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FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-1012724

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1. Liberty Mutual Insurance Company - PAC

    175 Berkeley Street
    Boston, MA 02117
    Email: brian.monteiro@libertymutual.com

2. Date:

3. FEC Committee ID #: C00171843 This committee is a separate segregated fund. Its connected organization is a Corporation W/O Capital Stock

Affiliated Committees/Organizations

Custodian of Records:

Treasurer:

Renee Harper
175 Berkeley Street
Boston, Massachusetts 02117
Title: AVP & Controller

Designated Agent(s):

Renee Harper
175 Berkeley Street
Boston, Massachusetts 02116
Title: AVP & Controller

Banks or Depositories

Bank of America
210 Berkeley Street
Boston, Massachusetts 02116

Signed: Renee Harper
Date Signed: 07/08/2015

(End FEC FORM 1)

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