North Pointe Holdings Corp - Statement of Changes in Beneficial Ownership (4)
May 01 2008 - 8:16AM
Edgar (US Regulatory)
FORM 4
[
X
]
Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue.
See
Instruction 1(b).
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UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP OF SECURITIES
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OMB APPROVAL
OMB Number:
3235-0287
Expires:
January 31, 2008
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Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934, Section 17(a) of the Public
Utility Holding Company Act of 1935 or Section 30(f) of the Investment Company Act of 1940
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1. Name and Address of Reporting Person
*
BERRY JOHN H
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2. Issuer Name
and
Ticker or Trading Symbol
NORTH POINTE HOLDINGS CORP
[
NPTE
]
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5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
_____ Director
_____ 10% Owner
__
X
__ Officer (give title below)
_____ Other (specify below)
Treasurer
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(Last)
(First)
(Middle)
28819 FRANKLIN ROAD
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3. Date of Earliest Transaction
(MM/DD/YYYY)
4/30/2008
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(Street)
SOUTHFIELD, MI 48034
(City)
(State)
(Zip)
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4. 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 Acquired, Disposed of, or Beneficially Owned
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1.Title of Security
(Instr. 3)
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2. Trans. Date
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2A. Deemed Execution Date, if any
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3. Trans. Code
(Instr. 8)
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4. Securities Acquired (A) or Disposed of (D)
(Instr. 3, 4 and 5)
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5. Amount of Securities Beneficially Owned Following Reported Transaction(s)
(Instr. 3 and 4)
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6. Ownership Form: Direct (D) or Indirect (I) (Instr. 4)
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7. Nature of Indirect Beneficial Ownership (Instr. 4)
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Code
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V
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Amount
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(A) or (D)
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Price
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Common Stock
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4/30/2008
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D
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21225
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D
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$16.00
(1)
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0
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I
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Trust
(2)
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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. 3)
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2. Conversion or Exercise Price of Derivative Security
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3. Trans. Date
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3A. Deemed Execution Date, if any
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4. Trans. Code
(Instr. 8)
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5. Number of Derivative Securities Acquired (A) or Disposed of (D)
(Instr. 3, 4 and 5)
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6. Date Exercisable and Expiration Date
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7. Title and Amount of Securities Underlying Derivative Security
(Instr. 3 and 4)
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8. Price of Derivative Security
(Instr. 5)
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9. Number of derivative Securities Beneficially Owned Following Reported Transaction(s) (Instr. 4)
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10. Ownership Form of Derivative Security: Direct (D) or Indirect (I) (Instr. 4)
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11. Nature of Indirect Beneficial Ownership (Instr. 4)
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Code
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V
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(A)
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(D)
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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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Common Stock
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$12.00
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4/30/2008
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D
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25000
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(3)
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9/28/2015
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Common Stock
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25000
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$0.00
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0
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D
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Explanation of Responses:
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(
1)
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On April 10, 2008, the Company's stockholders approved the Agreement and Plan of Merger, dated as of January 3, 2008, by and among the Company, Noble Acquisition Corporation, a Michigan corporation and QBE Holdings, Inc. (QBE), a Delaware corporation (the merger agreement). Pursuant to the merger agreement, the issuer was acquired by QBE, effective on April 30, 2008. Subsequent to the closing of the merger, the issuer's common stock ceased to be publicly traded and its registration was terminated with the SEC and NASDAQ. Pursuant to the terms of the merger agreement, each share of the issuer's common stock, whether vested or unvested, was cancelled in exchange for a cash payment equal to $16.00 per share.
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(
2)
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Held in Trust by John H. Berry and Christine M. Berry, as Trustees of the John H. Berry and Christine M. Berry Living dated June 1, 2004.
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(
3)
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Options were granted under the Company's Equity Incentive Plan and would have become exercisable in equal annual installments beginning on the first anniversary of the original grant date. The option provided for vesting over 5 anniversaries of the issue date. The option rights were disposed of in accordance with the merger agreement pursuant to which the reporting person is entitled to receive a cash payment equal to the difference between $16.00 and the exercise price of the underlying option multiplied by the number of shares available for purchase under the option, without interest and less any required withholding taxes.
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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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BERRY JOHN H
28819 FRANKLIN ROAD
SOUTHFIELD, MI 48034
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Treasurer
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Signatures
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/s/ John H. Berry
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4/30/2008
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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 4(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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