-----BEGIN PRIVACY-ENHANCED MESSAGE----- Proc-Type: 2001,MIC-CLEAR Originator-Name: webmaster@www.sec.gov Originator-Key-Asymmetric: MFgwCgYEVQgBAQICAf8DSgAwRwJAW2sNKK9AVtBzYZmr6aGjlWyK3XmZv3dTINen TWSM7vrzLADbmYQaionwg5sDW3P6oaM5D3tdezXMm7z1T+B+twIDAQAB MIC-Info: RSA-MD5,RSA, M4HlixdemFH0Em25J13JqpIiKZtk2vxczL0NgTkV5TFnDOEhEJr/HeKz+fyJ9+oi uKHBGPgFpBTQpVIpdw1T6Q== 0000950159-01-000108.txt : 20010223 0000950159-01-000108.hdr.sgml : 20010223 ACCESSION NUMBER: 0000950159-01-000108 CONFORMED SUBMISSION TYPE: 5 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20001231 FILED AS OF DATE: 20010215 SUBJECT COMPANY: COMPANY DATA: COMPANY CONFORMED NAME: ACCEL INTERNATIONAL CORP CENTRAL INDEX KEY: 0000001985 STANDARD INDUSTRIAL CLASSIFICATION: LIFE INSURANCE [6311] IRS NUMBER: 310788334 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 5 SEC ACT: SEC FILE NUMBER: 000-08768 FILM NUMBER: 1547249 BUSINESS ADDRESS: STREET 1: 75 WEST ST CITY: SIMSBURY STATE: CT ZIP: 06070 BUSINESS PHONE: 8608437600 MAIL ADDRESS: STREET 1: 75 WEST ST CITY: SIMSBURY STATE: CT ZIP: 06070 FORMER COMPANY: FORMER CONFORMED NAME: ACCELERATION CORP DATE OF NAME CHANGE: 19870814 COMPANY DATA: COMPANY CONFORMED NAME: CHASE ARNOLD L CENTRAL INDEX KEY: 0001024134 STANDARD INDUSTRIAL CLASSIFICATION: [] OWNER FILING VALUES: FORM TYPE: 5 BUSINESS ADDRESS: STREET 1: C/O CHASE ENTERPRISES STREET 2: ONE COMMERCIAL PLAZA CITY: HARTFORD STATE: CT ZIP: 06103-3599 BUSINESS PHONE: 8605491674 MAIL ADDRESS: STREET 1: C/O CHASE ENTERPRISES STREET 2: ONE COMMERCIAL PLAZA CITY: HARTFORD STATE: CT ZIP: 06103-3599 5 1 0001.txt U.S. SECURITIES AND EXCHANGE COMMISSION Washington, DC 20549 FORM 5 ANNUAL STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934, Section 17(a) of the Public Utility Holding Company Act of 1935 or Section 30(f) of the Investment Company Act of 1940 [_] Check box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b). [_] Form 3 Holdings Reported [X] Form 4 Transactions Reported - -------------------------------------------------------------------------------- 1. Name and Address of Reporting Person* Chase Arnold L. - -------------------------------------------------------------------------------- (Last) (First) (Middle) c/o Chase Enterprises One Commercial Plaza - -------------------------------------------------------------------------------- (Street) Hartford CT 06103 - -------------------------------------------------------------------------------- (City) (State) (Zip) - -------------------------------------------------------------------------------- 2. Issuer Name and Ticker or Trading Symbol ACCEL International Corporation (ACLE) - -------------------------------------------------------------------------------- 3. IRS Identification Number of Reporting Person, if an Entity (Voluntary) N/A - -------------------------------------------------------------------------------- 4. Statement for Month/Year January 2001 - -------------------------------------------------------------------------------- 5. If Amendment, Date of Original (Month/Year) - -------------------------------------------------------------------------------- 6. Relationship of Reporting Person to Issuer (Check all applicable) [_] Director [X] 10% Owner [_] Officer (give title below) [_] Other (specify below) - -------------------------------------------------------------------------------- 7. Individual or Joint/Group Filing (Check applicable line) [X] Form filed by one Reporting Person [_] Form filed by more than one Reporting Person - -------------------------------------------------------------------------------- ================================================================================ Table I -- Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned ================================================================================
5. 6. 4. Amount of Owner- Securities Acquired (A) or Securities ship Disposed of (D) Beneficially Form: 7. (Instr. 3, 4 and 5) Owned at End Direct Nature of 2. 3. ----------------------------- of Issuer's (D) or Indirect 1. Transaction Transaction (A) Fiscal Year Indirect Beneficial Title of Security Date Code Amount or Price (Instr. 3 (I) Ownership (Instr. 3) (mm/dd/yy) (Instr. 8) (D) and 4) (Instr.4) (Instr. 4) - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ ====================================================================================================================================
* If the form is filed by more than one Reporting Person, see Instruction 4(b)(v). Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly. (Print or Type Responses) (Over) (Form 5-07/99) Page 2 FORM 5 (continued) Table II -- Derivative Securities Acquired, Disposed of, or Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities)
9. 10. Number Owner- of ship 2. Deriv- of Conver- 5. 7. ative Deriv- 11. sion Number of Title and Amount Secur- ative Nature or Derivative 6. of Underlying 8. ities Secur- of Exer- Securities Date Securities Price Bene- ity: In- cise 3. Acquired (A) Exercisable and (Instr. 3 and 4) of ficially Direct direct Price Trans- 4. or Disposed Expiration Date ---------------- Deriv- Owned (D) or Bene- 1. of action Trans- of (D) (Month/Day/Year) Amount ative at End In- ficial Title of Deriv- Date action (Instr. 3, ---------------- or Secur- of direct Owner- Derivative ative (Month/ Code 4 and 5) Date Expira- Number ity Year (I) ship Security Secur- Day/ (Instr. ------------ Exer- tion of (Instr. (Instr. (Instr. (Instr. (Instr. 3) ity Year) 8) (A) (D) cisable Date Title Shares 5) 4) 4) 4) - ------------------------------------------------------------------------------------------------------------------------------------ Common Stock Warrants $2.00 1/20/00 J4 560,000 Immed. 1/20/05 Common 560,000 $0 --- I FN 1 (option to Stock purchase) Common Stock Warrants $2.00 4/19/00 J4 84,000 Immed. 4/19/05 Common 84,000 $0 --- I FN 1 (option to Stock purchase) Common Stock Warrants $2.00 4/26/00 J4 56,000 Immed. 4/26/05 Common 56,000 $0 --- I FN 1 (option to Stock purchase) Common Stock Warrants $2.00 5/4/00 J4 70,000 Immed. 5/4/05 Common 70,000 $0 --- I FN 1 (option to Stock purchase) Common Stock Warrants $2.00 6/16/00 J4 70,000 Immed. 6/16/05 Common 70,000 $0 --- I FN 1 (option to Stock purchase) Common Stock Warrants $2.00 6/29/00 J4 18,200 Immed. 6/29/05 Common 18,200 $0 --- I FN 1 (option to Stock purchase) Common Stock Warrants $2.00 7/14/00 J4 168,000 Immed. 7/14/05 Common 168,000 $0 --- I FN 1 (option to Stock purchase) Common Stock Warrants $2.00 7/14/00 J4 89,824 Immed. 7/14/05 Common 89,824 $0 --- I FN 1 (option to Stock purchase)
Explanation of Responses: **CONTINUED ON NEXT PAGE** Page 3 FORM 5 (continued) Table II -- Derivative Securities Acquired, Disposed of, or Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities)
9. 10. Number Owner- of ship 2. Deriv- of Conver- 5. 7. ative Deriv- 11. sion Number of Title and Amount Secur- ative Nature or Derivative 6. of Underlying 8. ities Secur- of Exer- Securities Date Securities Price Bene- ity: In- cise 3. Acquired (A) Exercisable and (Instr. 3 and 4) of ficially Direct direct Price Trans- 4. or Disposed Expiration Date ---------------- Deriv- Owned (D) or Bene- 1. of action Trans- of (D) (Month/Day/Year) Amount ative at End In- ficial Title of Deriv- Date action (Instr. 3, ---------------- or Secur- of direct Owner- Derivative ative (Month/ Code 4 and 5) Date Expira- Number ity Year (I) ship Security Secur- Day/ (Instr. ------------ Exer- tion of (Instr. (Instr. (Instr. (Instr. (Instr. 3) ity Year) 8) (A) (D) cisable Date Title Shares 5) 4) 4) 4) - ------------------------------------------------------------------------------------------------------------------------------------ Common Stock Warrants $2.00 8/16/00 J4 28,000 Immed. 8/16/05 Common 28,000 $0 --- I FN 1 (option to Stock purchase) Common Stock Warrants $2.00 8/16/00 J4 28,000 Immed. 8/16/05 Common 28,000 $0 --- I FN 1 (option to Stock purchase) Common Stock Warrants $2.00 9/07/00 J4 161,000 Immed. 9/07/05 Common 161,000 $0 --- I FN 1 (option to Stock purchase) Common Stock Warrants $2.00 9/07/00 J4 161,000 Immed. 9/07/05 Common 161,000 $0 --- I FN 1 (option to Stock purchase) Common Stock Warrants $2.00 9/29/00 J4 28,000 Immed. 9/29/05 Common 28,000 $0 --- I FN 1 (option to Stock purchase) Common Stock Warrants $2.00 12/29/00 J4 31,771 Immed. 12/29/05 Common 31,771 $0 996,147 I FN 1 (option to Stock purchase)
Explanation of Responses: Item 4: Issuer issued warrants to Accel Finance Company LLC, a Connecticut limited liability company ("LLC") to purchase an aggregate of 1,274,971 shares of common stock as a condition to loans made by LLC to Issuer. There was no additional consideration for the warrants. Warrants covering 278,824 shares of Common Stock were assigned by LLC to Chase Dover, Inc., a Delaware corporation ("Chase Dover"), as a condition to loans made by Chase Dover to LLC. LLC used the proceeds of the loans from Chase Dover to fulfill its obligation to loan funds to Issuer. There was no additional consideration for the assignment of warrants from LLC to Chase Dover. FN 1: By membership in LLC; 100% of the warrants held by LLC are reported here, but the reporting person holds less than a 100% interest in LLC and disclaims beneficial ownership of all of the warrants. /s/ Arnold L. Chase 2-14-01 - --------------------------------------------- ----------------------- **Signature of Reporting Person Date 2 Intentional misstatements or omissions of facts constitute Federal Criminal Violations. See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a). Note: File three copies of this Form, one of which must be manually signed. If space is insufficient, see Instruction 6 for procedure. Page 4 -----END PRIVACY-ENHANCED MESSAGE-----