-----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, Ga19v/6mm7HJnM9oSVibpTReDVEn3VEH8AhdSfERRuQEkGgE3wMAW+5I/DVa5YkL jpVPyI05lGs1qIoX9Blwrw== 0000783603-05-000104.txt : 20051109 0000783603-05-000104.hdr.sgml : 20051109 20051109145227 ACCESSION NUMBER: 0000783603-05-000104 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20051109 FILED AS OF DATE: 20051109 DATE AS OF CHANGE: 20051109 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: TREADWAY FREDERICK C CENTRAL INDEX KEY: 0001244819 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-14795 FILM NUMBER: 051189499 BUSINESS ADDRESS: BUSINESS PHONE: (441) 295-5688 MAIL ADDRESS: STREET 1: 44 CHURCH STREET STREET 2: P O BOX HM2064 CITY: HAMILTON STATE: D0 ZIP: 99999 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: AMERICAN SAFETY INSURANCE HOLDINGS LTD CENTRAL INDEX KEY: 0000783603 STANDARD INDUSTRIAL CLASSIFICATION: INSURANCE AGENTS BROKERS & SERVICES [6411] IRS NUMBER: 000000000 FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 44 CHURCH STREET CITY: HAMILTON STATE: D0 ZIP: HM HX BUSINESS PHONE: 4412968560 MAIL ADDRESS: STREET 1: 44 CHURCH STREET CITY: HAMILTON STATE: D0 ZIP: HM HX FORMER COMPANY: FORMER CONFORMED NAME: AMERICAN SAFETY INSURANCE GROUP LTD DATE OF NAME CHANGE: 19971218 4 1 treadway1109_ex.xml X0202 4 2005-11-09 0 0000783603 AMERICAN SAFETY INSURANCE HOLDINGS LTD C3CC@CCC 0001244819 TREADWAY FREDERICK C 9406 PROMONTORY CIRCLE INDIANAPOLIS IN 46236 0 0 1 0 Share Options 2005-11-09 2005-11-09 4 M 0 1000 6.00 D 199689 D Common Shares 2005-11-07 2005-11-07 4 S 0 1000 16.75 D 190689 D Frederick C. Treadway - By Power of Attorney 2005-11-09 -----END PRIVACY-ENHANCED MESSAGE-----