0001073397-21-000005.txt : 20210914 0001073397-21-000005.hdr.sgml : 20210914 20210914180751 ACCESSION NUMBER: 0001073397-21-000005 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20210914 FILED AS OF DATE: 20210914 DATE AS OF CHANGE: 20210914 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: 211253557 MAIL ADDRESS: STREET 1: C/O ICU MEDICAL 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 2021-09-14 0 0000883984 ICU MEDICAL INC/DE ICUI 0001073397 LOPEZ GEORGE A 951 CALLE AMANECER SAN CLEMENTE CA 92673 1 0 1 0 Common Stock 2021-09-14 4 M 0 15295 46.53 A 255609 D Common Stock 886843 I by Partnership Non-Qualified Stock Option (right to buy) 46.53 2021-09-14 4 M 0 15295 0.0 D 2016-02-01 2022-02-01 Common Stock 15295 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. By: Paula Darbyshire, Attorney-in-fact For: George A. Lopez, M.D. 2021-09-14