Form ID

Publication date

Location of premises

Certificate

Asphalt/Concrete Reinstatement

Date substantially performed:
Date certificate signed:

Participants

Name of Owner
The City of Greater Sudbury
Address of Owner
P.O. Box 5000, Station A, Sudbury, Ont. P3A 5P3
Name of Contractor
Lafarge Materials & Consruction Inc.
Address of Contractor
5625 Notre Dame Ave., Hanmer, Ont. P3P 1T2
Name of Certifier
Kevin Shaw, P.Eng.
Address of Certifier
P.O. Box 5000, Station A, Sudbury, Ont. P3A 5P3

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

The Clerk, The City of Greater Sudbury, P.O. Box 5000, Station A, Sudbury, ON P3A 5P3