Form ID

Publication date

Location of premises

Certificate

Contract No. O 00-09 for the supplying and placing of slurry seal at the following location: Raglan Road East (Simcoe St N to Townline Rd N)

Date substantially performed:
Date certificate signed:

Participants

Name of Owner
Corporation of the City of Oshawa
Address of Owner
50 Centre Street South, Oshawa, ON L1H 3Z7
Name of Contractor
Ashwarren International Inc.
Address of Contractor
2283 Argentia Rd., Unit 16, Mississauga, ON L5N 5Z2
Name of Certifier
M.J. Sims, P.Eng.
Address of Certifier
As above

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

Owner at above address