed herein. Our opinion is expressly limited to the matters set forth above and we render no opinion, whether by implication or otherwise, as to any other matters relating to the Company, the Shares or the Warrant Shares.
Very truly yours,
Brobeck, Phleger & Harrison LLP
Exhibit 23.1
Consent of Independent Accountants
We hereby consent to the incorporation by reference in this Registration Statement on Form S-3 and related prospectus of our report dated March 1, 2002 relating to the consolidated financial statements and consolidated financial statement schedule, which appears in BioLase Technology Inc.'s Annual Report on Form 10-K for the year ended December 31, 2001. We also consent to the reference to us under the heading "Experts" in such registration statement and related prospectus.
PricewaterhouseCoopers LLP
Orange County, California
June 3, 2002