Form ID

Publication date

Location of premises

Certificate

Construction of sanitary sewers, watermains and roads including but not limited to clearing and grubbing, geotextile, road base & ditching, culverts, sewermains and services, watermains and services, fire hydrants, sanitary pumping station and forcemain

Date substantially performed:
Date certificate signed:

Participants

Name of Owner
Moose Factory Island Local Services Board
Address of Owner
PO Box 159, Moose Factory, ON P0L 1W0
Name of Contractor
Moose Band Development Corporation
Address of Contractor
PO Box 158, Moose Factory, ON P0L 1W0
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., 61 Queen Street, PO Box 510, Sioux Lookout, ON P8T 1A8