-----BEGIN PRIVACY-ENHANCED MESSAGE----- Proc-Type: 2001,MIC-CLEAR Originator-Name: webmaster@www.sec.gov Originator-Key-Asymmetric: MFgwCgYEVQgBAQICAf8DSgAwRwJAW2sNKK9AVtBzYZmr6aGjlWyK3XmZv3dTINen TWSM7vrzLADbmYQaionwg5sDW3P6oaM5D3tdezXMm7z1T+B+twIDAQAB MIC-Info: RSA-MD5,RSA, R4HsNwTOcuhO3Kaocj7fKXIfw95+XRmG30d0dRqwPIBM04OUTmYQwzTy+BTnQNjX /KRpj/Ck+V9n3qYz7ogkWQ== 0000898432-09-001204.txt : 20090929 0000898432-09-001204.hdr.sgml : 20090929 20090929172147 ACCESSION NUMBER: 0000898432-09-001204 CONFORMED SUBMISSION TYPE: SC 13G/A PUBLIC DOCUMENT COUNT: 1 FILED AS OF DATE: 20090929 DATE AS OF CHANGE: 20090929 GROUP MEMBERS: JONATHAN W. OLD, III GROUP MEMBERS: LONG MEADOWS INVESTORS, LLC GROUP MEMBERS: MICHAEL J. MOSS SUBJECT COMPANY: COMPANY DATA: COMPANY CONFORMED NAME: AFFIRMATIVE INSURANCE HOLDINGS INC CENTRAL INDEX KEY: 0001282543 STANDARD INDUSTRIAL CLASSIFICATION: FIRE, MARINE & CASUALTY INSURANCE [6331] IRS NUMBER: 752770432 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: SC 13G/A SEC ACT: 1934 Act SEC FILE NUMBER: 005-79966 FILM NUMBER: 091093782 BUSINESS ADDRESS: STREET 1: 4450 SOJOURN DRIVE STREET 2: SUITE 500 CITY: ADDISON STATE: TX ZIP: 75001 BUSINESS PHONE: 972-728-6300 MAIL ADDRESS: STREET 1: 4450 SOJOURN DRIVE STREET 2: SUITE 500 CITY: ADDISON STATE: TX ZIP: 75001 FILED BY: COMPANY DATA: COMPANY CONFORMED NAME: LONG MEADOW HOLDINGS LP CENTRAL INDEX KEY: 0001019594 IRS NUMBER: 061459543 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: SC 13G/A BUSINESS ADDRESS: STREET 1: 1200 HIGH RIDGE ROAD CITY: STAMFORD STATE: CT ZIP: 06905 BUSINESS PHONE: 203-329-8857 MAIL ADDRESS: STREET 1: 1200 HIGH RIDGE ROAD CITY: STAMFORD STATE: CT ZIP: 06905 SC 13G/A 1 form_13g-a.htm

SECURITIES AND EXCHANGE COMMISSION
Washington, DC 20549

SCHEDULE 13G/A
(Rule 13d-102)

INFORMATION TO BE INCLUDED IN STATEMENTS FILED PURSUANT
TO RULES 13d-1(b) (c) AND (d) AND AMENDMENTS THERETO FILED
PURSUANT TO 13d-2(b)

(Amendment No. 3)

  

Affirmative Insurance Holdings, Inc.

(Name of Issuer)

 

Common Stock

(Title of Class of Securities)

 

008272106

(CUSIP Number)

 

September 18, 2009

(Date of Event Which Requires Filing of this Statement)

Check the appropriate box to designate the rule pursuant to which this Schedule is filed:


            o    Rule 13d-1(b)
            x   Rule 13d-1(c)
            o   Rule 13d-1(d)




     *The remainder of this cover page shall be filled out for a reporting person's initial filing on this form with respect to the subject class of securities, and for any subsequent amendment containing information which would alter the disclosures provided in a prior cover page.
 
 

     The information required on the remainder of this cover page shall not be deemed to be "filed" for the purpose of Section 18 of the Securities Exchange Act of 1934 or otherwise subject to the liabilities of that section of the Act but shall be subject to all other provisions of the Act (however, see the Notes).
 


 

 

 

 

 

CUSIP No.  008272106

 

13G/A

 

Page 2 of 8 Pages

 

 

 

 

1

 

NAME OF REPORTING PERSON:
Long Meadow Holdings, L.P.

 

 

 

2

 

CHECK THE APPROPRIATE BOX IF A MEMBER OF A GROUP*

 

(a) [   ]

 

 

 

 

(b) [X]

 

 

 

 

 

 

3

 

SEC USE ONLY

 

 

 

 

 

 

 

 

4

 

CITIZENSHIP OR PLACE OF ORGANIZATION

 

 

Delaware

 

 

 

 

 

5

 

SOLE VOTING POWER

NUMBER OF

 

 

 

0

SHARES

 

 

BENEFICIALLY

 

6

 

SHARED VOTING POWER

OWNED

 

 

 

691,867

BY

 

 

EACH

 

7

 

SOLE DISPOSITIVE POWER

REPORTING

 

 

 

0

PERSON

 

 

WITH:

 

8

 

SHARED DISPOSITIVE POWER

 

 

 

 

691,867

 

9

 

AGGREGATE AMOUNT BENEFICIALLY OWNED BY EACH REPORTING PERSON

 

 

 

 

691,867

 

 

 

10

 

CHECK IF THE AGGREGATE AMOUNT IN ROW (9) EXCLUDES CERTAIN SHARES*

 

o

 

 

 

 

 

 

11

 

PERCENT OF CLASS REPRESENTED BY AMOUNT IN ROW (9)

 

 

 

 

4.5%

 

 

 

12

 

TYPE OF REPORTING PERSON*

 

 

 

 

PN

   


 

 

 

 

 

CUSIP No.  008272106

 

13G/A

 

Page 3 of 8 Pages

 

 

 

 

1

 

NAME OF REPORTING PERSON:
Jonathan W. Old, III

 

 

 

2

 

CHECK THE APPROPRIATE BOX IF A MEMBER OF A GROUP*

 

(a)  [   ]

 

 

 

 

(b)  [X]

 

 

 

 

 

 

3

 

SEC USE ONLY

 

 

 

 

 

 

 

 

4

 

CITIZENSHIP OR PLACE OF ORGANIZATION

 

 

United States

 

 

 

 

 

5

 

SOLE VOTING POWER

NUMBER OF

 

 

 

20,000

SHARES

 

 

BENEFICIALLY

 

6

 

SHARED VOTING POWER

OWNED

 

 

 

691,867

BY

 

 

EACH

 

7

 

SOLE DISPOSITIVE POWER

REPORTING

 

 

 

20,000

PERSON

 

 

WITH:

 

8

 

SHARED DISPOSITIVE POWER

 

 

 

 

691,867

 

9

 

AGGREGATE AMOUNT BENEFICIALLY OWNED BY EACH REPORTING PERSON

 

 

 

 

711,867

 

 

 

10

 

CHECK IF THE AGGREGATE AMOUNT IN ROW (9) EXCLUDES CERTAIN SHARES*

 

o

 

 

 

 

 

 

11

 

PERCENT OF CLASS REPRESENTED BY AMOUNT IN ROW (9)

 

 

 

 

4.6%

 

 

 

12

 

TYPE OF REPORTING PERSON*

 

 

 

 

IN

   


 

 

 

 

 

CUSIP No.  008272106

 

13G/A

 

Page 4 of 8 Pages

 

 

 

 

1

 

NAME OF REPORTING PERSON:
Long Meadow Investors, LLC

 

 

 

2

 

CHECK THE APPROPRIATE BOX IF A MEMBER OF A GROUP*

 

(a)  [   ]

 

 

 

 

(b)  [X]

 

 

 

 

 

 

3

 

SEC USE ONLY

 

 

 

 

 

 

 

 

4

 

CITIZENSHIP OR PLACE OF ORGANIZATION

 

 

Delaware

 

 

 

 

 

5

 

SOLE VOTING POWER

NUMBER OF

 

 

 

0

SHARES

 

 

BENEFICIALLY

 

6

 

SHARED VOTING POWER

OWNED

 

 

 

691,867

BY

 

 

EACH

 

7

 

SOLE DISPOSITIVE POWER

REPORTING

 

 

 

0

PERSON

 

 

WITH:

 

8

 

SHARED DISPOSITIVE POWER

 

 

 

 

691,867

 

9

 

AGGREGATE AMOUNT BENEFICIALLY OWNED BY EACH REPORTING PERSON

 

 

 

 

691,867

 

 

 

10

 

CHECK IF THE AGGREGATE AMOUNT IN ROW (9) EXCLUDES CERTAIN SHARES*

 

o

 

 

 

 

 

 

11

 

PERCENT OF CLASS REPRESENTED BY AMOUNT IN ROW (9)

 

 

 

 

4.5%

 

 

 

12

 

TYPE OF REPORTING PERSON*

 

 

 

 

CO, HC

   


 

 

 

 

 

CUSIP No.  008272106

 

13G/A

 

Page 5 of 8 Pages

 

 

 

 

1

 

NAME OF REPORTING PERSON:
Michael J. Moss

 

 

 

2

 

CHECK THE APPROPRIATE BOX IF A MEMBER OF A GROUP*

 

(a)  [   ]

 

 

 

 

(b)  [X]

 

 

 

 

 

 

3

 

SEC USE ONLY

 

 

 

 

 

 

 

 

4

 

CITIZENSHIP OR PLACE OF ORGANIZATION

 

 

United States

 

 

 

 

 

5

 

SOLE VOTING POWER

NUMBER OF

 

 

 

55,757

SHARES

 

 

BENEFICIALLY

 

6

 

SHARED VOTING POWER

OWNED

 

 

 

722,091

BY

 

 

EACH

 

7

 

SOLE DISPOSITIVE POWER

REPORTING

 

 

 

55,757

PERSON

 

 

WITH:

 

8

 

SHARED DISPOSITIVE POWER

 

 

 

 

722,091

 

9

 

AGGREGATE AMOUNT BENEFICIALLY OWNED BY EACH REPORTING PERSON

 

 

 

 

777,848

 

 

 

10

 

CHECK IF THE AGGREGATE AMOUNT IN ROW (9) EXCLUDES CERTAIN SHARES*

 

o

 

 

 

 

 

 

11

 

PERCENT OF CLASS REPRESENTED BY AMOUNT IN ROW (9)

 

 

 

 

5.0%

 

 

 

12

 

TYPE OF REPORTING PERSON*

 

 

 

 

IN

   


 

 

 

 

 

CUSIP No.  008272106

 

13G/A

 

Page 6 of 8 Pages

ITEM 1(a).     NAME OF ISSUER:

Affirmative Insurance Holdings, Inc. (“Affirmative”)

ITEM 1(b).     ADDRESS OF ISSUER'S PRINCIPAL EXECUTIVE OFFICES:

4450 Sojourn Drive, Suite 500

Addison, Texas 75001        

ITEM 2(a).     NAME OF PERSON FILING:

This Schedule 13G/A is being filed on behalf of the following persons (the “Reporting Persons”):

 

(i)

 

Long Meadow Holdings, L.P. (“LMH”)

 

(ii)

 

Jonathan W. Old, III

 

(iii)

 

Long Meadow Investors, LLC (“LMI”)

 

(iv)

 

Michael J. Moss

ITEM 2(b).     ADDRESS OF PRINCIPAL BUSINESS OFFICE:

The principal business office of the Reporting Persons filing this Schedule 13G/A is located at 1200 High Ridge Road, Stamford, CT 06905.

ITEM 2(c).     CITIZENSHIP:

 

(i)

LMH:

a Delaware limited partnership

 

(ii)

Jonathan W. Old, III:

United States

 

(iii)

LMI:

a Delaware limited liability company

 

(iv)

Michael J. Moss

United States

ITEM 2(d).    TITLE OF CLASS OF SECURITIES:

Common Stock

ITEM 2(e).     CUSIP Number:

008272106

                       


 

 

 

 

 

CUSIP No.  008272106

 

13G/A

 

Page 7 of 8 Pages

ITEM 3.        IF THIS STATEMENT IS FILED PURSUANT TO RULE 13d-1(b), or 13d-2(b) or (c) CHECK WHETHER THE PERSON FILING IS:    One of the following

                       Not applicable.

ITEM 4.        OWNERSHIP:

                       The information in items 1 and 5 through 11 on the cover pages (pp. 2-5) on this Schedule 13G/A is hereby incorporated by reference.

ITEM 5.        OWNERSHIP OF FIVE PERCENT OR LESS OF A CLASS:

                       If this statement is being filed to report the fact that as of the date hereof the Reporting Persons have ceased to be the beneficial owner of more than five percent of the class of securities check the following.     X

ITEM 6.        OWNERSHIP OF MORE THAN FIVE PERCENT ON BEHALF OF ANOTHER PERSON:

                       Not applicable.

ITEM 7.        IDENTIFICATION AND CLASSIFICATION OF THE SUBSIDIARY WHICH ACQUIRED THE SECURITY BEING REPORTED ON BY THE PARENT HOLDING COMPANY:

          Long Meadow Holdings, L.P. (“LMH”) beneficially owns 691,867 shares of Affirmative Insurance Holdings, Inc.’s common stock (the “Company’s Common Stock”), which constitutes 4.5% of the Company’s Common Stock outstanding. Long Meadow Investors, LLC (“LMI”) is the general partner of LMH and because it could be deemed to share voting and dispositive power with LMH over the 691,867 shares of the Company’s Common Stock owned by LMH, LMI may be deemed to be the beneficial owner of such Common Stock. LMI disclaims beneficial ownership of all shares of the company’s Common Stock held by other persons.

          Jonathan W. Old, III is a managing member of LMI. Because Mr. Old is a managing member of the general partner of the LMH, and because he could be deemed to share with LMI voting and dispositive power over the 691,867 shares of the Company’s Common Stock held by LMH, Mr. Old may be deemed to be the beneficial owner of such Common Stock. Mr. Old is the beneficial owner of 20,000 shares of the Company’s Common Stock which he owns personally. Mr. Old disclaims beneficial ownership of all shares of the Company’s Common Stock held by other persons.

          Michael J. Moss is a managing member of LMI. Because Mr. Moss is a managing member of the general partner of LMH and shares the responsibilities of managing LMI with Mr. Old, and because he could be deemed to share with LMI and Mr. Old voting and dispositive power over the 691,867shares of the Company’s Common Stock held by LMH, Mr. Moss may be deemed to be the beneficial owner of such Common Stock. Mr. Moss is the beneficial owner of 55,757 shares of the Company’s Common Stock that he holds personally. Additionally, Mr. Moss’ spouse and children hold an aggregate of 30,224 shares of the Company’s Common Stock, and because Mr. Moss could be deemed to share with his wife and children voting and dispositive power over the Company’s Common Stock held by them, Mr. Moss may be deemed to be the beneficial owner of such Common Stock. Therefore, Mr. Moss may be deemed to be the beneficial owner of an aggregate of 777,848 shares, which constitutes 5.0% of the Company’s Common Stock outstanding. Mr. Moss disclaims beneficial ownership of all shares of the Company’s Common Stock held by other persons.

ITEM 8.        IDENTIFICATION AND CLASSIFICATION OF MEMBERS OF A GROUP:

                       Not applicable.

ITEM 9.        NOTICE OF DISSOLUTION OF GROUP:

                       Not applicable.


 

 

 

 

 

CUSIP No.  008272106

 

13G/A

 

Page 8 of 8 Pages

ITEM 10.        CERTIFICATION

                        By signing below I certify that, to the best of my knowledge and belief, the securities referred to above were not acquired and are not held for the purpose of or with the effect of changing or influencing the control of the issuer of the securities and were not acquired and are not held in connection with or as a participant in any transaction having that purpose or effect.

                        After reasonable inquiry and to the best of my knowledge and belief, I certify that the information set forth in this statement is true, complete and correct.

Dated:

 

September 29, 2009

/s/ Jonathan W. Old, III                              

Name: Jonathan W. Old, III *

/s/ Michael J. Moss                                     

Name: Michael J. Moss*

LONG MEADOW HOLDINGS, L.P.*

By:  Long Meadow Investors, LLC

  General Partner of Long Meadow Holdings, L.P.

/s/ Jonathan W. Old, III                               

Name:  Jonathan W. Old, III

Title:    Managing Member of Long Meadow Investors, LLC

LONG MEADOW INVESTORS, LLC*

By:  Jonathan W. Old, III

/s/ Jonathan W. Old, III                                

Name:  Jonathan W. Old, III

Title:   Managing Member

* The Reporting Persons disclaim beneficial ownership in the shares reported herein except to the extent of their pecuniary interest therein.


 

EXHIBIT A

In accordance with Rule 13d-1(k) under the Securities Exchange Act of 1934, as amended, each of the undersigned does hereby consent and agree to the joint filing on behalf of each of them of a statement on Schedule 13G and all amendments thereto with respect to the Common Stock of Affirmative Insurance Holdings, Inc. beneficially owned by each of them, and the inclusion of this Joint Filing Agreement as an exhibit thereto.

Dated: September 29, 2009
 

/s/ Jonathan W. Old, III                                 

Name: Jonathan W. Old, III

/s/ Michael J. Moss                                        

Name: Michael J. Moss

LONG MEADOW HOLDINGS, L.P.

By:  Long Meadow Investors, LLC

  General Partner of Long Meadow Holdings, L.P.

/s/  Jonathan W. Old, III                                  

Name:  Jonathan W. Old, III

Title:    Managing Member of Long Meadow Investors, LLC

LONG MEADOW INVESTORS, LLC

By:  Jonathan W. Old, III

/s/ Jonathan W. Old, III                                    

Name:  Jonathan W. Old, III

Title:    Managing Member

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