0001189727-17-000004.txt : 20170403
0001189727-17-000004.hdr.sgml : 20170403
20170403203227
ACCESSION NUMBER: 0001189727-17-000004
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20170327
FILED AS OF DATE: 20170403
DATE AS OF CHANGE: 20170403
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: BURCAR ALISON D
CENTRAL INDEX KEY: 0001189727
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-34634
FILM NUMBER: 17735994
MAIL ADDRESS:
STREET 1: C/O ICU MEDICAL INC
STREET 2: 951 CALLE AMANECER
CITY: SAN CLEMENTE
STATE: CA
ZIP: 92673
FORMER NAME:
FORMER CONFORMED NAME: BRUMMETT BURCAR ALISON
DATE OF NAME CHANGE: 20020916
4
1
edgardoc.xml
PRIMARY DOCUMENT
X0306
4
2017-03-27
0
0000883984
ICU MEDICAL INC/DE
ICUI
0001189727
BURCAR ALISON D
951 CALLE AMANECER
SAN CLEMENTE
CA
92673
0
1
0
0
Vice President and Gen'l Mgr.
Common Stock
0.0
2017-03-27
4
A
0
1535
0.0
A
2019-12-31
Common Stock
1535
1535
D
Common Stock
0.0
2017-03-27
4
A
0
1535
0.0
A
2020-03-27
Common Stock
1535
1535
D
These securities are Restricted Stock Units.
There is neither a purchase price nor an exercise price for the Restricted Stock Units.
The executive officers were notified of their awards by the Registrant on March 30, 2017.
The vesting for this performance-based restricted stock unit ("PRSU") award is dependent upon the reporting person's earning PRSUs based on the achievement of performance criteria related to the Company's fiscal year 2019 Cumulative Adjusted EBITDA in comparison to the fiscal year 2016 Adjusted EBITDA. The number of shares reported is the target award amount. The reporting person may potentially earn PRSUs ranging from 100% to 300% of the target award amount.
One third of the Units subject to the award shall vest on each of the first, second, and third anniversaries of the grant date.
By: Paula Darbyshire, Attorney-in-fact For: Alison D. Burcar
2017-04-03