0001140361-11-057561.txt : 20111215 0001140361-11-057561.hdr.sgml : 20111215 20111215100039 ACCESSION NUMBER: 0001140361-11-057561 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20111214 FILED AS OF DATE: 20111215 DATE AS OF CHANGE: 20111215 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: BIRDWELL CODY W CENTRAL INDEX KEY: 0001244782 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-14795 FILM NUMBER: 111262524 MAIL ADDRESS: STREET 1: 100 GALLERIA PARKWAY, SE STREET 2: SUITE 700 CITY: ATLANTA STATE: GA ZIP: 30339 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: AMERICAN SAFETY INSURANCE HOLDINGS LTD CENTRAL INDEX KEY: 0000783603 STANDARD INDUSTRIAL CLASSIFICATION: INSURANCE AGENTS BROKERS & SERVICES [6411] IRS NUMBER: 000000000 FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 31 QUEENS STREET STREET 2: 2ND FLOOR CITY: HAMILTON STATE: D0 ZIP: HM 11 BUSINESS PHONE: 441-296-8560 MAIL ADDRESS: STREET 1: 31 QUEENS STREET STREET 2: 2ND FLOOR CITY: HAMILTON STATE: D0 ZIP: HM 11 FORMER COMPANY: FORMER CONFORMED NAME: AMERICAN SAFETY INSURANCE GROUP LTD DATE OF NAME CHANGE: 19971218 4 1 doc1.xml FORM 4 X0304 4 2011-12-14 0 0000783603 AMERICAN SAFETY INSURANCE HOLDINGS LTD ASI 0001244782 BIRDWELL CODY W 31 QUEEN STREET 2ND FLOOR HAMILTON D0 HM II BERMUDA 1 0 0 0 Common Stock 2011-12-14 4 S 0 100 21.63 D 116539 D Common Stock 2011-12-14 4 S 0 120 21.62 D 116419 D Common Stock 2011-12-14 4 S 0 900 21.61 D 115519 D Common Stock 2011-12-14 4 S 0 3880 21.55 D 111639 D Common Stock 98250 I Shares owned by the Cody Birdwell Family Limited Partnership Cody W. Birdwell 2011-12-15