Form ID

Publication date

Location of premises

Certificate

Culvert Replacement

Date substantially performed:
Date certificate signed:

Participants

Name of Owner
The City of Greater Sudbury
Address of Owner
P.O. Box 5000, Station “A”, Sudbury, ON P3A 5P3
Name of Contractor
Hollaway Equipment Rental Ltd.
Address of Contractor
57 Heino Rd., Unit #1, Garson, ON P3L 1L5
Name of Certifier
Kevin Shaw, P. Eng
Address of Certifier
As Owner

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

The Clerk, The City of Greater Sudbury, P.O. Box 5000, Stn A, Sudbury, ON P3A 5P3