Form ID

Publication date

Location of premises

Certificate

Double Surface Treatment

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 Ontario
Address of Owner
Postal Bag 4000,
Name of Contractor
Smiths Construction Company Limited
Address of Contractor
PO Box 218, Arnprior, ON K7S 3H4
Name of Certifier
Robert Robinson
Address of Certifier
Postal Bag 4000, 355 Counter Street, Kingston, ON K7L 5A3

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