SEC Form 4 · accession 0001189727-17-000005
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
May 17, 2017
Accepted (ET)
May 18, 2017 · 1:44 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 | May 17, 2017 | X | 1,042 | $43.62 | A | 3,727 | D | |
| Common Stock | May 17, 2017 | X | 14,649 | $61.76 | A | 18,376 | D | |
| Common StockF1 | May 17, 2017 | S | 17,510 | $160.6956 | D | 866 | D | |
| Common StockF2 | May 17, 2017 | S | 200 | $161.40 | D | 666 | D | |
| Common Stock | May 17, 2017 | S | 141 | $162.35 | D | 525 | D | |
| Common StockF3,F4 | May 17, 2017 | S | 432 | $160.8963 | D | 93 | D | |
| Common StockF3 | May 17, 2017 | S | 7 | $162.35 | D | 86 | D | |
| Common Stock | May 17, 2017 | X | 2,160 | $46.53 | A | 2,246 | 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)F6,F5 | $43.62 | May 17, 2017 | X | 1,042 | D | — | Jul 20, 2021 | Common Stock | 1,042 | 0 | D |
| Non-Qualified Stock Option (right to buy)F6,F5 | $46.53 | May 17, 2017 | X | 2,160 | D | — | Feb 1, 2022 | Common Stock | 2,160 | 0 | D |
| Non-Qualified Stock Option (right to buy)F6,F5 | $61.76 | May 17, 2017 | X | 14,649 | D | — | Feb 6, 2023 | Common Stock | 14,649 | 0 | D |
Explanation of responses
- F1The price reported in Column 4 is a weighted average price. These shares were sold in multiple transactions at prices ranging from $161.175 to $161.150, inclusive. The reporting person undertakes to provide ICU Medical, Inc., any security holder of ICU Medical, Inc., or the staff of the Securities and Exchange Commission, upon request, full information regarding the number of shares sold at each separate price within the range set forth in this Form 4.
- F2The price reported in Column 4 is a weighted average price. These shares were sold in multiple transactions at prices ranging from $161.30 to $161.50, inclusive. The reporting person undertakes to provide ICU Medical, Inc., any security holder of ICU Medical, Inc., or the staff of the Securities and Exchange Commission, upon request, full information regarding the number of shares sold at each separate price within the range set forth in this Form 4.
- F3Shares were previously acquired through the Registrant's Employee Stock Purchase Plan.
- F4The price reported in Column 4 is a weighted average price. These shares were sold in multiple transactions at prices ranging from $160.70 to $161.10, inclusive. The reporting person undertakes to provide ICU Medical, Inc., any security holder of ICU Medical, Inc., or the staff of the Securities and Exchange Commission, upon request, full information regarding the number of shares sold at each separate price within the range set forth in this Form 4.
- F5Options 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.
- F6Transaction is the exercise of a derivative security; see Column 2.