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Minnesota Department of Labor and Industry <br /> Construction Codes and Licensing Division Licensing and Certification Services <br /> 443 Lafayette Road N Phone: 651.284.5034 <br /> Saint Paul, 55155 Email: DLI.License@state.mn.us <br /> MWebsite: www.dli.mn.gov/ccld.asp <br /> NOTICES <br /> NOT TRANSFERABLE <br /> CHANGE YOUR BUSINESS STRUCTURE <br /> SUBMIT A NEW APPLICATION FOR NEW ENTITY GREEN CLEAN RESTORATION <br /> RENEW OR REPLACE INSURANCE POLICY 7229 UNIVERSITY AVE NE <br /> FRIDLEY, MN 55432 <br /> SUBMIT NEW CERTIFICATE OF INSURANCE <br /> NOTIFY THE DEPARTMENT OF A CHANGE IN YOUR BUSINESS. <br /> Failure to do so, subjects you to administrative penalties of up to$10,000. <br /> 15-Day Notice Requirement—Forms available online at www.dli.mn.gov/CCLD/LicUndatP asn <br /> • Change in business'physical address,mailing address,phone number,or email address <br /> • Change in control,owners,officers,directors,members,partners <br /> • Change in business'legal name and/or assumed name <br /> • Loss of or change in QUALIFYING BUILDER <br /> • Change in general liability insurance or workers'compensation insurance coverage <br /> immediate Notice Requirement—Notification to DLI in writing <br /> • Judgmen�t pebtor. A licensed contractor has 15 days to provide written notice of the finding that it is found to be a judgment <br /> debtor based upon conduct requiring licensure. <br /> • Bankru tc Petition Filed. A licensed contractor has 15 days to provide written notice that it filed a petition for bankruptcy. <br /> • Conviction Notice. A licensed contractor has 10 days to provide written notice that it has been found guilty of a felony, gross <br /> misdemeanor, misdemeanor or any comparable offense related to the license, including convictions of fraud, <br /> misrepresentation,misuse of funds, theft, criminal sexual conduct, assault, burglary, conversion of funds, or theft of proceeds <br /> in this or any other state or any other United States jurisdiction. <br /> YOUR CERTIFICATE IS BELOW THE PERFORATION. <br /> SHOW CERTIFICATE WHEN OBTAINING PERMITS. <br /> 15Z- <br /> MINNESOTA DEPARTMENT or <br /> iLABOR & INDUSTRY RESIDENTIAL BLDG CONTRACTOR <br /> Construction Codes and Licensing Division <br /> Website: www.dli.mn.00v/CcId.as0 Licensing and Certification Services 443 Lafayette Road N St.Paul,MN 55155 <br /> Email: dii Iicensetaastat m c <br /> This is to certify that the certificate holder is licensed as a RESIDENTIAL BUILDING CONTRACTOR in the state of Minnesota is <br /> nesota and651.284.5034 in <br /> compliance with Minnesota Statutes 326B.805,and may build residential real estate,contract or offer to contract with an owner to build <br /> residential real estate,and contract or offer to contract with an owner to improve existing residential real estate;provided the <br /> responsible individual is at all times a QUALIFYING BUILDER and the certificate holder maintains compliance with the required general <br /> liability insurance,and workers'compensation laws. <br /> License : RESIDENTIAL BLDG CONTRACTOR <br /> I <br /> Lic Number : BC631450 GREEN CLEAN RESTORATION <br /> Effective Date : 04/01/2012 7229 UNIVERSITY AVE NE <br /> Expiration Date : 03/31/2014 E, <br /> FRIDLEY, MN 55432 t <br /> r, <br /> VERIFY UP-TO-DATE STATUS, BOND,AND INSURANCE INFO AT www.dli.mn.Qov;ccldLicVerifY.asp (ENTER NUMBER). <br />