Form ID

Publication date

Location of premises

Certificate

C-30 Miscellaneous Concrete

Date substantially performed:
Date certificate signed:

Participants

Name of Owner
North American Palladium Ltd.
Address of Owner
130 Adelaide St. W., Suite 2116, Toronto, ON M5H 3P5
Name of Contractor
Form & Pour Construction Limited
Address of Contractor
P.O. Box 23021 County Fair Plaza, Thunder Bay, ON P7B 6P1
Name of Certifier
Agra Simons Limited
Address of Certifier
111 Dunsmuir Street, Suite 400, Vancouver B.C. V6B 5W3

Identification of Premises

Parcels 2982, 2983, 2984 and 2985 Thunder Bay Leasehold Lac Des Iles Area, District of Thunder Bay