| 20 |
| THIS IS TO CERTIFY THAT |
| of is licensed in accordance |
| with the Public Health Regulations, and is given permission to operate a |
| valid until December 31st |
| This Licence is issued with the understanding that the operator adheres to the Public Health Act failing which the Licence may be revoked by the Public Health Board. |
| |
| Chairperson
Public Health Board |
| Note: Licence must be conspicuously displayed on the premises. |