Form ID

Publication date

Location of premises

Certificate

Contract #. 2004-5266 Highway rehabilitation

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, 207 Main St. West, Huntsville, O
Name of Contractor
Fowler Construction
Address of Contractor
1206 Rosewarn Dr., PO Box 630, Bracebridge, ON P1L 1T9

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

Director, Legal Services Branch, 1st Floor, West Tower, 1201 Downsview, Ont. M3M 1J8