DESCRIPTION OF INFRASTRUCTURE WORKS

Recipient (full legal name and address):
[webform_submission:values:schedule_recipient]

If the Recipient will be conducting the Infrastructure Works on behalf of another entity,
indicate on whose behalf the Infrastructure Works will be conducted (include entity’s legal
name and address):
[webform_submission:values:schedule_behalf]

Scope of Infrastructure Works (e.g. completion of asset register, infrastructure climate risk
assessment, infrastructure asset management planning, etc.). Please set out in as much
detail as is available at this time:
[webform_submission:values:schedule_scope]

Location of infrastructure:
[webform_submission:values:schedule_location]

Anticipated start and completion date:
[webform_submission:values:schedule_dates]

Future time horizons for Infrastructure Works (e.g. 2030s, 2050s, 2080s, etc.):
[webform_submission:values:schedule_horizons]

Names of all members of the Project Assessment team, and their expected role(s) in the
Infrastructure Works (indicate whether they will receive or view a copy of the FN-IRT):
[webform_submission:values:schedule_members]

SCHEDULE “B”

PERMITTED PARTY ACKNOWLEDGEMENT

As an individual identified by <Recipient Name> (the “Recipient”) to be a “Permitted Party”
under the First Nations Infrastructure Resilience Toolkit Confidentiality and Release
Agreement (the “Agreement”) signed between the Recipient and OFNTSC, I hereby
acknowledge and agree that I have read, understand and agree to be bound by the terms
and conditions of the Agreement concerning the use and disclosure of the FN-IRT.

Name:
Title:
Signature:
Date:

Name:
Title:
Signature:
Date:

Name:
Title:
Signature:
Date:

Name:
Title:
Signature:
Date:

[webform_submission:values:signature]