Form ID

Publication date

Location of premises

Certificate

Structure Rehabilitation

Date substantially performed:
Date certificate signed:

Participants

Name of Owner
Her Majesty The Queen in Right of Ontario as represented by the Minister of Transportation
Address of Owner
615 James Street South, Thunder Bay, ON P7E 6P6
Name of Contractor
Belanger Construction (1981) Inc.
Address of Contractor
100 Radisson Avenue, Chelmsford, ON P0M 1L0
Name of Certifier
Shawn Nickerson, Area Contracts Engineer
Address of Certifier
615 James Street South, Thunder Bay, ON P7E 6P6

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

Director, Legal Services Branch 125 Sir William Hearst Avenue, 1st Floor Downsview, Ontario M3M 1J8