Luxa Registration 2024CITY OF BLAIR
218 S 16"i Street
Blair, NE 68008
(402) 426-4191
Fax (402) 426-4195
Email: building@blairnebraska.org
FOR OFFICE USE ONLY
Date Paid:
0-40
Receipt No:
i
Check # or CC:
0
Amount Paid:
CONTRACTOR REGISTRATION / LICENSE RENEWAL
LUXA CONSTRUCTION COMPANY INC
P O BOX 105
BLAIR NE 68008
Type of Business: CONTRACTOR R 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:
Please submit new certificates or bond renewals and NDOL for those which will or have exnir�ed,.-
Name:
Certificate of Liability or Bond:
Expires:
LUXA CONSTRUCTION
GENERAL
8/01/2024
LUXA CONSTRUCTION
NDOL
10/01/2023
Place a check in the box next to the licenses you wish to renew.'
Renews
Name:
License / Registration:
Expires:
Amount:
LUXA CONSTRUCTION COMPANY INC
CONTRACTOR LICENSE
1/01/2024
60.00
Pay this amount: 60.00
Please list any additional licenses or registrations. -
Name: I License / Registration: Amount:
I hereby make an 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.
Authorizeld Signature Date
12/21/23, 10:39 AM Official Nebraska Department of Labor - Contractor Registration - Contractor Details
Contractor Details
j Contractor/Subcontractor Name LUXA CONSTRUCTION COMPANY, INCORPORATED
i
Corporation Name LUXA CONSTRUCTION COMPANY, INCORPORATED
j
Business Entity S-Corporation
Address PO BOX 105
BLAIR, NE 68008
City
State
Zip
Telephone
Registration Number
Registration Expiration
Sales Tax Option
Number of Employees
Worker's Compensation Status
BLAIR
NE
68008
(402)426-2778
22236-23
10/1/2024
2
25
Certificate on File
https://dol.nebraska.gov/conreg/Contractor/Deta!Is/2223623 1 /1