Form ID

Publication date

Location of premises

Certificate

Contract No. 5, 2002 Part A, James St. McKellar St., Park Ave., and Cumming Street.

Date substantially performed:
Date certificate signed:

Participants

Name of Owner
City of Thunder Bay.
Address of Owner
500 Donald Street E., Thunder Bay, Ont.
Name of Contractor
LTL Contracting Ltd.
Address of Contractor
1186 Russell Street, Thunder Bay, ON P7B 5N2
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 Donald St. E.