Form ID

Publication date

Location of premises

Certificate

Watermain Replacement

Date substantially performed:
Date certificate signed:

Participants

Name of Owner
City of Toronto, Technical Services Division
Address of Owner
399 The West Mall, Etobicoke, ON M9C 2Y2
Name of Contractor
Rabcon Contractors Ltd.
Address of Contractor
63 Smithy Street Markham ON L3P 6M7
Name of Certifier
Tom Ellerbusch, P. Eng., Manager, District Engineering, Etobicoke York District
Address of Certifier
as owner

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

City Clerk Metro Hall, 55 John Street, Toronto, Ontario M5V 3C6