Form ID

Publication date

Location of premises

Certificate

Single and Double Surface Treatment

Date substantially performed:
Date certificate signed:

Participants

Name of Owner
Ministry of Transportation Ontario
Address of Owner
Ministry of Transportation Box 1390, New Liskeard, ON P0J 1P
Name of Contractor
Bruell Contracting Ltd.
Address of Contractor
131 Bain Drive, North Bay ON P1C 1M4
Name of Certifier
Robert Hutchinson
Address of Certifier
Ministry of Transportation Bag 5000, 74 2nd Street, Cochrane

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

Ministry of Transportation Box 1390, New Liskeard, ON P0J 1P0