0000883984-13-000020.txt : 20130415 0000883984-13-000020.hdr.sgml : 20130415 20130415171745 ACCESSION NUMBER: 0000883984-13-000020 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20130415 FILED AS OF DATE: 20130415 DATE AS OF CHANGE: 20130415 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: KOVALCHIK MICHAEL T CENTRAL INDEX KEY: 0001073390 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-34634 FILM NUMBER: 13762044 MAIL ADDRESS: STREET 1: C/O ICU MEDICAL INC STREET 2: 951 CALLE AMANECER CITY: SAN CLEMENTE STATE: CA ZIP: 92673 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: ICU MEDICAL INC/DE CENTRAL INDEX KEY: 0000883984 STANDARD INDUSTRIAL CLASSIFICATION: SURGICAL & MEDICAL INSTRUMENTS & APPARATUS [3841] IRS NUMBER: 330022692 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 951 CALLE AMANECER CITY: SAN CLEMENTE STATE: CA ZIP: 92763-6212 BUSINESS PHONE: 949-366-2183 MAIL ADDRESS: STREET 1: 951 CALLE AMANECER CITY: SAN CLEMENTE STATE: CA ZIP: 92763-6212 4 1 edgardoc.xml PRIMARY DOCUMENT X0306 4 2013-04-15 0 0000883984 ICU MEDICAL INC/DE ICUI 0001073390 KOVALCHIK MICHAEL T 951 CALLE AMANECER SAN CLEMENTE CA 92673 1 0 0 0 Common Stock 2013-04-15 4 X 0 15000.0 39.25 A 17762 D Common Stock 2013-04-15 4 S 0 15000.0 59.8366 D 2762 D Non-Qualified Stock Option (right to buy) 39.25 2013-04-15 4 X 0 15000.0 D 2002-11-16 2013-05-16 Common Stock 15000 0 D The sales reported in this Form 4 were effected pursuant to a Rule 10b5-1 Trading Plan adopted by the reporting person on April 19, 2012. he price reported in Column 4 is a weighted average price. These shares were sold in multiple transactions at prices ranging from $59.38 to $60.13, inclusive. The reporting person undertakes to provide ICU Medical, Inc., any security holder of ICU Medical, Inc., or the staff of the Securities and Exchange Commission, upon request, full information regarding the number of shares sold at each price within the range set forth in this Form 4. Transaction is the exercise of a derivative security; see Column 2. By: Lynn DeMartini For: Michael T. Kovalchik, III, M.D. 2013-04-15