Form ID

Publication date

Location of premises

Certificate

Concrete Repair and Overhead Gantry System

Date substantially performed:
Date certificate signed:

Participants

Name of Owner
Ministry of Natural Resources
Address of Owner
R.R. #2, Bracebridge, ON P1L 1W9
Name of Contractor
MTM Restoration & Construction Group
Address of Contractor
440 Harrop Drive, Milton, ON L9T 3H2.
Name of Certifier
Nick Parocchy
Address of Certifier
1350 High Falls Rd., R.R. #2, Bracebridge, ON P1L 1W9

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

Ministry of Natural Resources