Form ID

Publication date

Location of premises

Certificate

Road Reconstruction

Date substantially performed:
Date certificate signed:

Participants

Name of Owner
City of Waterloo
Address of Owner
Waterloo City Centre, 100 Regina Street S., PO Box 337 STN Waterloo, ON N2J 4A8
Name of Contractor
Terracon Underground Ltd.
Address of Contractor
14 Papple Road, Brantford, ON N3T 5V6
Name of Certifier
GM BluePlan Engineering Limited
Address of Certifier
330 Trillium Drive, Unit D, Kitchener, ON N2E 3J2

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

City of Waterloo, 100 Regina Street S., PO Box 337 STN Waterloo, ON N2J 4A8