X0303 4 2010-11-16 0 0000783603 AMERICAN SAFETY INSURANCE HOLDINGS LTD ASI 0001486659 Cloutier Guy 44 CHURCH STREET P.O. BOX HM2064 HAMILTON D0 HM 11 BERMUDA 0 1 0 0 Chief Actuary Common Stock 2010-11-16 2010-11-16 4 A 0 5621 9.10 A 57850 D Stock Option (Right To Buy) 19.55 2012-03-17 2017-03-17 Common Stock 5000 5000 D Stock Option (Right To Buy) 17.95 2009-03-01 2018-03-01 Common Stock 2500 7500 D Stock Option (Right To Buy) 9.10 2010-03-09 2019-03-09 Common Stock 11241 18741 D Stock Option (Right To Buy) 14.34 2011-03-05 2020-03-05 Common Stock 10941 29682 D Exercised portion of opition granted on 3/9/2009. Options awarded pursuant to the Company's 2007 Incentive Stock Option Plan. These options have a three-year vesting schedule, pursuant to which the shares underlying the options shall cliff vest on the 5th anniversary of the date of grant. The date shown is the date the first vested number of shares becomes/became exercisable. Options awarded pursuant to the Company's 2007 Incentive Stock Option Plan. These options have a three-year vesting schedule, pursuant to which the shares underlying the options shall vest in one-third increments commencing one year after the date of grant. The date shown is the date the first vested number of shares becomes/became exercisable. Options awarded pursuant to the Company's 2007 Incentive Stock Option Plan. These options have a three-year vesting schedule, pursuant to which the shares underlying the options shall vest in one-third increments commencing one year after the date of grant. The date shown is the date the first vested number of shares becomes/became exercisable. 5,621 options were exercised on 11/16/2010 of 16,862 originally issued. Guy Cloutier 2010-11-16