0001127602-20-005082.txt : 20200212
0001127602-20-005082.hdr.sgml : 20200212
20200212164506
ACCESSION NUMBER: 0001127602-20-005082
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 2
CONFORMED PERIOD OF REPORT: 20200210
FILED AS OF DATE: 20200212
DATE AS OF CHANGE: 20200212
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Benjamin Eric
CENTRAL INDEX KEY: 0001731734
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-33462
FILM NUMBER: 20604838
MAIL ADDRESS:
STREET 1: C/O INSULET CORPORATION
STREET 2: 600 TECHNOLOGY PARK DR, SUITE 200
CITY: BILLERICA
STATE: MA
ZIP: 01821
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
2020-02-10
0001145197
INSULET CORP
PODD
0001731734
Benjamin Eric
C/O INSULET CORPORATION
100 NAGOG PARK
ACTON
MA
01720
1
SVP, R&D, New Prod Dev & Comm
Common Stock
2020-02-10
4
A
0
925
0
A
13373
D
Employee Stock Option (Right to Buy)
202.64
2020-02-10
4
A
0
2618
0
A
2030-02-10
Common Stock
2618
2618
D
Annual Restricted Stock Unit ("RSU") award. RSUs vest in equal installments on each of the first, second and third anniversaries of the grant date and are settled in shares of common stock on a one-for-one basis.
Includes 207 shares acquired on May 31, 2019 and 64 shares acquired on November 29, 2019 under the Insulet Corporation Employee Stock Purchase Plan.
Annual Non-Qualified Stock Option ("Option") Award. The Options become exercisable in substantially equal installments on each of the first, second, third and fourth anniversaries of the grant date.
/s/ John W. Kapples, attorney-in-fact
2020-02-12
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 either 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 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/ Eric Benjamin
Name: Eric Benjamin