0001127602-24-007635.txt : 20240229 0001127602-24-007635.hdr.sgml : 20240229 20240229163744 ACCESSION NUMBER: 0001127602-24-007635 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20240228 FILED AS OF DATE: 20240229 DATE AS OF CHANGE: 20240229 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Petrovic Shacey CENTRAL INDEX KEY: 0001631895 ORGANIZATION NAME: FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-33462 FILM NUMBER: 24704470 MAIL ADDRESS: STREET 1: 600 TECHNOLOGY PARK DRIVE STREET 2: 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] ORGANIZATION NAME: 08 Industrial Applications and Services 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 X0508 4 2024-02-28 0001145197 INSULET CORP PODD 0001631895 Petrovic Shacey C/O INSULET CORPORATION 100 NAGOG PARK ACTON MA 01720 1 0 Common Stock 2024-02-28 4 M 0 11609 92.11 A 14176 D Common Stock 2024-02-28 4 S 0 11609 162.92 D 2567 D Common Stock 30000 I By NG Trust Employee Stock Option (Right to Buy) 92.11 2024-02-28 4 M 0 11609 0 D 2029-02-26 Common Stock 11609 0 D The price reported represents the weighted average sale price of the shares sold. The shares were sold at varying prices in the range of $162.76 to $163.29. The Reporting Person hereby undertakes, upon request of the Staff of the U.S. Securities and 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, which is fully vested, vested over a four-year period with 25% of the total award vesting on each of the first, second, third and fourth anniversaries of the grant date. /s/ Patricia K. Dolan, attorney-in-fact 2024-02-29