Weatherguard Registration 2015.tif CITY OF BLAIR FOR OFFICE USE ONLY -
,' 218 S 16TH STREET
BLAIR, NE 68008 Date Paid:
Receipt No:
�_, , w r❑ (402) 426 - 4191 p
=. FAX (402) 426 - 4195 Date Issued: I
o ?�iso� a' Email: cityofblair@ci.blair.ne.us
BOND EXPIRES
CONTRACTOR REGISTRATION / LICENSE RENEWAL
Please verify and correct
the company /business
Weatherguard, Inc. information listed here:
11440 S 146 St
OMAHA, NE 68138 ❑_
Phone numbers on record:
Type: Phone Number: Type: Phone Number:
Office 402 289 4316 Fax 402 289 3 ❑
Mobile 4.02 510 2877
Email Address: o .c- (�",olv, "c oyy A ,
Type of Business: General
Please submit new certificates or bond renewals for those which have expired:
Name Certificate of Liability or Bond Expires
Higgins, John General Certificate of Liability 11/5/2014
Place a check in the box next to the licenses you wish to renew:
Renew? Name License / Registration Expires Amount
❑ Higgins, John General Contractor 12/31/2014 $60
Please list any additional license or registrations:
Name License / Registration Amount
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YOUR C OF LIABIL PLEASE SUBMIT A COPY _ YOUR
INSURANCE IS EXPIRED OR ABOUT CURRENT NEBRASKA De� OF
TO EXPIRE. PLEASE SUBMIT I`I' A LABOR REGISTRi'XION
NEW COPY WITH YOUR RENEWAL.
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 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.
1 orized Signature Date
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4 WN II �E B R A S K A Department of Labor
L abor L aw / Contractor Regi strati on
550 South 16th Strom, 3rd Floor
DEPARTMENT OF LABOR L i ncol n, NE 68508
www.dol.nebraska.gov (402) 471 - 2239
Registered Contractors and Subcontractors Locator
Contractor /SubcontractorNanw. WEATHERGUARD INC.
Address: 11440 S. 146TH ST., STE. 101
City: OMAHA
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State: NE
Zip: 68138
Telephone: (402) 289 - 4316
Certificate Number: 20656
Certificate Expi rati on: 05/01/2015
Contractor Option: 2
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