0001104659-20-057624.txt : 20200506
0001104659-20-057624.hdr.sgml : 20200506
20200506211411
ACCESSION NUMBER: 0001104659-20-057624
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20200430
FILED AS OF DATE: 20200506
DATE AS OF CHANGE: 20200506
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Bold William
CENTRAL INDEX KEY: 0001811264
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-38873
FILM NUMBER: 20854266
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
2020-04-30
0
0001761312
Palomar Holdings, Inc.
PLMR
0001811264
Bold William
7979 IVANHOE AVENUE, SUITE 500
LA JOLLA
CA
92037
0
1
0
0
Chief Strategy Officer
Employee Stock Option (right to buy)
58.50
2020-04-30
4
A
0
20000
0
A
2030-04-30
Common Stock
20000
20000
D
Twenty-five percent (25%) of the option shares shall vest and become exercisable on April 30, 2021 and the remaining option shares shall thereafter vest and become exercisable in equal monthly installments over the subsequent thirty-six (36) month period.
/s/ William Bold
2020-05-06