DAVITA INC. — Director's Dealing 2021

Jun 24, 2021

SEC Form 3 — Initial Statement of Beneficial Ownership

Issuer: Miromatrix Medical Inc. (MIRO)
CIK: 0001527096
Period of Report: 2021-06-23

Reporting Person: Cheshire MD Holdings, LLC (10% Owner)
Reporting Person: DAVITA INC. (10% Owner)

Holdings (Derivative)

Security	Exercise Price	Expiration	Underlying	Shares	Ownership
Series B-2 Preferred Stock	$		Common Stock (933334.0)		Direct
Warrants	$		Series C Preferred Stock (240000.0)		Direct
Convertible Promissory Note	$		Series C Preferred Stock (956887.0)		Direct

Footnotes

F1: Each share of Series B-2 Preferred Stock will automatically convert into shares of Common Stock upon the closing of the Issuer's Initial Public Offering ("IPO").

F2: As a result of DaVita Inc.'s ownership interest in Cheshire MD Holdings, LLC, DaVita Inc. may be deemed to have an indirect pecuniary interest in the shares held directly by Cheshire MD Holdings, LLC.

F3: The Warrants will be exercised for 240,000 shares of Series C Preferred Stock immediately prior to the underwriting agreement being signed in connection with Issuer's IPO.

F4: The Convertible Promissory Note will convert into 956,887 shares of Series C Preferred Stock immediately prior to the underwriting agreement being signed in connection with the Issuer's IPO.