Form ID

Publication date

Location of premises

Certificate

Contract No. ISD10-5006 Asphaltic Overlay on Lyon St. Etc.

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
R W Tomlinson Ltd.
Address of Contractor
5597 Power Rd., RR 6, Gloucester, ON K1G 3N4
Name of Certifier
Steven Forestell
Address of Certifier
Same as Owner

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