0000899243-21-031709.txt : 20210804 0000899243-21-031709.hdr.sgml : 20210804 20210804211908 ACCESSION NUMBER: 0000899243-21-031709 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20210804 FILED AS OF DATE: 20210804 DATE AS OF CHANGE: 20210804 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Fleming-Wood Simon CENTRAL INDEX KEY: 0001532594 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-39711 FILM NUMBER: 211145966 MAIL ADDRESS: STREET 1: 2101 WEBSTER STREET STREET 2: SUITE 1650 CITY: OAKLAND STATE: CA ZIP: 94612 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: Hippo Holdings Inc. CENTRAL INDEX KEY: 0001828105 STANDARD INDUSTRIAL CLASSIFICATION: FIRE, MARINE & CASUALTY INSURANCE [6331] IRS NUMBER: 981562010 FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 150 FOREST AVENUE CITY: PALO ALTO STATE: CA ZIP: 94301 BUSINESS PHONE: (650) 294-8463 MAIL ADDRESS: STREET 1: 150 FOREST AVENUE CITY: PALO ALTO STATE: CA ZIP: 94301 FORMER COMPANY: FORMER CONFORMED NAME: Reinvent Technology Partners Z DATE OF NAME CHANGE: 20201029 FORMER COMPANY: FORMER CONFORMED NAME: Reinvent Technology Partners B DATE OF NAME CHANGE: 20201013 4 1 doc4.xml FORM 4 SUBMISSION X0306 4 2021-08-04 0 0001828105 Hippo Holdings Inc. HIPO 0001532594 Fleming-Wood Simon C/O HIPPO HOLDINGS INC. 150 FOREST AVENUE PALO ALTO CA 94301 0 1 0 0 Chief Marketing Officer Stock Option (Right to Buy) 1.06 2021-08-04 4 A 0 2086299 A 2030-12-03 Common Stock 2086299 2086299 D 25% of the shares underlying the option vest on the first anniversary measured from October 26, 2020, and 1/16th of the shares vest on each quarterly anniversary thereafter, subject to the Reporting Person continuing to provide services to the Issuer through the applicable vesting date. Pursuant to the business combination of Hippo Holdings Inc. (the "Issuer") and Hippo Enterprises Inc. ("Old Hippo"), each outstanding Old Hippo equity award was automatically converted into a corresponding equity award of the Issuer based on a 1 to 6.95433 conversion ratio and with the same terms and vesting conditions as the Old Hippo equity award. /s/ Stewart Ellis, as Attorney-in-Fact for Simon Fleming-Wood 2021-08-04