IdealH Registration 2021218 S. 16th Street
Blair, NE 68008
(402) 426 4191 FAX: (4.02) 426 4.195
Email: cityofblair@ci.blainne.us
FOR OFFICE USE ONLY
Date Paid• 0110- A
Receipt No: !ter
Date issued:
BOND EXPIRES:
Application is: f-1New19<
Renewal
CONTRACTOR REGISTRATION/LICENSE RENEWAL
(Please type or print in ink - If you need more space, please attaeh additional sheets)
Application is for: ❑ Contractor- $60.00 ❑ Electrical Contractor- $60.00
❑ Water Service Line Installer $60.00 [] Tree Trimmer- $60.00
❑ Fire/Security System Installer - $25.00 ❑ Gas Line installer - $25.00
Business P
Applicant
B Mechanical Contractor- $60.00 El Plumbing Contractor- $60.00
❑ Dram Laver- $60.00
Business Address: G7�5 Ce %' F � � ES 1 City: OWAa hof State: AIF Zip: V) 17
Email Address: P-0 r (,fit n �P i1'E; oL --i m r t r O rAa, ()a . e D �
Phone #: Do Llq Mobile #:
Business Address outside of Nebraska:
City: State Zip: Phone:
C,O(-
Contact Person: to i n e �\ e k
Number of Employees: •J Apprentices: , , Journeymen: 91
Other Licenses Held: /
Insurance/Worker's Compensation Company: � PA('Ae A R,,A�c�L 1L1F c4yrvh C -e
Drain Layers/Electrical, Plumbing and Mechanical Contractors/Water Service Line installers need a $5,000 permit bond In favor
of the City of Blair. Tree Trimmers need a $5,000 permit bond In favor of the City of Blair. Electrical Contractor and Fire
Security Systems Installer will need to submit a copy of your Nebraska State License.
General Contractors need to submit a Certificate of Insurance with minimum limits of $1,000,000 Aggregate/$300,000 each
occurrence.
Ail 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 the change.
1 hereby make application to the Licensing Board of Blair, Nebraska and certify that i am competent and experienced to
engage in above said vocation. 1 agree to conform strictly to the Ordiriances of the City of Blair, Nebraska relative to said
vocation and obey all order, requirements and regulations of its lawful constituted authorities. This certification applies to the
original license and/or registration and any renewals thereof.
Authorized Signature
- 8 - ZD
Date
218S. 16th Street
Blair, W 68008
(402) 426 4191 FAX: (4021 426 4195
Email: cityoflilair@ci.blainne.us
FOR OFFICE USE ONLY
Date Paid:
Receipt No:
Date Issued:
BOND EkPIRI=s;
C lVTRACTOR nEGXSTRATt( Ni/ILICE S RENEWAL
(Please type or print in ink -- If you need more space, please attach additional sheets)
Application is for: Journeymen/Apprentice - $25.00 etch.
Business Name:
W
Master's Name.2D
(7
Business Address: Sfiail Zip: b e6117
Phone #: d 7 " 0 9 • Mobile*
Please. List all employees that you wish to register and check the appropriate boxes.
Name Plumber Heater Electrician Apprentice Journeyman
El EJ
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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 the 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. i agree to conform strictly to the Ordinances of the City of Blair, Nebra§Ica relative to said
vocation and obe rder, equirements and regulations of its lawful constituted authorities: This certification applies to the
original licen and/or regls r4tion and any renewals thereof.
Date
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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 the 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. i agree to conform strictly to the Ordinances of the City of Blair, Nebra§Ica relative to said
vocation and obe rder, equirements and regulations of its lawful constituted authorities: This certification applies to the
original licen and/or regls r4tion and any renewals thereof.
Date
a AR V CA
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218 S. 16th Street
Blair, NE 68008
(402) 426 4 191 FAX: (402) 426 4195
Email: cityofblair@ci.blainne.us
FOR OFFICE USE ONLY
Date Paid:
Receipt No:
Date Issued:
BOND EXPIRES:
CONTRACTOR REGISTRATION/LICENSE RENEWAL
(Please type or print in ink -- If you need more space, please attach additional sheets)
Application is for: Journeymen/.apprentice - $25.00 each
Business Name:
Master's Name:
Business Address: U V- S� City:b r�Oka State:.N G Zip: 8
Phone #: r _qJZ —V(P`Z / Mobile#:
Please List all employees that you wish to register and check the appropriate boxes.
Name Plumber
Heater
Electrician
Apprentice
Journeyman
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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 the 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. I agree to conform strictly to the Ordinances of the City of Blair, Nebraska relative to said
vocation and obey all order, requirements and regulations of its lawful constituted authorities. This certification applies to the
original license and/or registration and any renewals thereof.
Authorized Signature
ka-8-Zo
Date
12/10/2020 Official Nebraska Department of Labor - Contractor Registration - Contractor Details
3 Conktractor is
Contractor/Subcontractor Name
Ideal Heating and Air Conditioning, LLC
Corporation Name
Business Entity
LLC
5366 F Street
Address
Omaha, NE 68117
City
Omaha
State
NE
Zip
68117
Telephone
(402) 932-0649
Registration Number
40955-20
Certificate Expiration
4/15/2021
Sales Tax Option
Number of Employees
Worker's Compensation Status
2
3
Certificate on File
https:/Idol.nebraska.gov/conreg/Contractor/Details/4095520 1/1