0001104659-20-022047.txt : 20200214 0001104659-20-022047.hdr.sgml : 20200214 20200214172022 ACCESSION NUMBER: 0001104659-20-022047 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20200212 FILED AS OF DATE: 20200214 DATE AS OF CHANGE: 20200214 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Notaras Martha CENTRAL INDEX KEY: 0001803071 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-38873 FILM NUMBER: 20621997 MAIL ADDRESS: STREET 1: 7979 IVANHOE AVENUE, SUITE 500 CITY: LA JOLLA STATE: CA ZIP: 92037 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: Palomar Holdings, Inc. CENTRAL INDEX KEY: 0001761312 STANDARD INDUSTRIAL CLASSIFICATION: FIRE, MARINE & CASUALTY INSURANCE [6331] IRS NUMBER: 000000000 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 7979 IVANHOE AVENUE STREET 2: SUITE 500 CITY: LA JOLLA STATE: CA ZIP: 92037 BUSINESS PHONE: 619-567-5290 MAIL ADDRESS: STREET 1: 7979 IVANHOE AVENUE STREET 2: SUITE 500 CITY: LA JOLLA STATE: CA ZIP: 92037 FORMER COMPANY: FORMER CONFORMED NAME: GC Palomar Holdings DATE OF NAME CHANGE: 20181211 4 1 a4.xml 4 X0306 4 2020-02-12 0 0001761312 Palomar Holdings, Inc. PLMR 0001803071 Notaras Martha 7979 IVANHOE AVENUE, SUITE 500 LA JOLLA CA 92037 1 0 0 0 Common Stock (RSUs) 2020-02-12 4 A 0 125 0 A 125 D Stock Option (right to buy) 58.06 2020-02-12 4 A 0 1722 0 A 2030-02-12 Common Stock 1722 1722 D The Restricted Stock Units (RSUs) will vest in full on the first anniversary of the grant date. Fifty percent (50%) of the option shares vest and become exercisable on February 12, 2021 and the remaining option shares vest and become exercisable in twelve (12) equal successive monthly installments thereafter. /s/ Martha Notaras 2020-02-14