-----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, I7GZLOJDtqa8k13CER4zE/k1EWEg6abaM/jqeMMgo6wCI58sAtubtnsVZGWSJa0B VGqTgz1Y2OV3Be89YIvxBA== 0001005477-03-000238.txt : 20030506 0001005477-03-000238.hdr.sgml : 20030506 20030506083059 ACCESSION NUMBER: 0001005477-03-000238 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20030326 FILED AS OF DATE: 20030506 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: 03683079 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 edgar123.xml FORM 4 X0101 4 2003-03-26 0 0000883984 ICU MEDICAL INC/DE ICUI 0001073390 KOVALCHIK MICHAEL T 1 0 0 0 Common Stock 2003-03-26 4 G 0 500 0 D 9062 D Common Stock 2005-03-26 4 G 0 500 0 A 500 D Options to Acquire Common Stock (Grant 11/2/01) 28.1833 2003-03-26 4 P 0 0 0 A 2002-05-02 2012-11-02 Common Stock 0 1875 D Options to Acquire Common Stock (Grant 5/16/02) 39.2500 2003-03-26 4 P 0 0 0 A 2002-11-15 2010-01-02 Common Stock 0 15000 D Options to Acquire Common Stock (Grant 8/16/02) 36.3050 2003-03-26 4 P 0 0 0 A 2003-02-16 2013-08-16 Common Stock 0 1875 D Options to Acquire Common Stock (Grant 11/16/02) 39.5550 2003-03-23 4 P 0 0 0 A 2003-05-16 2013-05-16 Common Stock 0 1875 D Options to Acquire Common Stock (Grant 02/16/03) 30.2950 2003-03-26 4 P 0 0 0 A 2003-08-16 2014-02-16 Common Stock 0 1875 D Gift of a joint tenancy interest to son who shares Reporting Person's household. Held by Reporting Person's son as joint tenants with right of survivorship. /s/ Michael T. Kovalchik, III, M.D. 2003-03-26 -----END PRIVACY-ENHANCED MESSAGE-----