Form ID

Publication date

Location of premises

Certificate

City of Waterloo, Contract # PT04-016: Replacement of storm sewer, watermain, grading, granular base courses, asphalt paving, curb and gutter and related landscape restoration

Date substantially performed:
Date certificate signed:

Participants

Name of Owner
City of Waterloo
Address of Owner
100 Regina Street South, Waterloo, ON N2J 4A8
Name of Contractor
410754 Ontario Limited o/a Sousa Concrete Ltd.
Address of Contractor
1430 Branchton Rd., Branchton, ON N0B 1L0
Name of Certifier
McCormick Rankin Corporation
Address of Certifier
2655 North Sheridan Way, Mississauga, ON L5K 2P8

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

As above