Initial Statement of Beneficial Ownership (3)
30 September 2017 - 6:09AM
Edgar (US Regulatory)
FORM 3
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UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
INITIAL STATEMENT OF BENEFICIAL OWNERSHIP OF SECURITIES
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OMB APPROVAL
OMB Number:
3235-0104
Estimated average burden
hours per response...
0.5
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Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934 or Section 30(h) of the Investment Company Act of 1940
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1. Name and Address of Reporting Person
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Sompo International Holdings Ltd.
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2. Date of Event Requiring Statement (MM/DD/YYYY)
9/27/2017
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3. Issuer Name
and
Ticker or Trading Symbol
Blue Capital Reinsurance Holdings Ltd. [BCRH]
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(Last)
(First)
(Middle)
WATERLOO HOUSE, 100 PITTS BAY ROAD
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4. Relationship of Reporting Person(s) to Issuer (Check all applicable)
_____ Director
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X
___ 10% Owner
_____ Officer (give title below)
_____ Other (specify below)
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(Street)
PEMBROKE, D0 HM08
(City)
(State)
(Zip)
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5. If Amendment, Date Original Filed
(MM/DD/YYYY)
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6. Individual or Joint/Group Filing
(Check Applicable Line)
_
X
_ Form filed by One Reporting Person
___ Form filed by More than One Reporting Person
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Table I - Non-Derivative Securities Beneficially Owned
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1.Title of Security
(Instr. 4)
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2. Amount of Securities Beneficially Owned
(Instr. 4)
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3. Ownership Form: Direct (D) or Indirect (I)
(Instr. 5)
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4. Nature of Indirect Beneficial Ownership
(Instr. 5)
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Common Shares
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412458
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D
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Common Shares
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2500000
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I
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See Footnote
(1)
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Table II - Derivative Securities Beneficially Owned (
e.g.
, puts, calls, warrants, options, convertible securities)
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1. Title of Derivate Security
(Instr. 4)
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2. Date Exercisable and Expiration Date
(MM/DD/YYYY)
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3. Title and Amount of Securities Underlying Derivative Security
(Instr. 4)
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4. Conversion or Exercise Price of Derivative Security
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5. Ownership Form of Derivative Security: Direct (D) or Indirect (I)
(Instr. 5)
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6. Nature of Indirect Beneficial Ownership
(Instr. 5)
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Date Exercisable
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Expiration Date
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Title
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Amount or Number of Shares
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Restricted Share Units
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(2)
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(2)
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Common Shares
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4028.0
(3)
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(4)
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D
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Explanation of Responses:
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(1)
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Owned by Endurance Specialty Insurance Ltd., a wholly-owned subsidiary of Sompo International Holdings Ltd.
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(2)
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These awards will vest in three equal tranches on June 15, 2018, 2019 and 2020, subject to Messrs. Del Col and McGuire remaining actively engaged as directors of the Issuer in good standing on such dates.
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(3)
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In accordance with agreements between Endurance Specialty Holdings Ltd. ("ESHL") and John V. Del Col and Michael J. McGuire, respectively, all remuneration, including cash fees, restricted share units, any other equity-based awards and other compensation, to which they were entitled for their service as Directors of the Issuer was assigned or paid directly to ESHL. Mr. Del Col and Mr. McGuire disclaim beneficial ownership of all such restricted share units. The Reporting Person is the successor in interest to ESHL, pursuant to the Stock and Asset Purchase and Sale Agreement by and between ESHL and the Reporting Person, dated September 27, 2017.
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(4)
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Each restricted share unit represents a contingent right to receive one Issuer common share.
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Reporting Owners
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Reporting Owner Name / Address
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Relationships
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Director
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10% Owner
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Officer
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Other
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Sompo International Holdings Ltd.
WATERLOO HOUSE
100 PITTS BAY ROAD
PEMBROKE, D0 HM08
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X
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Signatures
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SOMPO INTERNATIONAL HOLDINGS LTD., By /s/ John V. Del Col
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9/29/2017
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**
Signature of Reporting Person
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Date
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Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly.
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*
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If the form is filed by more than one reporting person,
see
Instruction 5(b)(v).
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**
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Intentional misstatements or omissions of facts constitute Federal Criminal Violations.
See
18 U.S.C. 1001 and 15 U.S.C. 78ff(a).
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Note:
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File three copies of this Form, one of which must be manually signed. If space is insufficient,
see
Instruction 6 for procedure.
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Persons who respond to the collection of information contained in this form are not required to respond unless the form displays a currently valid OMB control number.
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