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FEC Form 1 for AmSurg Corp. Good Government FundForm 1 for AmSurg Corp. Good Government Fund

FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-1403517


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: 04/27/2020

3. FEC Committee ID #: C00484410 This committee is a separate segregated fund. Its connected organization is a Corporation

Affiliated 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:

Steve Holt
1A Burton Hills Blvd
Nashville, TN 37215
Title: Custodian of Records
Phone # (615) 461-9040

Treasurer:

Steve Holt
1A Burton Hills Blvd
Nashville, Tennessee 37215
Title: Treasurer
Phone # (615) 461-9040

Designated Agent(s):

Banks or Depositories

Bank of America
414 Church Street
Nashville, Tennessee 37219

Signed: Steve Holt
Date Signed: 04/27/2020
Official Committee URL: www.amsurg.com

FORM TEXT-1

(End FEC FORM 1)


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