-----BEGIN PRIVACY-ENHANCED MESSAGE----- Proc-Type: 2001,MIC-CLEAR Originator-Name: webmaster@www.sec.gov Originator-Key-Asymmetric: MFgwCgYEVQgBAQICAf8DSgAwRwJAW2sNKK9AVtBzYZmr6aGjlWyK3XmZv3dTINen TWSM7vrzLADbmYQaionwg5sDW3P6oaM5D3tdezXMm7z1T+B+twIDAQAB MIC-Info: RSA-MD5,RSA, NUdTMM06eOCVopA/mskRDNumFhDAlmMBlxnG+YEiqP/+ystCL6eea0CHGGxK6EzV 3GMQ3wd9L97gXaTD8ES3TA== 0000883984-03-000023.txt : 20030903 0000883984-03-000023.hdr.sgml : 20030903 20030903175731 ACCESSION NUMBER: 0000883984-03-000023 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 2 CONFORMED PERIOD OF REPORT: 20030902 FILED AS OF DATE: 20030903 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: ICU MEDICAL INC/DE CENTRAL INDEX KEY: 0000883984 STANDARD INDUSTRIAL CLASSIFICATION: SURGICAL & MEDICAL INSTRUMENTS & APPARATUS [3841] IRS NUMBER: 330022692 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 951 CALLE AMANECER CITY: SAN CLEMENTE STATE: CA ZIP: 92769 BUSINESS PHONE: 9493662183 MAIL ADDRESS: STREET 1: 951 CALLE AMANELER CITY: SANCLEMENTE STATE: CA ZIP: 92769 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: COSTELLO RICHARD A CENTRAL INDEX KEY: 0001073401 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-19974 FILM NUMBER: 03879943 BUSINESS ADDRESS: STREET 1: C/O ICU MEDICAL INC STREET 2: 951 CALLE AMANECER CITY: SAN CLEMENTE STATE: CA ZIP: 92673 BUSINESS PHONE: 9493662183 MAIL ADDRESS: STREET 1: C/O ICU MEDICAL INC STREET 2: 951 CALLE AMANECER CITY: SAN CLEMENTE STATE: CA ZIP: 92673 4 1 edgardoc.xml PRIMARY DOCUMENT X0201 4 2003-09-02 0 0000883984 ICU MEDICAL INC/DE icui 0001073401 COSTELLO RICHARD A C/O ICU MEDICAL INC 951 CALLE AMANECER SAN CLEMENTE CA 92673 0 1 0 0 Vice President Sales Non-Qualified Stock Option (right to buy) 29.565 2003-09-02 4 P 0 10000 0 A 2014-09-02 Common Stock 10000 10000 D Purchase price is zero; no purchase price applies. Options exercisable one-third annually over the first three anniversaries of the grant date. By: Lynn DeMartini For: Richard A. Costello 2003-09-03 EX-24 3 powerofattyrac.txt EDGAR SUPPORTING DOCUMENT POWER OF ATTORNEY SEC FORMS 3, 4 and 5 The undersigned, Richard A. Costello, hereby appoints and designates each of Lynn DeMartini and Janice Rough his attorney-in-fact, signing singly, to execute and file on the undersigned's behalf all Forms 3, 4, and 5 (including any amendments thereto) that the undersigned may be required to file with the U.S. Securities and Exchange Commission as a result of the undersigned's ownership of or transactions in securities of ICU Medical Inc. Any previous authority to act on the undersigned's behalf in connection with such execution and filing of Forms 3, 4 and 5 is hereby revoked and the authority of Lynn DeMartini and Janice Rough under this Statement shall continue until the undersigned is no longer required to file Forms 3, 4 and 5 with regard to the undersigned's ownership of or transactions in securities of ICU Medical Inc., unless earlier revoked in writing. The undersigned acknowledges that neither Lynn DeMartini nor Janice Rough is assuming any of the undersigned's responsibilities to comply with Section 16 of the Securities Exchange Act of 1934. Date: August 25, 2003 /s/ Richard A. Costello - ------------------------------ Richard A. Costello -----END PRIVACY-ENHANCED MESSAGE-----