Loading...
Weatherguard Registration 2014 p Weatherguard, Inc. 402 -289 -4345 p.1 Tom Iupfer 402- p.1 JAI i t FOR OFFICE USE +Qhri.Y CITY urtS K pate f m 218 tit Rece No; patelsssed: Blair, NE 68008 [4021 426 419 "1 1r AX: (4 021 426 Email: C fb1a1 @c1.b a"lr• Application iv X New Q Renew CONTRACTOR REGISTRATION/LICENSE RENEWAL (Please type or print in ink— if you need more spacer please attadh additional sheets) ,Appli cation is for. $- Contractor- $60.00 0 Electrical Contractor- $60.00 [D Water Service Line installer- $$0 - 100 Q Tree Te mer - $60.00 Q Fire/Seccrrfity System Installer - $25.00 © Gas Line installer - $25.00 © Mechanical Contractor - $60-00 Q Plumbing Contractor- W-00 ❑ Drain Layer- $60.00 Business Name: Appiicanx Marne: - - JO( City: T � 1 /�}�,� State: 3r.lsl Hess Acldl'ess. Email Address: c - ' cc- Phone #; "�-` Fax #: -r� MabeFe M. Business .Address outside of Nebraska: City: State .dip: Phone: Contact Person: Apprentices: .journeymen: Nu m ben a� Emp ,.,,.. -. . other Li censes Held: ' insurance/W Compensation Company: o t La FCcMicaa ?, Plumbing artd Aomhanlear cordracsors/water Ser" LWf Installers need a sS,oca pennft bond rn favor & t rf r 1 f bond in favor of the �Clty r�f glair. Electrical contractor and Fire of t city o f Wait. 'i i�`�r`s need a $5,000 penult bond security Systems imtaver vAll need to subnA a copy aryour Nebraska State 1.3eense. General Cwtrattols need to submit aE Certificate of insurance with minimurn limits or $ ],()00,0G0Aggregatq/$300,Ofl0 each occurrerme. i All information contained In this application is true and co rrect . I w i ll �notify the City cif Blair of any changes in the Information + reported on or with this applicattOn fO r'm within I5 days o f the ng I hereby make application to the Ucerising Board of l;llair. Nebraska and certify that i am competent and experienced to engage m above sold vocation. M agree to conform strictly to the arsifnances -of the City of Blain, Nedraska re}ative to said vocation and obey all order, requrrements and regula#crs of its laWVfut constituted au0milties. This certificatlnn applies to the original license and anon renewals ttweof r r� Au ,., Slgr}atuK Dati' r l Weatherguard, Inc, 402 -289 -4345 p.2 i COMNRJNITY REFERENCES: City of Omaha Lie # 68616 1819 Farnam. St. Rni 11.10 Omaha, NE 68183 402-444-5350 a City of Bellevue Lic # D00617 210 w Mission Ave Bellevue, NE 68005 402-293-3014 a City of Council Bluffs IA Lie #10926 209 Pearl St. Council Bluffs IA 51503 712.328 -4625 BUSINESS REFERRENCES: * Builders Supply Co 402- 331 -4500 • RSG Roofing Supply Group 402-734-2322 • Norandex 402 - 334 -5286 0 i i i i I i I f I i I i i Weatherguard, Inc, 402 -289 -4345 p.4 i t t i I � .�� - - -- = s��:�: - ,:���,�.��•,. ��•�, �,.�.x. rte:; .• - — ..._..:,:� :�::��>. �< i •' M , NebraAa.De aMnentof Labor '�� e4ntaactai•Ftegistretion _ ;; I• t 550 So. i6th.Streer, Lincoln,Iti ', � r : • - .(402)471-2)39' . Tate Issucd j 4 05101r -014 Date Expires i f l " 05101,2015 r CONTRACTOR REGISTRAnCiN CER.TIFJ•CATE 4 d This cMiGwb is woa- IruuYc�Lk i l? i 1''m P2 d :. 40.00 L ` i nrfM1 tYDA S t: ' 20656 Year j 14 :. f : Business: .. .. i WEATHERGUAR.D INC. s :. . ., 11440 S. 146TH ST STE 101 € i O1VY WE 6$1 3$ ee�mmissiuneroC r t � + r. � rvr , � - •S4t i�' • 9'RQr�'fjii^Y�.`� _ _ _ _ -- ••- �- - % ^; i i