SEC Form 4 · accession 0001615192-16-000011

ICU MEDICAL INC/DE · ICUI

Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗

Reporting owner

Officer — Controller

Period of report

Aug 15, 2016

Accepted (ET)

Aug 17, 2016 · 6:04 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
Common Stock	Aug 15, 2016	X	750	$32.31	A	1,922	D
Common Stock	Aug 15, 2016	X	1,000	$37.00	A	2,922	D
Common Stock	Aug 15, 2016	X	2,188	$43.12	A	5,110	D
Common Stock	Aug 15, 2016	X	3,500	$46.53	A	8,610	D
Common Stock	Aug 15, 2016	X	3,062	$61.76	A	11,672	D
Common Stock	Aug 15, 2016	X	2,430	$58.79	A	14,102	D
Common Stock^F1	Aug 15, 2016	S	327	$124.84	D	13,775	D
Common Stock	Aug 15, 2016	X	1,000	$38.40	A	14,775	D
Common Stock^F2	Aug 15, 2016	S	13,930	$124.0897	D	845	D

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	$32.31	Aug 15, 2016	X	750	D	Feb 4, 2014	Feb 4, 2020	Common Stock	750	0	D
Non-Qualified Stock Option (right to buy)^F4,F3	$37.00	Aug 15, 2016	X	1,000	D	Jul 21, 2014	Jul 21, 2020	Common Stock	1,000	0	D
Non-Qualified Stock Option (right to buy)^F4,F3	$38.40	Aug 15, 2016	X	1,000	D	Oct 19, 2012	Oct 19, 2017	Common Stock	1,000	0	D
Non-Qualified Stock Option (right to buy)^F4,F3	$43.12	Aug 15, 2016	X	2,188	D	Feb 2, 2015	Feb 2, 2021	Common Stock	2,188	0	D
Non-Qualified Stock Option (right to buy)^F4,F3	$46.53	Aug 15, 2016	X	3,500	D	Feb 1, 2016	Feb 1, 2022	Common Stock	3,500	0	D
Non-Qualified Stock Option (right to buy)^F4,F3	$58.79	Aug 15, 2016	X	2,430	D	—	Feb 24, 2024	Common Stock	2,430	3,805	D
Non-Qualified Stock Option (right to buy)^F4,F3	$61.76	Aug 15, 2016	X	3,062	D	—	Feb 6, 2023	Common Stock	3,062	438	D

F1Shares purchased through Employee Stock Purchase Plan.
F2The price reported in Column 4 is an average weighted price. These shares were sold in multiple transactions at prices ranging from $124.00 to $124.35, 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.
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.