Form ID

Publication date

Location of premises

Certificate

Culvert replacment on Highways 124 & 121.

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
207 Main St., Huntsville, Ont. P1H 1Z9.
Name of Contractor
R.M. Belanger Limited
Address of Contractor
PO Box 160, Radisson Ave., Chelmsford, ON P0M 1L0

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

Director, Legal Services Branch, 1st Floor, West Tower, 1201 Wilson Ave., Downsview, Ont. M3M 1J8.