0001127602-17-010311.txt : 20170303 0001127602-17-010311.hdr.sgml : 20170303 20170303182229 ACCESSION NUMBER: 0001127602-17-010311 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20170302 FILED AS OF DATE: 20170303 DATE AS OF CHANGE: 20170303 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: INSULET CORP CENTRAL INDEX KEY: 0001145197 STANDARD INDUSTRIAL CLASSIFICATION: SURGICAL & MEDICAL INSTRUMENTS & APPARATUS [3841] IRS NUMBER: 043523891 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 600 TECHNOLOGY PARK STREET 2: SUITE 200 CITY: BILLERICA STATE: MA ZIP: 01821 BUSINESS PHONE: 978-600-7000 MAIL ADDRESS: STREET 1: 600 TECHNOLOGY PARK STREET 2: SUITE 200 CITY: BILLERICA STATE: MA ZIP: 01821 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Zakrzewski Joseph S CENTRAL INDEX KEY: 0001331852 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-33462 FILM NUMBER: 17665838 MAIL ADDRESS: STREET 1: 110 ALLEN ROAD CITY: LIBERTY CORNER STATE: NJ ZIP: 07938 4 1 form4.xml PRIMARY DOCUMENT X0306 4 2017-03-02 0001145197 INSULET CORP PODD 0001331852 Zakrzewski Joseph S C/O INSULET CORPORATION 600 TECHNOLOGY PARK DRIVE, SUITE 200 BILLERICA MA 01821 1 Common Stock 2017-03-02 4 M 0 9520 18.75 A 37369 D Common Stock 2017-03-02 4 M 0 18480 7.06 A 55849 D Common Stock 2017-03-02 4 M 0 4000 14.48 A 59849 D Common Stock 2017-03-02 4 M 0 4000 20.90 A 63849 D Common Stock 2017-03-02 4 M 0 4000 17.75 A 67849 D Common Stock 2017-03-02 4 S 0 4000 48.031 D 63849 D Common Stock 2017-03-02 4 S 0 13721 46.3133 D 50128 D Common Stock 2017-03-02 4 S 0 22279 46.9907 D 27849 D Stock Option (Right to Buy) 18.75 2017-03-02 4 M 0 9520 0 D 2018-05-08 Common Stock 9520 0 D Stock Option (Right to Buy) 7.06 2017-03-02 4 M 0 18480 0 D 2019-07-30 Common Stock 18480 0 D Stock Option (Right to Buy) 14.48 2017-03-02 4 M 0 4000 0 D 2020-06-01 Common Stock 4000 0 D Stock Option (Right to Buy) 20.90 2017-03-02 4 M 0 4000 0 D 2021-05-12 Common Stock 4000 0 D Stock Option (Right to Buy) 17.75 2017-03-02 4 M 0 4000 0 D 2022-06-01 Common Stock 4000 0 D Includes 3,810 restricted stock units granted on May 11, 2016, which vest on April 30, 2017; 1,000 restricted stock units granted on June 2, 2014, which vest on April 30, 2017; and 2,020 restricted stock units granted on May 13, 2015, which vest 50% of the total units on April 30, 2017 and 50% of the total units on April 30, 2018, subject to continued service as a director or consultant. Vested shares will be delivered to the reporting person as soon as practiable following a vesting date. The price reported represents the weighted average sale price of the shares sold. The shares were sold at varying prices in the range of $45.65 to $46.645. The Reporting Person hereby undertakes, upon request of the Staff of the U.S. Securities Exchange Commission, the Issuer or a security holder of the Issuer, to provide full information regarding the number of shares sold at each separate price. The price reported represents the weighted average sale price of the shares sold. The shares were sold at varying prices in the range of $46.66 to $47.54. The Reporting Person hereby undertakes, upon request of the Staff of the U.S. Securities Exchange Commission, the Issuer or a security holder of the Issuer, to provide full information regarding the number of shares sold at each separate price. This option is subject to a three-year vesting period with 50% of the total award vesting one year after the grant date, 25% of the total award vesting two years after the grant date and 25% of the total award vesting three years after the grant date, subject to continued service as a director or consultant. This option is subject to a three-year vesting period with 50% of the total award vesting on the first anniversary of the date of grant and 25% on each of the second and third anniversaries of the date of grant, subject to continued service as a director or consultant. This option shall vest as to 100% of the total award on April 30, 2017, subject to continued service as a director or consultant. This option is subject to a three-year vesting period with 50% of the total award vesting on April 30, 2013, 25% of the total award vesting on April 30, 2014 and 25% of the total award vesting on April 30, 2015, subject to continued service as a director or consultant. /s/ David Colleran, attorney-in-fact 2017-03-03