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