0001140361-12-021875.txt : 20120430 0001140361-12-021875.hdr.sgml : 20120430 20120430142711 ACCESSION NUMBER: 0001140361-12-021875 CONFORMED SUBMISSION TYPE: 3 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20120330 FILED AS OF DATE: 20120430 DATE AS OF CHANGE: 20120430 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Jain Ambuj CENTRAL INDEX KEY: 0001548263 FILING VALUES: FORM TYPE: 3 SEC ACT: 1934 Act SEC FILE NUMBER: 001-14795 FILM NUMBER: 12794103 MAIL ADDRESS: STREET 1: 4737 OUTLOOK WAY CITY: MARIETTA STATE: GA ZIP: 30066 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 X0205 3 2012-03-30 0 0000783603 AMERICAN SAFETY INSURANCE HOLDINGS LTD ASI 0001548263 Jain Ambuj BOYLE BUILDING, 2ND FLOOR 31 QUEEN STREET HAMILTON D0 HM 11 BERMUDA 0 1 0 0 Senior Vice President Common Stock 1755 D Common Stock 3791 D Common Stock 12500 D Common Stock 2459 D Common Stock 4032 D Common Stock 25000 D Common Stock 4465 D Stock Option (Right to Buy) 13.77 2009-07-27 2014-07-27 Common Stock 10000 D Stock Option (Right to Buy) 16.40 2009-03-15 2016-03-15 Common Stock 4000 D Stock Option (Right to Buy) 19.05 2010-03-15 2017-03-15 Common Stock 4000 D Stock Option (Right to Buy) 17.95 2011-03-04 2018-03-04 Common Stock 4000 D Stock Option (Right to Buy) 9.10 2012-03-11 2019-03-11 Common Stock 10342 D Stock Option (Right to Buy) 14.64 2013-03-05 2020-03-05 Common Stock 6565 D Restricted Stock Award given on March 4, 2008, pursuant to the Company's 2007 Incentive Compensation Plan, which vests 25% on the first and second anniversary and 50% on the third anniversary of the grant date. Restricted Stock Award given on March 11, 2009, pursuant to the Company's 2007 Incentive Compensation Plan, which vests 25% on the first and second anniversary and 50% on the third anniversary of the grant date. Restricted Stock Awards given on March 5, 2010, pursuant to the Company's 2007 Incentive Compensation Plan. Shares cliff vest three years from grant date. Restricted Stock Award given on March 5, 2010, pursuant to the Company's 2007 Incentive Compensation Plan, which vests 25% on the first and second anniversary and 50% on the third anniversary of the grant date. Restricted Stock Award given on March 14, 2011, pursuant to the Company's 2007 Incentive Compensation Plan, which vests 25% on the first and second anniversary and 50% on the third anniversary of the grant date. Restricted Stock Awards given on July 29, 2011, pursuant to the Company's 2007 Incentive Compensation Plan. Shares cliff vest five years from grant date. Restricted Stock Award given on March 14, 2012, pursuant to the Company's 2007 Incentive Compensation Plan, which vests 25% on the first and second anniversary and 50% on the third anniversary of the grant date. Options awarded pursuant to the Company's 2007 Incentive Compensation Plan. These options cliff vested at the fifth anniversary of the grant date. The date shown is the date the first vested number of shares became exercisable. Options awarded pursuant to the Company's 2007 Incentive Compensation 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 grant date. The date shown is the date the first vested number of shares became/becomes exercisable. Options awarded pursuant to the Company's 2007 Incentive Compensation Plan. These options cliff vested at the third anniversary of the grant date. The date shown is the date the first vested number of shares became exercisable. Ambuj Jain 2012-03-30