Form ID

Publication date

Location of premises

Certificate

Frog Creek Subdivision Extension - Phase IV Water and Sewer Servicing

Date substantially performed:
Date certificate signed:

Participants

Name of Owner
Couchiching First Nation
Address of Owner
Administrative Office, RMB 2027, R.R. No. 2, Highway No. 11-
Name of Contractor
Tom Veert Contracting Ltd.
Address of Contractor
P.O. Box 417, Station Main, Fort Frances, ON P9A 3M7
Name of Certifier
Neegan Burnside Ltd.
Address of Certifier
15 Townline, Orangeville, ON L9W 3R4

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

Couchiching First Nation, Administrative Office, RMB 2027, R.R. No. 2, Highway No. 11-71 East, Fort Francs, ON P9A 3M3