Form ID

Publication date

Location of premises

Certificate

Construct new shower/washroom building.

Date substantially performed:
Date certificate signed:

Participants

Name of Owner
Ministry of Natural Resources.
Address of Owner
Hwy 101E, P.O. Box 3020, South Porcupine, Ont. P0N 1H0.
Name of Contractor
939604 Ontario Inc. o/a Quality Contracting
Address of Contractor
2616 Falconbridge Road, Unit 1, Garson ON P3L 1K6
Name of Certifier
Anne Marie Larivee (for MNR).
Address of Certifier
Ontario Gov’t Complex MNR Timmins District, Hwy 101 Eas

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

Director, Legal Services Branch, Room 3420 Whitney Block, 99 Wellesley St. W., Toronto, Ont. M7A 1W3.