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