Form ID

Publication date

Location of premises

Certificate

Contract No: 50-00-17 Grading, Pulverizing, Drainage and Surface Treament Hwy. 518, 10.4 km East of Hwy. 69 Easterly for 4.0 km

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
207 Main Street West, Huntsville, ON P1H 1Z9.
Name of Contractor
Miller Paving Limited.
Address of Contractor
Hwy. 11B North, Box 248, New Liskeard, ON P0J 1P0
Name of Certifier
William H. Woodruff
Address of Certifier
207 Main Street West, Huntsville, ON P1H 1Z9.

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

Director, Legal Services Office, Main Floor, East Building, 1201 Wilson Avenue, Downsview, Ontario M3N 1J8