Downs Registration 2016.tifDowns Electric, Inc.
1808 Madison St
Omaha, NE 68107
CITY OF BLAIR
218 S 16TH STREET
BLAIR, NE 68008
(402) 426 - 4191
FAX (402) 426 - 4195
Email: cityofblair@ci.blair.ne.us
FOR OFFICE USE ONLY
Date Paid:;
Receipt No:
Date Issued:
BOND EXPIRES'
CONTRACTOR REGISTRATION / LICENSE RENEWAL
Phone numbers on record:
Type: Phone Number:
Office 402-733-3080
Mobile
Email Address:
Phone Number:
Type of Business: ELECTRICAL, GENERAL
Please submit new reciprocating license for those which have expired:
Please verify and correct
the company/business
information listed here:
Name Reciprocating License Expires
Arett, Al— Nebraska State Electrical Board License 12/31/2016
Downs, Dan L.Nebraska State Electrical Board License 12/31/2016
Graeve III, Eugene C'— Nebraska State Electrical Board License 12/31/2016
Suden, Steve Nebraska State Electrical Board License 12/31/2016
Please submit new certificates or bond renewals for those which have expired:
Name Certificate of Liability or Bond Expires
Downs, Dan L. General Certificate of Liability 5/16/2016/
Downs, Dan L.
Electrical Bond
11/14/20161
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Place a check in the box next to the licenses you wish to renew:
Renew? Name License / Registration Expires Amount
Arett, Al Journeyman Electrical 12/31/2015 $25
Downs, Dan L. General Contractor— 12/31/2015 $60
Downs, Dan L. Electrical Contractor-- 12/31/2015 $60 n�re
❑ Gr ve u an Elec ca L•Jl�/ G
Hall, Ryan J. Journeyman Electrical--- 12/31/2015 $25
Suden, Steve Journeyman Electrical--- 12/31/2015 $25
Please list any additional license or registrations:
Name License / Registration Amount
All information contained in this application is true and correct. I will notify the City of Blair of any changes in the
information reported on or with this application form within 15 days of change.
I hereby make application to the Licensing Board of Blair, Nebraska and certify that I am competent and experienced to
engage in above said vocation, agree to conform strictly to the Ordinances of the City of Blair, Nebraska relative to said
vocat' a obey all o er, r uirements and regulations of its lawful c nstituted authorities.
Aut rized Sig4W4 Date
11 -CRA