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Luxa Registration 2023CITY OF BLAIR 218 S 161h Street Blair, NE 68008 (402) 426-4191 Fax (402) 426-4195 Email: building@blairnebraska.org FOR OFFICE USE ONLY Date Paid: Receipt No: Date Issues: BOND EXPIRES: CONTRACTOR REGISTRATION / LICENSE RENEWAL LUXA CONSTRUCTION COMPANY INC P O BOX 105 BLAIR NE 68008 Type of Business: CONTRACTOR LICENSE Contact information on record: Please verify and correct the company / business Information listed here: Type: Phone Number: Type: Phone Number: ± Work 402 426-2778 Fax Cell 402 510-8200 Email Address: Please submit a current reciprocating license or^ those which will or• have expired: Name: Reciprocating License: Expires: Plen,re .vuhmit new certifrcnte.c or hnnd renewals and ArDOL for those which will or• have exnired..- Name: Certificate of Liability or Bond: Expires: LUXA CONSTRUCTION GENERAL 8/01/2023 LUXA CONSTRUCTION NDOL 10/01/2022 Plnce n check in the hox next to the licenses you wish to renew., Renew? Name: License / Registration: Expires: Amount: LUXA CONSTRUCTION COMPANY INC CONTRACTOR LICENSE 1/01/2023 60.00 Pay this amount: 60.00 Please list any additional licenses or registrations., istr°ations: Name: I License / Re istration: Amount: I hereby make application to the Licensing Board of Blair, Nebraska and certify that I am competent and experienced to engage in the above said vocation. I agree to conform strictly to the Ordinances of the City of Blair, Nebraska relative to said vocation and obey all orders, requirements and regulations of its lawful constituted authorities. I also certify that 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 any change. Ic-21? ae �, Date 1 /3/23, 2:30 PM Official Nebraska Department of Labor - Contractor Registration - Contractor Details Contractor Details Contractor/Subcontractor Name LUXA CONSTRUCTION COMPANY, INCORPORATED Corporation Name LUXA CONSTRUCTION COMPANY, INCORPORATED Business Entity S-Corporation Address PO BOX 105 BLAIR, NE 68008 City BLAIR State NE Zip 68008 Telephone (402) 426-2778 Registration Number 22236-22 Registration Expiration 10/1/2023 Sales Tax Option 2 Number of Employees 25 Worker's Compensation Status Certificate on File https:Hdol.nebraska.gov/conreg/Contractor/Details/2223622