FR:3002,8q

MAIL TO: COMMERCIAL FUNDRAISER FOR CHARITABLE PURPOSES

Office of the Attorney General
Registry of Charitable Trusts
P.O. Box 903447 ANNUAL REGISTRATION FORM FOR 20 17
Sacramento, CA 94203-4470
Section 12599, California Government Code
11 Cal. Code Rags. section 308
STREET ADDRESS:
1300 I Street
Sacramento, CA 95814 Failure to register by January 15th annually for each calendar year of solicitation may
Telephone: (916) 323-5079 result In late fees as defined in Government Code section 12586.1.

WEB SITE ADDRESS: A CERTIFIED OR CASHIER'S CHECK IN THE AMOUNT OF $350

http://ag.Ca.0ovicharities/ MUST ACCOMPANY THIS REGISTRATION FORM

Official Name and Address of Commercial Fundraiser for

Charitable Purposes:
FP0002849
Manifold Productions, Inc. CF Registration Number
Name of commercial fundraiser for charitable purposes
'-
13-2907220
5508 Surrey Street Federal Employer ID Number
Address (Do Not Use P.O. Box)
941-0445
Chevy Chase, MD 20815 Telephone Number (301)
City or Town, State and ZIP Code

Mailing Address (if different from Official Address):

same
Mailing Address

City, State, and ZIP Code

In addition to the OFFICIAL name, enter all other names and addresses under which this commercial fundraiser for charitable
purposes Is known or operates:

none

Legal Form of Commercial Fundraiser for Charitable Purposes: Corporation 0Unincorporated Association

[]Partnership 0Soie Proprietorship

May 1977
State In which organized NY Date organized

Enter name, individual home address, and relationship to the commercial fundraiser for charitable purposes of each
officer and director of corporation or unincorporated association; each partner in the partnership; or the owner of the
sole proprietorship.

Name Home Address Title/Relationship to

Commercial Fundraiser for Charitable Purposes
Gina Cappo Pack 5508 Surrey Street,
President
Chevy Chase, MD 20815
Michael Pack 5508 Surrey Street, Director
...._ .,.. ',...hAvy Chace, MD 2nRis - .

CT-1U, CFR REGISTRATION FORM (3-05) ,

k. alt7
COMMERCIAL FUNDRAISER FOR CHARITABLE PURPOSES
ANNUAL REGISTRATION FORM FOR 20j2
Page 2
Identify commercial fundraiser for charitable purposes' activities:

000 000 00
O Auction El Advertising Sales Baby Pageant
El Beauty Pageant 0 Car Donations
7-
Circus
O Concert r:4 Dinner Direct Mail
O Discount Coupons 0 Door-to-Door Solicitation Entertainment Event
O Honor Boxes 0 Magazine Sales Publication
O Salvageable Personal 0 Safety Products Sports Event
Property EC1 Telephone Solicitation Theater
0 Telemarketing 0 Trash Bags Vending Machines
O Thrift Store
g Other: I n veysoln t ivta,',k , eet,,,,,,,-tic,,a_k , , ,,,,,,,,L, i evev\-tt,
Is any director, officer, or employee of the commercial fundraiser for charitable purposes a director, officer, or
employee of any charitable organization with which It has contracted to solicit?

jg( Yes No

If "yes," complete the following:

Name and address of director,
officer, or employee of commercial
fundraiser for charitable purposes
Michael Pack
Name and address of Relationship of officer, etc. to
charitable organization charitable organization
Claremont Institute President, Director
1317 W Foothill Blvd., Ste. 120

Upland, CA 91786

For each affiliation identified above, attach a copy of the contract between the commercial fundraiser for charitable
purposes and the charity.
Has the commercial fundraiser for charitable purposes ever had any license, registration or permit denied, cancelled,
suspended or revoked, or had any official disciplinary or legal action taken against it? is any such action currently
pending against the commercial fundraiser for charitable purposes or any of its representatives in relation to any
fundraising activity?

O Yes [33 No
If "yes," complete the following:
Name and address of government Nature of action. Indicate against whom
agency bringing action action was taken and disposition Date

0 "X" box if attachments are included.

I certify under penalty of perjury that I am authorized to sign this registration form and that the information provided
herein, includingattachments, isAe and complete to the best of my knowledge and belief.

(1-(11 /1(1
Title Date

CT-1 CF CFR REGISTRATION FORM (3-05)

 CONTRACT ADDENDUM

This addendum made and entered into this _pi day of June 2016 by and between MANIFOLD

PRODUCTIONS, a corporation (hereinafter referred to as "MANIFOLD ") THE CLAREMONT

INSTITUTE FOR THE STUDY OF STATESMANSHIP AND POLITICAL PHILOSOPHY, a non-

profit corporation (hereinafter referred to as "CLAREMONT").

WHEREAS, CLAREMONT and MANIFOLD are parties to a certain agreement dated February

1, 2016; and

WHEREAS, in order to affect registration in compliance with the laws of the states and for that
—
portion of the contract where activities will be conducted in the respective states an addendum is required.

W1TNESSETH

FOR AND CONSIDERATION of the mutual covenants herein contained, the sufficiency of

which is acknowledged as evidenced by the signatures of the parties hereto, it is mutually agreed as

follows:

I. The term of the contract dated February 1,2016 shall be from the Effective Date through

December 31, 2016. The contract shall be automatically extended for additional twelve (12) month

periods thereafter until all Services shall have been completed to the satisfaction of CLAREMONT.

2. In all other respects not specifically modified herein the existing agreement dated February 1,

. 2016 shall remain in full force and effect. A copy of said agreement is attached hereto and incorporated

herein by this reference.

Further, this agreement may not be modified, changed or terminated in whole or in part, in any

manner except by an agreement duly signed by CLAREMONT and MANIFOLD.

1
 •
WHEREFORE, the parties hereto have executed this addendum on the day and year first above

written.

AGREED AND ACCEPTED.

MANIFOLD PRODUCTIONS THE CLAREMONT INSTITUTE FOR THE

STUDY OF STATESMANSHIP AND POLITICAL
PHILOSOPHY

BY BY

at:Ar tY44.1 v41 w-)•5 ■14‘5,

printed name and title.
printed num nd title

By.

ot9 0. 4,1 0'VI 5r. c2 F0

printed name and title

Dated: 1 Dated:

2
 - INDEPENDENT CONTRACTORAGREEM ENT

THIS INDEPENDENT CONTRACTOR AGREEMENT, effective this 1st day of February, 2016 (the
"Effective Date"), together with the Standard Terms and Conditions attached hereto and by this
reference incorporated herein (together, the "Agreement"), is made and entered by and between The
Claremont Institute for the Study of Statesmanship and Political Philosophy, a California nonprofit
corporation with an address of 1317 West Foothill Boulevard, Suite 120, Upland, California 91786
(the "Institute"), and Manifold Productions, with an address of 5508 Surrey Street, Chevy Chase,
MD 20815 ("you").

I. SERVICES

The Institute hereby engages you, and you hereby accept such engagement, as an independent
contractor to provide the following services in accordance with the following timelines and on
the terms and conditions set forth in this Agreement: duties as Senior Consultant in
accordance with the services set forth in Exhibit 1 (the "Services").

2. TERM

The term of this Agreement (the "Term") shall be from the Effective Date through the date
that all Services have been rendered to the satisfaction of the Institute and the results and
proceeds thereof ("Results and Proceeds") accepted by the Institute. During the Term, you
shall render the Services on a non-exclusive, no material interference, first priority basis, in
accordance with the terms and conditions of this Agreement, including without limitation, the
terms of paragraph 14 of the Standard Terms and Conditions.

3. FEES

In full and complete consideration for all Services and the Rights (defined below), the
Institute shall pay you the following fee on the terms and conditions set forth in this
Agreement: $75,000 ("Fee"), to be paid according to the following schedule:
Jan. 1, 2016 - $6,250
Feb. 1,2016 -$6,250
March 1,2016 - $6,250
April 1, 2016 -$6,250
May 1,2016 -$6,250
June 1,2016 -$6,250
July 1,2016 -$6,250
Aug. 1, 2016 - $6,250
Sept. 1, 2016 - $6,250
Oct. 1,2016 -$6,250
Nov. 1,2016 - $6,250
Dec. 1,2016 -$6,250
 • •
You hereby expressly acknowledge and agree that you shall not be entitled to any further
compensation or royalty in connection with your Services hereunder.

4. RIGHTS

The Institute shall be the sole and exclusive owner of all right, title and interest in and all
Results and Proceeds, including all copyrights and moral rights (and extensions and renewals
thereof) therein, and shall have the exclusive right to publish, reproduce, distribute, use and
exploit in any way, any or all of the foregoing, in any and all media, including promotional
media and merchandise, whether now known or hereafter devised, in perpetuity throughout
the universe, in all languages. All Results and Proceeds shall be "works made for hire" for the
Institute as such term is defined in Section 201 of Title 17 of the United States Code. In the
event that any of the Results and Proceeds are found not to be works made for hire, then you
hereby irrevocably grant, assign and transfer to the Institute, free and clear of any and all
claims for royalties or other compensation except as may be expressly set forth herein, all
rights, including all copyrights and copyright renewals and extensions, with respect thereto,
exclusively and perpetually, throughout the universe, in any and all media, whether now
known or hereafter devised, in all languages. The Institute may edit, alter, add to subtract
from or otherwise change any or all of the Results and Proceeds, including combining the
Results and Proceeds with other material, in its sole discretion. You herby waive any and all
so-called "moral rights" or similar rights. You agree to execute (and to cause your employees
to execute, if applicable) any further documents or instruments reasonably requested by the
Institute consistent with the grant of rights to the Institute hereunder, and you hereby
irrevocably appoint (and shall cause your employees to irrevocably appoint, if applicable), the
Institute as your (or your employees', if applicable) attorney-in-fact, with full power, coupled
with an interest, to execute such documents on your (or your employees', if applicable)
behalf, with full powers of substitution and delegation. You hereby expressly acknowledge
and agree that you shall have no right publish, reproduce, distribute, use or exploit in any way
the Results and Proceeds or element thereof, nor shall you have any right to the Institute's
name, trademarks, service marks, trade names, logos, symbols or brand names without the
Institute's approval.

5. STANDARD TERMS AND CONDITIONS

The balance of the terms and conditions of this Agreement are set forth in the Standard Terms
and Conditions attached hereto.

[Signatures on following page.]

IN WITNESS WHEREOF, the parties hereto have duly executed this Agreement as of the Effective
Date.

ACCEPTED AND AGREED:

THE CLAREMONT INSTITUTE FOR THE STUDY OF

STATESMANSHIP AND POLITICAL PHILOSOPHY

By

Title; CI4 i"-• c1mIfr 6EFrcek

MANIFOLD PRODUCTIONS

Ix]

Print Nam0 j.6k. [Independent Contractor]

Federal Taxpayer ID Number (or SSN): —1—).-)-0

 STANDARD TERMS AND CONDITIONS

The Institute shall not control the manner or means by which you perform the Services,

2. You are an independent contractor of the Institute, and this Agreement shall not be construed
to create any association, partnership, joint venture, employee or agency relationship between
you and the Institute for any purpose. You have no authority (and shall not hold yourself out
as having authority) to bind the Institute and you shall not make any agreements or
representations on the Institute's behalf without the Institute's prior written consent.

3. Without limiting the generality of the foregoing, you shall not be eligible under this
Agreement to participate in any vacation, group medical or life insurance, disability,
retirement or other benefits or benefit plans offered by the Institute to its employees, and the
Institute shall not be responsible for withholding or paying any income, payroll, Social
Security or other federal, state or local taxes, making any insurance contributions, including
unemployment or disability or obtaining worker's compensation insurance on your behalf.
You shall be responsible for, and shall indemnify the Institute against, all such taxes or
contributions, including penalties and interest. Any persons employed by you in connection
with the performance of the Services shall be your employees and you shall be fully
responsible for them.

4. The Institute shall pay the Fee according to the payment schedule set forth in the Agreement,
provided that each payment shall be made within thirty (30) days of the Institute's receipt and
acceptance of an invoice from you, which invoice must set forth in detail the Services
rendered for the Institute and Results and Proceeds delivered to the Institute during the
applicable pay period.

5. You hereby expressly acknowledge and agree that adhering to the timeline and any delivery
dates set by the Institute is of the essence to this Agreement and that your failure to do so
shall constitute a material breach of this Agreement, entitling the Institute to immediately
terminate this Agreement and pursue all available remedies.

6. Except as expressly provided herein, you shall furnish, at your own expense, any equipment,
supplies and other materials used to perform the Services. The Institute agrees to reimburse
you for any actual reasonable and necessary expenditures, which are directly related to the
Services, provided that such expenses are sought in accordance with Institute policies and
approved by the Institute in advance of being incurred. The Institute shall provide you with
access to its premises and equipment to the extent necessary for the performance of the
Services.

7, During your provision of the Services, you shall have access to confidential and proprietary
information of the Institute, which includes, without limitation, the existence and terms of this
Agreement as well as financial information, technology, operations, plans, projects, strategies,
research, studies and data of the Institute and/or its affiliates, which information may or may
not be printed and may exist in any medium(collectively, the Confidential
Information),Confidential Information may or may not be marked as
 "Confidential."Confidential Information shall not include information that is or becomes
generally available to the public through other than through your breach of this Agreement or
information that is communicated to you by a third party that has no confidentiality
obligations with respect to such information. You shall not disclose or use for any purpose, or
permit to be disclosed or use for any purpose, any Confidential Information to any third party
without the prior written consent of the Institute in each instance, except as required by law,
provided that you give the Institute prior notice of such disclosure and an opportunity to
consent thereto. You shall notify the Institute immediately if you become aware of any loss or
disclosure of any Confidential Information. You acknowledge that wrongful disclosure or use
of Confidential Information may result in irreparable harm for which there would be no
adequate remedy at law and that any breach of your obligations under this paragraph would
constitute a material breach of this Agreement, giving Institute the right to immediately
terminate this Agreement without liability to you and bring legal action against you to enjoin
such breach and recover legal fees and expenses in addition to other appropriate relief.

8. You hereby represent and warrant that:

(a) you have full right, power and authority to enter into this Agreement, grant the
rights granted herein and fully perform each and all of your obligations hereunder;
(b) your entering into this Agreement and performance of the Services do not and shall
not conflict with or result in any breach or default under any other agreement to
which you arc subject;
(c) you have the required skill, experience and qualifications to perform the Services,
you shall perform the Services in a professional and workmanlike manner and in
accordance with generally recognized industry standards for such and similar
services and you shall devote sufficient resources to ensure that the Services are
performed in a timely and reliable manner;
(d) you shall perform the Services in compliance with all applicable federal, state and
local laws and regulations;

(e) the Results and Proceeds are and shall be your original work (except for material in
the public domain or provided by the Institute) and do not and shall not violate or
infringe upon any intellectual property right or any other right whatsoever of any
third party;
you shall abide by all institute policies; and
you shall require each of your employees rendering any Services, or any part
thereof, to execute written agreements binding them to all terms and conditions of
this Agreement, including without limitation, the terms of paragraph 4 of the
Agreement and paragraph 8 of these Standard Terms and Conditions.

9, The Institute hereby represents and warrants to you that:

(a) it has the full right, power and authority to enter into this Agreement and perform its
obligations hereunder; and
 (b) the representative who executes this Agreement on the Institute's behalf has been
duly authorized by the Institute to bind the Institute hereunder.

10. You shall defend, indemnify and hold harmless the Institute and its affiliates and each of their
officers, directors, employees, agents, successors, licensees and assigns from and against any
and all losses, damages, liabilities, deficiencies, actions, judgments, interest, awards,
penalties, fines, costs or expenses of whatever kind (including reasonable attorneys' fees)
arising in connection with your breach of this Agreement or the bodily injury, death of any
person or damage to real or tangible property resulting from your acts or omissions.

The Institute may terminate this Agreement without cause for any reason upon thirty (30)
days' written notice to you. In the event of termination without cause, the Institute shall pay
you on a proportional basis any Fees then due and payable for any Services completed up to
and including the date of such termination. The Institute may terminate this Agreement,
effective immediately upon written or oral notice to you, in the event that you commit a
serious breach of the terms of this Agreement. The determination of "serious breach" shall be
in the sole discretion of the Institute reasonably exercised,

12. Upon expiration or termination of this Agreement for any reason, or at any other time upon
the Institute's request, you shall promptly: deliver to the Institute all Results and Proceeds
(whether complete or incomplete) and any and all hardware, software or other equipment,
tools or materials provided to you by the Institute; deliver to the Institute all tangible and
intangible documents and materials, and any copies, containing, reflecting, incorporating or
based on Confidential Information; permanently remove all Confidential Information from
your hard copy and digital files; and deliver to the Institute your written certification that you
have complied with the same.

13. The terms and conditions of the following paragraphs shall survive the expiration or
termination of this Agreement: paragraphs 4 and 5 of the Agreement; paragraphs 3, 7, 8, 9,
10, 12, 15, 17, 18, 19 and 23 of these Standard Terms and Conditions.

14, During the Term, you may be engaged or employed in any other business, trade, profession or
other activity that does not place you in a conflict of interest with the Institute; provided, you
shall not be engaged or employed in any business activities that do or may compete with the
business of the Institute or perform any services for direct competitors of the Institute without
the Institute's prior written consent, which consent the Institute may grant or withhold in its
sole discretion.

15. During the Term and for a twelve (12) month period following the Term, you shall not make
any solicitation or inducement to employ any personnel, employees, independent contractors,
vendors or other affiliates of the Institute without the Institute's prior written consent in each
instance, which consent the Institute may grant or withhold in its sole discretion..For the
purposes of this paragraph, a general advertisement or notice of a job listing or opening or
other similar general publication of a job search or availability to fill employment positions,
including on the internet, shall not be construed as a solicitation or inducement, and the hiring
of any personnel, employees, independent contractors, vendors or other affiliates of the
Institute who responds to such advertisement or notice or publication shall not be deemed a
breach of this paragraph.
16. You shall not assign, license, subcontract or delegate, including to your employees, any of
your rights or obligations hereunder without the Institute's prior written consent in each
instance, which consent the Institute may grant or withhold in its sole discretion. Any
assignment, license, subcontract or other delegation in violation of the foregoing shall be
deemed null and void. The Institute may freely assign any or all of its rights and obligations
hereunder at any time. Subject to the limits stated above, this Agreement shall inure to the
benefit of, be binding upon, and be enforceable against, each of the parties hereto and their
respective permitted successors and assigns.

17. You shall not export, directly or indirectly, any technical data acquired from the Institute, or
any products utilizing any such data, to any country in violation of any applicable export laws
or regulations.

18. All notices, requests, consents, claims, demands, waivers and other communications
hereunder (each, a "Notice") shall be in writing and addressed to the parties at the addresses
set forth on the first page of the Agreement (or such other address as each party may
designate).All Notices shall be delivered by personal delivery; certified or registered mail,
return receipt requested, postage prepaid; nationally recognized overnight courier with all fees
pre-paid; or facsimile or e-mail of a PDF document with confirmation of transmission. Except
as otherwise provided in this Agreement, a Notice is effective only if (a.) the receiving party
has received the Notice and (b) the party giving the Notice has complied with the
requirements of this paragraph.

19. This Agreement constitutes the sole and entire agreement of the parties hereto subject matter
contained herein and supersedes any and all prior and contemporaneous agreements,
understandings, representations and warranties between the parties hereto, whether written
and oral, with respect to such subject matter.

20. This Agreement may be modified or amended only by a writing signed by each party hereto.

21. In the event that any term or provision of this Agreement is held invalid or unenforceable by a
court of competent jurisdiction, all other terms of this Agreement shall remain in full force
and effect.

22. No provision of this Agreement may be waived by either party hereto except in writing. The
waiver of any provision hereof shall not be deemed a waiver of any other provision hereof.

23. This Agreement shall be governed by and construed in accordance with the internal laws of
the State of California without giving effect to any choice or conflict of law provision or rule.
Each party irrevocably submits to the exclusive jurisdiction and venue of the federal and state
courts located in Los Angeles County, California in any legal suit, action or proceeding based
upon or arising out of this Agreement or the Services.

This Agreement may be executed in multiple counterparts, which may be transmitted by

facsimile or email, and each such counterpart shall be deemed an original for all purposes and
together all such counterparts shall constitute one instrument.
 EXHIBIT I

1. SERVICES

In accordance with the terms of this Agreement and for the Term set forth herein, the scope of
work, as determined in the sole discretion of the Institute shall include, but is not limited to, the
following duties as Senior Consultant:

(a) Furnish advice and assistance with VIP donor events and relations, with monthly reports
to Claremont Institute VP of Development, Christine Domenech
 •
MAIL TO: COMMERCIAL FUNDRAISER FOR CHARITABLE PURPOSES
Office of the Attorney General
Registry of Charitable Trusts
P.O. Box 903447
Sacramerno, CA 94203-4470
ANNUAL REGISTRATION FORM FOR 20 I ta , hbeiy
Section 12599, California Government Code and juarie«!
11 Cal. Code Rags, section 308 VUndst;isii '
STREET ADDRESS:
1300 I Street
Sacramento, CA 95814 Failure to register by January 18v, annually for each calendar year of solicitation may
Telephone: (916) 323-5079 result in late fees as defined in Government Code section 12688.1.

vyge SITE ADDRESS: A CERTIFIED OR CASHIER'S CHECK IN THE AMOUNT OF $350

hap://ao,ca:tiovicharitleei. MUST ACCOMPANY THIS REGISTRATION FORM

R 4-ci96
Official Name and Address of Commercial Funaraiser for
Charitable Purposes:

Manifold _P• rocitictions :Cm a it71 C°0000.i4Pk'

Name of commercial fundraiser for charitable purposes'
13-2907220
5508 Surrey Street Federal Employer ID Number

I Address (Do Not Use P.O. Box)

Chevy Chase, MD 20815
City or Town, State and ZIP Code
Telephone Number (301 )•
941-0445

Mailing Address (if different from Official Address):

same
Mailing Address
same
City, State, and ZIP Code

In addition to the OFFICIAL name, enter all other names and addresses under which this commercial fundraiser for charitable
purposes is known or operates:

none

Legal Form of Commercial Fundraiser for Charitable Purposes: 5a Corporation 0 Unincorporated Association

0Partnership 0Gole Proprietorship

NY May 1977
State In which organized Date organized

Enter name, individual home address, and relationship to the commercial fundraiser for charitable purposes of each
officer and director of corporation or unincorporated association; each partner in the partnership; or the owner of the
sole proprietorship.

Name Home Address Title/Relationship to

Commercial Fundraiser for Charitable Purposes

Please refer to attached list of officers.

Gina Cappo Pack 5508 Surrey St, Chevy Chase, MD President

Michael Pack 5508 Surrey St, Chevy Chase, MD Director

• RECEIVED CT-1 CF CFR REGISTRATION FORM (3-05)

mitompy Sonciralic nffiCe

MAY ' 2 3 2018
Regtstry 0i
Charitable Trusts
,/
COMMERCIAL FUNDRAISER FOR CHARWLE PURPOSES
ANNUAL REGISTRATION FORM FOR 20
Page 2
identify commercial fundraiser for charitable purposes' activities:

opio a non=10

0 0 0000 0 0
Auction Advertising Sales Baby Pageant
Beauty Pageant Car Donations Circus
El Concert Dinner Direct Mall •
0 Discount Coupons Door-to•Door Solicitation Entertainment Event
Honor Boxes Magazine Sales Publication
Salvageable Personal Safety Products Sports Event
Property Telephone Solicitation Theater
Telemarketing Trash Bags Vending Machines
Thrift Store
[4 PAtiOr'' .2-01. &NA Otitil c4 044 ( t sec;ai
Is any director, officer, or employee of the commercial fundraiser for charitable purposes a director, officer, or
employee of any charitable organization with which It has contracted to solicit?

Yes El No

If "yes," complete the following:

Name and address of director, Name and address of Relationship of officer, etc. to
officer, or employee of commercial H charitable organization charitable organization
fundraiser for charitable purposes 1
Michael Pack , Claremont Institute President, Director
1317 W Foothill Blvd, Ste 120
Upland, CA 91786
For each affiliation identified above, attach a copy of the contract between the commercial fundraiser for charitable
purposes and the charity.
Has the commercial fundraiser for charitable purposes ever had any license, registration or permit denied, cancelled,
suspended or revoked, or had any official disciplinary or legal action taken against it? is any such action currently
pending against the commercial fundraiser for charitable purposes or any of its representatives In relation to any
fundraising activity?

0 Yes No

If "yes," cdmplete the following:

Name and address of government Nature of action. Indicate against whom
agency bringing action action was taken and disposition Date

"X" box if attachments are included.

I certify under penalty of perjury that I am authorized to sign this registration form and that the information provided
j...._attachmenls true and complete to the best of my knowledge and belief.
herein, includlpg1
..

CTACF CFR REGISTRATION FORM (3-05)

LIST OF OFFICERS AND DIRECTORS
Gina Cappo Pack, President, 5508 Surrey St, Chevy Chase, MD 20815
Michael Pack, Director, 5508 Surrey St, Chevy Chase, MD 20815
 COPILEVITZ
&CANTER
May 19, 2016
Via Federal Express
Ms. Candy Hetherington
Registrar of Charitable Trusts Office
Office of the Attorney General RECEIVED
Attormay sangr2iic Offi ce
P.O. Box 903447
Sacramento, CA 94203 MAY'2 3:2016
Registry or
Re: Manifold Productions, Inc. Charitable Trustt

Dear Ms. Hetherington,

Enclosed please find the above-referenced organization's completed initial Commercial

Fundraiser for Charitable Purposes Annual Registration Form, the $350 filing fee and
the surety bond.

Please review the enclosed materials and register this organization with your office.
Thank you, in advance, for your assistance with this matter.

Kind Regards,

Christine Fisher
Legal Assistant
For the Firm
cfisher@cckc-law.corn

Enclosures

cs 310W. 20th Street Suite 300 Kansas City, MO 64108 816.472.9000 816.472.5000 • copilevitz-canter.com
MAIL TO:
Office of the Attorney General
Registry of Charitable Trusts
P.O. Box 903447
OFFICE OF THE ATTORNEY GENERAL
Sacramento, CA 94203-4470 REGISTRY OF CHARITABLE TRUSTS
STREET ADDRESS: SURETY BOND FORM
1300 I Street
Sacramento, CA 95814
Telephone: (916) 323-5079 Commercial Fundraiser for Charitable Purposes
WEB SITE ADDRESS:
(Government Code section 12599.5)
http://aq.ca.00vicharities/

674025085
Bond Number

$500.00 2016
Premium $ Term

KNOW ALL PERSONS BY THESE PRESENTS:

Manifold Productions, Inc.
That
Name of Principal

Manifold Productions, Inc.

as principal, doing business under the name of

as a commercial fundraiser for charitable purposes, and whose address for service is

5508 Surrey Street Chevy Chase MD 20815

Street Address City State ZIP

Liberty Mutual Insurance Company

and corporation authorized to transact a general surety
Name of Surety

business in the State of California, as surety, and whose address for service is

175 Berkeley Street Boston MA 02117

Street Address City State ZIP

are held and firmly bound to the State of California in the penal sum of the total amount of $25,000
for the payment of which, we bind ourselves, our heirs, executors, successors and assigns, jointly
and severally, firmly by these presents.

WHEREAS, the provisions of Section 12599.5 of the Government Code require that the
principal file or have on file with the Registry of Charitable Trusts of the Department of Justice a
bond in the amount of twenty-five thousand dollars ($25,000) pursuant to Government Code section
12599.5. This bond is executed and tendered in accordance therewith.

NOW THEREFORE, the conditions of the foregoing obligation are that if the principal
complies with the provisions of the subdivision (a) of Sect. of the Government Code of the
State of California, and pays all sums due any individual o Whibialuals when such principal
Aftritvwsv otr&e nfOnr
MAY ' 2 3 211•, CT-4CF BOND FORM (3-05)

Regisuy
Ch8t1tSh10 Tn ref
or its representative or agent has received such sums, and pays all damages occasioned to any
person by unlawful acts, or omissions of the principal mentioned above, or of its agents or
employees while acting within the scope of their employment, then this obligation is to be void;
otherwise it is to remain in full force and effect.

PROVIDED HOWEVER, this bond is issued subject to the following express conditions:

1. This bond shall be deemed continuous in form and shall remain in full force and
effect for all liabilities incurred before, and for acts, omissions, or causes existing or which arose
before, the cancellation or withdrawal of the Surety from the bond.

2. This bond is executed by the Surety to comply with the provisions of subdivision (a)
of Section 12599 of the Government Code and of Chapter 2 (commencing with Section 995.010), Title
14, Part 2 of the Code of Civil Procedure and said bond shall be subject to all of the terms and
provisions thereof.

3. The aggregate liability of the Surety hereunder on all claims whatsoever shall not
exceed the penal sum of this bond in any event.

4. This bond may be canceled by the Surety in accordance with the provisions of
Section 996.310 et seq. of the Code of Civil Procedure.

5. The Surety, its successors and assigns, are jointly and severally liable on the
obligations of section 12599 of the Government Code.

6. The Principal and Surety may be served with notices, papers and other documents
under Chapter 2 (commencing with section 995.010) Title 14, Part 2 of the Code of Civil Procedure
and section 12599 of the Government Code, at the addresses given above.

Manifold Productions, Inc. Liberty Mutual Insurance Company

Name of Officer or Business Name of Surety

5508 Surrey Street, Chevy Chase, MD 20815 175 Berkeley Street Boston, MA 02117
Address Address

This bond is executed under an unrevoked appointment of power of attorney.

I certify (or declare) under penalty under the laws of the State of California that the
foregoing is true and correct.

05/04/2016
Date Signature of Attorney-In-Fact for Surety

Nathan Buhrmester
Printed or Typed Name of Attorney-In-Fact for Surety

CT-4CF BOND FORM (3-05)

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