0000883984-12-000015.txt : 20120203 0000883984-12-000015.hdr.sgml : 20120203 20120203160915 ACCESSION NUMBER: 0000883984-12-000015 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20120201 FILED AS OF DATE: 20120203 DATE AS OF CHANGE: 20120203 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: 92763-6212 BUSINESS PHONE: 949-366-2183 MAIL ADDRESS: STREET 1: 951 CALLE AMANECER CITY: SAN CLEMENTE STATE: CA ZIP: 92763-6212 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: LOPEZ GEORGE A CENTRAL INDEX KEY: 0001073397 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-34634 FILM NUMBER: 12570047 MAIL ADDRESS: STREET 1: C/O ICU MEDICAL STREET 2: 951 CALLE AMANECER CITY: SAN CLEMENTE STATE: CA ZIP: 92673 4 1 edgardoc.xml PRIMARY DOCUMENT X0304 4 2012-02-01 0 0000883984 ICU MEDICAL INC/DE ICUI 0001073397 LOPEZ GEORGE A 951 CALLE AMANECER SAN CLEMENTE CA 92673 1 1 1 0 Chairman Non-Qualified Stock Option (right to buy) 46.53 2012-02-01 2012-02-01 4 A 0 88857.0 46.53 A 2022-02-01 Common Stock 88857.0 88857.0 D Non-Qualified Stock Option (right to buy) 2012-02-01 4 A 0 8409.0 0.0 A 2013-02-01 Common Stock 8409.0 8409.0 D Options vest and are exercisable as to 25% of the underlying grant one year after the date of grant and in equal monthly installments thereafter for three additional years. These securities are Restricted Stock Units. There is neither a purchase price nor an exercise price for the Restricted Stock Units. If the Company's adjusted TSR for 2012 is equal or greater than the 33d percentile of the peer companies (but less than 50%), 50% of the shares covered by the RSUs would be earned; if adjusted TSR for the Company is equal or greater than the 75th percentile of the peer companies, 200% of the shares shown above for the RSUs would be earned. Vesting of any amount earned would be 33% on the anniversary date of the award; 33% of the award two years after grant, and the remaining 33% a year later, with the employee having to be employed by the Company at the time the award was earned and at the time of any vesting. Vesting of any amount earned would be 33% on the anniversary date of the award; 33% of the award two years after grant, and the remaining 33% a year later, with the employee having to be employed by the Company at the time of any vesting. By: Lynn DeMartini For: George A. Lopez, M.D. 2012-02-03