0001127602-19-012924.txt : 20190322
0001127602-19-012924.hdr.sgml : 20190322
20190322161747
ACCESSION NUMBER: 0001127602-19-012924
CONFORMED SUBMISSION TYPE: 3
PUBLIC DOCUMENT COUNT: 2
CONFORMED PERIOD OF REPORT: 20190318
FILED AS OF DATE: 20190322
DATE AS OF CHANGE: 20190322
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Kapples John W.
CENTRAL INDEX KEY: 0001663408
FILING VALUES:
FORM TYPE: 3
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-33462
FILM NUMBER: 19700057
MAIL ADDRESS:
STREET 1: C/O GCP APPLIED TECHNOLOGIES INC.
STREET 2: 62 WHITTEMORE AVENUE
CITY: CAMBRIDGE
STATE: MA
ZIP: 02140
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
3
1
form3.xml
PRIMARY DOCUMENT
X0206
3
2019-03-18
0
0001145197
INSULET CORP
PODD
0001663408
Kapples John W.
C/O INSULET CORPORATION
100 NAGOG PARK
ACTON
MA
01720
1
SVP, Secretary and GC
No Securities Are Beneficially Owned
0
D
/s/ John W. Kapples
2019-03-22
EX-24
2
doc1.txt
POWER OF ATTORNEY (PUBLIC):
POWER OF ATTORNEY
KNOW ALL MEN BY THESE PRESENTS, that the undersigned hereby constitutes
and appoints Shacey Petrovic, Wayde D. McMillan and Keith Bilezerian,
and any of them acting singly, the true and lawful attorneys-in-fact
and agents, with full power of substitution and resubstitution, for
the undersigned and in the undersigned's name, place and stead, in
any and all capacities (until revoked in writing) to execute for and
on behalf of the undersigned, in any and all of the undersigned's
capacities, any and all statements on Forms 3, 4 and 5 with respect
to the undersigned's holdings of and transactions in securities
issued by Insulet Corporation (the ?Company?) in accordance with
Sections 16(a) of the Securities Exchange Act of 1934, as amended
(the ?Exchange Act?), and any and all regulations promulgated
thereunder, and to file the same, with all exhibits thereto, and
any other documents in connection therewith, with the Securities
and Exchange Commission, and with any other entity when and if such
is mandated by the Exchange Act or by the By-laws of the National
Association of Securities Dealers, granting unto said attorneys-in-fact
and agents full power and authority to do and perform each and every
act and thing requisite and necessary fully to all intents and
purposes as the undersigned might or could do in person thereby
ratifying and confirming all that said attorneys-in-fact and
agents, or their substitute or substitutes, may lawfully do or
cause to be done by virtue hereof.
This Power of Attorney shall remain in full force and effect
until the undersigned is no longer required to file Forms 3, 4
and 5 with respect to the undersigned?s holdings of and
transactions in securities issued by the Company, unless
earlier revoked by the undersigned in a signed writing
delivered to the foregoing attorneys-in-fact.
IN WITNESS WHEREOF, this Power of Attorney has been
signed as of March 22, 2019.
Signature: /s/ John W. Kapples
Name: John W. Kapples