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Page 1 of 1 <br />S MNESOTA REVENUE <br />Contractor's Withholding Affidavit <br />Confirmation <br />1 <br />1 <br />RANDY S KIRSCHMAN ID 8414399 <br />PIease keep this nformation for your records. <br />Submit opy of this page t the business that hired you to receive your final payment. <br />Confirmation number 383012 Mon May 232G:O2:12 CDT 2011 <br />Project owner L|NOLAKES <br />Project number 20111ino|ekea <br />Project begin date May 2011 <br />Project end date May 2011 <br />Project location LINO LAKES MN <br />Subcontractors No subcontractors Iistea. <br />' 5/23/2011 <br />b1tpa:/hxnvvv.ozod0r.utotc.ozn.uu/wc/aotu)o/oOuIozuozoo�ro� <br />