-----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, Ffk0+3AGZS58J40L5XlpEs+LFMxIAgOR4Anus+RARFev3QJuKhwa7vXDH3zifCmj TA9DUUJ077xwU7Qs27A+NQ== 0000783603-09-000031.txt : 20090313 0000783603-09-000031.hdr.sgml : 20090313 20090313162114 ACCESSION NUMBER: 0000783603-09-000031 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20090311 FILED AS OF DATE: 20090313 DATE AS OF CHANGE: 20090313 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 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: William Clarence Tepe CENTRAL INDEX KEY: 0001345760 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-14795 FILM NUMBER: 09680372 BUSINESS ADDRESS: STREET 1: 1845 THE EXCHANGE CITY: ATLANTA STATE: 2Q ZIP: 30102 BUSINESS PHONE: 770-485-4373 MAIL ADDRESS: STREET 1: 1845 THE EXCHANGE CITY: ATLANTA STATE: 2Q ZIP: 30102 4 1 tepe20090313form4_ex.xml X0303 4 2009-03-11 0 0000783603 AMERICAN SAFETY INSURANCE HOLDINGS LTD ASI 0001345760 William Clarence Tepe C/O AMERICAN SAFETY INSURANCE 100 GALLERIA PKWY., #700 ATLANTA GA 30339 0 1 0 0 CFO/Treasurer Common Stock 2009-03-11 2009-03-11 4 A 0 5348 0.00 A 12226 D Stock Option (Right To Buy) 9.10 2009-03-11 2009-03-11 4 A 0 14589 9.10 A 2010-03-11 2019-03-11 Common Stock 14589 66355 D Restricted Stock Awards pursuant to the Company's 2008 Long-Term Incentive Compensation Plan, which vest 25% on the first and second anniversary of the date of grant and 50% on the third anniversary of the date of grant. Options awarded pursuant to the Company's 2007 Incentive Stock Option Plan. These options have a three-year vesting schedule, pursuant to which the shares underlying the options shall vest in one-third increments commencing one year after the date of grant. The date shown is the date the first vested number of shares becomes exercisable. William C. Tepe 2009-03-13 -----END PRIVACY-ENHANCED MESSAGE-----