0001104659-19-021988.txt : 20190417 0001104659-19-021988.hdr.sgml : 20190417 20190417170400 ACCESSION NUMBER: 0001104659-19-021988 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20190416 FILED AS OF DATE: 20190417 DATE AS OF CHANGE: 20190417 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Christianson Jon CENTRAL INDEX KEY: 0001772607 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-38873 FILM NUMBER: 19753628 MAIL ADDRESS: STREET 1: 7979 IVANHOE AVENUE STREET 2: SUITE 500 CITY: LA JOLLA STATE: CA ZIP: 92037 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: Palomar Holdings, Inc. CENTRAL INDEX KEY: 0001761312 STANDARD INDUSTRIAL CLASSIFICATION: FIRE, MARINE & CASUALTY INSURANCE [6331] IRS NUMBER: 000000000 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 7979 IVANHOE AVENUE STREET 2: SUITE 500 CITY: LA JOLLA STATE: CA ZIP: 92037 BUSINESS PHONE: 619-567-5290 MAIL ADDRESS: STREET 1: 7979 IVANHOE AVENUE STREET 2: SUITE 500 CITY: LA JOLLA STATE: CA ZIP: 92037 FORMER COMPANY: FORMER CONFORMED NAME: GC Palomar Holdings DATE OF NAME CHANGE: 20181211 4 1 a4.xml 4 X0306 4 2019-04-16 0 0001761312 Palomar Holdings, Inc. PLMR 0001772607 Christianson Jon 7979 IVANHOE AVENUE, SUITE 500 LA JOLLA CA 92037 0 1 0 0 Chief Operating Officer Employee Stock Option (right to buy) 15.00 2019-04-16 4 A 0 40937 0 A 2029-04-16 Common Stock 40937 40937 D Fifty percent (50%) of the option shares vest and become exercisable on April 16, 2020 and the remaining option shares vest and become exercisable in twelve (12) equal monthly installments thereafter. /s/ Mac Armstrong, Attorney-in-fact 2019-04-17