Form ID

Publication date

Location of premises

Certificate

Watermain Extension Phae 1, Project No. EN02011

Date substantially performed:
Date certificate signed:

Participants

Name of Owner
Weeneebayko Health Ahtuskaywin
Address of Owner
P.O. Box 664, Moose Factory, ON P0L 1W0
Name of Contractor
Moose Band Development Corporation
Address of Contractor
P.O. Box 158, Moose Factory, ON P0L 1W0
Name of Certifier
Sutcliffe Rody Quesnel Inc.
Address of Certifier
9 Wellington Street, P.O. Box 1208, New Liskeard, ON P0J 1P0

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

Weeneebayko Health Ahtuskaywin (at above address)