Form ID

Publication date

Location of premises

Certificate

Shoulder Restoration - Hwy. 417 Location #2-Area’s A & B.

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 Ontario.
Address of Owner
Postal Box 9530, 530 Tremblay Rd., Ottawa, ON K1G 0E4.
Name of Contractor
Cornwall Gravel Ltd.
Address of Contractor
390 Eleventh Street West, Cornwall, ON K6H 5R9.
Name of Certifier
Sam Cheng, District Engineer.
Address of Certifier
Postal Bag 4000, 355 Counter Street, Kingston, ON K7L 5A3.

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.
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