Annual Lobbyist Registration
1/15/2019 2:25 PM
Business Information
Organization
Dorn Policy Group, Inc.
(602) 606-4667
101 N 1ST AVENUE, 20TH FLOOR, SUITE 2090
PHOENIX
AZ
85003
List CEO, ALL OFFICERS AND EMPLOYEES WHO LOBBY and their positions with organization. Organization MUST NOTIFY IN WRITING all lobbyists it registers. Officers and employees do not need to register seperately.
Main Contact Name Position Email Address
Tom Dorn President 602-606-4667
Carly Daniels Associate 602-606-4667
Cole Libera Associate 602-606-4667
Eric Emmert Vice President 602-606-4667
List all persons by whom the lobbyist is compensated to lobby and on whose behalf lobbying is performed.
Main Contact Name Client/Business Name Business Address Email Address
Manuel Moreno 3M 3M Center Bldg 0235-03-A-09
St. Paul, MN, 55144
Glen Kasprzyk American Medical Response 415 El Camino Way
Lake Havasu City, , AZ, 86403
Derrick Hall Arizona Diamondbacks POBox 2095
Phoenix, AZ, 85001
Sheila McGinley-Graziosi Cigna for Government and Education CIGNA Healthcare 900 Cottage Grove Rd.
C8GOV Bloomfield, CT, 06152
David Skinner HDR, Inc. 3200 E. Camelback Rdl, #350
Phoenix, AZ, 85018
By checking this box and typing my name below, the undersigned does hereby certify under penalty of perjury that: (1) I am submitting this lobbying registration form on behalf of the entity named on form; (2) I am duly authorized to submit the names of the individual lobbyist(s) named in this registration on behalf of the entity; (3) all of the information provided in the lobbying registration form filed on behalf of and authorized by the entity is true and correct to the best of my knowledge; and (4) by typing my name below I acknowledge that such action constitutes the legal equivalent of my signature and by typing my name I hereby waive any requirement that this form be notarized in order to be legally enforceable.

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