0001502292-15-000003.txt : 20150713 0001502292-15-000003.hdr.sgml : 20150713 20150713170946 ACCESSION NUMBER: 0001502292-15-000003 CONFORMED SUBMISSION TYPE: D PUBLIC DOCUMENT COUNT: 1 ITEM INFORMATION: 06b FILED AS OF DATE: 20150713 DATE AS OF CHANGE: 20150713 EFFECTIVENESS DATE: 20150713 FILER: COMPANY DATA: COMPANY CONFORMED NAME: Conifer Holdings, Inc. CENTRAL INDEX KEY: 0001502292 STANDARD INDUSTRIAL CLASSIFICATION: FIRE, MARINE & CASUALTY INSURANCE [6331] IRS NUMBER: 271298795 STATE OF INCORPORATION: MI FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: D SEC ACT: 1933 Act SEC FILE NUMBER: 021-243604 FILM NUMBER: 15985968 BUSINESS ADDRESS: STREET 1: 550 WEST MERRILL STREET STREET 2: SUITE 200 CITY: BIRMINGHAM STATE: MI ZIP: 48009 BUSINESS PHONE: (248) 559-0840 MAIL ADDRESS: STREET 1: 550 WEST MERRILL STREET STREET 2: SUITE 200 CITY: BIRMINGHAM STATE: MI ZIP: 48009 D 1 primary_doc.xml X0707 D LIVE 0001502292 Conifer Holdings, Inc. 550 WEST MERRILL STREET SUITE 200 BIRMINGHAM MI MICHIGAN 48009 (248) 559-0840 MICHIGAN None None Corporation true James G. Petcoff 550 W. Merrill Street Suite 200 Birmingham MI MICHIGAN 48009 Executive Officer Director Brian J. Roney 550 W. Merrill Street Suite 200 Birmingham MI MICHIGAN 48009 Executive Officer Nicholas J. Petcoff 550 W. Merrill Street Suite 200 Birmingham MI MICHIGAN 48009 Executive Officer Director Andrew Petcoff 550 W. Merrill Street Suite 200 Birmingham MI MICHIGAN 48009 Executive Officer Harold Meloche 550 W. Merrill Street Suite 200 Birmingham MI MICHIGAN 48009 Executive Officer Mark McCammon 550 W. Merrill Street Suite 200 Birmingham MI MICHIGAN 48009 Director Jorge Morales 550 W. Merrill Street Suite 200 Birmingham MI MICHIGAN 48009 Director Joseph Sarafa 550 W. Merrill Street Suite 200 Birmingham MI MICHIGAN 48009 Director Richard Jamison Williams, Jr. 550 W. Merrill Street Suite 200 Birmingham MI MICHIGAN 48009 Director Insurance Decline to Disclose 06b false 2015-07-01 false true false 0 6060000 2955000 3105000 Total offering amount represents amount outstanding of preferred stock. Company offered to repurchase this amount in cash or stock at holders' option. Holders of $2,955,000 irrevocably committed to purchase shares; remaining will be repurchased in cash. false 21 0 0 0 false Conifer Holdings, Inc. Brian Roney Brian Roney President 2015-07-13