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Minnesota Department of Labor and Industry Licensing and Certification Services <br /> Construction Codes and Licensing Uivision Phone: 651.284.5034 <br /> 443 Lafayette Road N Email: DLI.License@state.mn.us <br /> Saint Paul, MN 55155 Website: www.dli.mn.gov/ccld.asp <br /> NOTICES <br /> NOT TRANSFERABLE <br /> CHANGE YOUR BUSINESS STRUCTURE THOMAS BREN HOMES INC <br /> SUBMIT A NEW APPLICATION FOR NEW ENTITY 2073 W WAYZATA BLVD STE 50 <br /> RENEW OR REPLACE INSURANCE POLICY LONG LAKE, MN 55356 <br /> SUBMIT NEW CERTIFICATE OF INSURANCE <br /> N071FY THE DEPARTMENT OF A CHANGE IN YOUR BUSINESS. <br /> Failure to do so, subjects you to administrative penalties a�f up to$10,000. <br /> 15-Day Notice Requirement—Forms available online at www dli mn aov/CCLDILicUadate.asp <br /> . Change in business'physical address,mailing address,phone number,or email address <br /> . Change in control, nwners,officers,directots,members,partners <br /> • Change in business'iegal name and/or assumed name <br /> . Loss of or change in GlUALIFYING'BUILDER <br /> . Cha�ge in general liability insurance or workers'compensation insurance coverage <br /> Immediate Notice Requirement—Notification to DLI in writing <br /> • Judament Debtor. A ticensed contractor has 15 days to provide written noiice of the finding,that it is found to be a judgment <br /> debtor based upon conduct requiring licensure. <br /> . Bankruotcy Petition Fileii': A licensed conttactor has 15 days to provide written notice that it filed a petition for bankrup#cy: <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, misdeme�nar or any ', comparable offense related to the license, including < convictions 'af fraud, <br /> misrepresentation,rnisuse of funds,theft,criminal sexual conduct, assault, burglary, conversion of funds, or`tfieft-of proceeds <br /> in this or any other state or any other United States jurisdiction. <br /> YOUR CERTIFICATE IS BEL.OW THE PERFORATION. SHOW CERTIFICA7E WH�N OBTAINING PERMITS. <br /> y R,�µNE5aT�,DEP^RTMENTpF RESIDENTIAL BLDG CONTRACTOR <br /> LABOR & 1NDUSTRY <br /> � ' <br /> Construction Codes and Lfcensing Division Licensing and Certification Services 443 Latayette'WoadN St.Paul;MM55155 <br /> Websile: www dli.mn aov/ccld.asa Email: dli IicenseC�state.mn.us Phone: 651.284.5034 <br /> "I'his is to certify that the certificate�l�older is licensed as a RESIDENT[AL BUILDING CONTRACTOR in the state of�Minncsota ai�d is in <br /> compliance with Minnesofa Statutes 326B.805,and may build residential real estate,contract'or offer to contract with an owner to build <br /> resideiitial rcal estate, and contract or offer to contract with an owner to improve existing residential real estate;providcd 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 CONTRACTaR � <br /> Lic Number : BC128144' THOMAS BREN HOMESINC � <br /> e <br /> Effective Date : 04/01/2012 : 2073 W WAYZATA BLVD-STE 50 � <br /> Expiration Date : 03/31/2014 " LONG LAKE, MN 55356 T <br /> V�RIFY UP-T0-DA7E STATUS, BOND,AND INSURANCE INFO ATwww.dli,rttn.aov/ccidlLicVerifV:asp (ENTER NUMBER). <br />