Pelican Catch Mode 110 - Page 8

Sold in the State / Province of
The undersigned manufacturer hereby certies that the new kayak described
below, the property of said manufacturer, has been transferred on this
day of ,
on invoice number
to
MANUFACTURER’S DECLARATION OF ORIGIN
The manufacturer further certies that this was the rst transfer of said new kayak in ordinary trade and commerce,
and that all information given herein is true and accurate to the best of its knowledge.
NAME OF MANUFACTURER
Pelican International Inc.
1000 Place Paul-Kane
Laval QC H7C 2T2 Canada
KAYAK DESCRIPTION
SERIAL NUMBER (ZEP):
MODEL YEAR:
MODEL NAME:
LENGTH:
DEALER NAME:
ADDRESS:
CITY:
STATE/PROVINCE:
ZIP/POSTAL CODE:
7
AUTHORIZED BY
Danick Lavoie, President