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Pa,=e 1 of'] <br />N1INItNESO A- REVS V(lE <br />Contractor Affidavit Completed <br />Thank you, your Contractor Affidavt has been approved. <br />Confirmation Summary <br />Confirmation Number: <br />Submitted Date and Time: <br />Legal Name: <br />Federal Employer ID: <br />User Who Submitted: <br />Type of Request Submitted: <br />Affidavit Summary <br />Affidavit Number: <br />Account Number: <br />Project Owner: <br />Project Number: <br />Project Begin Date: <br />Project End Date: <br />Project Location: <br />Project Amount: <br />Subcontractors: <br />1-721-788-288 <br />14 -Aug -2015 4:16:57 PM <br />GENERAL SPRINKLER CORP <br />41-1637692 <br />general1863 <br />Contractor Affidavit <br />1269448704 <br />2564736 <br />CITY OF RAMSEY <br />14-28 <br />16 -Apr -2015 <br />05 -Aug -2015 <br />7550 SUNWOOD DRIVE, RAMSEY, MN 55303 <br />S23,900.00 <br />No Subcontractors <br />Important Messages <br />A copy of this page must be provided to the contractor or government agency that hired you. <br />Q LI' w ; a <br />Contact Us <br />If you need further assistance, contact our Withholding Tax Division at 651-282-9999, (toll-free) 800-657-3594, or (email) <br />Withholding.tax@state.mn.us. Business hours are 8:00 a.m. - 4:30 p.m. Monday - Friday. <br />Please Print this confirmation page for your records using the print or save functionality built into your browser. <br />https:irwww.mndot-.state.mn.us!tp/eservices!iRetrieve,-Orb-/RrCIYRvlOcbpHtpLiEMZL(,_?FILE^=Print2 S'14201_> <br />