OmahaD Registration 2015.tif .._ CIT1f 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:
BOND EXPIRES
Email: cityofblair @ci.blair.ne.us
CONTRACTOR REGISTRATION / LICENSE RENEWAL
Please verify and correct
the company /business
Omaha Door & Window Co., Inc. information listed here:
4665 V St
Omaha, NE 68117
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Phone numbers on record:
Type: Phone Number: Type: Phone Number:
Office 402 733 6440
4
Office 402 590 2847
Email Address:
Type of Business: GENCRR.L __ — - - - - --
Please submit new certificates or bond renewals for those which have expired: }
Name Certificate of Liability or Bond Expires
Omaha Door & Window Co., General Certificate of Liability 4/1/2015
Place a check in the box next to the licenses you wish to renew:
Renew? Name License / Registration Expires Amount
Omaha Door & Window General Contractor 12/31/2014 $60
Please list any additional license or registrations:
Name License / Registration Amount
PLEASE .&LMAdLIi T A COPY OF Y OUR
CURRENT NEBRASKA DEFA�a `i��sH `a' OF
LABOR Ri z�?- 7RIATK)M
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 sai vocation. I agree to conform strictly to the Ordinances of the City of Blair, Nebraska relative to said
vocati obe II order, requirements and regulations of its lawful constituted authorities.
Authorized Signature Date
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1.
F Nebraska Department of Labor � N
M Contractor Registration
55O So. 16th Street, Lincoln, NE 68508 � I
t (402) 471 - 2239 I
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�1 F
Date Issued Date Expires
09/15/2014
09/15/2015
CONTRACTOR REGISTRATION CERTIFICATE
i This certificate is non - transferable
Fee Paid: $40.00 Registration #
21334
t�
Year
i 14
Business:
OMAHA DOOR & WINDOW COMPANY, INC.
ATTN: TOM MURNAN 1 d
4665 G STREET Commissioner ofL r
OMAHA, NE 68117 -1489
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