Form ID

Publication date

Location of premises

Certificate

Contract #4, 2006 Sewer & Water Replacement

Date substantially performed:
Date certificate signed:

Participants

Name of Owner
City of Thunder Bay
Address of Owner
111 Syndicate Ave. South
Name of Contractor
Nadin Contracting Ltd.
Address of Contractor
1166 Russel St.
Name of Certifier
Brian Newman, P. Eng.
Address of Certifier
111 Syndicate Ave. S., Thunder Bay, ON P7C 5K4

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

City of Thunder Bay, 111 Syndicate Ave. S., Thunder Bay, ON P7C 5K4