Watertight Registration 2024Blair, NE 68006
Email: building@blairnebrasi(a.org
FOR OFFICE USE ONLY
Date Paid:, w
Receipt No:. i�- j 4 1" i k
Date Issued:
BOND EXPIRES:
Application is: ❑ New ❑ Renewal
CCU'T[AT Ti T! L[C 10
Application is for:
Business Name:
' Contractor-$60.00
❑ Electrical Contractor - $60.00
❑ Gas Line Installer - $Z 5.00
❑ Mechanical Contractor- $60.00
ContractorEl Plumbing 0x
i _
Business Address: 561,3 .City:
Mailing Address:
Email Address:
Phone #: Fax #:
M
Contact Person:
Number of Employees:
Other Licenses Held:
State
Apprentices:
Insurance/Worlcer's Compensation Company:
-A,/
❑ Tree Trimmer- $60.00
❑ Drain Layer - $60.00
❑ Fire -Security System Installer-$60.00
❑ Water Service Line installer - $60.00
State:
Kam
Zip:
obile 0: Y e-:P`Z 7o- e9 c-, SrS—
Electrical, Gas Line Installer, Mechanical, Plumbing Contractors and Tree Trimmers need a $5,000 permit bond stating John Doe
dba Company Name" in favor of the City of Blair. Electrical Contractor and Fire Security Systems Installer will need to submit a
copy of your Nebraska State License.
General Contractors need to submit a Certificate of insurance with minimum limits of $1,000,000 Aggregate/$ 300,000 each
occurrence vvith the certificate holder being the "City of Blair".
All types of registrations must include proof of registration with the Nebraska Department of Labor.
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 the change.
i hereby make application to the Licensing Board of Blair, Nebraska and certify that 1 am competent and experienced to engage in
above said vocation. I agree to conform strictly to the Ordinances of the City of Blair, Nebraska relative to said vocation and obey
all order, requirements and regulations of its lawful constituted authorities. This certification applies to the original license and/or
registration and any renewals thereof,
1-7
Authorize ignature Date
5/14/24, 12:32 PM Official Nebraska Department of Labor - Contractor Registration - Contractor Details
Contractor Details
Contractor/Subcontractor Name WATERTIGHT ROOFING
I
i
Corporation Name HONEY DO GUY INC
i
i
Business Entity S-Corporation
Address
i
City
I
State
Zip
Telephone
I
Registration Number
Registration Expiration
Sales Tax Option
i
Number of Employees
j
Worker's Compensation Status
3493 CO RD G
TEKAMAH, NE 68061
TEKAMAH
NE
68061
(402)870-0255
29900-23
8/1/2024
2
0
Exempt
https:Hdol.nebraska.gov/conreg/Contractor/Details/2990023 1 /1