Form 17 nebraska: Fill out & sign online

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Click ‘Get Form’ to open it in the editor.
Begin by filling in the 'Name and Address of Prime Contractor' section. Ensure you provide the full name, street address, city, state, and zip code.
Next, complete the 'Name and Address of Governmental Unit or Exempt Organization' section with similar details as above.
In the 'Appointment Information' section, enter the effective date and expiration date for the appointment. Don't forget to include the Nebraska Exemption Number if applicable.
Identify the project by providing a clear description in the 'Identify Project' field.
Sign and date where indicated under 'Authorized Signature of Governmental Unit or Exempt Organization'.
For delegation purposes, fill out the 'Name and Address of Subcontractor' section if applicable, including effective dates.
Finally, ensure all signatures are completed for both sections before saving your document.

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