ATTACHMENT E-3 TAX IDENTIFICATION AND REGISTRATION FORM OFFICIAL NAME OF COMPANY: A. If a Corporation, what is the state of Incorporation? B. If a Partnership, state full names of Copartners: C. If a Limited Liability Company, what is the state in which formed: D. If a sole proprietorship, are you an independent contractor? ____ Yes ____ No E. SOCIAL SECURITY OR I.D. # MINNESOTA STATE TAX I.D.# Pursuant to Minn. Stat. § 270C.65, Subd. 3, Minnesota Contract Vendors are required to provide their Minnesota Tax Identification Number (or and Federal Employer Identification Number (or Social Security Number). Non-Minnesota Contract Vendors are required to provide their Federal Employer I.D. Number (or Social Security Number) only. This information may be used in the enforcement of Federal and State Tax Laws. Supplying these numbers could result in action to require a Contract Vendor to file tax returns and pay delinquent State Tax Liabilities. These numbers will be available to Federal and State Tax Authorities and State personnel involved in the payment of State obligations. F. BUILDING CONSTRUCTION CONTRACTOR REGISTRATION NO.: Or LICENSE NO.:_____________ TYPE OF LICENSE:_________________________ Minn. Stat § 181.723 as amended (Minn. Laws, chapter 295) requires Contractors and Subcontractors that provide commercial or residential building construction or improvement services in Minnesota to be registered with the Minnesota Department of Labor and Industry unless they are already licensed, certified or registered by the Minnesota Department of Labor and Industry. Contractors are required to have a Building Construction Contractor Registration No. prior to receiving a Contract Award. For additional information and to register go to or contact DLI at 651.284.5074 or email: . G. STATE OF MINNESOTA VENDOR ID#_______________ Contractors are required to have a Minnesota Vendor ID prior to receiving a Contract Award. For information on requesting or registering your Minnesota Vendor ID: . ATTACHMENT E-4 MINNESOTA DEPARTMENT OF REVENUE 1C-134 FORM All construction work requires an IC-134 form submitted by the Contractor before payment can be made.
There are 2 options for submitting Electronically: Go to the Dept of Revenue’s website at: Sign up for e-services. Complete the online form, print it and submit with final payment Manual: Download the form and instructions from the Dept of Revenue’s website at: Fill out the form (the form is on the next page along with instructions). Mail the form to the Dept of Revenue (address is in the instructions) Receive form back from Revenue with their signature Submit the form with final payment request.
ATTACHMENT E-6.2 ADDITIONAL SUBCONTRACTORS LIST PRIME CONTRACTOR TO SUBMIT AS SUBCONTRACTORS ARE ADDED TO THE PROJECT PROJECT TITLE: _________________________________________________________________ This form must be submitted to the Project Manager or individual as identified in the solicitation document. Minn. Stat. § 16C.285, Subd. 5. … If a prime contractor or any subcontractor retains additional subcontractors on the project after submitting its verification of compliance, the prime contractor or subcontractor shall obtain verifications of compliance from each additional subcontractor with which it has a direct contractual relationship and shall submit a supplemental verification confirming compliance with subdivision 3, clause (7), within 14 days of retaining the additional subcontractors. … ADDITIONAL SUBCONTRACTOR NAMES (Legal name of company as registered with the Secretary of State) Name of city where company home office is located