0001722438-22-000082.txt : 20220701 0001722438-22-000082.hdr.sgml : 20220701 20220701164938 ACCESSION NUMBER: 0001722438-22-000082 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20220629 FILED AS OF DATE: 20220701 DATE AS OF CHANGE: 20220701 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Simkoff Maxwell CENTRAL INDEX KEY: 0001868802 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-39754 FILM NUMBER: 221062090 MAIL ADDRESS: STREET 1: 101 MISSION ST. STREET 2: SUITE 740 CITY: SAN FRANCISCO STATE: CA ZIP: 94105 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Saslaw-Simkoff Revocable Trust CENTRAL INDEX KEY: 0001875424 STATE OF INCORPORATION: CA FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-39754 FILM NUMBER: 221062089 BUSINESS ADDRESS: STREET 1: 101 MISSION ST. STREET 2: SUITE 740 CITY: SAN FRANCISCO STATE: CA ZIP: 94105 BUSINESS PHONE: 703-789-5646 MAIL ADDRESS: STREET 1: 101 MISSION ST. STREET 2: SUITE 740 CITY: SAN FRANCISCO STATE: CA ZIP: 94105 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: Doma Holdings, Inc. CENTRAL INDEX KEY: 0001722438 STANDARD INDUSTRIAL CLASSIFICATION: TITLE INSURANCE [6361] IRS NUMBER: 000000000 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 101 MISSION STREET STREET 2: SUITE 740 CITY: SAN FRANCISCO STATE: CA ZIP: 94105 BUSINESS PHONE: (650) 419-3827 MAIL ADDRESS: STREET 1: 101 MISSION STREET STREET 2: SUITE 740 CITY: SAN FRANCISCO STATE: CA ZIP: 94105 FORMER COMPANY: FORMER CONFORMED NAME: Capitol Investment Corp. V DATE OF NAME CHANGE: 20171113 4 1 wf-form4_165670856424045.xml FORM 4 X0306 4 2022-06-29 0 0001722438 Doma Holdings, Inc. DOMA 0001868802 Simkoff Maxwell 101 MISSION ST. SUITE 740 SAN FRANCISCO CA 94105 1 1 1 0 Chief Executive Officer 0001875424 Saslaw-Simkoff Revocable Trust 101 MISSION ST. SUITE 740 SAN FRANCISCO CA 94105 0 0 1 0 Common stock 2022-06-29 4 A 0 2435325 0 A 2937461 D Common stock 2022-06-29 4 A 0 2435325 0 A 5372786 D Common stock 48053275 I By The Saslaw-Simkoff Revocable Trust Common stock 346609 I By Max Simkoff 2020 GRAT Common stock 346609 I By Jennifer Saslaw 2020 GRAT Grant of Doma Holdings, Inc.'s (the "Company") common stock to the reporting person in the form of restricted stock units ("RSUs") pursuant to the Company's Omnibus Incentive Plan (the "Plan"). The "Date of Grant" is June 29, 2022. These RSUs will be settled solely by delivery of shares of Company common stock and vest as follows: 1/16th of the total RSUs will vest on each successive Scheduled Vesting Date (as defined below) following the Date of Grant, with the "Scheduled Vesting Date" being September 1, December 1, March 1 and June 1 of the applicable year, provided the reporting person is continuously employed through such date as applicable, with the first 1/16th of the RSUs vesting on September 1, 2022 and the final 1/16th of the RSUs vesting on September 1, 2026. Grant of Company common stock to the reporting person in the form of performance restricted stock units ("PRSUs") pursuant to the Plan. The PRSUs will be settled solely by delivery of shares of Company common stock. The PRSUs will vest subject to the satisfaction of a (A) service requirement on the following schedule: 1/16th of the PRSUs will vest on September 1, December 1, March 1 and June 1 of the applicable year, provided the reporting person is continuously employed through such date as applicable, with the first 1/16th of PRSUs vesting on September 1, 2022 and the final 1/16th of PRSUs vesting on September 1, 2026; and (B) performance condition during the period beginning on June 29, 2022 and ending on June 1, 2026, pursuant to which the Company achieves a price hurdle of $5.00 (as to 1/3 of the target PRSUs), $7.00 (as to 1/3 of the target PRSUs) and $10.00 (as to 1/3 of the target PRSUs) based on the 90-day volume weighted average price of the Company's common stock. These shares are owned directly by The Saslaw-Simkoff Revocable Trust and indirectly by Maxwell Simkoff as trustee of the trust. The reporting person disclaims beneficial ownership except to the extent of his pecuniary interest therein. These shares are owned directly by the Max Simkoff 2020 GRAT. The reporting person disclaims beneficial ownership except to the extent of his pecuniary interest therein. These shares are held for the benefit of the reporting person's wife. The reporting person disclaims beneficial ownership of these shares except to the extent of his pecuniary interest therein. /s/ Christian Ameri, as Attorney-in-Fact for Maxwell Simkoff 2022-07-01 /s/ Christian Ameri, as Attorney-in-Fact for Maxwell Simkoff, Trustee 2022-07-01