Form ID

Publication date

Location of premises

Certificate

Contract #5, 2001Sewer and Water Improvements

Date substantially performed:
Date certificate signed:

Participants

Name of Owner
City of Thunder Bay.
Address of Owner
111 Syndicate Avenue
Name of Contractor
Nadin Contracting.
Address of Contractor
1166 Russell St.

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

City of Thunder Bay.