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VIRGINIA CONFLICT OF INTEREST AND ETHICS ADVISORY COUNCIL

Lobbyist Registration Form (Rev. 10/2016)

There is a $100 fee required for registration (local government employees are exempted from this fee). This form can be submitted electronically on the Council's website at ethics.dls.virginia.gov or mailed to:

Secretary of the Commonwealth
Attn: Lobbyist Specialist
1111 East Broad Street, 4th Fl.
Richmond, Virginia 23219

PART I: PRINCIPAL INFORMATION

Please provide the name of the Principal for which you intend to lobby

• 1.NAME OF PRINCIPAL:Dominion Energy
  
• Permanent Business Address:120 Tredegar Street Richmond, VA 23219
• Business Telephone:804-819-2140




Please provide the type of business the Principal is engaged in

• 2.Type of Business:Issues related to the energy industry
  
  

  Please provide the name of the individual authorizing your employment as a lobbyist. The lobbyist filing this registration MAY NOT be the same as the Principal Officer.

• 3.NAME OF PRINCIPAL OFFICER:William Murray


• Permanent Business Address:120 Tredegar Street Richmond, VA 23219


• Business Telephone:804-771-3802


• E-Mail Address:william.l.murray@dominionenergy.com




Please provide the name of the individual who will retain ALL records, on behalf of the Principal, with respect to your lobbying activities for their organization, if different from the Principal Officer.

• 4.NAME:William Murray


• Permanent Business Address:120 Tredegar Street Richmond, VA 23219


• Business Telephone:804-771-3802


• E-Mail Address:william.l.murray@dominionenergy.com
  

Please list the full name(s), business address(es), and telephone number(s) of all other individual(s) that are registered to lobby on behalf of the Principal identified in Part I, item 1.

PART II: LOBBYIST INFORMATION

Please provide the name of the Lobbyist registering to represent the Principal listed in Part I, item 1

1. 1.NAME OF LOBBYIST:Eva Hardy


2. Permanent Business Address:120 Tredegar Street Richmond, VA 23219


3. Business Telephone:804-819-2570


4. E-Mail Address:evahardy1@gmail.com




Please provide the name of the individual who will retain ALL records, on behalf of the Lobbyist, with respect to your lobbying activities for the Principal identified in Part I, item 1, if different from the Lobbyist listed in Part II, item 1

5. 2.NAME:Eva Hardy


6. Permanent Business Address:120 Tredegar Street Richmond, VA 23219


7. Business Telephone:804-819-2570


8. E-Mail Address:evahardy1@gmail.com

Identify the subject matter (with as much specificity as possible) for which you expect to lobby

1. 3.SUBJECT MATTER:Issues related to the energy industry



Describe your relationship with the Principal listed in Part I, item 1 (check only one):

2. 4.As a lobbyist, you are:


3. Employed (on the payroll of the principal)
4. Retained (compensated but not on the payroll of the principal)
5. Not Compensated (not compensated but expenses may be reimbursed)



If you are employed by the Principal provide your job title

6. 5.JOB TITLE:

I, the undersigned lobbyist, do state that the information furnished on this registration statement and on any and all accompanying statements attached thereto, is to the best of my knowledge and belief, complete and accurate.

Date: 8/25/2017 2:19:45 PM       Lobbyist Signature: Eva Hardy (Electronically Signed:8/25/2017 2:19:45 PM )

Note: Pursuant to § 2.2-423, a principal may elect to waive the principal signature requirement on disclosure filings by submitting a signature waiver form to the Virginia Conflict of Interest and Ethics Advisory Council after this registration form has been approved.