Form ID

Publication date

Location of premises

Certificate

Contract No. 4, 2001 Hot-In-Place Recycling

Date substantially performed:
Date certificate signed:

Participants

Name of Owner
City of Thunder Bay
Address of Owner
Victoriaville Civic Centre, 111 Syndicate Avenue South, Thun
Name of Contractor
Hot-In-Place Recycling Inc.
Address of Contractor
PO Box 272 85 Passmore Avenue, Agincourt, ON M1S 3B6
Name of Certifier
Rick Harms, P.Eng. Project Engineer
Address of Certifier
As owner

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

City of Thunder Bay