Form ID

Publication date

Location of premises

Certificate

to provide all labour, materials, tools, equipment and supervision required to complete Interior Alterations to above building by Bromac Construction and Engineering Ltd. (Their Project No. 1181) This work and material is only for the contracted work between Bromac Construction and Engineering Ltd. and The Regional Municipality of Niagara and excludes the following rooms: 1. Ammunition and Gun Storage Room 2. Drug Control Storage Room and 3. Drug Vault. (refer to letter from Mahendra Shah to Nelson Wong dated Feb. 19th 2004)

Date substantially performed:
Date certificate signed:

Participants

Name of Owner
Regional Municipality of Niagara
Address of Owner
2201 St. David’s Road, PO Box 1042, Thorold, ON L2V 4T7
Name of Contractor
Bromac Construction and Engineering Ltd.
Address of Contractor
P.O. Box 62, 796 Highway 20 West, Fenwick, ON L0S 1C0
Name of Certifier
Public Works Department Operational Support Services
Address of Certifier
2201 St. David’s Road, PO Box 1042, Thorold, ON L2V 4T7

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

Public Works Department Operational Support Services, 2201 St. Davids Road, PO Box 1042, Thorold, ON L2V 4T7 Attention