Form ID

Publication date

Location of premises

Certificate

Three Nations Lake & Creek Replacement

Date substantially performed:
Date certificate signed:

Participants

Name of Owner
Porcupine Joint Venture
Address of Owner
1 Gold Mine Road, Postal Bag 300, South Porcupine, ON
Name of Contractor
450477 Ontario Limited OP/AS Chartrand Equipment
Address of Contractor
2401 Airport Road, Timmins, ON
Name of Certifier
Porcupine Joint Venture - Mr. Bill Van Breugel
Address of Certifier
1 Gold Mine Road, Postal Bag 300, South Porcupine, ON

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

1 Gold Mine Road, Postal Bag 300, South Porcupine, Ontario
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