0000883984-13-000012.txt : 20130207 0000883984-13-000012.hdr.sgml : 20130207 20130207202117 ACCESSION NUMBER: 0000883984-13-000012 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20130206 FILED AS OF DATE: 20130207 DATE AS OF CHANGE: 20130207 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: 13584369 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 2013-02-06 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 0.0 2013-02-06 4 A 0 2047.0 0.0 A 2016-02-06 Common Stock 2047.0 2047.0 D Non-Qualified Stock Option (right to buy) 61.76 2013-02-06 4 A 0 23624.0 61.76 A 2023-02-06 Common Stock 23624.0 23624.0 D 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 2013 is equal or greater than the 33rd percentile of the peer companies (but less than 50%), 50% of the shares covered by the RSUs would be earned; at an adjusted TSR equal or greater than the 50th percentile of the peer companies, 100% of the award would be earned; and, at an adjusted TSR 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 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 the award was earned and at the time of any vesting. 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. 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. By: Lynn DeMartini For: Richard A. Costello 2013-02-07