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QualityF Registration 2024CITY OF BL&IR 218 S 16kh Blair, NE 68008 (402) 426-4191 Fax (402) 426-4195 Email: building@blairilebraska,org Date Paid: Receipt N Check # or Cc: Amount Paid: I -I,-) CONTRACTOR RE' GISTRATION / LICENSE RENE, WAL QUALITY FENCE LLC 401 N JACKSTON ST PAPILLION NE 68046 Type of Business: CONTRACTOR LICENSE . Contact information on record: Name: QUALITY FENCE LLC QYALITY FENCE LLC Certificate of Liability or GENERAL NDOL Place a cheek in the bov next to the neenvat, mi, ),�L , - ?f andcorreciffie Please �ve a C0111 P� I cOMPOfty lbushiess IsIll ss h f 01,111(lijoll 1I.S It ifonnotiol, fiste(dl here: .4.__ Rene ? 0 Name: _QUALITY FENCE LLC ri furfew. License/Re istration: CONTRACTOR LICENSE Ex fires: 1/01/2024 Amount: 60-00 ❑ O El ❑NI u 0 0 Pav this amount: 60.00 Please list any additional licenses or re istt-ations; Name: I License / Registration: .simount: 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. #'z #' '4,6,G bl 7 q Authorized linature Date LO N (0 (D CN 6 U) (f) 00 I'tt C (1) 0 W LL -0 W Z v 0 if LO --) .0 Z Co