SEC Form 3
FORM 3 UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549

INITIAL STATEMENT OF BENEFICIAL OWNERSHIP OF SECURITIES

Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934
or Section 30(h) of the Investment Company Act of 1940
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1. Name and Address of Reporting Person*
KINGSWAY FINANCIAL SERVICES INC

(Last) (First) (Middle)
150 PIERCE RD
SUITE 600

(Street)
ITASCA IL 60143

(City) (State) (Zip)
2. Date of Event Requiring Statement (Month/Day/Year)
11/19/2019
3. Issuer Name and Ticker or Trading Symbol
Limbach Holdings, Inc. [ LMB ]
4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
Director X 10% Owner
Officer (give title below) Other (specify below)
5. If Amendment, Date of Original Filed (Month/Day/Year)
6. Individual or Joint/Group Filing (Check Applicable Line)
X Form filed by One Reporting Person
Form filed by More than One Reporting Person
Table I - Non-Derivative Securities Beneficially Owned
1. Title of Security (Instr. 4) 2. Amount of Securities Beneficially Owned (Instr. 4) 3. Ownership Form: Direct (D) or Indirect (I) (Instr. 5) 4. Nature of Indirect Beneficial Ownership (Instr. 5)
Common Stock, $0.0001 par value 594,750 I By wholly-owned subsidiary(1)
Table II - Derivative Securities Beneficially Owned
(e.g., puts, calls, warrants, options, convertible securities)
1. Title of Derivative Security (Instr. 4) 2. Date Exercisable and Expiration Date (Month/Day/Year) 3. Title and Amount of Securities Underlying Derivative Security (Instr. 4) 4. Conversion or Exercise Price of Derivative Security 5. Ownership Form: Direct (D) or Indirect (I) (Instr. 5) 6. Nature of Indirect Beneficial Ownership (Instr. 5)
Date Exercisable Expiration Date Title Amount or Number of Shares
$15 Exercise Price Sponsor Warrant 08/19/2016 07/20/2023 Common Stock, $0.0001 par value(2) 400,000 $15 I By wholly-owned subsidiary(1)
Explanation of Responses:
1. Held by the reporting person's wholly-owned subsidiary, Kingsway America Inc.
2. Each $15 Exercise Price Sponsor Warrant is exercisable to purchase one share of common stock at an exercise price of $15.00 per share, subject to adjustment as described under the heading "Description of Securities--$15 Exercise Price Sponsor Warrants" in the Issuer's registration statement on Form S-1 (File No. 333-195695).
/s/ John T. Fitzgerald, President and CEO 11/26/2019
** Signature of Reporting Person Date
Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly.
* If the form is filed by more than one reporting person, see Instruction 5 (b)(v).
** Intentional misstatements or omissions of facts constitute Federal Criminal Violations See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a).
Note: File three copies of this Form, one of which must be manually signed. If space is insufficient, see Instruction 6 for procedure.
Persons who respond to the collection of information contained in this form are not required to respond unless the form displays a currently valid OMB Number.