Form ID

Publication date

Location of premises

Certificate

Regional Municipality of Waterloo Contract No. 2004-020 Widening of Two to Four Lanes Construction of New South Bound Two Lane Bridge Refurbishment of North Bound Two Lane Bridge Construction of New East & West Side Walks Construction of New West Noise Barrier including Landscaping

Date substantially performed:
Date certificate signed:

Participants

Name of Owner
The Regional Municipality of Waterloo
Address of Owner
Transportation and Environmental Services Dept., Design and
Name of Contractor
Bel-Air
Address of Contractor
RR #4 Cambridge, ON N1R 5S5
Name of Certifier
Giffels Associates Limited
Address of Certifier
30 International Boulevard Toronto, ON M9W 5P3

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

As above