0001615186-20-000001.txt : 20200121 0001615186-20-000001.hdr.sgml : 20200121 20200121135948 ACCESSION NUMBER: 0001615186-20-000001 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20200117 FILED AS OF DATE: 20200121 DATE AS OF CHANGE: 20200121 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: McCall Thomas D CENTRAL INDEX KEY: 0001615186 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-34634 FILM NUMBER: 20536005 MAIL ADDRESS: STREET 1: 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 2020-01-17 0 0000883984 ICU MEDICAL INC/DE ICUI 0001615186 McCall Thomas D 951 CALLE AMANECER SAN CLEMENTE CA 92673 0 1 0 0 Vice President and Gen'l Mgr. Common Stock 2020-01-17 4 M 0 3153 0.0 A 9539 D Common Stock 2020-01-17 4 F 0 1698 0.0 D 7841 D Common Stock 0.0 2020-01-17 4 M 0 1051 0.0 D 2020-01-17 2019-12-31 Common Stock 3153 0 D These Securities are Performance-based Restricted Stock Units (PRSU). There is neither a purchase price nor an exercise price for the PRSUs. Each PRSU reflects the contingent right to receive a variable number of shares of common stock based on achieving performance goals. At the determination date, based on certification of the achievement of the performance criteria, the reporting person earned 300% of the target award amount. These PRSUs were granted on March 27, 2017. The vesting for this performance-based restricted stock unit ("PRSU") award was dependent upon the achievement of a minimum Cumulative Adjusted EBITDA over the Fiscal Years 2017-2019. The reporting person was able to earn PRSUs ranging from 100% to 300% of the target award amount. By: Paula Darbyshire, Attorney-In-Fact For: Thomas D. McCall 2020-01-21