Form ID

Publication date

Location of premises

Certificate

Installation of a new fuel oil distribution system, including new above ground, self contained storage tank, containment ring and related equipment, underground distribution piping, pumps, alarms, controls, interior day tanks, as well as the decommissioning of all existing above ground tanks, fuel transfer piping (including underground piping) interior day tanks and related equipment

Date substantially performed:
Date certificate signed:

Participants

Name of Owner
Fort Severn First Nation
Address of Owner
General Delivery, Fort Severn, ON P0V 1W0
Name of Contractor
Parkwest Projects Ltd.
Address of Contractor
Box 52, Grp. 525, RR 5, Winnipeg, Manitoba R2C 2Z2
Name of Certifier
Keewatin-Aski Ltd.
Address of Certifier
61 Queen Street PO Box 510, Sioux Lookout ON P8T 1A8

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

Keewatin-Aski Ltd., PO Box 510, Sioux Lookout ON P8T 1A8