SEC Form 4 · accession 0001410442-16-000004
ICU MEDICAL INC/DE · ICUI
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Vivek Jain
Officer — Chairman and CEO · Director
Period of report
Feb 11, 2016
Accepted (ET)
Feb 12, 2016 · 6:54 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 | Feb 11, 2016 | M | 5,492 | $0.00 | A | 46,283 | D | |
| Common Stock | Feb 11, 2016 | F | 2,082 | $87.57 | D | 44,201 | D | |
| Common Stock | Feb 12, 2016 | M | 22,680 | $0.00 | A | 66,881 | D | |
| Common Stock | Feb 12, 2016 | F | 11,116 | $88.92 | D | 55,765 | D |
Table II — derivative securities
| Security | Conv. / exercise price | Date | Code | Shares | A/D | Exercisable | Expires | Underlying | Underlying shares | Owned after | D/I |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Common StockF1,F2,F3 | $0.00 | Feb 11, 2016 | M | 5,492 | D | Feb 11, 2016 | Feb 11, 2018 | Common Stock | 5,492 | 10,986 | D |
| Common StockF4,F2,F5 | — | Feb 12, 2016 | M | 22,680 | D | Feb 12, 2015 | Feb 24, 2017 | Common Stock | 22,680 | 22,680 | D |
Explanation of responses
- F1These securities are Restricted Stock Units.
- F2There is neither a purchase price nor an exercise price for the Restricted Stock Units.
- F3One third of the Units subject to the award shall vest on each of the first, second, and third anniversaries of the grant date.
- F4These securities are Restricted Stock Units awarded under the 2014 Inducement Stock Incentive Plan.
- F5Restricted Stock Units under the 2014 Inducement Stock Incentive Plan vest as one-third of the Units subject to the award on each of the first, second, and third anniversaries of the Vesting Commencement Date of February 13, 2014, with the employee having to be employed by the Company at the time of any vesting. One hundred percent of unvested units shall immediately vest as the result of an involuntary termination of employment.