SEC Form 4 · accession 0001189727-15-000006
ICU MEDICAL INC/DE · ICUI
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Alison D Burcar
Officer — Vice President and Gen'l Mgr.
Period of report
Jun 19, 2015
Accepted (ET)
Jun 19, 2015 · 5:52 pm EDT
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 | Jun 19, 2015 | X | 8,370 | $61.76 | A | 8,370 | D | |
| Common Stock | Jun 19, 2015 | S | 8,370 | $97.00 | D | 0 | D | |
| Common Stock | Jun 19, 2015 | X | 588 | $46.53 | A | 588 | D | |
| Common Stock | Jun 19, 2015 | S | 588 | $97.00 | D | 0 | D | |
| Common Stock | Jun 19, 2015 | X | 453 | $43.62 | A | 453 | D | |
| Common Stock | Jun 19, 2015 | S | 453 | $97.00 | D | 0 | D |
Table II — derivative securities
| 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)F3,F2 | $43.62 | Jun 19, 2015 | X | 453 | D | — | Jul 20, 2021 | Common Stock | 453 | 1,042 | D |
| Non-Qualified Stock Option (right to buy)F3,F2 | $46.53 | Jun 19, 2015 | X | 588 | D | — | Feb 1, 2022 | Common Stock | 588 | 2,160 | D |
| Non-Qualified Stock Option (right to buy)F3,F2 | $61.76 | Jun 19, 2015 | X | 8,370 | D | — | Feb 6, 2023 | Common Stock | 8,370 | 14,649 | D |
Explanation of responses
- F1The sales reported in this Form 4 were effected pursuant to a Rule 10b5-1 Plan adopted by the reporting person on May 7, 2015.
- F2Options vest and are exercisable as to 25% of the underlying grant one year after the date of grant and in equal monthly installments thereafter for three additional years.
- F3Transaction is the exercise of a derivative security; see Column 2.