Form ID

Publication date

Location of premises

Certificate

Rehabilitation

Date substantially performed:
Date certificate signed:

Participants

Name of Owner
City of Mississauga
Address of Owner
3185 Mavis Rd., Mississauga, ON L5C 1T7
Name of Contractor
Bob Hendricksen Construction Ltd.
Address of Contractor
12051 Ashburn Rd., RR #4, Uxbridge, ON L9P 1R4
Name of Certifier
Michael Gibson, P. Eng., Barker Terp Gibson Ltd.
Address of Certifier
37 Elynhill Dr., North York, ON M2R 1C5

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

City of Mississauga