PrairieC Registration 2022--mise of ao"
CITY OF BLAIR
218 S 16th Street
Blair, NE 68008
(402) 426-4191
Fax (402) 426-4195
Email: building@blairnebraska.org
PRAIRIE CONSTRUCTION
13316 B ST
OAMAHA NE 68144
Type of Business: CONTRACTOR LICENSE
Contact information on record:
Type: Phone Number: Type: Phone Number:
Work (402)330-8522 Fax (402)330-8544
Cell
Email Address: MATT PRAIRIE-CONSTRUCTION.COM
FOR OFFICE USE ONLY
Date Paid:'
Receipt No:
Date Issues:
BOND EXPIRES:
Please verify and correct the
company /business
Information listed here:
Please submit a current reciprocating license and NDOL or• those which have expired:
Name: Reciprocating License: Expires:
PRAIRIE CONSTRUCTION NDOL 10/01/2021
Please submit new certificates or bond renewals for those which have expired.•
Name:
Certificate ofLiabilit or Bond:
Expires:
PRAIRIE CONSTRUCTION
GENERAL
1/01/2022
Place a check in the box next to the licenses you wish to renew.-
Renew?
enew:
Renew? Name: License / Registration: Expires: Amount:
❑ PRAIRIE CONSTRUCTION CONTRACTOR LICENSE 1/01/2022 60.00
§
§
0
§
0 \»
\
.
Um.
g CD
&
�
0 �
E
R
\
§
M& @
3
ma 2:
� m
�
Lc