﻿<?xml version="1.0" encoding="utf-8"?>
<Return xmlns="http://www.irs.gov/efile" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" returnVersion="2025v4.0">
  <ReturnHeader binaryAttachmentCnt="0">
    <ReturnTs>2026-06-01T11:06:21-04:00</ReturnTs>
    <TaxPeriodEndDt>2025-12-31</TaxPeriodEndDt>
    <PreparerFirmGrp>
      <PreparerFirmEIN>381968022</PreparerFirmEIN>
      <PreparerFirmName>
        <BusinessNameLine1Txt>DE BOER BAUMANN &amp; COMPANY PLC</BusinessNameLine1Txt>
      </PreparerFirmName>
      <PreparerUSAddress>
        <AddressLine1Txt>355 SETTLERS ROAD</AddressLine1Txt>
        <CityNm>HOLLAND</CityNm>
        <StateAbbreviationCd>MI</StateAbbreviationCd>
        <ZIPCd>49423</ZIPCd>
      </PreparerUSAddress>
    </PreparerFirmGrp>
    <ReturnTypeCd>990</ReturnTypeCd>
    <TaxPeriodBeginDt>2025-01-01</TaxPeriodBeginDt>
    <Filer>
      <EIN>381940510</EIN>
      <BusinessName>
        <BusinessNameLine1Txt>ROCKFORD AMBULANCE SERVICE INC</BusinessNameLine1Txt>
      </BusinessName>
      <BusinessNameControlTxt>ROCK</BusinessNameControlTxt>
      <PhoneNum>6168660724</PhoneNum>
      <USAddress>
        <AddressLine1Txt>8450 SHANER AVENUE</AddressLine1Txt>
        <CityNm>ROCKFORD</CityNm>
        <StateAbbreviationCd>MI</StateAbbreviationCd>
        <ZIPCd>49341</ZIPCd>
      </USAddress>
    </Filer>
    <BusinessOfficerGrp>
      <PersonNm>TIMOTHY ARMSTRONG</PersonNm>
      <PersonTitleTxt>CEO</PersonTitleTxt>
      <PhoneNum>6168844103</PhoneNum>
      <SignatureDt>2026-05-13</SignatureDt>
      <DiscussWithPaidPreparerInd>true</DiscussWithPaidPreparerInd>
    </BusinessOfficerGrp>
    <PreparerPersonGrp>
      <PreparerPersonNm>BRAD WEBER</PreparerPersonNm>
      <PTIN>P01530142</PTIN>
      <PhoneNum>6163961435</PhoneNum>
      <PreparationDt>2026-06-01</PreparationDt>
    </PreparerPersonGrp>
    <TaxYr>2025</TaxYr>
    <BuildTS>2025-03-06 01:10:19Z</BuildTS>
  </ReturnHeader>
  <ReturnData documentCnt="6">
    <IRS990 documentId="RetDoc3" referenceDocumentId="RetDoc6">
      <PrincipalOfficerNm>TIMOTHY ARMSTRONG</PrincipalOfficerNm>
      <USAddress>
        <AddressLine1Txt>8450 SHANER AVE NE</AddressLine1Txt>
        <CityNm>ROCKFORD</CityNm>
        <StateAbbreviationCd>MI</StateAbbreviationCd>
        <ZIPCd>49341</ZIPCd>
      </USAddress>
      <GrossReceiptsAmt>10447948</GrossReceiptsAmt>
      <GroupReturnForAffiliatesInd>false</GroupReturnForAffiliatesInd>
      <Organization501c3Ind>X</Organization501c3Ind>
      <WebsiteAddressTxt>WWW.ROCKFORDAMBULANCE.COM</WebsiteAddressTxt>
      <TypeOfOrganizationCorpInd>X</TypeOfOrganizationCorpInd>
      <FormationYr>1970</FormationYr>
      <LegalDomicileStateCd>MI</LegalDomicileStateCd>
      <ActivityOrMissionDesc>PROVIDE PREHOSPITAL EMERGENCY MEDICAL SERVICE FOR ROCKFORD, BELMONT, LOWELL, SPARTA, GRATTAN AND GRAND RAPIDS TOWNSHIP MICHIGAN. THE SERVICE IS PROVIDED TO ALL REGARDLESS OF ABILITY TO PAY. SUBSCRIBERS TO THE CARE PLAN RECEIVE SERVICES AT NO COST FOR THE YEAR TERM.</ActivityOrMissionDesc>
      <VotingMembersGoverningBodyCnt>9</VotingMembersGoverningBodyCnt>
      <VotingMembersIndependentCnt>9</VotingMembersIndependentCnt>
      <TotalEmployeeCnt>139</TotalEmployeeCnt>
      <TotalVolunteersCnt>9</TotalVolunteersCnt>
      <TotalGrossUBIAmt>0</TotalGrossUBIAmt>
      <PYContributionsGrantsAmt>88451</PYContributionsGrantsAmt>
      <CYContributionsGrantsAmt>411673</CYContributionsGrantsAmt>
      <PYProgramServiceRevenueAmt>9025872</PYProgramServiceRevenueAmt>
      <CYProgramServiceRevenueAmt>9825097</CYProgramServiceRevenueAmt>
      <PYInvestmentIncomeAmt>9929</PYInvestmentIncomeAmt>
      <CYInvestmentIncomeAmt>150295</CYInvestmentIncomeAmt>
      <PYOtherRevenueAmt>22309</PYOtherRevenueAmt>
      <CYOtherRevenueAmt>15105</CYOtherRevenueAmt>
      <PYTotalRevenueAmt>9146561</PYTotalRevenueAmt>
      <CYTotalRevenueAmt>10402170</CYTotalRevenueAmt>
      <CYGrantsAndSimilarPaidAmt>0</CYGrantsAndSimilarPaidAmt>
      <CYBenefitsPaidToMembersAmt>0</CYBenefitsPaidToMembersAmt>
      <PYSalariesCompEmpBnftPaidAmt>4811038</PYSalariesCompEmpBnftPaidAmt>
      <CYSalariesCompEmpBnftPaidAmt>5978851</CYSalariesCompEmpBnftPaidAmt>
      <CYTotalProfFndrsngExpnsAmt>0</CYTotalProfFndrsngExpnsAmt>
      <CYTotalFundraisingExpenseAmt>0</CYTotalFundraisingExpenseAmt>
      <PYOtherExpensesAmt>3698084</PYOtherExpensesAmt>
      <CYOtherExpensesAmt>3629031</CYOtherExpensesAmt>
      <PYTotalExpensesAmt>8509122</PYTotalExpensesAmt>
      <CYTotalExpensesAmt>9607882</CYTotalExpensesAmt>
      <PYRevenuesLessExpensesAmt>637439</PYRevenuesLessExpensesAmt>
      <CYRevenuesLessExpensesAmt>794288</CYRevenuesLessExpensesAmt>
      <TotalAssetsBOYAmt>5812251</TotalAssetsBOYAmt>
      <TotalAssetsEOYAmt>7165073</TotalAssetsEOYAmt>
      <TotalLiabilitiesBOYAmt>387997</TotalLiabilitiesBOYAmt>
      <TotalLiabilitiesEOYAmt>946531</TotalLiabilitiesEOYAmt>
      <NetAssetsOrFundBalancesBOYAmt>5424254</NetAssetsOrFundBalancesBOYAmt>
      <NetAssetsOrFundBalancesEOYAmt>6218542</NetAssetsOrFundBalancesEOYAmt>
      <InfoInScheduleOPartIIIInd>X</InfoInScheduleOPartIIIInd>
      <MissionDesc>PROVIDE PREHOSPITAL EMERGENCY MEDICAL SERVICE FOR ROCKFORD, BELMONT, LOWELL, SPARTA, GRATTAN AND GRAND RAPIDS TOWNSHIP MICHIGAN. THE SERVICE IS PROVIDED TO ALL REGARDLESS OF ABILITY TO PAY. SUBSCRIBERS TO THE CARE PLAN RECEIVE SERVICES AT NO COST FOR THE YEAR TERM.</MissionDesc>
      <SignificantNewProgramSrvcInd>false</SignificantNewProgramSrvcInd>
      <SignificantChangeInd>false</SignificantChangeInd>
      <ExpenseAmt>7028502</ExpenseAmt>
      <RevenueAmt>9825097</RevenueAmt>
      <Desc>AMBULANCE AND EMERGENCY SERVICES TO PEOPLE IN SERVICE AREA.</Desc>
      <ProgSrvcAccomActy2Grp>
        <ExpenseAmt>771549</ExpenseAmt>
        <GrantAmt>411673</GrantAmt>
        <Desc>EDUCATION AND TRAINING INCOME. WE PROVIDE TRAINING IN CPR AND OTHER EMERGENCY RESPONSE PROCEDURES TO THE GENERAL PUBLIC.</Desc>
      </ProgSrvcAccomActy2Grp>
      <TotalProgramServiceExpensesAmt>7800051</TotalProgramServiceExpensesAmt>
      <DescribedInSection501c3Ind referenceDocumentId="RetDoc7">true</DescribedInSection501c3Ind>
      <ScheduleBRequiredInd referenceDocumentId="RetDoc1">true</ScheduleBRequiredInd>
      <PoliticalCampaignActyInd>false</PoliticalCampaignActyInd>
      <LobbyingActivitiesInd>false</LobbyingActivitiesInd>
      <SubjectToProxyTaxInd>false</SubjectToProxyTaxInd>
      <DonorAdvisedFundInd referenceDocumentId="RetDoc4">false</DonorAdvisedFundInd>
      <ConservationEasementsInd referenceDocumentId="RetDoc4">false</ConservationEasementsInd>
      <CollectionsOfArtInd referenceDocumentId="RetDoc4">false</CollectionsOfArtInd>
      <CreditCounselingInd referenceDocumentId="RetDoc4">false</CreditCounselingInd>
      <DonorRstrOrQuasiEndowmentsInd referenceDocumentId="RetDoc4">false</DonorRstrOrQuasiEndowmentsInd>
      <ReportLandBuildingEquipmentInd referenceDocumentId="RetDoc4">true</ReportLandBuildingEquipmentInd>
      <ReportInvestmentsOtherSecInd referenceDocumentId="RetDoc4">false</ReportInvestmentsOtherSecInd>
      <ReportProgramRelatedInvstInd referenceDocumentId="RetDoc4">false</ReportProgramRelatedInvstInd>
      <ReportOtherAssetsInd referenceDocumentId="RetDoc4">false</ReportOtherAssetsInd>
      <ReportOtherLiabilitiesInd referenceDocumentId="RetDoc4">false</ReportOtherLiabilitiesInd>
      <IncludeFIN48FootnoteInd referenceDocumentId="RetDoc4">false</IncludeFIN48FootnoteInd>
      <IndependentAuditFinclStmtInd referenceDocumentId="RetDoc4">false</IndependentAuditFinclStmtInd>
      <ConsolidatedAuditFinclStmtInd referenceDocumentId="RetDoc4">false</ConsolidatedAuditFinclStmtInd>
      <SchoolOperatingInd>false</SchoolOperatingInd>
      <ForeignOfficeInd>false</ForeignOfficeInd>
      <ForeignActivitiesInd>false</ForeignActivitiesInd>
      <MoreThan5000KToOrgInd>false</MoreThan5000KToOrgInd>
      <MoreThan5000KToIndividualsInd>false</MoreThan5000KToIndividualsInd>
      <ProfessionalFundraisingInd>false</ProfessionalFundraisingInd>
      <FundraisingActivitiesInd>false</FundraisingActivitiesInd>
      <GamingActivitiesInd>false</GamingActivitiesInd>
      <OperateHospitalInd>false</OperateHospitalInd>
      <GrantsToOrganizationsInd>false</GrantsToOrganizationsInd>
      <GrantsToIndividualsInd>false</GrantsToIndividualsInd>
      <ScheduleJRequiredInd referenceDocumentId="RetDoc5">true</ScheduleJRequiredInd>
      <TaxExemptBondsInd>false</TaxExemptBondsInd>
      <EngagedInExcessBenefitTransInd>false</EngagedInExcessBenefitTransInd>
      <PYExcessBenefitTransInd>false</PYExcessBenefitTransInd>
      <LoanOutstandingInd>false</LoanOutstandingInd>
      <GrantToRelatedPersonInd>false</GrantToRelatedPersonInd>
      <BusinessRlnWithOrgMemInd>false</BusinessRlnWithOrgMemInd>
      <BusinessRlnWithFamMemInd>false</BusinessRlnWithFamMemInd>
      <BusinessRlnWith35CtrlEntInd>false</BusinessRlnWith35CtrlEntInd>
      <DeductibleNonCashContriInd>false</DeductibleNonCashContriInd>
      <DeductibleArtContributionInd>false</DeductibleArtContributionInd>
      <TerminateOperationsInd>false</TerminateOperationsInd>
      <PartialLiquidationInd>false</PartialLiquidationInd>
      <DisregardedEntityInd>false</DisregardedEntityInd>
      <RelatedEntityInd>false</RelatedEntityInd>
      <RelatedOrganizationCtrlEntInd>false</RelatedOrganizationCtrlEntInd>
      <TrnsfrExmptNonChrtblRltdOrgInd>false</TrnsfrExmptNonChrtblRltdOrgInd>
      <ActivitiesConductedPrtshpInd>false</ActivitiesConductedPrtshpInd>
      <ScheduleORequiredInd>true</ScheduleORequiredInd>
      <IRPDocumentCnt>17</IRPDocumentCnt>
      <IRPDocumentW2GCnt>0</IRPDocumentW2GCnt>
      <BackupWthldComplianceInd>true</BackupWthldComplianceInd>
      <EmployeeCnt>139</EmployeeCnt>
      <EmploymentTaxReturnsFiledInd>true</EmploymentTaxReturnsFiledInd>
      <UnrelatedBusIncmOverLimitInd>false</UnrelatedBusIncmOverLimitInd>
      <ForeignFinancialAccountInd>false</ForeignFinancialAccountInd>
      <ProhibitedTaxShelterTransInd>false</ProhibitedTaxShelterTransInd>
      <TaxablePartyNotificationInd>false</TaxablePartyNotificationInd>
      <NondeductibleContributionsInd>false</NondeductibleContributionsInd>
      <QuidProQuoContributionsInd>false</QuidProQuoContributionsInd>
      <Form8282PropertyDisposedOfInd>false</Form8282PropertyDisposedOfInd>
      <RcvFndsToPayPrsnlBnftCntrctInd>false</RcvFndsToPayPrsnlBnftCntrctInd>
      <PayPremiumsPrsnlBnftCntrctInd>false</PayPremiumsPrsnlBnftCntrctInd>
      <Form8899Filedind>false</Form8899Filedind>
      <Form1098CFiledInd>false</Form1098CFiledInd>
      <IndoorTanningServicesInd>false</IndoorTanningServicesInd>
      <SubjToTaxRmnrtnExPrchtPymtInd>false</SubjToTaxRmnrtnExPrchtPymtInd>
      <SubjectToExcsTaxNetInvstIncInd>false</SubjectToExcsTaxNetInvstIncInd>
      <InfoInScheduleOPartVIInd>X</InfoInScheduleOPartVIInd>
      <GoverningBodyVotingMembersCnt>9</GoverningBodyVotingMembersCnt>
      <IndependentVotingMemberCnt>9</IndependentVotingMemberCnt>
      <FamilyOrBusinessRlnInd>false</FamilyOrBusinessRlnInd>
      <DelegationOfMgmtDutiesInd>false</DelegationOfMgmtDutiesInd>
      <ChangeToOrgDocumentsInd>false</ChangeToOrgDocumentsInd>
      <MaterialDiversionOrMisuseInd>false</MaterialDiversionOrMisuseInd>
      <MembersOrStockholdersInd>false</MembersOrStockholdersInd>
      <ElectionOfBoardMembersInd>false</ElectionOfBoardMembersInd>
      <DecisionsSubjectToApprovaInd>false</DecisionsSubjectToApprovaInd>
      <MinutesOfGoverningBodyInd>true</MinutesOfGoverningBodyInd>
      <MinutesOfCommitteesInd>true</MinutesOfCommitteesInd>
      <OfficerMailingAddressInd>false</OfficerMailingAddressInd>
      <LocalChaptersInd>false</LocalChaptersInd>
      <Form990ProvidedToGvrnBodyInd>true</Form990ProvidedToGvrnBodyInd>
      <ConflictOfInterestPolicyInd>true</ConflictOfInterestPolicyInd>
      <AnnualDisclosureCoveredPrsnInd>true</AnnualDisclosureCoveredPrsnInd>
      <RegularMonitoringEnfrcInd>true</RegularMonitoringEnfrcInd>
      <WhistleblowerPolicyInd>false</WhistleblowerPolicyInd>
      <DocumentRetentionPolicyInd>true</DocumentRetentionPolicyInd>
      <CompensationProcessCEOInd>true</CompensationProcessCEOInd>
      <CompensationProcessOtherInd>true</CompensationProcessOtherInd>
      <InvestmentInJointVentureInd>false</InvestmentInJointVentureInd>
      <StatesWhereCopyOfReturnIsFldCd>MI</StatesWhereCopyOfReturnIsFldCd>
      <OtherWebsiteInd>X</OtherWebsiteInd>
      <UponRequestInd>X</UponRequestInd>
      <BooksInCareOfDetail>
        <PersonNm>SHERI VERWEY</PersonNm>
        <PhoneNum>6168660724</PhoneNum>
        <USAddress>
          <AddressLine1Txt>8450 SHANER AVE</AddressLine1Txt>
          <CityNm>ROCKFORD</CityNm>
          <StateAbbreviationCd>MI</StateAbbreviationCd>
          <ZIPCd>49341</ZIPCd>
        </USAddress>
      </BooksInCareOfDetail>
      <Form990PartVIISectionAGrp>
        <PersonNm>LAURA HOFFMAN</PersonNm>
        <TitleTxt>PRESIDENT</TitleTxt>
        <AverageHoursPerWeekRt>0.50</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>DAVE PIERANGELI</PersonNm>
        <TitleTxt>VICE PRESIDE</TitleTxt>
        <AverageHoursPerWeekRt>0.50</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>DAVE SPENCER</PersonNm>
        <TitleTxt>SECRETARY/TR</TitleTxt>
        <AverageHoursPerWeekRt>0.50</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>LAURAL WALKONS</PersonNm>
        <TitleTxt>DIRECTOR</TitleTxt>
        <AverageHoursPerWeekRt>0.50</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>BETTY MORLOCK</PersonNm>
        <TitleTxt>DIRECTOR</TitleTxt>
        <AverageHoursPerWeekRt>0.50</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>TOM CARLSON</PersonNm>
        <TitleTxt>DIRECTOR</TitleTxt>
        <AverageHoursPerWeekRt>0.50</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>JOSH REIMER</PersonNm>
        <TitleTxt>DIRECTOR</TitleTxt>
        <AverageHoursPerWeekRt>0.50</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>MACKENZIE WOODWARD</PersonNm>
        <TitleTxt>DIRECTOR</TitleTxt>
        <AverageHoursPerWeekRt>0.50</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>DR ROBERT MCDANIELS</PersonNm>
        <TitleTxt>DIRECTOR</TitleTxt>
        <AverageHoursPerWeekRt>0.50</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>TIMOTHY ARMSTRONG</PersonNm>
        <TitleTxt>CEO</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>141936</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>29272</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>SHERI VERWEY</PersonNm>
        <TitleTxt>CFO</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>125579</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>12014</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>MEGHAN MATTHEW</PersonNm>
        <TitleTxt>COO</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>108603</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>24548</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>GILLIAN JACQUES</PersonNm>
        <TitleTxt>SUPERVISOR</TitleTxt>
        <AverageHoursPerWeekRt>48.00</AverageHoursPerWeekRt>
        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
        <ReportableCompFromOrgAmt>103205</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>24548</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>RICHARD KEIZER</PersonNm>
        <TitleTxt>EMPLOYEE</TitleTxt>
        <AverageHoursPerWeekRt>48.00</AverageHoursPerWeekRt>
        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
        <ReportableCompFromOrgAmt>151533</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>14371</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>COURTLAND HEALEY</PersonNm>
        <TitleTxt>EMPLOYEE</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
        <ReportableCompFromOrgAmt>103760</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <TotalReportableCompFromOrgAmt>734616</TotalReportableCompFromOrgAmt>
      <TotalOtherCompensationAmt>104753</TotalOtherCompensationAmt>
      <IndivRcvdGreaterThan100KCnt>6</IndivRcvdGreaterThan100KCnt>
      <FormerOfcrEmployeesListedInd>false</FormerOfcrEmployeesListedInd>
      <TotalCompGreaterThan150KInd>true</TotalCompGreaterThan150KInd>
      <CompensationFromOtherSrcsInd>false</CompensationFromOtherSrcsInd>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>GREAT LAKES WILDERNESS</BusinessNameLine1Txt>
            <BusinessNameLine2Txt>EMERGENCY RESPONSE</BusinessNameLine2Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>2510 RIMROCK CT NE</AddressLine1Txt>
            <CityNm>GRAND RAPIDS</CityNm>
            <StateAbbreviationCd>MI</StateAbbreviationCd>
            <ZIPCd>49525</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>FIRST AID TRAIN</ServicesDesc>
        <CompensationAmt>135780</CompensationAmt>
      </ContractorCompensationGrp>
      <CntrctRcvdGreaterThan100KCnt>1</CntrctRcvdGreaterThan100KCnt>
      <GovernmentGrantsAmt>411673</GovernmentGrantsAmt>
      <TotalContributionsAmt>411673</TotalContributionsAmt>
      <ProgramServiceRevenueGrp>
        <Desc>AMBULANCE SERVICE</Desc>
        <BusinessCd>621910</BusinessCd>
        <TotalRevenueColumnAmt>9672051</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>9672051</RelatedOrExemptFuncIncomeAmt>
      </ProgramServiceRevenueGrp>
      <ProgramServiceRevenueGrp>
        <Desc>ASSESSMENTS</Desc>
        <BusinessCd>621990</BusinessCd>
        <TotalRevenueColumnAmt>250232</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>250232</RelatedOrExemptFuncIncomeAmt>
      </ProgramServiceRevenueGrp>
      <ProgramServiceRevenueGrp>
        <Desc>CARE PLAN REVENUE</Desc>
        <BusinessCd>621990</BusinessCd>
        <TotalRevenueColumnAmt>-97186</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>-97186</RelatedOrExemptFuncIncomeAmt>
      </ProgramServiceRevenueGrp>
      <TotalProgramServiceRevenueAmt>9825097</TotalProgramServiceRevenueAmt>
      <InvestmentIncomeGrp>
        <TotalRevenueColumnAmt>17033</TotalRevenueColumnAmt>
        <ExclusionAmt>17033</ExclusionAmt>
      </InvestmentIncomeGrp>
      <GrossAmountSalesAssetsGrp>
        <OtherAmt>179040</OtherAmt>
      </GrossAmountSalesAssetsGrp>
      <LessCostOthBasisSalesExpnssGrp>
        <OtherAmt>45778</OtherAmt>
      </LessCostOthBasisSalesExpnssGrp>
      <GainOrLossGrp>
        <OtherAmt>133262</OtherAmt>
      </GainOrLossGrp>
      <NetGainOrLossInvestmentsGrp>
        <TotalRevenueColumnAmt>133262</TotalRevenueColumnAmt>
        <ExclusionAmt>133262</ExclusionAmt>
      </NetGainOrLossInvestmentsGrp>
      <OtherRevenueMiscGrp>
        <Desc>COMMUNITY ROOM INCOME</Desc>
        <TotalRevenueColumnAmt>8300</TotalRevenueColumnAmt>
        <ExclusionAmt>8300</ExclusionAmt>
      </OtherRevenueMiscGrp>
      <OtherRevenueMiscGrp>
        <Desc>OTHER INCOME</Desc>
        <TotalRevenueColumnAmt>6805</TotalRevenueColumnAmt>
        <ExclusionAmt>6805</ExclusionAmt>
      </OtherRevenueMiscGrp>
      <OtherRevenueTotalAmt>15105</OtherRevenueTotalAmt>
      <TotalRevenueGrp>
        <TotalRevenueColumnAmt>10402170</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>9825097</RelatedOrExemptFuncIncomeAmt>
        <ExclusionAmt>165400</ExclusionAmt>
      </TotalRevenueGrp>
      <CompCurrentOfcrDirectorsGrp>
        <TotalAmt>441952</TotalAmt>
        <ManagementAndGeneralAmt>441952</ManagementAndGeneralAmt>
      </CompCurrentOfcrDirectorsGrp>
      <OtherSalariesAndWagesGrp>
        <TotalAmt>4602934</TotalAmt>
        <ProgramServicesAmt>4370634</ProgramServicesAmt>
        <ManagementAndGeneralAmt>232300</ManagementAndGeneralAmt>
      </OtherSalariesAndWagesGrp>
      <PensionPlanContributionsGrp>
        <TotalAmt>79933</TotalAmt>
        <ProgramServicesAmt>69173</ProgramServicesAmt>
        <ManagementAndGeneralAmt>10760</ManagementAndGeneralAmt>
      </PensionPlanContributionsGrp>
      <OtherEmployeeBenefitsGrp>
        <TotalAmt>486195</TotalAmt>
        <ProgramServicesAmt>398892</ProgramServicesAmt>
        <ManagementAndGeneralAmt>87303</ManagementAndGeneralAmt>
      </OtherEmployeeBenefitsGrp>
      <PayrollTaxesGrp>
        <TotalAmt>367837</TotalAmt>
        <ProgramServicesAmt>317676</ProgramServicesAmt>
        <ManagementAndGeneralAmt>50161</ManagementAndGeneralAmt>
      </PayrollTaxesGrp>
      <FeesForServicesManagementGrp>
        <TotalAmt>24000</TotalAmt>
        <ManagementAndGeneralAmt>24000</ManagementAndGeneralAmt>
      </FeesForServicesManagementGrp>
      <FeesForServicesLegalGrp>
        <TotalAmt>2540</TotalAmt>
        <ManagementAndGeneralAmt>2540</ManagementAndGeneralAmt>
      </FeesForServicesLegalGrp>
      <FeesForServicesAccountingGrp>
        <TotalAmt>16740</TotalAmt>
        <ManagementAndGeneralAmt>16740</ManagementAndGeneralAmt>
      </FeesForServicesAccountingGrp>
      <AdvertisingGrp>
        <TotalAmt>869</TotalAmt>
        <ManagementAndGeneralAmt>869</ManagementAndGeneralAmt>
      </AdvertisingGrp>
      <OfficeExpensesGrp>
        <TotalAmt>117373</TotalAmt>
        <ProgramServicesAmt>36371</ProgramServicesAmt>
        <ManagementAndGeneralAmt>81002</ManagementAndGeneralAmt>
      </OfficeExpensesGrp>
      <InformationTechnologyGrp>
        <TotalAmt>104447</TotalAmt>
        <ProgramServicesAmt>55028</ProgramServicesAmt>
        <ManagementAndGeneralAmt>49419</ManagementAndGeneralAmt>
      </InformationTechnologyGrp>
      <OccupancyGrp>
        <TotalAmt>144424</TotalAmt>
        <ProgramServicesAmt>105818</ProgramServicesAmt>
        <ManagementAndGeneralAmt>38606</ManagementAndGeneralAmt>
      </OccupancyGrp>
      <ConferencesMeetingsGrp>
        <TotalAmt>415632</TotalAmt>
        <ProgramServicesAmt>398836</ProgramServicesAmt>
        <ManagementAndGeneralAmt>16796</ManagementAndGeneralAmt>
      </ConferencesMeetingsGrp>
      <DepreciationDepletionGrp>
        <TotalAmt>658566</TotalAmt>
        <ProgramServicesAmt>599944</ProgramServicesAmt>
        <ManagementAndGeneralAmt>58622</ManagementAndGeneralAmt>
      </DepreciationDepletionGrp>
      <InsuranceGrp>
        <TotalAmt>595569</TotalAmt>
        <ProgramServicesAmt>174574</ProgramServicesAmt>
        <ManagementAndGeneralAmt>420995</ManagementAndGeneralAmt>
      </InsuranceGrp>
      <OtherExpensesGrp>
        <Desc>VEHICLE EXPENSE</Desc>
        <TotalAmt>559679</TotalAmt>
        <ProgramServicesAmt>541810</ProgramServicesAmt>
        <ManagementAndGeneralAmt>17869</ManagementAndGeneralAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>CREDIT LOSSES</Desc>
        <TotalAmt>499543</TotalAmt>
        <ProgramServicesAmt>399853</ProgramServicesAmt>
        <ManagementAndGeneralAmt>99690</ManagementAndGeneralAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>PATIENT SUPPLIES</Desc>
        <TotalAmt>219533</TotalAmt>
        <ProgramServicesAmt>205238</ProgramServicesAmt>
        <ManagementAndGeneralAmt>14295</ManagementAndGeneralAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>MAINTENANCE AGREEMENT</Desc>
        <TotalAmt>98615</TotalAmt>
        <ProgramServicesAmt>73200</ProgramServicesAmt>
        <ManagementAndGeneralAmt>25415</ManagementAndGeneralAmt>
      </OtherExpensesGrp>
      <AllOtherExpensesGrp>
        <TotalAmt>171501</TotalAmt>
        <ProgramServicesAmt>53004</ProgramServicesAmt>
        <ManagementAndGeneralAmt>118497</ManagementAndGeneralAmt>
      </AllOtherExpensesGrp>
      <TotalFunctionalExpensesGrp>
        <TotalAmt>9607882</TotalAmt>
        <ProgramServicesAmt>7800051</ProgramServicesAmt>
        <ManagementAndGeneralAmt>1807831</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
      </TotalFunctionalExpensesGrp>
      <CashNonInterestBearingGrp>
        <BOYAmt>67259</BOYAmt>
        <EOYAmt>140582</EOYAmt>
      </CashNonInterestBearingGrp>
      <SavingsAndTempCashInvstGrp>
        <BOYAmt>610533</BOYAmt>
        <EOYAmt>777051</EOYAmt>
      </SavingsAndTempCashInvstGrp>
      <AccountsReceivableGrp>
        <BOYAmt>1614367</BOYAmt>
        <EOYAmt>1931567</EOYAmt>
      </AccountsReceivableGrp>
      <ReceivablesFromOfficersEtcGrp>
        <BOYAmt>4543</BOYAmt>
      </ReceivablesFromOfficersEtcGrp>
      <InventoriesForSaleOrUseGrp>
        <BOYAmt>50349</BOYAmt>
        <EOYAmt>38350</EOYAmt>
      </InventoriesForSaleOrUseGrp>
      <PrepaidExpensesDefrdChargesGrp>
        <BOYAmt>69477</BOYAmt>
        <EOYAmt>90000</EOYAmt>
      </PrepaidExpensesDefrdChargesGrp>
      <LandBldgEquipCostOrOtherBssAmt>8064616</LandBldgEquipCostOrOtherBssAmt>
      <LandBldgEquipAccumDeprecAmt>3877093</LandBldgEquipAccumDeprecAmt>
      <LandBldgEquipBasisNetGrp>
        <BOYAmt>3395723</BOYAmt>
        <EOYAmt>4187523</EOYAmt>
      </LandBldgEquipBasisNetGrp>
      <TotalAssetsGrp>
        <BOYAmt>5812251</BOYAmt>
        <EOYAmt>7165073</EOYAmt>
      </TotalAssetsGrp>
      <AccountsPayableAccrExpnssGrp>
        <BOYAmt>290239</BOYAmt>
        <EOYAmt>396349</EOYAmt>
      </AccountsPayableAccrExpnssGrp>
      <DeferredRevenueGrp>
        <BOYAmt>97758</BOYAmt>
        <EOYAmt>150182</EOYAmt>
      </DeferredRevenueGrp>
      <MortgNotesPyblScrdInvstPropGrp>
        <EOYAmt>400000</EOYAmt>
      </MortgNotesPyblScrdInvstPropGrp>
      <TotalLiabilitiesGrp>
        <BOYAmt>387997</BOYAmt>
        <EOYAmt>946531</EOYAmt>
      </TotalLiabilitiesGrp>
      <OrganizationFollowsFASB117Ind>X</OrganizationFollowsFASB117Ind>
      <NoDonorRestrictionNetAssetsGrp>
        <BOYAmt>5424254</BOYAmt>
        <EOYAmt>6218542</EOYAmt>
      </NoDonorRestrictionNetAssetsGrp>
      <TotalNetAssetsFundBalanceGrp>
        <BOYAmt>5424254</BOYAmt>
        <EOYAmt>6218542</EOYAmt>
      </TotalNetAssetsFundBalanceGrp>
      <TotLiabNetAssetsFundBalanceGrp>
        <BOYAmt>5812251</BOYAmt>
        <EOYAmt>7165073</EOYAmt>
      </TotLiabNetAssetsFundBalanceGrp>
      <ReconcilationRevenueExpnssAmt>794288</ReconcilationRevenueExpnssAmt>
      <MethodOfAccountingAccrualInd>X</MethodOfAccountingAccrualInd>
      <AccountantCompileOrReviewInd>true</AccountantCompileOrReviewInd>
      <AcctCompileOrReviewBasisGrp>
        <SeparateBasisFinclStmtInd>X</SeparateBasisFinclStmtInd>
      </AcctCompileOrReviewBasisGrp>
      <FSAuditedInd>false</FSAuditedInd>
      <AuditCommitteeInd>false</AuditCommitteeInd>
      <FederalGrantAuditRequiredInd>false</FederalGrantAuditRequiredInd>
    </IRS990>
    <IRS990ScheduleA documentId="RetDoc7">
      <PubliclySupportedOrg509a2Ind>X</PubliclySupportedOrg509a2Ind>
      <GiftsGrantsContrisRcvd509Grp>
        <CurrentTaxYearMinus4YearsAmt>348800</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>172436</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>99507</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>88451</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>411673</CurrentTaxYearAmt>
        <TotalAmt>1120867</TotalAmt>
      </GiftsGrantsContrisRcvd509Grp>
      <GrossReceiptsAdmissionsGrp>
        <CurrentTaxYearMinus4YearsAmt>5818687</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>7263801</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>7665993</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>9025872</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>9825097</CurrentTaxYearAmt>
        <TotalAmt>39599450</TotalAmt>
      </GrossReceiptsAdmissionsGrp>
      <Total509Grp>
        <CurrentTaxYearMinus4YearsAmt>6167487</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>7436237</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>7765500</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>9114323</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>10236770</CurrentTaxYearAmt>
        <TotalAmt>40720317</TotalAmt>
      </Total509Grp>
      <PublicSupportTotal509Amt>40720317</PublicSupportTotal509Amt>
      <GrossInvestmentIncome509Grp>
        <CurrentTaxYearMinus4YearsAmt>658</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>344</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>7384</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>9379</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>17033</CurrentTaxYearAmt>
        <TotalAmt>34798</TotalAmt>
      </GrossInvestmentIncome509Grp>
      <InvestmentIncomeAndUBTIGrp>
        <CurrentTaxYearMinus4YearsAmt>658</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>344</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>7384</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>9379</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>17033</CurrentTaxYearAmt>
        <TotalAmt>34798</TotalAmt>
      </InvestmentIncomeAndUBTIGrp>
      <OtherIncome509Grp>
        <CurrentTaxYearMinus1YearAmt>22309</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>15105</CurrentTaxYearAmt>
        <TotalAmt>37414</TotalAmt>
      </OtherIncome509Grp>
      <TotalSupportCalendarYearGrp>
        <CurrentTaxYearMinus4YearsAmt>6168145</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>7436581</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>7772884</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>9146011</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>10268908</CurrentTaxYearAmt>
        <TotalAmt>40792529</TotalAmt>
      </TotalSupportCalendarYearGrp>
      <PublicSupportCY509Pct>0.99820</PublicSupportCY509Pct>
      <PublicSupportPY509Pct>0.99890</PublicSupportPY509Pct>
      <InvestmentIncomeCYPct>0.00000</InvestmentIncomeCYPct>
      <InvestmentIncomePYPct>0.00000</InvestmentIncomePYPct>
      <ThirtyThrPctSuprtTestsCY509Ind>X</ThirtyThrPctSuprtTestsCY509Ind>
      <Form990ScheduleAPartVIGrp>
        <FormAndLineReferenceDesc>PART III, LINE 12</FormAndLineReferenceDesc>
        <ExplanationTxt>OTHER INCOME 37,414</ExplanationTxt>
      </Form990ScheduleAPartVIGrp>
    </IRS990ScheduleA>
    <IRS990ScheduleB documentId="RetDoc1">
      <ContributorInformationGrp>
        <ContributorNum>RESTRICTED</ContributorNum>
        <ContributorBusinessName>
          <BusinessNameLine1>RESTRICTED</BusinessNameLine1>
        </ContributorBusinessName>
        <ContributorUSAddress>
          <AddressLine1>RESTRICTED</AddressLine1>
          <AddressLine2>RESTRICTED</AddressLine2>
          <City>RESTRICTED</City>
          <State>RESTRICTED</State>
          <ZIPCode>RESTRICTED</ZIPCode>
        </ContributorUSAddress>
        <TotalContributionsAmt>RESTRICTED</TotalContributionsAmt>
      </ContributorInformationGrp>
    </IRS990ScheduleB>
    <IRS990ScheduleD documentId="RetDoc4">
      <LandGrp>
        <OtherCostOrOtherBasisAmt>234793</OtherCostOrOtherBasisAmt>
        <BookValueAmt>234793</BookValueAmt>
      </LandGrp>
      <BuildingsGrp>
        <OtherCostOrOtherBasisAmt>3058222</OtherCostOrOtherBasisAmt>
        <DepreciationAmt>1404075</DepreciationAmt>
        <BookValueAmt>1654147</BookValueAmt>
      </BuildingsGrp>
      <EquipmentGrp>
        <OtherCostOrOtherBasisAmt>4595378</OtherCostOrOtherBasisAmt>
        <DepreciationAmt>2352664</DepreciationAmt>
        <BookValueAmt>2242714</BookValueAmt>
      </EquipmentGrp>
      <OtherLandBuildingsGrp>
        <OtherCostOrOtherBasisAmt>176223</OtherCostOrOtherBasisAmt>
        <DepreciationAmt>120354</DepreciationAmt>
        <BookValueAmt>55869</BookValueAmt>
      </OtherLandBuildingsGrp>
      <TotalBookValueLandBuildingsAmt>4187523</TotalBookValueLandBuildingsAmt>
    </IRS990ScheduleD>
    <IRS990ScheduleJ documentId="RetDoc5">
      <WrittenEmploymentContractInd>X</WrittenEmploymentContractInd>
      <CompensationSurveyInd>X</CompensationSurveyInd>
      <BoardOrCommitteeApprovalInd>X</BoardOrCommitteeApprovalInd>
      <SeverancePaymentInd>false</SeverancePaymentInd>
      <SupplementalNonqualRtrPlanInd>false</SupplementalNonqualRtrPlanInd>
      <EquityBasedCompArrngmInd>false</EquityBasedCompArrngmInd>
      <CompBasedOnRevenueOfFlngOrgInd>false</CompBasedOnRevenueOfFlngOrgInd>
      <CompBsdOnRevRelatedOrgsInd>false</CompBsdOnRevRelatedOrgsInd>
      <CompBsdNetEarnsFlngOrgInd>false</CompBsdNetEarnsFlngOrgInd>
      <CompBsdNetEarnsRltdOrgsInd>false</CompBsdNetEarnsRltdOrgsInd>
      <AnyNonFixedPaymentsInd>false</AnyNonFixedPaymentsInd>
      <InitialContractExceptionInd>false</InitialContractExceptionInd>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>TIMOTHY ARMSTRONG</PersonNm>
        <TitleTxt>CEO</TitleTxt>
        <BaseCompensationFilingOrgAmt>141936</BaseCompensationFilingOrgAmt>
        <DeferredCompensationFlngOrgAmt>4724</DeferredCompensationFlngOrgAmt>
        <NontaxableBenefitsFilingOrgAmt>24548</NontaxableBenefitsFilingOrgAmt>
        <TotalCompensationFilingOrgAmt>171208</TotalCompensationFilingOrgAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>RICHARD KEIZER</PersonNm>
        <TitleTxt>EMPLOYEE</TitleTxt>
        <BaseCompensationFilingOrgAmt>151533</BaseCompensationFilingOrgAmt>
        <DeferredCompensationFlngOrgAmt>6187</DeferredCompensationFlngOrgAmt>
        <NontaxableBenefitsFilingOrgAmt>8184</NontaxableBenefitsFilingOrgAmt>
        <TotalCompensationFilingOrgAmt>165904</TotalCompensationFilingOrgAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
    </IRS990ScheduleJ>
    <IRS990ScheduleO documentId="RetDoc6">
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990 - ORGANIZATION'S MISSION</FormAndLineReferenceDesc>
        <ExplanationTxt>PROVIDE PREHOSPITAL EMERGENCY MEDICAL SERVICE FOR ROCKFORD, BELMONT, LOWELL, SPARTA, GRATTAN AND GRAND RAPIDS TOWNSHIP MICHIGAN. THE SERVICE IS PROVIDED TO ALL REGARDLESS OF ABILITY TO PAY. SUBSCRIBERS TO THE CARE PLAN RECEIVE SERVICES AT NO COST FOR THE YEAR TERM.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PAGE 6, PART VI, LINE 11B</FormAndLineReferenceDesc>
        <ExplanationTxt>FORM 990 IS REVIEWED BY MANAGEMENT AND BOARD OF DIRECTORS PRIOR TO FILING.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PAGE 6, PART VI, LINE 12C</FormAndLineReferenceDesc>
        <ExplanationTxt>BOARD MEMBERS ARE REGULARLY REMINDED OF CONFLICT OF INTEREST REQUIREMENTS.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PAGE 6, PART VI, LINE 15A</FormAndLineReferenceDesc>
        <ExplanationTxt>BOARD DETERMINES COMPENSATION OF THE CHIEF EXECUTIVE OFFICER BY COMPARING TO COMPENSATION OF SIMILAR SIZED NON-PROFIT ORGANIZATIONS.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PAGE 6, PART VI, LINE 15B</FormAndLineReferenceDesc>
        <ExplanationTxt>CHIEF EXECUTIVE OFFICER AND BOARD REVIEW COMPARABLE POSITIONS IN OTHER SIMILAR ORGANIZATIONS AS WELL AS EMPLOYEE PERFORMANCE AND VALUE TO THE ORGANIZATION.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PAGE 6, PART VI, LINE 19</FormAndLineReferenceDesc>
        <ExplanationTxt>AVAILABLE TO PUBLIC UPON REQUEST.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleO>
  </ReturnData>
</Return>