Form ID

Publication date

Location of premises

Certificate

Contract # 2004-3028 Hwy 3, Grading, Drainage, Granular Base, Hot Mix Paving and Traffic Signals at Norfolk County Road 41 Intersection.

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
Operational Services - London, Ministry of Transportation, 6
Name of Contractor
Robert Simon Construction Ltd.
Address of Contractor
P.O. Box 973, R.R. #1, Waterford, ON N0E 1Y0

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

Director, Legal Services Branch, 1st Floor, West Tower, 1201 Wilson Avenue, Downsview, ON M3M 1J8