0000950170-24-026286.txt : 20240305
0000950170-24-026286.hdr.sgml : 20240305
20240305172359
ACCESSION NUMBER: 0000950170-24-026286
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20240301
FILED AS OF DATE: 20240305
DATE AS OF CHANGE: 20240305
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Insignia Capital Partners (Parallel A), L.P.
CENTRAL INDEX KEY: 0001586845
ORGANIZATION NAME:
STATE OF INCORPORATION: DE
FISCAL YEAR END: 1231
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-39671
FILM NUMBER: 24722427
BUSINESS ADDRESS:
STREET 1: TWO WALNUT CREEK CENTER
STREET 2: 200 PRINGLE AVENUE, SUITE 400
CITY: WALNUT CREEK
STATE: CA
ZIP: 94596
BUSINESS PHONE: (925)399-8900
MAIL ADDRESS:
STREET 1: TWO WALNUT CREEK CENTER
STREET 2: 200 PRINGLE AVENUE, SUITE 400
CITY: WALNUT CREEK
STATE: CA
ZIP: 94596
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Insignia Capital Partners, L.P.
CENTRAL INDEX KEY: 0001586847
ORGANIZATION NAME:
STATE OF INCORPORATION: DE
FISCAL YEAR END: 1231
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-39671
FILM NUMBER: 24722429
BUSINESS ADDRESS:
STREET 1: 1333 N. CALIFORNIA BLVD, SUITE 520
CITY: WALNUT CREEK
STATE: CA
ZIP: 94596
BUSINESS PHONE: (925) 399-8900
MAIL ADDRESS:
STREET 1: 1333 N. CALIFORNIA BLVD, SUITE 520
CITY: WALNUT CREEK
STATE: CA
ZIP: 94596
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: INSIGNIA CAPITAL PARTNERS (AIV), L.P.
CENTRAL INDEX KEY: 0001829472
ORGANIZATION NAME:
STATE OF INCORPORATION: DE
FISCAL YEAR END: 1231
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-39671
FILM NUMBER: 24722428
BUSINESS ADDRESS:
STREET 1: 1333 NORTH CALIFORNIA BOULEVARD
STREET 2: SUITE 520
CITY: WALNUT CREEK
STATE: CA
ZIP: 94596
BUSINESS PHONE: (925) 399-8900
MAIL ADDRESS:
STREET 1: 1333 NORTH CALIFORNIA BOULEVARD
STREET 2: SUITE 520
CITY: WALNUT CREEK
STATE: CA
ZIP: 94596
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: INSIGNIA A QL HOLDINGS, LLC
CENTRAL INDEX KEY: 0001829476
ORGANIZATION NAME:
STATE OF INCORPORATION: DE
FISCAL YEAR END: 1231
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-39671
FILM NUMBER: 24722425
BUSINESS ADDRESS:
STREET 1: 1333 NORTH CALIFORNIA BOULEVARD
STREET 2: SUITE 520
CITY: WALNUT CREEK
STATE: CA
ZIP: 94596
BUSINESS PHONE: (925) 399-8900
MAIL ADDRESS:
STREET 1: 1333 NORTH CALIFORNIA BOULEVARD
STREET 2: SUITE 520
CITY: WALNUT CREEK
STATE: CA
ZIP: 94596
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: INSIGNIA CAPITAL PARTNERS GP, L.L.C.
CENTRAL INDEX KEY: 0001829474
ORGANIZATION NAME:
STATE OF INCORPORATION: DE
FISCAL YEAR END: 1231
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-39671
FILM NUMBER: 24722430
BUSINESS ADDRESS:
STREET 1: 1333 NORTH CALIFORNIA BOULEVARD
STREET 2: SUITE 520
CITY: WALNUT CREEK
STATE: CA
ZIP: 94596
BUSINESS PHONE: (925) 399-8900
MAIL ADDRESS:
STREET 1: 1333 NORTH CALIFORNIA BOULEVARD
STREET 2: SUITE 520
CITY: WALNUT CREEK
STATE: CA
ZIP: 94596
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: INSIGNIA QL HOLDINGS, LLC
CENTRAL INDEX KEY: 0001829475
ORGANIZATION NAME:
STATE OF INCORPORATION: DE
FISCAL YEAR END: 1231
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-39671
FILM NUMBER: 24722426
BUSINESS ADDRESS:
STREET 1: 1333 NORTH CALIFORNIA BOULEVARD
STREET 2: SUITE 520
CITY: WALNUT CREEK
STATE: CA
ZIP: 94596
BUSINESS PHONE: (925) 399-8900
MAIL ADDRESS:
STREET 1: 1333 NORTH CALIFORNIA BOULEVARD
STREET 2: SUITE 520
CITY: WALNUT CREEK
STATE: CA
ZIP: 94596
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: MediaAlpha, Inc.
CENTRAL INDEX KEY: 0001818383
STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-BUSINESS SERVICES, NEC [7389]
ORGANIZATION NAME: 07 Trade & Services
IRS NUMBER: 851854133
STATE OF INCORPORATION: DE
FISCAL YEAR END: 1231
BUSINESS ADDRESS:
STREET 1: 700 SOUTH FLOWER STREET
STREET 2: SUITE 640
CITY: LOS ANGELES
STATE: CA
ZIP: 90017
BUSINESS PHONE: 619-393-9368
MAIL ADDRESS:
STREET 1: 700 SOUTH FLOWER STREET
STREET 2: SUITE 640
CITY: LOS ANGELES
STATE: CA
ZIP: 90017
4
1
ownership.xml
4
X0508
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2024-03-01
false
0001818383
MediaAlpha, Inc.
MAX
0001829474
INSIGNIA CAPITAL PARTNERS GP, L.L.C.
1333 NORTH CALIFORNIA BOULEVARD, STE 520
WALNUT CREEK
CA
94596
false
false
true
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0001586847
Insignia Capital Partners, L.P.
1333 NORTH CALIFORNIA BOULEVARD, STE 520
WALNUT CREEK
CA
94596
false
false
true
false
0001829472
INSIGNIA CAPITAL PARTNERS (AIV), L.P.
1333 NORTH CALIFORNIA BOULEVARD, STE 520
WALNUT CREEK
CA
94596
false
false
true
false
0001586845
Insignia Capital Partners (Parallel A), L.P.
1333 NORTH CALIFORNIA BOULEVARD, STE 520
WALNUT CREEK
CA
94596
false
false
true
false
0001829475
INSIGNIA QL HOLDINGS, LLC
1333 NORTH CALIFORNIA BOULEVARD, STE 520
WALNUT CREEK
CA
94596
false
false
true
false
0001829476
INSIGNIA A QL HOLDINGS, LLC
1333 NORTH CALIFORNIA BOULEVARD, STE 520
WALNUT CREEK
CA
94596
false
false
true
false
false
Class A Common Stock
2024-03-01
4
C
false
3000000
A
3000000
I
See Footnote
Class B Common Stock
2024-03-01
4
J
false
3000000
D
5774694
I
See Footnote
Class B-1 Units
0.00
2024-03-01
4
C
false
3000000
0.00
D
Class A Common Stock
3000000
5774694
I
See Footnote
Reflects the exchange (the "Exchange") of 1,676,591 and 1,323,409 Class B-1 Units of QL Holdings, LLC (the "LLC") held directly by Insignia QL Holdings, LLC ("Insignia QL") and Insignia A QL Holdings, LLC ("Insignia A"), respectively, into an equal number of shares of the Issuer's Class A Common Stock ("Class A Shares"), pursuant to the Exchange Agreement, dated October 27, 2020, by and among the Issuer, the LLC and the members of the LLC (the "Exchange Agreement"). In connection with the Exchange, the Reporting Persons forfeited for no consideration an equal number of shares of the Issuer's Class B Common Stock ("Class B Shares").
Insignia Capital Partners (Parallel A), L.P. ("Parallel A") and Insignia Capital Partners (AIV), L.P. ("Insignia AIV") are members of Insignia A having the power to appoint the majority of the board of managers of Insignia A. Insignia Capital Partners, L.P. ("Insignia Capital" and together with Parallel A and Insignia AIV, the "Insignia Fund") is the managing member of Insignia QL. Insignia Capital Partners GP, LLC ("Insignia GP") is the general partner of the Insignia Fund. The three member Investment Committee of Insignia GP comprised of David Lowe, Anthony Broglio and Melvyn Deane exercises voting and investment control over the securities held directly by Insignia A and Insignia QL, which acts by a majority vote of its members. Consequently,
(Continued from footnote 2) the Insignia Fund and Insignia GP may be deemed to beneficially own the securities held directly by Insignia A and Insignia QL. Messrs. Lowe, Broglio and Deane disclaim beneficial ownership of the securities held directly by Insignia A and Insignia QL.
Includes 2,547,428 Class B Shares held directly by Insignia A and 3,227,266 Class B Shares held directly by Insignia QL.
Pursuant to the Exchange Agreement, Class B-1 Units of the LLC (together with one Class B Share of the Issuer for every Class B-1 Unit) are exchangeable at any time for one Class A Share. Class B-1 Units of the LLC do not expire.
Includes 2,547,428 Class B-1 Units of the LLC held directly by Insignia A and 3,227,266 Class B-1 Units of the LLC held directly by Insignia QL.
/s/ Tony Broglio, as Managing Member of Insignia Capital Partners GP, LLC
2024-03-05
/s/ Tony Broglio, as Managing Member of Insignia Capital Partners LP
2024-03-05
/s/ Tony Broglio, as Managing Member of Insignia Capital Partner (AIV), LP
2024-03-05
/s/ Tony Broglio, as Managing Member of Insignia Capital Partner (Parallel A), LP
2024-03-05
/s/ Tony Broglio, as President and Secretary of Insignia QL Holdings, LLC
2024-03-05
/s/ Tony Broglio, as President and Secretary of Insignia A QL Holdings, LLC
2024-03-05