Form ID

Publication date

Location of premises

Certificate

Contract No.: 99-504, Rout and Seal Cracks.

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 and Communications.
Address of Owner
159 Cedar Street, 5th Floor, Suite 503, Sudbury, ON P3E 6A5.
Name of Contractor
788893 Ontario Limited o/a Niagara Crack Sealing.
Address of Contractor
6441 Kister Road, Box #55A, Niagara Falls, ON L2E 6X8.
Name of Certifier
R.C. David, Special Projects Supervisor.
Address of Certifier
159 Cedar Street, 5th Floor, Suite 503, Sudbury, ON P3E 6A5.

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.