Form of Class A Common Stock Certificate of the Company

Contract Categories: Business Finance - Stock Agreements
EX-4.1 4 tm2133671d1_ex4-1.htm EXHIBIT 4.1

 

Exhibit 4.1

 

NUMBER SHARES
C- SEE REVERSE FOR CERTAIN DEFINITIONS
  CUSIP  405166109

 

SEE REVERSE FOR CERTAIN DEFINITIONS

 

HAGERTY, INC.

 

INCORPORATED UNDER THE LAWS OF THE STATE OF DELAWARE

 

CLASS A COMMON STOCK

 

This certifies that
is the owner of
FULLY PAID AND NON-ASSESSABLE SHARES OF THE PAR VALUE OF $0.0001 EACH OF THE CLASS A COMMON STOCK OF

 

HAGERTY, INC.
(THE “COMPANY”)

 

transferable on the books of the Company in person or by duly authorized attorney upon surrender of this certificate properly endorsed.

 

This certificate is not valid unless countersigned by the Transfer Agent and Registrar of the Company.

 

Witness the seal of the Company and the facsimile signatures of its duly authorized officers.

 

[Corporate Seal]

 

Delaware

 

     
Chief Executive Officer   Chief Financial Officer [or other Authorized Officer]

 

   
Transfer Agent and Registrar  

 

 

 

 

HAGERTY, INC.

 

The Company will furnish without charge to each stockholder who so requests, the powers, designations, preferences and relative, participating, optional or other special rights of each class of stock or series thereof of the Company and the qualifications, limitations, or restrictions of such preferences and/or rights. This certificate and the shares represented thereby are issued and shall be held subject to all the provisions of the Company’s amended and restated certificate of incorporation and all amendments thereto and resolutions of the Board of Directors providing for the issue of securities (copies of which may be obtained from the secretary of the Company), to all of which the holder of this certificate by acceptance hereof assents.

 

The following abbreviations, when used in the inscription on the face of this certificate, shall be construed as though they were written out in full according to applicable laws or regulations:

 

TEN COM — as tenants in common

UNIF GIFT

MIN ACT

 —   Custodian  
               
TEN ENT — as tenants by the entireties     (Cust)   (Minor)
               
JT TEN — as joint tenants with right of survivorship and not as tenants in common     under Uniform Gifts to Minors Act
          (State)

 

Additional abbreviations may also be used though not in the above list.

 

For value received, _______________________ hereby sells, assigns and transfers unto ______________

 

(PLEASE INSERT SOCIAL SECURITY OR OTHER IDENTIFYING NUMBER(S) OF ASSIGNEE(S))

 

 

 

(PLEASE PRINT OR TYPEWRITE NAME(S) AND ADDRESS(ES), INCLUDING ZIP CODE, OF ASSIGNEE(S))

 

____________ shares of the capital stock represented by the within Certificate, and hereby irrevocably constitutes and appoints _____________________ Attorney to transfer the said stock on the books of the within named Company with full power of substitution in the premises.

 

Dated:      
    Notice: The signature(s) to this assignment must correspond with the name as written upon the face of the certificate in every particular, without alteration or enlargement or any change whatever.

 

Signature(s) Guaranteed:

 

By:      
THE SIGNATURE(S) MUST BE GUARANTEED BY AN ELIGIBLE GUARANTOR INSTITUTION (BANKS, STOCKBROKERS, SAVINGS AND LOAN ASSOCIATIONS AND CREDIT UNIONS WITH MEMBERSHIP IN AN APPROVED SIGNATURE GUARANTEE MEDALLION PROGRAM, PURSUANT TO S.E.C. RULE 17Ad-15 (OR ANY SUCCESSOR RULE).