Form ID

Publication date

Location of premises

Certificate

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 Ontario.
Address of Owner
Postal Bag 4000, 355 Counter Street, Kingston, ON K7L 5A3.
Name of Contractor
Miller Paving Limited.
Address of Contractor
P.O. Box 4080, Markham Industrial Park, Markham, ON L3R 9R8.
Name of Certifier
MTO.
Address of Certifier
Postal Bag 4000, 355 Counter Street, Kingston, ON K7L 5A3.

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.