FEC FORM 1
STATEMENT OF ORGANIZATION
FILING FEC-871054
1. AHS Medical Holdings LLC Good Government Fund
One Burton Hills BoulevardSuite 250
Nashville, TN 37215
Email: Ashley.Crabtree@ardenthealth.com
2. Date: 05/15/2013
3. FEC Committee ID #: C00390963 This committee is a separate segregated fund. Its connected organization is a CorporationAffiliated Committees/Organizations
AHS Medical Holdings LLCOne Burton Hills Boulevard
Suite 250
Nashville, Tennessee 37215
Affiliated Relationship Code: Connected Organization
Custodian of Records:
Mrs. Ashley M. Crabtree4200 Belmont Boulevard
Nashville,, TN 37215
Title: Treasurer
Phone # (615) 296-3202
Treasurer:
Mrs. Ashley M. Crabtree4200 Belmont Boulevard
Nashville,, Tennessee 37215
Title: Treasurer
Phone # (615) 296-3202
Designated Agent(s):
Mr. Stephen C. Petrovich9013 Brentmeade Boulevard
Brentwood,, Tennessee 37027
Title: Assistant Treasurer
Phone # (615) 296-3384
Banks or Depositories
Bank of America N.A.600 Peachtree Street NE
14th Floor
Atlanta,, Georgia 30308
Fifth Third Bank
Nashville Financial Center
424 Church Street, Suite 600
Nashville,, Tennessee 37219