Form ID

Publication date

Location of premises

Certificate

Hot Mix Patching and Shoulder Restoration at Hwy #15 between Cty #32 and #42.

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 Ontario.
Address of Owner
P.O. Box 9530, 530 Tremblay Rd., Ottawa, ON K1G 0E4.
Name of Contractor
Karson Kartage and Konstruction.
Address of Contractor
3725 Carp Road, PO Box 264, Carp, ON K0A 1L0.
Name of Certifier
Sam Cheng, District Engineer.
Address of Certifier
P.O. Box 9530, 530 Tremblay Rd., Ottawa, ON K1G 0E4.

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

Director, Legal Services Office, Main Floor, East Building, 1201 Wilson Avenue, Downsview, Ontario M3M 1J8.