Form ID

Publication date

Location of premises

Certificate

Cap Mundic Mine Shaft

Date substantially performed:
Date certificate signed:

Participants

Name of Owner
Ministry of Northern Development & Mines
Address of Owner
933 Ramsey Lake Road, Sudbury, ON P3E 6B5
Name of Contractor
Mindecom Industrial Constructors Limited
Address of Contractor
667 St. Clair St., Sudbury, ON P3E 4G9
Name of Certifier
As above - owner
Address of Certifier
as owner

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

as above -owner