Form ID

Publication date

Location of premises

Certificate

Part C: Transit Shelters

Date substantially performed:
Date certificate signed:

Participants

Name of Owner
City of Burlington
Address of Owner
City Hall, 426 Brant Street, P.O. Box 5013, Burlington, ON L7R 3Z6
Name of Contractor
Pine Valley Corporation
Address of Contractor
125 Edilcan Drive, Concord, ON L4K 3S6
Name of Certifier
The MBTW Group
Address of Certifier
255 Wicksteed Ave., Unit 1A, Toronto, ON M4H 1G8

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

City Hall, 426 Brant Street, P.O. Box 5013, Burlington, ON., L7R 3Z6