Form ID

Publication date

Location of premises

Certificate

for the Removal and Replacement of Aeration Tank Inlet Gates, Contract No. RFT-14806-28536-T01

Date substantially performed:
Date certificate signed:

Participants

Name of Owner
City of Ottawa
Address of Owner
City Clerk, City of Ottawa, 110 Laurier Avenue West, Ottawa,
Name of Contractor
Black & McDonald
Address of Contractor
2460 Don Reid Drive, Ottawa ON K1H 1E1
Name of Certifier
James Hill, P. Eng.
Address of Certifier
Same as owner

Identification of Premises

PIN # 04391-0899

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

City Clerk, City of Ottawa, 110 Laurier Avenue West, Ottawa, ON K1P 1J1