Form ID

Publication date

Location of premises

Certificate

Contract #: 2003-4270

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
Address of Owner
Postal Bag 4000, 355 Counter St., Kingston, ON K7L 5A3
Name of Contractor
Crains’ Construction Limited
Address of Contractor
R.R. #1, Maberly, ON K0H 2B0
Name of Certifier
W.R. Robinson, TSS (A)
Address of Certifier
Same as owner

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

Ministry of Transportation