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1 DEPARTMENT <br />OF REVENUE <br />Contractor Affidavit Submitted <br />Thank you, your Contractor Affidavit 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 />Minnesota ID: <br />Project Owner. <br />Project Number: <br />Project Begin Date: <br />Project End Dale: <br />Project Location: <br />Project Amount: <br />Subcontractors: <br />1-737-261-664 <br />7-Jun-2023 2:36:20 PM <br />SAFETY SIGNS LLC <br />41-1991774 <br />belh novak <br />ContractorAfridevil <br />1630818304 <br />5139558 <br />CITY OF ELK RIVER <br />NWA PROJECT NO.1265 <br />10-May-2022 <br />01-Jul-2022 <br />13085 ORONO PARKWAY, ELK RIVER, MN <br />$13,760.00 <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 />Contact Us <br />If you need further assistance, contact our Withholding Tax Division at 651-282-9999, (toll -free) 800-657-3594, or (email) withholding.taxQo stale minus, Business hours <br />are Monday through Friday 8:00 a.m, to 4.30 p.m. Central Time. <br />Please print Ihis cage for your records using the print or save functionality built Into your browser. <br />Page 72 of 201 <br />