Cheshire MD Holdings, LLC - Jun 28, 2021 Form 4 Insider Report for Miromatrix Medical Inc. (MIRO)

Role: 10%+ Owner
Signature: By: Cheshire MD Holdings, LLC Name: Steve Phillips Title: Vice President /s/ Stephanie Berberich, Attorney-in-Fact
Stock symbol: MIRO
Transactions as of: Jun 28, 2021
Transactions value $: $0
Form type: 4
Date filed: 6/29/2021, 06:08 PM
Previous filing: Jun 23, 2021

Transactions Table

Type	Sym	Class	Transaction	Value $	Shares	Change %	* Price $	Shares After	Date	Ownership	Footnotes
transaction	MIRO	Common Stock	Conversion of derivative security		+933K			933K	Jun 28, 2021	Direct	F1, F2
transaction	MIRO	Common Stock	Conversion of derivative security		+1.05M	+112.15%		1.98M	Jun 28, 2021	Direct	F2, F3

Derivative Securities (e.g., puts, calls, warrants, options, convertible securities)

Type	Sym	Class	Transaction	Value $	Shares	Change %	* Price $	Shares After	Date	Underlying Class	Amount	Exercise Price	Ownership	Footnotes
transaction	MIRO	Series B-2 Preferred Stock	Conversion of derivative security	$0	-933K	-100%	$0.00^*	0	Jun 28, 2021	Common Stock	933K		Direct	F1, F2
transaction	MIRO	Series C Preferred Stock	Conversion of derivative security	$0	-1M	-100%	$0.00^*	0	Jun 28, 2021	Common Stock	1.05M		Direct	F2, F3

* An asterisk sign (*) next to the price indicates that the price is likely invalid.

Explanation of Responses:

Id	Content
F1	Each share of Series B-2 Preferred Stock had no expiration date and automatically converted into one share 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	Each share of Series C Preferred Stock had no expiration date and automatically converted into shares of Common Stock upon the closing of the Issuer's IPO at a rate determined by dividing $7.50 by $7.20.