SEC Filings

10-12G
AMSURG CORP filed this Form 10-12G on 03/11/1997
Entire Document
 
<PAGE>   45

                                   EXHIBIT C

                              REQUEST FOR ADVANCE
                                 (Section 5.02)


         Pursuant to Section 5.02 of that certain Amended and Restated Loan
Agreement dated June 25, 1996 entered into by and between AmSurg Corp. (the
"Borrower") and SunTrust Bank, Nashville, N.A. (the "Lender") (the "Loan
Agreement"), the Borrower hereby requests that Lender advance it monies under
the Amended and Restated Revolving Credit Note, which Advance is requested in a
principal amount equal to $__________________.

         The Borrower advises Lender that no event of Default or Default
Condition exists under the Loan Agreement.

         The Borrower affirms that the total amount outstanding under all
Advances made subsequent to June 25, 1996, plus the requested Advance, do not
and will not exceed the sum of (i) 85% of Development Costs, plus (ii) 65% of
the total cost of all Acquisitions or a Physician Practice Acquisitions.

         The Borrower requests that the Advance be made by Lender on
_________________, 199____.

         All terms used herein shall have the same meaning as set forth in the
Amended and Restated Loan Agreement.

         Submitted by Borrower this _____ day of ________________, 199___.


                               AMSURG CORP.
                               
                               
                               By:                                
                                   -------------------------------
                               
                               Title:                             
                                      ----------------------------
                               

Received by Lender this       day of                , 199   .
                        -----        ---------------     --- 


                               SUNTRUST BANK, NASHVILLE, N.A.



                               By:                                      
                                   --------------------------------    
                                                                        
                               Title:                                   
                                      -----------------------------