-----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, BMz4nGpKKG/Gk5qS/IVA5llHw8FUl+m2RWTKfXTqfCxwDYcTdKG32QBukwt3ft4f BgPGJEXLidi+adQ9XlUrvA== 0000783603-09-000007.txt : 20090202 0000783603-09-000007.hdr.sgml : 20090202 20090202151334 ACCESSION NUMBER: 0000783603-09-000007 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20090130 FILED AS OF DATE: 20090202 DATE AS OF CHANGE: 20090202 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: SCOLLO JOSEPH D CENTRAL INDEX KEY: 0001244815 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-14795 FILM NUMBER: 09561213 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 FORMER NAME: FORMER CONFORMED NAME: SCOLLO JOSEPH D JR DATE OF NAME CHANGE: 20030620 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: 31 QUEENS STREET STREET 2: 2ND FLOOR CITY: HAMILTON STATE: D0 ZIP: HM 11 BUSINESS PHONE: 441-296-8560 MAIL ADDRESS: STREET 1: 31 QUEENS STREET STREET 2: 2ND FLOOR CITY: HAMILTON STATE: D0 ZIP: HM 11 FORMER COMPANY: FORMER CONFORMED NAME: AMERICAN SAFETY INSURANCE GROUP LTD DATE OF NAME CHANGE: 19971218 4 1 scollo20080202form4_ex.xml X0303 4 2009-01-30 0 0000783603 AMERICAN SAFETY INSURANCE HOLDINGS LTD ASI 0001244815 SCOLLO JOSEPH D 44 CHURCH STREET P O BOX HM2064 HAMILTON D0 99999 BERMUDA 0 1 0 0 Exec. VP/COO Common Stock 2009-01-30 2009-01-30 4 D 0 2000 13.96 D 6005 D Common Stock 2009-01-30 2009-01-30 4 A 0 5374 9.50 A 11379 D Common Stock 9.50 2009-01-30 2009-01-29 4 A 0 10000 9.50 A 2000-02-12 2009-02-12 Common Stock 10000 11379 D 2,000 shares surrendered @ $13.96 per share to purchase 2,938 shares of 10,000 share option exercise 4,626 shares surrendered @ $14.50 per share to purchase 2,436 shares of 10,000 share option exercise Options exercised 01/29/2009 Joseph D. Scollo, Jr. 2009-02-02 -----END PRIVACY-ENHANCED MESSAGE-----