Form ID

Publication date

Location of premises

Certificate

Contract No. 17 111 16152 Rena Road Culvert Replacement

Date substantially performed:
Date certificate signed:

Participants

Name of Owner
City of Mississauga
Address of Owner
201 City Centre Drive, Suite 800, Mississauga, ON L5B 2T4
Name of Contractor
KAPP Contracting Inc.
Address of Contractor
161 Trade Valley Drive, Vaughan, ON L4H 3N6
Name of Certifier
Teddy Natanegara P.Eng.,
Address of Certifier
201 City Centre Drive, Suite 800, Mississauga, ON L5B 2T4

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

City of Mississauga - Clerk's Department, 300 City Centre Drive, Mississauga, ON L5B 3C1