Form ID

Publication date

Location of premises

Certificate

Date substantially performed:
Date certificate signed:

Participants

Name of Owner
Her Majesty the Queen in Right of Ontario as Represented by the Minister of Transportation
Address of Owner
Ministry of Transportation, 500 Rockley Rd., PO Box 1390, Ne
Name of Contractor
Miller Paving Ltd.
Address of Contractor
377400 Hwy 65, PO Box 248, New Liskeard, ON P0J 1P0

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

Director, Legal Services Office, Main Floor, East Building, 1201 Wilson Avenue, Downsview, ON M3M 1J8