FEC Form 1 for Herzog Contracting Corp. Political Action CommitteeForm 1 for Herzog Contracting Corp. Political Action Committee

FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-760386

1. Herzog Contracting Corp. Political Action Committee

330 Encinitas Blvd., Ste. 101
Encinitas, CA 92024
Email: rstephen@thinkcpa.com

2. Date: 01/27/2012

3. FEC Committee ID #: C00391979 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

Herzog Contracting Corp.
600 S. Riverside Rd.
St. Joseph, Missouri 64507
Affiliated Relationship Code: Connected Organization

Custodian of Records:

Robin Stephen
330 Encinitas Blvd., Ste. 101
Encinitas, CA 92024
Title: Custodian of Records
Phone # (760) 632-3600

Treasurer:

Michael W. Rogers
3760 Kilroy Airport Way, Suite 120
Long Beach, California 90806
Title: Treasurer
Phone # (562) 595-7414

Designated Agent(s):

Art Van Meter
600 S. Riverside Rd.
St. Joseph, Missouri 64507
Title: Assistant Treasurer
Phone # (816) 233-9001

FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-760386

1. Herzog Contracting Corp. Political Action Committee

2. Date: 01/27/2012

Affiliated Committees/Organizations

Custodian of Records:

Treasurer:

Designated Agent(s):

Banks or Depositories

Signed: Michael Rogers
Date Signed: 01/26/2012

(End FEC FORM 1)

FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-760386

1. Herzog Contracting Corp. Political Action Committee

2. Date: 01/27/2012

Affiliated Committees/Organizations

Custodian of Records:

Treasurer:

Designated Agent(s):

Banks or Depositories

Signed: Michael Rogers Date Signed: 01/26/2012

(End FEC FORM 1)

Signed: Michael Rogers
Date Signed: 01/26/2012