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