Form ID

Publication date

Location of premises

Certificate

Project No. G15050 Underground Fuel Tank Replacement, Project D.A.R.E. South River Project No. G15064 Underground Fuel Tank Replacement, North Bay Courthouse Project No. G15066 Underground Fuel Tank Replacement, OGB, North Bay

Date substantially performed:
Date certificate signed:

Participants

Name of Owner
Ontario Realty Corporation acting as agent on behalf of Her Majesty the Queen in right of Ontario as represented by the
Address of Owner
Vice-President Project Management Branch, Ontario Realty Cor
Name of Contractor
Gap Construction Co. Ltd.
Address of Contractor
1310 Franklin Street, North Bay, ON P1B 2M3
Name of Certifier
B.H. Martin Consultants Ltd.
Address of Certifier
834 Mountjoy Street South, Timmins, ON P4N 7C5

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

President and Chief Executive Officer, Ontario Realty Corporation, 77 Wellesley Street West, 11th Floor, Ferguson Block, Queens Park, Toronto, ON M7A 1N3