Form ID

Publication date

Location of premises

Certificate

Contract No. TR-18-2003 Patrick Cummings Memorial Sports Complex (Phase 1A - Grading)

Date substantially performed:
Date certificate signed:

Participants

Name of Owner
City of Niagara Falls
Address of Owner
4310 Queen Street Box 1023, Niagara Falls, ON L2E 6X5
Name of Contractor
984265 Ontario Ltd.
Address of Contractor
1994 Stevensville Road, Stevensville, ON L0S 1S0
Name of Certifier
Jamie Douglas
Address of Certifier
as owner

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

Owners address for service as above