Form ID

Publication date

Location of premises

Certificate

Contract No. 4, 2002 Carrick St./Harbour Expressway Part B

Date substantially performed:
Date certificate signed:

Participants

Name of Owner
City of Thunder Bay
Address of Owner
500 E. Donald St., Thunder Bay, ON
Name of Contractor
Makkinga Contracting & Equipment Rentals
Address of Contractor
570 Squier Place, Thunder Bay, ON P7B 6M6
Name of Certifier
Rick Harms, Project Engineer
Address of Certifier
Same as owner

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

City of Thunder Bay, 500 E. Donald St., Thunder Bay, ON