Form ID

Publication date

Location of premises

Certificate

Date substantially performed:
Date certificate signed:

Participants

Name of Owner
City of Greater Sudbury
Address of Owner
Box 5000, Station 'A', Sudbury, ON P3A 5P3
Name of Contractor
1650939 Ontario Ltd. (Dominion Construction)
Address of Contractor
2300 Dominion Drive, Hanmer, ON P3P 0A5
Name of Certifier
R.V. Anderson Associates Limited
Address of Certifier
436 Westmount Avenue, Unit 6, Sudbury, ON P3L 1L5

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

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