Project No. 90039 PROJECT COMPLETION CERTIFICATEPhone: 785-296-3081 Division of Taxation
Fax: 785-296-7928 109 SW 9th Street
www.ksrevenue.orgTopeka, KS, 66601·3506
Mark A. Burghart, Secretary Department of Revenue Laura Kelly, Governor
STATE OF KANSAS
PROJECT COMPLETION CERTIFICATION
TO: City of Salina
Name ofEntity to whom Project Exemption Certificate was Issued
300 West Ash Salina KS 67402-0736
Street Address City State Zip Code
This is to certify, to the best of my knowledge and belief, that all materials purchased under Exemption
Certificate N urnber 029·001857 , issued by the Kansas Department of Revenue, were
incorporated into the building or project for which the exemption was issued and were entitled to an
exemption pursuant to K.S.A. 79·3606(c), (d), (e), (xx), (aaa), (ccc), (iii), (qqq), (sss), (ttt), (uuu), (xxx)
and (yyy) as amended.
Contractor 1Subcontractor
P.O. Box and/or Street Number and Name
State Zip
Signature and Title ofAuthorized Representative Date
INSTRUCTIONS
Upon completion of a tax exempt project, the contractor must furnish this certification to the exempt entity for
which the work was performed. The exempt entity needs to retain this document in their files and record the actual
date that the project was completed on-line at https:llwww.kdor.ks.gov/apps/kcsc/. All invoices must be retained
by the contractor for a period of five (5) years and are subject to audit by the Kansas Department ofRevenue.
PR-77 (Rev. 09/16)
Stevens Contractors, Inc.
PO Box 1276
Salina KS 67402-1276
11/11/2022