0001502292-17-000033.txt : 20171011 0001502292-17-000033.hdr.sgml : 20171011 20171011135130 ACCESSION NUMBER: 0001502292-17-000033 CONFORMED SUBMISSION TYPE: D PUBLIC DOCUMENT COUNT: 1 ITEM INFORMATION: 06b FILED AS OF DATE: 20171011 DATE AS OF CHANGE: 20171011 EFFECTIVENESS DATE: 20171011 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: 021-296394 FILM NUMBER: 171132320 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 X0708 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 West Merrill Suite 200 Birmingham MI MICHIGAN 48009 Executive Officer Director Brian J. Roney 550 West Merrill Suite 200 Birmingham MI MICHIGAN 48009 Executive Officer Nicholas J. Petcoff 550 West Merrill Suite 200 Birmingham MI MICHIGAN 48009 Executive Officer Director Andrew D. Petcoff 550 West Merrill Suite 200 Birmingham MI MICHIGAN 48009 Executive Officer Harold J. Meloche 550 West Merrill Suite 200 Birmingham MI MICHIGAN 48009 Executive Officer Mark McCammon 550 West Merrill Suite 200 Birmingham MI MICHIGAN 48009 Director Jorge Morales 550 West Merrill Suite 200 Birmingham MI MICHIGAN 48009 Director Joseph Sarafa 550 West Merrill Suite 200 Birmingham MI MICHIGAN 48009 Director Richard Jamison Williams, Jr. 550 West Merrill Suite 200 Birmingham MI MICHIGAN 48009 Director Isolde O'Hanlon 550 West Merill Suite 200 Birmingham MI MICHIGAN 48009 Director Insurance Decline to Disclose 06b false 2017-09-27 false true false 0 - None None None - - XX Unknown - MI MICHIGAN false 7000000 5000000 2000000 false 8 0 0 0 false Conifer Holdings, Inc. Brian Roney Brian Roney President 2017-10-11