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            <BusinessNameLine1Txt>ECP SERVICES</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>117 N MAIN STREET SUITE B</AddressLine1Txt>
            <CityNm>LAKE MILLS</CityNm>
            <StateAbbreviationCd>WI</StateAbbreviationCd>
            <ZIPCd>53551</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>MEDICAL BILLING SERVICES</ServicesDesc>
        <CompensationAmt>156732</CompensationAmt>
      </ContractorCompensationGrp>
      <CntrctRcvdGreaterThan100KCnt>6</CntrctRcvdGreaterThan100KCnt>
      <GovernmentGrantsAmt>216051</GovernmentGrantsAmt>
      <TotalContributionsAmt>216051</TotalContributionsAmt>
      <ProgramServiceRevenueGrp>
        <Desc>AMBULANCE SERVICE</Desc>
        <BusinessCd>621910</BusinessCd>
        <TotalRevenueColumnAmt>9837209</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>9837209</RelatedOrExemptFuncIncomeAmt>
      </ProgramServiceRevenueGrp>
      <ProgramServiceRevenueGrp>
        <Desc>OTHER PROGRAM ACTIVITY</Desc>
        <BusinessCd>621910</BusinessCd>
        <TotalRevenueColumnAmt>2966</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>2966</RelatedOrExemptFuncIncomeAmt>
      </ProgramServiceRevenueGrp>
      <TotalProgramServiceRevenueAmt>9840175</TotalProgramServiceRevenueAmt>
      <InvestmentIncomeGrp>
        <TotalRevenueColumnAmt>101337</TotalRevenueColumnAmt>
        <ExclusionAmt>101337</ExclusionAmt>
      </InvestmentIncomeGrp>
      <GrossRentsGrp>
        <RealAmt>14400</RealAmt>
      </GrossRentsGrp>
      <LessRentalExpensesGrp>
        <RealAmt>0</RealAmt>
      </LessRentalExpensesGrp>
      <RentalIncomeOrLossGrp>
        <RealAmt>14400</RealAmt>
      </RentalIncomeOrLossGrp>
      <NetRentalIncomeOrLossGrp>
        <TotalRevenueColumnAmt>14400</TotalRevenueColumnAmt>
        <ExclusionAmt>14400</ExclusionAmt>
      </NetRentalIncomeOrLossGrp>
      <GrossAmountSalesAssetsGrp>
        <SecuritiesAmt>250000</SecuritiesAmt>
        <OtherAmt>13300</OtherAmt>
      </GrossAmountSalesAssetsGrp>
      <LessCostOthBasisSalesExpnssGrp>
        <SecuritiesAmt>230067</SecuritiesAmt>
        <OtherAmt>38837</OtherAmt>
      </LessCostOthBasisSalesExpnssGrp>
      <GainOrLossGrp>
        <SecuritiesAmt>19933</SecuritiesAmt>
        <OtherAmt>-25537</OtherAmt>
      </GainOrLossGrp>
      <NetGainOrLossInvestmentsGrp>
        <TotalRevenueColumnAmt>-5604</TotalRevenueColumnAmt>
        <ExclusionAmt>-5604</ExclusionAmt>
      </NetGainOrLossInvestmentsGrp>
      <OtherRevenueMiscGrp>
        <Desc>RELATED PARTY MANAGEMENT INCOME</Desc>
        <BusinessCd>561000</BusinessCd>
        <TotalRevenueColumnAmt>917950</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>917950</RelatedOrExemptFuncIncomeAmt>
      </OtherRevenueMiscGrp>
      <MiscellaneousRevenueGrp>
        <TotalRevenueColumnAmt>50410</TotalRevenueColumnAmt>
        <ExclusionAmt>50410</ExclusionAmt>
      </MiscellaneousRevenueGrp>
      <OtherRevenueTotalAmt>968360</OtherRevenueTotalAmt>
      <TotalRevenueGrp>
        <TotalRevenueColumnAmt>11134719</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>10758125</RelatedOrExemptFuncIncomeAmt>
        <UnrelatedBusinessRevenueAmt>0</UnrelatedBusinessRevenueAmt>
        <ExclusionAmt>160543</ExclusionAmt>
      </TotalRevenueGrp>
      <CompCurrentOfcrDirectorsGrp>
        <TotalAmt>459437</TotalAmt>
        <ManagementAndGeneralAmt>459437</ManagementAndGeneralAmt>
      </CompCurrentOfcrDirectorsGrp>
      <OtherSalariesAndWagesGrp>
        <TotalAmt>4038965</TotalAmt>
        <ProgramServicesAmt>3272786</ProgramServicesAmt>
        <ManagementAndGeneralAmt>766179</ManagementAndGeneralAmt>
      </OtherSalariesAndWagesGrp>
      <PensionPlanContributionsGrp>
        <TotalAmt>145956</TotalAmt>
        <ProgramServicesAmt>117215</ProgramServicesAmt>
        <ManagementAndGeneralAmt>28741</ManagementAndGeneralAmt>
      </PensionPlanContributionsGrp>
      <OtherEmployeeBenefitsGrp>
        <TotalAmt>502605</TotalAmt>
        <ProgramServicesAmt>384357</ProgramServicesAmt>
        <ManagementAndGeneralAmt>118248</ManagementAndGeneralAmt>
      </OtherEmployeeBenefitsGrp>
      <PayrollTaxesGrp>
        <TotalAmt>404710</TotalAmt>
        <ProgramServicesAmt>296781</ProgramServicesAmt>
        <ManagementAndGeneralAmt>107929</ManagementAndGeneralAmt>
      </PayrollTaxesGrp>
      <FeesForServicesLegalGrp>
        <TotalAmt>9891</TotalAmt>
        <ManagementAndGeneralAmt>9891</ManagementAndGeneralAmt>
      </FeesForServicesLegalGrp>
      <FeesForServicesAccountingGrp>
        <TotalAmt>110686</TotalAmt>
        <ManagementAndGeneralAmt>110686</ManagementAndGeneralAmt>
      </FeesForServicesAccountingGrp>
      <FeesForSrvcInvstMgmntFeesGrp>
        <TotalAmt>9322</TotalAmt>
        <ManagementAndGeneralAmt>9322</ManagementAndGeneralAmt>
      </FeesForSrvcInvstMgmntFeesGrp>
      <FeesForServicesOtherGrp>
        <TotalAmt>464746</TotalAmt>
        <ProgramServicesAmt>464746</ProgramServicesAmt>
      </FeesForServicesOtherGrp>
      <AdvertisingGrp>
        <TotalAmt>44803</TotalAmt>
        <ManagementAndGeneralAmt>44803</ManagementAndGeneralAmt>
      </AdvertisingGrp>
      <OfficeExpensesGrp>
        <TotalAmt>88365</TotalAmt>
        <ProgramServicesAmt>60298</ProgramServicesAmt>
        <ManagementAndGeneralAmt>28067</ManagementAndGeneralAmt>
      </OfficeExpensesGrp>
      <OccupancyGrp>
        <TotalAmt>162732</TotalAmt>
        <ProgramServicesAmt>146945</ProgramServicesAmt>
        <ManagementAndGeneralAmt>15787</ManagementAndGeneralAmt>
      </OccupancyGrp>
      <TravelGrp>
        <TotalAmt>271075</TotalAmt>
        <ProgramServicesAmt>271075</ProgramServicesAmt>
      </TravelGrp>
      <ConferencesMeetingsGrp>
        <TotalAmt>196851</TotalAmt>
        <ProgramServicesAmt>196851</ProgramServicesAmt>
      </ConferencesMeetingsGrp>
      <InterestGrp>
        <TotalAmt>305</TotalAmt>
        <ProgramServicesAmt>260</ProgramServicesAmt>
        <ManagementAndGeneralAmt>45</ManagementAndGeneralAmt>
      </InterestGrp>
      <DepreciationDepletionGrp>
        <TotalAmt>712298</TotalAmt>
        <ProgramServicesAmt>685927</ProgramServicesAmt>
        <ManagementAndGeneralAmt>26371</ManagementAndGeneralAmt>
      </DepreciationDepletionGrp>
      <InsuranceGrp>
        <TotalAmt>77094</TotalAmt>
        <ProgramServicesAmt>58303</ProgramServicesAmt>
        <ManagementAndGeneralAmt>18791</ManagementAndGeneralAmt>
      </InsuranceGrp>
      <OtherExpensesGrp>
        <Desc>BAD DEBT EXPENSE</Desc>
        <TotalAmt>864850</TotalAmt>
        <ManagementAndGeneralAmt>864850</ManagementAndGeneralAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>DUES AND SUBSCRIPTIONS</Desc>
        <TotalAmt>489947</TotalAmt>
        <ProgramServicesAmt>244974</ProgramServicesAmt>
        <ManagementAndGeneralAmt>244973</ManagementAndGeneralAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>MEDICAL SUPPLIES</Desc>
        <TotalAmt>309391</TotalAmt>
        <ProgramServicesAmt>309391</ProgramServicesAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>MN CARE TAX</Desc>
        <TotalAmt>69292</TotalAmt>
        <ProgramServicesAmt>69292</ProgramServicesAmt>
      </OtherExpensesGrp>
      <AllOtherExpensesGrp>
        <TotalAmt>130572</TotalAmt>
        <ProgramServicesAmt>105463</ProgramServicesAmt>
        <ManagementAndGeneralAmt>25109</ManagementAndGeneralAmt>
      </AllOtherExpensesGrp>
      <TotalFunctionalExpensesGrp>
        <TotalAmt>9563893</TotalAmt>
        <ProgramServicesAmt>6684664</ProgramServicesAmt>
        <ManagementAndGeneralAmt>2879229</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
      </TotalFunctionalExpensesGrp>
      <CashNonInterestBearingGrp>
        <BOYAmt>7740</BOYAmt>
        <EOYAmt>12567</EOYAmt>
      </CashNonInterestBearingGrp>
      <SavingsAndTempCashInvstGrp>
        <BOYAmt>2498015</BOYAmt>
        <EOYAmt>3314337</EOYAmt>
      </SavingsAndTempCashInvstGrp>
      <AccountsReceivableGrp>
        <BOYAmt>1240045</BOYAmt>
        <EOYAmt>2042069</EOYAmt>
      </AccountsReceivableGrp>
      <PrepaidExpensesDefrdChargesGrp>
        <BOYAmt>43665</BOYAmt>
        <EOYAmt>0</EOYAmt>
      </PrepaidExpensesDefrdChargesGrp>
      <LandBldgEquipCostOrOtherBssAmt>9099302</LandBldgEquipCostOrOtherBssAmt>
      <LandBldgEquipAccumDeprecAmt>4468419</LandBldgEquipAccumDeprecAmt>
      <LandBldgEquipBasisNetGrp>
        <BOYAmt>4622036</BOYAmt>
        <EOYAmt>4630883</EOYAmt>
      </LandBldgEquipBasisNetGrp>
      <InvestmentsPubTradedSecGrp>
        <BOYAmt>1947428</BOYAmt>
        <EOYAmt>2653779</EOYAmt>
      </InvestmentsPubTradedSecGrp>
      <InvestmentsOtherSecuritiesGrp>
        <BOYAmt>414073</BOYAmt>
        <EOYAmt>604150</EOYAmt>
      </InvestmentsOtherSecuritiesGrp>
      <OtherAssetsTotalGrp>
        <BOYAmt>20044</BOYAmt>
        <EOYAmt>95261</EOYAmt>
      </OtherAssetsTotalGrp>
      <TotalAssetsGrp>
        <BOYAmt>10793046</BOYAmt>
        <EOYAmt>13353046</EOYAmt>
      </TotalAssetsGrp>
      <AccountsPayableAccrExpnssGrp>
        <BOYAmt>1130363</BOYAmt>
        <EOYAmt>1740798</EOYAmt>
      </AccountsPayableAccrExpnssGrp>
      <OtherLiabilitiesGrp>
        <BOYAmt>27088</BOYAmt>
        <EOYAmt>95262</EOYAmt>
      </OtherLiabilitiesGrp>
      <TotalLiabilitiesGrp>
        <BOYAmt>1157451</BOYAmt>
        <EOYAmt>1836060</EOYAmt>
      </TotalLiabilitiesGrp>
      <OrganizationFollowsFASB117Ind>X</OrganizationFollowsFASB117Ind>
      <NoDonorRestrictionNetAssetsGrp>
        <BOYAmt>9635595</BOYAmt>
        <EOYAmt>11516986</EOYAmt>
      </NoDonorRestrictionNetAssetsGrp>
      <TotalNetAssetsFundBalanceGrp>
        <BOYAmt>9635595</BOYAmt>
        <EOYAmt>11516986</EOYAmt>
      </TotalNetAssetsFundBalanceGrp>
      <TotLiabNetAssetsFundBalanceGrp>
        <BOYAmt>10793046</BOYAmt>
        <EOYAmt>13353046</EOYAmt>
      </TotLiabNetAssetsFundBalanceGrp>
      <InfoInScheduleOPartXIInd>X</InfoInScheduleOPartXIInd>
      <ReconcilationRevenueExpnssAmt>1570826</ReconcilationRevenueExpnssAmt>
      <NetUnrlzdGainsLossesInvstAmt>120488</NetUnrlzdGainsLossesInvstAmt>
      <OtherChangesInNetAssetsAmt>190077</OtherChangesInNetAssetsAmt>
      <MethodOfAccountingAccrualInd>X</MethodOfAccountingAccrualInd>
      <AccountantCompileOrReviewInd>0</AccountantCompileOrReviewInd>
      <FSAuditedInd>1</FSAuditedInd>
      <FSAuditedBasisGrp>
        <SeparateBasisFinclStmtInd>X</SeparateBasisFinclStmtInd>
      </FSAuditedBasisGrp>
      <AuditCommitteeInd>1</AuditCommitteeInd>
      <FederalGrantAuditRequiredInd>0</FederalGrantAuditRequiredInd>
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    <IRS990ScheduleA documentId="RetDoc1039100001">
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      <GiftsGrantsContrisRcvd509Grp>
        <CurrentTaxYearMinus4YearsAmt>1516221</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>371826</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>441154</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>361557</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>216051</CurrentTaxYearAmt>
        <TotalAmt>2906809</TotalAmt>
      </GiftsGrantsContrisRcvd509Grp>
      <GrossReceiptsAdmissionsGrp>
        <CurrentTaxYearMinus4YearsAmt>5454346</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>7500223</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>7717246</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>8230189</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>9840175</CurrentTaxYearAmt>
        <TotalAmt>38742179</TotalAmt>
      </GrossReceiptsAdmissionsGrp>
      <Total509Grp>
        <CurrentTaxYearMinus4YearsAmt>6970567</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>7872049</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>8158400</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>8591746</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>10056226</CurrentTaxYearAmt>
        <TotalAmt>41648988</TotalAmt>
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      <AmountsRcvdDsqlfyPersonGrp>
        <TotalAmt>0</TotalAmt>
      </AmountsRcvdDsqlfyPersonGrp>
      <SubstantialContributorsAmtGrp>
        <TotalAmt>0</TotalAmt>
      </SubstantialContributorsAmtGrp>
      <SubstAndDsqlfyPrsnsTotGrp>
        <TotalAmt>0</TotalAmt>
      </SubstAndDsqlfyPrsnsTotGrp>
      <PublicSupportTotal509Amt>41648988</PublicSupportTotal509Amt>
      <GrossInvestmentIncome509Grp>
        <CurrentTaxYearMinus4YearsAmt>29925</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>128965</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>199642</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>77030</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>115737</CurrentTaxYearAmt>
        <TotalAmt>551299</TotalAmt>
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      <InvestmentIncomeAndUBTIGrp>
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        <CurrentTaxYearMinus3YearsAmt>128965</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>199642</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>77030</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>115737</CurrentTaxYearAmt>
        <TotalAmt>551299</TotalAmt>
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      <OtherIncome509Grp>
        <CurrentTaxYearMinus4YearsAmt>644406</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>775988</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>836923</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>959337</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>968360</CurrentTaxYearAmt>
        <TotalAmt>4185014</TotalAmt>
      </OtherIncome509Grp>
      <TotalSupportCalendarYearGrp>
        <CurrentTaxYearMinus4YearsAmt>7644898</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>8777002</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>9194965</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>9628113</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>11140323</CurrentTaxYearAmt>
        <TotalAmt>46385301</TotalAmt>
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      <PublicSupportCY509Pct>0.89790</PublicSupportCY509Pct>
      <PublicSupportPY509Pct>0.89670</PublicSupportPY509Pct>
      <InvestmentIncomeCYPct>0.01190</InvestmentIncomeCYPct>
      <InvestmentIncomePYPct>0.01230</InvestmentIncomePYPct>
      <ThirtyThrPctSuprtTestsCY509Ind>X</ThirtyThrPctSuprtTestsCY509Ind>
      <Form990ScheduleAPartVIGrp>
        <FormAndLineReferenceDesc>SCHEDULE A, PART III, LINE 12, EXPLANATION OF OTHER INCOME:</FormAndLineReferenceDesc>
        <ExplanationTxt>MANAGEMENT FEE INCOME - 2020 AMOUNT: $ 644,406. 2021 AMOUNT: $ 775,988. 2022 AMOUNT: $ 836,923. 2023 AMOUNT: $ 871,443. 2024 AMOUNT: $ 917,950. OTHER INCOME - 2023 AMOUNT: $ 87,894. 2024 AMOUNT: $ 50,410.</ExplanationTxt>
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    <IRS990ScheduleB documentId="RetDoc1234500001">
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        <ContributorBusinessName>
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        </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="RetDoc1040000001">
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        <OtherCostOrOtherBasisAmt>205242</OtherCostOrOtherBasisAmt>
        <BookValueAmt>205242</BookValueAmt>
      </LandGrp>
      <BuildingsGrp>
        <OtherCostOrOtherBasisAmt>4163951</OtherCostOrOtherBasisAmt>
        <DepreciationAmt>1131692</DepreciationAmt>
        <BookValueAmt>3032259</BookValueAmt>
      </BuildingsGrp>
      <EquipmentGrp>
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        <DepreciationAmt>3336727</DepreciationAmt>
        <BookValueAmt>1390596</BookValueAmt>
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      <OtherLandBuildingsGrp>
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        <BookValueAmt>2786</BookValueAmt>
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      <TotalBookValueLandBuildingsAmt>4630883</TotalBookValueLandBuildingsAmt>
      <OtherLiabilitiesOrgGrp>
        <Desc>FINANCE LEASE OBLIGATIONS</Desc>
        <Amt>95262</Amt>
      </OtherLiabilitiesOrgGrp>
      <TotalLiabilityAmt>95262</TotalLiabilityAmt>
      <TotalRevEtcAuditedFinclStmtAmt>11435962</TotalRevEtcAuditedFinclStmtAmt>
      <NetUnrealizedGainsInvstAmt>120488</NetUnrealizedGainsInvstAmt>
      <OtherRevenueAmt>190077</OtherRevenueAmt>
      <RevenueNotReportedAmt>310565</RevenueNotReportedAmt>
      <RevenueSubtotalAmt>11125397</RevenueSubtotalAmt>
      <InvestmentExpensesNotIncldAmt>9322</InvestmentExpensesNotIncldAmt>
      <RevenueNotReportedFinclStmtAmt>9322</RevenueNotReportedFinclStmtAmt>
      <TotalRevenuePerForm990Amt>11134719</TotalRevenuePerForm990Amt>
      <TotExpnsEtcAuditedFinclStmtAmt>9554571</TotExpnsEtcAuditedFinclStmtAmt>
      <ExpensesNotReportedAmt>0</ExpensesNotReportedAmt>
      <ExpensesSubtotalAmt>9554571</ExpensesSubtotalAmt>
      <InvestmentExpensesNotIncld2Amt>9322</InvestmentExpensesNotIncld2Amt>
      <ExpensesNotRptFinclStmtAmt>9322</ExpensesNotRptFinclStmtAmt>
      <TotalExpensesPerForm990Amt>9563893</TotalExpensesPerForm990Amt>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART XI, LINE 2D - OTHER ADJUSTMENTS:</FormAndLineReferenceDesc>
        <ExplanationTxt>CHANGE IN INVESTMENT IN ST. CROIX VALLEY EMS 190,077.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleD>
    <IRS990ScheduleJ documentId="RetDoc1042400001">
      <BoardOrCommitteeApprovalInd>X</BoardOrCommitteeApprovalInd>
      <SeverancePaymentInd>0</SeverancePaymentInd>
      <SupplementalNonqualRtrPlanInd>0</SupplementalNonqualRtrPlanInd>
      <EquityBasedCompArrngmInd>0</EquityBasedCompArrngmInd>
      <CompBasedOnRevenueOfFlngOrgInd>0</CompBasedOnRevenueOfFlngOrgInd>
      <CompBsdOnRevRelatedOrgsInd>0</CompBsdOnRevRelatedOrgsInd>
      <CompBsdNetEarnsFlngOrgInd>0</CompBsdNetEarnsFlngOrgInd>
      <CompBsdNetEarnsRltdOrgsInd>0</CompBsdNetEarnsRltdOrgsInd>
      <AnyNonFixedPaymentsInd>0</AnyNonFixedPaymentsInd>
      <InitialContractExceptionInd>0</InitialContractExceptionInd>
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        <PersonNm>AARRON REINERT</PersonNm>
        <TitleTxt>EXECUTIVE DIRECTOR</TitleTxt>
        <BaseCompensationFilingOrgAmt>194906</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>58540</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>0</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>7181</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>0</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>260627</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>BEN WASMUND</PersonNm>
        <TitleTxt>DIRECTOR OF OPERATIONS</TitleTxt>
        <BaseCompensationFilingOrgAmt>159931</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>37439</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>0</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>8155</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>27087</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>232612</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>MICHELLE ANDERSON</PersonNm>
        <TitleTxt>DIRECTOR OF ADMINISTRATION</TitleTxt>
        <BaseCompensationFilingOrgAmt>139111</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>31464</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>0</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>6705</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>21530</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>198810</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>LEE HUBER</PersonNm>
        <TitleTxt>OPERATIONS MANAGER</TitleTxt>
        <BaseCompensationFilingOrgAmt>114171</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>19037</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>7566</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>6146</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>27087</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>174007</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
    </IRS990ScheduleJ>
    <IRS990ScheduleO documentId="RetDoc1044400001">
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION B, LINE 11B</FormAndLineReferenceDesc>
        <ExplanationTxt>THE FORM 990 FIRST GOES TO THE FINANCE COMMITTEE FOR REVIEW/APPROVAL, AND THEN MOVES ON TO THE BOARD. THE BOARD WILL VOTE AND APPROVE, THEN THE FORM 990 IS SENT TO THE IRS.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION B, LINE 12C</FormAndLineReferenceDesc>
        <ExplanationTxt>EACH DIRECTOR, OFFICER AND MEMBER OF A COMMITTEE WITH BOARD-DELEGATED POWERS SHALL ANNUALLY SIGN A STATEMENT THAT AFFIRMS THAT SUCH PERSON: A. HAS RECEIVED A COPY OF THE CONFLICTS OF INTEREST POLICY; B. HAS READ AND UNDERSTANDS THE CONFLICTS OF INTEREST POLICY; C. AGREES TO COMPLY WITH THE CONFLICTS OF INTEREST POLICY; AND D. UNDERSTANDS THAT LREMS IS A CHARITABLE ORGANIZATION AND THAT, IN ORDER TO MAINTAIN ITS FEDERAL TAX EXEMPTION, IT MUST ENGAGE PRIMARILY IN ACTIVITIES WHICH ACCOMPLISH ONE OR MORE OF ITS TAX-EXEMPT PURPOSES AND NO PART OF ITS NET EARNINGS, DIRECTLY OR INDIRECTLY, IMPROPERLY INURE TO THE BENEFIT OF ANY PRIVATE PERSON. TO ENSURE THAT LREMS OPERATES IN A MANNER CONSISTENT WITH ITS CHARITABLE PURPOSES AND THAT IT DOES NOT ENGAGE IN ACTIVITIES THAT COULD JEOPARDIZE ITS STATUS AS AN ORGANIZATION EXEMPT FROM FEDERAL INCOME TAX, LREMS'S BOARD OF DIRECTORS SHALL CONDUCT PERIODIC REVIEWS. IF IT IS UNCLEAR WHETHER A CONFLICT EXISTS, THE REMAINING BOARD MEMBERS MAKE THE DETERMINATION. AN INTERESTED PERSON MUST DISCLOSE ACTUAL OR POTENTIAL CONFLICTS TO THE BOARD AS SOON AS THE INTERESTED PERSON BECOMES AWARE OF IT. THE INTERESTED PERSON MUST LEAVE THE ROOM FOR DISCUSSIONS OF THE TRANSACTION AND ANY VOTES CONCERNING THE TRANSACTION.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION B, LINE 15</FormAndLineReferenceDesc>
        <ExplanationTxt>THE EXECUTIVE DIRECTOR'S COMPENSATION PACKAGE IS REVIEWED EACH YEAR BY THE EXECUTIVE COMMITTEE. AT TIMES THE MEMBERS WILL REQUEST COMPARATIVE INFORMATION FROM AN OUTSIDE SOURCE. THE REVIEW WAS LAST COMPLETED IN 2022. THE COMPENSATION OF OTHER OFFICERS OR KEY EMPLOYEES OF THE ORGANIZATION ARE REVIEWED AND DETERMINED BY THE EXECUTIVE DIRECTOR. THE EXECUTIVE DIRECTOR MAY CHOOSE TO SEND A 360 REVIEW TO SELECT STAFF TO HELP IN THE PROCESS. THE INFORMATION IS COMPILED FOR CONFIDENTIALITY AND SUMMARIZED. THE REVIEW IS THEN PRESENTED TO THE EMPLOYEE AND SAVED IN THEIR PERSONNEL FILE.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION C, LINE 19</FormAndLineReferenceDesc>
        <ExplanationTxt>GOVERNING DOCUMENTS AND THE CONFLICT OF INTEREST POLICY ARE MADE AVAILABLE TO THE PUBLIC ONLY BY APPOINTMENT. FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC THROUGH THE MINNESOTA ATTORNEY GENERAL'S OFFICE.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART XI, LINE 9:</FormAndLineReferenceDesc>
        <ExplanationTxt>CHANGE IN INVESTMENT IN ST. CROIX VALLEY EMS 190,077.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleO>
    <IRS990ScheduleR documentId="RetDoc1043400001">
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>ST CROIX VALLEY EMERGENCY MEDICAL SERVICES INC</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>235 EAST STATE STREET</AddressLine1Txt>
          <CityNm>ST CROIX FALLS</CityNm>
          <StateAbbreviationCd>WI</StateAbbreviationCd>
          <ZIPCd>54024</ZIPCd>
        </USAddress>
        <EIN>452872803</EIN>
        <PrimaryActivitiesTxt>EMERGENCY AMBULANCE SERVICES</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>WI</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(C)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>LINE 10</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>LAKES REGION EMS INC</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>1</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <ReceiptOfIntAnntsRntsRyltsInd>0</ReceiptOfIntAnntsRntsRyltsInd>
      <GiftGrntOrCapContriToOthOrgInd>0</GiftGrntOrCapContriToOthOrgInd>
      <GiftGrntCapContriFromOthOrgInd>0</GiftGrntCapContriFromOthOrgInd>
      <LoansOrGuaranteesToOtherOrgInd>0</LoansOrGuaranteesToOtherOrgInd>
      <LoansOrGuaranteesFromOthOrgInd>0</LoansOrGuaranteesFromOthOrgInd>
      <DivRelatedOrganizationInd>0</DivRelatedOrganizationInd>
      <AssetSaleToOtherOrgInd>0</AssetSaleToOtherOrgInd>
      <AssetPurchaseFromOtherOrgInd>0</AssetPurchaseFromOtherOrgInd>
      <AssetExchangeInd>0</AssetExchangeInd>
      <RentalOfFacilitiesToOthOrgInd>0</RentalOfFacilitiesToOthOrgInd>
      <RentalOfFcltsFromOthOrgInd>0</RentalOfFcltsFromOthOrgInd>
      <PerformOfServicesForOthOrgInd>0</PerformOfServicesForOthOrgInd>
      <PerformOfServicesByOtherOrgInd>0</PerformOfServicesByOtherOrgInd>
      <SharingOfFacilitiesInd>1</SharingOfFacilitiesInd>
      <PaidEmployeesSharingInd>1</PaidEmployeesSharingInd>
      <ReimbursementPaidToOtherOrgInd>0</ReimbursementPaidToOtherOrgInd>
      <ReimbursementPaidByOtherOrgInd>0</ReimbursementPaidByOtherOrgInd>
      <TransferToOtherOrgInd>1</TransferToOtherOrgInd>
      <TransferFromOtherOrgInd>1</TransferFromOtherOrgInd>
    </IRS990ScheduleR>
  </ReturnData>
</Return>