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Contractor Affidavit Submitted <br />Thank you, your Contractor Affidavit has been approved. <br />Confirmation Summary <br />Confirmation Number: 2-111-325-408 <br />Submitted Date and Time: 11-Dec-2024 8:53:59 AM <br />Legal Name: MILLER EXCAVATING INC <br />Federal Employer ID: 41-0951547 <br />User Who Submitted: pmillerexc <br />Type of Request Submitted: Contractor Affidavit <br />Affidavit Summary <br />Affidavit Number: 2037895168 <br />Minnesota ID: 9363164 <br />Project Owner: CITY OF LITTLE CANADA <br />Project Number: SAP 200-101-012 <br />Project Begin Date: 06-May-2024 <br />Project End Date: 15-Nov-2024 <br />Project Location: LITTLE CANADA 2024 STS <br />Project Amount: $1,143,208.64 <br />Subcontractor Summary <br />Name ID Affidavit Number <br />SAFETY SIGNS LLC 5139558 1688064000 <br />NEATON BROS LLC 4990862 219009024 <br />KNIFE LAKE CONCRETE INC 5836054 191090688 <br />HOFFMAN & MCNAMARA 5520215 393072640 <br />BURSCHVILLE CONST INC 6887256 814731264 <br />BITUMINOUS ROADWAYS INC 8225235 733204480 <br />ALLIED BLACKTOP CO 8606387 215732224 <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 />Firefox https://www.mndor.state.mn.us/tp/eservices/_/Retrieve/0/Dc/fvyChQzk... <br />1 of 1 12/11/2024, 8:57 AM <br />Docusign Envelope ID: 3FD52EC2-113E-47E2-998E-542900EAE514