0000856982-18-000036.txt : 20180607 0000856982-18-000036.hdr.sgml : 20180607 20180607123554 ACCESSION NUMBER: 0000856982-18-000036 CONFORMED SUBMISSION TYPE: 3 PUBLIC DOCUMENT COUNT: 2 CONFORMED PERIOD OF REPORT: 20180529 FILED AS OF DATE: 20180607 DATE AS OF CHANGE: 20180607 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Parra Raul Jr. CENTRAL INDEX KEY: 0001742555 FILING VALUES: FORM TYPE: 3 SEC ACT: 1934 Act SEC FILE NUMBER: 000-18592 FILM NUMBER: 18885814 MAIL ADDRESS: STREET 1: 1600 WEST MERIT PARKWAY CITY: SOUTH JORDAN STATE: UT ZIP: 84095 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: MERIT MEDICAL SYSTEMS INC CENTRAL INDEX KEY: 0000856982 STANDARD INDUSTRIAL CLASSIFICATION: SURGICAL & MEDICAL INSTRUMENTS & APPARATUS [3841] IRS NUMBER: 870447695 STATE OF INCORPORATION: UT FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 1600 WEST MERIT PARK WAY CITY: SOUTH JORDAN STATE: UT ZIP: 84095 BUSINESS PHONE: 8012531600 MAIL ADDRESS: STREET 1: 1600 WEST MERIT PARKWAY CITY: SOUTH JORDAN STATE: UT ZIP: 84095 3 1 wf-form3_152838933784361.xml FORM 3 X0206 3 2018-05-29 0 0000856982 MERIT MEDICAL SYSTEMS INC MMSI 0001742555 Parra Raul Jr. 1600 WEST MERIT PARKWAY SOUTH JORDAN 84095 0 1 0 0 Interim CFO Common Stock, No Par Value 283 I By 401 (k) plan Non-qualified stock options (right to buy) 12.06 2015-10-04 2021-10-04 Common Stock 2000.0 D Non-qualified stock options (right to buy) 17.27 2016-02-13 2022-02-13 Common Stock 2000.0 D Non-qualified stock options (right to buy) 16.05 2017-01-28 2023-01-28 Common Stock 3000.0 D Non-qualified stock options (right to buy) 28.2 2018-04-14 2024-04-14 Common Stock 8000.0 D Non-qualified stock options (right to buy) 44.8 2019-03-02 2025-03-02 Common Stock 10000.0 D Represents plan holdings as of 06/05/2018. Becomes exercisable in equal annual installments of 20% commencing on 10/04/2015. Becomes exercisable in equal annual installments of 20% commencing on 02/13/2016. Becomes exercisable in equal annual installments of 20% commencing on 01/28/2017. Becomes exercisable in equal annual installments of 20% commencing on 04/14/2018. Becomes exercisable in equal annual installments of 20% commencing on 03/02/2019. Raul Parra, Jr. 2018-06-07 EX-24 2 parrapoatext.txt POA MERIT MEDICAL SYSTEMS, INC. POWER OF ATTORNEY For Executing Forms 3, 4 and 5 Knowing all by these presents that the undersigned hereby constitutes and appoints each of Fred P. Lampropoulos and Brian LLoyd signing singly, his/hers true and lawful attorney-in-fact to: (1) prepare, execute in the undersigned's name and on the undersigned's behalf, and submit to the U.S. Securities and Exchange Commission a Form ID, including amendments thereto, and any other documents necessary or appropriate to obtain codes and passwords enabling the undersigned to make electronic filings with the SEC of reports required by Section 16(a) of the Securities Exchange Act of 1934 or any rule or regulation of the SEC; (2) execute for and on behalf of the undersigned, in the undersigned's capacity as an office and/or director of Merit Medical Systems, Inc., Forms 3, 4, and 5 in accordance with Section 16(a) of the Securities Exchange Act of 1934 and the rules thereunder, and any other forms or reports the undersigned may be required to file in connection with the undersigned's ownership, acquisition or disposition of securities of Merit Medical Systems, Inc.; (3) do and perform any and all acts for and on behalf of the undersigned which may be necessary or desirable to complete and execute any such Form 3, 4, or 5 or other form or report, and timely file such form or report with the U.S. Securities and Exchange Commission and any stock exchange or similar authority; and (4) take any other action of any type whatsoever in connection with the foregoing which, in the opinion of such attorney-in-fact, may be of benefit to, in the best interest of, or legally required by, the undersigned, it being understood that the documents executed by such attorney-in-fact on behalf of the undersigned pursuant to this Power of Attorney shall be in such form and shall contain such terms and conditions as such attorney-in-fact may approve in such attorney-in-fact's discretion. The undersigned hereby grants to each such attorney-in-fact full power and authority to do and perform any and every act and thing whatsoever requisite, necessary or proper to be done in the exercise of any of the rights and powers herein granted, as fully to all intents and purposes as the undersigned might or could do if personally present, with full power of substitution or revocation, hereby ratifying and confirming all that such attorney-in-fact, or his/her substitute or substitutes, shall lawfully do or cause to be done by virtue of this power of attorney and the rights and powers herein granted. The undersigned acknowledges that the foregoing attorneys-in-fact, in serving in such capacity at the request of the undersigned, are not assuming, nor is Merit Medical Systems, Inc. assuming, any of the undersigned's responsibilities to comply with Section 16 of the Securities Exchange Act of 1934. 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 Merit Medical Systems, Inc., unless earlier revoked by the undersigned in a signed writing delivered to the foregoing attorneys-in-fact. Photographic copies of this Power of Attorney shall have the same force and effects as the original. IN WITNESS WHEREOF, the undersigned has caused this Power of Attorney to be executed as of this 30 day of May, 2018. /s/ Raul Parra, Jr. Signature Raul Parra, Jr. Printed Name