Image (20)CONSUMER FIREWORKS RETAIL
SALES (CFRS) FACILITY
SUPPLEMENTAL SUPPLIER CARD
Supplemental Supplier Cards are .NOT to be considered a Retailers License on their own
and cannot be used to permit the operation of any CFRS Facility. These cards are only used
when purchasing product from a Licensed Fireworks Wholesaler to supply a single specific
stand. A single retailer location may use multiple suppliers, so may therefor have multiple
Supplemental Supplier Cards.
This Supplemental Supplier Card is a companion
piece to the Fireworks Retailers License issued to
Kenneth A. Kersey for Stand Number SN-16600. It
is ONLY valid to supply state legal consumer
fireworks to that specific stand from:
Pacific Northwest Fireworks, Inc.
THIS DOCUMENT IS NOT VALID FOR
WHOLESALE PURCHASE WITHOUT EVIDENCE
OF THE LICENSE DETAILED BELOW:
Licensee: Kenneth A. Kersey
License Number: WSPFL-02827
Stand Number: SN-16600
CFRS Operator:
CFRS Operator Number:
CFRS Operator Email:
Actual License Expires:
Ken Kersey
(253) 208-0489
kerseycheryl@gmail.com
January 31, 2026
Licensee or Operator Signature
NOT A LICENSE. DO NOT ISSUE A PERMIT