Form ID

Publication date

Location of premises

Certificate

Installation of Municipal Services.

Date substantially performed:
Date certificate signed:

Participants

Name of Owner
City of North Bay.
Address of Owner
200 McIntyre Street East, North Bay, ON P1B 8H8
Name of Contractor
Pedersen Construction Inc.
Address of Contractor
PO Box 2409, New Liskeard, ON P0J 1P0
Name of Certifier
Earth Tech (Canada) Inc.
Address of Certifier
222 McIntyre Street West, Suite 410, North Bay, ON P1B 2Y8.

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

City of North Bay.