SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
----------------------------------------
FORM 8-K
CURRENT REPORT
Pursuant to Section 13 or 15(d) of the Securities Exchange Act of
1994.
Date of Report (Date of earliest event reported) September 30,
1996
CUMBERLAND HOLDINGS, INC.
-----------------------------------------------------------------
--
(Exact name of registrant as specified in its charter)
Florida 0-19727 59-3094503
-----------------------------------------------------------------
--
(State or other jurisdiction (Commission (IRS Employer
of incorporation) File Number) Identification No.)
4311 West Waters Avenue, Suite 501, Tampa, Florida 33614
-----------------------------------------------------------------
--
(Address of principal executive offices) (Zip Code)
Registrant's telephone number, including area code (813) 885-
2112
Not applicable
-----------------------------------------------------------------
--
Former name or former address, if changed since last report.<PAGE>
Item 5. OTHER EVENTS
On November 5, 1996, Cumberland Holdings, Inc., issued
1,723,290 shares at the fair market value of $3.00 per share of
its common stock to Kimmins Corp. (f/k/a Kimmins Environmental
Service, Corp.) in exchange for surrender the Company's term note
payable in the amount of Five Million One Hundred Sixty-nine
Thousand, Eight Hundred Seventy Dollars ($5,169,870).
SECURITY OWNERSHIP OF CERTAIN BENEFICIAL OWNERS AND MANAGEMENT.
The common stock ownership of certain beneficial owners and
management on November 5, 1996 as reflected in the pro forma
September 30, 1996 balance sheet is set forth in the following
table:
Name and address of Amount and Nature of Percent of Issued
Beneficial Owner Beneficial Ownership and Outstanding
of Common Stock Common Stock
-------------------- -------------------- --------------------
Francis M. Williams 2,483,286 (3) 44.5 %
(1)
Joseph M. Williams 334,783 (4) 6.0 %
(1)
George A. Chandler 2,509 (5) *
(1)
Kimmins Corp. 1,723,290 (6) 30.9 %
1501 Second Avenue -------------------- --------------------
East
Tampa, Florida 33605
4, 543,868 81.4 %
==================== ====================
(1) The address of all officers and Directors of Cumberland
listed above are in care of Cumberland at 4311 West Waters
Avenue, Suite 501, Tampa, Florida 33614.
(2) Cumberland believes that the persons named in the table have
sole voting and investment power with respect to all shares
of common stock beneficially owned by them, unless otherwise
noted.<PAGE>
Item 5. OTHER EVENTS
(continued)
(3) Includes 2,259,207 shares owned by Mr. Francis Williams;
29,345 shares owned by Mr. Williams' wife; 22,748 shares
held by Mr. Williams as trustee for his wife and children;
18,296 shares held by Mr. Williams as custodian under the
New York Uniform Gifts to Minors Act for his children; and
153,690 held by various Real Estate Partnerships of which
Mr. Williams is 100 percent Owner.
(4) Includes 8,800 shares owned by Mr. Joseph M. Williams;
options to acquire 92,000 shares of Cumberland Common Stock;
219 shares held by the KVN 401(K) Plan and ESOP of which Mr.
Williams is fully vested; 205,764 shares held by KVN's
401(K) Plan, Profit Participation Plan and ESOP, options to
acquire 20,000 shares of Cumberland Common Stock held by the
ESOP, of which Mr. Williams is a trustee, but of which Mr.
Williams disclaims beneficial ownership.
(5) Includes 1,869 shares owned by Mr. George A. Chandler and
options to acquire 640 shares of Cumberland Common Stock.
(6) Francis M. Williams has a 61.5% ownership in Kimmins Corp.
and Joseph M. Williams has a 5.4% ownership in Kimmins Corp.
* Less than one percent.
Item 7. FINANCIAL STATEMENTS AND EXHIBITS
(a) Unaudited Condensed Consolidated Pro Forma Balance
Sheet dated September 30, 1996.<PAGE>
PRO FORMA FINANCIAL INFORMATION
CUMBERLAND HOLDINGS, INC.
PRO FORMA CONDENSED CONSOLIDATED BALANCE SHEETS
FOR THE NINE MONTHS ENDED SEPTEMBER 30, 1996
(UNAUDITED)
Historical Pro Forma Pro Forma
September 30 Adjustments September 30
1996 1996
------------- --------------------------
ASSETS
------
Investments:
Securities available-
for-sale at fair value:
Fixed maturities $ 3,046,700 $ $ 3,046,700
Equity securities 1,066,405 1,066,405
Fixed maturity
securities held to
maturity . . . . . . 1,664,285 1,664,285
Mortgage loan . . . . . 45,948 45,948
Short term investments 323,993 323,993
Cash and cash
equivalents . . . . . 550,712 550,712
Reinsurance recoverable 1,299,181 1,299,181
Deferred policy
acquisition costs 599,309 599,309
Intangibles, net . . . 1,929,478 1,929,478
Other assets . . . . . 1,398,585 1,398,585
------------- --------------------------
$ 11,924,596 $ 0 $ 11,924,596
============= ==========================<PAGE>
PRO FORMA FINANCIAL INFORMATION
CUMBERLAND HOLDINGS, INC.
PRO FORMA CONDENSED CONSOLIDATED BALANCE SHEETS
FOR THE NINE MONTHS ENDED SEPTEMBER 30, 1996
(UNAUDITED)
(continued)
Historical Pro Forma Pro Forma
September 30 Adjustments September 30
1996 1996
------------- --------------------------
LIABILITIES
-----------
Policy liabilities and
accruals:
Loss and loss
adjustment expenses . 1,436,553 1,436,553
Unearned premiums . . . 1,607,548 1,607,548
Ceded reinsurance
payable . . . . . . . 184,517 184,517
Accounts payable and
other liabilities 1,224,433 1,224,433
Long-term debt:
Affiliate, including
accrued interest . . 5,169,870 5,169,870(1) 0
Nonaffiliate . . . . . 1,533,488 1,533,488
------------- --------------------------
Total liabilities . . .$ 11,156,409 $ 5,169,870 $ 5,986,539
============= ==========================
<PAGE>
PRO FORMA FINANCIAL INFORMATION
CUMBERLAND HOLDINGS, INC.
PRO FORMA CONDENSED CONSOLIDATED BALANCE SHEETS
FOR THE NINE MONTHS ENDED SEPTEMBER 30, 1996
(UNAUDITED)
(continued)
Historical Pro Forma Pro Forma
September 30 Adjustments September 30
1996 1996
------------- --------------------------
STOCKHOLDERS' EQUITY
--------------------
Common stock, $.001 par
value; 10,000,000
shares authorized,
4,056,480 shares issued
September 30, 1996;
5,779,770 shares issued
on pro forma . . . . . 4,056 1,724(2) 5,780
Capital in excess of par
value . . . . . . . . . . 2,069,727 5,168,146(2) 7,237,873
Net unrealized
appreciation of
available-for-sale
securities . . . . . . . 76,357 76,357
Accumulated deficit . . . (1,147,395) (1,147,395)
------------- --------------------------
1,002,745 5,169,870 6,172,615
Less treasury stock at
cost, 317,173 shares at
September 30, 1996 . . (234,558) (234,558)
------------- --------------------------
Total Stockholders'
equity . . . . . . . . 768,187 5,169,870 5,938,057
$ 11,924,596 $ 0 $ 11,924,596
============= ==========================
(1) Elimination of term note payable to Kimmins Corp.
(2) Issue of 1,723,290 shares of common stock at $3.00 per
share.<PAGE>
SIGNATURES
Pursuant to the requirements of the Securities Exchange Act of
1934, the registrant has duly caused this report to be signed on
its behalf by the undersigned thereunto duly authorized.
CUMBERLAND HOLDINGS, INC.
Dated: November 13, 1996 By: /s/ Joseph M. Williams
----------------------- -------------------------
Joseph M. Williams
President and Chief
Executive Officer
(Principle Executive
Officer)
Dated: November 13, 1996 By: /s/ Carol S. Black
----------------------- -------------------------
Carol S. Black
Controller and Chief
Financial Officer
(Principle Accounting and
Financial Officer)<PAGE>
