Form ID

Publication date

Location of premises

Certificate

Contract No. TOE-03-09 (W)

Date substantially performed:
Date certificate signed:

Participants

Name of Owner
The City of Hamilton
Address of Owner
P.O. Box 910, Hamilton, ON L8P 4Y5
Name of Contractor
Super Sucker Hydro Vac Service Inc.
Address of Contractor
623 Shaver Rd., Ancaster, ON L9G 3K9
Name of Certifier
Atheling Seunarine, P. Eng.
Address of Certifier
P.O. Box 910, Hamilton, ON L8P 4Y5

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

City Clerks Office, 71 Main St. W., Hamilton, ON L8P 4Y5