Form ID

Publication date

Location of premises

Certificate

Contract No. 10, 2004 Hot-In-Place Recycling

Date substantially performed:
Date certificate signed:

Participants

Name of Owner
City of Thunder Bay
Address of Owner
111 Syndicate Ave S., Thunder Bay, ON
Name of Contractor
Lafarge Materials & Construction Inc.
Address of Contractor
845 Old Goulais Bay Road, Sault Ste. Marie, ON P6A 5K8
Name of Certifier
Rick Harms 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