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WSW5 MN e-Services <br /> ry11NJt,,J a (�_ <br /> Contractor Affidavit Submitted - <br /> Enter Information Review and Submit Complete <br /> Thank you,your Contractor Affidavit has been approved. <br /> Confirmation Summary <br /> Confirmation Number 0-248-420-224 <br /> Submitted Date and Time. 25-Aug-2015 9:09:27 AM <br /> Legal Name: E J MAYERS INC <br /> Federal Employer ID, 48-1257369 <br /> User Who Submitted: EJMayers <br /> Type of Request Submitted: Contractor Affidavit <br /> Affidavit Summary <br /> Affidavit Number: 694566912 <br /> Minnesota ID: 6130608 <br /> Project Owner: CITY OFCENTERVILLE <br /> Project Number: 2012014.1412 <br /> Project Begin Date: 01-Jul-2014 <br /> Project End Date: 30-Jul-2014 <br /> Project Location: CENTERVILLE,ROYAL MEADOWS WATERMAIN <br /> ProjectAmount: $41,469.00 <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 at651-282-9999,(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 /> How to View and Print this Request <br /> You can see copies ofyour requests by going to the History Tab,or by clicking the link below.To Print or email a copy of this <br /> confirmation page,click one ofthe buttons below <br /> Click here to ac,to the History Tab <br /> Printer Friendry Email Me Close <br /> .• , i i �.•a • a ..�,, r�r.•� ,� , • ,.• <br /> haps:/,wm.mndor.state.mn.usltp/eservicmi MC4 111 <br /> 52 <br />