0001140361-13-014272.txt : 20130328 0001140361-13-014272.hdr.sgml : 20130328 20130328083414 ACCESSION NUMBER: 0001140361-13-014272 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20130308 FILED AS OF DATE: 20130328 DATE AS OF CHANGE: 20130328 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Jain Ambuj CENTRAL INDEX KEY: 0001548263 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-14795 FILM NUMBER: 13721694 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 4 1 doc1.xml FORM 4 X0306 4 2013-03-08 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 2013-03-08 4 A 0 3562 23.19 A 51314 D Common Stock 2013-03-15 4 A 0 22500 25.67 A 73814 D Restricted Stock Award pursuant to the Company's 2007 Long-Term Incentive Compensation Plan, which vests 25% on the first and second anniversary and 50% on the third anniversary of the grant date. Performance Based Restricted Stock Award pursuant to the Company's 2007 Long-Term Incentive Compensation Plan, which vests 50% on 12/31/16 and the remaining 50% on 12/31/17 or, will vest at 100% upon an earlier change in control. Original grant of 12,500 Performance Based Restricted Stock Award on 3/5/2010. Based on performance, 6,250 shares cliff vested on 3/5/2013. Ambuj Jain 2013-03-28