Form ID

Publication date

Location of premises

Certificate

Grading, Drainage, Granular Base Hot Mix Paving & Bridge Replacement.

Date substantially performed:
Date certificate signed:

Participants

Name of Owner
Her Majesty the Queen in right of Ontario as representted by the Minister of Transportation.
Address of Owner
447 McKeown Ave., North Bay, ON
Name of Contractor
Belanger Construction (1981) Inc.
Address of Contractor
Box 160, Radisson Ave., Chelmsford, ON P0M 1L0.
Name of Certifier
Trow Consulting Engineer.
Address of Certifier
1074 Webbwood Drive, Sudbury, ON P3C 3B7.

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

MTO Northern Region Const., 447 McKeown Ave., North Bay, ON P1B 8L2.