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FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-495068

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1. AMERICAN CONCRETE PAVEMENT ASSOCIATION PAC (ACPA)

    9450 W. Bryn Mawr Road
    Suite 150
    Rosemont, IL 60018

    NOTE: Address is different than previously reported

    Email: bdavenport@acpa.org

    NOTE: Email address is different than previously reported

2. Date: 09/23/2010

3. FEC Committee ID #: C00322727 This committee is a separate segregated fund. Its connected organization is a Trade Association

Affiliated Committees/Organizations

American Concrete Pavement Association
9450 W. Bryn Mawr Ave.
Suite 150
Rosemont, Illinois 60018
Affiliated Relationship Code: Connected Organization

Custodian of Records:

William L. Davenport
9450 W. Bryn Mawr
Ste 150
Rosemont, IL 60018
Title: Treasurer/VP
Phone # (847) 966-2272

Treasurer:

William L. Davenport
9450 W. Bryn Mawr
Ste 150
Rosemont, Illinois 60018
Title: Treasurer/VP
Phone # (847) 966-2272

Designated Agent(s):

Leif G Wathne
500 New Jersey Ave
7th Floor
Washington, DC 20001
Title: Assist. Treas. / VP
Phone # (202) 638-2272

Banks or Depositories

Harris Bank of Skokie
9731 Skokie Boulevard
Skokie, Illinois 60077

Signed: William L. Davenport
Date Signed: 09/24/2010

(End FEC FORM 1)

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