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FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-1234151

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1. HORNBECK OFFSHORE SERVICES INC POLITICAL ACTION COMMITTEE

    103 NORTHPARK BLVD SUITE 300
    COVINGTON, LA 70433
    Email: beth.labrosse@hornbeckoffshore.com

    NOTE: Email address is different than previously reported

2. Date: 05/24/2018

3. FEC Committee ID #: C00424366 This committee is a separate segregated fund. Its connected organization is a Corporation

Affiliated Committees/Organizations

Hornbeck Offshore Services, Inc.
103 Northpark Blvd Suite 300
Covington, Louisiana 70433
Affiliated Relationship Code: Connected Organization

Custodian of Records:

Beth A. LaBrosse
103 Northpark Blvd. Suite 300
Covington, LA 70433
Title: Assistant Treasurer
Phone # (985) 727-6811

Treasurer:

Samuel A. Giberga
10 Cherokee Lane
Covington, Louisiana 70433
Title: Treasurer
Phone # (985) 727-2000

Designated Agent(s):

Beth A. LaBrosse
103 Northpark Blvd. Suite 300
Covington, Louisiana 70433
Title: Assistant Treasurer
Phone # (985) 727-6811

Banks or Depositories

Capital One Bank
313 Carondolet
New Orleans, Louisiana 70130

Signed: Samuel A. Giberga
Date Signed: 05/24/2018

(End FEC FORM 1)

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