Form ID

Publication date

Location of premises

Certificate

Date substantially performed:
Date certificate signed:

Participants

Name of Owner
City of Ottawa
Address of Owner
City Clerk, City of Ottawa, 110 Laurier Avenue West, Ottawa, ON K1P 1J1
Name of Contractor
Clean Water Works Inc.
Address of Contractor
1800 Bantree St., Ottawa, ON K1B 5L9
Name of Certifier
Carol Hall
Address of Certifier
Same as Owner

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

City Clerk, City of Ottawa, 110 Laurier Avenue West, Ottawa, ON K1P 1J1