Form ID

Publication date

Location of premises

Certificate

Construction of Street A

Date substantially performed:
Date certificate signed:

Participants

Name of Owner
Nicickousemenecaning First Nation
Address of Owner
PO Box 68, Fort Frances, ON P9A 3M5
Name of Contractor
Nor-Quip Construction 2002 Inc.
Address of Contractor
117-7 RR #1, Kenora, ON P9N 3W7
Name of Certifier
(P. Morrison) Neegan Burnside Engineering & Environmental Ltd.
Address of Certifier
15 Townline, Orangeville, ON L9W 3R4

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

Administration Office - Nicickousemenecaning First Nation