0001127602-19-020530.txt : 20190603 0001127602-19-020530.hdr.sgml : 20190603 20190603173556 ACCESSION NUMBER: 0001127602-19-020530 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 2 CONFORMED PERIOD OF REPORT: 20190530 FILED AS OF DATE: 20190603 DATE AS OF CHANGE: 20190603 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: CRAWFORD SALLY CENTRAL INDEX KEY: 0001199735 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-33462 FILM NUMBER: 19874486 MAIL ADDRESS: STREET 1: C/O HOLOGIC, INC. CITY: BEDFORD STATE: MA ZIP: 01730 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 2019-05-30 0001145197 INSULET CORP PODD 0001199735 CRAWFORD SALLY C/O INSULET CORPORATION 100 NAGOG PARK ACTON MA 01720 1 Common Stock 2019-05-30 4 A 0 1726 0 A 28469 D Common Stock 2019-05-31 4 M 0 5235 28.87 A 33704 D Common Stock 2019-05-31 4 M 0 3587 40.60 A 37291 D Common Stock 2019-05-31 4 M 0 5525 27.37 A 42816 D Common Stock 2019-05-31 4 M 0 2000 20.90 A 44816 D Common Stock 2019-05-31 4 M 0 4000 17.75 A 48816 D Common Stock 2019-05-31 4 M 0 4000 30.04 A 52816 D Common Stock 2019-05-31 4 M 0 4000 35.11 A 56816 D Common Stock 2019-05-31 4 S 0 28347 108.60 D 28469 D Stock Option (Right to Buy) 28.87 2019-05-31 4 M 0 5235 0 D 2017-04-30 2026-05-11 Common Stock 5235 0 D Stock Option (Right to Buy) 40.60 2019-05-31 4 M 0 3587 0 D 2018-04-30 2027-05-17 Common Stock 3587 0 D Stock Option (Right to Buy) 27.37 2019-05-31 4 M 0 5525 0 D 2025-05-13 Common Stock 5525 0 D Stock Option (Right to Buy) 20.90 2019-05-31 4 M 0 2000 0 D 2021-05-12 Common Stock 2000 0 D Stock Option (Right to Buy) 17.75 2019-05-31 4 M 0 4000 0 D 2022-06-01 Common Stock 4000 0 D Stock Option (Right to Buy) 30.04 2019-05-31 4 M 0 4000 0 D 2023-06-03 Common Stock 4000 0 D Stock Option (Right to Buy) 35.11 2019-05-31 4 M 0 4000 0 D 2024-06-02 Common Stock 4000 0 D Annual equity award in the form of restricted stock units ("RSUs"). RSUs vest in full on April 30, 2020 and are settled in shares of common stock on a one-for-one basis. The transactions reported in this Form 4 were effected pursuant to a Rule 10b5-1 trading plan adopted by the reporting person on March 11, 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 $106.965 to $110.395. 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 on April 30, 2016, 25% of the total award vesting on April 30, 2017 and 25% of the total award vesting on April 30, 2018, 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, 2012, 25% of the total award vesting on April 30, 2013 and 25% of the total award vesting on April 30, 2014, 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. This option is subject to the following vesting schedule: 50% of the total award shall vest on April 30, 2014, 25% of the total award shall vest on April 30, 2015 and 25% of the total award shall vest on April 30, 2016, 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, 2015, 25% of the total award vesting on April 30, 2016 and 25% of the total award vesting on April 30, 2017, subject to continued service as a director or consultant. /s/ John W. Kapples, attorney-in-fact 2019-06-03 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/ Sally Crawford Name: Sally Crawford