Form ID

Publication date

Location of premises

Certificate

Bluewater Youth Centre, Asphalt Paving Repairs

Date substantially performed:
Date certificate signed:

Participants

Name of Owner
Her Majesty the Queen in right of Ontario as represented by the Chair of the Management Board of Cabinet
Address of Owner
Project Manager, Tempest Management Corp., 304 The East Mall
Name of Contractor
Lavis Contracting Co. Ltd.
Address of Contractor
R.R. #2, Clinton, ON N0M 1L0.
Name of Certifier
Howard Crummer, Project Manager
Address of Certifier
900 Highbury Avenue, London, ON N5Y 1A4

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

The Chief Executive Officer, Ontario Realty Corporation, 11th Floor, Ferguson Block, Queens Park, Toronto, ON M7A 1N3