Jorgensen Registration 2021~0 ise of ago
CITY OF BLAIR
218S 16th Street
Blair, NE 68008
(402) 426-4191
Fax (402) 426-4195
Email: building@blairnebraska.org
CONTRACTOR REGISTRATION / LICENSE
JORGENSEN CONTRACTING INC
530 FRONT ST
BLAIR NE 68008
Type of Business: CONTRACTOR LICENSE
Contact information on record:
Type: Phone Number: Type: ' Phone Number:
Work Fax
Cell (402)533-3165
Email Address:
FOR OFFICE USE ONLY
Date Paid:
Receipt No: i it
Date Issues:
BOND EXPIRES:
t -
RENEWAL ,
Please verify and correct the
company /business
Information listed here:
Please submit a current reciprocating license or those which have expired:
Name: Reciprocating License: Expires:
Please submit new certificates or bond renewals for those which have expired:
Name: Certificate of Liability or Bond; Expires:
Place a check in the box next to the licenses you wish to renew:
Renew? Name: License / Re'' istratibm Expires: Amount:
1/15/2021 Official Nebraska Department of Labor - Contractor Registration - Contractor Details
r Lietaffs
Contractor/Subcontractor Name
JORGENSEN CONTRACTING, INC.
Corporation Name
JORGENSEN CONTRACTING, INC.
Business Entity
Corporation
Address
530 FRONT ST
BLAIR, NE 68008
City
BLAIR
State
NE
Zip
68008
Telephone
(402) 426-4440
Registration Number
23004-21
Certificate Expiration
1/1/2022
Sales Tax Option
2
Number of Employees
0
Worker's Compensation Status
Certificate on File
https:Hdol.nebraska.gov/conreg/Contractor/Details/2300421 1 /1