Sec Form 13G Filing - Genstar VI GP AIV Ltd. filing for Palomar Holdings Inc. (PLMR) - 2020-02-11

Insider filing report for Changes in Beneficial Ownership

  • Schedule 13G & 13D forms are used to report a party's ownership of stock which exceeds 5% of a company's total stock issue.
  • Schedule 13G is a shorter version of Schedule 13D with fewer reporting requirements.
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SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549

SCHEDULE 13G
(Rule 13d-102)

INFORMATION TO BE INCLUDED IN STATEMENTS FILED
PURSUANT TO RULES 13d-1 (b), (c) AND (d)
AND AMENDMENTS THERETO FILED PURSUANT TO 13d-2 (b)
(Amendment No.     )*

PALOMAR HOLDINGS, INC.
(Name of Issuer)

Common Stock, par value $0.0001 per share
(Title of Class of Securities)

69753M105
(CUSIP Number)

December 31, 2019
(Date of Event Which Requires Filing of this Statement)

Check the appropriate box to designate the rule pursuant to which this Schedule is filed:

☐
Rule 13d-1(b)
☐
Rule 13d-1(c)
☒
Rule 13d-1(d)


*The remainder of this cover page shall be filled out for a reporting person’s initial filing on this form with respect to the subject class of securities, and for any subsequent amendment containing information which would alter the disclosures provided in a prior cover page.

The information required in the remainder of this cover page shall not be deemed to be “filed” for the purpose of Section 18 of the Securities Exchange Act of 1934 (“Act”) or otherwise subject to the liabilities of that section of the Act but shall be subject to all other provisions of the Act (however, see the Notes).

(Continued on following pages)
Page of 1 of 16
Exhibit Index on Page 16

CUSIP # 69753M105
  
Page 2 of 16

1
NAMES OF REPORTING PERSONS
 
 
Genstar VI GP AIV Ltd.
 
 
 
 
2
CHECK THE APPROPRIATE BOX IF A MEMBER OF A GROUP
    
(a)☐
    
(b)☒
 
 
3
SEC USE ONLY
 
 
 
 
 
 
 
4
CITIZENSHIP OR PLACE OF ORGANIZATION
 
 
Cayman Islands
 
 
 
 
NUMBER OF SHARES BENEFICIALLY OWNED BY EACH REPORTING PERSON WITH
5
SOLE VOTING POWER
 
 
0
 
 
 
 
6
SHARED VOTING POWER
 
 
1,063,139(*)
 
 
 
 
7
SOLE DISPOSITIVE POWER
 
 
0
 
 
 
 
8
SHARED DISPOSITIVE POWER
 
 
1,063,139(*)
 
 
 
 
9
AGGREGATE AMOUNT BENEFICIALLY OWNED BY EACH REPORTING PERSON
 
 
1,063,139(*)
 
 
 
 
10
CHECK IF THE AGGREGATE AMOUNT IN ROW (9) EXCLUDES CERTAIN SHARES (SEE INSTRUCTIONS)
 
 
☐
 
 
 
 
11
PERCENT OF CLASS REPRESENTED BY AMOUNT IN ROW (9)
 
 
4.4%
 
 
 
 
12
TYPE OF REPORTING PERSON (SEE INSTRUCTIONS)
 
 
OO
 
 
 
 

(*) As of February 11, 2020.

CUSIP # 69753M105
  
Page 3 of 16

1
NAMES OF REPORTING PERSONS
 
 
Genstar Capital VI AIV, L.P.
 
 
 
 
2
CHECK THE APPROPRIATE BOX IF A MEMBER OF A GROUP
    
(a)☐
    
(b)☒
 
 
3
SEC USE ONLY
 
 
 
 
 
 
 
4
CITIZENSHIP OR PLACE OF ORGANIZATION
 
 
Cayman Islands
 
 
 
 
NUMBER OF SHARES BENEFICIALLY OWNED BY EACH REPORTING PERSON WITH
5
SOLE VOTING POWER
 
 
0
 
 
 
 
6
SHARED VOTING POWER
 
 
1,063,139(*)
 
 
 
 
7
SOLE DISPOSITIVE POWER
 
 
0
 
 
 
 
8
SHARED DISPOSITIVE POWER
 
 
1,063,139(*)
 
 
 
 
9
AGGREGATE AMOUNT BENEFICIALLY OWNED BY EACH REPORTING PERSON
 
 
1,063,139(*)
 
 
 
 
10
CHECK IF THE AGGREGATE AMOUNT IN ROW (9) EXCLUDES CERTAIN SHARES (SEE INSTRUCTIONS)
 
 
☐
 
 
 
 
11
PERCENT OF CLASS REPRESENTED BY AMOUNT IN ROW (9)
 
 
4.4%
 
 
 
 
12
TYPE OF REPORTING PERSON (SEE INSTRUCTIONS)
 
 
PN
 
 
 
 

(*) As of February 11, 2020.

CUSIP # 69753M105
  
Page 4 of 16

1
NAMES OF REPORTING PERSONS
 
 
Genstar Capital Partners VI AIV, L.P.
 
 
 
 
2
CHECK THE APPROPRIATE BOX IF A MEMBER OF A GROUP
    
(a)☐
    
(b)☒
 
 
3
SEC USE ONLY
 
 
 
 
 
 
 
4
CITIZENSHIP OR PLACE OF ORGANIZATION
 
 
Cayman Islands
 
 
 
 
NUMBER OF SHARES BENEFICIALLY OWNED BY EACH REPORTING PERSON WITH
5
SOLE VOTING POWER
 
 
0
  ;
 
 
 
6
SHARED VOTING POWER
 
 
984,934(*)
 
 
 
 
7
SOLE DISPOSITIVE POWER
 
 
0
 
 
 
 
8
SHARED DISPOSITIVE POWER
 
 
984,934(*)
 
 
 
 
9
AGGREGATE AMOUNT BENEFICIALLY OWNED BY EACH REPORTING PERSON
 
 
984,934(*)
 
 
 
 
10
CHECK IF THE AGGREGATE AMOUNT IN ROW (9) EXCLUDES CERTAIN SHARES (SEE INSTRUCTIONS)
 
 
☐
 
 
 
 
11
PERCENT OF CLASS REPRESENTED BY AMOUNT IN ROW (9)
 
 
4.1%
 
 
 
 
12
TYPE OF REPORTING PERSON (SEE INSTRUCTIONS)
 
 
PN
 
 
 
 

(*) As of February 11, 2020.

CUSIP # 69753M105
  
Page 5 of 16

1
NAMES OF REPORTING PERSONS
 
 
Genstar Capital Partners VI AIV (DEL), L.P.
 
 
 
 
2
CHECK THE APPROPRIATE BOX IF A MEMBER OF A GROUP
    
(a)☐
    
(b)☒
 
 
3
SEC USE ONLY
 
 
 
 
 
 
 
4
CITIZENSHIP OR PLACE OF ORGANIZATION
 
 
Delaware
 
 
 
 
NUMBER OF SHARES BENEFICIALLY OWNED BY EACH REPORTING PERSON WITH
5
SOLE VOTING POWER
 
 
0
 
 
 
 
6
SHARED VOTING POWER
 
 
40,723(*)
 
 
 
 
7
SOLE DISPOSITIVE POWER
 
 
0
 
 
 
 
8
SHARED DISPOSITIVE POWER
 
 
40,723(*)
 
 
 
 
9
AGGREGATE AMOUNT BENEFICIALLY OWNED BY EACH REPORTING PERSON
 
 
40,723(*)
 
 
 
 
10
CHECK IF THE AGGREGATE AMOUNT IN ROW (9) EXCLUDES CERTAIN SHARES (SEE INSTRUCTIONS)
 
 
☐
 
 
 
 
11
PERCENT OF CLASS REPRESENTED BY AMOUNT IN ROW (9)
 
 
0.2%
 
 
 
 
12
TYPE OF REPORTING PERSON (SEE INSTRUCTIONS)
 
 
PN
 
 
 
 

(*) As of February 11, 2020.

CUSIP # 69753M105
  
Page 6 of 16

1
NAMES OF REPORTING PERSONS
 
 
Stargen VI AIV, L.P.
 
 
 
 
2
CHECK THE APPROPRIATE BOX IF A MEMBER OF A GROUP
    
(a)☐
    
(b)☒
 
 
3
SEC USE ONLY
 
 
 
 
 
 
 
4
CITIZENSHIP OR PLACE OF ORGANIZATION
 
 
Cayman Islands
 
 
 
 
NUMBER OF SHARES BENEFICIALLY OWNED BY EACH REPORTING PERSON WITH
5
SOLE VOTING POWER
 
 
0
 
 
 
 
6
SHARED VOTING POWER
 
 
37,482(*)
 
 
 
 
7
SOLE DISPOSITIVE POWER
 
 
0
 
 
 
 
8
SHARED DISPOSITIVE POWER
 
 
37,482(*)
 
 
 
 
9
AGGREGATE AMOUNT BENEFICIALLY OWNED BY EACH REPORTING PERSON
 
 
37,482(*)
 
 
 
 
10
CHECK IF THE AGGREGATE AMOUNT IN ROW (9) EXCLUDES CERTAIN SHARES (SEE INSTRUCTIONS)
 
 
☐
 
 
 
 
11
PERCENT OF CLASS REPRESENTED BY AMOUNT IN ROW (9)
 
 
0.2%
 
 
 
 
12
TYPE OF REPORTING PERSON (SEE INSTRUCTIONS)
 
 
PN
 
 
 
 

(*) As of February 11, 2020.

CUSIP # 69753M105
  
Page 7 of 16

1
NAMES OF REPORTING PERSONS
 
 
Genstar V GP AIV Ltd.
 
 
 
 
2
CHECK THE APPROPRIATE BOX IF A MEMBER OF A GROUP
    
(a)☐
    
(b)☒
 
 
3
SEC USE ONLY
 
 
 
 
 
 
 
4
CITIZENSHIP OR PLACE OF ORGANIZATION
 
 
Cayman Islands
 
 
 
 
NUMBER OF SHARES BENEFICIALLY OWNED BY EACH REPORTING PERSON WITH
5
SOLE VOTING POWER
 
 
0
 
 
 
 
6
SHARED VOTING POWER
 
 
2,480,658(*)
 
 
 
 
7
SOLE DISPOSITIVE POWER
 
 
0
 
 
 
 
8
SHARED DISPOSITIVE POWER
 
 
2,480,658(*)
 
 
 
 
9
AGGREGATE AMOUNT BENEFICIALLY OWNED BY EACH REPORTING PERSON
 
 
2,480,658(*)
 
 
 
 
10
CHECK IF THE AGGREGATE AMOUNT IN ROW (9) EXCLUDES CERTAIN SHARES (SEE INSTRUCTIONS)
 
 
☐
 
 
&#x A0;
 
11
PERCENT OF CLASS REPRESENTED BY AMOUNT IN ROW (9)
 
 
10.2%
 
 
 
 
12
TYPE OF REPORTING PERSON (SEE INSTRUCTIONS)
 
 
OO
 
 
 
 

(*) As of February 11, 2020.

CUSIP # 69753M105
  
Page 8 of 16

1
NAMES OF REPORTING PERSONS
 
 
Genstar Capital V AIV, L.P.
 
 
 
 
2
CHECK THE APPROPRIATE BOX IF A MEMBER OF A GROUP
    
(a)☐
    
(b)☒
 
 
3
SEC USE ONLY
 
 
 
 
 
 
 
4
CITIZENSHIP OR PLACE OF ORGANIZATION
 
 
Cayman Islands
 
 
 
 
NUMBER OF SHARES BENEFICIALLY OWNED BY EACH REPORTING PERSON WITH
5
SOLE VOTING POWER
 
 
0
 
 
 
 
6
SHARED VOTING POWER
 
 
2,480,658(*)
 
 
 
 
7
SOLE DISPOSITIVE POWER
 
 
0
 
 
 
 
8
SHARED DISPOSITIVE POWER
 
 
2,480,658(*)
 
 
 
 
9
AGGREGATE AMOUNT BENEFICIALLY OWNED BY EACH REPORTING PERSON
 
 
2,480,658(*)
 
 
 
 
10
CHECK IF THE AGGREGATE AMOUNT IN ROW (9) EXCLUDES CERTAIN SHARES (SEE INSTRUCTIONS)
 
 
☐
 
 
 
 
11
PERCENT OF CLASS REPRESENTED BY AMOUNT IN ROW (9)
 
 
10.2%
 
 
 
 
12
TYPE OF REPORTING PERSON (SEE INSTRUCTIONS)
 
 
PN
 
 
 
 

(*) As of February 11, 2020.

CUSIP # 69753M105
  
Page 9 of 16

1
NAMES OF REPORTING PERSONS
 
 
Genstar Capital Partners V AIV, L.P.
 
 
 
 
2
CHECK THE APPROPRIATE BOX IF A MEMBER OF A GROUP
    
(a)☐
    
(b)☒
 
 
3
SEC USE ONLY
 
 
 
 
 
 
 
4
CITIZENSHIP OR PLACE OF ORGANIZATION
 
 
Cayman Islands
 
 
 
 
NUMBER OF SHARES BENEFICIALLY OWNED BY EACH REPORTING PERSON WITH
5
SOLE VOTING POWER
 
 
0
 
 
 
 
6
SHARED VOTING POWER
 
 
2,408,405(*)
 
 
 
 
7
SOLE DISPOSITIVE POWER
 
 
0
 
 
 
 
8
SHARED DISPOSITIVE POWER
 
 
2,408,405(*)
 
 
 
 
9
AGGREGATE AMOUNT BENEFICIALLY OWNED BY EACH REPORTING PERSON
 
 
2,408,405(*)
 
 
 
 
10
CHECK IF THE AGGREGATE AMOUNT IN ROW (9) EXCLUDES CERTAIN SHARES (SEE INSTRUCTIONS)
 
 
☐
 
 
 
 
11
PERCENT OF CLASS REPRESENTED BY AMOUNT IN ROW (9)
 
 
9.9%
 
 
 
 
12
TYPE OF REPORTING PERSON (SEE INSTRUCTIONS)
 
 
PN
 
 
 
 

(*) As of February 11, 2020.

CUSIP # 69753M105
  
Page 10 of 16

1
NAMES OF REPORTING PERSONS
 
 
Stargen V AIV, L.P.
 
 
 
 
2
CHECK THE APPROPRIATE BOX IF A MEMBER OF A GROUP
    
(a)☐
    
(b)☒
 
 
3
SEC USE ONLY
 
 
 
 
 
 
 
4
CITIZENSHIP OR PLACE OF ORGANIZATION
 
 
Cayman Islands
 
 
 
 
NUMBER OF SHARES BENEFICIALLY OWNED BY EACH REPORTING PERSON WITH
5
SOLE VOTING POWER
 
 
0
 
 
 
 
6
SHARED VOTING POWER
 
 
72,253(*)
 
 
 
 
7
SOLE DISPOSITIVE POWER
 
 
0
 
 
 
 
8
SHARED DISPOSITIVE POWER
 
 
72,253(*)
 
 
 
 
9
AGGREGATE AMOUNT BENEFICIALLY OWNED BY EACH REPORTING PERSON
 
 
72,253(*)
 
 
 
 
10
CHECK IF THE AGGREGATE AMOUNT IN ROW (9) EXCLUDES CERTAIN SHARES (SEE INSTRUCTIONS)
 
 
☐
 
 
 
 
11
PERCENT OF CLASS REPRESENTED BY AMOUNT IN ROW (9)
 
 
0.3%
 
 
 
 
12
TYPE OF REPORTING PERSON (SEE INSTRUCTIONS)
 
 
PN
 
 
 
 

(*) As of February 11, 2020.

CUSIP # 69753M105
  
Page 11 of 16

Item 1(a).
Name of Issuer:

Palomar Holdings, Inc. (the “Issuer”)

Item 1(b).
Address of Issuer’s Principal Executive Offices:

7979 Ivanhoe Avenue, Suite 500
La Jolla, California 92037

Item 2(a).
Name of Persons Filing:

Genstar VI GP AIV Ltd.
Genstar Capital VI AIV, L.P.
Genstar Capital Partners VI AIV, L.P.
Genstar Capital Partners VI AIV (DEL), L.P.
Stargen VI AIV, L.P.
Genstar V GP AIV Ltd.
Genstar Capital V AIV, L.P.
Genstar Capital Partners V AIV, L.P.
Stargen V AIV, L.P.

Item 2(b).
Address of Principal Business Office:

c/o Genstar Capital LLC
Four Embarcadero Center, Suite 1900
San Francisco, California 94111

Item 2(c).
Citizenship:

Genstar VI GP AIV Ltd. and Genstar V GP AIV Ltd. are Cayman Islands exempted companies. Genstar Capital VI AIV, L.P., Genstar Capital Partners VI AIV, L.P., Stargen VI AIV, L.P., Genstar Capital V AIV, L.P., Genstar Capital Partners V AIV, L.P. and Stargen V AIV, L.P. are Cayman Islands exempted limited partnerships. Genstar Capital Partners VI AIV (DEL), L.P. is a Delaware limited partnership.

Item 2(d).
Title of Class of Securities:

Common stock, par value $0.0001 per share (“Common Stock”)

Item 2(e).
CUSIP Number:

69753M105

Item 3.

Not applicable.

CUSIP # 69753M105
  
Page 12 of 16

Item 4.
Ownership

Ownership (a-c)

The information regarding ownership as set forth in Items 5-11 of pages 2-10 hereto is hereby incorporated by reference, which sets forth the information with respect to beneficial ownership of Common Stock of the Issuer by the persons filing this Statement as of February 11, 2020 and is based on 24,218,750 shares of Common Stock outstanding after giving effect to the offering of Common Stock described in the Issuer’s prospectus, dated January 9, 2020, and filed with the Securities and Exchange Commission on January 10, 2020 pursuant to Rule 424(b)(4) of the Securities Act of 1933, as amended.

The following information with respect to beneficial ownership of the Common Stock of the Issuer by the persons filing this Statement is provided as of December 31, 2019:

   
   
   
(c) Number of shares as to which person
has:
  
Name of Reporting Person
  
(a) Amount
beneficially
owned
   
(b)
Percent
of class*
    
Sole power to vote
or to direct the vote,
and sole power to
dispose or to direct
the disposition of
   
Shared power to
vote or to direct the
vote, and shared
power to dispose or
to direct the
disposition of
 
Genstar VI GP AIV Ltd.
    
2,558,039
      
10.9
%
    
—
      
2,558,039
  
Genstar Capital VI AIV, L.P.
    
2,558,039
      
10.9
%
    
—
      
2,558,039
  
Genstar Capital Partners VI AIV, L.P.
    
2,369,869
      
10.1
%
    
—
      
2,369,869
  
Genstar Capital Partners VI AIV (DEL), L.P.
    
97,983
      
0.4
%
    
—
      
97,983
  
Stargen VI AIV, L.P.
    
90,187
      
0.4
%
    
—
      
90,187
  
Genstar V GP AIV Ltd.
    
5,968,758
      
25.4
%
    
—
      
5,968,758
  
Genstar Capital V AIV, L.P.
    
5,968,758
      
25.4
%
    
—
      
5,968,758
  
Genstar Capital Partners V AIV, L.P.
    
5,794,910
      
24.7
%
    
—
      
5,794,910
  
Stargen V AIV, L.P.
    
173,848
      
0.7
%
    
—
      
173,848
  

*
All percentages in this table are based on 23,468,750 shares of Common Stock outstanding on November 4, 2019, as reported in the Quarterly Report on Form 10-Q for the quarterly period ended September 30, 2019 filed by the Issuer with the Securities and Exchange Commission on November 5, 2019.

Genstar VI GP AIV Ltd. is the general partner of Genstar Capital VI AIV, L.P., which in turn is the general partner of each of Genstar Capital Partners VI AIV, L.P., Genstar Capital Partners VI AIV (DEL), L.P. and Stargen VI AIV, L.P.  Each of Genstar VI GP AIV Ltd. and Genstar Capital VI AIV, L.P. disclaims beneficial ownership of the shares of Common Stock directly held by Genstar Capital Partners VI AIV, L.P., Genstar Capital Partners VI AIV (DEL), L.P. and Stargen VI AIV, L.P.

Genstar V GP AIV Ltd. is the general partner of Genstar Capital V AIV, L.P., which in turn is the general partner of each of Genstar Capital Partners V AIV, L.P. and Stargen V AIV, L.P.  Each of Genstar V GP AIV Ltd. and Genstar Capital V AIV, L.P. disclaims beneficial ownership of the shares of Common Stock directly held by Genstar Capital Partners V AIV, L.P. and Stargen V AIV, L.P.

CUSIP # 69753M105
  
Page 13 of 16

Item 5.
Ownership of Five Percent or Less of a Class

Not applicable.

Item 6.
Ownership of More than Five Percent on Behalf of Another Person

Not Applicable.

Item 7.
Identification and Classification of the Subsidiary Which Acquired the Security Being Reported on by the Parent Holding Company or Control Person

Not Applicable.

Item 8.
Identification and Classification of Members of the Group

See Item 4 above.

Item 9.
Notice of Dissolution of Group

Not Applicable.

Item 10.
Certifications

Not Applicable.

CUSIP # 69753M105
  
Page 14 of 16

SIGNATURES

After reasonable inquiry and to the best of my knowledge and belief, I certify that the information set forth in this statement is true, complete and correct.

Date: February 11, 2020

 
GENSTAR VI GP AIV LTD., a Cayman Islands
exempted company
     
 
By:
/s/ J. Ryan Clark
 
Name:
J. Ryan Clark
 
Title:
Director

 
GENSTAR CAPITAL VI AIV, L.P., a Cayman Islands
exempted limited partnership
   
 
By:
Genstar VI GP AIV Ltd., its General Partner
     
 
By:
/s/ J. Ryan Clark
 
Name:
J. Ryan Clark
 
Title:
Director

 
GENSTAR CAPITAL PARTNERS VI AIV, L.P., a
Cayman Islands exempted limited partnership
   
 
By:
Genstar Capital VI AIV, L.P., its General Partner
   
 
By:
Genstar VI GP AIV Ltd., its General Partner
     
 
By:
/s/ J. Ryan Clark
 
Name:
J. Ryan Clark
 
Title:
Director

 
GENSTAR CAPITAL PARTNERS VI AIV (DEL), L.P.,
a Delaware limited partnership
   
 
By:
Genstar Capital VI AIV, L.P., its General Partner
   
 
By:
Genstar VI GP AIV Ltd., its General Partner
     
 
By:
/s/ J. Ryan Clark
 
Name:
J. Ryan Clark
 
Title:
Director

CUSIP # 69753M105
  
Page 15 of 16

 
STARGEN VI AIV, L.P., a Cayman Islands exempted
limited partnership
   
 
By:
Genstar Capital VI AIV, L.P., its General Partner
   
 
By:
Genstar VI GP AIV Ltd., its General Partner
     
 
By:
/s/ J. Ryan Clark
 
Name:
J. Ryan Clark
 
Title:
Director

 
GENSTAR V GP AIV LTD., a Cayman Islands
exempted company
     
 
By:
/s/ J. Ryan Clark
 
Name:
J. Ryan Clark
 
Title:
Director

 
GENSTAR CAPITAL V AIV, L.P., a Cayman Islands
exempted limited partnership
   
 
By:
Genstar V GP AIV Ltd., its General Partner
     
 
By:
/s/ J. Ryan Clark
 
Name:
J. Ryan Clark
 
Title:
Director

 
GENSTAR CAPITAL PARTNERS V AIV, L.P., a
Cayman Islands exempted limited partnership
   
 
By:
Genstar Capital V AIV, L.P., its General Partner
   
 
By:
Genstar V GP AIV Ltd., its General Partner
     
 
By:
/s/ J. Ryan Clark
 
Name:
J. Ryan Clark
 
Title:
Director

 
STARGEN V AIV, L.P., a Cayman Islands exempted
limited partnership
   
 
By:
Genstar Capital V AIV, L.P., its General Partner
   
 
By:
Genstar V GP AIV Ltd., its General Partner
     
 
By:
/s/ J. Ryan Clark
 
Name:
J. Ryan Clark
 
Title:
Director

CUSIP # 69753M105
  
Page 16 of 16

EXHIBIT

Exhibit
  
Agreement of Joint Filing dated February 11, 2020.