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FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-422492

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1. CEMEX Inc. Employees Political Action Committee

    920 Memorial City Way Suite 100
    Houston, TX 77024

    NOTE: Address is different than previously reported

    Email: thomasj.edgeller@cemex.com

2. Date: 06/30/2009

3. FEC Committee ID #: C00111880 This committee is a separate segregated fund. Its connected organization is a Corporation

Affiliated Committees/Organizations

CEMEX Inc.
920 Memorial City Way Suite 100
Houston, Texas 77024
Affiliated Relationship Code: Connected Organization

Custodian of Records:

Thomas J Edgeller
920 Memorial City Way Suite 100
Houston, TX 77024
Title: Custodian
Phone # (713) 722-5918

Treasurer:

Thomas J Edgeller
920 Memorial City Way Suite 100
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: 06/30/2009
Official Committee URL: N/A

FORM TEXT

(End FEC FORM 1)

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