Form ID

Publication date

Location of premises

Certificate

Contract No. 50-99-54, Supply, Treat and Stockpile Sand Various Patrols in Cochrane Area.

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
P.O. Bag 5000, 50 3rd Ave., Cochrane, ON P0L 1C0.
Name of Contractor
Bernt Gilbertson Ent. Ltd.
Address of Contractor
R.R. #1, Richards Landing.
Name of Certifier
Clifford W. Wilson.
Address of Certifier
P.O. Bag 5000, 50 3rd Ave., Cochrane, ON P0L 1C0.

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

Director, Legal Services Office, Main Floor, East Building, 1201 Wilson Avenue, Downsview, Ontario M3M 1J8.