0001127602-19-018976.txt : 20190517 0001127602-19-018976.hdr.sgml : 20190517 20190517160750 ACCESSION NUMBER: 0001127602-19-018976 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 2 CONFORMED PERIOD OF REPORT: 20190515 FILED AS OF DATE: 20190517 DATE AS OF CHANGE: 20190517 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Lemoine David A CENTRAL INDEX KEY: 0001501185 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-33462 FILM NUMBER: 19835700 MAIL ADDRESS: STREET 1: C/O THE L S STARRETT COMPANY STREET 2: 121 CRESCENT STREET CITY: ATHOL STATE: MA ZIP: 01331 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: 100 NAGOG PARK CITY: ACTON STATE: MA ZIP: 01720 BUSINESS PHONE: 978-600-7000 MAIL ADDRESS: STREET 1: 100 NAGOG PARK CITY: ACTON STATE: MA ZIP: 01720 4 1 form4.xml PRIMARY DOCUMENT X0306 4 2019-05-15 0001145197 INSULET CORP PODD 0001501185 Lemoine David A C/O INSULET CORPORATION 100 NAGOG PARK ACTON MA 01720 1 Common Stock 2019-05-15 4 S 0 874 102.49 D 9148 D Common Stock 2019-05-16 4 M 0 8752 26.00 A 17900 D Common Stock 2019-05-16 4 S 0 8752 106.9192 D 9148 D Stock Option (Right to Buy) 26.00 2019-05-16 4 M 0 8752 0 D 2026-02-09 Common Stock 8752 0 D This transaction represents the sale of shares intended to approximate the associated tax liability resulting from the vesting of restricted stock units on April 30, 2019. The sales reported in this Form 4 were effected pursuant to a Rule 10b5-1 trading plan adopted by the reporting person on March 1, 2019. The price reported represents the weighted average sale price of the shares sold. The shares were sold at varying prices in the range of $106.89 to $107.105. 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 one-half of the total award vesting on February 9, 2017, one-quarter of the total award vesting on February 9, 2018 and one-quarter of the total award vesting on February 9, 2019, subject to continued service as a director or consultant. /s/ John W. Kapples, attorney-in-fact 2019-05-17 EX-24 2 doc1.txt POWER OF ATTORNEY (PUBLIC): POA POWER OF ATTORNEY KNOW ALL MEN BY THESE PRESENTS, that the undersigned hereby constitutes and appoints Shacey Petrovic, John W. Kapples, Wayde D. McMillan and Keith Bilezerian, and any one of them acting singly, the true and lawful attorneys-in-fact and agents, with full power of substitution and resubstitution, for the undersigned and in the undersigned's name, place and stead, in any and all capacities (until revoked in writing) to execute for and on behalf of the undersigned, in any any and all of the undersigned's capacities any and all statements on Forms 3, 4 and 5 with respect to the undersigned's holdings of and transactions in securities issued by Insulet Corporation (the "Company") in accordance with Sections 16(a) of the Securities Exchange Act of 1934, as amended (the "Exchange Act"), and any and all regulations promulgated thereunder, and to file the same, with all exhibits thereto, and any other documents in connection therewith, with the Securities and Exchange Commission, and with any other entity when and if such is mandated by the Exchange Act or by the By-laws of the National Association of Securities Dealers, granting unto said attorneys-in-fact and agents full power and authority to do and perform each and every act and thing requisite and necessary fully to all intents and purposes as the undersigned might or could do in person thereby ratifying and confirming all that said attorneys-in-fact and agents, or their substitute or substitutes, may lawfully do or cause to be done by virtue hereof. This Power of Attorney shall remain in full force and effect until the undersigned is no longer required to file Forms 3, 4 and 5 with respect to the undersigned's holdings of and transactions in securities issued by the Company, unless earlier revoked by the undersigned in a signed writing delivered to the foregoing attorneys-in-fact. IN WITNESS WHEREOF, this Power of Attorney has been signed as of March 26, 2019. Signature: /s/ David A. Lemoine Name: David A. Lemoine