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Corizon Health 461Major Donor and Independent Expenditure Committee Campaign Statement (Government Code sections O42OO'V4215.5) from SEE INSTRUCTIONS ON REVERSE Type or print in ink. Statement covers period 1/1/2014 12/31/2014 1. Name and Address of Filer NAME OF FILER (|ncludemame(s ) of all affihiated entities whose contributions are included in this statement.) Cohzon Health, Inc. MAILING ADDRESS (NO. AND STREET) 1O3 Powell [t. CITY STATE ZIP CODE Brentwood TN 37027 RESPONSIBLE OFFICER (If filer is other than an individual) AREA CODE/DAYTIME PHONE Scott King-SeniorVP & General Counsel 615'373-3100 J. Nature Filer (Complete each applicable sonhon.) El A FILER WHO IS AN INDIVIDUAL MUST LIST THE NAME, ADDRESS, AND BUSINESS INTERESTS OF EMPLOYER OR, IF SELF-EMPLOYED, THE NAME, ADDRESS, AND NATURE OF THE BUSINESS NAME OF EMPLOYER/BUSINESS BUSINESS INTERESTS ADDRESS OF EMPLOYER/BUSINESS ��A�LEnT*xrmAnomwsooswr�vMonrosnomasrxsoua/wsooAcnvr,/ww*/n*/rm —oNGwaso Provithng healthcare to patients in correctional facilities El A FILER THAT IS AN ASSOCIATION MUST PROVIDE A SPECIFIC DESCRIPTION OF ITS INTERESTS A FILER THAT 15 NOT AN INDIVIDUAL, BUSINESS ENTITY, OR ASSOCIATION MUST DESCRIBE THE COMMON ECONOMIC NTEREST OF TI-IE GROUP OR ENTITY Amendment (Explain): PENDITURE 1 Date of election if applicable: 2 CITY []F d y0un�.�ay�� u��e��-- CITY CLERK'S 0FRICE"/ Use only 3. Summary (Amounts may be rounded to whole doflars.) 1. Expenditures and contributions (including loans) of $100 or more made this period. (Part 5.) � 2. Unitemized expenditures and contributions (including loans) under $100 made this period. � 3. Total expenditures and contributions made this period. (Add Lines 1 + 2.) SUBTOTAL $ 4. Total expenditures and contributions made from prior statement. (Enter amount from Line 5 of last statement filed. If this is the first statement for the calendar year, enter zero.) � 5. Tota! expenditures and contributions (including loans) made since January 1 of the current calendar year. (Add Lines 3 + 4.) TOTAL $ 21500.00 0.00 21500.00 0.00 21500.00 4. Verification | have used all reasonable diligence in preparing this statement. | have reviewed the statement and to the best of my knowledge the information contained herein is true and complete. | certify under penalty of perjury under the laws of the State of California that the foregoing is true and correct. Executed on ��DI°� � DAM By SIGNATURE op/woIVI pownBLs OFFICER /poT* NOR OR AN AN INDIVIDUAL FPPC Form 461 pPPo Toll-Free HolpUne: 866/ASK-FPPC Major Donor and Independent Expenditure Committee Campaign Statement SEE INSTRUCTIONS ON REVERSE NAME OF FILER Corizon Health, Inc. Type or print in ink. Amounts may be rounded to whole dollars. INDEPENDENT EXPENDITURE COMMITTEE AND MAJOR DONOR COMMI I I EE STATEMENT Statement covers period from through 1/1/2014 12/31/2014 5. Contributions (Including Loans, Forgiveness of Loans, and Loan Guarantees) and Expenditures Made (If more space is needed, use additional copies of this page for continuation sheets.) DATE 2/21/2014 2/26/2014 4/15/2014 10/28/14 NAME, STREET ADDRESS, CITY, STATE AND ZIP CODE OF PAYEE (IF COMMIT-1.H, ALSO ENTER I.D. NUMBER) Friends of Mike Boudreaux for Sheriff 23739 Road 126 Tulare, CA 93274 FPPC#1361520 Committee for a Healthy Alameda County ( 1221 Oak Street Oakland, CA 94612 FPPC #1362028 1221 Oak St, Suite 536 Oakland, CA 94612 FPPC #890744 Mark Ridley-Thomas 10250 Constellation Blvd., STE 270 Los Angeles, CA 90067 FPPC #1372330 DESCRIPTION OF CANDIDATE AND OFFICE, TYPE OF PAYMENT PAYMENT MEASURE AND JURISDICTION, (IF OTHER THAN MONETARY OR COMMITTEE CONTRIBUTION OR LOAN) 1:1- Monetary Contribution 0 Loan EiNon-Monetary Contribution Ei Independent Expenditure 0 Monetary Contribution LiLoan ElNon-Monetary Contribution ElIndependent Expenditure E3 Monetary Contribution ElLoan Non-Monetary Contribution El Independent Expenditure Monetary Contribution DLoan ElNon-Monetary Contribution El Independent Expenditure Mike Boudreaux, Sheriff Tulare County lig Support 0 Oppose Measure A for Essential Healthcare Services Alameda County Support 0 Oppose Keith Carson, Supervisor Alameda County E3 Support 0 Oppose General Purpose Committee Support 0 Oppose SUBTOTAL $ AMOUNT THIS PERIOD CUMULATIVE AMOUNT RELATED TO THIS CANDIDATE, MEASURE, OR COMMITTEE 2500.00 2500.00 2500.00 2500.00 1500.00 1500.00 10000.00 10000.00 21500.00 1 $2t500.00 00 FPPC Form 461 (Jan/03) FPPC Toll-Free Helpline: 8661ASK-FPPC 866/275-3772