0001073393-15-000011.txt : 20151005 0001073393-15-000011.hdr.sgml : 20151005 20151005183522 ACCESSION NUMBER: 0001073393-15-000011 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20151005 FILED AS OF DATE: 20151005 DATE AS OF CHANGE: 20151005 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: BROWN JACK CENTRAL INDEX KEY: 0001073393 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-34634 FILM NUMBER: 151144620 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 X0306 4 2015-10-05 0 0000883984 ICU MEDICAL INC/DE ICUI 0001073393 BROWN JACK 951 CALLE AMANECER SAN CLEMENTE CA 92673 1 0 0 0 Common Stock 2015-10-05 4 M 0 1875.0 24.21 A 20875 D Common Stock 2015-10-05 4 F 0 554.0 107.0888 D 20321 D Common Stock 2015-10-05 4 F 0 459.0 108.3264 D 19862 D Non-Qualified Stock Option (right to buy) 24.21 2015-10-05 4 X 0 1875.0 D 2005-05-16 2015-11-16 Common Stock 1875 0 D The sales reported in this Form 4 were effected pursuant to a Rule 10b5-1 Plan adopted by the reporting person on November 26, 2014. The price recorded in Column 4 is a weighted average price. These shares were sold in multiple transactions at prices ranging from $106.66 to 107.57, inclusive. The reporting person undertakes to provide ICU Medical, Inc., any security holder of ICU Medical, Inc., or the staff of the Securities and Exchange Commission, upon request, full information regarding the number of shares sold at each separate price within the range set forth in this Form 4. The price recorded in Column 4 is a weighted average price. These shares were sold in multiple transactions at prices ranging from $107.79 to 108.71, inclusive. The reporting person undertakes to provide ICU Medical, Inc., any security holder of ICU Medical, Inc., or the staff of the Securities and Exchange Commission, upon request, full information regarding the number of shares sold at each separate price within the range set forth in this Form 4. Transaction is the exercise of a derivative security; see Column 2. By: Lauren Tarquin For: Jack Brown 2015-10-05