SEC Form 4 · accession 0001410442-17-000002
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, 2017
Accepted (ET)
Feb 13, 2017 · 7:52 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 StockF1 | Feb 11, 2017 | M | 5,493 | $0.00 | A | 56,309 | D | |
| Common Stock | Feb 11, 2017 | F | 2,476 | $145.70 | D | 53,833 | D | |
| Common StockF1 | Feb 13, 2017 | M | 22,680 | $0.00 | A | 76,513 | D | |
| Common Stock | Feb 13, 2017 | F | 11,835 | $146.10 | D | 64,678 | 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, 2017 | M | 5,493 | D | Feb 11, 2016 | Feb 11, 2018 | Common Stock | 5,493 | 5,493 | D |
| Common StockF1,F2 | — | Feb 13, 2017 | M | 22,680 | D | Feb 12, 2015 | Feb 24, 2017 | Common Stock | 22,680 | 0 | 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.