Form ID

Publication date

Location of premises

Certificate

Contract 3, 2010 Sewer and Watermain Replacement I

Date substantially performed:
Date certificate signed:

Participants

Name of Owner
City of Thunder Bay
Address of Owner
500 Donald Street East, Thunder Bay, ON P7E 5V3
Name of Contractor
Menei Bros. Construction
Address of Contractor
820 Toms Road, Thunder Bay, ON P7G 1M3
Name of Certifier
Brian Newman, P.Eng. Project Engineer
Address of Certifier
500 Donald Street East

Office to which claim for lien must be given to preserve lien

500 Donald Street East, Attention