0000950103-19-014317.txt : 20191028
0000950103-19-014317.hdr.sgml : 20191028
20191028214128
ACCESSION NUMBER: 0000950103-19-014317
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20191028
FILED AS OF DATE: 20191028
DATE AS OF CHANGE: 20191028
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Valentine John A.
CENTRAL INDEX KEY: 0001787661
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-39095
FILM NUMBER: 191174324
MAIL ADDRESS:
STREET 1: 4010 W. BOY SCOUT BLVD. SUITE 200
CITY: TAMPA
STATE: FL
ZIP: 33607
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: BRP Group, Inc.
CENTRAL INDEX KEY: 0001781755
STANDARD INDUSTRIAL CLASSIFICATION: INSURANCE AGENTS BROKERS & SERVICES [6411]
IRS NUMBER: 611937225
FISCAL YEAR END: 1231
BUSINESS ADDRESS:
STREET 1: 4010 W. BOY SCOUT BLVD.
STREET 2: SUITE 200
CITY: TAMPA
STATE: FL
ZIP: 33607
BUSINESS PHONE: (866) 279-0698
MAIL ADDRESS:
STREET 1: 4010 W. BOY SCOUT BLVD.
STREET 2: SUITE 200
CITY: TAMPA
STATE: FL
ZIP: 33607
4
1
dp114764_4-valentine.xml
FORM 4
X0306
4
2019-10-28
0
0001781755
BRP Group, Inc.
BRP
0001787661
Valentine John A.
C/O BRP GROUP, INC.
4010 W. BOY SCOUT BLVD. SUITE 200
TAMPA
FL
33607
0
1
0
1
Chief Partnership Officer
Member of 10% owner group
Class B Common Stock
2019-10-28
4
A
0
1268843
0.0001
A
1268843
D
Class B Common Stock
2019-10-28
4
A
0
190326
0.0001
A
190326
I
By John A. Valentine 2019 Grantor Retained Annuity Trust dated September 30, 2019
LLC Units in Baldwin Risk Partners, LLC
0
2019-10-28
4
A
0
1268843
0
A
Class A Common Stock
1268843
1268843
D
LLC Units in Baldwin Risk Partners, LLC
0
2019-10-28
4
A
0
190326
0
A
Class A Common Stock
190326
190326
I
By John A. Valentine 2019 Grantor Retained Annuity Trust dated September 30, 2019
This excludes securities owned by the Villages Invesco, LLC (the "Villages") relating to a voting agreement between the Villages and members of the "group" (which includes the reporting person) referenced in the Form 3 for Baldwin Insurance Group Holdings, LLC, filed October 28, 2019, for which the reporting person disclaims beneficial ownership.
These securities were acquired through the conversion immediately prior to the issuer's initial public offering of historical interests held by the reporting person in Baldwin Risk Partners, LLC.
Each LLC Unit, together with a share of Class B common stock, may be converted by the holder into one share of Class A common stock at any time. The LLC Units do not expire.
/s/ Christopher J. Stephens, as Attorney-in Fact, for John A. Valentine
2019-10-28