SEC Form 4 · accession 0001615186-16-000006
ICU MEDICAL INC/DE · ICUI
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Thomas D McCall
Officer — Vice President and Gen'l Mgr.
Period of report
Aug 11, 2016
Accepted (ET)
Aug 11, 2016 · 6:36 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 | Aug 11, 2016 | X | 1,700 | $43.12 | A | 2,129 | D | |
| Common StockF1 | Aug 11, 2016 | S | 1,700 | $126.0314 | D | 429 | D | |
| Common StockF2 | Aug 11, 2016 | S | 371 | $126.2612 | D | 58 | 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)F4,F3 | $43.12 | Aug 11, 2016 | X | 1,700 | D | Feb 2, 2015 | Feb 2, 2021 | Common Stock | 1,700 | 300 | D |
Explanation of responses
- F1The price recorded in Column 4 is a weighted average price. These shares were sold in multiple transactions at prices ranging from $125.98 to $126.08, 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.
- F2These securities are Restricted Stock Units.
- F3Options 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.
- F4Transaction is the exercise of a derivative security; see Column 2.