Form ID

Publication date

Location of premises

Certificate

Contract No. 99012 Erb Street Watermain, Erb Street Reservoir to Zone 6 Pumping Station.

Date substantially performed:
Date certificate signed:

Participants

Name of Owner
Regional Municipality of Waterloo.
Address of Owner
150 Frederick Street, Kitchener, ON N2G 4J3.
Name of Contractor
Omega Contractors.
Address of Contractor
4104 Breck Ave., London, ON N6L 1B5.
Name of Certifier
Regional Municipality of Waterloo.
Address of Certifier
150 Frederick Street, Kitchener, ON N2G 4J3.

Identification of Premises

1) Pt Lots 40 and 41, GCT, City of Waterloo 2) Pt Lot 32 GCT being Part 1 on 58R-4759, City of Waterloo.

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

Regional Municipality of Waterloo (Address as Above).