Form ID

Publication date

Location of premises

Certificate

Rout & Seal asphalt cracks in two locations has been completed

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
Head of Engineering Services, 530 Tremblay Rd., Postal Box 9
Name of Contractor
D.S. LaFlamme Construction Inc.
Address of Contractor
17 John Sidney Cr., Stittsville, ON K2S 1J7
Name of Certifier
David Levere, Engineering Services Supervisor.
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.