4
<.
RSM Richter
RSM Richter Inc.
200 King St. W., P.O. Box 48, Suite 1100
Toronto, ON M5H 3T4
Tel: 416.932.8000 Fax: 416.932.6200
www.rsmrichter.com
Estate File No.:
31-1290574
IN THE MAFER OF THE BANKRUPTCY OF
4393309 CANADA INC. (FORMERLY KNOWN AS MONDRIAN HALL INC.),
OF THE CITY OF VAUGHAN, IN THE PROVINCE OF ONTARIO
NOTICE OF BANKRUPTCY AND FIRST MEETING OF CREDITORS
(Subsection 102(1))
Take notice that:
1.
4393309 Canada Inc. (formerly known as Mondrian Hall Inc.) filed an assignment on
the 23rd day of November, 2009 and RSM Richter Inc. was appointed as trustee of the
estate of the bankrupt by the official receiver, subject to affirmation by the creditors of
the trustee's appointment or the substitution of another trustee by the creditors.
2.
The first meeting of creditors of the bankrupt will be held on the ioth day of December,
2009, at 2:30 p.m., at the offices of the trustee, RSM Richter Inc., 200 King Street West,
Suite iioo, Toronto, Ontario.
3.
To be entitled to vote at the meeting, creditors must lodge with the trustee, prior to the
meeting, proofs of claim and, where necessary, proxies.
4.
Enclosed with this notice is a form of proof of claim, a form of general proxy, and a list of
creditors with claims amounting to twenty-five dollars or more, showing the amounts of
their claims.
5.
Creditors must prove their claims against the estate of the bankrupt in order to share in
any distribution of the proceeds realized from the estate.
DATED at Toronto, this 24th day of November, 2009.
RSM RICHTER INC.
TRUSTEE
200 King Street West
Suite 1100, P.O. Box 48
Toronto, Ontario MH 3T4
;:ODMA\PCDOCS\DMTOR2478O1\1
PSM Richter is an independent member firm of RSM International,
an affiliation of independent accounting and professional firms.
Ontario
09 - Toronto
District of:
Court No,
Court No.
Estate No,
OriginaI
Amended
--FORM 78-Statement of Affairs ( Business Bankruptcy) made by an enitity
(Subsection 49(2) and Paragraph 158(d) of the Act I Subsections 50(2) and 62(1) of the Act)
In the matter of the bankruptcy of
4393309 Canada Inc. (formerly known as Mondrian Hall Inc.)
of the City of Vaughan, in the Province of Ontario
To the bankrupt
You are required to caretully and accurately complete this Form and the applicable attachments, showing the state ot your aflairs on the dat e ot your bankwptcy,
on the 19th day ot November 2009. When completed, this Form and the applicable attached lists will constitute the Statement of Aftairs and must be veritied by oath or
solemn declaration.
ASSETS
(As stated and estimated by the officer)
LIABILITIES
(As stated and estimated by the officer)
4,263371.93
1. Unsecured creditors as per list "A".... ...........
0.00
Balance ot claims unsecured as per list "A"
Total unsecured creditors ................
4263,371.93
_______________
0.00
2. Secured creditors value ot security as per list B
______________
3. Preferred creditors as per list C
....................
0.00
4. Contingent, trust claims or other liabilities as per list 'D'
estimated lobe reclaimable for
es.........................
Surplus ..............................
iota a
ii
0 00
4,263,371.93
________________
NIL
1. Inventory.......................................
2. Trade fixtures, etc .............................
3. Accounts receivable and other receivables, as per List 'E"
0.00
Good ....................
0.00
..................
0.00
Bad .....................
Estimated to produce ...........................
4. Bills of exchange, promissory note, etc., as per List
5. Deposits in Financial Institutions ....................
Doubtful
6. Cash .........................................
7. Livestock .......................................
8. Machinery, equipmentand plant .....................
9. Real property or immovable as per List G"
10. Furniture ......................................
11. RRSPs, RRIF5, Life insurance, etc ..................
12. Securities (Shares, Bonds, Debentures, etc.)
13. Interests under wills .............................
14. Vehicles ...................................... .
15. Other property, as per List 'H' .....................
If bankrupt is a corporation, add:
Note:
As directed in the Initial Order pursuant to the Companies
Creditors Arrangement Act, made by the Ontario Superior
Court of Justice on July 8, 2009, cash on hand is net of
a Directors' Charge to the extent of $550,000 and an
Administration Charge to the extent of $150,000. Any funds
remaining after payment of these charges will become an
asset of the estate.
0.00
0.00
Amount of subscribed capital
0.00
Amount paid on capital
Balance subscribed and unpaid................. .
Estimated to produce .........................
Total assets ................... .
Deficiency .................... .
0.00
0.00
0.00
1,443,337.00 (Note
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
60,000.00
0.00
0.00
1503,337.00
2,760,034.93
I, John J. Ford, of the city of Southborough, MA, do swear (or solemnly declare) that this statement and the attached lists are to the
best of my knowledge a full, true and complete statement of the affairs of 4393309 Canada Inc. (formerly known as Mondrian Hall Inc.)
on November 19, 2009, and fully disclose all of its property of every description that is in its possession or that may devolve on it in
accordance with the Act.
Sworn before me at the City
of Toronto, Province of Ontario
this l9 day of November, 2009.
Schwartz, aCmoner3O9 Canada Inc
(formerly k,92 as 1v,4ndriaall Inc.)
Trustee in Bankruptcy andSM Biebtel LLP,
Chartered tvccountants.
it
Expires FebiuaY 7, 20.)
____________________________________________________________ )
A Commissioner, etc., in and Tor the Province of Ontario.
Per: __________________________________
/John J. Ford
IN THE MATTER OF THE BANKRUPTCY OF
4393309 CANADA INC. (FORMERLY KNOWN AS MONDRIAN HALL INC.),
OF THE CITY OF VAUGHAN, IN THE PROVINCE OF ONTARIO
1
(Preliminary list of creditors as at November 19, 2009,
as submitted by the debtor, without admission as to any liabilities or privilege herein shown.)
Unsecured Creditors
3DELTAE
3M CANADA COMPANY (TM)
407 ETR
9111-9545 QUEBEC INC.
ABC FIRE EXTINGUISHER CO.
ABL X-PRESS LTD.
ACCESS COMMUNICATIONS
ADNM INTERNATIONAL INC.
ADT SECURITY SERVICES CANADA
AGFA INC. T46105
AMERICAN PLASTICS COMPANY
AMPLIS FOTO INC (AM)
ANTHONY'S JANITORIAL SERVICES
APEX MOTOR EXPRESS LTD.
APPLEONE SERVICES LTD.
ARGUS CARRIERS LTD.
ARK\NRIGHT
ASSOCIATED REPROGRAPHICS
ATS ANDLAUER TRANSPORTATION
AVERY DENNISON G.DIV (AD)
AZORES CLEANING SERVICES
BC HYDRO
BC WORKERS COMPENSATION BOARD
BEAVER DELIVERY SERVICE INC.
BELL CANADA INSOLVENCY GROUP
BELL CANADA INSOLVENCY GROUP
BELL CANADA INSOLVENCY GROUP
BELL CANADA INSOLVENCY GROUP
BELL CANADA INSOLVENCY GROUP
BELLEY INC.
BFI CANADA
BLITZ COURIER
BOOTH PHOTOGRAPHIC (BO)
BPO MANAGEMENT SERVICES, LTD.
BRENNAN OFFICE PLUS
BRESARA WINDOW CLEANING
BRYMAG TRANSPORT INC.
BUREAUNET
BYERS TRANSPORT LTD.
CANADA FASTENAL
Account Number
6961516, 6961523, 6961520
423353-AQ (93)
Address
58 Hamilton Street, Toronto, ON M4M 2C8
Commerce Court, Box 3616, Toronto, ON M5L 1 K1
Concord P/S, Box 6300, Toronto, ON L4K 4Y3
5875 Cavendich, #603, Cote St.Luc, QC H4W2X9
B3 - 116 103rd St. East, Saskatoon, SK S7N 1Y7
11650- 120 Street, Edmonton, AB 15G 2Y2
2250 Park Street, Regina, 5K S4N 7K7
4085 Lavoisier Street, Boisbriand, QC J7H 1 Ni
615- 18th Street SE., Calgary, AB T2E 6J5
P.O. Box 4386, Station A, Toronto, ON M5W 312
6733 Mid Cities Avenue, Beltsville, MD 20705 U.S.A.
22 Telson Road, Markham, ON L3R 1E5
147 Woodard Avenue, Regina, 5K S4R 3H5
P.O. Box 1107, Winnipeg, MB R3C 2Y4
50 Paxman Road, Unit 8, Etobicoke, ON M9C 1B7
3839 Myrtle Street, Burnaby, BC V5C 4G1
538 Main Street, Fiskeville, RI 28230-1 39 U.S.A.
6877 Wynnwood Lane, Houston TX 77008 U.S.A.
680-l90Attwell Drive, Etobicoke, ON M9W6H8
96586 Collection, Centre Drive, Chicago IL 60693 U.S.A.
P.O. Box 31051, Arlington RPO, Winnipeg, MB R3E 3N1
P.O. Box 9501, Stn. Terminal, Vancouver, BC V6B 4N1
P.O. Box 5350, Stn. Terminal, Vancouver, BC V6B 5L5
10156 Hwy. #27, Woodbridge, ON L4L 1A7
600 Jean Talon East, Suite 901, Montréal, QC H2R3A8
600 Jean Talon East, Suite 901, Montréal QC H2R 3A8
5143353141
9056704280; 6137371110;
90595795
600 Jean Talon East, Suite 901, Montréal QC H2R 3A8
4186220442;4186222251;
5143353141
600 Jean Talon East, Suite 901, Montréal QC H2R 3A8
300006548; 3000110076;
300110078
112604822409; 112878722409 600 Jean Talon East, Suite 901, Montréal QC H2R 3A8
1035 Rue Panneton, Sherbrooke, QC J1K2B3
25 Fawcett Road, Coquitlam, BC V3K 6V2
6 Britanica Road, Winnipeg, MB R2N 1J4
1145 Nicholson Rd., Unit #3, Newmarket, ON L3Y 9C3
19 Allstate Parkway, 2 Fl, do HSBC Bank Cda, Markham, ON L3R 9T8
1162 Osler Street, Regina, 5K S4R 5G9
1049 PacificAvenue, Winnipeg, MB R3E 1G5
P.O. Box 539, St. Laurent Post Office, Montreal, QC H4L 4V7
1484 Hymus Blvd., Dorval, QC H9P 1J6
P.O. Box 157, Edmonton, AB T5J 2J1
Unit 1340, 55th Avenue, Lachine, QC H8T 3J8
Amount
(CON $)*
1,137.56
45,112.24
842.28
363.52
33.00
128.71
27.06
65.63
1,481.77
91,426.74
4,743.58
6,432.43
276.39
2,131.36
163.80
10,867.77
59,209,69
6,675.28
1,545.44
7,496.33
1,082.18
1,858.09
324.85
5,061.00
59.64
652.34
978.77
1,528.50
5,296.97
19,129.98
36.79
1,807.15
2,245.05
42,625.80
130.16
173.09
1,071.23
1,704.04
750.07
57.82
IN THE MATTER OF THE BANKRUPTCY OF
4393309 CANADA INC. (FORMERLY KNOWN AS MONDRIAN HALL INC.),
OF THE CITY OF VAUGHAN, IN THE PROVINCE OF ONTARIO
(Preliminary list of creditors as at November 19, 2009,
as submitted by the debtor, without admission as to any liabilities or privilege herein shown.)
Unsecured Creditors
Account Number
Address
CANADA REVENUE AGENCY
CANADIAN FREIGHTWAYS LTD.
CANADIAN LINEN AND UNIFORM SERVICE
CANON CANADA INC.
CARRERA PAUSE-CAFE
CBV COLLECTION SERVICES LTD.
CDW CANADA INC.
CEDAR SPRINGS
CHARTPAK
CHRIS ST. CLAIR CET
CHRIS' YARD CARE
CIRCO PACKAGING INC.
CIT FINANCIAL
CITY OF REGINA
CITY OF SASKATOON-UTILITIES
CITY OF WINNIPEG-WATER UTILITY
CLEAR CAST TECHNOLOGIES
CLEAR FOCUS IMAGING (CO) INC.
CLEARSTAR LP
CLIFFORD PAPER INC.
COAST PAPER
COLE PARMER CANADA INC.
COMMISSION DE LA SANTE ET DE
CONSOLIDATED FASTFRATE
CSA TRANSPORTATION
CSST
CULLIGAN
CUSTOM LAWN CARE
D.M.G. INC.
DANKA FINANCIAL SERVICES
DATALINKS (DD)
DAY & ROSS
DAYMEN PHOTO MRKTG LP
DCC SOLUTIONS GROUP
DEBLECX
DELL FINANCIAL SERVICES
DENNY MFG. CO. INC., (DN)
DHL EXPRESS (CANADA) LTD.
DIAZIT COMPANY
DISTRIBUTION 3 SOURCES LTEE.
DUROFLEX SPECIALTY PAPERS INC.
DURST IMAGE TECHNOLOGY US, LLC
DWL DELIVERY
DYNAMEX CANADA
12157 2979
5800 Hurontario Street, Mississauga, ON L5A4E9
P.O. Box 1236, Stn. Main, Edmonton, AB T5J 2M4
1860 King Edward Street, Winnipeg, MB R2R 0N2
P.O. Box 77271, RPO Courtney Park, Mississauga, ON L5T 0A9
1425 Ouellette Street, St. Hubert, QC J3Y 7M4
814 Richards Street, #100, Vancouver, BC V6B 3A7
20 Carlson Court, #300, Etobicoke, ON M9W 7K6
45 Villarboit Crescent, #2, Concord ON L4K 4R2
I River Road, LEEDS, MA 11053 U.S.A.
P.O. Box 72, Falcon Lake, MB, R3B 3M1
100 Crawford, Winnipeg, MB R2H 1X7
630 McCaffreu, St. Laurent, QC H4T 1N1
P.O. Box 4094, Station A, Toronto, ON M5W 3T1
P.O. Box 5022, Regina, SKS4P4J3
P.O. Box 7030, Treasurer's Dept., Saskatoon, SKS7K4E5
510 Main Street, Winnipeg, MB R3B 3M1
99 North Water Street, OSSINING, NY 10562 U.S.A.
60 Maxwell Court, Santa Rosa, CA 95401 U.S.A.
P.O. Box 40397, Charleston, SC 29423-0397 U.S.A.
600 East Crescent Ave., Upper Saddle River, NJ 17458 U.S.A.
200 Galcat Drive, Vaughan, ON L4L 1B9
210-5101 Rue Buchan, Montreal, QC H4P 2R9
CP11493 Centre-ViIle, Securite du Travail du Quebec, Montreal, QC H3C
9701 Highway 50, Woodbridge, ON L4H 2G4
1 Valleybrook Drive, #305, Toronto, ON M3B 2S7
CP1200 Succursale Terminus, 524 Rue Bourdages, Quebec, QC G1K 7E2
P.O. Box 4800, Regina, SK S4P 3Y4
R.R. #9 Station Main, Hwy 5 & McOrmond Rd., Saskatoon, SK S7K 1P3
46, Rue YVO, Granby, QC J2G 8C8
100-1 235 North Service Rd. W., Oakville, ON L6M 2W2
Parkway N., Unit. #12, 350 Harry Walker, Newmarket, ON L3Y 8L3
398 Main Street, Hartland, NB E7P 1C6
55 Valleywood Drive, Markham, ON L3R 5L9
314 Queen St. South, Unit 115, Bolton, ON L7E 4Z9
1440, Rue Hocquart Bureau, St-Bruno-De-Montarville, QC J3V6E1
P.O. Box 8751, Station A, Toronto, ON M5W3C2
P.O. Box 7200, Mobile, AB 36670 U.S.A.
200 Westcreek Blvd., Brampton, ON L6T 5T7
941 US 1 Hwy., Box 276, Youngville, NC 27596 U.S.A.
3062 Gonthier, Montreal, QC Hi L 3W5
1705 Argentia Rd., Units i0& 12, Mississauga, ON L5N 3A9
50 Methodist Hill Drive, Rochester, NY 14623 U.S.A.
896 ERIN PLACE, Edmonton, AB T2T 1M6
MALTON CSC, P.O. BOX 243, Mississauga, ON L4T 3B6
100290; 311060
100451013
33609000006
1164253628
Amount
(CON $)*
1.00
6,246,36
1,549.47
403.98
716.44
346.94
480.47
0.50
22,079.93
230.00
136.50
3,785.08
155.82
77.42
849.25
261.30
1,947.92
11,002.00
5,939.04
252,125.90
1,513.93
301.68
3,596.47
15,254.95
1,725.00
190.48
42.24
156.83
1,357.33
628.38
184.03
1,069.67
4,364.38
11,394.75
191.00
191.12
4,510.75
286.60
939.85
50.00
794.01
5,240.46
2,183.45
1,353.63
IN THE MATTER OF THE BANKRUPTCY OF
4393309 CANADA INC. (FORMERLY KNOWN AS MONDRIAN HALL INC),
OF THE CITY OF VAUGHAN, IN THE PROVINCE OF ONTARIO
(Preliminary list of creditors as at November 19, 2009,
as submitted by the debtor, without admission as to any liabilities or privilege herein shown.)
Unsecured Creditors
EDB
ELECTRO SONIC INC.
ELMER'S PRODUCT INC.
EN BRIDGE
EN MAX
EPSON CANADA LTD.
EXCEL PACKAGING LTD.
EXPRESSDIGITAL (ED)
FARRELL ESTATES LTD.
FEDERAL EXPRESS
FEDEX TRADE NETWORKS
FIRST CANADIAN MESSENGER
FIRST TEAM TRANSPORT INC.
FLETCHER-TERRY (TF)
FUELLBRANDT, MICHAEL
FUJI PHOTO FILM (FU)
GATEWAY BOOKBINDERY
GAZ METROPOLITAN
GBC CANADA INC.
GE SECURITY CANADA
GEl - CALGRAPH
GEl WIDE FORMAT
GENERATION MULTIMEDIA
GENTEC INTERNATIONAL (GI)
GRAND & TOY LTD.
GRANT THORNTON
GRANVILLE HOLDINGS LTD.
GRAPHTEC AMERICA INC.
GREYHOUND COURIER
GROUPE CDP SUCCURSALE LACHINE
H&H JANITOR SERVICE
HARGRAVE HOLDINGS (RENT)
HERCULITE INC.
HEWLETT PACKARD
HEWLETT-PACKARD COMPANY
HEXIS USA LLC (HU)
HOOVER MECHANICAL PLUMBING &
HYDRO OTTAWA LTD.
HYDRO QUEBEC
IKON OFFICE SOLUTIONS
IKS INTERNATIONAL KNIFE & SAW
IMPERIAL COFFEE SERVICES INC.
Account Number
173560337440;
173560337332; 0565
500743725
32808210028
541153000
2.99002E+1 1
Address
4365 BOUL ST. ELZEAR OUEST, Laval, QC H7P 4J3
1100 GORDON BAKER ROAD, Willowdale, ON M2H 3B3
P0 BOX 19095, POSTAL STN A, Toronto, ON M5W 2W8
P0 BOX 644, PAYMENT PROCESSING, Scarborough ON M1K 5H1
P0 BOX 2900 STN M, Calgary AB T2P 3A7
BOX 9780, STN A, ROYAL BANK OF CANADA, Toronto ON M5W 1 R6
105 - 86 NORTH BEND ST, Coquitlam BC V3K 6H1
9200 E. PANORAMA CIRCLE, #150, ENGLEWOOD CO 80112 U.S.A.
220 - 6911 GRAYBAR ROAD, Richmond BC V6W I H3
P0 BOX 4626, TORONTO STN A, Toronto ON M5S 5B4
P.O. BOX 10007, POSTAL STN A, T10007C/U, Toronto ON M5W2B1
13350 COMBER WAY, Surrey BC V3W 5V9
180 ATTWELL DRIVE, #600, Toronto ON M9W 6A9
65 Spring Lane, Farmer Solutions.Com, Farmington, CT 60323-311
410 GILMORE AVENUE, Winnipeg MB R2G 2G6
600 SUFFOLK COURT, Mississauga ON L5R 4G4
385 DEBAETS STREET, Winnipeg MB R2J 4J8
CP6115 STATION A, MontrealQC H3C4N7
P.O. BOX 57341, STATION A, Toronto ON M5W 5M5
P.O. BOX 9547, Station A, Toronto, ON M5W 2K3
P.O. BOX 8475 STN A, Toronto ON M5W 3P1
P0 BOX 643842, Pittsburgh PA 15264-3842 U.S.A.
5570, CARTIER, #105, Montreal QC H2H 1X9
90 ROYAL CREST COURT, Markham ON L3R 9X6
15 SCURFIELD BLVD., Winnipeg MB R3Y 1V4
94 COMMERCE DRIVE, Winnipeg MB R3P 0Z3
102-1 027 8TH STREET E., Saskatoon SK S7H 0S2
1251 EAST DYER Rd., #110, SANTA ANA CA 92705 U.S.A.
BAG 2577, Calgary AB T2P 4N4
150, Blvd. Montreal-Toronto, #101, Lachine QC H85 4L8
369 DEERVIEW DR SE, Calgary AB T2J 6X2
171 DONALD St., CROSSTOWN CREDIT UNION, Winnipeg MB R3B 3M1
P.O. BOX 435, EMIGSVILLE PA 17318 U.S.A.
P0 BOX 8803, POSTAL STATION A, Toronto ON M5W 1 P8
P.O. Box 100866, Atlanta GA 30384-0866 U.S.A.
4375 PRADO ROAD, #106, CORONA CA 91720 U.S.A.
100-30 GLENDEER CIRCLE SE., CalgaryAB T2H 2Z0
P0 BOX 4483, STATION A, Toronto ON M5W 5Z1
do Michel Blackburn, 140 Cremazie W., 1st Fl., Montreal QC H2P 1C3
16011- I16AVENUE, EdmontonABT5M 3Y1
1153 ROBERVAL SUD, GRANBY QC J2G 8C8
12 KODIAK CRESCENT, North York ON M3J 3G5
Amount
(CDN $)*
538.40
1,195.66
6,229.94
244.22
1,352.92
192,344.63
4,677.75
604.59
2,763.77
2,264.74
78.61
75.48
191.15
6,216.61
183.75
33,138.63
107.05
50.01
1,010.59
475.49
4,064.16
542.02
81.11
3,353.50
2,106.35
8,960.00
872.16
29,832.65
233.61
294,90
911.47
2,786.80
719.92
56,984.26
5,561.21
170.63
1,804.14
93.64
3,542.68
7,132.18
740.75
90.90
IN THE MATTER OF THE BANKRUPTCY OF
4393309 CANADA INC. (FORMERLY KNOWN AS MONDRIAN HALL INC.),
OF THE CITY OF VAUGHAN, IN THE PROVINCE OF ONTARIO
(Preliminary list of creditors as at November 19, 2009,
as submitted by the debtor, without admission as to any liabilities or privilege herein shown.)
Unsecured Creditors
INGRAM MICRO
INTELICOAT TECHNOLOGIES
IRON MOUNTAIN
JOHNSON WASTE MANAGEMENT
JOSEPH HOMA CONSULTANTS INC.
KINGSWAY TRANSPORT
KODAK CANADA INC (KO)
KODAK CANADA INC. (GOVT)
LAIRD PLASTICS
LES ENT. D'ELECTRICITE MAZZOLA
LES EQUIPMENTS CKG PRO-SERVICE
LESLIE TAYLOR MANUFACTURING CO.
LG CHEM AMERICA-CONTAINERS
LG HAUSYS AMERICA, INC.
LOGISTIQUE CANAMEX INC.
LOMBARD GRAPHICS
LORAAS DISPOSAL (REG)
LORAAS DISPOSAL (SKN)
LOWRY'S MANUFACTURING
MACPHERSON LESLIE & TYERMAN
MACTAC CANADA LTD. (MF)
MANITOBA HYDRO
MANITOULIN TRANSPORT
MAYER'S FIBRE TUBE & CORE
MAYLINE GROUP
MB WORKERS COMPENSATION BOARD
MERX
MESSIER, RAJEAN
MID-COUNTRY LAMINATING
MIDLAND TRANSPORT
MILLS BASICS
MILNE OFFICE SYSTEMS INC.
MILNE'S MOVING & STORAGE
MINISTER OF FINANCE - INSOLVENCY UNIT
MINISTER OF FINANCE - MANITOBA
MINUTE-MAN DELIVERY LTD.
MONARCH MESSENGER SERVICES LTD.
MORGUARD IND PROP (1) INC.
MOUNTAIN SPRING WATER
MTS ALLSTREAM INC.
MUTOH AMERICA INC(MU)
NADEL ENTERPRISES (NA)
NAZDAR CANADA
NEOLT S.P.A
Account Number
713 3339 6019356
088757-0
100904
12157 2979
121572879 MT
Address
55 STANDISH COURT, Mississauga ON L5R 4A1
P0 BOX 751434, CHARLOTTE NC 28262 U.S.A.
P0 BOX 3527, Station A, Toronto ON M5W 3G4
201 - 60 EAGLE DRIVE, Winnipeg MB R2R 1V5
57 SUNNYSIDE AVENUE, Westmount QC H3Y 1C3
6700 CHEMIN ST. FRANCOIS, St. Laurent QC H4S 1 B7
P.O. BOX 3419, Station A, Toronto ON M5W4C4
P.O. BOX 3419, Station A, TORONTO ON M5W 4C4
8 PLYMOUTH STREET, Winnipeg MB R2X 2W
5319 CLARENDON AVE., Laval QC H7W4Z5
686, RUE PIE XII, VAUDREUIL-DORION QC J7V 8S3
157 KENREI PARK ROAD, Lindsay ON K9V4R1
920 SYLVAN AVE., ENGLEWOOD CLIFFS NJ 17600 U.S.A.
900 CIRCLE 75 PARKWAY, #1500, Atlanta GA 30339 U.S.A.
1933 LIONEL-BERTRAND, BOISBRIAND QC J7H 1N8
650 DUFFERIN AVENUE, Winnipeg MB R2W 2Z2
620 MCLEOD STREET, Regina SK 54N 4Y1
2614 FAITHFUL AVENUE, Saskatoon SK S7K 5W3
30 MIDLAND STREET, Winnipeg MB R3E 2Y6
1500- 1874 SCARTH STREET, Regina SK S4P 4E9
P.O. BOX 57673, Station A, Toronto ON M5W 5M5
P0 BOX 7900 STN MAIN, Winnipeg MB R3C SRi
P0 BOX 390, 154 HWY 540B, GORE BAY ON POP IHO
1707 DUGALD ROAD, WINNIPEG MB R2J 0H3
BOX 3090, Dept. 5236, MILWAUKEE WI 53201-3090 U.S.A.
210-363 BROADWAY, Winnipeg MB R3C 3N9
P0 BOX 11684, STN CENTRE-VILLE, Montreal QC H3C 6H4
251 NAPIERVILLE, REPENTIGNY QC J5Y 2S9
P.0.BOX 1510, MAPLE CREEK SK SON 1NO
100 MIDLAND DRIVE, Dieppe NB E1A6X4
(PREV.BURNABY OFFICE), 1111 CLARK Dr., Vancouver BC V5L 3K5
UNIT J - 301 WESTON STREET, Winnipeg MB R3E 3H4
1301 OSLER STREET, Regina SK S4R 1W6
MANAGER, 6th Fl., 33 King St. W., Oshawa ON L1H 8H5
101-401 York Avenue, Winnipeg MB R3AOX7
1560 BRIMLEY ROAD, #225, Toronto ON M1P 3G9
P.O. BOX 966, STATION T, Calgary AB T2H 2H4
505 - 3RD St. SW., # 200, CALGARY AB T2P 3E6
19500 56TH AVENUE, Surrey BC V3S 6K4
P.O. BOX 7500, Winnipeg MB R3C 3B5
16395 COLLECTION CENTER Dr., Chicago IL 60693 U.S.A.
425 ATTWELL DRIVE, Rexdale ON M9W 5C4
925 ROSELAWN AVENUE, Toronto ON M6B 1B7
8/24036 PONTE S. PIETRO, VIA G. GALILEI, BERGAMO ITALY
Amount
(CON $)*
316,071.14
180,227.35
930.51
849.81
6,138,59
2,650.34
614,464.66
42,730.09
10,356.53
339.52
502.97
137.03
53,555.15
33,608.14
790.25
33,511.42
283.52
216.62
1,574.98
55.29
738.76
1,856.75
7,814.31
413.75
3,376.42
789.68
37.90
4,584.38
701.27
3,660.53
331.24
279.09
228.38
1.00
1.00
10,270.05
5,498.22
1,953.42
67.20
314.15
24,773.31
527.06
1,206.18
0.01
IN THE MATTER OF THE BANKRUPTCY OF
4393309 CANADA INC. (FORMERLY KNOWN AS MONDRIAN HALL INC.),
OF THE CITY OF VAUGHAN, IN THE PROVINCE OF ONTARIO
(Prelimina,y list of creditors as at November 19, 2009,
as submitted by the debtor, without admission as to any liabilities or privilege herein shown.)
Unsecured Creditors
Account Number
Address
NEOPOST CANADA LTD.
NEOPOST LEASING SERVICES
NESCHEN AMERICAS CORPORATION
NEW PENN MOTOR EXPRESS, INC.
NIMBUS WATER OF CANADA
NORITSU CANADA LTD. (NU)
NORTH AMERICAN EURO PRODUCTS
NORTH ISLAND TRADE SHOWS LTD.
NOVEL GRAPHICS
NUCLEUS INC.
OCE CANADA
ONYX GRAPHICS CORP.
PANTONE, INC.
PAPIERFABRIKEN CHAM-TENERO AG
DP0C9003822949
150 STEELCASE ROAD WEST, Markham ON L3R 3J9
150 STEELCASE ROAD WEST, MARKHAM ON L3R 3J9
1601 MATHESON BLVD E., Unit 4, Mississauga ON L4W 1H9
24801 NETWORK PLACE, Chicago IL 60673-1248 U.S.A.
1075 MCDONALD STREET, Regina SK 54N 2X9
2680 ARGENTIA RD, Mississauga ON L2N 5V4
8467 DALTON, MOUNT ROYAL QC H4T 1V5
1606 SEDLESCOMB DR. #8, MISSISSAUGA ON L4X 1M6
2956 ISLINGTON AVENUE, Toronto ON M9L 2K5
1835B 10TH AVENUE SW., Calgary AB T3C 0K2
1100-4711 YONGE STREET, Toronto ON M2N 6K8
13355 COLLECTIONS CENTER Dr., Chicago IL 60693 U.S.A.
P0 BOX 633354, Cincinnati OH 45263-3354 U.S.A.
do First Union National Bank, SWIFT ID PN8PUS33, PA 19178-8500
PEAK MECHANICAL
PENVEST REALTY LIMITED
PERMALITE
PFS INC (VAST)
PHOTO TECH INC. (PB)
PICO DESIGN INC.
PITMAN/CHARRETTE
PITNEY BOWES
PITNEY BOWES LEASING
PITNEYWORKS
PLS SIGN & GRAPHICS
POULIN'S EXTERMINATORS
POWER PLUS 4 SERVICES
POWERSTREAM
PRECISION GRAPH-TECH INC.
PRIMUS CANADA
PROCESS COLOR PRINT
PRO-DATA INC.
PUROLATOR COURIER
QUIK X TRANSPORTATION
QUI KTRAX
RAC SERVICES INC.
RAYVEN INC.
RED RIVER COLLEGE
RED RIVER MESSENGER
RELAY COURIER
REPROGRAPHIC TECHNOLOGY INTL.
ACCT 2014149880175,
CHIPSO5O9
15-41-01800-014
61037
409-45TH A St. E., Saskatoon SK S7K 0W6
10 CARLSON COURT, #500, Etobicoke ON M9W6L2
230 EAST ALONDRA, GARDENA CA 90248 U.S.A.
3500 PHARMACY AVENUE, #5, Toronto ON M1W2T6
7200 HUDSON BLVD. #170, ST. PAUL MN 55128 U.S.A.
170 OAKDALE ROAD, TORONTO ON M3N 2S5
3000 SOUTH ASHLAND AVENUE, Chicago IL 60608 U.S.A.
P.O. BOX 190, Orangeville ON L9W 2Z6
P.O. BOX 278, ORANGEVILLE ON L9W 2Z7
P0 BOX 280, ORANGEVILLE ON L9W2Z7
1855 CAMERON STREET, Regina SK S4T 2T9
24 MARION PLACE, Winnipeg MB R2H 0S9
47 WILSONGARY CIRCLE, Ajax ON LIT 0G6
P.O. BOX 3700, CONCORD ON L4K 5N2
P0 BOX 2028, STONEWALL MB ROC 2Z0
5343 DUNDAS STREET WEST, #400, Toronto ON M9B 6K5
7007- 5TH STREET SE., Calgary AB T2H 2G2
1560 St. JAMES STREET, Winnipeg MB R3H 0L2
ETOBICOKE Postal Stn, BOX 1100, Etobicoke ON M9C 5K2
2575 INKSTER BLVD, Winnipeg MB R3C 2E6
2575 INKSTER BLVD, WINNIPEG MB R3C 2E6
21 STAPLETON STREET, WINNIPEG MB R2L 1Z9
Coface Canada, do Ms. Lorraine Curry, 251 Consumers Rd., #910, Toronto
ON M2J 4R3
2055 NOTRE DAME AVENUE, Winnipeg MB R3H 0J9
P0 BOX 351, SELKIRK MB R1A2B1
3220 WELLS AVENUE, Saskatoon SK S7K 5W5
40 DUMART PLACE. KitchenerON N2K3C7
Amount
(CON $)*
700.52
647.96
117,140.48
156,97
27.50
530.09
2,737.35
7,985.25
145.95
268.30
939,304.04
19,104.73
735.67
109,102.55
559.71
1.00
29,650.18
1,163.49
2,812.60
1,785.76
406.48
3,842.35
2,225.23
312.08
275.00
91.18
864.73
5,233.46
1,640.10
6,136.84
1,157.10
5,348.18
40,815.77
5,971.81
6,792.15
972.39
7,974.87
158.59
15.02
25.20
6,110.39
IN THE MATTER OF THE BANKRUPTCY OF
4393309 CANADA INC. (FORMERLY KNOWN AS MONDRIAN HALL INC.),
OF THE CITY OF VAUGHAN, IN THE PROVINCE OF ONTARIO
(Preliminary list of creditors as at November 19, 2009,
as submitted by the debtor, without admission as to any liabilities or privilege herein shown.)
Amount
(CDN $)*
Unsecured Creditors
Account Number
Address
REVENUE SERVICES OF B.C.
RICOH CANADA INC.
RIVERSIDE DELIVERY
RJF INTERNATIONAL
ROGERS AT&T
ROGERS BUSINESS SOLUTIONS
ROGERS BUSINESS SOLUTIONS
ROLLY'S TRANSFER ALL POINTS
RS CANADA INC.
SA INTERNATIONAL
SAFCO PRODUCTS COMPANY
SALMONS TRANSFER
SAMEDAY RIGHT-0-WAY
SASK ENERGY
SASK POWER
SASKATCHEWAN TELEPHONE
R0061 32
MEDICAL SERVICE PLAN BILLING, Box 9482, VICTORIA BC V8W 9W6
300 - 5520 EXPLORER Dr., Mississauga ON L4W 5L1
BOX 2011, Saskatoon 5K S7K 3S7
P.O. BOX 5235N, CLEVELAND OH 44193 U.S.A.
P0 BOX 9100, Don Mills ON M3C 3P9
1 Mount Pleasant Rd., 5th Fl., (ROGERS TELECOM), Toronto ON M4Y 2Y5
1 MOUNT PLEASANT ROAD, TORONTO ON M4Y 2Y5
1611 St. Annes Rd., Moving Systems, Winnipeg MB R2N 4G1
1025 WESTPORT CRESCENT, Mississauga ON L5T 1 E8
1490 North 2200W. #120, SALT LAKE CITY UT 84116 U.S.A.
P.O. Box 86, MInneapolis MN 55486-0752 U.S.A.
100-9500 VAN HORNE WAY, Richmond BC V6X 1W3
6975 MENKES DRIVE, Mississauga ON L5S 1Y2
P0 BOX 6300, STN MAIN, Regina SK S4P 4J5
P0 BOX 6300 STN MAIN, REGINA SK S4P 4J5
P0 BOX 2121, REGINA SK S4P 4C5
1.00
1,907.18
285.72
2,828,86
4,017.19
3,556.06
15,763.07
131.70
23,799.86
5,141.56
34,202.84
183.75
1,528.25
178.11
680.25
1,330.24
1881 SCARTH STREET, Regina SK S4P 4L1
SUCCURSALE Desjardins, CP 366, Montreal QC H5B lBS
70-1ST AVENUE NORTH, YORKTON SKS3N 1J6
P0 BOX 200997, DALLAS TX 75332-0099 U.S.A.
75 FRESHWAY DRIVE, Concord ON L4K 1R9
1050 STACEY COURT, Mississauga ON L4W 2X8
5875 KENNEDY ROAD, MISSISSAUGA ON L4Z 2G3
P0 BOX 57518, STATION A, Toronto ON M5W 5M5
136 MERIZZI, St. Laurent QC H4T 1S4
UNIT 2, 20010-bOA AVE., Langley BC ViM 3G4
4221 COURTNEY Rd., FRANKSVILLE WI 531 26-9795 U.S.A.
5490 THIMENS BLVD., #110, SUMMITREIT PROPERTY MANAGEMENT,
St. Laurent QC H4R 2K9
5725 MCLAUGHLIN ROAD, Mississauga ON L5R 3K5
BOX 1953 STN D, CITI COMMERCE SOLUTIONS, Scarborough ON M1P
1717 SASKATCHEWAN DRIVE, Regina SK S4P 2E2
2 - 30 CORSTATE AVE, Concord ON L4K 4X2
P.O. BOX 4318, Regina SKS4P3W6
16424- 117 Aye, Edmonton AB T5M 3W2
STATION TERMINAL, BOX 6449, Vancouver BC V6B 6R3
Borden Ladner Gervais LLP, do Ms. Mary Arzourmandis, Scotia Plaza, 40
King St. W., Toronto ON M5H 3Y3
489-2nd AVE N., do NORTHRUP & ASSOCIATES SERV, Saskatoon 5K
S7K2C1
22 VOYAGER CT. SOUTH, Etobicoke ON M9W 5M7
P0 BOX 7785, COLUMBIA SC 29202-7785 U.S.A.
552.52
40.22
22.94
19,873.24
82.00
2,098.95
26.44
28,418.24
365.72
109.31
496.19
5,760.06
SASKATCHEWAN WORKERS
SEAO CONSTRUCTO
SECURTEK MONITORING SOLUTIONS
SEIKO-I INFOTECH
SMITH-WAY
SOKKIA CORP.
SON ITROL
SONOCO CANADA
SOS TECHNOLOGIES ACTION URGENC
SPECIALTY BULB (SB) PRODUCTS INC.
SPECIALTY TAPES (SP)
SREIT (AVISTA NO. 3) LTD.
STAEDTLER MARS
STAPLES
STC
SUNRISE MEDIA PRODUCTS CORP.
SUPREME BASICS
SUPREMEX
SYNNEX CANADA
SYNNEX CANADA LIMITED
T&B JANITORIAL SERVICES
TCT GRAPHIC PRODUCTS (TG)
TEKGRAF
ACC.#641 686
SDS 12-0752
110970 50698 01019
1103 01218 00019
7846942-8; 01793940;
7346753-1
A549881
843.69
38.39
184.60
5,061.00
1,762.24
2,126.23
53,193.94
83,834.90
930.47
73.45
47,276.55
IN THE MATTER OF THE BANKRUPTCY OF
4393309 CANADA INC. (FORMERLY KNOWN AS MONDRIAN HALL INC),
OF THE CITY OF VAUGHAN, IN THE PROVINCE OF ONTARIO
(Preliminaiy list of creditors as at November 19, 2009,
as submitted by the debtor, without admission as to any liabilities or privilege herein shown.)
Unsecured Creditors
Account Number
Address
TELUS COMMUNICATIONS
2070267930:2290227807;
2006690690
2007043
P0 BOX 7575, Vancouver BC V6B 8N9
TELUS MOBILITY (BC)
TENAQUIP EQUIPEMENT
TERASEN GAS
THOMSON'S DELIVERY LTD.
TOP NOTCH BUILDING MAINTENACE
TOWER SECURITY SYSTEMS INC.
TRANS-CITE EXPRESS INC.
TRANSILWRAP OF CANADA LTD.
TRINITECH INC.
TURNMORE SANITATION INC
ULTRAFLEX
UNITED PARCEL SERVICE
UNIVERSITY PRODUCTS, INC.
UPS CANADA LTD.
UPS SUPPLY CHAIN SOLUTIONS
VEND-TEC SERVICES
VISTEK LTD (VK)
WASTE MANAGEMENT
WATER MATTERS INC.
WAYNE SAFETY INC. (WS)
WEBSHERPA.CA
WESTERN DIAZO COATERS LTD.
WESTERN MATERIALS HANDLING
WHITEMUD EQUITIES INC.
WIL-TOM ENTERPRISES
XEROX CANADA INC.
X-RITE
X-RITE, INC
YELLOW PAGES GROUP
YORK DISPOSAL SERVICES
701634; 1241856; 827388
Supplementary Mailing List
John J. Ford
REGISTRAR OF BANKRUPTCY
SUPERINTENDENT OF BANKRUPTCY
* US$ converted to CDN$ at an exchange rate of 1.056
P0 BOX 8950 STN TERMINAL, VANCOUVER BC V6B 3C3
20701 Chemin Ste-Marie, St-Anne-De-Bellevue QC H9X 5X5
P0 BOX 6666 STN TERMINAL, VANCOUVER BC V6B 6M9
1233 QUEBEC AVENUE, Saskatoon SK S7K 1V3
#210-2268 NO.5 ROAD, Richmond BC V6X 2T1
23 PARKWAY PLACE, Winnipeg MB R2G 3T5
7851 RUE JARRY E., # 264, VILLE D'ANJOU QC H1J 2C3
333 FINCHDENE SQUARE, Scarborough ON MiX 1B9
#105 - 1772 Broadway St., Port Coquitlam BC V3C 2M8
4711-13 STREET NE, Bay 105, Calgary AB T2E 6M3
1578 Sussex Turnpike, Bldg 4, RANDOLPH NJ 17869 U.S.A.
CP #11086 SUCC CENTRE-VILLE, Montreal QC H3C 5C6
P.O. BOX 101, HOLYOKE MA 11041 U.S.A.
P0 BOX 2127 CR0, Halifax NS B3J 3B7
BOX 689, Stn ST-LAURENT, ST-LAURENT QC H4L 4V9
753 HENRY AVENUE, Winnipeg MB R3E 1V2
496 QUEEN STREET EAST, Toronto ON M5A 4G8
4668 25th St. SE., Box 138, STATION M, Calgary AB T2P 2H6
301 CENTRAL AVENUE, Saskatoon SK S7N 2E9
1250 SHEPPARD AVE. WEST, Toronto ON M3K 2A6
65 ELGIN STREET, Box 185, Waterdown ON LOR 2H0
Postal Stn M, do CH3008, Box 2509, Calgary AB T2P 0E2
4427D -72 AVENUE SE., CALGARY AB T2C 2G5
10060 Jasper Ave., #1100, Scotia Place, Edmonton AB T5J 3R8
P.O. BOX 125, LANMARK MB ROA OXO
3400 DE MAISONNEUVE #900, Montreal QC H3Z 3G1
P.O. BOX 4406, Station A, Toronto ON M5W 3V5
P.O. BOX 633354, Cincinnati OH 45263-3354 U.S.A.
SUCC.CENTRE VILLE, Box 11788, Montreal QC H3C 002
650 CREDITSTONE ROAD, Concord ON L4K 508
330 UNIVERSITY AVE., 7TH FL., TORONTO ON M5G 1 R7
6TH FL., 25ST. CLAIR AVE. E., TORONTO ON M4T 1M2
Amount
(CDN $)*
1,340.88
86.35
170.50
228.31
210.00
328.20
87.63
9,539.55
13,780.64
873.20
111.83
31,403.91
11,130.42
862.91
1,337.96
5,562.73
87.25
1,250.47
201,13
26.00
14.70
945.98
2,476.32
809.04
584.67
370.55
37,539.14
2,234.2 1
10,133.95
3,438.83
935.31
RSM Richter
200 KIng Street West
Bankruptcy and insolvency Act (Act)
P.O. Box 48, Suite 1100
Toronto, ON M5H 3T4
Proof of Claim
(Section 50.1, subsections 65,2(4), 81.2(1), 81.3(8), 81.4(8), 102(2), 124(2), 12811). Facsimile: (416) 932-6200
and paragraphs 51(1)(e) and 66.14(b) of the Act)
(All notices or correspondence regarding this claim must be forwarded to the following address:
Creditor Name:
Telephone:
Address:
Fax:
Email:
Account No.:
.................................................
........ (city and province) and the claim of ..................................................
In the matter of the bankruptcy (or the proposal, orthe receivership) of
.................
(name of creditor or representative of the creditor), of
(name of debtor) of
creditor.
............................................
(city and provvtce), do
hereby certify:
................................................................
(state position or title) of
1,
That I am a creditor of the above-named debtor (or that I am
(name of creditor))
2.
That I have knowledge of all the circumstances connected with the claim referred to below.
3.
That the debtor was, at the date of bsnkwptcy, (or the date of the receivership, orin the case of a proposal, the date of the notice of
intention orof the proposal, if no notice of intention was tiled), namely the ........... day of .............................. and still is, indebted to
the creditor in the sum of $ ............................ as specifi ad in the statement of account (or affidavit) attached and marked Schedule "A",
............................
after deducting any counterclaims to which the debtor is entitled. (The attached statement of account. oraffidavit most specify the vouchers orother
evidence in support of the claim.)
4.
(chch and complete appropriate category,)
U A. UNSECURED CLAIM OF
$_________
(other than as a customer contemplated by Section 262 of the Act)
That in respect of this debt, (do not hold any assets of the debtor as security and
(chech appropriate descn'ptisn.)
U
U
Regarding the amount of $ ______________, I do not claim a right to a priority.
Regarding the amount of $ ______________, I claim a right to a priority under section 136 of the Act.
(Set out on an attached sheet details to support priority claim.)
U
B. CLAIM OF LESSOR FOR DISCLAIMER OF A LEASE
$__________
That I hereby make a claim under subsection 65.2(4) of the Act, particulars of which are as follows:
(Give foIl particulars of the claim, including the calculations upon which the claim is based)
U
C. SECURED CLAIM OF
$___________
That in respect of this debt, I hold assets of the debtor valued at $_____________ as security, particulars of which are as follows:
(Give foil padicutars of the security, including the date on which the security was given and the value at Which 55 assess the security, and attach a copy of the secunty
documents.)
U
D. CLAIM BY FARMER, FISHERMAN OR AQUACULTURIST OF
$_________
That I hereby make a claim under subsection 81.2(1) of the Act for the unpaid amount of $______________ (Attach a copy of sales agreement
and dehvery receipts.)
U
U
E. CLAIM BY WAGE EARNER OF $_________
O
That I hereby make a claim under subsection 81.3(8) of the Act in the amount of $ _______________
O
That I hereby make a claim under subsection 81.4(8) of the Act in the amount of $ _______________
F. CLAIM AGAINST DIRECTOR
$_________
(To be completed when a proposal pro video for the compromise of claims against directors.)
That I hereby make a claim under subsection 50(13) of the Act, particulars of which are set out on the attached sheet(s).
(Give full particulars of the claim, including the calcslatisns upon which the claim is based)
U
G. CLAIM OF A CUSTOMER OF A BANKRUPT SECURITIES FIRM $__________
That I hereby make a claim as a customer for net equity as contemplated by Section 262 øf the Act, particulars of which are set out on
the attached sheet(s).
(Give foil particulars of the claim, including the calcslahnns upon which the claim is based)
Continued on Page 2
RSM Richter
Page 2
Bankruptcy and InsoivencyAct (Act)
Proof of Claim
(Section 50.1 subsections 05.2(4), 81.2(1), 81.3(8), 81.4(8), 1 02(2), 124(2), 128(1),
and paragraphs 51(1)(e) sod 60.14(b) of the Act)
5.
That, to the best of my knowledge, am (orthe above-named creditor is) (oram not or is not> related to the debtor within the meaning of
section 4 of the Act, and have (or has) (or have not or has not) dealt with the debtor in a non-arm's-length manner.
6.
That the following are the payments that I have received from, the credits that I have allowed to, and the transfers at undervalue within
the meaning of subsection 2(1) of the Act that I have been privy to or a party to with the debtor within the three months (or, if the creditor and
the debtor are related within the meanihg sf section 4 of the Act or were not dealing with each other at arm's length, within the 12 months) immediately before the
date of the initial bankruptcy event within the meaning of subsection 2(1) of the Act: (Provide deta Is of paymento, cred,ts and transfers at undervalue.)
(Applicable only in the case of the bankruptcy of an individusl.)
0
I request that a copy of the report filed by the trustee regarding the bankrupt's application for discharge pursuant to subsection 170)1) of the Act be sent to
the above address.
Dated st
.............................................................................
this
............. day of .................................
Witness
Creditor
NOTE: If an affidavit is attached, it must have been made before a person qualified to take affidavits.
WARNINGS:
A trustee may, pursuant to subsection 128(3) of the Act, redeem a security on payment to the secured creditor of the debt or the value of
the security as assessed, in a proof of security, by the secured creditor.
Subsection 20l (1) of the Act provides severe penalties for making any false claim, proof, declaration or statement of account.
DIRECTIONS FOR COMPLETION OF THIS FORM ARE ON THE REVERSE SIDE
GENERAL PROXY
(Paragraphs 51(1)(e) and 66,15(3)(b) and subsection 102(2))
In the matter of the bankruptcy) (orpropo.nal) of
..........................................................................................
a bankrupt (or en insolvent)
I (or We) .......................................................... (name of creditoi), of .................................................... (name of city, town or village), a creditor in the
above matter hereby appoint ...................................................... of .............................................. to be my (or Our) general proxy in the
above matter except as to the receipt of dividends, with (or without) power to appoint another general proxy in his or her place.
DATED AT
.....................................................
this
.........
day of ..........................................
Witness
Individual Creditor
OR
Name of Corporate Creditor
Witness
Name and Title of Signing Officer
,ODMhlPc000sloMToRllstsrylt
CHECKLIST FOR PROOFS OF CLAIM
This checklist is provided to assist you in preparing the accompanying proof of claim form and, where required, proxy form in
a complete and accurate manner. Please specifically check each requirement.
Under Section 109 of the Bankruptcy and Insolvency Act only those creditors who have filed their claims in the proper form
with the trustee, before the time appointed for the meeting, are entitled to vote at the meeting.
Section 124 states that every creditor shall prove his claim and the creditor who does not prove his claim is not entitled to
share in any distribution that may be made.
General
• The signature of a witness is required;
• The claim must be signed personally by the individual completing this declaration;
• Give the complete address where all notices or correspondence is to be forwarded;
• The amount of the statement of account must correspond to the amount indicated on the proof of claim.
Paragraph I
+ Creditor must state full and complete legal name of company or firm;
• If the individual completing the proof of claim is not the creditor himself, he/she must state his/her position or title.
Paragraph 3
• The statement of account must be complete;
A detailed statement of account must be attached to the proof of claim and jfl
show the date, the number and the
amount of all the invoices or charges, together with the date, the number and the amount of all credits or payments.
statement of account is not complete if it begins with an amount brought forward.
Paragraph 4
• Subparagraph 4.A must be completed by an unsecured creditor and must indicate if priority is claimed pursuant to
Section 136.
• Subparagraph 4.8 must be completed by a landlord only in a Proposal, for any claim related to disclaimer of lease. The
amount of the claim is to be calculated according to the terms of the proposal. Provide details of calculation.
• Subparagraph 4.C must be completed by a secured creditor. A certified true copy of the security instrument as
registered must be provided.
• Subparagraph 4.0 must be completed a farmer, fisherman or aquaculturist creditor. A copy of the sales agreement and
delivery documents must be provided.
• Subparagraph 4.E applies if you are a wage earner (ie, a clerk, servant, travelling salesperson, labourer or worker
who is owed wages, salaries, commissions or compensation by a bankrupt (subsection 81.3) or by a "person" that is
subject to a receivership (subsection 81.4) for services rendered during the six months immediately before the date of
bankruptcy or receivership).
• Subparagraph 4.F is to be completed only in a Proposal, and only if the proposal provides for the compromise of claims
against Directors. Provide full details including calculations.
• Subparagraph 4.G applies if you are a "customer" of a bankrupt securities firm (as contemplated by Section 262 of the
Bankruptcy and Insolvency Act).
Paragraph 5
• All claimants must indicate if he or she is related or not to the debtor, as defined in Section 4 of the Bankruptcy and
Insolvency Act, by striking out "AM" or "IS" or 'AM NOT" or "IS NOT".
Paragraph 6
• All claimants must attach a detailed list of all payments or credits received or granted, as follows:
a) Within the three (3) months preceding the bankruptcy or the proposal, in the case where the claimant and the
debtor are not related;
b) Within the twelve (12) months preceding the bankruptcy or proposal, in the case where the claimant and the
debtor are related.
- APPOINTING PROXY Note:
The Bankruptcy and Insolvency Act permits a proof of claim to be made by a duly authorized agent of a creditor but
this does not give such a person power to vote at the first meeting of creditors or to act as the proxy of the creditor.
General
• A creditor may vote either in person or by proxy;
•
A debtor may not be appointed as proxy to vote at any meeting of his creditors;
•
The Trustee may be appointed as a proxy for any creditor;
•
In order for a duly authorized person to have a right to vote he must himself be a creditor or be the holder of a properly
executed proxy. The name of the creditor must appear in the proxy.