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12/4/2018 https://www.mndor.state,mn.us/tp/eservices/ /Retrieve/0/c-/D5D41wuO_Ir04nPNMIPW6Q_?FILE=Print2&PARAMS=88531704620... <br />DEPARTMENT <br />y OF REVENUE <br />Contractor Affidavit Submitted <br />Thank you, your Contractor Affidavit has been approved. <br />Confirmation Summary <br />Confirmation Number: 2-113-443-264 <br />Submitted Date and Time: 4-Dec-2018 10:43:22 AM <br />Legal Name: ZAK INDUSTRIES INC <br />Federal Employer ID: 26-1605885 <br />User Who Submitted: z13834 <br />Type of Request Submitted: Contractor Affidavit <br />Affidavit Summary <br />Affidavit Number 1655742464 <br />Minnesota ID: 9254906 <br />Project Owner: CITY OF RAMSEY <br />Project Number: SUNWOOD DRIVE <br />Project Begin Date: 01-Aug-2017 <br />Project End Date: 29-Sep-2017 <br />Project Location: SUNWOOD DRIVE RAMSEY MN <br />Project Amount: $3,360.00 <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) 800-657-3694, 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 image for your records using the print or save functionality built Into your browser, <br />https://www.mndor.state.mn.us/ip/eservices//Retrieve/O/c-/D5D41wuOJr04nPNMIPW6Q_?FILE_=Print2&PARAMS= 8853170462044786061 1/1 <br />