Form ID

Publication date

Location of premises

Certificate

Sidewalk Jacking (year 1 of 2 year Contract)

Date substantially performed:
Date certificate signed:

Participants

Name of Owner
City of Mississauga.
Address of Owner
3185 Mavis Road, Mississauga, ON L5C 1T7
Name of Contractor
Pioneer North Concrete Raising
Address of Contractor
7197 Wellington Rd. 30 R.R. #1, Ariss, ON N0B 1B0
Name of Certifier
A.V. Sousa
Address of Certifier
3185 Mavis Road, Mississauga, Ont. L5C 1T7

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

City of Mississauga - Clerks Department, 300 City Centre Drive, Mississauga, Ont. L5B 3C1