0001209191-21-023019.txt : 20210325
0001209191-21-023019.hdr.sgml : 20210325
20210325163631
ACCESSION NUMBER: 0001209191-21-023019
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20210323
FILED AS OF DATE: 20210325
DATE AS OF CHANGE: 20210325
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Topjian Serge
CENTRAL INDEX KEY: 0001829887
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-39671
FILM NUMBER: 21772864
MAIL ADDRESS:
STREET 1: 700 SOUTH FLOWER STREET
STREET 2: SUITE 640
CITY: LOS ANGELES
STATE: CA
ZIP: 90017
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: MediaAlpha, Inc.
CENTRAL INDEX KEY: 0001818383
STANDARD INDUSTRIAL CLASSIFICATION: INSURANCE CARRIERS, NEC [6399]
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
doc4.xml
FORM 4 SUBMISSION
X0306
4
2021-03-23
0
0001818383
MediaAlpha, Inc.
MAX
0001829887
Topjian Serge
C/O MEDIAALPHA, INC.
700 SOUTH FLOWER STREET, SUITE 640
LOS ANGELES
CA
90017
0
1
0
0
VICE PRESIDENT, MEDIA
Class A Common Stock
2021-03-23
4
C
0
29882
A
37539
D
Class A Common Stock
2021-03-23
4
S
0
29882
44.62
D
7657
D
Class B-1 Units of QL Holdings LLC and Class B Common Stock
2021-03-23
4
C
0
29882
D
Class A Common Stock
29882
140910
D
On March 23, 2021, MediaAlpha, Inc. (the "Issuer") closed a secondary offering of its shares of Class A common stock, par value $0.01 per share (the "Class A Common Stock"). The Issuer did not offer any of its common stock in the offering and did not receive any proceeds from the offering.
On March 23, 2021, Mr. Topijan exchanged 29,882 Class B-1 Units of QL Holdings LLC (the "Class B-1 Units"), along with 29,882 shares of Class B Common Stock (the "Class B Common Stock"), for shares of Class A Common Stock on a one-for-one basis.
This amount represents the $46.00 secondary public offering price per share of Class A Common Stock, less the underwriting discount of $1.38 per share.
Pursuant to the Exchange Agreement, dated October 27, 2020, among the Issuer, QL Holdings LLC ("QLH"), Guilford Holdings, Inc. and the Class B-1 members of QLH, each Class B-1 Unit, together with one share of Class B Common Stock, is exchangeable for one share of Class A Common Stock.
/s/ Lance Martinez, attorney-in-fact for Topijan Serge
2021-03-25