Form ID

Publication date

Location of premises

Certificate

Contract #: 2004-4274 Routing and Sealing of Cracks in Hot Mix Asphalt Pavement; Highways 7 & 60

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
Postal Bag 4000, 355 Counter Street, Kingston, ON K7L 5A3
Name of Contractor
Niagara Crack Sealing 788893 Ontario Ltd.
Address of Contractor
40 Stonebridge Drive, Loyalist Industrial Park, Port Colborn
Name of Certifier
Robert Robinson TSS (A)
Address of Certifier
Postal Bag 4000, 355 Counter Street, Kingston, ON K7L 5A3

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