Form ID

Publication date

Location of premises

Certificate

Contract #6,2000 Misc. Sewer & Water Const.

Date substantially performed:
Date certificate signed:

Participants

Name of Owner
City of Thunder Bay
Address of Owner
111 Syndicate Ave. S., Thunder Bay, ON P7C 5K4
Name of Contractor
Makkinga Contracting and Equipment Rentals 1204626 Ontario Inc.
Address of Contractor
R.R. #1, Murillo, ON P0T 2G0
Name of Certifier
Rick Harms, P. Eng.
Address of Certifier
City of Thunder Bay, 111 Syndicate Ave. S., Thunder Bay, OB

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

City of Thunder Bay, as above