Form ID

Publication date

Location of premises

Certificate

Date substantially performed:
Date certificate signed:

Participants

Name of Owner
Her Majesty the Queen in Right of Ontario as Represented by the Minister of Transportation
Address of Owner
Ministry of Transportation, 615 South James Street, Thunder
Name of Contractor
Miller Paving Ltd.
Address of Contractor
PO Box 4080, Markham, ON L3R 9R8

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

Director, Legal Services Branch, 1st Floor, West Tower, 1201 Wilson Avenue, Downsview, ON M3M 1J8