Form ID

Publication date

Location of premises

Certificate

Contract No.: 40-00-017 Selective Resurfacing - Hwy 417 West of Dunvegan Rd.

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 and Communications
Address of Owner
PO Box 9530 Terminal, Ottawa, ON K1G 0E4
Name of Contractor
Dibblee Construction
Address of Contractor
16773 Cornwall Center Road, PO Box 248, Cornwall, ON K6H 5R8
Name of Certifier
R. Trembly, MTO
Address of Certifier
P.O. Box 9530 Terminal, Ottawa, ON K1G 0E4

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