-----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, PLxH8O7x69kIL7Ah/ktgT0kjgIf/NFKrleuUkDEh6XYiCoKoNQqRk+vka+oTjyME Iwc/QW9SIkXNfgBWpYi6og== 0000883984-04-000031.txt : 20040517 0000883984-04-000031.hdr.sgml : 20040517 20040517144858 ACCESSION NUMBER: 0000883984-04-000031 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20040516 FILED AS OF DATE: 20040517 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: KOVALCHIK MICHAEL T CENTRAL INDEX KEY: 0001073390 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-19974 FILM NUMBER: 04811706 BUSINESS ADDRESS: STREET 1: C/O ICU MEDICAL INC STREET 2: 951 CALLE AMANECER CITY: SAN CLEMENTE STATE: CA ZIP: 92673 BUSINESS PHONE: 949366283 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 X0202 4 2004-05-16 0 0000883984 ICU MEDICAL INC/DE ICUI 0001073390 KOVALCHIK MICHAEL T C/O ICU MEDICAL INC 951 CALLE AMANECER SAN CLEMENTE CA 92673 1 0 0 0 Non-Qualified Stock Option (right to buy) 32.435 2004-05-16 2004-05-16 4 A 0 1875 A 2004-11-16 2015-05-16 Common Stock 1875 1875 D Purchase price is zero; no purchase price applies. By: Lynn DeMartini For: Michael T. Kovalchik, III, M.D. 2004-05-17 -----END PRIVACY-ENHANCED MESSAGE-----