EX-99.5 6 d321603dex995.htm EXHIBIT 99.5 Exhibit 99.5

EXHIBIT 99.5

 

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VOTING INSTRUCTION FORM STANTEC INC.

SEE VOTING INSTRUCTIONS ON REVERSE INTERNET VOTE: WWW.PROXYVOTE.COM WE NEED TO RECEIVE YOUR VOTING INSTRUCTIONS AT LEAST TELEPHONE VOTE: 1-800-474-7493

ONE BUSINESS DAY BEFORE THE PROXY DEPOSIT DATE.

MEETING TYPE: ANNUAL MEETING

MEETING DATE: THURSDAY, MAY 10, 2012 AT 10:30 A.M. MDT

RECORD DATE: FOR HOLDERS AS OF MARCH 13, 2012

PROXY DEPOSIT DATE: MAY 08, 2012

ACCOUNT NUMBER:

CUSIP: 85472N109 CUID: P22636 E CONTROL NO. :

APPOINTEE(S) ARAM H. KEITH, ROBERT J. GOMES

IF YOU WISH TO ATTEND THE MEETING OR DESIGNATE ANOTHER PERSON TO ATTEND, VOTE AND ACT ON YOUR BEHALF AT THE MEETING, OR ANY ADJOURNMENT THEREOF, OTHER THAN THE PERSON(S) SPECIFIED ABOVE, PRINT YOUR NAME OR THE NAME OF THE PERSON ATTENDING THE MEETING ON THE APPOINTEE LINE BELOW.

1 ELECTION OF DIRECTORS (FILL IN ONLY ONE BOX “ ” PER NOMINEE IN BLUE OR BLACK INK) VOTING RECOMMENDATION: FOR ALL THE NOMINEES PROPOSED AS DIRECTORS

FOR WITHHOLD

01-DOUGLAS K. AMMERMAN

02-ROBERT J. BRADSHAW 03-DAVID L EMERSON, PC

04-DELORES M. ETTER

05-ANTHONY P. FRANCESCHINI 06-ROBERT J. GOMES 07-SUSAN E. HARTMAN

08-ARAM H. KEITH 09-IVOR M. RUSTE

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PLEASE PRINT APPOINTEE NAME

ITEM(S)

VOTING RECOMMENDATIONS

FOR 0010200

FOR 0029440

2 *- THE REAPPOINTMENT OF ERNST & YOUNG, CHARTERED ACCOUNTANTS, AS

STANTEC’S AUDITOR AND AUTHORIZING THE DIRECTORS TO FIX THE AUDITOR’S REMUNERATION.

3 *- RESOLVED, ON AN ADVISORY BASIS AND NOT TO DIMINISH THE ROLE AND

RESPONSIBILITIES OF THE BOARD OF DIRECTORS, THAT THE SHAREHOLDERS ACCEPT THE APPROACH TO EXECUTIVE COMPENSATION DISCLOSED IN THE COMPANY’S INFORMATION CIRCULAR DELIVERED IN ADVANCE OF THE 2012 ANNUAL MEETING OF SHAREHOLDERS.

*NOTE* THIS FORM CONFERS DISCRETIONARY AUTHORITY TO VOTE ON SUCH OTHER BUSINESS AS MAY PROPERLY COME BEFORE THE MEETING OR ANY ADJOURNMENT THEREOF.

*NOTE* THIS VOTING INSTRUCTION FORM SHOULD BE READ IN CONJUNCTION WITH THE ACCOMPANYING INFORMATION CIRCULAR.

VOTE USING YOUR MOBILE DATA DEVICE SUCH AS SMART PHONES AND TABLETS AT WWW.PROXYVOTE.COM

ITEM(S) (FILL IN ONLY ONE BOX “ ” PER ITEM IN BLUE OR BLACK INK) 0000

2 ITEM(S)

FOR WITHHOLD SHARE(S)

2 3 FOR AGAINST

CONTROL NO.:

BroadridgeTM

5970 CHEDWORTH WAY 2 2 P22636 E 1 OF 1

MISSISSAUGA, ON L5R 4G5

STANTEC INC.

10160 - 112TH STREET

EDMONTON, AB T5K 2L6

CANADA

* ISSUER CONFIRMATION COPY - INFO ONLY *

THIS FORM IS PROVIDED FOR INFORMATIONAL PURPOSES ONLY PLEASE DO NOT USE IT FOR VOTING PURPOSES. SIGNATURE(S) DATE (DD/MM/YY) * INVALID IF NOT SIGNED * 06


 

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2 1-0001

VOTING INSTRUCTION FORM STANTEC INC.

FOLD AND DETACH HERE

SEE VOTING INSTRUCTION INTERNET VOTE: WWW.PROXYVOTE.COM NO. 2 ON REVERSE TELEPHONE VOTE: 1-800-454-8683

MEETING TYPE: ANNUAL MEETING

MEETING DATE: THURSDAY, MAY 10, 2012 AT 10:30 A.M. MDT

RECORD DATE: FOR HOLDERS AS OF MARCH 13, 2012

PROXY DEPOSIT DATE: MAY 08, 2012 85472N109

2 1-0001

WE NEED TO RECEIVE YOUR VOTING INSTRUCTIONS AT LEAST ONE BUSINESS DAY BEFORE THE PROXY DEPOSIT DATE.

ITEM(S) VOTING RECOMMENDATIONS

FOR 0010200

FOR 0029440

2 -THE REAPPOINTMENT OF ERNST & YOUNG, CHARTERED ACCOUNTANTS, AS

STANTEC’S AUDITOR AND AUTHORIZING THE DIRECTORS TO FIX THE AUDITOR’S REMUNERATION.

3 -RESOLVED, ON AN ADVISORY BASIS AND NOT TO DIMINISH THE ROLE AND RESPONSIBILITIES OF THE BOARD OF DIRECTORS, THAT THE SHAREHOLDERS ACCEPT THE APPROACH TO EXECUTIVE COMPENSATION DISCLOSED IN THE COMPANY’S INFORMATION CIRCULAR DELIVERED IN ADVANCE OF THE 2012 ANNUAL MEETING OF SHAREHOLDERS.

*NOTE* THIS FORM CONFERS DISCRETIONARY AUTHORITY TO VOTE ON SUCH OTHER BUSINESS AS MAY PROPERLY COME BEFORE THE MEETING OR ANY ADJOURNMENT THEREOF.

*NOTE* THIS VOTING INSTRUCTION FORM SHOULD BE READ IN CONJUNCTION WITH THE ACCOMPANYING INFORMATION CIRCULAR.

FOLD AND DETACH HERE

VOTE USING YOUR MOBILE DATA DEVICE SUCH AS SMART PHONES AND TABLETS AT WWW.PROXYVOTE.COM

STANTEC INC.

ANNUAL MEETING TO BE HELD 05/10/12 AT 10:30 A.M. MDT FOR HOLDERS AS OF 03/13/12 1 ELECTION OF DIRECTORS (FILL IN ONLY ONE BOX “ ” PER NOMINEE IN BLUE OR BLACK INK)

VOTING RECOMMENDATION: FOR ALL THE NOMINEES PROPOSED AS DIRECTORS

FOR WITHHOLD

01-DOUGLAS K.AMMERMAN 02-ROBERT J. BRADSHAW 03-DAVID L. EMERSON, PC 04-DELORES M. ETTER 05-ANTHONY P. FRANCESCHINI 06-ROBERT J. GOMES

07-SUSAN E. HARTMAN 08-ARAM H. KEITH 09-IVOR M. RUSTE

ITEM(S) (FILL IN ONLY ONE BOX “ ” PER ITEM IN BLUE OR BLACK INK) FOR WITHHOLD A/C*** ISSUER COPY ***

2 FOR AGAINST FILL IN THE BOX “ ” TO THE RIGHT IF YOU PLAN TO

ATTEND AND VOTE YOUR SHARES AT THE MEETING 3 BroadridgeTM

51 MERCEDES WAY 2 2 EDGEWOOD NY 11717

STANTEC INC.

10160 - 112TH STREET EDMONTON, AB T5K 2L6 CANADA* ISSUER CONFIRMATION COPY - INFO ONLY *

SIGNATURE(S) DATE

P22635 85472N109