Form ID

Publication date

Location of premises

Certificate

DGS Project Completion & Commissioning

Date substantially performed:
Date certificate signed:

Participants

Name of Owner
Sandy Lake First Nation
Address of Owner
P.O. Box 12, Sandy Lake, ON
Name of Contractor
Nortuk Contracting Ltd.
Address of Contractor
16917 Steeles Avenue, Hornby, ON L0P 1E0
Name of Certifier
B.J. Tworzyanski Limited
Address of Certifier
7291 Victoria Park Avenue, Suite #1, Markham, ON L3R 3A4

Office to which claim for lien must be given to preserve lien

Sandy Lake First Nation - P.O. Box 12, Sandy Lake, Ontario P0V 1V0