FEC Form 1 for CEMEX Inc. Employees Political Action CommitteeForm 1 for CEMEX Inc. Employees Political Action Committee

FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-409779

1. CEMEX Inc. Employees Political Action Committee

840 Gessner Road Suite 1400
Houston, TX 77024
Email: thomasj.edgeller@cemex.com

2. Date: 03/24/2009

3. FEC Committee ID #: C00111880 This committee is a separate segregated fund. Its connected organization is a Corporation
In addition, this committee is a Lobbyist/Registrant PAC.

Affiliated Committees/Organizations

CEMEX Inc.
840 Gessner Road Suite 1400
Houston, Texas 77024
Affiliated Relationship Code: Connected Organization

Custodian of Records:

Thomas J Edgeller
840 Gessner Road Suite 1400
Houston, TX 77024
Title: Custodian
Phone # (713) 722-5918

Treasurer:

Thomas J Edgeller
840 Gessner Road Suite 1400
Houston, Texas 77024
Title: Treasurer
Phone # (713) 722-5918

Designated Agent(s):

L. Douglas Carpenter
3701 Sugar Spring Rd.
Gastonia, North Carolina 28054
Title: Assistant Treasurer
Phone # (704) 868-6333

Banks or Depositories

Bank of America N.A.
P.O. Box 831547
Dallas, Texas 75283

Signed: Thomas J Edgeller
Date Signed: 03/26/2009
Official Committee URL: N/A

(End FEC FORM 1)

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