Form ID

Publication date

Location of premises

Certificate

Contract No. ISB03-6011

Date substantially performed:
Date certificate signed:

Participants

Name of Owner
City Clerk, City of Ottawa
Address of Owner
110 Laurier Ave. West, Ottawa, ON K1P 1J1
Name of Contractor
Dibblee Paving & Materials Limited
Address of Contractor
P.O. Box 11068 (994 Moodie Dr. S.) Nepean, ON K2H 7T5
Name of Certifier
M.J. Richards, P. Eng.
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 Ave. West, Ottawa, ON K1P 1J1