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2006M EL March 3, 2006 Rich Ludvik Ka- Boomers Fireworks P.O. Box 86 Wahoo, NE 68066 RE: Firework License in Blair Dear Mr. Ludvik, The Trinity Lutheran Church and JOY Preschool has been awarded a license for fireworks in Blair for 2006. Enclosed is a copy of a map indicating the location of your stand on the Vet's Field property and the refund of two (2) cashier's checks which were not awarded a license. If you have any questions or need additional information, feel free to contact me. We look forward to working with you for a safe and profitable fireworks season. Sincerely, Brenda Wheeler City Clerk Enc EOUAL NOOSING 218 South 16th Street • Blair, Nebraska 68008 • 402 - 426 -4191 • Fax 402 - 426 -4195 • E -mail cityofblair @ci,blair.ne.us OPPONTUNITY ''?lse o f a" Y /' Y 1. 2. 3. Calendar Year for Application 2006 Name of Applicant Trinity Luthern Church & JOY Preschool Address of Applicant 141 South 20th St. Blair, NE 68008-188 Contact Person John Emslie Phone # 402 - 426 -2851 4. Is applicant working through a vendor? Yes Ea No ❑ 5. Name of vendor participating with applicant (if applicable) Ka- Boomer's Inc. PO Box 86 Wahoo, NE 68066 Phone 402 - 443 -4593 6. Address ofvendor Mail - PO Box 86 Wahoo, NE 68066 Warehouse - 1258 County Road 18, Wahoo, NE Contact Person Rich Ludvik. Phone # 402 - 443 -4593 7. Is certificate of insurance held by applicant or vendor? Vendor 12 Applicant 8. If held by vendor, does insurance name applicant and city as additional insurers? Yes E3 No El 9. License fee - $5,000 (Attached) 10. Certificate of Insurance (Attached) 11. Sales Tax # 15671981 (Name of Holder) Ka- Enterprises, I nc. I /we, the authorized representative of the above applicant and/or vendor, do hereby make application for a fireworks license to be issued by and through the City of Blair, Nebraska. I/we further agree to abide by all regulations and ordinances of the City of Blair, Nebraska and State of Nebraska relative to this application and the sale and storage of fireworks in the City of Blair, Nebraska. FOR CITY USE ONLY: Date Received Time Received Applicant awarded license: Yes 0 No F ONEBRASKA STATE FIRE MARSHAL 246 South 14th Street Lincoln. NE 68508 -1804 LICENSE FIREWORKS Permissible fireworks may be sold at retail commencing 12:01 AM June 25 and ending 11:59 PM July 4 and must be purchased from a licensed distributor or jobber. A jobber may not sell retail. Invoice copies for all fireworks must be kept available for inspection and must show the license number of the distributor or jobber. Fireworks may not be sold outside the city limits of an incorporated town or village. Violations of State Fire Marshal regulations may result in immediate revocation of this license. LICENSE GOOD ONLY FOR JUNE 25 _ JULY 4 OF YEAR LICENSE ISSUED This copy signed, dated and numbered by the STATE FIRE MARSHAL constitutes issuance of a LICENSE pursuant to the provisions of Nebraska Revised Statute 28 -1246 (1994 Supp.). Such license shall be displayed at licensee's place of business. DATE RECEIVED: 1/23/2006 TYPE OF LICENSE AND FEE: RETAILER $250 LOCATION OF OUTLET FOR RETAIL SALE OF FIREWORKS: Stand# 2006 -E- 006 -RL -003 13TH AND BUTLER COUNTY BLAIR WASHINGTON STORAGE LOCATION: 13TH AND BUTLER BLAIR WASHINGTON DISTRIBUTOR(S): KA- BOOMERS ENTERPRISES INC SALES TAX NUMBER: DATE ISSUED: 15671981 1/23/2006 ALLIED SPECIALTY INSURANCE OF TEXAS 05 NE -LOOP 4*10 GUITE 600.+ SAN•ANTON10 -TEXAS 76216 210--341-1321 Cel - ti - FiC-ate Nt-tn)1:)er*` 00056 mwrIFICATE OF INSURANCE FIREWORKS STANDS 'This cer 'neither- aff-irinaflveLy no negative. . Ly-amends e: ;tends or aL the coverage .,-.-.-•F-forded by the too L icy <jes) described hereon and i1i; issued as mattc-:n- Of iy1l'or-mation aTICJ can-Fers no righ.t upon the hoLder T he t jio`.i i d e n t i f i e d be Low by a r-�o L i c number is i f on the date i. afforded On L with r -to fn t a f a c 0 v� -c i f i L i b i L i -1 hais been and is poLlay having r e F er e nc e h al r e t o t Y) m4 h e r e i n c , o ri t ,.I ned sh I. I. m o d i f y -a n F ., v i z i 0 n a f sa i d F) o L i c: y In the e-v o tf _. ay1c �jj 'le Company issuinc,i said PoLicy I P-- P Y;p 'I I wi LL make a L L reasonab Le effort to send Not ice of CanceL Lat i on -t ti've Cor t i f 1 Ca ie Ho Lde• a the address shown here in b ut • the Co'(11pa n%- assumes no resp ns i b i L i t i es -f- or a,ny m 1 stake or. f a 1 Lure * o g i ve such no •t i cF-.- Any insurance made a part of the poLic incLudes. as a perso'n i -..: w i - 1 "e s p ec + rl..; 1 . , ed i h ' an or pLacem a�, a Fil Stand (1) the Or (A_XhiN;itiOT1 aSSO('.- jai - i oyj. sr.�onsori-n orc-4aniza-tio- or , :-, * . Fa i -.2) the 0w he oi th�-: (3) a frtunicipziLit '�-J I a 11t i T)�!J t rile{.! :1: y1sU P 0- l" (n i s Sion I rjpe:�n- ale- IeNyi'l Or proper t) OT e Na el i T)-Sui-a� w� a ma e C a cl t •I i b U t b 1 Vt a c t Tl T1 C o u sf;�L � - nd sc 0 p e 0'r h lc: 1 0 y1ne -I t NAME ADDRESS OF I NSURED ADDITIONAL INSUREI:14+ Ka--Doocflers P .0 Box 103 City of Blair and Empoyee's Boystown Trinity Luthern Church NE 6GO1.0 NAME & ADDRESS OF CERTIFICATE HOLDER City of Blair 218 South 16th Blair, NE 68008 Company; T.1--I** E4 Insurance Cofnpa Tly Po 1, i cy Number I MIMT'7937 LIABILITY LIMITS DI/Pr OCC Po From 02/15/06 *ro 02/15/07 JOY Preschool .0 STAND LOCATION* Vets Field 13th & Butler Blair, NE 68008 Bodi Ly Injur tv Propert Lxcess O_­i*`­­­ ............. 00/00/00 00/00/00 * -- COMBINED 8INGLE L" 0 Cl !"Y Injury & y Da m 9 e X c., -------- 00411't. -0/00 001f to/00 Co'Veratie shown hC4-rein a0l:sLies only to thoz items schedu Led 'on or endorsed - t the Policy. This certificate i no t valid unLess an or.iginal sivnature-ar�)P( ars be Low, (Copies Not VaL!d)* overage C under A-he PoLie:�- is conditioned upon fuLL Cofpi:, aLL insured with al.l. cn1:- Nat'iwnaL Fire PrOteCtiOn Assoc i'-aition (NFPA':'codes and -, *-;I T) d a I- d S, i n �_ f* f 0 a • - M t t h c I i 111e 't1 ---: + a n d i ii;i or) v_- T i February 1,, 2006 '7 f A64 - H — W , SIGNAqUE March 3, 2006 Douglas Bellinger Bellino Fireworks, Inc. 501 Olson Drive, Suite 214 Papillion, NE 68046 RE: Firework License in Blair Dear Mr. Bellinger Y 31- 1 The Friends of the Jeanette Hunt Animal Shelter have been awarded a license for fireworks in Blair for 2006. Enclosed is a copy of a map indicating the location of your stand on the Vet's Field property and the refund of two (2) cashier's checks which were not awarded a license. If you have any questions or need additional information, feel free to contact me. We look forward to working with you for a safe and profitable fireworks season. Sincerely, 1 Brenda Wheeler City Clerk Enc MAL H.M. 218 South 16th Street • Blair, Nebraska 68008 • 402 - 426 -4191 • Fax 402 -426 -4195 • E -mail cityofblair @ci,blair,ne,us OPPORTUNITY 1 ' 7 ise of a" Se APPLICATION FIREWORK LICENSE 1. Calendar Year for Application c�C 9. License fee - $5,000 (Attached) 10. Certificate of Insurance (Attached) 11. Sales Tax # (Name of Holder) 1 Uwe, the authorized representative of the above applicant and/or vendor, do hereby make application for a fireworks license to be issued by and through the City of Blair, Nebraska. I/we further agree to abide by all regulations and ordinances of the City of Blair, Nebraska and State of Nebraska relative to this application and the sale and storage of fireworks in the City of Blair, Nebraska. Date Vendor (if alicable) z-- Date FOR CITY USE ONLY: Date Received '-2 Z 6 o Time Received 1 oo A Applicant awarded license: Yes No D Nebraska State Fire Marshal - Public Fireworks/Retail License Page 1 of I Nebraska State Fire Marshal's Online Fireworks License Applicati (APPLICATION COMPLETE: Click here to print your receipt Your application has been completed. Upon approval, you will receive your permit within the next 14 business days. Please print this page as a record of your request and payment. Need the Ru les for Retail Sales of Fir Your Pending Application License Number Is: 2006-E - 036 Your Pending Application Order Confirmation Number 43315 Is: Your Change Application Password Is: 8e5a7535 * ** Your Retail Stand Application License Number(s) Are: 2006 -E- 036 -RL -001: (Blair, Vets Field ) * ** Password is required for change requests. To make a change to your application, please call (402) 323 -0330 )RICE TO TAL: 1 Retail Stand(s) @ $25.00 per stand: $ Total: $ https://v N? - ww. nebraska. gov/ SFMJpermit/cgi/sessionStore.cgi 2/27/2006 CERTIFICATE OF LIABILITY INSURANCE j 2/DATE 28/2006 ru 6 PRODUCER Phone: 440- 248 -4711 Fax: 440- 248 -5406 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Britton - Gallagher and Associates, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 6240 SOM Center Rd. HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ,Cleveland OH 44139 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. INSURERS AFFORDING COVERAGE NAIC # INSURED INSURERA: Lexington Iris CO 19437 Bellino Fireworks Inc INSURERB: 501 Olson Drive, St 210 Papillion NE 68046 INSURERC: INSURER D: INSURER E: L.0 V r_"k2C3 GIYYI,RACMCIYI 1.71 - cult _CKUVIbIVlYS Location: Vets Field Blair, NE Additional Insurred: City of Blair Blair Friends of the Animal Shelter Donald J & Valerie R Bellino CERTIFICATE BOLDER Bellino Fireworks Inc. 501 Olson Drive Suite 21.4 Papillion NE 68046 ACORD 25 (2001108) CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR,REPRESENTATIVES. AUTHORIZED REPRESENTATIVE f © ACORD CORPORATION 1988 THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAYD CLAIMS_ INSR LTR DD' NSR TYPE OF INSURANCE POLICYNUMBER POLICYEFFECTIVE POLICY EXPIRATION LIMITS A GENERAL LIABILITY 2831429 5/4/2006 5/4/2007 EACH OCCURRENCE $1,000,000 X COMMERCIAL GENERAL LIABILITY DAMAGE O N PREMISES fEa occurence S0,000 $ CLAIMS MADE P R_ 1 OCCUR MED EXP (Any one person) $ PERSONAL & ADV INJURY $ 1,000,000 GENERALAGGREGATE $2,000,000 GEN'LAGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP /OPAGG $2,000,000 POLICY PRO- X LOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ ANYAUTO (Ea accident) ALL OWNED AUTOS BODILY INJURY $ SCHEDULED AUTOS (Perperson) HIRED AUTOS BODILY INJURY $ NON-OWNED AUTOS (Peraccident) PROPERTYDAMAGE $ (Peraccident) GARAGELIABILITY AUTO ONLY- EAACCIDENT OTHERTHAN EAACC $ ANYAUTO 1 $ AUTOONLY: AGG EXCESSIUMBRELLA LIABILITY EACH OCCURRENCE $ AGGREGATE $ OCCUR FI CLAIMS MADE $ $ DEDUCTIBLE $ RETENTION $ WORKERS COMPENSATION AND WC STAT OTH- EMPLOYERS' LIABILITY TORY LI ITS ER E.L. EACH ACCIDENT $ ANYPROPRIETOR/PARTNER/EXECUTIVE OFFiCER/MEMBEREXCLUDED? Ifyyes, describe under - E.L. DISEASE -EA EMPLOYEE $ E.L. DISEASE -POLICYLIMIT $ SPECIAL PROVISIONS below OTHER GIYYI,RACMCIYI 1.71 - cult _CKUVIbIVlYS Location: Vets Field Blair, NE Additional Insurred: City of Blair Blair Friends of the Animal Shelter Donald J & Valerie R Bellino CERTIFICATE BOLDER Bellino Fireworks Inc. 501 Olson Drive Suite 21.4 Papillion NE 68046 ACORD 25 (2001108) CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR,REPRESENTATIVES. AUTHORIZED REPRESENTATIVE f © ACORD CORPORATION 1988 N1 MEN March 3, 2006 American Promotional Events dba TNT Fireworks 16 North 9th Avenue Bozeman, MT 59715 RE: Firework License in Blair Dear Sir or Madam, The Washington County CB's have been awarded a license for fireworks in Blair for I►11. Enclosed is a copy of a map indicating the location of your stand on the Vet's Field property and the refund of two (2) cashier's checks which were not awarded a license. If you have any questions or need additional information, feel free to contact me. We look forward to working with you for a safe and profitable fireworks season. Sincerely, Brenda Wheeler City Clerk Enc EOUALHOVSWO 218 South 16th Street • Blair, Nebraska 68008 • 402 -426 -4191 • Fax 402 - 426 -4195 • E -mail cityofblair @ci.blair,ne,us OPPORTUNITY ''7ise o f o►v N FROM :TNT FAX NO. :4028275117 Feb. 16 2006 12:22PM- P2 C3 02/16/06 12:01 FAT 402 426 4195 CITY OF BLAIR 0003 APP FEREWORKL l Uen dar Year for A.pplicatim February 21, 2, . Name o;i; Applicemt American Promotional Events -dba -TNT Fireworks Ad&esa of Applicat 16 North 9th Ave, Bozeman, MT 59715 Salds Rd& Kevin Benson Phone # 402 - 960 -5030 Contact P oA _ - 4. Is applicant workitg through a vendor? Yes ❑ No n We have a operator 5, Name of vendor participating via applicant (if applicable) Our is: h e Y� �l G �.' .Adclmsa of vendor 22 2344 College Drive, 111a 1 x NF 68118 Contact person Ron DeSutter 'bons # 402 - 533 =3259 7, Is certifloste of insurance hold by applicant or vendor? Vendor Applic act � 8. If held by vendor, does i nsu ce n=0 applicant and city as additional inswM7 Y es ® No ❑ See attached'lnsurance Cert. 9. Liege fee - S5,000 (Attached) 10. Certificat+e oflnsumce (Attached) To be obtained �, �- 11, Selo 'I'�X # f Qm ,- ope ator (Name of Hold _ -- ;�� � `�° y � Uwe, the authorized rep reswtative of the above applicmt and/or vcndor, do h=by make ap plimfm for a 'fireworks ljowee to be issued by and through. the City of Blair, Nebraska, Tlwe Autber agree to abide by all - regulations apd osdis►aticas of the City of BW4 Nebraska and State of Nebraska relative to this appfioafion, and the sale and storage of fireworks fa the City of flair, N'ebnwk& App gan.t . 7 Vendor (if applicable) Date FOR CITY USB ONLY: Dat ' R .a R eceiv e d Feb. 16 2006 12:22PM P3 004 ---------- I fit 1 OVA - 7 7 II rI ova -peal- C.0 ca rk r fey r raft& 4P rl ---------- I fit 1 OVA - 7 7 II rI ova cW CD Wo II rI ova ACOR 02/23/2006 CERTIFICATE OF INSURANCE ISSUE DATE PRODUCER MCGRIFF, SEIBELS & WILLIAMS, INC. P.O. Box 10265 This certificate is issued as a matter of information only and confers no rights upon the Certificate Holder. This Certificate does not amend, extend or alter the coverage afforded by the policies below. COMPANIES AFFORDING COVERAGE Birmingham, AL 35202 205 - 252 -9871 ComApany Crum & Forster Insurance Company INSURED Company American Promotional Events, Inc. B dba TNT Fireworks P.O. Box 1318 Company Florence, AL 35631 C Company D Company E This is to certify that the policies of insurance described herein have been issued to the Insured named herein for the policy period indicated. Notwithstanding any requirement, term or condition of contract or other document with respect to which this certificate may be issued or may pertain, the insurance afforded by the policies described herein is subject to all the terms, conditions and exclusions of such policies. Limits shown may have been reduced by paid claims. CO TYPE OF INSURANCE POLICY NUMBER EFFECTIVE LIMITS OF LIABILITY LT EXPIRATION A GENERAL LIABILITY GL0090947 11/01/2005 EACH OCCURRENCE $ 1,000,000 ® Commercial General Liability ❑ Claims Made ® Occurrence El Owners'and Contractors' Protection ® SIR: 50,000 11/01/2006 FIRE DAMAGE $ 100,000 MEDICAL EXPENSE $ EXCLUDED PERS. AND ADVERTISING INJURY $ 1,000,000 GENERAL AGGREGATE Is 2,000,000 ❑ General Aggregate Limit applies per: O Policy ❑ Project ❑ Location PRODUCTS AND COMP. OPER. AGG. $ 2,000,000 AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ ❑Any Automobile ❑ All Owned Automobiles ❑ scheduled Automobiles ❑ Hired Automobiles BODILY INJURY Per erson $ BODILY INJURY Per accident $ PROPERTY DAMAGE Per accident $ COMPREHENSIVE ❑ Non -owned Automobiles ❑ COLLISION WORKERS' COMPENSATION AND EMPLOYERS' LIABILITY WC Statutory Limit Other EL EACH ACCIDENT $ EL DISEASE Each em to ee $ EL DISEASE (Policy Limit $ EXCESS LIABILITY EACH OCCURRENCE $ ❑ Occurrence ❑Claims Made AGGREGATE $ $ This certificate pertians to location @ Vet's Field - 13th & Bulter, Blair, NE. The Certificate Holder is named as Additional Insured with respect to General Liability as required by written contract subject to policy terms, conditions, and exclusions. CERTIFICATE HOLDER SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. City of Blair Authorized Representative Washington County CB's Blair Officials & Officers 218 S. 16th F w ; Blair, NE 68008 ... Page 1 of 1 Certificate ID # 1 FU920KO NEBRASKA STATE FIRE MARSHAL Fireworks Uncense. Applica lon • Appllcatlons must be filled out COMPLETELY. _Incomplete applications will. be returned and could result in missed deadlines. Each stand requires- a separate application. • Check or m oney. order i)avable'to the-State Fire Marshal for the license fee MUST ST accompany the application. Cash Will NOT be accepted; Credit cards. are accepted O NLY if application .completed online. Retail applicationsm ust be submitted between JANUARY.Ist and .J.UNE.1 oth each year. Applications ppstma'rked or ei-halled after midnight June 1 0 th wi -e assessed an additional fee of $50.00. Distributors and jobbers may.licen-se anytime. during the -year, - • Any changes MUST be submitted on the Fireworks License Applic'tibh Change Form available from this Office or.6n the a websitel*. Only one location change is allowed within the same city. Addlt!6nal'location'chan.ges shall re*qqire anew application and fee. • Applicants are subject to all provisions of State and regulations g o*verning fireworks,. *It is the applicant's respqnsibility.to read and comply with these requirements. These requirements are subject to change without notice A copy ofthe -fireworks perrnissibles list may be obtained . from our-Website at http:/1www.sfm.ne.q6v or upon req uestl if you do not have Internet access. **PRINT THE FOLLOWING INFORMATION** TYPE OF LICENSE: - Distributor .($500) Jobber ($200) X. Retailer ($25) RETAIL LOCATION: LEI I V . Address ­'NOT Bok Number) (pity/Village) ounty) PLEASE NOTE: Retail sales Pre -unlawful outs-ide.the limits of any incorporated, city.orNilla.ge-i The State Fire Marshal - assumes locations submitted are within the requ'ired'cilty limits. Any license -inadvertently issued fora -site outside these* I! 'its,will be invalid e m PHYSICAL DESCRIPTION.:. Specify garage, etc. 06uh—'i . Ci L, o fireworks* will be sold. Examples: Tent in parking lot., inside-vacant store, in: STORAGE LOCATION: ilsame -as. 4bbvelf. B , +� 1 __� _1 (Street Address — NOT Box Number) (City/Village) (CountyJ SALES TAkNUMBER'. Nebraska Sales Tax NU: mbeir.­ to. be -obtained from pperator-. RETAILERS AND JOBBERS ONLY:' b1str1b.utorNam&(s):* American Promotional - Events, "db.!—. FirtigqLk.pLicense 2006-023 (Company flr6works will be -purchased -from-MUST hold a:current State of Nebraska llc'ehse) *PLEASE -PRINT LEGIBLY' APPLICANT AME: gVenta* PLICANT -!�-dba— TNT-'-Fi_rewo±ks- kDDRESS- 16 North 9th, suite # 6 CITY: Bozeman MT STATE: ZIP CODE!59715; )HONE: (_406 )_586 1901 _ _ _ _ EMAIL ADDRESS S andersouk@tntfrewokks.com ' ►ETURN APPLICATION AND FEE- TO: NEBRASKA STATE FIRE MARSHAL 246 South 14" Street Lincoln, NE 68508-1.804 Phone:- (402) 323-0220 Email: jodi.pillard@sfm.ne.gov LICENSE GOOD ONLY.FOR JUNE 25 - JULY 4 OF YEAR LICENSE ISSUED This copy signed, dated and numbered by the STATE FIRE MARSHAL constitutes issuance of a LICENSE pursuant to the provisions of Nebraska Revised Statute 28 -1246 (1994 Supp.). Such license shall be displayed at licensee's place of business. DATE RECEIVED: 3/8/2006 TYPE OF LICENSE AND FEE: RETAILER $25 LOCATION OF OUTLET FOR RETAIL SALE OF FIREWORKS: Stand# 1 13TH & BUTLER COUNTY BLAIR WASHINGTON STORAGE LOCATION: 13TH & BUTLER BLAIR WASHINGTON DISTRIBUTOR(S) /JOBBER(S): AMERICAN PROMOTIONAL EVENTS SALES TAX NUMBER: DATE ISSUED: 3/14/2006 STATE FIRE MARSHAL LICENSE HOLDER: AMERICAN PROMOTIONAL EVENTS DBA/TNT FIREWORKS LICENSE NUMBER 16 N 9TH, STE 6 BOZEMAN - MT 59715-