Form ID

Publication date

Location of premises

Certificate

Package “T” - Electrical 1 - Duct Banks and Manholes

Date substantially performed:
Date certificate signed:

Participants

Name of Owner
Thunder Bay Regional Hospital
Address of Owner
325 S. Archibald Street, Thunder Bay, ON P7E 1G6
Name of Contractor
Form & Pour Construction Limited
Address of Contractor
PO Box 23021 County Fair Plaza, Thunder Bay, ON P7B 6P1
Name of Certifier
Salter Farrow Pilon Architects Inc.
Address of Certifier
151 Ferris Lane, Suite 400, Barrie, ON L4M 6C1

Identification of Premises

Parts 1 and 5 on Reference Plan 65R-11213, The City of Thunder Bay, District of Thunder Bay