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.. <br /> Page 1 of 1 <br /> MINNESOTA-REVENUE RECEIVED <br /> Contractor Affidavit Submitted <br /> Thank you,your contractor Affidavit has been approved. <br /> Confirmation Summary PCf <br /> Confirmation Number: 1-829-429-824 <br /> Submitted Date and Time: 27-Apr-2016 8:29:52 AM <br /> Legal Name: MID STATE TILE CO <br /> Federal Employer ID: 41-1767267 <br /> User Who Submitted: mroden00 <br /> Type of Request Submitted: Contractor Affidavit <br /> Affidavit Summary <br /> Affidavit Number: 978272256 <br /> Minnesota ID: 1392808 <br /> Project Owner: CITY OF RAMSEY <br /> Project Number: 15-12 <br /> Project Begin Date: 15-Dec-2015 <br /> Project End Date: 16-Mar-2016 <br /> Project Location: 5650 ALPINE DR NW RAMSEY MN 55303 <br /> Project Amount: $22,663.00 <br /> Subcontractors: No Subcontractors <br /> Important Messages <br /> A copy of this page must be provided to the contractor or government agency that hired you. <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 /> withhoiding.tax@state.mn.us.Business hours are 8:00 a.m.-4:30 p.m.Monday-Friday. <br /> Please print this oaae for your records using the print or save functionality built into your browser. <br /> �. .nn n rr r�i ri r r>A<fll Y•T A AY1.11'I111!_ <br />