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Minnesota Department oi Labor and Industry Licensing and CertiTication Services Construction Codes snd Licensing Division Phone: 651.284.5034 443 L�fayette Road N Email: DLI.License@state.mn.us Saint Paul, MN 55155 Website: www.dli.mn.gov/ccld.asp NOTICES NOT TRANSFERABLE KLEVE &JC MECHANICAL LLC CHANGE YOUR BUSINESS STRUCTURE 12907 PIONEER TRAIL SUBMIT A NEW APPLICATION FOR NEW ENTITY EDEN PRAIRIE, MN 55347 , RENEW OR REPLACE INSURANCE POLICY SUBMIT NEW CERTIFICATE OF INSURANCE NOTIFY THE DEPARI"MENT OF A CHANGE IN YOUR BUSINESS. Failure to do so, subjects you to administrative penalties of up to $10,000. 15-Day Notice Requirement=Forms available online at www.dli.mn.qov/CCLD/LicUpdate asp • Change in business'{�hysical address,mailing address, phone number, or email address • Change in control, owr�ers,officers,directors, membe�s, partners � - • Change in business'legal name and/or assumed name • Loss of or change in RESPONSIBLE INDIVIDUAL • Change in general liability insurance or workers'compensation insurance coverage Immediate Notice Requirement—Notification to DLI in writing • Judqment Debtor. A licensed contractor has 15 days to provide written notice of the finding that it:is found to be a judgment debtor based upon conduct reqLiring Iicensur�.- -_ =_- • Bankruptcv Petition Filed A iicensed contractor has 15 days to provide written notice that it filed a petition for bankruptcy. • Conviction Notice A licensed cont�actor has 10 days io provide written notice that it has been found guilty ot a felony, gross misdemeanor, misdemeanor or any comparable offense related to the license, including convictions of fraud, misrepresentation,misuse of funds, the�t, criminal sexual conduct, assault, burglary,conversion of funds, or theft of proceeds in this or any other state or any other United States jurisdiction. YOUR CERTIFICATE IS BELOW THE PERFORATIOtJ. SHOW CERTIFICATE WHEN OBTAINING PERMITS. ' �� MINNFSOTADFPAi2TMf.NTOF MECHANICAL CONTRACTOR-�BOND � LABOR & INDUSTRY Construction Codes and Licensing Division Licensing and Certification Services 443 Lafayerie Road N St.Paul,MN 55155 Website: www.dli.mn.qov/ccld.asp Email: dli.licenseCa�state.mn us Phone: 651.284.5034 This is to certify that the certificate holder is registered as a MECHANICAL CONTRACTOR BOND in the state of Minnesota and is in compliance with Minnesota Statutes 326B.197,and has filed a$25,000 mechanical bond to perform gas,heating,ventilation,cooling, air conditioning, fnel buming,or refrigeration work in al]areas of the state during the registration period;provided the work performed complies with the State Mechanica] Code and the certificate holder maintains compliance w;th the required bond and workers'compensation laws. Registration : MECHANICAL CONTRACTOR BOND RegNumber : MB658861 KLEVE & JC MECHANICAL LLC i Effective Date : 07/03/20�a 12907 PIONEER TRAIL B Expiration Date : 07/03/2016 EDEN PRAIRIE, MN 55347 � T VERIFY UP-TO-DATE STATUS, BOND,AND INSURANCE IfJFO AT www.dli.mn.qov/ccldlLicVerifv asp (ENTER NUMBER).