Form ID

Publication date

Location of premises

Certificate

Contract No. O 02-12 for the construction of concrete sidewalks, ramps and bus pads Various Locations (within the City of Oshawa)

Date substantially performed:
Date certificate signed:

Participants

Name of Owner
Corporation of the City of Oshawa
Address of Owner
50 Centre Street South, Oshawa, ON L1H 3Z7
Name of Contractor
Trisan Construction
Address of Contractor
P.O. Box 502, Schomberg, ON L0G 1T0.
Name of Certifier
M. J. Sims, P. Eng.
Address of Certifier
As above

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

Owner at above address