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11/20/25, 3:08 PM mndor.state.mn.us/tp/eservices/_/Retrieve/O/Dc/KLF1i5D7oD5rCGYNrYIOYw_ <br />DEPARTMENT <br />Attachment C <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 Date: <br />Project Location: <br />Project Amount: <br />Subcontractor Summary <br />0-142-540-256 <br />20-Nov-2025 3:08:13 PM <br />BRZ COATINGS INC <br />82-0926902 <br />bracoatingsinc <br />Contractor Affidavit <br />990556160 <br />8506898 <br />CITY OFARDEN HILLS, MINNESOTA <br />17993.001 <br />20-Aug-2025 <br />08-Oct-2025 <br />1230 RED FOX ROAD IN ARDEN HILLS, MN 55112 <br />$402,675.00 <br />Name <br />ID <br />Affidavit Number <br />SIBLEY ELECTRIC <br />6322955 <br />345288704 <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 />withholding.tax@state.mn.us. Business hours are Monday through Friday 8:00 a.m. to 4:30 p.m. Central Time. <br />Please print this page for your records using the print or save functionality built into your browser. <br />https://www.mndor.state.mn.us/tp/eservices/_/Retrieve/O/Dc/KLF1 i5D7oD5rCGYNrYIOYw_?FILE_=Print2&PARAMS_=9080100493874178176 1/1 <br />