ABC Registration 2013.tif a
CITY OF BLAIR FOR OFFICE USE ONLY
218 S 16TH STREET
BLAIR, NE 68008 Date Paid: ®`
(402) 426 - 4191 Receipt No: , ��
FAX (402) 426 - 4195 Date Issued:
Email: cityofblair @ci.blair.ne.us B OND EXPIRES
CONTRACTOR REGISTRATION / LICENSE RENEWAL
Please verify and correct
the company /business
ABC Seamless of Omaha information listed here:
8032 Maple St
Omaha, NE 68134
Phone numbers on record:
Type: Phone Number: Type: Phone Number:
Office 402 3914500 Fax 402 3914500
Mobile 308 379 3369
Email Address:
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Type of Business:
Please submit new certificates or bond renewals for those which have expired:
Name Certificate of Liability or Bond Expires
Franssen, Ted General Certificate of Liability 8/29/2012
Place a check in the box next to the licenses you wish to renew:
Renew? Name License / Registration Expires Amount
Lk,J Franssen, Ted General Contractor 12/31/2012 $60
Please list any additional license or registrations:
Name License / Registration Amount
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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 change.
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I hereby make application to the Licensing Board of Blair, Nebraska and certify that I 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.
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thorized ignature Date