0001181431-14-011198.txt : 20140306 0001181431-14-011198.hdr.sgml : 20140306 20140306141248 ACCESSION NUMBER: 0001181431-14-011198 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20140304 FILED AS OF DATE: 20140306 DATE AS OF CHANGE: 20140306 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: AMERISAFE INC CENTRAL INDEX KEY: 0001018979 STANDARD INDUSTRIAL CLASSIFICATION: FIRE, MARINE & CASUALTY INSURANCE [6331] IRS NUMBER: 752069407 STATE OF INCORPORATION: TX FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 2301 HIGHWAY 190 WEST CITY: DERIDDER STATE: LA ZIP: 70634 BUSINESS PHONE: 337-463-9052 MAIL ADDRESS: STREET 1: 2301 HIGHWAY 190 WEST CITY: DERIDDER STATE: LA ZIP: 70634 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Gau Brendan CENTRAL INDEX KEY: 0001466489 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-12251 FILM NUMBER: 14672455 MAIL ADDRESS: STREET 1: 2301 HIGHWAY 190 WEST CITY: DERIDDER STATE: LA ZIP: 70634 4 1 rrd404733.xml FORM 4 X0306 4 2014-03-04 0 0001018979 AMERISAFE INC AMSF 0001466489 Gau Brendan 2301 HIGHWAY 190 WEST DERIDDER LA 70634 0 1 0 0 Exec.VP & Chief Investment Of. Common Stock, par value $0.01 2014-03-04 4 M 0 5534 17.10 A 24971 D Common Stock, par value $0.01 2014-03-04 4 S 0 5534 44.07 D 19437 D Employee Stock Option (right to purchase) 17.1 2014-03-04 4 S 0 5534 0 D 2010-08-07 2017-08-07 Common Stock, par value $.01 per share 5534 69466 D Represents the weighted average selling price of the Issuer's common stock. The range of the sales prices were between $44.00 and $44.36. The Reporting Person undertakes, upon request, to provide the SEC, the Issuer and any security holder of the Issuer, full information regarding the number of shares sold at each separate price. /s/ Brendan Gau 2014-03-06