Form ID

Publication date

Location of premises

Certificate

Contract #: 2001-5603 Selective Resurfacing

Date substantially performed:
Date certificate signed:

Participants

Name of Owner
Her Majesty the Queen in Right of Ontario
Address of Owner
159 Cedar St., 5th Floor, Suite 503, Sudbury, ON P3E 6A5
Name of Contractor
Warren Bitulithic Ltd.
Address of Contractor
5625 Notre Dame St. N., Box 310, Hanmer, ON P3P 1T2
Name of Certifier
Ministry of Transportation Ontario
Address of Certifier
159 Cedar St., 5th Floor, Suite 503, Sudbury, ON P3E 6A5

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

159 Cedar St., 5th Floor, Suite 503, Sudbury, ON P3E 6A5