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Lion's Head Harbour Lease for Berthing

Lion's Head Harbour
1 Bruin Street, Lion's Head
Ontario, N0H 1W0
Phone: 519-793-4060
Fax: 519-793-4259
lhmarina@northernbruce.ca

Previous slip no.:

Lessee(s) name:

Mailing address:

City:

Postal code:

Telephone number:

Cell phone number:

Email address:

Resident slip holder means "a slip is issued for a specific period of time to person(s) renting or leasing residentially on a full time, year-round basis or owning improved property in the Municipality". Please provide the civic address or roll number:

Boat details

Make of boat:

Name of boat:

Registered length:

Overall length of boat:

Insurance

As per the Policies and Procedures Handbook, a Certificate of Insurance is required from all seasonal slip holders at the Harbour. Please see page 10 for insurance requirements and coverages that must be outlined on the Certificate of Insurance. The Certificate of Insurance needs to come from your insurance provider, not a broker, and be submitted with berthing agreement.

Certificate of Insurance:

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Permission is hereby granted to use the above-mentioned wharf for the purpose of berthing the above-named vessel, upon receipt of a signed lease and payment, subject to acceptance of the following terms and conditions set out in the policy handbook.

In signing this agreement for lease, I acknowledge that I have read, understood and will comply with the rules, regulations, policies and procedures as outlined in the Policy Handbook.

Signature of lessee(s):

Clear

Date:

Personal information on this form is collected under the authority of the Municipal Act, 2001, and will be used for the purpose of processing your lease for berthing. Questions regarding the collection of this information should be directed to the Clerk at 1-833-793-3537 ext. 236.