0001375852-16-000006.txt : 20160208 0001375852-16-000006.hdr.sgml : 20160208 20160208173319 ACCESSION NUMBER: 0001375852-16-000006 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20160205 FILED AS OF DATE: 20160208 DATE AS OF CHANGE: 20160208 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: Lamb Scott E CENTRAL INDEX KEY: 0001375852 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-34634 FILM NUMBER: 161396555 MAIL ADDRESS: STREET 1: ICU MEDICAL, INC. STREET 2: 951 CALLE AMANECER CITY: SAN CLEMENTE STATE: CA ZIP: 92673 4 1 edgardoc.xml PRIMARY DOCUMENT X0306 4 2016-02-05 0 0000883984 ICU MEDICAL INC/DE ICUI 0001375852 Lamb Scott E 951 CALLE AMANECER SAN CLEMENTE CA 92673 0 1 0 0 Secretary, Treasurer, Common Stock 0.0 2016-02-05 4 A 0 2742.0 0.0 A 2018-12-31 Common Stock 2742 2742 D Common Stock 0.0 2016-02-05 4 A 0 2742.0 0.0 A 2019-02-05 Common Stock 2742 2742 D These securities are Restricted Stock Units. There is neither a purchase price nor an exercise price for the Restricted Stock Units. 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 2018 Adjusted EBITDA per share CAGR in comparison to the fiscal year 2015 Adjusted EBITDA per weighted average basic share. 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. The shares subject to the actual earned PRSU award will vest prior to March 15, 2019, the determination date, based on certification of the achievement of the performance criteria. 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 For: Scott E. Lamb 2016-02-08