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FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-798885

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1. American Medical Response Inc Political Action Committee

    6200 S Syracuse Way, Suite 200
    Greenwood Village, CO 80111
    Email: john_ranieri@emcare.com

2. Date: 07/17/2012

3. FEC Committee ID #: C00389585 This committee is a separate segregated fund. Its connected organization is a Corporation

Affiliated Committees/Organizations

EmCare Political Action Committee
1717 Main Street, Suite 5200
Dallas, Texas 75201
Affiliated Relationship Code: Affiliated Committee

Custodian of Records:

Terri Olmsted
6200 S. Syracuse Way, Suite 200
Greenwood Villiage, CO 80111
Title: Supervisor Bank Rec
Phone # (303) 495-1418

Treasurer:

Mr John Ranieri
2263 Forest Glen Drive
Warrington, Pennsylvania 18976
Title: Government Relations
Phone # (610) 834-2828

Designated Agent(s):

John Ranieri
6200 S. Syracuse Way, Suite 200
Greenwood Village, Colorado 80111
Title: Government Relations
Phone # (610) 834-2828

Banks or Depositories

Wells Fargo Bank
600 Cuthbert Blvd
Haddon Township, New Jersey 08108

Signed: Mr John Ranieri
Date Signed: 07/17/2012

FORM TEXT

(End FEC FORM 1)

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