0001209191-11-059244.txt : 20111202
0001209191-11-059244.hdr.sgml : 20111202
20111202180221
ACCESSION NUMBER: 0001209191-11-059244
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 2
CONFORMED PERIOD OF REPORT: 20111130
FILED AS OF DATE: 20111202
DATE AS OF CHANGE: 20111202
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: OLSON CHARLES W
CENTRAL INDEX KEY: 0001286125
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 000-23837
FILM NUMBER: 111241533
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: SURMODICS INC
CENTRAL INDEX KEY: 0000924717
STANDARD INDUSTRIAL CLASSIFICATION: PHARMACEUTICAL PREPARATIONS [2834]
IRS NUMBER: 411356149
STATE OF INCORPORATION: MN
FISCAL YEAR END: 0930
BUSINESS ADDRESS:
STREET 1: 9924 W 74TH ST
CITY: EDEN PRAIRIE
STATE: MN
ZIP: 55344
BUSINESS PHONE: 6128292700
MAIL ADDRESS:
STREET 1: 9924 WEST 74TH ST
CITY: EDEN PRAIRIE
STATE: MN
ZIP: 55344
FORMER COMPANY:
FORMER CONFORMED NAME: BSI CORP
DATE OF NAME CHANGE: 19970506
4
1
doc4.xml
FORM 4 SUBMISSION
X0304
4
2011-11-30
0
0000924717
SURMODICS INC
SRDX
0001286125
OLSON CHARLES W
9924 WEST 74TH STREET
EDEN PRAIRIE
MN
55344
0
1
0
0
Senior VP & GM, Med Dev
Stock Option (Right to Buy)
12.40
2011-11-30
4
A
0
21469
0.00
A
2018-11-30
Common Stock
21469
21469
D
Represents an annual stock option award granted pursuant to the issuer's executive compensation program.
The award vests in four equal installments on each of the first four anniversaries of the November 30, 2011 grant date.
/s/ Bryan K. Phillips, on behalf of Charles W. Olson
2011-12-02
EX-24.4_399441
2
poa.txt
POA DOCUMENT
POWER OF ATTORNEY
I, Charles W. Olson, hereby authorize and designate each of Bryan K. Phillips,
Douglas P. Long, Nicole J. Kroetsch, and Brook T. Nuernberg signing singly, as
my true and lawful attorney in fact to:
(1) execute for and on my behalf, in my capacity as an officer and/or director
of SurModics, Inc., a Minnesota corporation (the "Company"), the Forms 4 and 5
in accordance with Section 16(a) of the Securities Exchange Act of 1934 (the
"Exchange Act") and the rules and regulations promulgated thereunder;
(2) do and perform any and all acts for and on my behalf which may be necessary
or desirable to complete and execute any such Forms 4 or 5 and timely file such
form with the Securities and Exchange Commission, any stock exchange or similar
authority, and the NASDAQ Stock Market; and
(3) take any other action of any type whatsoever in connection with the
foregoing which, in the opinion of such attorney in fact, may be to my benefit,
in my best interest, or legally required of me, it being understood that the
statements executed by such attorney in fact on my behalf pursuant to this Power
of Attorney shall be in such form and shall contain such terms and conditions as
such attorney in fact may approve in such attorney in fact's discretion.
I hereby further grant to each such attorney in fact full power and authority
to do and perform any and every act and thing whatsoever requisite, necessary,
or proper to be done in the exercise of any of the rights and powers herein
granted, as fully to all intents and purposes as I might or could do if
personally present, with full power of substitutes or revocation, hereby
ratifying and confirming all that such attorney in fact, or such attorney in
fact's substitute or substitutes, shall lawfully do or cause to be done by
virtue of this Power of Attorney and the rights and powers herein granted. I
hereby acknowledge that the foregoing attorneys in fact, in serving in such
capacity at my request, are not assuming, nor is the Company assuming, any of my
responsibilities to comply with Section 16 of the Exchange Act.
This Power of Attorney shall remain in full force and effect until I am no
longer required to file Forms 4 and 5 with respect to my holdings of and
transactions in securities issued by the Company, unless earlier revoked by me
in a signed writing delivered to the foregoing attorneys in fact.
Notwithstanding the foregoing, if any such attorney-in-fact hereafter ceases to
be either a partner or employee of Faegre & Benson LLP, or an employee of the
Company, this Power of Attorney shall be automatically revoked solely as to such
individual, immediately upon such cessation, without any further action on my
part.
I hereby revoke all previous Powers of Attorney that have been granted by me
in connection with my reporting obligations under Section 16 of the Exchange Act
with respect to my holdings of and transactions in securities issued by the
Company.
IN WITNESS WHEREOF, I have caused this Power of Attorney to be duly executed
as of this 30th day of November, 2011.
/s/ Charles W. Olson