-----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, Lms9HlAmznfwc8N2mOYfBTkrsJ5cnuqQEeHprx3d0/74q6SMV03QrHUDm0sRw7H/ prigrlmHQexfQ2GLdutHZw== 0000898432-10-000183.txt : 20100219 0000898432-10-000183.hdr.sgml : 20100219 20100219161031 ACCESSION NUMBER: 0000898432-10-000183 CONFORMED SUBMISSION TYPE: SC 13G/A PUBLIC DOCUMENT COUNT: 1 FILED AS OF DATE: 20100219 DATE AS OF CHANGE: 20100219 SUBJECT COMPANY: COMPANY DATA: COMPANY CONFORMED NAME: AFFIRMATIVE INSURANCE HOLDINGS INC CENTRAL INDEX KEY: 0001282543 STANDARD INDUSTRIAL CLASSIFICATION: FIRE, MARINE & CASUALTY INSURANCE [6331] IRS NUMBER: 752770432 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: SC 13G/A SEC ACT: 1934 Act SEC FILE NUMBER: 005-79966 FILM NUMBER: 10619735 BUSINESS ADDRESS: STREET 1: 4450 SOJOURN DRIVE STREET 2: SUITE 500 CITY: ADDISON STATE: TX ZIP: 75001 BUSINESS PHONE: 972-728-6300 MAIL ADDRESS: STREET 1: 4450 SOJOURN DRIVE STREET 2: SUITE 500 CITY: ADDISON STATE: TX ZIP: 75001 FILED BY: COMPANY DATA: COMPANY CONFORMED NAME: LONG MEADOW HOLDINGS LP CENTRAL INDEX KEY: 0001019594 IRS NUMBER: 061459543 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: SC 13G/A BUSINESS ADDRESS: STREET 1: 1200 HIGH RIDGE ROAD CITY: STAMFORD STATE: CT ZIP: 06905 BUSINESS PHONE: 203-329-8857 MAIL ADDRESS: STREET 1: 1200 HIGH RIDGE ROAD CITY: STAMFORD STATE: CT ZIP: 06905 SC 13G/A 1 sc13ga.htm sc13ga.htm



 
SECURITIES AND EXCHANGE COMMISSION
Washington, DC 20549
 
 
SCHEDULE 13G/A
(Rule 13d-102)
 
 
INFORMATION TO BE INCLUDED IN STATEMENTS FILED PURSUANT
TO RULES 13d-1(b) (c) AND (d) AND AMENDMENTS THERETO FILED
PURSUANT TO 13d-2(b)
 
(Amendment No. 4)
 

 
Affirmative Insurance Holdings, Inc.
(Name of Issuer)
 
Common Stock
(Title of Class of Securities)
 
008272106
(CUSIP Number)
 
December 31, 2009
(Date of Event Which Requires Filing of this Statement)
 
Check the appropriate box to designate the rule pursuant to which this Schedule is filed:
 
    o
Rule 13d-1(b))
    x
Rule 13d-1(c)
    o
Rule 13d-1(d)
 
 
               *The remainder of this cover page shall be filled out for a reporting person's initial filing on this form with respect to the subject class of securities, and for any subsequent amendment containing information which would alter the disclosures provided in a prior cover page.
 
 
The information required on the remainder of this cover page shall not be deemed to be "filed" for the purpose of Section 18 of the Securities Exchange Act of 1934 or otherwise subject to the liabilities of that section of the Act but shall be subject to all other provisions of the Act (however, see the Notes).
 



 
 

 


         
CUSIP No. 008272106
 
13G/A
 
Page 2 of 8 Pages
     

 
1
 
 NAME OF REPORTING PERSON:
 Long Meadow Holdings, L.P.
   
 
2
 
 CHECK THE APPROPRIATE BOX IF A MEMBER OF A GROUP*
(a) 
o  
      (b) 
x
         
 
3
 
 SEC USE ONLY
   
         
 
4
 
 CITIZENSHIP OR PLACE OF ORGANIZATION
   
Delaware
   
 

   
5
 
 SOLE VOTING POWER
NUMBER OF
     
0
SHARES
   
BENEFICIALLY
 
6
 
 SHARED VOTING POWER
OWNED
     
 848,946
BY
   
EACH
 
7
 
 SOLE DISPOSITIVE POWER
REPORTING
     
0
PERSON
   
WITH:
 
8
 
 SHARED DISPOSITIVE POWER
       
 848,946
 
9
 
 AGGREGATE AMOUNT BENEFICIALLY OWNED BY EACH REPORTING PERSON
   
   
 848,946
   
 
 
10
 
 CHECK IF THE AGGREGATE AMOUNT IN ROW (9) EXCLUDES CERTAIN SHARES*
 
o
         
 
 
11
 
 PERCENT OF CLASS REPRESENTED BY AMOUNT IN ROW (9)
   
   
 5.5%
 
   
 
12
 
 TYPE OF REPORTING PERSON*
   
   
 PN
   


 
 

 


         
CUSIP No. 008272106
 
13G/A
 
Page 3 of 8 Pages
 
     
 

 
1
 
 NAME OF REPORTING PERSON:
 Jonathan W. Old, III
   
 
2
 
 CHECK THE APPROPRIATE BOX IF A MEMBER OF A GROUP*
  (a) 
o
       (b) 
x
         
 
3
 
 SEC USE ONLY
   
         
 
4
 
 CITIZENSHIP OR PLACE OF ORGANIZATION
   
United States
 
   
 

   
5
 
 SOLE VOTING POWER
NUMBER OF
     
 20,000
SHARES
   
BENEFICIALLY
 
6
 
 SHARED VOTING POWER
OWNED
     
  848,946
BY
   
EACH
 
7
 
 SOLE DISPOSITIVE POWER
REPORTING
     
20,000
PERSON
   
WITH:
 
8
 
 SHARED DISPOSITIVE POWER
       
  848,946
 
9
 
 AGGREGATE AMOUNT BENEFICIALLY OWNED BY EACH REPORTING PERSON
   
   
 868,946
 
   
 
10
 
 CHECK IF THE AGGREGATE AMOUNT IN ROW (9) EXCLUDES CERTAIN SHARES*
 
o
   
 
 
   
 
11
 
 PERCENT OF CLASS REPRESENTED BY AMOUNT IN ROW (9)
   
   
 5.6%
 
   
 
12
 
 TYPE OF REPORTING PERSON*
   
   
 IN
   


 
 

 


         
CUSIP No. 008272106
 
13G/A
 
Page 4 of 8 Pages
     

 
1
 
 NAME OF REPORTING PERSON:
 Long Meadow Investors, LLC
   
 
2
 
 CHECK THE APPROPRIATE BOX IF A MEMBER OF A GROUP*
(a) 
o
      (b) 
x
         
 
3
 
 SEC USE ONLY
   
         
 
4
 
 CITIZENSHIP OR PLACE OF ORGANIZATION
   
Delaware
 
   
 

   
5
 
 SOLE VOTING POWER
NUMBER OF
     
 0
SHARES
   
BENEFICIALLY
 
6
 
 SHARED VOTING POWER
OWNED
     
  848,946
BY
   
EACH
 
7
 
 SOLE DISPOSITIVE POWER
REPORTING
     
0
PERSON
   
WITH:
 
8
 
 SHARED DISPOSITIVE POWER
       
  848,946
 
9
 
 AGGREGATE AMOUNT BENEFICIALLY OWNED BY EACH REPORTING PERSON
   
   
  848,946
 
   
 
10
 
 CHECK IF THE AGGREGATE AMOUNT IN ROW (9) EXCLUDES CERTAIN SHARES*
 
o
         
 
11
 
 PERCENT OF CLASS REPRESENTED BY AMOUNT IN ROW (9)
   
   
 5.5%
 
   
 
12
 
 TYPE OF REPORTING PERSON*
   
   
 CO, HC
 
   


 
 

 


         
CUSIP No. 008272106
 
13G/A
 
Page 5 of 8 Pages
 
     
 

 
1
 
 NAME OF REPORTING PERSON:
 Michael J. Moss
   
 
2
 
 CHECK THE APPROPRIATE BOX IF A MEMBER OF A GROUP*
  (a)
o
        (b)
x  
         
 
3
 
 SEC USE ONLY
   
         
 
4
 
 CITIZENSHIP OR PLACE OF ORGANIZATION
   
United States
 
   
 

   
5
 
 SOLE VOTING POWER
NUMBER OF
     
 55,757
SHARES
   
BENEFICIALLY
 
6
 
 SHARED VOTING POWER
OWNED
     
 879,170
BY
   
EACH
 
7
 
 SOLE DISPOSITIVE POWER
REPORTING
     
55,757
PERSON
   
WITH:
 
8
 
 SHARED DISPOSITIVE POWER
       
 879,170
 
9
 
 AGGREGATE AMOUNT BENEFICIALLY OWNED BY EACH REPORTING PERSON
   
   
 934,927
 
   
 
10
 
 CHECK IF THE AGGREGATE AMOUNT IN ROW (9) EXCLUDES CERTAIN SHARES*
 
o
   
 
 
   
 
11
 
 PERCENT OF CLASS REPRESENTED BY AMOUNT IN ROW (9)
   
   
 6.1%
 
   
 
12
 
 TYPE OF REPORTING PERSON*
   
   
 IN
 
   


 
 

 


         
CUSIP No. 008272106
 
13G/A
 
Page 6 of 8 Pages

 
ITEM 1(a).      NAME OF ISSUER:
 
 
Affirmative Insurance Holdings, Inc. (“Affirmative”)
 
 
ITEM 1(b).      ADDRESS OF ISSUER'S PRINCIPAL EXECUTIVE OFFICES:
 
 
4450 Sojourn Drive, Suite 500
Addison, Texas 75001
 
ITEM 2(a).      NAME OF PERSON FILING:
 
This Schedule 13G/A is being filed on behalf of the following persons (the “Reporting Persons”):
 
 
(i)
 
Long Meadow Holdings, L.P. (“LMH”)
 
(ii)
 
Jonathan W. Old, III
 
(iii)
 
Long Meadow Investors, LLC (“LMI”)
 
(iv)
 
Michael J. Moss
 
ITEM 2(b).      ADDRESS OF PRINCIPAL BUSINESS OFFICE:
 
 
The principal business office of the Reporting Persons filing this Schedule 13G/A is located at 1200 High Ridge Road, Stamford, CT 06905.
 
 
ITEM 2(c).      CITIZENSHIP:
 
 
(i)
LMH:
a Delaware limited partnership
 
(ii)
Jonathan W. Old, III:
United States
 
(iii)
LMI:
a Delaware limited liability company
 
(iv)
Michael J. Moss
United States
 
ITEM 2(d).      TITLE OF CLASS OF SECURITIES:
 
 
Common Stock
 
 
ITEM 2(e).      CUSIP Number:
 
 
008272106
 
                       

 
 

 


         
CUSIP No. 008272106
 
13G/A
 
Page 7 of 8 Pages
 
ITEM 3.        IF THIS STATEMENT IS FILED PURSUANT TO RULE 13d-1(b), or 13d-2(b) or (c) CHECK WHETHER THE PERSON FILING IS:    One of the following
 
 
Not applicable.
 
 
ITEM 4.        OWNERSHIP:
 
 
The information in items 1 and 5 through 11 on the cover pages (pp. 2-5) on this Schedule 13G/A is hereby incorporated by reference.
 
 
ITEM 5.        OWNERSHIP OF FIVE PERCENT OR LESS OF A CLASS:
 
 
If this statement is being filed to report the fact that as of the date hereof the Reporting Persons have ceased to be the beneficial owner of more than five percent of the class of securities check the following.     X
 
 
ITEM 6.        OWNERSHIP OF MORE THAN FIVE PERCENT ON BEHALF OF ANOTHER PERSON:
 
 
Not applicable.
 
 
ITEM 7.        IDENTIFICATION AND CLASSIFICATION OF THE SUBSIDIARY WHICH ACQUIRED THE SECURITY BEING REPORTED ON BY THE PARENT HOLDING COMPANY:
 
 
Long Meadow Holdings, L.P. (“LMH”) beneficially owns 848,946 shares of  Affirmative Insurance Holdings, Inc.’s common stock (the “Company’s Common Stock”), which constitutes 5.5% of the Company’s Common Stock outstanding.  Long Meadow Investors, LLC (“LMI”) is the general partner of LMH and because it could be deemed to share voting and dispositive power with LMH over the 848,946 shares of the Company’s Common Stock owned by LMH, LMI may be deemed to be the beneficial owner of such Common Stock.  LMI disclaims beneficial ownership of all shares of the company’s Common Stock held by other persons.
 
 
Jonathan W. Old, III is a managing member of LMI.  Because Mr. Old is a managing member of the general partner of LMH, and because he could be deemed to share with LMI voting and dispositive power over the 848,946 shares of the Company’s Common Stock held by LMH, Mr. Old may be deemed to be the beneficial owner of such Common Stock.  Mr. Old is the beneficial owner of 20,000 shares of the Company’s Common Stock which he owns personally.  Mr. Old disclaims beneficial ownership of all shares of the Company’s Common Stock held by other persons.
 
 
Michael J. Moss is a managing member of LMI.  Because Mr. Moss is a managing member of the general partner of LMH and shares the responsibilities of managing LMI with Mr. Old, and because he could be deemed to share with LMI and Mr. Old voting and dispositive power over the 848,946 shares of the Company’s Common Stock held by LMH, Mr. Moss may be deemed to be the beneficial owner of such Common Stock.  Mr. Moss is the beneficial owner of 55,757 shares of the Company’s Common Stock that he holds personally. Additionally, Mr. Moss’ spouse and children hold an aggregate of 30,224 shares of the Company’s Common Stock, and because Mr. Moss could be deemed to share with his wife and children voting and dispositive power over the Company’s Common Stock held by them, Mr. Moss may be deemed to be the beneficial owner of such Common Stock. Therefore, Mr. Moss may be deemed to be the beneficial owner of an aggregate of 934,927 shares, which constitutes 6.1% of the Company’s Common Stock outstanding.  Mr. Moss disclaims beneficial ownership of all shares of the Company’s Common Stock held by other persons.
 

 
ITEM 8.        IDENTIFICATION AND CLASSIFICATION OF MEMBERS OF A GROUP:
 

 
 

 

 
Not applicable.
 
 
ITEM 9.        NOTICE OF DISSOLUTION OF GROUP:
 
 
Not applicable.
 

 
 

 


         
CUSIP No. 008272106
 
13G/A
 
Page 8 of 8 Pages
 
ITEM 10.        CERTIFICATION
 
 
By signing below I certify that, to the best of my knowledge and belief, the securities referred to above were not acquired and are not held for the purpose of or with the effect of changing or influencing the control of the issuer of the securities and were not acquired and are not held in connection with or as a participant in any transaction having that purpose or effect.
 
 
After reasonable inquiry and to the best of my knowledge and belief, I certify that the information set forth in this statement is true, complete and correct.
 
Dated:
 
 February 19, 2010



     /s/ Jonathan W. Old, III   
 
Name:
Jonathan W. Old, III *
 
       
       
       
     /s/ Michael J. Moss   
 
Name:
Michael J. Moss*
 
       
       
       
       
 
LONG MEADOW HOLDINGS, L.P.*
 
By:
Long Meadow Investors, LLC
   
General Partner of Long Meadow Holdings, L.P.
       
       
     /s/ Jonathan W. Old, III  
 
Name:
Jonathan W. Old, III
 
 
Title:
Managing Member of Long Meadow Investors, LLC
       
       
       
       
 
LONG MEADOW INVESTORS, LLC*
 
By:
Jonathan W. Old, III
 
       
       
       
     /s/ Jonathan W. Old, III  
 
Name:
Jonathan W. Old, III
 
 
Title:
Managing Member
 


* The Reporting Persons disclaim beneficial ownership in the shares reported herein except to the extent of their pecuniary interest therein.

 
 

 


EXHIBIT A

In accordance with Rule 13d-1(k) under the Securities Exchange Act of 1934, as amended, each of the undersigned does hereby consent and agree to the joint filing on behalf of each of them of a statement on Schedule 13G and all amendments thereto with respect to the Common Stock of Affirmative Insurance Holdings, Inc. beneficially owned by each of them, and the inclusion of this Joint Filing Agreement as an exhibit thereto.

Dated: February 19, 2010


     /s/ Jonathan W. Old, III  
 
Name:
Jonathan W. Old, III
 
       
       
       
     /s/ Michael J. Moss  
 
Name:
Michael J. Moss
 
       
       
       
       
 
LONG MEADOW HOLDINGS, L.P.
 
By:
Long Meadow Investors, LLC
 
   
General Partner of Long Meadow Holdings, L.P.
       
       
     /s/ Jonathan W. Old, III  
 
Name:
Jonathan W. Old, III
 
 
Title:
Managing Member of Long Meadow Investors, LLC
       
       
       
       
 
LONG MEADOW INVESTORS, LLC
 
By:
Jonathan W. Old, III
 
       
       
       
     /s/ Jonathan W. Old, III  
 
Name:
Jonathan W. Old, III
 
 
Title:
Managing Member
 



-----END PRIVACY-ENHANCED MESSAGE-----