Form ID

Publication date

Location of premises

Certificate

Contract No. O99-09 for the in-place processing of asphaltic surface and for the supplying and placing of emulsified asphalt and class 2 aggregates and for the supplying and placing of slurry seal at various locations.

Date substantially performed:
Date certificate signed:

Participants

Name of Owner
Corporation of the City of Oshawa.
Address of Owner
50 Centre Street South, Oshawa, ON L1H 3Z7.
Name of Contractor
Miller Paving Limited.
Address of Contractor
8050 Woodbine Avenue, Markham, ON L3R 2N8.
Name of Certifier
M.J. Sims, P.Eng.
Address of Certifier
As above.

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

Owner at above address.