CAMPAIGN FINANCE DIVISION

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1 State of Rhode Island and Providence Plantations BOARD of ELECTIONS CAMPAIGN FINANCE DIVISION 50 Branch Avenue, Providence Rhode Island TEL (401) AFFIDAVIT OF STATE VENDOR UNDER CHAPTER OF THE GENERAL LAWS OF RHODE ISLAND Statement Under Oath of Affirmation The undersigned, upon oath or affirmation, does hereby make the following statements and provide the following information 1. Name, address and telphone number of person making this affidavit MR. Nicholas Rago III Name of Person Making this Affidavit One Citizens Plaza Address1 8th Floor Address2 Providence, RI City State Zip Phone 2. Within the 24 month period preceding the date of the contract with the state agency, or with respect to the contracts that are not in writing within the 24 month period preceding the date of notification that the contract has reached the $5000 threshold, have you contributed an aggregate amount of more than $250 within a calendar year to any R.I. general officer, candidate for R.I. general office, any member of the general assembly or candidate for general assembly, or any R.I. political party? (includes an individual contracting party, or business entity on behalf of a related party, or a related party reporting on his/her own behalf) NOTE: If this is a semi-annual filing (i.e. January 1 to June 30 or July 1 to December 31), you must report contributions made from the date of execution of the last contract entered into during such semi-annual period to the date which is 24 months prior to the first day of the same semi-annual period. Yes [x] No [ ] 3. If the answer to question 2 is "yes", provide the name of the R.I. general officer, candidate for R.I. general office, member of the general assembly or candidate for general assembly, or R.I. political party and the date and the amount of each contribution. List all contributins even if reported on a previously filed affidavit. However please indicate the previously reported contributions by the letter "PR" following the date of the contribution listed below.

2 Name of Officer, Candidate or Political Party Date of Contribution Amount of Contribution Name of Contributor Relationship to Contracting Party Gina Raimondo 04/28/2016 1, Victoria M Almeida Executive Officer Seth Magaziner 01/15/2016 1, Victoria M Almeida Executive Officer Seth Magaziner 03/07/ Victoria M Almeida Executive Officer Dominick Ruggerio 03/02/ Victoria M Almeida Executive Officer John G Edwards 02/28/ Victoria M Almeida Executive Officer Gina Raimondo 02/06/2017 1, Victoria M Almeida Executive Officer K Joseph Shekarchi 02/02/ Victoria M Almeida Executive Officer M Teresa Paiva Weed 01/24/ Victoria M Almeida Executive Officer Nicholas Mattiello 01/12/ Victoria M Almeida Executive Officer Michael McCaffrey 05/01/ Victoria M Almeida Executive Officer Seth Magaziner 06/19/ Victoria M Almeida Executive Officer Gina Raimondo 04/26/ Nicole J Benjamin Executive Officer Seth Magaziner 01/18/ Nicole J Benjamin Executive Officer Gina Raimondo 02/03/ Nicole J Benjamin Executive Officer Nicholas Mattiello 01/17/ Nicole J Benjamin Executive Officer Seth Magaziner 06/20/ Nicole J Benjamin Executive Officer Nicholas Mattiello 09/25/ Richard R Beretta Jr Executive Officer Dennis Algiere 06/23/ Richard R Beretta Jr Executive Officer Mike McCaffrey 05/25/ Richard R Beretta Jr Executive Officer Joseph Shekarchi 05/25/ Richard R Beretta Jr Executive Officer Rhode Island Senate Leadership PAC 05/24/ Richard R Beretta Jr Executive Officer William Conley 05/23/ Richard R Beretta Jr Executive Officer Robert Jacquard 05/18/ Richard R Beretta Jr Executive Officer Mary Ellen Goodwin 05/11/ Richard R Beretta Jr Executive Officer Michael Marcello 05/10/ Richard R Beretta Jr Executive Officer Gina Raimondo 04/29/2016 1, Richard R Beretta Jr Executive Officer Frank Lombardi 04/19/ Richard R Beretta Jr Executive Officer William Walaska 04/19/ Richard R Beretta Jr Executive Officer Louis DiPalma 04/13/ Richard R Beretta Jr Executive Officer Joshua Miller 04/12/ Richard R Beretta Jr Executive Officer Brian Kennedy 04/11/ Richard R Beretta Jr Executive Officer Robert Craven 03/31/ Richard R Beretta Jr Executive Officer Hannah Gallo 03/31/ Richard R Beretta Jr Executive Officer Eileen Naughton 03/31/ Richard R Beretta Jr Executive Officer Jared Nunes 03/31/ Richard R Beretta Jr Executive Officer Daniel McKiernan 03/31/ Richard R Beretta Jr Executive Officer Susan Sosnowski 03/16/ Richard R Beretta Jr Executive Officer Stephen Ucci 03/16/ Richard R Beretta Jr Executive Officer Brian Newbury 03/16/ Richard R Beretta Jr Executive Officer Marc Cote 03/16/ Richard R Beretta Jr Executive Officer Joseph Shekarchi 03/14/ Richard R Beretta Jr Executive Officer Deborah Ruggiero 03/10/ Richard R Beretta Jr Executive Officer Joseph Solomon 03/10/ Richard R Beretta Jr Executive Officer John Carnavale 03/01/ Richard R Beretta Jr Executive Officer Erin Lynch Prata 03/01/ Richard R Beretta Jr Executive Officer Joseph McNamara 02/24/ Richard R Beretta Jr Executive Officer Christopher Blazejewski 02/24/ Richard R Beretta Jr Executive Officer Roger Picard 02/24/ Richard R Beretta Jr Executive Officer Jay Edwards 02/10/ Richard R Beretta Jr Executive Officer Dominick Ruggerio 02/02/ Richard R Beretta Jr Executive Officer John DeSimone 02/02/ Richard R Beretta Jr Executive Officer

3 Teresa Paiva Weed 01/27/ Richard R Beretta Jr Executive Officer Nicholas Mattiello 01/21/ Richard R Beretta Jr Executive Officer Seth Magaziner 01/19/2016 1, Richard R Beretta Jr Executive Officer William J Conley Jr 05/24/ Richard R Beretta Jr Executive Officer Joshua Miller 03/30/ Richard R Beretta Jr Executive Officer Robert Emmett Craven Sr. 03/28/ Richard R Beretta Jr Executive Officer Peter F Kilmartin 03/08/ Richard R Beretta Jr Executive Officer Marvin Abney 03/08/ Richard R Beretta Jr Executive Officer Dominick Ruggerio 03/02/ Richard R Beretta Jr Executive Officer John G Edwards 02/28/ Richard R Beretta Jr Executive Officer Christopher R Blazejewski 02/15/ Richard R Beretta Jr Executive Officer Gina Raimondo 02/06/2017 1, Richard R Beretta Jr Executive Officer K Joseph Shekarchi 02/02/ Richard R Beretta Jr Executive Officer M Teresa Paiva Weed 01/25/ Richard R Beretta Jr Executive Officer Nicholas Mattiello 01/17/ Richard R Beretta Jr Executive Officer Roger Picard 02/22/ Richard R Beretta Jr Executive Officer Deb Ruggiero 02/22/ Richard R Beretta Jr Executive Officer Nicholas Mattiello 02/27/ Richard R Beretta Jr Executive Officer Walter Felag 03/08/ Richard R Beretta Jr Executive Officer Erin Lynch 03/08/ Richard R Beretta Jr Executive Officer Frank Lombardo 03/08/ Richard R Beretta Jr Executive Officer Anastasia Williams 03/22/ Richard R Beretta Jr Executive Officer Dan McKiernan 03/23/ Richard R Beretta Jr Executive Officer Nicholas Mattiello 03/28/ Richard R Beretta Jr Executive Officer Hanna Gallo 03/30/ Richard R Beretta Jr Executive Officer Joseph Shekarchi 03/30/ Richard R Beretta Jr Executive Officer Susan Sosnowski 04/03/ Richard R Beretta Jr Executive Officer Pat Serpa 04/05/ Richard R Beretta Jr Executive Officer Joe Solomon 04/05/ Richard R Beretta Jr Executive Officer RI Senate Leadership PAC 04/06/ Richard R Beretta Jr Executive Officer Robert Jacquard 04/06/ Richard R Beretta Jr Executive Officer Frank Ciccone 04/22/ Richard R Beretta Jr Executive Officer Marc Cote 04/27/ Richard R Beretta Jr Executive Officer Lou Dipalma 05/01/ Richard R Beretta Jr Executive Officer Stephen Ucci 05/01/ Richard R Beretta Jr Executive Officer Alex Marszalkowski 05/09/ Richard R Beretta Jr Executive Officer Mary Ellen Goodwin 05/09/ Richard R Beretta Jr Executive Officer Michael McCaffrey 05/16/ Richard R Beretta Jr Executive Officer Joseph McNamara 05/18/ Richard R Beretta Jr Executive Officer Dominick Ruggerio 05/25/ Richard R Beretta Jr Executive Officer Frank Lombardi 05/30/ Richard R Beretta Jr Executive Officer Brian Patrick Kennedy 06/05/ Richard R Beretta Jr Executive Officer Seth Magaziner 06/19/2017 1, Richard R Beretta Jr Executive Officer Gina Raimondo 04/29/2016 1, Amy Beretta Spouse of Executive Officer Gina Raimondo 02/07/2017 1, Amy Beretta Spouse of Executive Officer Nicholas Mattiello 07/17/ Robert P Brooks Executive Officer Dominick J Ruggerio 08/04/ Robert P Brooks Executive Officer Gina Raimondo 04/29/ Robert P Brooks Executive Officer Seth Magaziner 01/13/ Robert P Brooks Executive Officer Robert Emmett Craven Sr 03/28/ Robert P Brooks Executive Officer Dominick J Ruggerio 03/02/ Robert P Brooks Executive Officer Gina M Raimondo 02/07/2017 1, Robert P Brooks Executive Officer K Joseph Shekarchi 02/02/ Robert P Brooks Executive Officer M. Teresa Paiva Weed 01/25/ Robert P Brooks Executive Officer

4 Seth Magaziner 06/15/2017 1, Robert P Brooks Executive Officer Gina Raimondo 04/29/ Paul A Campellone Executive Officer Nicholas Mattiello 01/22/ Paul A Campellone Executive Officer Seth Magaziner 01/19/ Paul A Campellone Executive Officer Gina M Raimondo 02/06/ Paul A Campellone Executive Officer M Teresa Paiva Weed 01/25/ Paul A Campellone Executive Officer Deborah Ruggiero 10/31/ Joseph DeAngelis Executive Officer Gina Raimondo 04/27/ Joseph DeAngelis Executive Officer Seth Magaziner 01/19/ Joseph DeAngelis Executive Officer Gina Raimondo 02/07/ Joseph DeAngelis Executive Officer K Joseph Shekarchi 02/02/ Joseph DeAngelis Executive Officer M Teresa Paiva Weed 01/25/ Joseph DeAngelis Executive Officer Nicholas Mattiello 01/18/ Joseph DeAngelis Executive Officer Seth Magaziner 06/22/ Joseph DeAngelis Executive Officer Gina Raimondo 06/10/ Susan Leach DeBlasio Executive Officer Gina Raimondo 04/20/2016 1, Mark O Denehy Executive Officer Seth Magaziner 01/15/2016 1, Mark O Denehy Executive Officer Gina Raimondo 01/27/2017 1, Mark O Denehy Executive Officer K Joseph Shekarchi 01/30/ Mark O Denehy Executive Officer Seth Magaziner 06/15/2017 1, Mark O Denehy Executive Officer Gina Raimondo 02/01/2017 1, Cynthia Denehy Spouse of Executive Officer Gina Raimondo 04/20/2016 1, Cynthia Denehy Spouse of Executive Officer Gina Raimondo 04/29/ Joseph R DiStefano Executive Officer Gina Raimondo 01/30/ Joseph R DiStefano Executive Officer Peter Neronha 10/04/ Sarah T Dowling Executive Officer Gina Raimondo 04/15/2016 1, Sarah T Dowling Executive Officer Josh Miller 04/02/ Sarah T Dowling Executive Officer Joseph Shekarchi 03/14/ Sarah T Dowling Executive Officer Seth Magaziner 01/15/2016 1, Sarah T Dowling Executive Officer Teresa Paiva Weed 01/15/ Sarah T Dowling Executive Officer Nicholas Mattiello 01/15/ Sarah T Dowling Executive Officer Gina Raimondo 02/03/2017 1, Sarah T Dowling Executive Officer Nellie Gorbea 02/03/2017 1, Sarah T Dowling Executive Officer Nicholas Mattiello 01/17/ Sarah T Dowling Executive Officer Seth Magaziner 06/20/2017 1, Sarah T Dowling Executive Officer Gina Raimondo 04/15/2016 1, Joseph L Dowling Spouse of Executive Officer Seth Magaziner 01/15/2016 1, Joseph L Dowling Spouse of Executive Officer Gina Raimondo 02/03/2017 1, Joseph L Dowling Spouse of Executive Officer Seth Magaziner 06/20/2017 1, Joseph L Dowling Spouse of Executive Officer Gina Raimondo 02/06/ Stephen Geanacopoulos Executive Officer Gina Raimondo 02/03/ E Hans Lundsten Executive Officer Gina Raimondo 04/29/ Elizabeth Noonan Executive Officer Donna Nesselbush 03/29/ Elizabeth Noonan Executive Officer Joseph Shekarchi 03/14/ Elizabeth Noonan Executive Officer Dominick Ruggerio 02/16/ Elizabeth Noonan Executive Officer John DeSimone 02/03/ Elizabeth Noonan Executive Officer Teresa Paiva Weed 01/27/ Elizabeth Noonan Executive Officer Nicholas Mattiello 01/22/ Elizabeth Noonan Executive Officer Nellie Gorbea 03/01/ Elizabeth Noonan Executive Officer Gina Raimondo 02/06/ Elizabeth Noonan Executive Officer Nicholas Mattiello 01/18/ Elizabeth Noonan Executive Officer Seth Magaziner 06/15/ Elizabeth Noonan Executive Officer Nicholas Mattiello 07/18/ Patricia K Rocha Executive Officer Dominick Ruggerio 08/04/ Patricia K Rocha Executive Officer

5 Gina Raimondo 04/25/2016 1, Patricia K Rocha Executive Officer Joseph Shekarchi 03/14/ Patricia K Rocha Executive Officer Dominick Ruggerio 02/16/ Patricia K Rocha Executive Officer John DeSimone 02/03/ Patricia K Rocha Executive Officer Teresa Paiva Weed 01/28/ Patricia K Rocha Executive Officer Nicholas Mattiello 01/22/ Patricia K Rocha Executive Officer Seth Magaziner 01/19/2016 1, Patricia K Rocha Executive Officer Gina Raimondo 02/07/2017 1, Patricia K Rocha Executive Officer K Joseph Shekarchi 02/02/ Patricia K Rocha Executive Officer M Teresa Paiva Weed 01/26/ Patricia K Rocha Executive Officer Nicholas Mattiello 01/18/ Patricia K Rocha Executive Officer Mike Marcello 05/10/ Alan M Shoer Executive Officer Gina Raimondo 04/29/ Alan M Shoer Executive Officer Gina M Raimondo 01/20/ Alan M Shoer Executive Officer Nicholas Mattiello 01/17/ Alan M Shoer Executive Officer Seth Magaziner 06/22/ Alan M Shoer Executive Officer Gina M Raimondo 12/14/ Lori C Silveira Executive Officer State Democrats PAC 05/26/ Lori C Silveira Executive Officer Gina Raimondo 04/29/ Lori C Silveira Executive Officer Stephen Ucci 03/15/ Lori C Silveira Executive Officer Joseph Shekarchi 03/10/ Lori C Silveira Executive Officer Dominick Ruggerio 02/04/ Lori C Silveira Executive Officer John D DeSimone 02/03/ Lori C Silveira Executive Officer Teresa Paiva Weed 01/28/ Lori C Silveira Executive Officer Nicholas Mattiello 01/21/ Lori C Silveira Executive Officer Frank A Ciccone III 04/11/ Lori C Silveira Executive Officer Dominick J Ruggerio 03/02/ Lori C Silveira Executive Officer Gina M Raimondo 02/03/ Lori C Silveira Executive Officer M Teresa Paiva Weed 01/26/ Lori C Silveira Executive Officer Nicholas Mattiello 01/18/ Lori C Silveira Executive Officer Gregg Amore 04/24/ Lori C Silveira Executive Officer Stephen Ucci 05/02/ Lori C Silveira Executive Officer Michael McCaffrey 05/16/ Lori C Silveira Executive Officer RI Senate Democrats 05/25/ Lori C Silveira Executive Officer Ray Hull 06/29/ Lori C Silveira Executive Officer Dominick J Ruggerio 03/02/ Robert Stolzman Executive Officer Gina Raimondo 02/07/2017 1, Robert Stolzman Executive Officer K Joseph Shekarchi 01/30/ Robert Stolzman Executive Officer M Teresa Paiva Weed 01/25/ Robert Stolzman Executive Officer Nicholas Mattiello 01/17/ Robert Stolzman Executive Officer M Teresa Paiva Weed 03/02/ Robert Stolzman Executive Officer Michael McCaffery 05/16/ Robert Stolzman Executive Officer Brian Kennedy 06/05/ Robert Stolzman Executive Officer Seth Magaziner 06/17/2017 1, Robert Stolzman Executive Officer Gina Raimondo 04/25/2016 1, John A Tarantino Executive Officer Joseph Shekarchi 03/11/ John A Tarantino Executive Officer Dominick Ruggerio 02/03/ John A Tarantino Executive Officer John D DeSimone 02/03/ John A Tarantino Executive Officer M Teresa Paiva Weed 01/26/ John A Tarantino Executive Officer Nicholas Mattiello 01/21/ John A Tarantino Executive Officer Dominick J Ruggerio 03/02/ John A Tarantino Executive Officer Gina M Raimondo 02/06/2017 1, John A Tarantino Executive Officer K Joseph Shekarchi 02/01/ John A Tarantino Executive Officer M Teresa Paiva Weed 01/25/ John A Tarantino Executive Officer

6 Nicholas Mattiello 01/17/ John A Tarantino Executive Officer Seth Magaziner 06/10/2017 1, John A Tarantino Executive Officer Gina Raimondo 08/24/2017 1, R Bart Totten Executive Officer Gina Raimondo 04/28/2016 1, R Bart Totten Executive Officer Gina Raimondo 09/27/ Nicole M Verdi Executive Officer Edith Ajello 11/06/ Nicole M Verdi Executive Officer Alex Marszalkowski 08/29/ Nicole M Verdi Executive Officer Edith Ajello 05/19/ Nicole M Verdi Executive Officer William Conley 05/17/ Nicole M Verdi Executive Officer Shelby Maldonado 04/19/ Nicole M Verdi Executive Officer Christopher R Blazejewski 02/15/ Nicole M Verdi Executive Officer Evan Patrick Shanley 01/13/ Nicole M Verdi Executive Officer Teresa Tanzi 04/12/ Nicole M Verdi Executive Officer Alex Marszalkowski 05/18/ Nicole M Verdi Executive Officer Edith Ajello 05/18/ Nicole M Verdi Executive Officer Gayle Goldin 05/19/ Nicole M Verdi Executive Officer Gina Raimondo 02/07/ Todd White Executive Officer Seth Magaziner 06/22/ Todd White Executive Officer 4. What is the date of execution of the written contract requiring filing of this affidavit [Such contract must be filed with this affidavit] 07/25/ If the contract requiring the filing of this affidavit is not in writing, when were you first notified that the contract had reached the $5000 threshold? 6. If the contract requiring the filing of this affidavit is not in writing, describe the goods and/or services to be provided, the state agency involved, and the term or duration of such contract. If the term is indefinite, so state. Agency Goods / Services Contract Expire Date 7. Is this affidavit made by you as an individual or on behalf of a business entity? Individual [ ] Business Entity [ ] 8. If on behalf of a business entity, what is the name and nature of the business entity? Adler Pollock & Sheehan P.C. - Legal Services Business Name FEIN# Corporation [ ] Partnership [ ] Sole Proprietorship [ ] Other Business Entity [ ] 9. If "Other Business Entity" is checked above what is the nature of such business entity? 10. Are you a state vendor because you are the contracting party in a contract with a state ag Yes [x] No [ ] 11. If yes, what is the name of the state agency to which you are providing goods and/or services? Multiple State Agencies 12. If the answer to question 10 is "no", are you a state vendor because you are related to a contracting party Yes [ ] No [ ] 13. If the answer to question 12 is "yes", what is the nature of your relationship with the contracting party?

7 14. If you are a related party, provide the name and address of the contracting party and the state agency involved in such contract. Name of Contracting Party State Agency Address1 Address2 City State Zip 15. If you are the contracting party, have you surveyed all related parties and does this affidavit contain all reportable political contributions made by such related parties? 16. If the answer to question 15 is "no", have you notified all such parties of the requirements of the law and of their oblicagation to file this affidavit if they have made reportable political contributions? Yes [x] No [ ] Yes [ ] No [ ] 17. If the answer to question 16 is "yes", provide the names and addresses of related parties who might be required to file this affidavit and the nature of such relationship. Name Address Relationship 18. What is the total gross amount in dollars, of contracts entered into during the said preceding 24 month period between the contracting period and ALL state agencies? Include all contracts regarless of amount. If you are filing this affidavit as a party related to the contracting party and do not have knowledge of the information required by this question, please so state by marking " Yes." NOTE: If this is a semi-annual filing (i.e. January 1 to June 30 or July 1 to December 31), you must report contributions made from the date of execution of the last contract entered into during such semi-annual period to the date which is 24 months prior to the first day of the same semi-annual period. Yes [ ] No [ ] State Agency Date of Contract Amount of Contract Rhode Island Department of Adminis 1,476, n/a Board of Governors 80, n/a Employees' Retirement System of the 145, n/a Narragansett Bay Commission 297, n/a Rhode Island Airport Corporation n/a Rhode Island Convention Center Aut 2, n/a Rhode Island Health and Educational 94, n/a Rhode Island Public Transit Authority 82, n/a Rhode Island State Investment Comm 274, n/a Rhode Island Turnpike & Bridge Aut 118, n/a State of Rhode Island 62, n/a University of Rhode Island 27, n/a FEIN # P.O. # Total Gross Amount: 2,662, State of: County of: RI Providence Signature of Person making the Affidavit Subscribed and sworn to or Affirmed before me, an official authorized to administer oaths in the jurisdiction where this affidavit was made, on this day of 20 Signature of Notary or Other Person Authorized to Administer Oaths Printed Name of Notary or Other Person Authorized to Administer Oaths

North Dakota Notarial Certificates

Acknowledgment by Individual: North Dakota Notarial Certificates On this day of, in the year before me personally appeared known to me (or proved to me on the oath of ) to be the person who is described