0001127602-21-028955.txt : 20211112 0001127602-21-028955.hdr.sgml : 20211112 20211112160654 ACCESSION NUMBER: 0001127602-21-028955 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20211111 FILED AS OF DATE: 20211112 DATE AS OF CHANGE: 20211112 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Lemoine David A CENTRAL INDEX KEY: 0001501185 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-33462 FILM NUMBER: 211403436 MAIL ADDRESS: STREET 1: C/O THE L S STARRETT COMPANY STREET 2: 121 CRESCENT STREET CITY: ATHOL STATE: MA ZIP: 01331 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: INSULET CORP CENTRAL INDEX KEY: 0001145197 STANDARD INDUSTRIAL CLASSIFICATION: SURGICAL & MEDICAL INSTRUMENTS & APPARATUS [3841] IRS NUMBER: 043523891 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 100 NAGOG PARK CITY: ACTON STATE: MA ZIP: 01720 BUSINESS PHONE: 978-600-7000 MAIL ADDRESS: STREET 1: 100 NAGOG PARK CITY: ACTON STATE: MA ZIP: 01720 4 1 form4.xml PRIMARY DOCUMENT X0306 4 2021-11-11 0001145197 INSULET CORP PODD 0001501185 Lemoine David A C/O INSULET CORPORATION 100 NAGOG PARK ACTON MA 01720 1 Common Stock 2021-11-11 4 M 0 5235 28.87 A 11734 D Common Stock 2021-11-11 4 M 0 3587 40.60 A 15321 D Common Stock 2021-11-11 4 S 0 4565 314.96 D 10756 D Stock Option (Right to Buy) 28.87 2021-11-11 4 M 0 5235 0 D 2017-04-30 2026-05-11 Common Stock 5235 0 D Stock Option (Right to Buy) 40.60 2021-11-11 4 M 0 3587 0 D 2018-04-30 2027-05-17 Common Stock 3587 0 D The price reported represents the weighted average sale price of the shares sold. The shares were sold at varying prices in the range of $314.59 to $315.225. The Reporting Person hereby undertakes, upon request of the Staff of the U.S. Securities Exchange Commission, the Issuer or a security holder of the Issuer, to provide full information regarding the number of shares sold at each separate price. /s/ John W. Kapples, attorney-in-fact 2021-11-12