Form ID

Publication date

Location of premises

Certificate

Road and Sidewalk Reconstruction

Date substantially performed:
Date certificate signed:

Participants

Name of Owner
City of Toronto Works & Emergency Services, Technical Services
Address of Owner
399 The West Mall, Etobicoke ON M9C 2Y2
Name of Contractor
Pave-Tar Construction Ltd.
Address of Contractor
366 Watline Ave., Mississauga, ON L4Z 1X2
Name of Certifier
Tom Ellerbusch P.Eng., Manager, Distict Engineering, West District
Address of Certifier
as owner

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

City Clerk, Metro Hall, 55 John Street, Toronto, ON M5V 3C6