0001209191-18-015709.txt : 20180302
0001209191-18-015709.hdr.sgml : 20180302
20180302164457
ACCESSION NUMBER: 0001209191-18-015709
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20180302
FILED AS OF DATE: 20180302
DATE AS OF CHANGE: 20180302
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Frost G. Janelle
CENTRAL INDEX KEY: 0001449515
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-12251
FILM NUMBER: 18662721
MAIL ADDRESS:
STREET 1: 2301 HIGHWAY 190 WEST
CITY: DERIDDER
STATE: LA
ZIP: 70634
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: AMERISAFE INC
CENTRAL INDEX KEY: 0001018979
STANDARD INDUSTRIAL CLASSIFICATION: FIRE, MARINE & CASUALTY INSURANCE [6331]
IRS NUMBER: 752069407
STATE OF INCORPORATION: TX
FISCAL YEAR END: 1231
BUSINESS ADDRESS:
STREET 1: 2301 HIGHWAY 190 WEST
CITY: DERIDDER
STATE: LA
ZIP: 70634
BUSINESS PHONE: 337-463-9052
MAIL ADDRESS:
STREET 1: 2301 HIGHWAY 190 WEST
CITY: DERIDDER
STATE: LA
ZIP: 70634
4
1
doc4.xml
FORM 4 SUBMISSION
X0306
4
2018-03-02
0
0001018979
AMERISAFE INC
AMSF
0001449515
Frost G. Janelle
2301 HIGHWAY 190 WEST
DERIDDER
LA
70634
1
1
0
0
President & CEO
Common stock, par value $0.01
2018-03-02
4
A
0
15000
0.00
A
69322
D
Common stock, par value $0.01
2018-03-02
4
S
0
7500
55.53
D
61822
D
Employee Stock Option (right to purchase)
4.46
2018-03-02
4
M
0
15000
0.00
D
2013-11-10
2018-11-10
Common Stock
15000
0
D
Represents the weighted average selling price of the Issuer's common stock. The range of sales prices were between $55.50 and $56.05. The Reporting Person undertakes, upon request, to provide the SEC, the Issuer and any security holder of the Issuer, full information regarding the number of shares sold at each separate price.
/s/G. Janelle Frost
2018-03-02