-----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, OYVYVjnDZxa4YUjWCtvkMVEbOnhX+nDfqacMD1wwXMwkMEQNeBOXaX0qPFV28jCh YUuljTdK9NmxO2uKgp/TIg== 0001140361-09-023966.txt : 20091028 0001140361-09-023966.hdr.sgml : 20091028 20091028155621 ACCESSION NUMBER: 0001140361-09-023966 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20090727 FILED AS OF DATE: 20091028 DATE AS OF CHANGE: 20091028 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: BIRDWELL CODY W CENTRAL INDEX KEY: 0001244782 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-14795 FILM NUMBER: 091141754 MAIL ADDRESS: STREET 1: 100 GALLERIA PARKWAY, SE STREET 2: SUITE 700 CITY: ATLANTA STATE: GA ZIP: 30339 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 doc1.xml FORM 4 X0303 4 2009-07-27 0 0000783603 AMERICAN SAFETY INSURANCE HOLDINGS LTD ASI 0001244782 BIRDWELL CODY W 44 CHURCH STREET P.O. BOX HM2064 HAMILTON D0 HM HX BERMUDA 1 0 0 0 Common Stock 2009-07-27 4 A 0 2790 14.34 A 119280 D Common Stock 98250 I Shares held by The Cody Birdwell Family Limited Partnership, of which the Reporting Person is the Ge Shares issued under the Director Compensation Policy. Per the policy shares will be held in escrow until the 2010 Shareholders meeting. /s/ Cody W. Birdwell 2009-10-28 -----END PRIVACY-ENHANCED MESSAGE-----