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Page 1 of l <br />MINNESOTA- 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 />Account Number: <br />Project Owner: <br />Project Number: <br />Project Begin Date: <br />Project End Date: <br />Project Location: <br />Project Amount: <br />1-014-549-888 <br />30 -Mar -2015 4:22:24 PM <br />LLOYDS CONSTRUCTION SERVICES INC <br />41-1581003 <br />LloydConst <br />Contractor Affidavit <br />2105819136 <br />3909541 <br />CITY OF NEW BRIGHTON <br />1417 <br />10 -Oct -2014 <br />05 -Mar -2015 <br />NEW BRIGHTON COMM CENTER 400 10TH ST NW, NEW BRIGHTON, MN 55112 <br />$62,240.00 <br />Subcontractor Summary <br />Name ID Affidavit Number <br />LANGFORD TOOL & DRILL CO 8651782 206454784 <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 />With holding.tax@state.mn.us. Business hours are 8:00 a.m. - 4:30 p.m. Monday - Friday. <br />Please print this confirmation nage for your records using the print or save functionality built into your browser. <br />https://www.mndor.state.nm.us/tpleservices/ /Retrieve/0/b-lYv240r9g9KoZxkL2vMUpcw... 3/30/2015 <br />