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