0000883984-13-000003.txt : 20130204 0000883984-13-000003.hdr.sgml : 20130204 20130204205953 ACCESSION NUMBER: 0000883984-13-000003 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20130201 FILED AS OF DATE: 20130204 DATE AS OF CHANGE: 20130204 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: 001-34634 FILM NUMBER: 13571818 MAIL ADDRESS: STREET 1: C/O ICU MEDICAL INC STREET 2: 951 CALLE AMANECER CITY: SAN CLEMENTE STATE: CA ZIP: 92673 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 4 1 edgardoc.xml PRIMARY DOCUMENT X0306 4 2013-02-01 0 0000883984 ICU MEDICAL INC/DE ICUI 0001073401 COSTELLO RICHARD A 951 CALLE AMANECER SAN CLEMENTE CA 92673 0 1 0 0 Vice President Sales Common Stock 2013-02-01 4 M 0 980.0 0.0 A 1089.0 D Common Stock 2013-02-01 4 F 0 430.0 61.16 D 659.0 D Non-Qualified Stock Option (right to buy) 2013-02-01 4 M 0 490.0 0.0 D 2013-02-01 2013-02-01 Common Stock 490.0 978.0 D These securities are Restricted Stock Units. There is neither a purchase price nor an exercise price for the Restricted Stock Units. As disclosed in the Reporting Person's Form 4 for the original grant of the RSUs, the award agreement for the RSU provided that the shares covered by the RSU were subject to increase in the event that the Company's adjusted TSR for 2012 equaled or exceeded certain thresholds. On January 31 2013, the Company's Compensation Committee determined that the Company's adjusted TSR for 2012 equaled or exceed the 75th percentile of the Company's peer companies. As a result, the shares covered by the Reporting Person's RSU increased by 200%. The share amounts reported in Table II for the RSU reflect the unadjusted share amounts, and the share amount reported in Table I reflects the number of shares covered by the RSU that have vested, as adjusted for the increase. Vesting of any amount earned would be one-third on the anniversary date of the award; one-third of the award two years after grant, and the remaining one-third a year later, with the employee having to be employed by the Company at the time of any vesting. By: Lynn DeMartini For: Richard A. Costello 2013-02-04