FEC Form 1 for GOVERNMENT AFFAIRS COMMITTEE OF AXIS SPECIALTY US SERVICES INCForm 1 for GOVERNMENT AFFAIRS COMMITTEE OF AXIS SPECIALTY US SERVICES INC

FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-1183771

1. GOVERNMENT AFFAIRS COMMITTEE OF AXIS SPECIALTY US SERVICES INC

11680 Great Oaks Way
Suite 500
Alpharetta, GA 30022
Email: denise.pagliarulo@axiscapital.com;darral.aquino@axiscapital.com

NOTE: Email address is different than previously reported

2. Date: 09/26/2017

3. FEC Committee ID #: C00453571 This committee is a separate segregated fund. Its connected organization is a Corporation

Affiliated Committees/Organizations

Committee ID# C00453571
GOVERNMENT AFFAIRS COMMITTEE OF AXIS SPECIALTY US SERVICES INC
11680 Great Oaks Way
Suite 500
Alpharetta, Georgia 30022
Affiliated Relationship Code: Affiliated Committee

Custodian of Records:

Treasurer:

Denise Cristina Pagliarulo
11680 Great Oaks Way
Ste 500
Alpharetta, Georgia 30022
Title: Treasurer
Phone # (678) 746-9476

Designated Agent(s):

Darral Aquino
11680 Great Oaks Way
Ste 500
Alpharetta, Georgia 30022
Title: Assistant Treasurer
Phone # (678) 745-9648

FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-1183771

1. GOVERNMENT AFFAIRS COMMITTEE OF AXIS SPECIALTY US SERVICES INC

NOTE: Email address is different than previously reported

2. Date: 09/26/2017

Affiliated Committees/Organizations

Custodian of Records:

Treasurer:

Designated Agent(s):

Banks or Depositories

Signed: Denise Cristina Pagliarulo
Date Signed: 09/27/2017

(End FEC FORM 1)

FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-1183771

1. GOVERNMENT AFFAIRS COMMITTEE OF AXIS SPECIALTY US SERVICES INC

NOTE: Email address is different than previously reported

2. Date: 09/26/2017

Affiliated Committees/Organizations

Custodian of Records:

Treasurer:

Designated Agent(s):

Banks or Depositories

Signed: Denise Cristina Pagliarulo Date Signed: 09/27/2017

(End FEC FORM 1)

Signed: Denise Cristina Pagliarulo
Date Signed: 09/27/2017