0001140361-11-049147.txt : 20111012 0001140361-11-049147.hdr.sgml : 20111012 20111012104724 ACCESSION NUMBER: 0001140361-11-049147 CONFORMED SUBMISSION TYPE: 3 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20111003 FILED AS OF DATE: 20111012 DATE AS OF CHANGE: 20111012 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Pascall Nicholas CENTRAL INDEX KEY: 0001532360 FILING VALUES: FORM TYPE: 3 SEC ACT: 1934 Act SEC FILE NUMBER: 001-14795 FILM NUMBER: 111136829 MAIL ADDRESS: STREET 1: 10 BURNT HOUSE HILL STREET 2: A GATE CITY: WARWICK STATE: D0 ZIP: WR 04 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 3 1 doc1.xml FORM 3 X0204 3 2011-10-03 0 0000783603 AMERICAN SAFETY INSURANCE HOLDINGS LTD ASI 0001532360 Pascall Nicholas 44 CHURCH ST P.O. BOX HM2064 HAMILTON D0 HM11 BERMUDA 0 1 0 0 Chief Underwriting Officer Common Stock 7031 D Common Stock 3846 D Common Stock 3658 D Stock Option (Right To Buy) 9.10 2009-03-11 2019-03-11 Common Stock 12590 D Stock Option (Right To Buy) 14.87 2010-03-05 2020-03-05 Common Stock 9766 D Restricted stock award granted on 03/04/2008 to vest over three years (25%/25%/50%). Restricted stock award granted on 03/11/2009 to vest over three years (25%/25%/50%). Restricted stock award granted on 03/05/2010 to vest over three years (25%/25%/50%). 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 commencing in one year after the grant date. The date shown is the date the first vested number of shares becomes/ became exercisable. 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/ became exercisable. Nicholas Paschall 2011-10-03