Downs Registration 2014.tif CITY OF B LAIR FOR OFFICE USE ONLY � I
218 S 16TH STREET
BLAIR, NE 68008 Date Paid: / 4'
(402) 426 - 4191 Receipt No: /
FAX (402) 426 - 4195 Date Issued:
BOND EXPIRES
f r Email: cityofblair @ci.blair.ne.us
CONTRACTOR REGISTRATION / LICENSE RENEWAL
Please verify and correct
the company /business
Downs Electric, Inc. information listed here:
1808 Madison St
Omaha, NE 68107
Phone numbers on record:
Type: Phone Number: Type: Phone Number:
Office 402 -- 733 - 3080
Mobile — —
Email Address:
Type of Business: ELECTRICAL
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Please submit new reciprocating license for those which have expired:
Name Reciprocating License Expires
Arett, Al Nebraska State Electrical Board License 12/31/2014
Downs, Dan L. Nebraska State Electrical Board License 12/31/2014
Hazelton, Art Nebraska State Electrical Board License 12/31/2014
Suden, Steve Nebraska State Electrical Board License 12/31/2014
Please submit new certificates or bond renewals for those which have expired:
Name Certificate of Liability or Bond Expires
Downs, Dan L. General Certificate of Liability 5/16/2014
Downs, Dan L. Electrical Bond 11/14/? M 2,0
Place a check in the box next to the licenses you wish to renew:
Renew? Name License / Registration Expires Amount
Arett, AI Journeyman Electrical 12/31/2013 $25
Downs, Dan L. General Contractor 12/31/2013 $60
Downs, Dan L. Electrical Contractor 12/31/2013 $60
Hazelton, Art Journeyman Electrical 12/31/2013 $25
Suden, Steve Journeyman Electrical 12/31/2013 $25
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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.
I hereby make application to the Licensing Board of Blair, Nebraska and certify that I am competent and experienced to
engage in Above said voc . n. I agree to conform strictly to the Ordinances of the City of Blair, Nebraska relative to said
voc Wdobey I I r er, equirem
ents ts and regulations of its lawful constituted authorities.
Authorized Sighature Date
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