0001209191-21-059012.txt : 20211004 0001209191-21-059012.hdr.sgml : 20211004 20211004163956 ACCESSION NUMBER: 0001209191-21-059012 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20210930 FILED AS OF DATE: 20211004 DATE AS OF CHANGE: 20211004 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: HURWITZ JASON B CENTRAL INDEX KEY: 0001099190 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-34809 FILM NUMBER: 211303424 MAIL ADDRESS: STREET 1: 3 BALA PLAZA EAST, SUITE 300 CITY: BALA CYNWYD STATE: PA ZIP: 19004 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: Global Indemnity Group, LLC CENTRAL INDEX KEY: 0001494904 STANDARD INDUSTRIAL CLASSIFICATION: FIRE, MARINE & CASUALTY INSURANCE [6331] IRS NUMBER: 981304287 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 3 BALA PLAZA EAST STREET 2: SUITE 300 CITY: BALA CYNWYD STATE: PA ZIP: 19004 BUSINESS PHONE: 610-664-1500 MAIL ADDRESS: STREET 1: 3 BALA PLAZA EAST STREET 2: SUITE 300 CITY: BALA CYNWYD STATE: PA ZIP: 19004 FORMER COMPANY: FORMER CONFORMED NAME: Global Indemnity Ltd DATE OF NAME CHANGE: 20161107 FORMER COMPANY: FORMER CONFORMED NAME: Global Indemnity plc DATE OF NAME CHANGE: 20100622 4 1 doc4.xml FORM 4 SUBMISSION X0306 4 2021-09-30 0 0001494904 Global Indemnity Group, LLC GBLI 0001099190 HURWITZ JASON B 3 BALA PLAZA EAST, SUITE 300 BALA CYNWYD PA 19004 1 0 0 0 Class A Common Shares 2021-09-30 4 A 0 2368 26.39 A 106375 D Class A Common Shares 4080 I See Footnote Represents a grant of vested Class A Common Shares ("A Common Shares") in recognition of services rendered as a board member of the Issuer and GBLI Holdings, LLC, an indirect, wholly owned subsidiary of the Issuer. Includes restricted share units covering 41,667 A Common Shares of the issuer that vest ratably over three years on January 1, 2022, January 1, 2023, and January 1, 2024, subject to Mr. Hurwitz remaining a director or employee of the issuer through the applicable vesting date. Upon vesting, the reporting person will receive A Common Shares of the issuer. Shares held by Hurwitz Capital LLC. The sole member of Hurwitz Capital LLC is Jason B. Hurwitz. /s/Stephen W. Ries, Attorney-in-fact 2021-10-04