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Page 1 of 1 <br />rmDEPARTMENT <br />OF REVENUE <br />Contractor Affidavit Submitted <br />Thank you, your Contractor Affidavit has been approved. <br />Confirmation Summary <br />Confirmation Number: 2-080-980-672 <br />Submitted Date and Time: 16-Jul-2018 4:47:14 PM <br />Legal Name: NORTH VALLEY INC <br />Federal Employer ID: 41-1906523 <br />User Who Submitted: northva <br />Type of Request Submitted: Contractor Affidavit <br />Affidavit Summary <br />Affidavit Number: 1147183104 <br />Minnesota ID: 3744649 <br />Project Owner: CITY OF RAMSEY <br />Project Number: 16-98 <br />Project Begin Date: 11-Apr-2017 <br />Project End Date: 15-Jun-2017 <br />Project Location: CENTRAL PARK PARKING LOT-RAMSEY <br />Project Amount: $265,778.58 <br />Subcontractor Summary <br />Name ID Affidavit Number <br />SAFETY SIGNS LLC 5139558 1577132032 <br />SCHMIDT CURB COMPANY INC 3605361 2004131840 <br />AAA STRIPING SERVICE CO 6290097 1449353216 <br />ZAK INDUSTRIES INC 9254906 1288986624 <br />Important Messages <br />A copy of this page must be provided to the contractor or govemment 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 />withholding.tax@state.mn.us. Business hours are 8:00 a.m. - 4:30 p.m. Monday - Friday. <br />Please print this one for your records using the print or save functionality built into your browser. <br />httnw//www.mndor.state.mn.us/tn/eservices/ /Retrieve/O/c-/FZwhOSHVM6yhIU1b8c1pJg... 7/16/2018 <br />