0001214659-24-001482.txt : 20240130 0001214659-24-001482.hdr.sgml : 20240130 20240130192818 ACCESSION NUMBER: 0001214659-24-001482 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20240126 FILED AS OF DATE: 20240130 DATE AS OF CHANGE: 20240130 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Johnson Michelle Antoinette CENTRAL INDEX KEY: 0001808996 ORGANIZATION NAME: FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-38873 FILM NUMBER: 24580146 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] ORGANIZATION NAME: 02 Finance 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 marketforms-64511.xml PRIMARY DOCUMENT X0508 4 2024-01-26 0001761312 Palomar Holdings, Inc. PLMR 0001808996 Johnson Michelle Antoinette 7979 IVANHOE AVENUE, SUITE 500 LA JOLLA CA 92037 false true false false Chief People & Prod. Officer 0 Common Stock 2030 D Common Stock (RSUs) 2024-01-26 4 M false 656 0.00 A 2686 D Common Stock (RSUs) 2024-01-26 4 S false 273 60.1307 D 2413 D Common Stock (RSUs) 2024-01-26 4 M false 1313 0.00 A 3726 D Common Stock (RSUs) 2024-01-26 4 S false 531 60.1282 D 3195 D Common Stock (RSUs) 2024-01-27 4 M false 231 0.00 A 3426 D Common Stock (RSUs) 2024-01-27 4 S false 97 60.1292 D 3329 D Restricted Stock Units (RSUs) 0.00 2024-01-26 4 M false 656 0.00 D Common Stock 656 656 D Restricted Stock Units (RSUs) 0.00 2024-01-26 4 M false 1313 0.00 D Common Stock 1313 1312 D Restricted Stock Units (RSUs) 0.00 2024-01-27 4 M false 231 0.00 D Common Stock 231 0 D Represents shares automatically sold by the Company on behalf of the Reporting Person pursuant to a mandatory sell-to-cover provision in the RSU award agreement required to cover minimum statutory tax withholding obligations that became due upon the RSU vesting event. Includes 349 shares purchased pursuant to the Palomar Holdings, Inc. 2019 Employee Stock Purchase Plan (ESPP). The original RSU grant was for 1,968 shares on 1/26/2022. 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. The original RSU grant was for 3,937 shares on 1/26/2022. 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. The original RSU grant was for 692 shares on 1/27/2021. 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/ Angela Grant, Attorney-in-Fact 2024-01-30