Form ID

Publication date

Location of premises

Certificate

Contract 1, 2010 Asphalt Surface Rehabilitation

Date substantially performed:
Date certificate signed:

Participants

Name of Owner
City of Thunder Bay
Address of Owner
500 Donald Street East, Thunder Bay, ON P7E 5V3
Name of Contractor
Bruno's Contracting (Thunder Bay) Ltd.
Address of Contractor
665 Hewitson St., Thunder Bay, ON P7B 5V5
Name of Certifier
Rick Harms, P. Eng., Project Engineer
Address of Certifier
500 Donald Street East

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

500 Donald Street East, Attention