Form ID

Publication date

Location of premises

Certificate

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
659 Exeter Road, London, Ont. N6E 1L3.
Name of Contractor
Coco Paving (1990) Inc.
Address of Contractor
6725 South Service Road, R.R. #2, Windsor, Ont. N8N 2M1.

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

Director, Legal Services Branch, 1st Floor, West Tower, 1201 Wilson Ave., Downsview, Ont. M3M 1J8.