0001104659-20-104070.txt : 20200910
0001104659-20-104070.hdr.sgml : 20200910
20200910192051
ACCESSION NUMBER: 0001104659-20-104070
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20200908
FILED AS OF DATE: 20200910
DATE AS OF CHANGE: 20200910
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Johnson Michelle Antoinette
CENTRAL INDEX KEY: 0001808996
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-38873
FILM NUMBER: 201169617
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
2020-09-08
0
0001761312
Palomar Holdings, Inc.
PLMR
0001808996
Johnson Michelle Antoinette
7979 IVANHOE AVENUE, SUITE 500
LA JOLLA
CA
92037
0
1
0
0
Senior VP, People & Talent
Employee Stock Options (right to buy)
98.95
2020-09-08
4
A
0
727
0
A
2030-09-08
Common Stock
727
727
D
Restricted Stock Units
0
2020-09-08
4
A
0
727
0
A
Common Stock
727
727
D
Subject to continuing service with the Company, the option shall vest as follows: twenty-five percent (25%) shall vest on the first year anniversary of the date of the grant and the remaining shall vest in equal monthly installments over the subsequent thirty-six (36) month period.
Each restricted stock unit represents a contingent right to receive one share of Palomar Holdings, Inc. Common Stock.
Subject to continuing service with the Company, the restricted stock units shall vest as follows: one-third (1/3) shall vest on the first year anniversary of the date of the grant; an additional one-third (1/3) shall vest on the second year anniversary of the date of the grant; and the final one-third (1/3) shall vest on the third year anniversary of the date of grant.
/s/ Christopher Uchida, Attorney-in-Fact
2020-09-10