Form ID

Publication date

Location of premises

Certificate

Permanent Repairs to Utility Road Cuts

Date substantially performed:
Date certificate signed:

Participants

Name of Owner
City of Mississauga
Address of Owner
3185 Mavis Road, Mississauga, ON L5C 1T7
Name of Contractor
Pave-1 Construction Limited
Address of Contractor
1110 Finch Avenue West, Suite 1246, North York, ON M3J 3M2
Name of Certifier
Sam Inchasi, P. Eng., PMP
Address of Certifier
3185 Mavis Road, Mississauga, ON L5C 1T7

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

City of Mississauga Clerk's Department, 300 City Centre Drive, Mississauga, ON L5B 3C1