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Received: <br />10/03/2011 13:00 9524696689 <br />MINNESOTA. REV .ENUE <br />antractor's Withholding Affidavit <br />11".Confirmation <br />Oct 3 2011 02:09pm <br />SAFETY SIGNS <br />SAFETY SIGNS LLC ID 5139558 <br />SAFETY SIGNS <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 />Confirmation number 407786 Mon Oct 03 13:24:12 CDT 2011 <br />Project owner CITY OF LINO LAKES <br />Project number na <br />Project begin date May 2011 <br />Project end date June 2011 <br />Project location 2011 OVERLAY <br />Subcontractors No subcontractors listed. <br />• <br />• <br />1itt-nc• / /vxnartxr'vv.,An. .t•..te yn /xar"1,11"44 <br />PAGE 01/01 <br />Page 1 of 1 <br />