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FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-187530

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1. AMERICAN CONCRETE PAVEMENT ASSOCIATION PAC (ACPA)

    5420 Old Orchard Road
    Suite A-100
    Skokie, IL 60077
    Fax: 8479662272

2. Date: 09/29/2005

3. FEC Committee ID #: C00322727 This committee is a Separate Segregated Fund

Affiliated Committees/Organizations

Custodian of Records:

Erin McKnight
5420 Old Orchard Road
Ste A-100
Skokie, IL 60077
Title: Assistant Treasurer
Phone # (847) 966-2272

Treasurer:

, ____

Designated Agent(s):

Banks or Depositories

Signed: William L. Davenport
Date Signed: 09/29/2005
Official Committee FAX: 8479662272

(End FEC FORM 1)

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