SEC Form 4 · accession 0001189727-15-000001

ICU MEDICAL INC/DE · ICUI

Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗

Reporting owner

Officer — General Mgr, Infusion Systems

Period of report

Jan 30, 2015

Accepted (ET)

Feb 2, 2015 · 8:28 pm EST

Rule 10b5-1 plan

unknown — predates the checkbox

Issuer CIK

0000883984

Table I — non-derivative securities

Security	Date	Code	Shares	Price	A/D	Owned after	D/I	Nature of ownership
Common Stock	Jan 30, 2015	M	666	$0.00	A	666	D
Common Stock	Jan 30, 2015	F	291	$83.58	D	375	D

Security	Conv. / exercise price	Date	Code	Shares	A/D	Exercisable	Expires	Underlying	Underlying shares	Owned after	D/I
Non-Qualified Stock Option (right to buy)^F1,F3,F2,F4	—	Jan 30, 2015	M	333	D	Jan 30, 2015	Feb 1, 2013	Common Stock	333	0	D

F1These securities are Restricted Stock Units.
F2There is neither a purchase price nor an exercise price for the Restricted Stock Units.
F3If the Company's adjusted TSR for 2012 is equal or greater than the 33d percentile of the peer companies (but less than 50%), 50% of the shares covered by the RSUs would be earned; if adjusted TSR for the Company is equal or greater than the 75th percentile of the peer companies, 200% of the shares shown above for the RSUs would be earned. Vesting of any amount earned would be 33% on the anniversary date of the award; 33% of the award two years after grant, and the remaining 33% a year later, with the employee having to be employed by the Company at the time the award was earned and at the time of any vesting.
F4Vesting of any amount earned would be one-third on the anniversary date of the award; one-third of the award two years after grant, and the remaining one-third a year later, with the employee having to be employed by the Company at the time of any vesting.