UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549 SCHEDULE 13G Under the Securities Exchange Act of 1934 (Amendment No. )* |
Bristol West Holdings, Inc.
(Name of Issuer) |
Common Stock, $0.01 par value
(Title of Class of Securities) |
11037M105
|
December 31, 2004
(Date of Event which Requires Filing of this Statement) |
Check the appropriate box to designate the rule pursuant to which this Schedule is filed: |
[ | ] Rule 13d-1(b) | |
[ | ] Rule 13d-1(c) | |
[ | X | ] Rule 13d-1(d) |
* The remainder of this cover page shall be filled out for a reporting person's initial filing on this form with respect to the subject class of securities, and for any subsequent amendment containing information which would alter the disclosures provided in a prior cover page. |
The information required on the remainder of this cover page shall not be deemed to be "filed" for the purpose of Section 18 of the Securities Exchange Act of 1934 ("Act") or otherwise subject to the liabilities of that section of the Act but shall be subject to all other provisions of the Act (however, see the Notes). |
SCHEDULE 13G | ||||
CUSIP No. 11037M105 | ||||
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1. | Names of Reporting Persons. Bristol West Associates LLC I.R.S. Identification Nos. of above persons (entities only). 13-3994446 | |||
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2. | Check the Appropriate Box if a
Member of a Group (See Instructions) (a) [ ] (b) [ ] | |||
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3. | SEC USE ONLY | |||
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4. | Citizenship or Place of
Organization | |||
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Number
of Shares Beneficially Owned by Each Reporting Person With: |
5. | Sole Voting Power 12,257,368 | ||
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6. | Shared Voting Power 0 | |||
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7. | Sole Dispositive
Power 12,257,368 | |||
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8. | Shared Dispositive Power 0 | |||
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9. | Aggregate Amount Beneficially Owned
by Each Reporting Person 12,257,368 | |||
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10. | Check if the Aggregate Amount in Row (9) Excludes Certain Shares (See Instructions) [ ] | |||
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11. | Percent of Class Represented by
Amount in Row (9) | |||
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12. | Type of Reporting
Person | |||
2 |
SCHEDULE 13G | ||||
CUSIP No. 11037M105 | ||||
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1. | Names of Reporting Persons. KKR 1996 Fund L.P. I.R.S. Identification Nos. of above persons (entities only). 13-3900817 | |||
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2. | Check the Appropriate Box if a
Member of a Group (See Instructions) (a) [ ] (b) [ ] | |||
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3. | SEC USE ONLY | |||
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4. | Citizenship or Place of
Organization | |||
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Number
of Shares Beneficially Owned by Each Reporting Person With: |
5. | Sole Voting Power 12,257,368 | ||
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6. | Shared Voting Power 0 | |||
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7. | Sole Dispositive
Power 12,257,368 | |||
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8. | Shared Dispositive Power 0 | |||
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9. | Aggregate Amount Beneficially Owned
by Each Reporting Person 12,257,368 | |||
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10. | Check if the Aggregate Amount in Row (9) Excludes Certain Shares (See Instructions) [ ] | |||
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11. | Percent of Class Represented by
Amount in Row (9) | |||
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12. | Type of Reporting
Person | |||
3 |
SCHEDULE 13G | ||||
CUSIP No. 11037M105 | ||||
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1. | Names of Reporting Persons. KKR Associates 1996 L.P. I.R.S. Identification Nos. of above persons (entities only). 13-3977533 | |||
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2. | Check the Appropriate Box if a
Member of a Group (See Instructions) (a) [ ] (b) [ ] | |||
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3. | SEC USE ONLY | |||
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4. | Citizenship or Place of
Organization | |||
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Number
of Shares Beneficially Owned by Each Reporting Person With: |
5. | Sole Voting Power 12,257,368 | ||
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6. | Shared Voting Power 0 | |||
| ||||
7. | Sole Dispositive
Power 12,257,368 | |||
| ||||
8. | Shared Dispositive Power 0 | |||
| ||||
9. | Aggregate Amount Beneficially Owned
by Each Reporting Person 12,257,368 | |||
| ||||
10. | Check if the Aggregate Amount in Row (9) Excludes Certain Shares (See Instructions) [ ] | |||
| ||||
11. | Percent of Class Represented by
Amount in Row (9) | |||
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12. | Type of Reporting
Person | |||
4 |
SCHEDULE 13G | ||||
CUSIP No. 11037M105 | ||||
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1. | Names of Reporting Persons. KKR 1996 GP LLC I.R.S. Identification Nos. of above persons (entities only). 13-3900820 | |||
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2. | Check the Appropriate Box if a
Member of a Group (See Instructions) (a) [ ] (b) [ ] | |||
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3. | SEC USE ONLY | |||
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4. | Citizenship or Place of
Organization | |||
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Number
of Shares Beneficially Owned by Each Reporting Person With: |
5. | Sole Voting Power 12,257,368 | ||
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6. | Shared Voting Power 0 | |||
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7. | Sole Dispositive
Power 12,257,368 | |||
| ||||
8. | Shared Dispositive Power 0 | |||
| ||||
9. | Aggregate Amount Beneficially Owned
by Each Reporting Person 12,257,368 | |||
| ||||
10. | Check if the Aggregate Amount in Row (9) Excludes Certain Shares (See Instructions) [ ] | |||
| ||||
11. | Percent of Class Represented by
Amount in Row (9) | |||
| ||||
12. | Type of Reporting
Person | |||
5 |
Item 1. | ||||
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(a) |
Name of
Issuer | ||
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(b) |
Address of Issuer's Principal Executive
Offices | ||
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Item 2. | ||||
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(a) |
Name of Person Filing | ||
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(b) |
Address of Principal Business Office or, if
none, Residence | ||
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(c) |
Citizenship | ||
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(d) |
Title of Class of Securities | ||
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(e) |
CUSIP
Number | ||
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Item 3. |
If this statement is filed pursuant to §§240.13d-1(b) or 240.13d-2(b) or (c), check whether the person filing is a: | |||
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(a) |
[ ] |
Broker or dealer registered under section 15 of the Act (15 U.S.C. 78o). | |
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(b) |
[ ] |
Bank as defined in section 3(a)(6) of the Act (15 U.S.C. 78c). | |
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(c) |
[ ] |
Insurance company as defined in section 3(a)(19) of the Act (15 U.S.C. 78c). | |
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(d) |
[ ] |
Investment company registered under section 8 of the Investment Company Act of 1940 (15 U.S.C 80a-8). | |
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(e) |
[ ] |
An investment adviser in accordance with §240.13d-1(b)(1)(ii)(E); | |
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(f) |
[ ] |
An employee benefit plan or endowment fund in accordance with §240.13d-1(b)(1)(ii)(F); | |
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(g) |
[ ] |
A parent holding company or control person in accordance with § 240.13d-1(b)(1)(ii)(G); | |
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(h) |
[ ] |
A savings associations as defined in Section 3(b) of the Federal Deposit Insurance Act (12 U.S.C. 1813); | |
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(i) |
[ ] |
A church plan that is excluded from the definition of an investment company under section 3(c)(14) of the Investment Company Act of 1940 (15 U.S.C. 80a-3); | |
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(j) |
[ ] |
Group, in accordance with §240.13d-1(b)(1)(ii)(J). | |
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Item 4. |
Ownership. | |||
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(a) |
Amount beneficially
owned:
Shares shown as beneficially owned by KKR 1996 GP LLC are owned of record by Bristol West Associates LLC. KKR 1996 GP LLC is the general partner of KKR Associates 1996 L.P., which is the general partner of KKR 1996 Fund, L.P., which is the managing member of Bristol West Associates LLC, which owns 12,257,368 shares of common stock of Bristol West Holdings, Inc. Messrs. Henry R.
Kravis, George R. Roberts, Paul E. Raether, Michael W. Michelson, James H.
Greene, Jr., Perry Golkin, Scott M. Stuart, Edward A. Gilhuly, Johannes
Huth, Todd A. Fisher and Alexander Navab, as members of KKR 1996 GP LLC,
may be deemed to share beneficial ownership of any shares beneficially
owned by KKR 1996 GP LLC but disclaim such beneficial
ownership. | ||
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(b) |
Percent of
class: | ||
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(c) |
Number of shares as to which the person has: | ||
|
|
(i) |
Sole power to vote or to direct the
vote | |
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(ii) |
Shared power to vote or to direct the
vote | |
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(iii) |
Sole power to dispose or to direct the
disposition
of | |
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(iv) |
Shared power to dispose or to direct the
disposition
of |
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Item 5. |
Ownership of Five Percent or Less of a Class |
If this statement is being filed to report the fact that as of the date hereof the reporting person has ceased to be the beneficial owner of more than five percent of the class of securities, check the following [ ]. | |
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Instruction: Dissolution of a group
requires a response to this
item. | |
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Item 6. |
Ownership of More than Five Percent on Behalf of Another Person |
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Item 7. |
Identification and Classification of the Subsidiary Which Acquired the Security Being Reported on By the Parent Holding Company |
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Item 8. |
Identification and Classification of Members of the Group |
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Item 9. |
Notice of Dissolution of Group |
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Item 10. |
Certification |
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SIGNATURE |
After reasonable inquiry and to the best of my knowledge and belief, I certify that the information set forth in this statement is true, complete and correct. | ||||
Date: February 14, 2005 | ||||
Bristol West Associates LLC By: KKR
1996 Fund L.P., its managing member By: KKR Associates 1996 L.P., its
general partner By: KKR 1996 GP LLC, its general
partner | ||||
By: | /s/ William Janetschek
William Janetschek | |||
Title: | Attorney-in-fact for Perry Golkin | |||
KKR 1996 Fund L.P. By: KKR
Associates 1996, L.P., its general partner By: KKR 1996 GP LLC, its
general partner | ||||
By: | /s/ William Janetschek
William Janetschek | |||
Title: | Attorney-in-fact for Perry Golkin | |||
KKR Associates 1996 L.P. By: KKR
1996 GP LLC, its general partner | ||||
By: | /s/ William Janetschek
William Janetschek | |||
Title: | Attorney-in-fact for Perry Golkin | |||
KKR 1996 GP
LLC | ||||
By: | /s/ William Janetschek
William Janetschek | |||
Title: | Attorney-in-fact for Perry Golkin | |||
8 |
By: |
KKR
1996 Fund L.P., its managing member |
By: |
KKR
Associates 1996 L.P., its general partner |
By: |
KKR
1996 GP LLC, its general partner |
By: |
/s/
William Janetschek |
Name: |
William
Janetschek |
Title: |
Attorney-in-fact
for Perry Golkin |
By: |
KKR
Associates 1996 L.P., its general partner |
By: |
KKR
1996 GP LLC, its general partner |
By: |
/s/
William Janetschek |
Name: |
William
Janetschek |
Title: |
Attorney-in-fact
for Perry Golkin |
By: |
KKR
1996 GP LLC, its general partner |
By: |
/s/
William Janetschek |
Name: |
William
Janetschek |
Title: |
Attorney-in-fact
for Perry Golkin |
By: |
/s/
William Janetschek |
Name: |
William
Janetschek |
Title: |
Attorney-in-fact
for Perry Golkin |