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<br />_____90T-08-2008 WED 01:53 PM SHERYL KeEL FAX <br /> <br />, <br /> <br />MINNESOTA. REVENUE <br />Contractor's Withholding Affidavit <br />Confirmation <br /> <br />FAX NO. 13034253984 P, 01/01 <br />Page I of 1 <br />/trr AI ~rwt.",- <br />1(P 3,.,/.A Y'"i'JL{y' <br /> <br />QUALITY RESTORATION SERVICES INC <br /> <br />10 1626039 <br /> <br />Please keep thIs Information for your records. <br />Submit a copy of this page to the business that hired you to receive your final payment. <br /> <br />Confirmation number <br />Project owner <br />Project number <br />Project begin date <br />Projeot er,d date <br />Project locatIon <br />Subcontractor. <br /> <br />220331 Wed Oct 08 13:59:63 CDT 2008 <br />CITY OF CENTERVILLE <br />000616-07155-0 <br />July 2001 <br />August 2007 <br />CENTERVILLE. MN <br />No subcontractors listed. <br /> <br />Jtl <br />