0001140361-17-008603.txt : 20170222 0001140361-17-008603.hdr.sgml : 20170222 20170222162449 ACCESSION NUMBER: 0001140361-17-008603 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20170217 FILED AS OF DATE: 20170222 DATE AS OF CHANGE: 20170222 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: VASCULAR SOLUTIONS INC CENTRAL INDEX KEY: 0001030206 STANDARD INDUSTRIAL CLASSIFICATION: SURGICAL & MEDICAL INSTRUMENTS & APPARATUS [3841] IRS NUMBER: 411859679 STATE OF INCORPORATION: MN FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 6464 SYCAMORE COURT NORTH CITY: MINNEAPOLIS STATE: MN ZIP: 55369 BUSINESS PHONE: 7636564300 MAIL ADDRESS: STREET 1: 6464 SYCAMORE COURT NORTH CITY: MINNEAPOLIS STATE: MN ZIP: 55369 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: ERB JOHN L CENTRAL INDEX KEY: 0001213867 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-27605 FILM NUMBER: 17628742 MAIL ADDRESS: STREET 1: C/O VASCULAR SOLUTIONS, INC. STREET 2: 6464 SYCAMORE COURT N. CITY: MINNEAPOLIS, STATE: MN ZIP: 55369 4 1 doc1.xml FORM 4 X0306 4 2017-02-17 1 0001030206 VASCULAR SOLUTIONS INC VASC 0001213867 ERB JOHN L C/O VASCULAR SOLUTIONS INC 6464 SYCAMORE COURT N. MINNEAPOLIS MN 55369 1 0 0 0 Common Stock 11733 D Common Stock 2017-02-17 4 D 0 11733 D 0 D Stock Option (Right to Buy) 11.72 2017-02-17 4 D 0 20000 44.28 D 2021-04-22 Common Stock 20000 0 D In connection with the merger of Issuer and a subsidiary of Teleflex Incorporated (the "Merger") pursuant to an agreement and plan of merger dated December 1, 2016, all shares of Issuer common stock were cancelled and automatically converted into the right to receive $56.00 per share in cash, without interest and less any applicable withholding taxes. This option, which is fully vested, was cancelled pursuant to the Merger in exchange for a cash payment of $885,600, representing the difference between the exercise price of the option and the merger consideration per share ($56.00) multiplied by the total number of shares underlying the option, less any applicable withholding taxes. /s/ John Erb 2017-02-22