Form ID

Publication date

Location of premises

Certificate

Contract No O 02-02 for the rehabilitation of road including, granular base course, asphalt pavement, concrete curb & gutter, and sodding

Date substantially performed:
Date certificate signed:

Participants

Name of Owner
Corporation of the City of Oshawa
Address of Owner
50 Centre Street South, Oshawa Ontario L1H 3Z7
Name of Contractor
Miller Paving Limited
Address of Contractor
4615 Thickson Road North, PO Box 520, Brooklin, ON L1M 1B5
Name of Certifier
M.J. sims, P. Eng.
Address of Certifier
As Above

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

Owner at Above Address.