Form ID

Publication date

Location of premises

Certificate

Contract No. T-99-11 for the repaint of the London Road Elevated Tank.

Date substantially performed:
Date certificate signed:

Participants

Name of Owner
Regional Municipality of York.
Address of Owner
17250 Yonge Street, P.O. Box 147, Newmarket, ON L3Y 6Z1.
Name of Contractor
Blastco Corp.
Address of Contractor
P.O. Box 1886, Brantford, ON N3T 5W4.
Name of Certifier
William Patterson, P.Eng., Project Manager.
Address of Certifier
As owner.

Identification of Premises

Part 1, Plan 65R-3130, Regional Municipality of York.

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

The Regional Municipality of York, Clerk's Department, 17250 Yonge Street, Box 147, Newmarket, ON L3Y 6Z1.