Form ID

Publication date

Location of premises

Certificate

Project # R99-22 Regional Road #4, Surface Treatment.

Date substantially performed:
Date certificate signed:

Participants

Name of Owner
The Regional Municipality of Sudbury.
Address of Owner
P.O. Box 3700 Station A, Sudbury, ON P3S 5W5.
Name of Contractor
Interpaving Ltd.
Address of Contractor
76 Loach's Rd., Sudbury, Ont. P3E 2P7.
Name of Certifier
Ken Falcioni.
Address of Certifier
P.O. Box 3700 Station A, Sudbury, ON P3S 5W5.

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

The Clerk, The Regional Municipality of Sudbury, P.O. Box 3700 Sta A, Sudbury, ON P3S 5W5.