Form ID

Publication date

Location of premises

Certificate

Contract No. 99-210 Grading, Drainage, Granular Base and Hot Mix Paving.

Date substantially performed:
Date certificate signed:

Participants

Name of Owner
Her Majesty the Queen in Right of Ontario as Represented by the Minister of Transportation.
Address of Owner
Ministry of Transportation, 615 South James Street, Thunder
Name of Contractor
Hacquoil Construction Limited.
Address of Contractor
1408 Brown St., Thunder Bay, ON P7E 2M6.
Name of Certifier
Ministry of Transportation
Address of Certifier
615 South James Street, Thunder Bay, ON P7C 4X9.

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

Director, Legal Services Office, Main Floor, East Building, 1201 Wilson Avenue, Downsview, Ontario M3M 1J8.