FEC Form 1 for Surgery Partners, Inc. Political Action CommitteeForm 1 for Surgery Partners, Inc. Political Action Committee

FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-1377942

1. Surgery Partners, Inc. Political Action Committee

310 Seven Springs Way
Suite 500
Brentwood, TN 37027
Email: Jeff.Obrien@surgerypartners.com;mcureton@Surgerypartners.com

NOTE: Email address is different than previously reported

2. Date: 01/31/2020

3. FEC Committee ID #: C00520833 This committee is a separate segregated fund. Its connected organization is a Corporation

Affiliated Committees/Organizations

Surgery Partners, Inc.
310 Seven Springs Way
Suite 500
Brentwood, Tennessee 37027
Affiliated Relationship Code: Connected Organization

Committee ID# C00428086
NOVAMED INC POLITICAL ACTION COMMITTEE
333 W WACKER DRIVE SUITE 1010
CHICAGO, Illinois 60606
Affiliated Relationship Code: Affiliated Committee

Custodian of Records:

Jeffrey O'Brien
105 Hartley Ct
Nolensville, TN 37135
Title: VP Treasury
Phone # (615) 234-5931

Treasurer:

Jeffrey O'Brien
105 Hartley Ct
Nolensville, Tennessee 37135
Title: VP Treasury
Phone # (615) 234-5931

Designated Agent(s):

Banks or Depositories

Bank of America
4011 Hillsboro Road
Nashville, Tennessee 37215

Signed: Jeffrey O'Brien
Date Signed: 01/31/2020
Official Committee URL: www.surgerypartners.com

(End FEC FORM 1)

Generated Wed Sep 18 07:07:29 2024