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 must be submitted electronically on the Council's website at ethics.dls.virginia.gov.

PART I: PRINCIPAL INFORMATION

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

1.NAME OF PRINCIPAL:Balico, LLC
Permanent Business Address:13640 Cedar Run Lane Herndon, VA 20171
Business Telephone:703-371-5867

Please provide the type of business the Principal is engaged in

2.Type of Business:Electricity production and distribution.

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:Irfan Ali

Permanent Business Address:13640 Cedar Run Lane Herndon, VA 20171

Business Telephone:703-371-5867

E-Mail Address:irfankali@balicollc.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:Irfan Ali

Permanent Business Address:13640 Cedar Run Lane Herndon, VA 20171

Business Telephone:703-371-5867

E-Mail Address:irfankali@balicollc.com

Permanent business address and telephone number of location where records are stored, if different from above:

13640 Cedar Run Lane Herndon, VA 20171 703-371-5867

PART II: LOBBYIST INFORMATION

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

1.NAME OF LOBBYIST:Charles R. Duvall Jr.

Permanent Business Address:PO Box 170 Richmond, VA 23218

Business Telephone:804-644-7884

E-Mail Address:cduvall@lindlcorp.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

2.NAME:Lucy Ackerly

Permanent Business Address:2307 E. Broad Street Richmond, VA 23223

Business Telephone:804-644-7884

E-Mail Address:lackerly@lindlcorp.com

Permanent business address and telephone number of location where records are stored, if different from above:

2307 E. Broad Street Richmond, VA 23223 804-644-7884

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

3.SUBJECT MATTER:Any and all matters pertaining to electricity production and distribution.

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

4.As a lobbyist, you are:

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

If you are employed by the Principal provide your job title

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: 12/17/2019 10:13:18 AM Lobbyist Signature: Charles Duvall (Electronically Signed:12/17/2019 10:13:18 AM )

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.