Form ID

Publication date

Location of premises


Contract No. 50-99-42 Pulverize, Crush & Place Granular “A” and Crush & Stockpile Class II - Hwy. 569.

Date substantially performed:
Date certificate signed:


Name of Owner
Her Majesty the Queen in Right of Ontario as Represented by the Minister of Transportation, Ontario
Address of Owner
P.O. Box 1390, New Liskeard, ON P0J 1P0.
Name of Contractor
Bernt Gilbertson Ent. Ltd.
Address of Contractor
R.R. #1, Richards Landing, ON P0R 1J0.
Name of Certifier
S. McLellan.
Address of Certifier
P.O. Box 1390, New Liskeard, ON P0J 1P0.

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

Director, Legal Services Office, Main Floor, East Building, 1201 Wilson Avenue, Downsview, ON M3M 1J8.