Form ID

Publication date

Location of premises

Certificate

New Tile Bed

Date substantially performed:
Date certificate signed:

Participants

Name of Owner
Ministry of Natural Resources
Address of Owner
Mara Provincial Park, Ramara Twp.
Name of Contractor
Orillia Sewer & Water Ltd.
Address of Contractor
P.O. Box 2268, Orillia, ON L3V 6S1.
Name of Certifier
Ron Robinson
Address of Certifier
Bass Lake Prov. Park

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

Ministry of Natural Resources, 300 Water Street, 3rd Floor, North Tower, Peterborough, K9J 8M5.