0001209191-19-016745.txt : 20190305
0001209191-19-016745.hdr.sgml : 20190305
20190305172933
ACCESSION NUMBER: 0001209191-19-016745
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20190304
FILED AS OF DATE: 20190305
DATE AS OF CHANGE: 20190305
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Gagliano Vincent J.
CENTRAL INDEX KEY: 0001570960
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-12251
FILM NUMBER: 19659763
MAIL ADDRESS:
STREET 1: 2301 HIGHWAY 190 WEST
CITY: DERIDDER
STATE: LA
ZIP: 70634
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
4
1
doc4.xml
FORM 4 SUBMISSION
X0306
4
2019-03-04
0
0001018979
AMERISAFE INC
AMSF
0001570960
Gagliano Vincent J.
2301 HIGHWAY 190 WEST
DERIDDER
LA
70634
0
1
0
0
EVP - Chief Risk Officer
Common stock, par value $0.01
2019-03-04
4
M
0
5000
3.95
A
21929
D
Common stock, par value $0.01
2019-03-04
4
S
0
5000
61.29
D
16929
D
Common stock, par value $0.01
2019-03-04
4
S
0
744
61.29
D
16185
D
Employee Stock Option (right to pruchase)
3.95
2019-03-04
4
M
0
5000
0.00
D
2013-11-09
2019-11-09
Common stock
5000
0
D
The shares were sold pursuant to the Reporting Person's 10b5-1 plan.
Represents the weighted average selling price of the Issuer's common stock. The range of sales prices were between $61.04 and $62.13. 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.
The shares were sold pursuant to the Reporting Person's 10b5-1 plan for restricted stock that fully vested March 1, 2019.
/s/Kathryn H. Shirley attorney-in-fact for Vincent J. Gagliano
2019-03-05