Jacob Spellmeyer - 12 Sep 2025 Form 3 Insider Report for Black Rock Coffee Bar, Inc. (BRCB)

Signature
/s/ Sam Seiberling, Attorney in Fact for Jacob Spellmeyer
Issuer symbol
BRCB
Transactions as of
12 Sep 2025
Transactions value $
$0
Form type
3
Filing time
12 Sep 2025, 21:50:25 UTC
Next filing
16 Sep 2025

Reporting Owners (1)

Name Relationship Address Signature Signature date CIK
Spellmeyer Jacob Virgil Director, 10%+ Owner C/O BLACK ROCK COFFEE BAR, INC., 9170 E. BAHIA DRIVE, SUITE 101, SCOTTSDALE /s/ Sam Seiberling, Attorney in Fact for Jacob Spellmeyer 12 Sep 2025 0002077876

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
holding BRCB LLC Units 12 Sep 2025 Class A Common Stock 8,499,843 See footnote F1, F4
holding BRCB Class C Common Stock 12 Sep 2025 Class A Common Stock 8,499,843 See footnote F2, F3, F4
holding BRCB Restricted Stock Units 12 Sep 2025 Class A Common Stock 2,812 Direct F5
* An asterisk sign (*) next to the price indicates that the price is likely invalid.

Explanation of Responses:

Id Content
F1 LLC units ("LLC Units") represent the membership units of Black Rock Coffee Holdings, LLC ("Black Rock OpCo") and an equal number of shares of Class C common stock ("Class C Common Stock") of Black Rock Coffee Bar, Inc. (the "Issuer"). Holders may elect to have Black Rock OpCo redeem their LLC Units at any time on or following the closing of the Issuer's initial public offering for either shares of Class A common stock ("Class A Common Stock") on a one-for-one basis or, at the Issuer's election (determined solely by the Issuer's independent directors who are disinterested), a corresponding amount of cash, in either case, contributed to Black Rock OpCo by the Issuer, unless the Issuer elects, in its sole discretion (determined solely by the Issuer's independent directors who are disinterested), to effect such transaction as a direct exchange with the relevant holder. Upon any such redemption or exchange of LLC Units, the corresponding shares of Class C Common Stock will be cancelled.
F2 The Class C Common Stock is convertible at any time, at the holder's election, into Class A Common Stock on a one-for-one basis; provided that, at the Issuer's election (determined solely by the Issuer's independent directors who are disinterested), the Issuer may effect such exchange for a cash payment equal to a volume weighted average market price of one share of Class A Common Stock for each LLC Unit so redeemed.
F3 Each outstanding share of Class C Common Stock will automatically convert into one share of the Issuer's Class B common stock upon the earlier of (i) the ten-year anniversary of the later of the closing of the Issuer's initial public offering or the closing date of any exercise of the underwriters' option to purchase additional shares of Class A Common Stock and (ii) with respect to the Reporting Person, the date on which the aggregate number of shares of Class C Common Stock held by the Reporting Person or certain of his affiliates is less than thirty-three percent (33%) of the shares of Class C Common Stock held by the Reporting Person and certain of his affiliates as of the later of the closing of the Issuer's initial public offering or the closing date of any exercise of the underwriters' option to purchase additional shares of Class A Common Stock in the Issuer's initial public offering.
F4 Held by Viking Cake BR, LLC ("Viking Cake") and its wholly-owned subsidiaries, Viking Cake Fuel, LLC and Viking Cake Fuel II, LLC, for which the Reporting Person has voting and investment power. The Reporting Person disclaims beneficial ownership of the shares held by Viking Cake except to the extent of his pecuniary interest therein.
F5 Represents an award of restricted stock units ("RSUs"), each of which represents a contingent right to receive one share of Class A Common Stock. The RSUs vest in full on the earlier of the Issuer's 2026 annual meeting or the first anniversary of the closing of the Issuer's initial public offering.

Remarks:

Exhibit 24.1 - Power of Attorney