FEC FORM 1
STATEMENT OF ORGANIZATION
FILING FEC-1301836
1. AmSurg Corp. Good Government Fund
1A Burton Hills Blvd.Nashville, TN 37215
Email: fecinfo@pass1.com;goodgovernmentfund@amsurg.com
NOTE: Email address is different than previously reported
2. Date: 12/19/2018
3. FEC Committee ID #: C00484410 This committee is a separate segregated fund. Its connected organization is a CorporationAffiliated Committees/Organizations
AmSurg Corp.1A Burton Hills Blvd.
Nashville, Tennessee 37215
Affiliated Relationship Code: Connected Organization
Committee ID# C00398271
Envision Healthcare Corporation Politi
1A Burton Hills Boulevard
Nashville, Tennessee 37215
Affiliated Relationship Code: Affiliated Committee
Custodian of Records:
Thomas M. Sloan, Jr.1A Burton Hills Blvd
Nashville, TN 37215
Title: Treasurer
Phone # (615) 665-3608
Treasurer:
Thomas M. Sloan, Jr.1A Burton Hills Blvd
Nashville, Tennessee 37215
Title: Treasurer
Phone # (615) 665-3608
Designated Agent(s):
Banks or Depositories
Bank of America414 Church Street
Nashville, Tennessee 37219