Form ID

Publication date

Location of premises

Certificate

Contract TE 02-99, Reconstruction of Roosevelt Drive HL 3 Top Asphalt

Date substantially performed:
Date certificate signed:

Participants

Name of Owner
Town of Richmond Hill.
Address of Owner
P.O. Box 300, 225 East Beaver Creek Road, Richmond Hill, ON
Name of Contractor
Kapp Contracting Inc.
Address of Contractor
71 Buttermill Avenue, Concord, Ont. L4K 3X2.
Name of Certifier
Darryl Clark, Manager of Construction.
Address of Certifier
P.O. Box 300, 225 East Beaver Creek Road, Richmond Hill, ON

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

P.O. Box 300, 225 East Beaver Creek Road, Richmond Hill, ON L4C 4Y5