Form ID

Publication date

Location of premises

Certificate

Date substantially performed:
Date certificate signed:

Participants

Name of Owner
Atikameksheng Anishnawbek
Address of Owner
25 Reserve Road, Box 39, Naughton, ON P0M 2M0
Name of Contractor
Algoma BioSeptic Technologies Inc.
Address of Contractor
7 West Street, Mississauga First Nation, Blind River, ON P0R 1B0
Name of Certifier
EXP Services Inc.
Address of Certifier
885 Regent Street, Suite 3-6A, Sudbury, ON P3E 5M4

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

Atikameksheng Anishnawbek, 25 Reserve Road, Box 39, Naughton, ON P0M 2M0, Att: Mr. Arvind Sharma, P. Eng., Director of Planning and Infrastructure