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FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-1190309

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1. Liberty Mutual Insurance Company - PAC

    175 Berkeley Street
    Boston, MA 02116
    Email: melissa.cyr@libertymutual.com,christine.marchand@libertymutual.com

    NOTE: Email address is different than previously reported

2. Date: 11/06/2017

3. FEC Committee ID #: C00171843 This committee is a separate segregated fund. Its connected organization is a Corporation
     In addition, this committee is a Lobbyist/Registrant PAC.

Affiliated Committees/Organizations

Liberty Mutual Insurance Company
175 Berkeley Street
Boston, Massachusetts 02116
Affiliated Relationship Code: Connected Organization

Custodian of Records:

Melissa Cyr
175 Berkeley Street
Boston, MA 02116
Title: Financial Officer
Phone # (617) 654-4075

Treasurer:

Melissa Cyr
175 Berkeley Street
Boston, Massachusetts 02116
Title: Financial Officer
Phone # (617) 654-4075

Designated Agent(s):

Christine Marchand
175 Berkeley Street
Boston, Massachusetts 02116
Title: Assistant Treasurer
Phone # (857) 224-2899

Banks or Depositories

Bank of America
210 Berkeley Street
Boston, Massachusetts 02116

Signed: Melissa Cyr
Date Signed: 11/06/2017

(End FEC FORM 1)

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